Secucities drugs pilot training programme for the prevention and treatment of drug addictions

EUROPEAN FORUM FOR URBAN SAFETY

SECUCITIES DRUGS NETWORK

"pilot training programme on the prevention and treatment of drug dependence for elected officials and local leaders in small and medium-size towns"

1

Printed the 15th December 2001

By IMR – RENNES ISBN 2-913181-18-X English translation: Jacqueline Reuss

EUROPEAN FORUM FOR URBAN SAFETY 38, rue Liancourt 75014 – PARIS – France tel. 0033 – (0)1 40 64 49 00 - fax 0033 (0) 1 40 64 49 10 Internet : http://www.urbansecurity.org E-mail : fesu@urbansecurity.org

2

THE EUROPEAN FORUM FOR URBAN SAFETY

Writers: Nicole Chambron and Nicoletta Ratini

We would like to thank all the people whose experience and kind assistance helped make this project a success: Mayors and Deputy Mayors: Cyrille Tahay (Comblain-au-Pont, Belgique) Anne-Marie Lizin Vanderspeeten, Mireille D'Alessandro (Huy, Belgique) Philippe Robert (Tournai, Belgique) Danielle Delchambre, Jocelyne Desjardin (Waremme, Belgique) Jose Caballero Dominguez, Maria Isabel Sanz-Herrera (Alcobendas, Espagne) Valentin Martin Alonso (San Fernando de Henares, Espagne) Guy Geoffroy (Combs la Ville, France) Robert Guenat, Josette Guenat, Danièle Rebert, Valentigney, France) Antonio Donato, Anna Maria Simeone (Pagani, Italie) Claudio Adelmi, Mauro Ottavi (San Lazzaro di Savena, Italie) Professionals who accompanied them: Fabien Bassetti, Jacques Baudart, Stéphane Boichard, Michèle Bruffaerts, Marie Cabanillas, Miriam Consorti Paul Olivier Delannois, Guy Denonne, Solange Dijon, Denis Eyckmans, Elena Maria Fernandez Diez Nadine Forthomme, Rafael Gonzalez Garcia, Juan Carlos Gonzalez Sanchez, Maria Grazia Casalino, Giovanni Guescini, Clementina Izzo, José Luis Jimenes del Molino, Christelle Jousselin-Lainé, Pierre Leonard, Esther Martin Luna, Philippe Struvay Alexandra Thyssen, Ariste Wouters The "sponsor" cities: Barcelone (Carmen Vecino Santos, Carlota Gonzalez Rodriguez), Liège (Sophie Neuforge, Eric Adam, François Delire), Marseille (Dominique Reinosa, Gwénola Le Naour), Turin (Teresina Montenegro, Marco Bajardi)

C. Tascon-Mennetrier Programmes Director European Forum for Urban Safety

3

With the support of the European Commission, DG Consumer Health and Protection. “Neither the European Commission nor the persons acting in its name are responsible for any use that may be made of the following information.�

4

Table of Contents 1/ Introduction: Articulation of the Project’s Approach with the European Union’s Priorities 1-1 1-2 1-3

Towns and cities increasingly concerned by multiple drug addiction The European Union muster its forces to confront the drug issue EFUS organises debate with a view to action

2/ SecuCities - Drugs: the Project 2.1 2.2

Partners Organisation of Training 2.2.1 Trends in products and modes of consumption 2.2.2 Representations about drugs 2.2.3 Prevention strategies 2.2.4 Aid and support for drug addicts 2.2.5 Link between drugs and petty crime 2.2.6 Working in partnership 2.2.7 Involvement of the local population 2.2.8 Intermunicipality 2.2.9 Assessment

3/ Training Guidelines 3.1

Description of the Approach

4/ Training Proposal 4.1 Teaching Objectives 4.2 Organisation of Training 4.3 Teaching Programmes and Methods 5/ Conclusion

5

Preface A project involving exchanges among towns and grassroots players cannot be reduced to the summary content of an application for funding submitted to the European Commission. Such a document is too short to convey the underlying political considerations, or the perception of Europe and of the urban civilisation on which it continues to be based. The Naples Manifesto on "safety and democracy", which was approved by the European Forum, gives us a number of keys to interpreting towns.

The issue of drugs in Europe is commonly seen as applying to the big cities. This is an image we all share, influenced largely by the media’s portrayal of the drug scene. The big city is naturally the setting for all human perversity. At the same time, outside of the big city, there is no hope.

Helping to correct that image was the primary objective of this programme. Leaders from towns came to report that drugs affect their small communities, whose consumers procure their supplies on the big city’s market. It follows that the public authorities administering those small towns are likewise responsible for reducing the risks of such consumption and implementing prevention to dissuade young people from developing a consumption habit. Drug users too are inhabitants and citizens of small towns.

The programme’s second objective is to foster a commitment to drug prevention on the part of elected officials in small towns. This is not an easy task. It is more comfortable to close one’s eyes and cross one’s fingers, hoping that the problem will be dealt with by the town next door. The programme’s success demonstrates that elected officials are forging ahead with their eyes wide open. The determination to expand the network to include other towns shows that this awareness is more widespread than is generally thought.

What can be done when these services, depending in part on more elevated levels of government authority, focus their resources on the major cities?

How can the quality of services be maintained at a level commensurate with demand?

These questions raise another, more basic issue equality among the people living within a nation’s territory.

At the same time, this service obviously cannot be the same as that of a big city. This distinction lies not just in the issue of money, but also in a clear-minded analysis of needs. Consumers of illicit products very frequently lead a social life in close proximity with their surrounding community, which is more omnipresent. Discretion is of an essence! The availability of services must be more discreet, both when they are offered and when they are actually provided. Given the small number of professionals providing services to the population, they are obliged to show very considerable versatility. The specialisation of the person in contact with young people matters little, what counts is that he or she be capable of identifying their problems, convincing them to subscribe to a process and leading them to contact the appropriate person.

Such versatility, arising from the paucity of human resources, makes the need for training even more acute.

These human resources may include people in professions often quite unrelated to drug use. They must be recruited according to their ability to establish rapport with a youthful or even older public. The forum has on

6

many occasions worked with dance hall owners, whom we consider agents in prevention policy. There are dance halls in these towns, and there are other human resources yet to be discovered.

The first task, in short, is to create a territory-wide network of resource people and give them training; the second is for the big cities to accept co-operation, as the means to take into account some of the needs of the smaller towns. Most drug dealing continues to take place in large cities; the meeting ground is also a place where prevention and treatment are dispensed.

