The Trimbos Instituut - the Netherlands Institute of Mental Health and Addiction - is an independent nationally and internationally operating centre of expertise that, on scientific grounds, provides services in the field of mental health care, substance use and the care of addicts.

El Trimbos Instituut, el instituto holandés de salud mental y de toxicomanía, es una organización independiente al nivel national e internacional que dirige un centro que ofrece servicios en el ámbito de la salud mental, y del uso y abuso de substancias.

L’institut Trimbos – l’institut néerlandais spécialisé dans la santé mentale et les addictions – est un centre d’expertise indépendant opérant au niveau national et international.

Trimbos Instituut

 invite you to participate in the webinar that will provide information on drug policy evaluation as an effective instrument to guide, manage and support effective policies and services. The Webinar is supported by the 

European Monitoring Centre for Drugs and Drug Addiction

The Webinar will present an insight on how various actors can contribute to a process of monitoring and evaluation of drug policies and can benefit from. It will:

showcase the benefits of drug policy evaluations

provide examples of recent regional drug policy (e.g. Croatia, Cyprus)

provide opportunities of online evaluations

The webinar may serve as a source of inspiration to support all those involved process of building better drug policies. It is especially suitable for regional drug policy makers, regional civil society groups, European and other interested participants.

Drug Policy evaluations: approach and methods

Experiences from online/hybrid evaluation.

Three parallel breakout sessions will follow on What is needed to prepare a national drug policy?, How to monitor progress? and How to learn from and improve policies?

The Webinar will be held via Zoom at the following link https://us02web.zoom.us/j/86598224178 on Wednesday 10 February 2021 starting at 14:00 CET. The Webinar will last for 120 minutes.

As the number of participants is limited, please register by Monday 8 February using the form attached here>>>.

Drug Policy evaluation: Opportunities to support inclusive, effective and evidence-based public policy

The following letter was drafted by a coalition of 29 civil society organisations and community networks in the European Union. The letter urges the German Presidency to propose to the EU Horizontal Working Party on Drugs (HDG) that the current draft EU Agenda and Action Plan on Drugs 2021-2025 be rejected, and measures are taken to ensure an appropriate and inclusive strategic development process for the next EU drugs strategy.

We are writing regarding the proposed EU Agenda and Action Plan on Drugs 2021-2025, published by the European Commission on 24 July 2020 (the “2021-25 EU Drugs Agenda”, or the “Agenda”). We have serious concerns regarding both the process for its development as well as with the substance of the document and urge the German Presidency to propose to the EU Horizontal Working Party on Drugs (HDG) that this draft cannot be accepted, and to outline an appropriate and inclusive strategic development process for the next EU drugs strategy.

The formulation of the 2021-25 EU Drugs Agenda through a unilateral Communication of the European Commission without consultation with EU Member States and other relevant EU actors, including civil society is deeply problematic. If the HDG accepts this document as it stands, a worrying procedural precedent will be set. To date, the ‘EU’s drugs strategies and action plans are developed through a rigorous process that allows Member States to work together on the development of strategic approaches. This involves a series of negotiations, evaluations and compromises so that consensus can be reached in the form of a new strategy document.’ The 2021-25 EU Drugs Agenda appears to be the result of a hasty, opaque and non-participatory policy-making process, and represents a drastic departure from agreed EU policies. The lack of appropriate consultation and engagement inevitably means that the different experiences and views of EU Member States and other relevant EU actors have less weight in the new document. It fails to adopt a balanced, integrated, and multidisciplinary approach to drug matters; it is not rooted on human rights, public health, and the key international drug policy documents; and it envisages a diminished role for civil society and affected communities.

The European Union has been a global leader in advancing a balanced, integrated, and multidisciplinary approach to drug policies. The 2005 and 2013 EU Drugs Strategies established a consolidated framework that has become a ‘central guiding model’ for national-level drug strategies across the EU. However, the 2021-25 EU Drugs Agenda proposes -in its own words- a ‘paradigm-shift’. It disproportionately focuses EU policy on law enforcement and supply control, to the detriment of the priority previously given to public health, human rights, international cooperation, and scientific research and evaluation. If implemented, it will signal a diminished support for evidence-based drug treatment and harm reduction services, and it will weaken the voice of the EU in international drugs fora, where it has been a key global actor in defending the balanced, rights-based approach adopted by the 2016 UNGASS Outcome Document.

