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The International Scope of the Drug Problem


Hon. David Kilgour, P.C., M.P., Secretary of State (Latin America & Africa)
Background Paper for The International Society for the Reform of Criminal Law
12th International Conference "Drugs, Criminal Justice and Social Policy: New Alternatives for An Old Problem"
St. Michael, Bridgetown, Barbados August 9 - 12, 1998

International Cooperation

After attempting for decades to combat drugs essentially on a nation state basis, governments have finally learned that co-ordinated international efforts are the only way to reduce this commerce. The size of the drug trade defines the challenge; the timing of this conference is thus critical. Entering the new millennium, drug free societies remain an elusive ideal. There are some who ask if certain communities will even survive another decade of drug devastation. Drug wars appear to some police officers and social/health workers to be futile, dangerous and expensive undertakings; others say the problem is that effective measures have yet to be implemented internationally.

In 1991 Canada hosted the XIV World Conference of Therapeutic Communities: "Drugs and Society to the Year 2000". More than 2000 delegates from 52 nations attended the Montreal conference, which resulted from a widely-perceived need for international co-operation and unity in searching for solutions. Peter Vamos, the conference chairman, in his opening remarks expressed an opinion that I believe has reverberated in one form or another throughout the proceedings of this conference:

As long as the wars on drugs are declared by politicians and are fought only by bureaucrats, the police and the professional communities, the results are doomed. But if the whole population of each nation is mobilized by its leadership, by focusing attention on the real issues and giving the problem its due priority, then we collectively can shrug off the terrible yoke of a drug-infested society.

Like Vamos, I believe that effective strategies that work today against drugs lie not only with those on the front lines, but with caring individuals in each and every community across the world.

In my opinion, the success or failure of this conference will be measured by the degree to which we succeed in translating our commitment to fight drugs into vigorous sustained effort, specific actions and innovative prevention programs that can make a real difference in reducing drug related problems.

Drugs and Security in the Caribbean Narco-trafficking and money laundering are, of course, major threats to this region, particularly to the small-island states of the Eastern Caribbean. They include related crimes such as arms trafficking and corruption of officials, and are linked to serious health problems like HIV/AIDS and hepatitis C. The region is now a key transhipment area for drugs smuggled from South America to North America, Europe and elsewhere.

According to the United Nations Drug Control Program (UNDCP) Caribbean office, about 248 tons of cocaine alone flow to the United States through the Caribbean each year. Another 100 tons find their way to Europe. Just over 60 per cent of the cocaine produced in Latin America flows through the Caribbean. The UNDCP summarizes the local consequences of this drug traffic: "Drug-related crime is a growing concern in the Caribbean, be it in impoverished villagers in Haiti looting cocaine cargoes that have washed ashore, or gun battles between traffickers and police."

Canada is already active to a degree in anti-drug activities in these islands. We strongly support the Barbados plan of action and applaud the efforts of Caribbean governments to implement its provisions, in particular, strengthening regional enforcement institutions such as the Regional Security System and Caribbean Customs Law Enforcement Council. Canadians will continue to support the Barbados plan through contributions to the UNDCP, the Inter-American Drug Abuse Control Commission (known by its Spanish-language acronym CICAD), and through the long-standing bilateral assistance programs of National Defence, the Royal Canadian Mounted Police (RCMP), Canada Customs and other agencies.

Canada's Deputy Solicitor General, Jean Fournier, was recently named chair of the Working Group of CICAD on the Multilateral Evaluation Mechanism. The group will evaluate the performance and progress by all nations of the hemisphere against illicit drugs. Furthermore, leaders at the recent Summit of the Americas endorsed Canada's initiative to create a Foreign Ministers' Dialogue Group to look at long-term solutions to our hemispheric drug problem.

Drugs and Security in the Caribbean, Sovereignty under Siege, published last year by Ivelaw Lloyd Griffith, argues compellingly how since the mid 1980s narco-trafficking and its associated crimes pose a major security threat. The author acknowledges that winning the drug fight is easier said than done. Griffith concludes:

...Ending the siege in the Caribbean is something that people and governments both within and outside the region can ill afford not to pursue continuously. The 'war on drugs' will be a long 'war.' And it has to be a 'total war' and a 'collective war.' The words of Caribbean poet Martin Carter, first written in 1954 in Poems of Resistance, capture the exigency of the situation: Like a jig Shakes the loom Like a web is spun the pattern All are involved! All are consumed!

Canadian Experience

It is impossible to measure accurately the full extent of alcohol and drug abuse in Canada. Although we live in a world of statistics, none is completely accurate and all are subject to interpretation. Available drug and alcohol statistics do give a sense of the scope of the problem and highlight emerging trends. What the statistics fail to measure is the personal and social costs of drug abuse. The loss of human potential, the destruction of physical and mental health, the breakdown of marriages and families, the disruption of communities and social order - all directly or indirectly affect us. Drug abuse is a problem of many dimensions with unacceptable human and economic costs.

A comprehensive study by the Canadian Centre on Substance Abuse estimated that substance abuse cost more than $18.45 billion in Canada in 1992. This represents $649 per capita, or about 2.7% of our total GDP. Illicit drug abuse alone had direct economic costs to Canadians of about $48 per capita. These figures do not take into account the enforcement costs and losses created by all crime (thefts, murders, domestic incidents, etc.) indirectly associated with the use of illicit drugs. The largest item - approximately $823 million - was lost productivity due to illness and premature death. A substantial portion of the cost was for law enforcement ($400 million). Direct health case costs due to illicit drug use were estimated at $88 million. These estimates are widely regarded to have been conservative and will have risen considerably since 1992. To put things in perspective, total policing expenditures for Canada for 1992 were estimated at $5.3 billion.

