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Drug abuse: Tendencies and ways to overcome it (стр. 11 из 13)

The new government-run intelligence service for drugs has replaced the older drugs central intelligence. Police and customs officers staff the government-run intelligence. Its duty is to gather, analyze and distribute information obtained either abroad or at home.

The regional anti-drug departments have special support units. The customs service has been reinforced by top-class specialists and top-notch smuggling clampdown equipment. In compliance with the 1986 law on illegal drug trade, the police and the courts have received broader authority as to the identification, freezing and confiscation of drug dealers' profits. In 1988 the UK and the USA signed a bilateral agreement on the confiscation of the discredited bank assets.

The police and the customs service have formed a special financial division to accumulate on a national scale, survey and pass down for further investigation the data on financial issues, i.e. reports from the banks and other financial institutions on monetary deposits of questionable origin.

The government has outlined the procedure for police operations against the three categories of drug dealers, big, medium and small.

Great Britain upholds the international community's efforts by contributing annually Pound Sterling 150,000 to the UN Fund for Drug Abuse Control. As mentioned before, the UK also runs a program of assistance to overseas projects.

Regarding the drug abuse situation, a review of the government measures underlines that the government-sponsored policy works toward a closer international cooperation, enhances the efforts of the law-enforcement agencies, helps the younger generation realize the impact of drug addiction and boosts the effort against this evil.

Mexico:

The drug control programs in Mexico differ from those in other countries as Mexico is a hotbed of manufacture and export of opium, heroin and marijuana and a major cocaine trafficking transit point to the United States. Some Mexican states have traditional plantations of opium poppy, marijuana and Indian hemp. Economic hardships often force the farmers into dealing with drug dealers and prompt the growing of illegal crops, which produce profits higher than the earnings from lawful businesses. The anti-drug programs, therefore, focus on mass destruction of narcotic crops from the air or manually and the involvement of army units in such operations, harsh penal sanctions, intensive investigation of drug cartels and trafficking channels, and dissemination of information among the public.

Growing cooperation with the USA on the basis of bilateral agreements and a treaty of juridical assistance is an important element of the anti-narcotic policy. It facilitates the identification of drug-related money laundering in the financial and commercial institutions both in Mexico and the US. The Advance Guard program presupposes operations to detect and destroy the plantations of drug-bearing crops. Starting from 1986, units of the Mexican Army and of the US Coastal Guard have been conducting operations to detain suppliers of drugs in the Mexican territorial waters, to confiscate their cars and arms, and to control flights in the border area as part of the American Mexican operation Alliance.

Spain:

The national program against drug abuse in Spain deserves notice as the Spanish laws permit soft narcotic substances. Despite the expectations and arguments of the proponents of drug legalization, drug abuse in Spain does not subside. Neither does the crime rate. The number of violent assaults to obtain money for drugs is on the rise. The law-enforcement agencies' task has been set as eradicating drug abuse, opening specialized medical centers for the addicts who volunteer to undergo treatment, and combating drug addiction and prostitution as the factors increasing the risk of AIDS infection.

The main goals of the Spanish program against drug abuse are to halt the proliferation of the most heinous drugs like heroin and cocaine, organize prophylactic measures among the young people of 16-to-18, promulgate popular knowledge about medicine and treatment of drug addicts by way of educational lectures, and advance public organizations' activities.

France:

The French national program against narco-business sponsored by the Ministry of the Interior and Public Safety focuses on curbing the illegal trade in drugs, and, in particular, the street vending of narcotic substances. The document provides for the creation of special-task police units and a national center to coordinate all police operations against drug abuse. Narco-business-suppression training courses have been introduced at police schools. Large police commissariats now have specialized branches to monitor drug abuse. These branches render practical and financial assistance to various organizations engaged in fighting against the abuse of narcotic and toxic chemical substances.

The experience of foreign anti-narcotics programs can be adapted to the requirements of the Russian Federation and help work out a feasible National Program of Comprehensive Counteraction to Narcotics

Par. 2. Organization of Medical Counteraction to Narcotics

The primary aspect of the entire anti-narcotics effort is a series of medical treatment measures. They are carried out by different medical institutions as actions against narcotics is inalienable from the activities of public health services of all levels, including the medical service of the Ministry of Internal Affairs. In 1975 the former Soviet medical authorities detached the addictions treatment service from psychiatry. Thus the treatment of drug and other addicts became a separate branch of medicine known as narcology.