In spite of the EU’s commitment to seek the ‘active and meaningful participation and involvement of civil society’ in the ‘development and implementation of drug policies’, the participation of civil society in the preparation of the 2021-25 Drugs Agenda has been deeply flawed. European NGOs were only allowed to provide input to the Agenda with the publication of the Road Map, on 10 June 2020, with no other opportunity to feed in the process, besides a call between the Commission and certain CSFD members in April. It should be borne in mind that the Road Map is a document of just over two pages that does not allow for a genuine understanding of, or feedback on, the Agenda. No draft of the Agenda was ever shared.

Furthermore, the European Commission disregarded the overwhelming majority of the 27 submissions sent by European NGOs, which urged the EU to retain the balanced and multidisciplinary approach that characterized the 2005 and 2013 EU Drugs Strategies. The fact that the deadline for submitting feedback was 15 July 2020, a mere nine days before the publication of the Communication, suggests that the consultation was not undertaken in the spirit of genuine inquiry, and that the Agenda was at least near completion when the Road Map was published.

Crucially, although the external evaluation of the 2013 EU Drugs Strategy was finalised in April 2020, the evaluation was not published or otherwise shared with civil society until three months later, on 24 July 2020, thus depriving stakeholders of crucial information when providing feedback to the Road Map. This is important, as there would appear to be a significant disconnect between the Agenda and the external evaluation. For instance, the evaluation consistently found that the 2013 Strategy had ‘sparked a considerable amount of progress’ in the cross-cutting areas of coordination, international cooperation, and monitoring, research and evaluation, which are precisely the areas now removed from the Agenda.

In addition to the grave concerns regarding the process and procedure, we felt it is important to bring your attention the key flaws in the draft Agenda:

. Although the Agenda explicitly claims to seek an ‘integrated, balanced, and multidisciplinary approach’ to drug policies, the draft is not balanced, as over half of its eight priority areas concern security and supply control interventions, with the rest distributed between prisons, prevention, treatment, and harm reduction. Public health measures aimed at reducing the harms that can be associated to drug use have been relegated from the first priority of the 2013 Drugs Strategy to the end of the new Agenda. The cross-cutting themes of coordination, international cooperation, and information and research, which have been successfully developed since 2013 to materialise the multidisciplinary and integrated approach, have been dropped. The many references to the balanced approach across the operative parts of the 2013 Strategy, for instance as the basis for increased coordination across all actors, interventions at the CND, and international cooperation, have also disappeared.

Deprioritising human rights and public health.

 Human rights have practically disappeared from the draft Agenda, which contains no reference to the relevant international or regional human rights instruments, including the Universal Declaration of Human Rights. Furthermore, there is no mention of the International Guidelines on Human Rights and Drug Policy, a critical document developed with the leading support of Germany that lays down, for the first time, a set of clear and comprehensive international standards for articulating rights-based responses to illegal drug economies. In contrast, the 2013 EU Drugs Strategy explicitly referred to the Universal Declaration of Human Rights and the European Convention of Human Rights, amongst others, and human rights were mentioned several times in the section on international cooperation. Public health has been relegated from the first policy field in the 2013 Strategy to the last priority areas of the Agenda, and has been replaced by ‘drug-related security’ as the first goal of the document.

Dropping support for key international documents.

 Equally surprising is the little attention paid to the 2016 UNGASS Outcome Document - only a footnote in the preambular part of the Agenda, and a mention in the Action Plan, outside its priority areas -, even though it has been consistently described by the EU as ‘the most comprehensive policy agreement of the international community and a milestone in the discussions on international drug policy’. It is also inexplicable that the Agenda would completely fail to reference the 2018 UN System Common Position on Drugs, a watershed document championed by the EU and EU Member States, as it establishes for the first time a coherent position across all UN entities on key topics like decriminalisation and harm reduction.

