Speech at the Lithuanian Parliament on May 20th, 2005
Tomas Hallberg
ECAD was launched in 1994 as a reaction to the legalisation movement in Europe.
ECAD, which today consists of some 250 member cities in 30 European countries, was created to counteract legalisation of cannabis and other illegal drugs, distribution of heroin to heroin addicts, injecting rooms for drug abusers and other harm reduction measures. What is common to all our member cities is the conviction that a humane, restrictive drug policy is better than a liberal, laissez-faire variant.
ECADs overall vision is a drug free Europe.
Tell me how much you believe in peoples ability to change or get better, and I will tell you which methods of drug combat you support.
Even if the issue of treatment of drug abuse has many practical, financial and medical aspects, we have to above all look at the ethical and philosophical aspect. We must ask ourselves the crucial question. Can marginalised drug addicts recover and be reintegrated into the society as whole, healthy and honest citizens? Can all drug addicts return to a healthy life?
If not, which ones cannot and who decides which cases are hopeless? Can a drug addict make own choices and take the responsibility for his or hers own recovery? Does a drug addict have a right to continue his drug abuse?
I believe that everybody, given the right support, can leave drug abuse. It can take more or less long time, and be more or less difficult. There are a number of methods of supporting a person who wants to quit drug abuse. The most important thing is that all methods should aim at a life free of drugs.
I dont believe in condemning people as hopeless cases, or be called treatment resistent, like bureaucrats put it.
There are many people who dont share my view. They say, for instance, that it is impossible to become free of opiate addiction. Therefore, we should make the addicts life as tolerable as possible, and see to that they survive as long as possible. The addicts should be given some form of substitute, for example methadone or subutex as long as they wish.
This is called maintenance treatment. The reasoning behind maintenance treatment is that they cannot stop taking drugs in any case.
One of the best arguments for my point of view can be found in Italy, where there is a rehabiliation centre called San Patrignano. They were invited to speak at this conference but unfortunately couldnt come. I promised to help them with a little greeting from their treatment community.
Today it is May 20th in 2005. We are in Vilnius, in the heart of Europe, to discuss drug policies. We are discussing an issue which for many of you may be new. During the last couple of years, new words have appeared in our vocabulary. Words like methadone, subutex and harm reduction. Some countries in Europe give heroin to heroin addicts and set up special rooms for drug addicts where they can inject drugs under supervision. If you think this is something new, you couldnt be more wrong.
The phenomenom existed way back in the nineteen hundreds in China, and was called opium dens.
The discussions nowadays about what drug policy a country should choose are only a mild breeze compared to what similar conflicts in history have led to. Between 1839 and 1842 there was a war between two nations, China and Great Britain, because one of the countries wanted to keep selling drugs to the other.
China had become a victim of an enormous drug epidemic, and seen the damage it caused to its population. They wanted to ban the import of opium, but the Englishmen ignored it. There was way too much money to be made of opium, and so the Brits started a war. They argued that opium was an important merchandise, and moreover a medicine that greatly benefited the health care.
That it brought upon the Chinese a drug epidemic which paralysed large parts of their society didnt trouble the Englishmen.
A couple of years ago Swedish papers started to write about a new medicine against opiate addiction. It was called Subutex and was said to be highly effective against heroin dependence. Prescription of Subutex was not regulated by law, and it took only 5 years for the market to increase to the amount of 2000 daily doses for drug addicts, despite of the fact that the official number of Subutex patients was only 1000 according to the authorities in charge.
If you scratched the new label of the Subutex bottle, the old name, Buprenorphin, appeared.
Buprenorphin had been in the market for more than 40 years. How did an old medicine suddenly become so popular? Only in France it was prescribed to 75 000 opiate addicts.
The explanation is simple: marketing. Ingenious, clever marketing. Marketing is different in different countries. Most important to the owners, the American medical company Schering and Plough, is to make money, and we are talking about huge amounts of money.
Only the tiny Swedish market is worth 20 million euros. You need to understand the market. Obviously it is no high priority to the medical industry that the addicts should become completely cured, and stop taking the medicine. In consequence, they too are involved in the spreading of myths about how getting rid of opiate addiction is impossible.
When countries with relatively recent drug epidemics start looking for maintenance programs like those with methadone and Subutex, we need to turn back the clock once again.
After all, there is nothing much that is new under the sun.
The first maintenance programs in America were set up in 1905 in the Philippines, then an American colony. The Americans prescribed opium to 12 000 opium addicted Chinese in the Philippines. The programs were conducted in special narcotic clinics and went on for two and a half years, after which they were closed down.
The idea of giving drugs to drug addicts reappeared 7 years later in Florida, and spread forth to several American states. In New York there were 7500 drug addicts at the same time in a program which operated on the principle of successively prescribing less and less opium to the addicts. The results were not overly impressive. It was estimated that over 95 % relapsed to buying their drugs at the illegal market.