The efforts of the medical institutions make up a significant part of the anti-narcotics strategy. Their goal is to bring about a decrease in the demand for drugs. This is achieved by the treatment and rehabilitation of abusers and, in the final run, is a positive factor of a general improvement in the drug abuse situation.

The measures, which the health centers, are obliged to take, can roughly be divided into two groups. Group One includes the properly medical efforts in the treatment and rehabilitation of addicts. Group Two embraces other organizational steps to keep narcotics at bay.

The international community also pays considerable attention to the treatment of drug addicts. Article 38 of the Uniform Convention on Drugs states that the signatory countries will take every possible step to prevent the misuse of narcotic substances, ensure an early identification of abusers, treat them, restore them to full working capability, re-socialize, and monitor them after the completion of treatment (Paragraph 1). The countries will train appropriate personnel (Paragraph 2), and will inform the population about the hazards of drug abuse (Paragraph 3). The medical treatment of drug addicts is also presupposed by Resolution II of the UN conference on implementing the Uniform Convention on Drugs. Reminding of the provisions of Article 38, the conference stressed that hospital treatment in a drug-free atmosphere is the most efficacious medical approach to the issue. It recommended that economically potent countries where drug abuse is a serious problem provide the opportunities for such treatment.

The Treatment and Rehabilitation of Drug Addicts:

The issues of medical treatment/social rehabilitation of addicts and other relevant measures are to a greater or lesser degree incorporated in the public health programs of all nations and have found reflection in certain regional programs. As a rule, these documents emphasize perfection of the strategies and organization of drug abuse services on the assumption that drug abuse is a social disease. The other important aspects are financing and material/technical support, personnel, informing definite sectors of society on the hazardous impact of addiction, research in the field of more effective medicine.

Experts, however, warn against an overly simplified belief that containing drug addiction boils down to the availability of medicines and available hospital beds. The prophylactics of social illnesses like alcoholism, misuse of narcotics and toxic chemicals cannot be built upon the same methods as the treatment of serious infectious diseases. Alongside pharmaceutics, it requires psychological aid and education which more and more often involves the addicts' families and friends. It is naive to believe that medicines and injections alone can bring about the desired results and that the selection of individually suitable pharmaceutical preparations gives a clue to the problem of treatment. Good results are yielded by a combination of psychology and pharmacy. Therefore, the treatment for drug addiction consumes much painstaking effort of a doctor, psychologist, educator and other specialists working with a person who is likely to develop the illness or is ill already.

On the face of it, the issues of treatment and prophylactics necessitate comprehensive programming and proficient organization. Their solution lies in the medico-biological, medico-psychological and medico-social spheres.

From the standpoint of government policy, public health institutions have the exclusive authority to treat drug addicts by officially approved methods, including compulsory treatment of the addicts who pose danger to society.

According to the results expected in this field, health centers must organize and effectuate a series of measures destined to establish firm grounds for progress in the drug abuse situation.

In the first place, this means the early identification, diagnosis and registration of the persons who use drugs for non-medical purposes and hence stand in need of prophylactic and treatment. However, shortcomings in the existing methods of express-diagnostics and in the expert check-ups of drug addicts make establishing the degree and the type of drug dependence somewhat problematic.

Identification, Diagnosis, and Registration of Drug Users:

The identified addicts may belong to different age and social groups; their condition may have a different degree of narcotic neglect. This fact may influence the choice, distribution and intensity of medical measures, as well as their combination with other types of aid.

Of particular importance is the early identification of addicts among the young and the adolescents. A timely medical interference, caring participation and influence of parents, relatives, teachers, police officers, and the atmosphere of friendliness can stop the youngsters' slump into illness.

When the consumers of different drugs have been identified, it is exigent to inform the police to enable it to find the sources of drugs and trafficking channels and execute other preventive measures.

Information is especially important if the drugs have been manufactured illegally or their origins are unclear.