To give these policies greater coherency and strengthen their impact on people, the services should be linked to the individual’s place of residence, work or recreation. From that perspective, the need for co-operation among towns and cities is more crucial today than ever before.

The quality of the networking approach and the enthusiastic contribution of the big cities to this programme show that it is far more than just an experiment lasting a few months. It is living proof of a principle unifying the European towns and cities, and thus its citizens, based on mutualisation, sharing, and rationalisation in public policy.

Michel Marcus Delegate General of the European Forum for Urban Safety

7

1 – INTRODUCTION Articulation of the Project’s Approach with the European Union’s Priorities 1-1 Towns and Cities Increasingly Concerned by Multiple Drug Addiction The public policy issues posed by drug abuse come into play in several different fields, among them health, safety, social action, and education. The government plays a very predominant role in those fields, although local authorities have always played a complementary role, in handling community-focused functions and in promoting the strategies best suited to the local situation.

The AIDS outbreak in the early 90s obliged governments to step up their intervention in dealing with drug dependence, and the towns and cities had to devise or encourage more energetic prevention and treatment policies, in particular to reduce the risks of transmission of drug-abuse related diseases. The options taken by elected officials and the work of professionals were often misunderstood by the majority of inhabitants who, back then, did not see drug addicts as people having access to the law but rather as sources of problems and insecurity. At the time, drug addicts were perceived first and foremost as sick people, and policies on drug addiction were situated between the spheres of public health and law and order. Municipal authorities were increasingly called on to assume responsibility, and some cities developed genuine strategies.

Yet these were not conventional tasks or situations traditionally familiar to elected officials and municipal professionals. The difficulties encountered in dealing with drug abuse and drug addicts obliged them to work in interdisciplinary, and often novel, ways and fostered exchanges among professionals from differing backgrounds.

During the years prior to the discovery of AIDS, various types of responses, sometimes mutually contradictory, were set into motion all over Europe, ranging from experiments in the controlled use of heroin, in certain health services in England, to isolation in hardcore communities.

Lawmakers leaned towards certain solutions rather than promoting a civil and scientific debate among all parties involved, whether public or private, that could have produced an array of more co-ordinated responses, capable of meeting more effectively the highly complex requirements of drug addicts. As a result, a number of countries fell seriously behind in setting up services to counsel and treat drug addicts.

One of the obstacles to this debate lay in the pre-eminence ideology often took over methodology and in the deep-seated feeling of insecurity, even among policymakers, that drug addiction provokes, which prevented dispassionate consideration of the issue.

1-2 The European Union Musters its Forces to Confront the Drug Issue In 1992, the Treaty on the European Union referred for the first time to the fight against drug abuse as one of the requisite actions in achieving EU objectives. The Member States considered the fight against drug abuse as a common interest issue.

8

It is worth stressing that the use of the phrase “fight against drug abuse” instead of “fight against drugs” shows that the EU concentrated more on the individual than on the products or the consequences of abuse, which affect the cities’ populations as the victims of disturbance to their daily life. In that period, the EU’s preoccupations clearly focused on the drug addict, but not yet on the drug market and market-related organised crime.

A year later, the European Observatory on drugs and drug dependence was set up by the European Council.

Its task was to compile all the data useful in giving the European Community and the Member States a comprehensive overview on drugs and drug dependence when taking measures or defining actions.

In other words, the European Community recognised the need for a better grasp of the issue; the initial results of this awareness came to the fore in the following years’ Action Plans, considered common policy guidelines for all Member States and for the European Institutions.

The Action Programme for the years 1996-2000 was set up by the European Parliament and Council (16 December 1996), targeting two objectives indicative of the emphasis placed on inventorying and disseminating knowledge: -

“improve knowledge of the phenomenon of drugs and drug dependence and its consequences and of the means and methods of preventing drug dependence and the risks related thereto” “improve information, education and training”

The Action Programme is structured around annual work programmes, on which the European Commission’s invitations to tender are based. This means that the NGOs and public services working in the relevant area are called on to produce projects consistent with the actions proposed by the Commission.

The work programme for 1999 provides for a set of 16 actions organised according to 4 priorities: 1 – New synthetic drugs, multiple-drug dependence and young target groups; 2 – Prevention of relapses into drug dependence; 3 – Particularly vulnerable groups; mobility and prevention; 4 – Improvement of practices in Europe.

Our Secucities–Drugs Project ties in with the fourth priority and more specifically with the action which plans to: -

“support the development of further training programmes, teaching materials and modules for those likely to come into contact with drug users and groups at risk, including in particular social work, health care, police and other law enforcement professionals; promote multidisciplinary co-operation and co-operation between the public and private sectors, including NGOs, with a view to preventing drug dependence.”

In October 1999, the European Union once again broached the issue at the Tampere Council, which declared that “a high level of safety within the area of freedom, security and justice assumes an effective, comprehensive approach to

9

combating all forms of crime” and stated the necessity for instituting a co-operation programme for which one priority would be the fight against urban and drug-related crime.

The difference in the expressions used indicates a change within the Union. Over the years, declarations, Treaties and Action Plans have clarified the principles of action, objectives and respective roles. The purpose of the Treaties is to establish the political priorities, the action plans and the resulting invitations to tender. Translating political options into actions fosters exchanges, pooling of best practices and sharing of views among European professionals and in some cases notably within the European Forum for Urban Safety between professionals and elected officials.

The “Consumer Health and Protection” Directorate General is in charge of formulating priority actions to enhance knowledge and practices in the field of public health; the “Justice and Internal Affairs” Directorate General is in charge of formulating actions to enhance knowledge and practices relating to crime control, including drug-linked crime.

In light of the conclusions reached at Tampere on the topic of combating organised crime and drugs, the Helsinki Council in December 1999 formally acknowledged the European Union’s anti-drug strategy for 2000-2004 and invited the relevant institutions and bodies to proceed rapidly with its implementation through the Action Plan.

In this latter Plan, the Commission, assisted by input from the European Observatory on drug abuse and drug dependence and from Europol, reports on the recent trends in consumption, noting a stagnation in cannabis consumption, still the most widespread drug in the EU, and a rise in amphetamine consumption and in the misuse of medicines.

In the communication on Community strategy in health matters produced by the Commission in June 2000, these data were updated and indicate that, although the consumption of so-called hard drugs and drug use-related deaths seem to have stabilised in the late 90s, drug consumption continues to be a very widespread phenomenon. Consumption of such products as cannabis and amphetamines is particularly prevalent among young people and the inhalation of solvents is a practice encountered among teenagers. Moreover, it reports a rise in pharmaceuticals abuse by adults, often in combination with alcohol consumption.