The pattern of drug abuse in Canada mirrors changing patterns elsewhere and is particularly worrying with respect to youth. A recent Ontario Student Drug Use Survey by the Addiction Research Foundation recorded an important change in the environment and context in which drug use occurs. The authors of the study note that more students today hold a more benign view of drug use, especially for marijuana, than did their predecessors.

Other countries report similar trends in the number of youth using marijuana, stimulants and hallucinogens. In Canada, the average age of initiation is falling almost yearly. The social stigma associated with taking certain drugs has diminished and the rates of drug use among young Canadians has unfortunately increased, not only for drugs like marijuana, but for cocaine, heroin and LSD, as well as certain stimulants. In Europe, the United States and Japan, the abuse of synthetic drugs is on the rise, creating very serious concerns. The abuse of injected drugs contributes to the spread of diseases, including HIV/AIDS.

Based on estimates by the UNDCP, annual illicit drug consumption is now likely to involve 3.3 to 4.1 percent of the world's population. Although heroin consumption is still relatively small - eight million people or 0.14 percent of the world population, it is increasing. Cocaine use is more widespread in the total number of consumers - 13 million people or 0.23 percent of the world's population - though fewer countries are affected. Marijuana is the most widely used drug, involving more than 2.5 percent of the world's population or about 40 million people. The amount of amphetamine-type stimulants (ATS) consumed each year is increasing by 16 percent on average. Today an estimated 30 million people consume ATS. There appears to be a common perception, spread through some media and directed specifically to young people, that these substances are "fashionable" and "safe."

A 1995 study by our Addition Research Foundation on University Student Drug Use and Lifestyle Behaviours showed significant increases in the use of certain drugs. The proportion of students using LSD has more than doubled since 1988, from 3.2 percent to 7 percent. Heroin use increased from 0.3 percent in 1988 to 1.1 percent in 1993. The use of anabolic steroids, which were almost unknown at the time of the first survey, increased from 0.6 percent in 1988 to 1.5 percent in 1993. The use of crack cocaine and prescription stimulants was also up.

In some countries, certain drugs, for example MDMA (Ecstasy), are considered 'normal' by some young people. Law enforcement personnel and drug counsellors across the world confirm that young people especially view drugs as entertainment, not a means of escape from deprivation and poverty. Police in the U.K. warn that on the basis of current trends there, by the year 2005 up to 80% of children could be involved with drugs by the age of 10.

Trafficking

In a number of countries, the profits derived from the production, distribution and consumption of illegal drugs have rendered sections of local economies dependant on the trade, thus creating militant constituencies advocating its continuance. In some jurisdictions, administrative and judicial structures have been undermined to the extent of endangering political stability, and even destabilizing governments. The sheer volume of "drug money" affects money and exchange markets. A United Nations survey revealed that the worldwide dollar value of illegal drugs is second only to the amount spent on the arms trade. Drug trafficking constitutes a primary source of revenue for organized crime groups in Canada. The 1997 Annual Report on Organized Crime in Canada by the Criminal Intelligence Service of Canada offers a grim picture of the illicit drug trade in my country.

Most organized crime groups in Canada are involved in drug trafficking at some level. Police in Vancouver, for example, report that street level heroin trafficking has increased over the 1995/1996 period, to amounts of up to 3 or even 4 kilograms from the previous 1 kilogram average. Commercial shipping lines are being used increasingly to import large quantities of heroin. Earlier this year, U.S. police agencies identified Vancouver as the gateway for the Southeast Asian heroin now hitting North Americans. RCMP investigators confirm that Vancouver is the key to seriously disrupting the heroin trade as the city is the narrow part of the funnel before the drugs are dispersed throughout North America. According to one RCMP drug intelligence analyst, "We're perceived as a lot softer mark." Drug importers and traffickers prefer to set up shop in Canada and avoid the severe penalties in the U.S.

A cheaper, more potent form of heroin has also been linked to an increase in overdose deaths in British Columbia: 201 people across B.C. died from overdose in the past six months alone, versus 147 overdose deaths during the corresponding period last year. There are parts of Vancouver where HIV infection are at some of the highest levels in the so-called developed world. In the words of one top official of the United Nations International Drug Control Program, Christian Kornevall, some of the most troubling developments in the narcotic trade result from an over abundance of drugs. The glut of drugs on the world market is leading to more aggressive marketing and product development to provide drugs that are more refined and user-friendly.

One frustrated B.C. chief health officer believes, "It's time to admit that we lost the war on drugs". "Police", he says, "haven't a hope of stemming the supply into what is already a saturated market." The RCMP's provincial drug awareness co-ordinator, Chuck Doucette, admits that police can't easily fight billion dollar drug cartels. He stresses that while enforcement cannot be abandoned "we have to move to prevention programs in schools, businesses and the community. It's our only hope".