Reducing the space for civil society and people who use drugs.

 Whereas the 2013 EU Drugs Strategy contained a commitment to promote and encourage ‘the active and meaningful participation and involvement of civil society’, the EU Drugs Agenda only mentions ‘engagement’ with the CSFD. Involvement with civil society beyond the CSFD has been omitted, and there is no reference to engaging with people who use drugs and clients of drug services, which the 2013 Strategy did.

Weakening the external dimensions of drug policy.

 The 2021-25 Drugs Agenda risks weakening the external action of the EU in bilateral and multilateral drugs fora, as it does not set clear guidelines for EU coordinated intervention, and it does not provide strong support for the key international documents that the EU has been forcefully defending and promoting in the last years. For instance, the Agenda does not provide any concrete principle or guideline for intervening at the CND, even though it is arguably the centre of the international drug control system, and the role of the EU there is more important than ever. This contrasts greatly with the 2013 Drugs Strategy, which committed the EU to a ‘strong voice’ in the Commission on Narcotic Drugs, with the aim of promoting the balanced approach. Another case in point is the only reference to alternative development in the whole Agenda, which can be found under the heading ‘dismantling drug production’, and is not deemed to warrant even one of the 24 priority areas set in the document. This is especially surprising considering that the 2018 Council Conclusions adopted exclusively on this topic committed the EU to a ‘leading role (…) in the funding and implementation of alternative development’, and stated clearly that the success of alternative development goes ‘beyond an exclusive focus on illicit drug crop monitoring’.

 In spite of the EU’s leading role in fostering scientific knowledge and research on drug markets and drug use through the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the 2021-25 EU Drugs Agenda has dropped the cross-cutting theme on monitoring, research and evaluation, and science-based drug policies are scarcely mentioned in the operative parts of the document. Again, this makes a striking contrast with the 2013 Drugs Strategy, which featured a whole theme on research and evaluation for ‘a better understanding of all aspects of the drug phenomenon’, and provided a role for the EMCDDA in supply reduction, international cooperation, and the overall implementation of the document, among others.

 Although the 2021-25 Drugs Agenda explicitly seeks to reduce drug-related stigma, the European Commission press release accompanying the publication of the proposed Agenda was deeply stigmatising, as it puts drug policies at the same level as child abuse and firearms trafficking. Furthermore, the Agenda contains some instances of stigmatising language (‘substance abuse’ and ‘substance misuse’) that did not exist in the 2013 Drugs Strategy.

In light of the above and following established practices for the development of previous EU drugs strategies, we urge you, as the Council Presidency, to take political leadership and encourage the HDG to reject the draft proposed by the European Commission. A new process for strategy development should ensure that the new document reflects in a balanced manner the existing EU and the latest international commitments (in particular the 2016 UNGASS Outcome Document), the views of the EU Member States and all the relevant actors within the EU institutions, and engages meaningfully with civil society.

We would also be grateful if you could share this letter with your HDG colleagues before the 9 September meeting.
We remain at your disposal for any further discussion on this matter, and look forward to our continued cooperation on this and other topics during the German Presidency.

Drug policy experts raise concerns regarding the draft EU Agenda and Action Plan on Drugs 2021-2025 - Open Letter

Is drug checking a valuable tool to reduce the harm of drug use? In many countries this is still an ongoing debate, one often hampered by lack of empirical evidence and practical experience. In the Netherlands, government-licensed drug checking has occured for over the past two decades and has grown from a small scale project into a nationwide scientific monitor.

As one of the world’s oldest drug checking services, the ‘Drugs Information and Monitoring System’ (DIMS) can provide advice and insight from lessons learned on how to set up and operate a drug checking service to all international collaborators, many of whom are taking their first steps in providing national drug checking programs.

This factsheet offers an overview of the history, organisation, common practice and strategies for warning campaigns of DIMS, and aims to serve as an objective insight into the ins and outs of drug checking as being executed in the Netherlands. While political and public opinion on the subject differs from country to country, sharing information will have its value for public health for certain.