Clearly, then, toxic substance abuse is not declining but on the contrary, despite shifts in the kinds of products consumed, increasingly widespread.

Again with respect to that Plan, several aspects are particularly important, especially for those who, like EFUS, have always focused on the role of towns and cities in policy implementation. It recommends a comprehensive, multidisciplinary, integrated approach to the fight against drugs, shows an awareness that drugs involve social and health concerns that must be taken into account, and emphasises the need to build a balanced approach between demand reduction and supply reduction.

Lastly, the Plan recalls that the Amsterdam Treaty imposed the integration of health concerns in all Community policies and actions. Consequently, drugs are a priority in Community action on public health matters, as they are a priority for co-operation in the fields of justice and home affairs.

10

In May 2001, the Council of the European Union, noting the Tampere conclusions, decided to reinforce the crime prevention network by setting up a "European Crime Prevention Network", to help advance knowledge about criminal phenomena and the effectiveness of prevention policies. One of the areas to which the network is committed targets drug-related crime.

The first programme presented by the Network stresses the need, specifically in that field, for prevention to be deployed through social and health policies and for law enforcement and crime control to be co-ordinated with prevention and treatment.

1-3 EFUS Organises Debate with a View to Action Meanwhile, the European Forum for Urban Safety, a network of European towns and cities, examined the role of municipalities in implementing policies on safety and the fight against social exclusion.

The assumption is that towns are the place where the contradictions and difficulties must be managed and where, in that respect, citizens are closest to the decision-making powers. This proximity, a factor in the relevancy of options, also fosters the population’s involvement and assumption of responsibility in issues that are at once social and the business of specialists, which is precisely the case of drug dependence.

In addition, towns are the place best suited to the implementation of experimental actions, partnerships and other such activities. Furthermore, the citizens mandate their local officials directly, giving the latter the authority to demand that the State respond to problems of national import.

For that reason, EFUS began in the early 90s to participate in disseminating knowledge and exchanging experiences and practices, through a number of European programmes set up and grouped together under the name, “Secucities-Drugs�.

Some of the topics dealt with during those years anticipated the future, in that certain questions analysed were only recognised as key issues much later on: -

-

Local strategies for HIV risk prevention among drug addicts - Methodological guide for use by elected officials in municipalities (1992-93) Drugs and AIDS: the Med-Urbs network (1992-93-94) involving Maghreb towns Reduction of risks (HIV) among drug addicts: Effort to reconcile the increasing reliance on records used in monitoring addict management and treatment, especially for those following a methadone substitution programme, and the necessary protection of individual rights (1994-95) Drugs and Prostitution - SecuCities Europe Network (1996) Cross-border routes in drug-related matters: Study (1995-96-97) Involvement of inhabitants in local prevention and drug dependence control strategies (1998) Urban Safety Practices in the field of drug dependence (1998) Prevention of drug addiction at primary school level (1998) Relevancy of Prevention messages (1998-99) Organisation of safety and socio-sanitary prevention within the framework of major musical events

11

In 2000, the hypothesis that small towns, just like their larger sisters, are confronted with drug consumption and the changes in behaviour it induces led EFUS and its partners to propose the SecuCities-Drugs project to the Commission to "create the beginnings of a network of small and medium-size towns in Europe in order to train elected officials and fieldworkers in the prevention and treatment of drug dependence".

This hypothesis was confirmed in the course of seminars attended by the professionals and elected officials, who stated with surprise that no difference exists today between large cities and small towns, even those in rural areas, as far as drug consumption is concerned.

There are several reasons for this: - Proximity with a large city: many small towns live under the influence of large cities, which act as magnets for work, leisure activities or shopping. Major progress has been made in transport infrastructure, making access easier.

- Young people are especially attracted to those large cities for their leisure activities, studies and shopping.

- The policies implemented by large cities, particularly with regard to housing, sometimes cause the most destitute to move to the outskirts of small towns, where the cost of living is lower and control less aggressive.

- Pushers find some of their regular customers among the new inhabitants of small towns. They rapidly realise that dealing is facilitated by the abundance of locations under little surveillance.

- With the changing pattern of drug consumption and the rise of new products, consumers can now lead a regular life and not see themselves as needing treatment, and young people in the smaller towns are also beginning to see consumption as “fashionable�. This has imposed a new job on professionals, that of finding how to set up prevention programmes directed towards a population which does not consider the occasional consumption of new drugs as dangerous.

- New types of parties, closely associated with drug consumption, have gained widespread acceptance among young people, both urban and rural.

Differences in the size of towns and cities, however, lead to a series of distinctions: - the inadequacy of facilities and means for prevention, counselling and treatment in small towns - the inadequacy of human and material resources - the population’s much more recent awareness of the stakes involved, the potential strategies, the ways in which the social body and institutions can react - a greater unfamiliarity with the products and behaviours; however, this is changing among non-specialised professionals, decision-makers and inhabitants.

To enable towns of that size to share experiences and practices and to succeed, with their input, in designing specific training, EFUS decided to bring together elected officials and professionals in various fields and form a pilot network.

For an entire year, this network produced a series of studies on the fundamental issues that elected officials and professionals should broach, among themselves and with others, in order to implement and supervise actions for drug abuse prevention and drug addict follow-up.

12

In keeping with the EFUS principle of mutual assistance among towns, four “sponsoring” cities were asked to participate in the seminars.

Through their attendance, the partners were able to learn about their most outstanding actions, working methods and ideas, that have been tried and tested over time. The sponsoring cities in turn had an opportunity to learn about the innovative actions devised by the smaller towns which, for lack of resources, had to rely on their imagination.

Thanks to all the partners’ commitment and to the contribution of a training specialist, training guidelines were devised and then validated by the participants as a whole during the final seminar. These guidelines provide the material for building a training model which could be duplicated.

2 – SECUCITIES – DRUGS: THE PROJECT 2 - 1 Partners The implementation of actions for treatment of drug users and addiction prevention is still a difficult matter.

Everyone feels entitled to take judgement on and intervene in decisions; the debate makes it clear that professionals and elected officials still have to handle with the population the conflict between the need to broach the subject and the fear of making it an issue, the compromise between the need to treat drug addicts and a refusal to have that done close to home, or the ambivalent attitude towards drug addicts, which are seen at once as young people suffering from an illness and juvenile delinquents.

At times, this same conflict opposes professionals and elected officials: the former are not faced with the difficulty of explaining and having their choices accepted by the citizenry, but their task is complicated by the inhabitants’ condemnation and rejection, whereas the latter are responsible for coping with the citizens’ feeling of insecurity and meeting the demand (sometimes impossible) for eliminating its causes.