The following list of measures can help identify the individuals who misuse narcotic substances:

medical check-ups of industrial labor staffs, school and college students;

medical check-ups of inmates in jails and penitentiaries;

medical examination of the perpetrators of drug abuse for further registration and treatment, including compulsory treatment;

specialized testing of certain professionals (the military, pilots, drivers of all means of transport, police officers) for the bodily presence of narcotic substances;

revealing the most dangerous forms of drug abuse that complicated detoxification, revealing the cases of multiple drug misuse (the combined use of more than one drug) and the cases of an intertwined abuse of drugs and alcohol;

identification of addicts who carry the HIV and other infectious diseases, elimination of the consequences of infectious transmission;

timely registration, treatment and rehabilitation of those who need it.

Another way to improve the health servicing of drug abusers is to organize:

fundamental research; development of efficacious pharmaceutical preparations and novel methods of treatment for different types of narcotic dependence, their speedy translation into public health practices; large-scale contribution to research from Russian and foreign scientists (the Academy of Sciences, medical, pedagogical, psychological and other research institutions, application of practices adopted abroad);

accelerated training of highly qualified personnel (addictive conditions psychiatrists, psychologists, educators, social workers) at medical colleges and upper level courses, specialized training of medical attendants, nurses and technicians. The study program should cover not only the novel methods of treatment, but also the specifics of contacts with the drug addicts and methods of readiness for treatment and prophylactic practice;

organization of new preventive-treatment/ registration clinics, out-patient departments at industrial facilities and offices, emergency aid centers and a wide publication of data on their mode of operation, anonymous and commercial treatment centers for drug addicts;

extensive adoption by drug-abuse monitoring services of the achievements in the medical science, psychology, pedagogy, pharmacy, and special-purpose technology;

modernization of drug-abuse monitoring services, improvement of material supplies and provision of the necessary personnel.

The post-treatment rehabilitation measures should include: a) the creation of purpose-oriented government-run and charity funds, ex-drug abusers support funds and diverse forms of work with them; b) development of rehabilitation methods based on the effective analysis of the existing rehabilitation procedures and of qualification levels of the personnel; c) psychological assistance to the former abusers' families, relatives, and friends who must be taught the techniques of exerting favorable influence on the patients.

Equally important is the organization of other anti-narcotics efforts taken by public health institutions.

The health of the nation is an important element of the social and economic development of a country. From this angle, the popularization of a rational way of life, the cultivation of respect for human health as the basic value of society ranks high among the priorities of medical institutions.

Publicizing Information Against Drugs:

A skillful and persistent dissemination of knowledge about the destructive impact of drugs and their detriment for the future generations is a crucial activity of medical institutions in the struggle against narcotics.

It is advisable to find a particular audience and do masterly presentations. Lectures and discussions are not the only means of knowledge dissemination. Meetings with former drug addicts and presentations about broken human lives have also proved productive.

To increase the prophylactic effects of popularization, it would be useful to train the instructors on the methods and tactics of campaigning against narcotics, design a system of mass anti-narcotic education, based on medical science, provide the necessary teaching aids, control and stimulate this activity.

Organization of Control Over the Use of Narcotic Substances:

Public health institutions have responsibilities in exercising control over narcotic substances under international conventions, treaties, agreements and other forms of international cooperation in combating drug abuse. As mentioned earlier, their primary responsibility is to control the proper use of drugs, the correct taking of their stock, their storage, distribution and removal. The issue of special prominence is the storage of narcotic substances at medical institutions and warehouses and the thwarting of attempts to misappropriate them. Inspections often expose serious flaws in this field.

To rule out a possible abuse, leakage or misappropriation of drugs, the following list of measures is essential:

guarding narcotic substance storage facilities, fitting them out with new equipment and fire/break-in alarm systems connected to the central control panel or to the 24-hour operational medical personnel or guards mail;

proper protection of the points where drugs are stored in small quantities for distribution as administered by the physicians;

tightened control over big-batch long-term storage facilities like the warehouses of regional drug-store administrations, and strategic reserves warehouses;

regular inspections at narcotic drug warehouses;

strict abidance by the rules of taking stock, storage and use of drugs for medical purposes;

a timely exchange of information with the police on the above issues and cooperation in drawing up the lists of drug storage facilities.

Experience suggests that a successful solution of the problem depends on the depth of our insight into it. This is especially true of such a complex issue as the treatment and rehabilitation of drug addicts regardless of what stage they are at. That is why the fullest and the most objective information is essential for the medical and other institutions to organize a counter-offensive against drug abuse. With that goal in mind, public health centers should adhere to the following organizational guidelines: