News from EU4Monitoring Drugs, an EMCDDA technical cooperation project

This content was published in the third EU4MD update released on 07.02.2020. This update also presents a section on partnerships and related activities, upcoming events, and a research corner.

Focus on new methods for drug monitoring

In recent years the EMCDDA has developed collaborative work with several European research groups to explore new tools and methods for monitoring drug use and related risks in the general population and among specific populations. To share these experiences and discuss the relevance of new methods for the European Neighbourhood Policy (ENP) countries, a workshop was organised with the partners on the occasion of the 8th extended Reitox network meeting in Lisbon in November 2019. Eight countries attending the workshop discussed whether and how these methods could be implemented in their countries.

Wastewater analysis (SCORE network)

Assessing illicit drugs in wastewater is a new approach to estimate drug use in populations, based on the detection and quantification of drugs and their metabolic products in community wastewater. Wastewater analysis allows for the better identification of the drugs being used and can provide near-real-time results; it has the potential to identify trends in drug use patterns, over time and geographically.

Syringe residue analysis (ESCAPE network)

A group of European researchers has developed an innovative method to obtain information on injected substances by chemically analysing the residual content of used syringes. This method, applied by the ESCAPE (European Syringe Collection and Analysis Project Enterprise) network, provides timely and local information that complements existing data on substances injected by users.

Hospital emergencies (Euro-DEN network)

Hospital emergency data can provide a unique insight into acute health harms related to drug use. The European Drug Emergencies Network (Euro-DEN) was established in October 2013 with the aim of improving knowledge at the European level on acute toxicity from established illicit/recreational drugs and new psychoactive substances (NPS). There are currently 32 active Euro-DEN Plus sentinel centres, collecting data in 22 countries. The Euro-DEN group developed a minimum dataset to capture the key demographic, clinical and outcome variables in presentations with acute drug toxicity to emergency departments. Active recruitment of centres continues in 2020.

Interview with Ketevan Sarajishvili, Secretary of the Inter-Agency Coordinating Council for Combating Drug Abuse

What are the main drug-related challenges facing Georgia?

The first main challenge for the Georgian authorities is the Darknet. Taking into account the emerging character of the drugs phenomenon, online drug trade seems challenging for Georgia, just like for the European countries and the whole international community.

The second challenge relates to statistics and data analysis because there is a lack of accurate and consolidated statistics, surveys and data analysis systems. Different stakeholders, including the governmental and non-governmental sector and academia, are collecting some data and conducting research studies, however, this does not create a clear and comprehensive picture of the drugs situation in Georgia. A drug monitoring system and well-functioning observatory, which would assess the situation from the perspective of demand/supply and harm reduction, constitute the best institutional guarantee for the development of evidence-based drug policy in Georgia. 

Finally, the third main challenge is prevention. Holistic and well-coordinated prevention is an important tool to address drug issues, to avoid substance misuse among children, adolescents and the general population. While the international community agrees that prevention should enhance protective factors and reduce risk factors, the state needs an entire strategy in order to ensure mutually agreed, synergic, and consistent anti-drug actions. It is worth mentioning that prevention is an integral priority of the National Strategy on Combating Drug Abuse in Georgia, however, we feel there is a lack of a complex proactive approach and coordinated preventive initiatives among governmental and non-governmental agencies.

What are the current health and security threats related to drugs?

The online access to new psychoactive substances (NPS) constitutes a growing and potential health and security threat. Apart from this, the geographical location of Georgia could also be the subject of security considerations, since drug trafficking is one of the forms of organised crime that has a transnational character. 

What has been done to address the challenges posed by drugs?

Georgian authorities acknowledge the challenges identified and have developed comprehensive measures to address them.
In particular, the Central Criminal Police Department of the Ministry of Internal Affairs (MIA) established a specialised Division for fighting with online dealing and postal distribution of drugs and NPSs. The division is staffed with law enforcement officers with relevant qualifications and skills.  As a result, 38 people were arrested for online drug dealing in 2019 and 15 drug-related online shops (through which drugs were traded) were closed.