Two arguments weigh in favour of choosing to have an elected official, a local or regional civil servant and a community leader participate for each town: - the ability to work with representatives of the town’s officials and professionals in order to experiment with interdisciplinary work and mutual communication. Often, even in small towns where logically policy-makers and professionals should be able to relate more easily, little dialogue and exchange occurs on a regular basis. This is not a question of organisation (which is in fact easier in small towns), but rather due to their differing roles and to the hierarchical relation that may render communication more difficult. Moreover, where drug dependence is concerned, for all the reasons already discussed, there is a vital need for exchanging and confronting viewpoints.

- a " local coalition" has to be set up, which can continue to think and work together, while at the same time maintaining their relations with the other participants.

The following towns and cities participated in the project: Comblain-au-Pont, Huy, Tournai, Waremme (Belgium),

13

Alcobendas, San Fernando de Henares (Spain), Combs-la-Ville, Valentigney (France) Pagani, San Lazzaro di Savena (Italy) And the sponsoring cities of Barcelona, Liege, Marseilles and Turin.

2-2 Organisation of Training In the course of a year, the partners met five times.

Seminars were held in: Huy, on 15 to 18 March 2001, Alcobendas, on 10 to 13 May 2001, Paris, on 11 and 12 June 2001 Comblain-au-Pont, on 5 and 6 October 2001.

The organisation of the work in seminars enabled us to hold group discussions and role-playing sessions, to work in subgroups, and carry out individual exercises. By experimenting in playing various roles, elected officials and professionals were able to “see the other side” of the problem, to put themselves “in the other’s skin” and gain a better understanding of their respective responsibilities.

The various partners were able to compare their reality with that of others, see that they were confronted with the same problems and realise that some of the solutions found, seemingly rooted in a specific national reality, could also be exported and adapted, possibly becoming more “European”.

The topics proposed during the seminars dealt with concrete aspects (urban issues, the state of knowledge about drug addiction, the links between drugs and small-time crime), personal approaches and group dynamics (representations on drugs, on professionals and on roles), methodological aspects (partnership work, prevention strategies, support and assistance for drug addicts, citizen involvement in the strategies to be implemented, the construction of intermunicipality, programme assessment).

By compiling and summing up all the discussions, the ideas put forward individually and in groups, the exercises, the descriptions of local actions and the role playing, a proposals was formulated for the training and training guidelines.

To help our readers understand the multiple content of this collective effort and benefit from the experience of the working group, we have outlined the main themes in the following sections and appended data sheets on practices prepared by the partners, to serve as examples.

2-2-1 Trends in Products and Modes of Consumption During the partners’ first meeting, comparisons clearly underscored the similarity of large cities and small towns as regards products and modes of consumption.

Proximity to large urban centres facilitated knowledge and acquisition.

14

The data provided by the participants highlighted a change in drug consumption.

For example, intravenous heroin, considered a taboo because of AIDS, now tends to be inhaled to limit the “down” following cocaine consumption, although professionals report cases of young people starting to use heroin, still inhaled, as an initial drug, without having tried other products previously.

Alcohol consumption has risen sharply among young people. The mode of consumption is relatively new: outside of meals, before beginning the evening, in large quantities, to get drunk right from the outset.

Cocaine is used increasingly, encouraged particularly by a drop in price. Young people consume it on weekends, adults much more frequently.

In that respect, the city of Barcelona reported a rise in the number of deaths due to heart attacks, which toxicological analyses determined were linked to the consumption of stimulant drug cocktails.

The press has not yet made the connection, and users do not perceive the risk.

The behaviour of young people is nearly the same throughout Europe and is linked to the use of drugs as a kind of “fashion”, a “plus” for the evening’s entertainment.

This attitude leads to an unawareness of the risk, the idea that there is no need for treatment, that one is not addicted.

Services will within a few years be facing health problems due to drug abuse and will probably have to seek solutions for types of dependence or suffering not yet foreseeable today.

15

The comparative table for the cities and towns is given below.

Spain Cocaine

Heroin Ecstasy Cannabis Tobacco

Poly-consumption (pharmeceuticals and alcohol) Alcohol L.S.D. Hallucinogenic mushrooms Amphetamines Speed SASSI (solvent) Energy drinks Ketamines Poppers G.H.B.

Belgium

X small market X large market age 30-35:regular consumption; young people: weekend consumption X X Leisure X Leisure X Explosion X Explosion Increase mainly Increase mainly among young women among young women and girls and girls X X

Increase and at a younger age

X

France

Italy

X small market

X drop X Leisure X Explosion Stable

X large market; age 30-35: regular consumption; young people: weekend consumption X drop changing use X X Explosion Stable

X

X

X

X

X X

X X X (Barcelona) X (Barcelona) X (Barcelona)

X X X X

X (Pagani) X (Pagani)

X (S.Lazzaro)

16

2-2-2-Representations About Drugs How do our representations affect the measures and policies we implement?

With regard to drugs, it was found that they are frequently associated with feelings of fear and insecurity, a link which complicates the professionals’ work and the policy options taken, as was pointed out earlier.

According to a number of specialists, drugs generate fear in people which most of the time cannot be linked to a real, identifiable danger in their personal experience, although with some basis in reality (drug addicts do exist and in increasing numbers), they also raise the spectre of social cleavage and a loss of common points of reference.

If we consider the extreme tolerance for alcohol as opposed to drug consumption, even though the social damage relating directly or indirectly to alcohol is far greater than that caused by drugs, we realise that, in a society for which communication between equals is the founding element of the social contract, alcohol is perceived as a factor of sociability. Drugs (the type matters little) signify a break in the social bond and a threat to communication of any kind.

The representation of the drug addict as a person withdrawn from the outside world and bonding with a product is thus usually that of a person rejecting communication and socialisation. This image is the most difficult to eradicate, despite the fact that new products have now brought to light a new type of consumer, integrated, healthy looking, who has a job, and so forth.

Through a word-association exercise on drug addiction (“What word do you associate with drug addiction?”), we were able to reflect together on the need for working on our representations (which are also those of most other people), which have perhaps not yet integrated the new behavioural patterns, products, and health problems among this century’s users. We need to try and avoid the trap of clichés like “drug addict = young, needle, rave party” or “drug addict = dependence, withdrawal, violence, isolation” and on the contrary constantly seek further information, so that we can better understand trends in the market and the products that modify lifestyles and customary behaviour, as well as the link between social changes and changing uses and products (“every society engenders its own specific kinds of drug addicts” - C. Olivenstein).

This exercise is a useful tool in verifying the state of our representations and, in some cases, in starting off meetings with unfamiliar partners.

Through this exercise, our partners further reminded us of the fact that, while drug addiction continues to cut across several spheres, including health, the law and education, as we already knew, it enters equally into the sphere of power in the form of money, drug dealing and organised crime This means that work has to be coordinated with everyone in the field, with inhabitants and elected officials, and that, when working together, we must also take into account the representations we have of others, of their roles, the images they convey to us and vice-versa.

Usually, in the course of multidisciplinary encounters, we never talk about the role our representations of others and our expectations play in the discussion.

The work on representations that we developed in the seminar showed us that the representation of certain roles and functions may be truncated or partial. For instance, we may focus far too much on the law and what tasks it

17

should accomplish or, on the other hand, we may see the elected official as someone who exercises substantial power but lacks close ties with the citizenry. We may perceive the police as a body for control, law enforcement and surveillance but not for information, or the welfare worker as “an office, a phone off the hook, and stacks of files”.

If we do not find the means to identify our preconceptions and discuss them with others, the result may be conflicts or misjudgements. If, on the other hand, we deal with the subject, we can open the way for developing more in-depth analysis and seeking genuinely shared objectives, while at the same time preserving our respective differences.

2-2-3 Prevention Strategies In the 80s, the designated place for prevention was in the schools and the targets, young people at the secondary level (high schools). Prevention was aimed at avoiding drug consumption and addictive types of conduct. The debate at the time was heated (today still, some wonder whether talking about products may not cause young people to want to try them). The message was anchored in the danger that drugs represent, in the hope of fostering rejection on the part of young people.

After it was realised that drugs were not a passing phenomenon, that the advent of AIDS worsened the problem and that the issue involved other aspects to be dealt with, the target population for prevention broadened and became differentiated. Professionals began setting up risk prevention programmes directed towards users and prevention actions in schools aimed at teenagers. Through interdisciplinary work and enhanced knowledge, professionals were able to better understand the possible causes for becoming an addict, leading them to devise prevention actions targeting children and pre-adolescents. These actions place greater emphasis on achieving a more overall wellbeing, relying additionally on building up self-esteem and self-reliance.

Whatever the case, the task implies being on an equal plane with young people, who are quick to pick up information through the media or simply from the environment in which they live, and who judge the credibility of what they hear on the basis of its honesty and intelligence, not on a condemnation of the evils of prohibited products.

All of the partners stressed the importance of avoiding a “moralistic” attitude in relating to young people and instead maintaining an ongoing presence, so that they can develop a trusting relationship with the professionals, on which the beginnings of a truly educational rapport can be built.

Prevention today has developed in several fields and its objectives have been differentiated according to the needs of the population it addresses, including drug users.

As an example, the aim of prevention directed at consumers of synthetic drugs and alcohol during a rave party may be to prevent dehydration or to tell them what their alcohol level is when they are leaving so they can decide whether or not to drive their car.

There are still several open questions regarding prevention: Does a generic approach exist in prevention?

Should prevention be oriented solely towards a vulnerable population?

Should prevention be the same for all age groups?

18

Should prevention be implemented solely in places where social problems have been identified?

It is worth remembering that all prevention necessitates action, but is defined by the objective it pursues and the social relationships it engenders. All the more reason for prevention to be the subject of genuine debate, open to everyone, leaving behind prejudice and preconceptions. ( A. Morel, PrĂŠvenir les Toxicomanies, Dunod, 2000, page 2).

The data sheets given below are examples of prevention action. It is worth noting that, depending on the action’s target group and on the objectives to be reached, the venues, proposals and partnerships chosen for the data sheets differ.

19

Key words: young people, alcohol, leisure, sex, discotheques Background: Lack of leisure facilities for young people without alcohol consumption or with moderate consumption Perimeter: Municipality and city of Alcobendas Objectives of the action: Lower alcohol consumption, leisure activities, places offering alternatives to discotheques, reduction in road accidents on weekends.

Action piloted by: Consejo juventud Coalition: Youth Council, Health Service, private companies.

Strategy implemented: “Thousand and One Nights” is a programme created on the initiative of young people and developed by them. It addresses young people between 25 and 30 years old. The objective is to discourage alcohol consumption. Activities are free, 62 associations participate in carrying out this programme. There are some 200 leisure activities organised throughout the year.

The activities take place at night and are taken in hand, managed and run by the young people themselves. They take part in creating, making decisions, managing and supervising the activities. The municipality loans them the facilities, which must remain open at night.

Budget: Facilities and equipment = 20,000,000 pesetas which will be spent to the limits of the budget Primary impacts: 1,900 young people/weekend. Major political visibility with the citizenry. Reduction in road accidents and violence. Evaluation of public health interventions under way.

Signs of success or factors of success: Night-time disturbance Fear of problems arising from the high concentration of young people Obstacles and/or shortcomings: Obstacles: money, neighbourhood, Prospects: good for the programme’s operation.

Action venue: Alcobendas (Spain)

20

Key words: Children – Tolerance – Solidarity – Growing up – Affection Background: Deviant behaviour (consumption, violence, bullying, etc.) that appears very early on among children – lack of harmonisation in the behaviour and messages conveyed by those in charge of children’s daily education Perimeter: 10 municipalities in the Ourthe-Amblève Region Objectives of the action: Give children the possibility of making informed choices – Develop self-esteem – Learn to live together in harmony with one’s environment – Improve consistency in education – Give teachers the resources and tools to lead sessions on day-to-day prevention Action piloted by: Action en Milieu Ouvert (AMO), “la Teignouse” Coalition: Municipalities, school principals and teachers, the students, the parents, AMO, the medico-psychosocial Centres, the Regional Council, the French Community of Belgium, the Regional Prevention Service Strategy implemented: see reports – 3-day training session for teachers plus further training – Exercise in real-life simulations – Sharing of knowledge and practices – Apprenticeship in group leadership techniques for meetings with parents.

Budget: 50,000 euros per group of 60 teachers, per year Primary impacts: Creation of dynamic interchange among the teachers in the various networks – Improvement of parent-teacher, student-teacher, child-parent, teacher-teacher relations.

Signs of success: Decrease in acts of delinquency – Greater cohesiveness within the groups of children – More parent participation Obstacles and/or shortcomings: the financial burden – opposition on the part of certain divisions – competition between the various teacher networks.

