6984-Couv.Prisons, drogues 13/07/09 17:01 Page 1 Drugs and addiction This publication has been produced within the framework of the Publishing Council of Europe Conference on Prisons, Drugs and Society held in Bern from 20 to 06.984 22 September 2001. The conference was organised jointly by the Pompidou Group and the World Health Organisation Regional Office for Europe (Health in Prisons Project), with the participa- tion and on the invitation of the Swiss authorities. The first part of the publication contains information about the conference itself including some of the reports presented. The second part contains a consensus statement adopted at this occa- sion. The aim of this consensus statement is to encourage, where appropriate, effective change in policies and practices relating to prisons and drugs. It draws together in a European context the fundamental areas on which a general agreement has been reached. PRISONS, D RUGS AND SOCIETY COUNCIL CONSEIL OF EUROPE DE L'EUROPE The Council of Europe has forty-four member states, covering virtually the entire continent of Europe. It seeks to develop common democratic and legal principles based on the European Convention on Human Rights and other reference texts on the protection of individuals. Ever since it was founded in 1949, in the aftermath of the second world war, the Council of P Europe has symbolised reconciliation. RISONS , D ISBN 92-871-5090-7 RUGS AND S 9 789287 150905 OCIETY Council of Europe Publishers http://book.coe.int EditionsCouncil du Conseil of Europe de l’Europe Publishing Council of Europe Publishing Editions du Conseil de l’Europe PRISONS, DRUGS AND SOCIETY p r o c e e d i n g s Conference co-organised by the Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drugs (Pompidou Group) and the World Health Organisation, Health in Prisons Project (HIPP) Bern (Switzerland) 20-22 September 2001 Drugs and addiction Council of Europe Publishing French edition: Prisons, drogues et société ISBN 92-871-5089-3 The opinions expressed in this work are the responsibility of the authors and do not necessarily reflect the official policy of the Council of Europe. All rights reserved. No part of this publication may be translated, reproduced or transmitted, in any form or by any means, electronic (CD-Rom, Internet, etc.) or mechanical, including photocopying, recording or any information storage or retrieval system, without prior permission in writing from the Publishing Division, Communication and Research Directorate (F-67075 Strasbourg or [email protected]). Council of Europe Publishing F-67075 Strasbourg Cedex ISBN 92-871-5090-7 ©Council of Europe, December 2002 Printed at the Council of Europe Contents The Pompidou Group ............................................................................. 5 Introduction ............................................................................................. 7 A review of the general context Drugs and society François van der Linde (Switzerland).........................................11 The prison, today and tomorrow Vivien Stern (United Kingdom) ...................................................17 Drugs in prisons: the realities Harald Spirig (Austria).................................................................23 Development of a reader for HIV prevention and management in prisons Paola Bollini (Italy).......................................................................31 The size and nature of the problem Assistance to drug users in European prisons – Results of an overview study Heino Stöver (Germany) .............................................................41 The size and nature of the problem in Eastern European Countries (New Independent States) Alexander Gunchenko (Ukraine) ................................................69 The efficacy of health strategies Drug abuse treatment in the prison milieu: A review of the evidence Ambros Uchtenhagen (Switzerland)............................................79 The role of key actors and facilitators A new non-punitive order: judicial care of addicts Paul C. Vegter (Netherlands).......................................................99 3 Prisons, Drugs and Society: A Consensus Statement on principles, policy and practice......... 111 Appendix I Programme............................................................................................. 141 Appendix II List of participants................................................................................... 145 4 The Pompidou Group The Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drugs (Pompidou Group) is an inter-governmental body formed in 1971. Since 1980 it has carried out its activities within the framework of the Council of Europe. It provides a multidisciplinary forum at the wider European level where it is possible for policy-makers, professionals and experts to discuss and exchange information and ideas on the whole range of drug misuse and trafficking problems. Its current work programme includes the promotion of global drug strategies at national, regional and local level; the improvement of data collection systems in Europe; the stimulation of transfer of knowledge and experience between the relevant administrations and professional groups in Europe on issues, policies and programmes for drug demand reduction; the promotion of effective implementation at European level of international drug control treaties and the improvement of cross-border collaboration against trafficking. The opinions expressed in this publication are those of the authors and do not necessarily reflect those of the Council of Europe/Pompidou Group. 5 Introduction The Conference on “Prisons, Drugs and Society”, which took place in Bern from 20 to 22 September 2001, was organised jointly by the Pompidou Group and the WHO Regional Office for Europe (Health in Prisons Project), with the participation and on the invitation of the Swiss authorities. The programme of the Conference is set out in Appendix I. The main aim of this Conference was to review the current situation concerning drugs in prison and to produce, on behalf of policy-makers and prison and health authorities, a Consensus Statement to guide future developments in this area. The Conference was attended by 100 participants from 33 countries who represented the prison administration, the prison health and social service and the drug policy or public health areas. Three international governmental organisations and seven international non- governmental organisations were also present. The list of participants figures in Appendix II. The Conference was divided into 3 sessions: During the first session, an attempt was made to review the general context of the interactions between prisons, drugs and society. The second session analysed the size and nature of the drug problem in Western and Eastern European prisons as well as the efficacy of health strategies. Lastly, in the third session, participants discussed the role of key actors and facilitators such as the judiciary, the media, the prison staff and the prisoner. The main outcome of the Conference was the adoption of a Consensus Statement on prisons, drugs and society. This Consensus Statement comprises four main parts. The first relates to principles and the second to policy and practice. This second part is arranged around the different stages an offender or prisoner can pass through within the criminal justice and prison systems. The third part deals with some cross cutting issues. 7 Checklists for key staff and governors make up the last part of the Statement. This publication contains a selection of reports presented at the Conference, as well as the full text of the Consensus Statement. 8 A review of the general context Drugs and society François van der Linde This Conference is being held in a country which often has a reputation for being very conservative, but which in terms of drugs policy tends to go its own way. Although this paper is not intended to be a presentation of Swiss drugs policy, the following comments will inevitably be influenced by our experiences here. The extent to which these experiences can be applicable to other countries depends much less on the properties of the various drugs themselves than on social factors. It is therefore interesting to look at the influences at work in the framing of national drug policies. Put very simply, there are three broad areas: - Pharmacological and medical considerations; - Socio-cultural influences; - Economic and political factors. Pharmacological and medical considerations The effects and potentially harmful consequences of psychoactive substances are well known. Quite a number of years ago, Professor Uchtenhagen attempted to draw up a comparative table of the risks inherent in the most widely used substances. Without going into details here, the table showed that it was very difficult to compare the risks inherent in the use of the various substances, but that overall there was no definite link between the risks associated with a drug and its legal status. The reasons why some substances such as cannabis are prohibited and others such as alcohol are allowed are not primarily medical. If drugs policy were dictated solely by pharmacological and medical considerations, then alcohol and tobacco would need to be regulated much more strictly and controlled in a similar way to cannabis products. The fact that this is not the case bothers a lot of people, particularly young people, who fail to understand why the