At the most there were 13 000 drug addicts at the same time in the clinics in the USA in beginning of the 1920ies. The authorities who monitored the experiment saw the results and realized that this was not the solution of treatment of drug addicts. In 1925, the last clinic was closed for many years to come. We must remember that USA had a much larger drug problem in the beginning of the 1900s than in the beginning of the 2000s. The situation was at best in the beginning of the 1950ies after a long period of restrictive drug policy. The idea to introduce maintenance programs for drug addicts didnt reappear until the 1950ies. Now there was a new miracle cure called methadone. Once again it became legal to prescribe drugs to drug addicts. It would seem that an interval of 30-40 years is enough to forget the results of previous policies.
Heroin is an old cough medicine from 1898. It is a trademark from Bayer Company of Germany. Actually it only took a couple of years to realize how dangerous and addictive the medicine was.
After 5 years of free Subutex in Sweden, its prescription has now been regulated in the same way as methadone.
Sweden has a very intresting history regarding drug abuse. We have gone through all phases and have a lot of experience to share with other countries. In the middle of the sixties we discovered that drugs might be prescribed to drug addicts. The reasoning was that by giving drugs to drug addicts, they would not need to engage themselves in criminal activities.
Just after a couple of years Sweden suffered a drug epidemic, and the experiment was stopped. Since then we have successively moved towards a more restrictive drug policy.
In the beginning of 1990 when we were the most successful, only 3-4 % of our 15-16-year olds had tried drugs at some time.
Sweden has a legislation which prohibits all consumption of narcotic drugs. You can even be sentenced to compulsory treatment for your drug abuse.
We also have a long experience of methadone treatment in Sweden. The general outlook on this form of treatment has been very restrictive. There are strict rules for placement in the programs, and the number of places was during a long time limited to 600 persons in Sweden as a whole. Admission to the program would be considered only after a very long period of drug addiction, and after all other forms of treatment had failed, or if you were HIV-infected.
So what are the results of the methadone programs?
A survey followed 261 methadone patients during 9 years.
11 patients recovered and didnt return to the program. 26 % stayed in the program during the whole period.
33 % died.
69% of the drug addicts continued to commit crimes, and were registered for criminal acts during the program.
The group as a whole were treated in hospital care on 5115 occasions during the 9-year period.
Is this satisfactory or not? It is up to anybodys judgment.
The struggles on which drug policies should prevail in the world have thus been going on for more than hundred years. The first major international drug conference was held in Shanghai in China in 1909. Since then, the international meetings have produced records and agreements on how we together should combat drugs. Did you know for instance that the Versailles peace treaty after the 1st World War included paragraphs on drug combat?
The conclusive international agreement is naturally the first UN Convention on Drugs from 1961. The drug legalisation lobby has tried to change it, or to influence the signatory countries to write off their commitment to this convention, without success however. And they are not likely succeed either, simply because the UN conventions on drugs are brilliant. However, the conventions have one weak point. This weak point is continuously exploited by those who want to legalise drugs. Namely, the UN conventions on drugs state that all handling with narcotic drugs is illegal except for medical use. This is what drug liberals were quick to make the most of. This is the reason why there are campaigns for medical marijuana in America.
By calling cannabis a medicine, the UN conventions can be circumvented. If a government gives drugs to drug addicts but uses medical staff for the distribution, the UN conventions can be circumvented. If you distribute syringes under the pretext of decreasing spread of infection, the needle distribution becomes a medical matter, and thus the UN conventions can be circumvented.
The international legalisation lobby is fully aware of how important it is that all these measures they call harm reduction, get a foothold in as many countries as possible.
Their present strategy is not to rewrite the UN conventions, but to undermine them by making them inoperative.
Are restrictive drug policies more effective than liberal policies? The answer to the question is a resolute Yes. If you compare equivalent countries like Norway, Sweden and Denmark, Sweden has the most restrictive drug policy and also least drug problems.
Every little administrative decision regarding the authorities and peoples relation to drugs has impact on the issue as a whole. All these decisions together are what makes a drug policy.
What decisions should we make then?
I think the slogan we have used in Sweden in many years covers it all:
It should be difficult to use drugs and easy to get treatment.
All measures which make it more difficult to use drugs, and make it easier to get treatment, contribute to achieve the overall goal. A drug free society.
Many people, and especially the legalisation lobby, maintain that this is a utopia.
If I had told you some 10-15 years ago, that one of the biggest sport events, the European Championship in horse jumping, would be arranged by a group of former drug addicts, most of them heroin addicts, within the premises of the treatment centre, you would all have called it a utopia. It was a childish thought. Now it is reality. What used to be a utopia has become reality.
How did it become reality? Because of some strong peoples belief that anybody can recover.
A belief, that even having lived as a marginalised heroin addict, it is possible to recover and become a strong resource in the society. But also that this is only possible by leaving drugs and living a drug free life.
For the sake of each individual, and for the sake of the whole society, a drug free life is both the way and the goal.
Thank you for your attention.