Prospects: Continuation of the project with new teachers – Periodic assessment with the trained teachers – Stimulation of the networks Action venue: Belgium, 10 municipalities in the Ourthe-Amblève Region

21

Key words: Mainly 12-18 olds – Exhibition, debate – Information on the products and reduction of risks Background: City with a population of 10,000 students – No prevention programme implemented – Rise in consumption and problem consumption – Commitment by the schools – Misapprehension or lack of information on the issues - Ambiguity of the legal framework Perimeter: Schools in the city of Huy and surrounding area – The French Community Objectives of the action: Information – Reduction of risks – Responsible consumption Action piloted by: The city via its “drug plan” Coalition: City, schools, medico-psychosocial centres, Home Office, French Community, SPP Strategy implemented: The city’s professionals worked out a an obstacle course for school students, which “immerses” the young people in situations reproducing the most basic aspects of drug addicts’ lives and giving a sense of their suffering, hallucinations, harm, pleasure and so forth. The course is followed silently by the young people, and has to include a debate that can continue in the schools. They have an opportunity for individual talks. One a week, they can run through the course again with their parents, friends, or acquaintances.

Budget : 75,000 euros: Home Office and French Community Primary impacts: Rise in the number of requests for visits – Recognition of the project by the schools Signs of success or factors of success 10,000 visitors in 2 1/2 years - Debates pursued within the schools – Parental awareness raising – Pilot project recognised on national and European levels Obstacles and/or shortcomings: Budget – Considerable staff investment Prospects:

22

Action venue: Huy (Belgium)

23

Key words Conviviality – exclusion – temporary housing – consumption - prevention Background: absence of places to meet, support for marginalised sectors of the population, response to a policy of eliminating housing, reduction of risks.

Perimeter: 10 municipalities: semi-rural, rural, near a city Objectives of the action: Help people assume an active role in their lives – Recreate a social fabric (re-socialisation) – Create a place for expressing concerns about housing uncertainties – Creation and presence of a team of social workers at young people’s evening get-togethers.

Action piloted by: The municipalities via “La Teignouse”, the Regional Prevention Service Coalition: Municipalities, inhabitants, young people, employers, owners, the Regional Council, the Integrated Pilot Action, Camp site, Public Welfare Assistance Centre, in-the-field action.

Strategy implemented (diagnosis, action plan, description of the action, assessment, communication) Precariousness and eventual disappearance of this living space planned by the regional authority – Provision of a mobile facility (the “Air Bus”) arranged as a meeting place and a team of workers to provide information, meet with and support various sectors of the population.

Budget: (costs and funding) 50,000 euros per year / the contracting municipalities and private foundations.

Primary impacts (practical results of the policy/ action) Raising the inhabitants’ awareness of the real facts of their lives and the actions they can undertake together – Information on products, types of consumption, consumption levels and status.

Signs of success or factors of success Return to more wholesome housing – Eliminating certain abuses by owners– Increased awareness of drunkenness as a condition. – Avoidance of accidents Obstacles and/or shortcomings: Cost of the project – Opposition from the organisers of parties – Temporary employment status of the staff.

24

Prospects: Continuation of the project – presence on other (new) sites Action venue: Belgium – 10 Ourthe-Amblève municipalities

25

Key words: Drug habit / Addiction, Drug user prevention / drug dependence in schools and halfway houses Teenagers Teachers Parents Educators Background (report behind the implementation of policies/actions): The experience initially acquired through contact with drug users, especially heroin addicts, led the network team to think about primary and secondary prevention strategies. Called on continually by the educational community and social workers dealing with young consumers of narcotics, the workers broadened the scope of their action and began reflecting and acting on the latter’s situation.

The existence of many huge dance halls in the region, the rise in cannabis consumption among young people, the high alcohol consumption, and the development of new prevention policies to meet the needs of certain professional circles led to the establishment of institutional projects.

Perimeter: Greater Tournai.

Objectives of the action: Citadelle, in conjunction with Canal J (AMO, an in-the-field aid organisation), runs a prevention programme targeting young people in their living environment (schools, boarding facilities) and aimed at giving the adult supervisory personnel a better understanding of the problems facing young people. The focus is on drug habits and more effective handling of situations arising out of licit and illicit drug use.

Action piloted by: A two-headed partnership operating according to a shared management process: ASBL Citadelle, Drug Dependence Help Network, Tournai, and Canal J, AMO, Tournai.

Coalition: This partnership was set up in 1997 to carry out the prevention programme.

Strategy implemented (diagnosis, action plan, description of the action, assessment, communication) Working orientation

26

With Canal J, the partner in-the-field organisation, Citadelle proposes institutional work: information, training or support (by educators, teachers, directors or MPS centres) in prevention approaches, assistance in group leadership, organisation of discussion, exchanges, dissemination of specialised documentation, organising and youth support tools, etc.

The approaches are set up within the institutions and may be medium or long-term. They are carried out after demand has been analysed, and care is taken to assess the actions. In practice, the process is participatory, on a group and community level, and meetings with young people set the orientations for action. Social workers lead the exchange, information or training sessions. They launch, structure and co-ordinate the actions worked out by the establishment’s staff.

Budget: This programme is funded by the French Community (Health Promotion, Mrs. Maréchal, Government Minister).

3,500,000 Belgian francs.

Primary impacts (practical results of the policy/action) Promotion of thinking and debate in the environments in which young people live, establishment of space where opinions can be voiced and the various members of educational teams can discuss.

Greater consideration, closer representation of consumers of psychotropic drugs, more effective handling of drug userelated situations.

Construction of places and facilities for exchanges between young people and adults, production of community-based prevention tools, clarification of the establishment’s management.

Signs of success or factors of success: The actions taken within the institutions help put the “drug” phenomenon in a more realistic, less alarming light, foster a more subtle approach to the questions posed by young people’s behaviour (less direct exclusion, etc.) and promote more consistent, relevant management of situations involving drug consumption or trafficking phenomena.

Encouragement of a participatory climate in the establishment Obstacles / shortcomings: Beyond the budgetary aspect and for lack of time to complete all of the activities the team has planned, we might also mention a series of questions raised by the issue of drug dependence and habits itself: o The “drug addict” label and the concomitant preconceptions o The changing references in drug habits, in terms of vocabulary, usage, products, place of consumption o The laws and the modifications currently envisaged (plan to decriminalise cannabis), which are sources of misunderstandings and contradictory situations in which no one (whether professionals, teachers, parents or young people) really knows exactly what is permitted or not, o etc.

27

Moreover, the basic training for adults is often inadequate when the public, and more particularly teenagers, make demands for an “additional” position of “educator”.

Prospects: Commitment to broadening the action.