Chemicals

The illicit chemical drug trade in Canada is also thriving according to The Criminal Intelligence Service Canada. It includes the clandestine manufacture and importation of chemical drugs and trafficking in precursor and essential chemicals. LSD continues to be available across Canada; PCP is limited mainly to our Western provinces. Some motorcycle gangs continue to be the major organized crime group involved in large scale methamphetamine, PCP and LSD trafficking. It is expected that with the forecast increase in methamphetamine demand in the United States, more U.S. groups will travel to Canada to purchase precursors and even set up illicit laboratories for the manufacture of this drug. A number of organized crime groups in Mexico already specialize in the manufacture and distribution of methamphetamine for the U.S. market. Canadian motorcycle gangs will most likely step up the supply of this drug to U.S.

The smuggling of steroids into Canada remains a serious problem. Various techniques are used to move steroids into the country, although the postal system is the most popular. The importation of steroids into Canada from various points around the world, mostly Europe and former Soviet Bloc countries, does not appear to involve organized crime groups so far. According to U.S. authorities, however, Russian-based organized crime elements are major importers of steroids into the United States.

Police in Montreal make regular seizures of Ecstasy (MDMA); the drug is known to be in demand in large cities across B.C. and is popular among European teenagers. It is believed that this appeal could spread in Canada, particularly now that its manufacture has been documented in B.C. and in Quebec. The Netherlands remains its single most important source in the world; large Ecstasy seizures, even in Asia, can be traced back to Holland.

Money Laundering

"Why does Mob love Canada?" Adrien Humphreys asked in a recent article. The journalist's answer includes: weakened banking regulations, close proximity to the United States, a generous parole system, the presence of large casinos, a diverse ethnic population, stable economy, absence of laws banning organized associations, and lack of reporting rules for money crossing our borders. The largest difficulty in fighting drug traffickers is often the colossal pay-off that awaits them if they are not caught. The U.S. State Department estimates the annual worldwide value of laundered funds at between $300 billion and $500 billion. The Canadian content, according to our RCMP, is now somewhere between $3 and $10 billion.

A number of years ago, The New York Times described Canada as "one of the world's leading havens for concealing illegal narcotics profits." The word has unfortunately spread to organized crime groups that my country provides a hospitable environment for money laundering. Law enforcement agencies worldwide have yet to obtain really effective legislation to combat money laundering.

Currency smuggling allows criminals to move the proceeds of crime into Canada. In the summer of 1996, Canadian police seized approximately $1.5 million in suspected drug money smuggled into the Vancouver area from the United States. Canada is also used as a transit point for proceeds of crime.

Our government has responded with new instruments to combat money laundering, to give police the tools they need to stop money laundering, and to take the profit out of crime. For example, ten new Integrated Proceeds of Crime (IPOC) Units were created in 1996. They combine the resources of federal and local police, Canada Customs, federal Crowns and forensic accountants to investigate and prosecute proceeds of crime cases. The units are now located in most of our major cities. Anti-gang legislation proclaimed last year gave new power for police, prosecutors and the courts to deal with criminal organizations. Comprehensive training programs are now being provided to assist police in enforcing this law.

"Organized crime affects all Canadians: it's a national problem that threatens public safety. I have called this meeting to set a course for a unified, national strategy to fight it. We must act on many fronts simultaneously to win the fight against organized crime," stated our Solicitor General, Andy Scott, at a recent national workshop on organized crime. A four-part action plan focusing on the following was presented:

  • Renewing National Police Services to ensure they meet the needs of law enforcement to fight organized crime in all its forms;
  • Strengthening criminal intelligence so that coordination and information-sharing across police jurisdictions is improved;
  • Targeting both the drugs and the organized criminals who cause the most harm in our communities, and refining strategies to reduce demand as well as supply;
  • Launching an offensive against economic crime to keep pace with technological advances made by criminal organizations, and hit them where it hurts most - in their wallets.


Last May, our Solicitor General released a consultation document on proposed anti-money laundering measures. It contained a number of proposals to improve detection, presentation, and deterrence of money laundering in Canada, including measures for reporting suspicious financial transactions and the cross-border movement of currency. It represents a first step in meeting the current needs of police on this issue. It also addresses Canada's international commitments to the Financial Action Task Force and other international partners.

Demand Reduction

The Economist magazine put one feature of the problem well: "the iron law of the market is that demand breeds supply." Others say that, although significant reduction in consumer demand for drugs cannot be achieved in view of virtually unlimited supply and that supply can never be significantly reduced in the face of increasing demands, both must be addressed at the same time. South American and Asian cartels meet the demands of millions of North American drug users. Yet, as Pino Arlacchi, Executive Director of the UNDCP remarked during last June's U.N. General Assembly Special Session on the World Drug Problem: "Success of demand reduction is crucial if we want to ensure permanent success in the fight against drugs." Barry R. McCaffrey, Director of the office of the U.S. National Drug Control Policy, said himself that reducing drug use will not be won through military interventions; progress for him can best be achieved through carefully targeted demand reduction programs at home and productive alternative development programs in producer countries.

The 1998 National Drug Control Strategy (U.S.) outlines a comprehensive ten-year plan to reduce drug use. It concentrates on shrinking American demand for drugs through treatment and prevention, and attacking the supply of drugs through law enforcement and international co-operation. The above-mentioned U N General Assembly on drugs adopted the Political Declaration on the Guiding Principles of Drug Demand Reduction. The declaration - the first international agreement with the sole objective of examining individual and collective problems that arise from individual drug abuse - indicates the priority strategies required to reduce drug demand worldwide in a major way by the year 2008.

