On June 7, 2017, the Council of the European Commission adopted the EU Action Plan on Drugs (2017-2020). The Civil Society Forum on Drugs struggled hard to include into the Action Plan targets and indicators that would help improve lives and health of people who use drugs in the EU.
"Although it was without much fanfare that the European Commission published the new Action Plan on Drugs (2017-2020), the drug policy community should celebrate it as a great achievement both for its progressive content and for the meaningful involvement of civil society in its preparation. We are glad to see many of our recommendations being reflected in the Action Plan. Now, the only question is if member states will provide adequate funding and political support to implement these actions. We hope it will not remain only on paper," says Peter Sarosi, head of the thematic working group of the Civil Society Forum on Drugs, advising the EU Commission on drug policies, and Co-Chair of EHRN’s Steering Committee.
Below is EHRN’s digest of the most important provisions of the Action Plan that members of our organization may use in their work, related to drug policy reform and promotion of harm reduction in their respective countries. The Plan also presents with ample opportunities to further gather evidence and share best practices, which will provide an even stronger evidence base for our advocacy activities.
Pill testing in nightclubs, self-testing for HIV, and drug consumption rooms
Action 8d of the new Plan, which EHRN finds the most innovative, specifically talks about the importance of information sharing with the objective to increase the effectiveness of services for “problematic and dependent drug users”:
“Exchange of information and where applicable best practice on risk and harm reduction measures such as, needle and syringe exchange programmes, opioid substitution treatment, drug consumption rooms, naloxone programmes, peer based interventions, outreach treatment programmes, hepatitis C treatment, pill testing, self-testing for HIV/ AIDS, in accordance with national legislation”.
As one of the indicators for this action, the Plan specifies the “number of programmes facilitating the access of people who inject drugs into treatment for the hepatitis C virus (HCV) and people covered”.
Although the previous Plan mentioned “drug use in nightlife and recreational settings”, it did not say a word about pill testing. The current document has the wording, and now it is our turn to make sure that such exchange of information and best practice about pill testing in nightclubs takes place.
Drug consumption rooms have already been mentioned in the previous Action Plan, but advocating about them is still an unfinished agenda in many countries of the EU.
As for hepatitis C, the new Action Plan advises Member States to report on the number of PWID who receive hepatitis C treatment.
Suggested advocacy actions:
1. Collect best practice examples related to drug consumption rooms and pill testing in other countries and prepare evidence-based advocacy materials
2. The best option is to advocate for assisted self-testing for HIV – it means that an outreach worker or a peer consultant provides the assistance in administrating the test and interpreting its result
3. Check if appropriate targets and reporting mechanisms, indicated in the Plan are included into your National Health/Infectious disease/Hepatitis/Drug plans and, if not, advocate with the state to do so.
Naloxone for overdose prevention distributed to non-medical staff
Although the issue of overdose has been acknowledged in the previous EU Action Plan (one of 15 overarching indicators of that Action Plan is “Trends in drug-induced deaths and mortality amongst drug users”), it has not mentioned naloxone or other specific measures to reduce overdose mortality. The newly adopted plan specifies what the response to the growing opioid overdose mortality in EU should be like:
“Action 8b. Better prevent drug related deaths according to national circumstances as for example in the case of opiates, by providing access to authorised pharmaceutical dosage forms of medicinal products containing naloxone specifically certified to treat opioid overdose symptoms by trained laypersons in the absence of medical professionals.”
In practice, this means that EU Member States should:
Firstly, register medicinal products containing naloxone specifically certified to treat opioid overdose symptoms by trained laypersons in the absence of medical professionals, and,
Secondly, provide access to it by giving funding to harm reduction services to purchase naloxone in quantities sufficient to cover the needs of those who use opioids.
Suggested advocacy actions:
1. This is the best moment to request your government to register naloxone for ‘lay persons’ administration’ and submit funding proposal to national drug policy stakeholders.
2. Contact EHRN to get support in working out an advocacy plan on overdose prevention in your country and in developing funding proposal if you have no previous experience with naloxone distribution.
Recommended alternative sanctions for drug-related crime include diversion from arrest
Advocacy for alternative, non-punitive sanctions for drug use and possession is one of EHRN’s key advocacy priorities. The previous EU Action Plan included the language, which we could use to strengthen our position and push national governments to apply alternative sanctions:
“22. Increased availability and implementation of alternatives to prison for drug-using offenders in the areas of education, treatment, rehabilitation, aftercare and social integration. Increased monitoring, implementation and evaluation of alternatives to coercive sanctions”.
The new Action Plan reiterates the need to implement and evaluate such alternatives, but also adds several important elements here.
First of all, the wording “alternatives to prisons” is replaced by “alternatives to coercive sanctions”, and now includes “suspension of investigation or prosecution” (action 22). This opens new horizons for the implementation of diversion from arrest programs, like LEAD in the US.
In addition to this important provision, the new Action Plan sets two indicators:
“Type and number of alternatives to coercive sanctions provided for and implemented by MS” and “Information on the effectiveness of the use of alternatives to coercive sanctions”.
EHRN currently implements two projects targeted at promoting the alternatives to arrest and prison for drug use and possession: the EU-funded project “Drug Policy Impact Assessment for Change in the Baltic States” and a small grant program supported by Robert Carr civil society Networks Fund.
Suggested advocacy actions:
1. Propose your government to support a pilot project on diversion from arrest and police referral to harm reduction services.
2. Contact EHRN about upcoming learning opportunities (study tours, conferences and trainings) to educate your country's legislators, law enforcement, health authorities, and civil society about best practices in providing alternatives for punishment for drug related crime.