Action venue (country, city, neighbourhood): Greater Tournai. (Belgium)

28

2-2-4-Aid and Support for Drug Addicts Even though heroin consumption is considered stable and the new drugs have changed the habits of new consumers, which we can no longer define as individuals in a state of addiction, there is still an awareness that the number of addicts is growing and that they need support and treatment.

Many years of experience have shown us that dependence is very difficult to treat and heroin causes harm at every level - juridical, economic, social, relational, family, and health amongst others. This drug addiction requires huge efforts to produce the necessary treatments and improve the heroin addict’s situation.

Therapies that extend the life of drug addicts suffering from AIDS do not solve their problems of dependence and precariousness.

We know that drug addicts need time to overcome their dependence, and a good number suffer relapses during treatment. Professionals are increasingly sensitive to the drug addicts’ time frames and strive to protect their health as much as possible until they are able to keep off drugs for a prolonged period.

Drug addicts undergoing treatment with substitute drugs often cannot find a job or a place in society; they are stigmatised and discriminated against by other citizens, discouraging their incentive to succeed.

Several responses were set up in recent years: drug substitution therapies, psychological and financial support, needle exchange systems, low-threshold counselling centres, etc., with differentiation in those responses depending on the type of need.

Professionals are faced with two additional problems: how to reach drug addicts who do not come into the centre even though they are suffering from withdrawal; how to help drug addicts whose life has so far deteriorated that they consume heroin right out in the open, without the requisite sanitary precautions, causing panicked reactions among the involuntary witnesses?

The answer to the first question most often chosen by towns is for professionals in a specially outfitted bus to drive around neighbourhoods and carry out short-term actions (e.g., needle exchange, methadone therapy, medical counselling), thereby maintaining contact with consumers who have not yet decided to undertake a withdrawal and treatment programme.

Some towns chose to set up facilities in which drug addicts can take their heroin dose in a sheltered place under good sanitary conditions, where doctors and nurses are ready to act should the need arise.

Does that mean that society has failed and the professionals’ hopes have been dashed? Is it a humane gesture towards these people’s condition? Is it a sign of respect towards these carriers of an illness that affects body and mind? Is it a response to reassure ordinary, integrated citizens who do not want to see? Is it yet another way of isolating drug addicts by shoving them to the margins of the town? The answers have still to be found.

2-2-5 Link between Drugs and Small-time Crime In small and medium-size towns, drug dependence produces small-time crime (trafficking stolen cars, minor swindles, burglaries) and, above all, a feeling of insecurity. In certain towns, introducing methadone brought

29

down small-time crime linked to consumption and lessened the perception of drug addicts as dangerous individuals.

However, annoying and rude conduct linked to multiple-drug consumption on weekends rose, as did road accidents.

Proximity to large cities facilitates buying drugs, but dealing is often individual and solitary.

In countries where immigration is on the rise, the final stage in drug dealing is in the hands of immigrants, oftentimes illegal. Sharing of information with the police (municipal or national) differs greatly depending on the city, and the debate on this issue is still open.

Nevertheless, it is difficult to gauge the exact extent of the phenomenon, and the police force in Liege (a sponsoring city which took part in this discussion) did not see a convincing relationship between the crime statistics and drug dependence. “While a growing phenomenon of drug dependence has certainly been reported, along with an increase in certain offences (robbery, theft in cars, etc.), no specific study or indicator exists that could measure the relationship between those acts and the potential number of drug users�.

The lack of relations among the institutions holding the data (police, justice, medical services, chemists, educators, etc.) has prevented a comprehensive overview of the issue and the development and cross-comparison of indicators that could, after several years, give reliable information on the link between drugs and small-time crime.

Several countries have set up local observatories in which the professions as a whole are represented and whose purpose is to compile, analyse and pass on all the data, in keeping with ethical rules.

2-2-6 Working in Partnership As we all know, drug addiction is a problem that concerns people in several different spheres - the police, treatment services, justice, school, the municipality, health and social services, and others.

All of them come to realise that their action has limits and that taking charge of drug addicts implies combining and co-ordinating various complementary responses. There is equally an awareness that users will not envisage a proposal, whether for treatment, drying out or rehabilitation, unless they are ready for it.

As a result, partnership in this field must address very specifically the need for adaptability: users may be approached via a needle distribution bus and then accept a process of treatment and integration, they may come in to apply for welfare benefits and then agree to start treatment, or again they may be arrested by the police before accepting detoxification.

Professionals of all kinds have succeeded in stabilising the interdisciplinary approach experimented in the early 90s. Today, the institutions need to gain mutual awareness, share their operating methods and discuss the problems they encounter in dealing with drug addicts; professionals should be encouraged to voice their difficulties in order to alleviate tensions and deficiencies in the quality of counselling, generated by stereotyped attitudes and fears. This has become even more necessary with the diversification of those involved in recent years: in addition to the traditional response of treatment, there are now teachers, social workers, community organisers and others who have no training and often little information.

30

The next step is to try and define, not specific actions, but rather co-ordination guidelines, in accordance with the particular background and past of the addict.

During the training, whenever role playing on partnership work was introduced, we noted virtually identical attitudes: a difficulty in opening the discussion, a tendency to cling to one’s own institutional functions rather than share responsibility, an inability to find common aims, an inability to overcome the representations that each has of the other.

Such co-operation is completely new and still difficult to achieve.

31

An experiment in partnership in Liege Key words: Severe distress – “hot potato” –reduction of risks – local co-ordination.

Background: The city of Liege, like other large cities in the years between 1985-1990, experienced a rise in the number of misdemeanours. This increase was attributed largely to people falling into the general category of “drug addicts”, the users of illicit drugs.

The city centre faces the reality of a “drug scene” composed essentially of severely marginalised multiple-drug users.

Their presence exercises a strong drawing power on drug addicts in neighbouring towns who in turn become just as dependent and excluded from society.

In addition to the aspects relating directly to drug addiction, the problems arising from this group’s presence cause strong feelings of insecurity within the population.

It should be noted that drug consumers finance their addiction in part through prostitution, soliciting and begging. Much of urban crime as well originates in the need to find money to buy drugs.

Stemming from these new problems, both the population’s feeling of insecurity and the situations encountered by professionals in the field are among the local authority’s priorities for action in line with Liege’s Urban Safety Contract since its inception in 1993.

Perimeter: neighbourhood, city, urban area City of Liege population 200,000.

Objectives of the action: Cope with drug issues from the viewpoints of security, prevention, health and social welfare. In collaboration with the fieldworkers.