In addition to reducing supply and demand, the Political Declaration calls on member states to take a number of actions. By the year 2003, governments are asked to establish new or enhanced drug reduction strategies and programs; establish or strengthen national legislation and programs to combat the illicit manufacturing, trafficking and abuse of ATS and their precursors; adopt national money-laundering legislation and programs; and strengthen multilateral, regional and bilateral co-operation among judicial and law enforcement authorities to deal with criminal organizations involved in drug-related crimes.

The member states committed themselves by the year 2008 to eliminate or significantly reduce the manufacture, marketing and trafficking of psychotropic substances and the diversion of precursors; also to achieve measurable results in demand reduction and to achieve significant benchmarks in the reduction of illicit cultivation of the coca bush, cannabis plant and the opium poppy.

Canada's Role

My country was instrumental in the decision to hold the Special Session of the UNGA originally proposed by Mexico, and has played a constructive role in working to ensure its success. A recognized leader in demand reduction, Canada provided the first draft and funded the first meetings of the working group that developed the Declaration on the Guiding Principles of Drug Demand Reduction.

Another Canadian contribution to preparation for the United Nations General Assembly Special Session (UNGASS) was the youth and substance abuse event hosted by Canada in Banff, Alberta in April 1998 (Youth Vision Jeunesse). Youth (aged 12 to 25 years) who work in substance abuse prevention programs around the world participated in identifying successful strategies to address drug abuse by youth and developed recommendations, which were presented to the Special Session.

Successfully combatting positive drug imaging in the media is challenging at best. Nearly one out of every three advertising messages on radio or television and in magazines and newspapers promotes drugs and drug use in some form, a pill for this or that or a beer to be sociable. The attitudes these ads foster towards the use of legal drugs can affect the way people think about drugs generally.

Canadian Drug Policy

Canada takes a "balanced approach" to the drug issue, based on the belief that the most effective way to address the problem is to deal with both supply and demand. Our policy sets out to reduce the harmful effects of the problem on individuals, families and communities. Our law enforcement agencies put an emphasis on going after traffickers and confiscating the proceeds of their crimes as an effective way to reduce the resources available to continue their activities.

It is our view that multilateral participation enables us to have the broadest influence on the anti-drug agenda and the biggest impact on the drug problem. The UNDCP and the OAS' CICAD enable primarily producer, transit and consumer nations to dialogue and participate in activities to our mutual benefit.

Canada takes the same balanced approach in its dealings with other countries and with the multilateral institutions of the United Nations and the OAS. The key organizations are the UNDCP and its governing body, the Commission on Narcotic Drugs (CND), and CICAD. Our acknowledgement of a shared responsibility - it is in part demand that drives the production and trafficking of illicit drugs - has enhanced Canada's reputation in international forums and in bilateral co-operation.

Substance Abuse in Alberta

Substance abuse has a pervasive effect on the health and well-being of residents of my own province of Alberta and a substantial economic impact on all levels of society. One third of Albertans report having experienced an addiction problem either personally or through a family member or friend. The costs in Alberta are estimated in excess of $1.6 billion annually; an amount equal to $613 for each person in the province. The use of illicit drugs in Alberta totalled $135 million in 1992. Most of these costs come from productivity losses due to death and disability ($88 million), followed by law enforcement costs for police services, courts, corrections, customs and excise ($30 million).

Growing research evidence suggests that substance abuse treatment is an effective strategy to reduce associated costs. It has been demonstrated that by effective intervention, treatment and prevention programs the social and economic costs of addictions can be reduced, workplace productivity improved, health care utilization decreased, social stability and personal well-being enhanced. Studies suggest that a return on investment is in the range of $2.00 to $7.00 per dollar invested in treatment for drug and alcohol abuse. The Alberta Alcohol and Drug Abuse Commission (AADAC), an agency of the Government of Alberta, demonstrates how modest investments in addiction services make a difference in Albertans' lives. AADAC provides a holistic alternative to higher cost hospital and medical services by delivering services and working closely with other community based agencies at 42 locations throughout the province. The AADAC's 1995-96 Annual Performance Report indicates that in that year 52% to 75% of the Commission treatment clients report improved health following treatment. Similarly clients report improved employment or school involvement. Criminal activity is also reduced following treatment. With a budget of $28.5 million, AADAC proves that addiction treatment is a relatively small up-front cost for a large rate of return over an extended time period.

New Alternatives for an old Problem

The late U.S. President John F. Kennedy quipped "Today's problems are the result of yesterday's solutions." The theme of this conference, "New alternatives for an old problem," suggests new approaches and alternative solutions to drug problems. It is clear that we need to reach beyond current criminal justice strategies, especially incarceration, in reducing drug consumption. We need truly effective education and prevention programs. They will not win the war on drugs, but will at least reduce the resulting harm.

As substance abuse among youth increased and the public alarm about it has grown, so has our understanding of how to speak more effectively to the issue. Currently, across North America, including my own country, various groups are designing strategies aimed at preventing alcohol and other drug use among teenagers.

A 1997 study by the Addiction Research Foundation (ARF) found that because many high school students think it's acceptable to use marijuana socially, they simply don't listen to anti-cannabis messages from adults. The implications of these findings suggest that educators refocus their drug prevention messages. The study was set up to examine why cannabis use has risen over the past few years among teenagers. Surveys across North America confirmed these increases. In Ontario, a 1993 survey found that almost one in four students from Grades 7 to 12 had tried marijuana in the past year, nearly double the number from a 1991 survey.