The Drugs Information and Monitoring System (DIMS) - Factsheet on drug checking in the Netherlands

By Trimbos, Mainline, Correlation and NIHR

In the Netherlands, for many years drug consumption rooms (DCRs) are one of the harm reduction interventions run by addiction treatment and social relief services. The first formal drug consumption room was run by an addiction treatment service2 and opened its doors 10 June 1994 in Maastricht. Since then, the number of drug consumption rooms increased, primarily aiming for the reduction of drug-related nuisance in the streets and public spaces. In the 21st century, the need for specific drug consumption rooms decreased, due to the many initiatives that took place in the field of housing of homeless people who use drugs (PWUD) (such as hostels and ‘around the clock (24/7) shelters’). Changes in the objectives of DCRs were noted over time, as more facilities now have included health promotion for PWUD as a main target. And since the 2010s, addiction care services are shifting their objectives towards recovery, which includes societal, social and personal recovery.

When describing and defining a DCR, a number of key aspects always pop up: safer drug use, nuisance control and reduction of adverse health effects. In this inventory, we use the following definition: “Drug consumption rooms are facilities where (homeless) people struggling with a drug addiction can use their drugs in a hygienic and quiet environment, with social workers present in the background. Drug consumption rooms aim to reduce nuisance in the neighborhood and to reduce the adverse health effects of drug use“ (Standard of Care Opiate Addiction3 , 2017) (Zorgstandaard Opiaatverslaving, 2017). Aside from drug consumption rooms, there are also a number of alcohol consumption rooms in the Netherlands, aiming to reduce nuisance caused by drinking in public. However, in this report we focus on DCRs.

Drug consumption rooms in the Netherlands were last monitored in 2013 (Laghaei et al., 2013). In 2013, for the first time since the monitoring of DCRs since 2000 (Linssen et al, 2002), a decrease in number was noted; 31 DCRs in 2013 compared to 37 in 2010 (Havinga & Van der Poel, 2011). In order to keep track of DCR developments over the years, a periodic inventory is needed. Therefore, Trimbos Institute, Mainline and Correlation/ European Harm Reduction Network initiated this new inventory.

Drug consumption rooms in the Netherlands

This third International City Health Conference, hosted by AIDS Foundation East-West (AFEW) and the Trimbos-instituut, organised by Knowledge•Action•Change, will take place over two days, at the Casa 400 Hotel, in Amsterdam, on 3rd and 4th November 2014.

The city of Amsterdam has a rich cultural history and today is home to vibrant, diverse communities. The city also boasts a proud tradition of innovation in public health, demonstrating the importance and effectiveness of city-level initiatives and interventions, to meet the needs of its citizens and visitors.

The conference will build on the achievements of previous City Health events and the programme will be designed to examine how cities around the globe respond to changing populations and adapt to changing health behaviours, to ensure and promote health and wellbeing to reflect diverse groups and cultures.

The hosts for the conference are both internationally acknowledged leaders in the field of public health and will use this to ensure the programme reflects current thinking and relates to current issues of concern for urban populations.

Click here to read more about the conference.

Keep up-to-date with drug policy developments by subscribing to the IDPC Monthly Alert.

3rd City Health International Conference

In response to concerns that the official data collected by the UNODC for the 10 year review of drug policy would be insufficient, the European Commission funded a research study into the scale and nature of global drug markets, and the trends in these markets over the last decade. The resulting report was launched at the 2009 CND, and concluded that there was no evidence to support the claim that the scale of the problem was being reduced.

Trimbos Instituut

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Drug Policy evaluation: Opportunities to support inclusive, effective and evidence-based public policy

Drug policy experts raise concerns regarding the draft EU Agenda and Action Plan on Drugs 2021-2025 - Open Letter

The Drugs Information and Monitoring System (DIMS) - Factsheet on drug checking in the Netherlands

Drug consumption rooms in the Netherlands

3rd City Health International Conference

A Report on Global Illicit Drug Markets 1998-2007