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In this issue
Article Type: In this issue From: Drugs and Alcohol Today, Volume 12, Issue 1
At a time when eurozone turmoil and the redrafting of European Union (EU) treaties dominates headlines the discussion about European drug policy has an added pertinence. Standring’s paper is a response to an ealier paper by Chatwin about the convergence of drug policies in EU member states. He underlines the importance of the EU in providing a strategic context, and points towards the contribution of the European Monitoring Centre on Drugs and Drug Addiction in raising scientific standards and harmonising data collection. He advances an argument of “soft convergence”, that results over time from the cooperation of policy makers, scientists and professionals.
In her retort, “What kind of union? Soft convergence – or top down harmonization”, Chatwin argues that there is a clear difference between the soft processes of cooperation and partnership and policy directives. In the EU as well as in EU member states drug policy has had minimal citizen participation but has been imposed from top down. There are achievements, such as the development of the evidence base, and opportunities for exchanging best practice but also risks.
The need for local autonomy is underlined by Moeller’s “Letter on the Copenhagen’s City council’s suggestion to legalize cannabis.” The deleterious consequences of closing down Copenhagen’s self-regulated cannabis market in Christiania were reported in previous issues (Frank, 2008, pp. 26-33). In an attempt to tackle the threats posed by organized crime groups that have taken over cannabis distribution the city council is now proposing to legalize not just consumption but distribution and production as well. It is interesting to see one country that has moved from a liberal to a repressive position change course, just The Netherlands are introducing ever sharper restrictions on the coffee shops, reported in the last issue (Cohen, 2011, pp. 188-193).
Significant changes are also underfoot in England and Wales with the introduction of Payment by Results as a funding mechanism for drugs and alcohol services. Katie Hill et al.’s article “Payment by Results made simple” takes the reader through the mechanics of the scheme, its origins and rationale, and discusses some of the different variants. The experience of Stockport, one of the pilot areas, is used to illustrate some of the main issues arising. She underlines the provisional nature of the current schemes with no plans for national roll out of any one model as yet. This is part of the tension between the ostensible policy of localism espoused by the current administration and the desire to impose new standards across the industry.
In this endeavor to improve the quality of services the new government continues one of the key policy contributions made by the last government. The National Treatment Agency made this one of its central concerns, with the development of DANOS and good practice guidelines. But drugs and alcohol are a cross cutting issue impacting on the work of professionals well beyond the field. Not many have the time and resources for extensive training, hence the need for short training courses that provide professionals working with young people, the homeless, or in A&E to work with confidence with drug and alcohol users. One such training scheme is described and evaluated by Martin et al.’s paper “Optimising service provision by non-specialist advisors: the impact of alcohol and drugs awareness training on perceived levels of role legitimacy, adequacy and satisfaction” explores the results of one training course against such indicators as role legitimacy, role adequacy and role support. Participants feel much more confident at the end of the training, but also realise that in understanding drug and alcohol problems there is a long, steep hill to climb.
Evidence-based policy making has become a mantra of modern public health, indeed, the discipline could be said to have emerged on the back of research findings. In their “Audit of alcohol detoxification at Leeds Addiction Unit”, Rana et al. illustrate the value of regular service audits for improving their practice. Predictably, perhaps, the team has found the provision of follow-up services critical for improving outcomes measured. What is most interesting is that while staff encourage patients towards abstinence, a rising proportion achieve control over their own drinking.
Frank, V. (2008), “Danish drug policy – shifting from liberalism to repression”, Drugs and Alcohol Today, Vol. 8 No. 2, pp. 26–33
Cohen, P. (2011), “Less THC, more public health?”, Drugs and Alcohol Today, Vol. 11 No. 4, pp. 188–93