The ARF researchers found that the teenagers' attitudes towards marijuana were largely based on their own or family members' experiences with the drug. Since students did not see many negative consequences from using occasionally, they tend to disregard messages that contradict their observations. Overall, there has been a shift in the way the drug is perceived compared to a generation ago points out one ARF scientist. Marijuana has lost its symbolic value as a sign of rebellion. Light social use was considered the norm. When adults delivered drug education messages, students questioned not only the content of the message, but also the experience of the source.

Parents who admitted to past use were considered hypocrites when asking their children to abstain. Many students also believed at least some of their teachers currently smoked marijuana, or had done so in the 1960s. Also, anti-drug messages from adults who had not tried drugs were not considered credible since such adults were not seen to be competent authorities on the effects of drug use.

Although students essentially ignored abstinence-related messages, they were receptive to factual, non-judgemental information. As the ARF points out, this suggests that since abstinence messages were often ignored and many teenagers experiment with marijuana, drug education programs should be focused toward students who are at risk of developing more serious drug problems.

Research on effective drug prevention shows that efforts are most effective when they involve communities, families, schools, community organizations and churches jointly. The strategies which appear to work most effectively address the problem by promoting students' values, knowledge and skills, and by creating a positive school climate, encouraging parents and mobilizing communities. A recent book, Preventing Substance Abuse, Interventions that Work, describes specific solutions that have produced desired changes. The authors present "substance abuse" as a constellation of problems that cannot be resolved through a single set of prevention solutions. They discuss successful prevention programs, identifying their origin, implementation and outcomes. General "dos" and "don'ts" of prevention are provided, including knowledge from vigorous evaluations of programs that don't work. We all, of course, need to move to programs that are the most effective

DARE's effectiveness In the United States, DARE (Drug Abuse Resistance Education) is the most widely disseminated school-based prevention program during the last year of elementary education. It is currently being offered to about 5 million students in all 50 states at a total cost of about $50 million and in a number of other countries. A recent article in Preventive Medicine reported the results of a 5-year, longitudinal evaluation of the effectiveness of DARE. The long term effectiveness of DARE unfortunately showed no significant differences between intervention and comparison schools with respect to cigarettes, alcohol or marijuana use during the 7th grade, approximately one year after completion of the program, or over the full 5-year measurement interval. The article concludes that the results of the 5-year study are largely consistent with the conclusions obtained from prior evaluations of the short-term effects of the DARE curriculum on adolescent drug use and drug related attitudes. They have reported limited effects of the program on drug use, greater efficacy with respect to attitudes, social skills and knowledge, but a general tendency for the program effects to decay over time. The authors draw a number of implications for DARE and other school-based prevention programs in general, especially the need for more robust programming targeted specifically at the primary risk factors for adolescent drug use. There is also a need for the inclusion of booster sessions to sustain positive effects of the program.

Another research team examined the evaluations of DARE and concluded that the average reduction in substance use was small. DARE has important strengths, including favourable reactions among students who have participated, widespread political support, and considerable funding. However, these strengths have not guaranteed that the program is always effective or a drug abuse preventive. A scientific advisory group has been established to review the research and evaluations of the DARE program and to consider changes in the curriculum.

Programs That Work

There is a wealth of data that programs already exist in many countries to make a reality of the knowledge of "what works." Programs that were demonstrated to be effective in bringing about the desired effects can be identified and put together to form a good range of programs: "The Anti-Drug Programs that Work World Bank," so to speak, could be accessed by any community looking for new approaches to local circumstances. Any new initiative that proved successful could be added, thereby becoming a catalyst for the development of other successful programs. Consider the following programs and initiatives that if put into practice on a large scale could reduce harm and abusive behaviour.

Life Skills Training Program

The Life Skills Training (LST) universal classroom program addresses a wide range of factors by teaching self-management skills in combination with drug resistance skills and normative education. The LST program teaches children social resistance and refusal skills, but it goes well beyond "Just say no." LST teaches skills to avoid high-risk situations. Along with age-appropriate drug information, students learn how popular culture and the media influence drug use in society. Studies have shown that simple information techniques of the past are not effective in preventing teen drug use, as they offered only a grocery list of the negative effects of drugs.

In the LST program, students learn techniques for coping with stress and anxiety, how to resist advertising appeals and how to formulate counter-arguments when offered drugs. The New York junior high students who received three-year LST programs used 45% less alcohol, tobacco and marijuana than students who received no classroom instruction, according to findings by the American Psychological Association. Young people also developed improved decision-making, communication and general assertiveness skills.

School Environments

A report by the Carnegie Council on Adolescent Development concluded that providing and focusing on knowledge alone in prevention programs is rarely effective and can even be counter-productive. It can even have the paradoxical result in some youths to sample the substance. Information alone was not sufficient to change either attitudes or behaviour. Programs that focus entirely on problem solving, self-esteem, and communication have little positive impact on drug use. These two approaches, according to the Carnegie report, placed too little emphasis on the kind of real-life skills students need to cope with various internal and external pressures to use drugs.

The programs that address a variety of skills, knowledge and values are more effective. For example, the Arkansas "Teens are Concerned" program is an exemplary comprehensive program. It involves training, statewide presentation by the program members, alcohol and drug free alternative activities, and media campaigns with local television, radio and newspapers.

