REPUBLIC OF TURKEY MINISTRY OF INTERIOR TURKISH NATIONAL POLICE Anti-Smuggling and Organized Crime Department EMCDDA 2009 ANNUAL REPORT (2008 data) Reitox National Focal Point TURKEY 2009 National Report on Counteracting Addictive Substances and Substance Addiction REITOX ANKARA 2009 REPUBLIC OF TURKEY MINISTRY OF INTERIOR TURKISH NATIONAL POLICE Anti-Smuggling and Organized Crime Department 2009 NATIONAL REPORT TO THE EMCDDA By the Reitox National Focal Point TURKEY New Developments, Trends and Selected Issues Mustafa PINARCI EMCDDA Turkey National Focal Point (TUBİM), President TABLE OF CONTENTS TABLE OF CONTENTS ........................................................................................................... 3 ABBREVIATIONS AND ACRONYMS .................................................................................. 6 SUMMARY ............................................................................................................................... 8 PART A .................................................................................................................................... 13 NEW DEVELOPMENTS AND TRENDS .............................................................................. 13 SECTION 1 .............................................................................................................................. 13 NATIONAL POLICIES AND CONTEXT ............................................................................. 13 1.1. Legal Framework .......................................................................................................... 14 1.1.1. International Agreements and Conventions ........................................................... 14 1.1.2. National Legislation ............................................................................................... 15 1.1.3. New Developments in Legal Frameworks ............................................................. 18 1.1.4. Implementation of Laws......................................................................................... 20 1.2. Strategy, Action Plan, Evaluation and Coordination .................................................... 21 1.2.1. National Strategy and Action Plan ..................................................................... 21 1.2.2. Implementation and Evaluation of the National Strategy and Action Plan ....... 22 1.2.2.1. Implementation ............................................................................................ 22 1.2.2.2. Evaluation ..................................................................................................... 23 1.2.3. Other Developments in Antidrug Policies ............................................................. 23 1.2.3.1. TGNA Research Commission ................................................................... 23 1.2.4. Coordination Arrangements ................................................................................... 23 1.2.5. Institutional Structure ............................................................................................. 26 1.3. Economic Analyses ................................................................................................... 27 SECTION 2 .............................................................................................................................. 28 DRUG USE PREVALENCE ................................................................................................... 28 2.1. Drug Use in the General Population ............................................................................. 28 2.2. Drug Use in the Youth Population ................................................................................ 28 2.3. Drug use among Specific Groups .................................................................................. 28 SECTION 3 .............................................................................................................................. 29 PREVENTION ......................................................................................................................... 29 3.1. Introduction ................................................................................................................... 29 3.2. Scope and Diversity of Addiction Preventive Activities .............................................. 30 3.3. Universal Prevention in Turkey .................................................................................... 31 3.3. Selective Prevention ...................................................................................................... 39 3.4. Conclusion ..................................................................................................................... 45 SECTION 4 .............................................................................................................................. 46 PROBLEM DRUG USE AND TREATMENT DEMAND ..................................................... 46 4.1.Overview ........................................................................................................................ 46 SECTION 5 .............................................................................................................................. 49 SUBSTANCE ADDICTION TREATMENT .......................................................................... 49 5.1. Introduction ................................................................................................................... 49 5.2. Strategy and Policy ........................................................................................................ 49 5.2.1. New Developments and Trends ............................................................................. 49 5.3. Treatment Systems ........................................................................................................ 50 5.3.1. Treatment Approach ............................................................................................... 51 5.3.2. Treatment Quality .................................................................................................. 52 5.3.3. Treatment without Pharmacological Assistance .................................................... 53 5.3.4. Medical Treatment ................................................................................................. 54 5.4. Profile of Clients in Treatment ...................................................................................... 55 SECTION 6 .............................................................................................................................. 65 HEALTH CORRELATES AND CONSEQUENCES ............................................................. 65 6.1. Drug-related Deaths and Mortality of Drug Users ........................................................ 65 6.1.1. Introduction ............................................................................................................ 65 6.1.2. Direct Drug related Deaths ..................................................................................... 66 6.1.3. Indirect Drug Related Deaths ................................................................................. 69 6.1.4. Evaluation ............................................................................................................... 70 6.2. Drug-related Infectious Diseases ................................................................................. 74 6.3. Drug-related Psychiatric Disorders ............................................................................... 76 6.4. Other Drug-related Health Correlates and Consequences ............................................. 76 SECTION 7 .............................................................................................................................. 77 RESPONSES TO HEALTH CORRELATES AND CONSEQUENCES ............................... 77 7.1. Prevention of Drug-Related Deaths .............................................................................. 77 7.2. Prevention and Treatment of Drug-Related Infectious Diseases .................................. 77 7.3. Interventions Related to Psychiatric Co-Morbidity, ..................................................... 78 7.4. Interventions Related to Other Health Correlates and Consequences ........................... 78 7.4.1. Drug-related Poisoning .......................................................................................... 78 SECTION 8 .............................................................................................................................. 81 8.1. Social Exclusion ............................................................................................................ 81 8. 2. Addicts and Reintegration ................................................................................................ 84 8.2.1.Shelter ...................................................................................................................... 85 8.2.2. Education and Training .......................................................................................... 86 8.2.3. Employment ........................................................................................................... 87 8.2.4. Basic Social Assistance .......................................................................................... 88 8.3. Conclusion ..................................................................................................................... 88 SECTION