When it comes to data collection and analysis, Georgia prioritises the importance of developing evidence-based drug policy. For that aim, the March 2018 Interagency Anti-Drug Coordinating Council decided to create the national drug observatory, which was established upon the Order of the Minister of Justice of Georgia on 16 January 2020. The National Drug Monitoring Centre is made up of experts on prevention, treatment and rehabilitation, harm-reduction, supply reduction, addictology, sociology, epidemiology and representatives from state agencies. It is the institutional guarantee for the dissemination of scientifically valid information on drugs and drug dependence issues.
Apart from this, the independent and objective evidence based on solid surveys and research studies prepared by the Centre will assist policymakers to trust reliable information and implement evidence-based drug policy.

As for prevention, the Inter-Agency Coordinating Council for Combating Drug Abuse, which is chaired by the Justice Minister with the assistance of national and international experts, is elaborating the Georgian National Strategy for Drug Misuse Prevention. This will be relevant to the Georgian context and promote coordinated, comprehensive and result-oriented drug prevention activities. 

Where and how can the EU4MD project make a difference?

The Georgian authorities closely cooperate with the EMCDDA within the framework of the Memorandum of Understanding signed 4 November 2015 between the Ministry of Justice and the EMCDDA.

Taking into consideration the fact that Georgia has already established the national drug observatory, capacity-building activities and experience-sharing from the EMCDDA are highly appreciated. The EMCDDA has sustainable and consistent experience and expertise in evaluation and monitoring tools and its support will enhance the proficiency and knowledge of the Georgian drug observatory.

Assistance from the EMCDDA in order to increase the response capacity to Darknet issues will also help strengthen the Georgian law enforcement institutions.

Interview with Rim Mansouri, Pharmacist Inspector General, Director of the Permanent Secretariat of the National Narcotics Office

What are the main drug-related challenges facing?

In Tunisia, we have a limited number of studies and data on drug use, therefore we may lack information to assess accurately the issue, which is felt by health professionals as very important and evolving, especially because the increase of the availability of these products.

The National Bureau of Narcotics, under the chairmanship of the Ministry of Health, is the guardian of the United Nations international conventions on Drugs. The bureau coordinates the drug-related activities in different ministries, namely health, justice, interior, customs, education, higher education, social affairs, women and families, youth and sport. What are our main challenges? We would like to establish a ‘Tunisian Monitoring Centre for Drugs and Addiction’ which would collect drug-related data and information from the various ministries involved in the field of drugs with the aim to produce annual reports that support the planning and implementation of our national drug policies.

We would also like to develop a drug information network, where we know what sources of information there are, how they operate, and who are the focal points. It would be important to train them on how to collect data and information. Finally, we would like to introduce opioid agonist therapy with methadone. We have around 33 000 people who inject opioids, but at the moment there is no specialised treatment centre that would provide medical care for them. 

What are the current health and security threats related to drugs?

Drugs remain a challenge for the health, safety and well-being of citizens in Tunisia. What we observe is a shift in lifestyles and behaviour, particularly among adolescents. We also see that the majority of people affected with HIV/AIDS are young, between 25 and 39. New psychoactive substances are another issue: they are mainly unknown to professionals in the health and safety sectors and they are increasingly available in the consumer market. Finally, a lack of specialised care services for people who inject drugs is an issue, especially when we speak about care needed to address hepatitis, HIV and other health problems.

What has been done to address the challenges posed by drugs?

First I would like to mention a new law on narcotics, which reduces the punitive aspect. The reformed law removes automatic prison sentences for drug use and the possession of drugs for personal use, and gives judges the possibility of applying mitigating circumstances, thus enhancing the state’s commitment to care and prevention in drug use.

The National Health Institute has agreed with the Minister of Health and the National Bureau of Narcotics a proposal for the implementation of a data collection network. In March 2019, after refurbishment, we opened a new rehabilitation and treatment centre for people who use drugs. There are several on-going projects, funded through the Global Fund to fight AIDS, Tuberculosis and Malaria, and to establish additional care centres in Tunisia.

Where and how can the EU4MD project make a difference?

We are thankful for the support so far from the EMCDDA and are committed to continue cooperation within the EU4Monitoring Drugs project.

Our wish is that the project would further increase the capacities of our health and law enforcement professionals. We welcome training sessions and exchanges on data collection, innovative methods for drug trafficking, updates on control of precursors and implementation of opioid agonist treatment.