A school climate where drugs are unacceptable and where students feel they are cared for makes a tremendous difference in preventing teen drug use. Research shows students in such schools are less likely than others to use drugs. A school can start with establishing clear policies about alcohol, tobacco and other drugs and developing an anti-drug curriculum and peer leadership training programs. Students' involvement in these efforts and positive extra-curricular activities help create an atmosphere where drugs are the wrong thing to do. "Schools remain our best shot at intervention," commented one director of the Institute for Prevention Research at Cornell University Medical College, referring to establishing prevention programs at schools. "If this program (Life Skills Training) were implemented across the U.S., we could save 100,000 lives a year."

Teen Challenge

This program, which started 40 years ago in New York slums, claims to be the most successful program of its kind in the world with a documented 86% success rate for participants who complete the one year residential training program. Teen Challenge of Barbados was formed two years ago to help those with substance abuse problems to retake control of their lives by embracing Christian values and applying Biblical principles to every area of life. The success of the program underscores the need for similar initiatives guided by the inspiration of religious convictions to allow people devastated by substance abuse to recover their ethical and spiritual compasses.

Culturally Sensitive Programs

First Nations peoples in Canada are increasingly reaching to the wealth of their own traditions to deal with their drug problem. In the words of Art Solomon, an Ojibway Elder: "To heal a nation, we must first heal the individuals, the families and the communities." Waseskun House in Québec is a unique community healing centre which offers services to Aboriginal offenders throughout Eastern Canada. Started by a group of volunteers in 1988, Waseskun House has become one of the most effective resources in North America. The healing camp focuses on helping male offenders (recently female offenders were included) to regain balance in their lives. It is a holistic residential program rooted in an inclusive approach to Native cultural traditions, a here-and-now awareness of current realities and a proactive view of responsible re-integration of individuals into societal harmony. Most of the ex-offenders who participate are dealing with drug and alcohol abuse problems. The men participate in a regular community healing circle, during which they are free to resolve whatever issues they choose, during a time frame they decide upon.

Other activities include traditional ceremonies, meditation, addictions and sexuality information groups, AA meetings, Talking Circles and individual sessions. The words of one of the residents of Waseskun Camp '97, when talking about his experiences there, underline the need for such programs rooted in cultural tradition: "I came to this treatment centre for my alcohol and drug addiction thus having begun my healing journey at the House in downtown Montréal.... The programs I did there were helpful to my healing journey since they were connected to my Native traditional culture. For me, the highlight of my story at Waseskun Camp was when I went into the sweat lodge (my first time). This is one experience that will stay forever in my memory."

Under Toronto's African-Canadian Youth Substance Abuse Program, lessons in African history and philosophy combine with harm reduction principles. The program gives African-Canadian youth a chance to learn and discuss topics such as the ethics of slavery, the historic liaison between Africans and Native Americans and ancient African history. In the opinion of it's counsellors, this improves self-esteem; and, as that improves, many are able to reduce the use of harmful substances and eventually eliminate them altogether.

The Nia Centre in Halifax offers prevention and education programs designed specifically for Black youth. Nia, Swahili for 'purpose', is one of the seven values celebrated as part of Kwanza, an African-American celebration. The Centre, a program of the Halifax Task Force on Drugs, was founded by community members and has been funded by Canada's Drug Strategy. Its goal is to increase awareness of health, social, cultural and educational issues in relation to drug abuse and to address prevention approaches.

Representatives from a variety of Toronto cultural communities came together for the first time to address addiction issues and to lobby for language-specific, culturally-sensitive addiction services. The group, called the Ethnocultural Coalition - Access to Addiction Services, consists of representatives from Somali, Iranian, Spanish, Tamil, Caribbean, Chinese, Serbian and Polish communities. Canada accepts more than 200,000 new immigrants every year. A majority of them settle in Ontario; almost 42% of those who end up in Toronto evidently speak neither English nor French. Immigrants have until now been all-but-invisible to mainstream addiction service providers because of their lack of English or French language skills or other cultural considerations. Certainly, this area of need for cultural-specific addiction services should be the target of specific programs and interventions.

RCMP Role

Earlier this year, the RCMP Drug Awareness Co-ordinator, Bob Kennedy, demonstrated how innovative, direct and culturally sensitive response by government agencies to a drug problem in a community can also make a difference in situations where traditional responses fail. Canada Customs were seizing 50kg a month of the Somali drug Khat at the Ottawa airport. About 200kg a week would arrive at Toronto's Pearson airport. Dealing with this problem consumed a great deal of RCMP time and manpower. The judiciary did not view Khat as serious, sentencing offenders to one day in jail per kilo they imported. Kennedy decided to contact the Somali community to learn more about its culture and meet its leaders. He found out that there was general awareness of the damage Khat was causing in the community but there was little understanding of the legal implications of its use. Further, there was a traditional fear of police ingrained in the community inherited from experiences in Somali.

As a result of Officer Kennedy's intervention, a meeting was set up with Somali leaders, community members and media and the representatives of federal departments of Transportation, Customs and Excise, and RCMP, to explain a broad range of issues associated with importation of the drug. As a result of the meeting, Kennedy was asked to sit on a community advisory committee on Khat; a booklet targeted at the Somali community explaining all laws and regulations associated with drugs was prepared, and the RCMP provides assistance to the community regarding translations and interpretations of the Canadian laws. There have been no significant seizures since at the Ottawa airport. The RCMP in Toronto, where some 200kg of Khat still arrive weekly, are planning a similar strategy.

Racing Against Drugs

Another alternative drug and alcohol abuse program, "Racing Against Drugs" (RAD), was developed by the province of Saskatchewan RCMP Drug Awareness Division in partnership with various organizations. Taking advantage of the fact that auto racing is one of the world's largest spectator sport and a growing family attraction in Saskatchewan and Canada, RAD targets all ages from pre-school to senior citizens. It offers people of all ages the opportunity to experience the world of auto racing while at the same time providing an alternative to drug and alcohol abuse. Community response to the program has reportedly been overwhelming. "RAD" has been showcased at events such as the Draggins Car Show in Saskatoon, the Majestics Car Show in Regina, the Moose Jaw Art Show and other events. Numerous school displays and presentations have also been done.

Problem-Solving Policing in Montréal

An innovative pilot project launched by the Montréal police in 1992 to assist a neighbourhood overrun by drug related crime is a good example of a balance between reducing both supply and demand. In essence, it employs a get-tough approach with people caught selling drugs while offering treatment instead of jail to those found in simple possession. A team of officers trained in "problem-solving policing" was put in place full time to stop the neighbourhood's crime from getting worse and to give residents a greater sense of personal safety. On the street, police offered drug users support and assistance as an alternative to arrest for possession. Agreements were made with detox and treatment centres in the area to allow those needing help to be referred there by police. Evaluations carried out during the year-long pilot project indicated such a high level of success that the program has been renewed and extended to other neighbourhoods.

The Importance of Family

The role of families in the start and maintenance of drug misuse and dependence is now getting more attention from the therapeutic community. While the epidemiological trends in drug abuse are also important, these should not be considered without recognition of the importance of the family as the most primary influence in the development and growth of individuals. A recent study by the Toronto-based Addiction Research Foundation indicates that the quality of family life and parent-child communication plays an important role in preventing substance use among adolescents. It examined the links between aspects of family life and smoking, heavy drinking, marijuana use, other illicit drug use, delinquency and drinking and driving.

Young people who lived with both natural parents had the lowest incidence for all six behaviours, while those living with neither natural parent were at the greatest risk. The data indicated a strong link between students' family lives and delinquency, heavy drinking and the use of marijuana and other illicit drugs. Factors in family life that influenced young people included the amount of time parents spend with their children and parental efforts to keep track of where their children are and what they are doing. Students who regularly talked over problems with their parents had the lowest rate of delinquency, and those who never talked with parents about problems were at greatest risk for heavy drinking, illicit drug use and delinquency.

A number of successful programs involving families demonstrates an important truth: parents can make a vital difference in teenage alcohol and other drug use. Young people who feel support from their families, who communicate well with their parents, and who live with standards and discipline are less likely to become involved in alcohol or other drugs. "Parents can be the greatest change in the world" commented one expert with the U.S. National Federation of Parents for Drug-Free Youth.

Some experts on youth crime say that while children from troubled, or low-income families tend to be more at risk of running into trouble with the law, there is a new category of young offender of middle class background showing up more frequently. Doug McNally, an ex-police chief and a member of Canada's National Crime Prevention Council, comments: "Although there is no statistical evidence, I worry that it's caused by the same problem - parental neglect."

The upheavals the family has experienced in recent decades serve to emphasize the need to strengthen it as an institution and to ensure that it is given adequate support to maintain its vital role as a societal pillar.

Project Family

A variety of anti-drug programs that involve parents have been implemented successfully in both Canada and other countries. The "Families Program" in the U.S. provides prevention programming for 6 to 10-year old children of substance abusers. Their intervention approach involves both generations in learning and practising new behaviours. Training sessions improve parenting skills and reduce substance abuse by parents; children's skills training decreases children's negative behaviours and increases their socially acceptable behaviour through work with a therapist.

This intervention approach has been evaluated in a variety of settings with several cultural groups. The results include reductions in family conflict, improvement in family communication and organization, and less youth behavioural disorders, aggressiveness and substance abuse.

A Seattle program, "Focus on Families", is designed for parents receiving methadone treatment and their children. Its goal is to reduce parents' use of illegal drugs by teaching them skills for relapse prevention and coping. Parents are also taught how to manage their families better; topics include family goal-setting, family communication, family management, creating family expectations about alcohol and other drugs, teaching children skills (problem solving and resisting drug offers) and helping children succeed in school. Booster sessions and care management services are also provided. Early results indicate that parents' drug use is dramatically lower and parenting skills significantly better than in control groups.

Street Kids Street kids are thought to be a group of particularly heavy drug users. They are also a better prey for abuse because of the environment. Some have lost their link with their families and have no friends, but striving to be part of a group is important to most adolescents. There are no reliable estimates of the size of the street youth population for Canada as a whole because of the transitory nature of this community. As many as 150,000 street youths probably move through Canadian cities every year; an estimated two-thirds of them use drugs or alcohol weekly or daily.

The 'squeegee kids', considered a nuisance by some in Canadian cities, are evidently heavy drug users. Just a few weeks ago, a former 'squeegee' young woman shared her experience on a local radio talk show of what life was like on streets where drugs and alcohol abuse are the norm. She says that for every dollar motorists pay to a 'squeegee' person wiping their car window directly supports a drug cartel. She pleaded passionately for more counselling that helped her recover her life, but pointed out that the street kids have to be forced off the streets because they will not go voluntarily. She herself was arrested and took advantage of available programs that helped her reconstruct her behaviour and develop a healthy attitude towards life.

The downtown Toronto 'Ambassador Program', operating as a "retrieval program" for street youth, is an example of young people helping each other. It goes beyond just finding kids who have dropped out of school and lived through drug abuse; it gives them an active role in dissuading others from making the same mistakes. The Ambassador Program, delivered by a coalition of eight youth services agencies under the auspices of Frontier College, has three priorities: to get street youths back onto an educational path; to give them practical experience in the workplace; and to offer them a chance to put a troubled life experience to work for the betterment of others. The payoff for the rest of the community is not only the reality that a number of kids find alternatives to drugs and crime, but that so many other 'high risk' youth are steered away from similar lifestyles.

The youth enrolled in the program are trained to visit senior elementary schools in 'high risk' neighbourhoods and make presentations to Grade 7 and 8 students about life on the street and on drugs, based on their own experiences. Educators have long identified twelve to fourteen-year olds as the best age group to target for risk reduction. The program director says the feedback from the youth enrolled in the Ambassador Program has been 'phenomenal' and that the overwhelming demand from the schools for these types of presentations shows their values and underscores the need for more peer education projects.

Harm Reduction

Harm reduction is still a controversial approach to addressing drug problems, but it has advanced in recent years, especially in Britain and the Netherlands. The first objective of harm reduction is to decrease the negative consequences of drug use, whereas drug policies elsewhere aim at reducing drug consumption. Harm reduction sets up a hierarchy of goals, with the more immediate and realistic ones to be achieved as first steps towards risk-free use or, if possible abstinence.

Diane Riley of the Canadian Centre on Substance Abuse in her recent article, "The Harm Reduction Model: Pragmatic Approaches to Drug Use from the Area between Intolerance and Neglect", outlines the arguments in favour of this model. "Harm reduction," she states, "acknowledges that policy makers, educators and health promoters can tell drug users how and why they should prevent harm and provide them with the means to do it, but only the users themselves can actually prevent the harm. Research has clearly shown that users will change their behaviour in response to information about safer use, and that this change is greater if skills training as well as the means to ensure safety are provided." Dr. Riley identifies the basic principals of harm reduction education: that the drug use is normal; it incurs benefits as well as risks; it cannot be completely eliminated but the harms can be reduced; many young people grow out of drug use; education should be non-judgmental; it requires an open dialogue with the young and respect for people's right to make their own decisions; it emphasizes positive peer support not decisiveness.

The British Advisory Council on the Misuse of Drugs declared that the spread of HIV is greater danger to health than drug misuse. The World Health Organization expressed a similar opinion, stressing that attempts to reduce drug use must not compromise measures against the spread of AIDS. The Canadian government adopted harm reduction as the framework for Canada's National Drug Strategy in 1987. It defined harm as "sickness, death, social misery, crime, violence and economic costs to all levels of government."

The only comprehensive harm reduction programs today are in Merseyside, England, developed in the early 1980s in response to an epidemic spread of drug use, particularly heroin. The Merseyside clinics, pharmacists and police force worked together to establish an unique model of harm reduction, one involving the prescription of drugs, syringe exchange and helping rather than punishing drug users. The service also offers counselling, the provision of drugs including heroin, and employment and housing services.

The police role in Merseyside was to deal with drug traffickers while operating a cautioning policy toward drug users: taking an offender to a police station, confiscating the drug, and formally warning the offender that any further unlawful possession of drugs would result in prosecution. Users are given information about local treatment services, including syringe exchanges. The first time offenders are warned and not given a criminal record. On the second and third occasions, they go to court and are fined upon conviction for possession of small quantities or sentenced for large amounts. If an addict becomes registered by getting in touch with service agencies, they are legally entitled to carry drugs for personal use. The overall effect is to steer users away from crime and possible imprisonment.

At the end of June 1991, Mersey Region had the second lowest rate of HIV positive injection drug use (IDU) of all 14 English regions: eight per million population compared with an English national rate of 34, and a top rate of 136 per million in North-West Thames; the rate for the UK as a whole was 51, with Scotland's 183 HIV positive IDU per million population. The Merseyside programs have also been successful in reducing crime. In 1990 and 1991, the Merseyside police were the only force in the U.K. to register a decrease in crime rates.

As Riley points out, harm reduction does not provide clear-cut answers and quick solutions, but it has potential, if properly applied, to address serious problems while not compromising the quality and integrity of human life. That is why it is essential that we more clearly define harm reduction approaches and carefully evaluate the impacts and effectiveness.

Youth Vision

The Banff "Youth Vision Jeunesse" Drug Abuse Forum of young people from 24 countries, mentioned earlier in this paper, was intended as a showcase for innovative drug prevention ideas was proof that young people want to take an active stand in the world's anti-drug efforts and be a part of the solution and not the problem. Secretary General Kofi Annan commented at the presentation of the "Vision from Banff" - document adopted at the forum on drug abuse: "But if this battle is to be won, our youth must join in it, for it is their future which is in the balance. Helping young people say "no" to drugs is one of our most important goals. All too often in this process, the voice of young people is not heard loud or clear enough. That is why the United Nations is proud to have organized the meetings in Banff and Paris, which you attended. That is why we are pleased to give you the opportunity to make your view even more widely known during this special session."

The youth vision crafted in Alberta echoed through the UN Special Session of the General Assembly on World Drug Problems with clearly identified recommendations to counter the drug problem.

Hopefully all the participants at this conference will make every effort to translate this youth-inspired vision into a reality.

 
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