As its overall objective, the city continues to promote integrated policies on drug dependence through co-ordination and joint action in the various sectors concerned with drug issues (social welfare, health, police, justice, administrative authorities and prevention).

Action piloted by: Co-ordination of Actions on Drug Dependence – Urban Security and Social Contract of the city of Liege Coalition: Public sector and associations:

32

-

Public Prosecutor.

College of Pharmacists.

Pharmacy Inspectorate.

Hospital emergency services.

Medical Association.

Provincial Medical Commission.

Forensic Medicine Department of Liege University (ULG).

ULG Toxicology and Food Sciences Department.

ULG Public Health and Epidemiology Department.

Liege Province Health and Environmental Services.

Group for the development of the medico-psychosocial sector (public and semi-private).

Street educators.

Police.

Gendarmerie.

City services for the Urban Security and Social Contract.

Strategy implemented: An inventory of resources, as well as obstacles, was drawn up with all of those concerned with the issues.

Low-threshold assistance aimed at stabilising and reducing risks in that sector of the population, marginalised and/or breaking social and family ties, and going beyond a medical approach or rehabilitation was lacking.

The implementation of front-line emergency support for that population was an initial step towards solving the problem.

In general, welfare aid systems operate according to the following stages: emergency reception unconditionally day and night; prevention and psychosocial assistance; stabilisation of critical conditions; referrals to the conventional assistance and treatment sector.

This is where the Co-ordination of Actions on Drug Dependence comes in, to co-ordinate all of these systems on both a practical level and in terms of more comprehensive consideration of the drug dependence phenomenon.

Primary impacts: The repercussions relating to the front-line measures in the Drug Dependence Plan, among them reducing public nuisance, re-motivating the second line and reducing social and sanitary risks, knock-on effects that were identified, are positive.

The overall impact of organising concerted action on a local level with all sectors concerned is to objectify and evaluate the practices of the people and institutions involved so that they harmonise their actions. The specific aim is to consolidate co-operation between the judicial system, the police, prevention and health.

Signs of success:

33

In order to manage this institutional crisis, the Co-ordination of Actions on Drug Dependence works on a multidisciplinary, multi-sectoral, multi-institutional basis, essentially to step up the existing resources and measures so that professionals, drug users or anyone else involved can find a solution tailored to their situation.

The service operates as a regulatory mechanism allowing for both concerted action and periodic readjustments between the front line and the second line.

Prospects: The implementation of a local drug observatory is an initial outcome of concerted local policy action.

An additional purpose is to provide citizens, professionals and policymakers with the information they need to carry out relevant preventive action, in terms of both public health and delinquency and crime.

Action venue: Belgium, City of Liege.

34

2-2-7 Involvement of the Local Population “Drugs, drug users, trafficking, and all of the nuisances that have been more or less associated (small-time crime, AIDS, gangs and so forth) have sometimes been the cause of violent reactions (opposition to the installation of a treatment centre or exposure of trafficking) and in any case brought many tensions and conflicts to a head that local officials and authorities have had to manage". (Dominique Vaquié- involvement of inhabitants in local strategies for prevention and the fight against drug dependence - EFUS - page 14) The main problems posed by the population each time a service gathers together drug addicts in a neighbourhood are the loss in property value and the degradation of the neighbourhood. The other aspect is the fear of violence or of drug addicts making converts, but also the irrational fear of contamination.

The inability to “cure” users is one of the criticisms most often directed at professionals, who too are victims of the conflict with the local population.

Until recent years, policymakers often opted for putting inhabitants before the fait accompli and then coping with any subsequent reactions, in the hope that they would not be too strong. Now, however, towns increasingly try to prepare the ground before setting up a centre.

Communication with inhabitants may take four forms: consultation, information, negotiation and involvement.

The difference between these forms lies in the aims. Consultation and information do not allow inhabitants the option of deciding, negotiation offers more power and sometimes involves compensations (let me open up a halfway house and in return I will renovate the run-down public park …). Involvement means the population’s commitment in implementing the project and in managing the problems.

Obviously, these interactions must be initiated beforehand and the approach taken by policymakers and professionals must be honest: genuine proactive and not just building a consensus.

A service for such a rejected population must be opened only after lengthy preparation and, even though the choice of location is in fact a political decision, the fact is also that ways have to be found to alleviate the conflict while at the same time seeking to meet each of the parties’ needs.

For the last ten years, officials in Alcobendas have, with all those involved, devoted thought to understanding what type of city they wanted and what space, within the city, should be assured to the inhabitants, including the mentally ill, drug addicts, young people or senior citizens. Through this kind of comprehensive outlook and allencompassing strategy, decisions that are potentially sources of conflict find their true place.

2-2-8 Intermunicipality How can all of the tasks required to manage a city be accomplished?

It is increasingly true, for example, that drug addiction does not stop short at city limits, no more than social or economic problems, small-time crime or urban policies.

Furthermore, the human and material resources of small towns do not suffice to set up services which often cover a very extensive territory. Working on and intermunicipal level would seem to offer one possible solution.

The partners in the project, despite representing small towns, described on the basis of their experience an array of possible experiments in co-operation:

35

-

intermunicipal work required by law, at least in certain fields (drug addiction was one of them), intermunicipality chosen on the basis of a desire to better utilise available means and fill the institutional vacuums or legislative gaps (such as a framework law regulating social aspects) - town networks to work on specific themes (e.g., the elderly, public health, childhood, drug addiction) and make policy decisions; - contracts (for prevention, on security, etc.) among towns that contribute to share the costs for professionals.

Our partners targeted different types of existing co-ordination that may be defined as: - networking, - partnership work - intermunicipal work.

Networking consists in a working method aimed at pooling resources for synergetic optimisation, based mainly on organisational exchanges.

Partnership work is first and foremost a gradual process of sharing on an issue, through agreement on the diagnosis made of the situation. It is also part of a project approach based on the formulation of common aims and on the division of labour among the various partners, which are in effect resources for achieving those aims.

It can mean more complementary interaction: each of the structures, better informed on what the others are doing, can guide users more judiciously; duplication can be avoided and needs can be met more fully. Through partnership, moreover, actions that would otherwise be impossible can be co-produced. It requires guidance and organised sharing of ideas and resources, but allows each partner to act independently of decisions reached by the others and remain entirely responsible for its own resources, which are not delegated to a joint authority.

Intermunicipality is a “pact” between neighbouring towns which provides for negotiated decisions on policy, co-ordination among elected officials, and pooling of resources. An administrative structure is set up to manage a mutualised budget. Professionals work in co-ordination, covering a scope broader than their respective fields of action and administrative affiliation. The towns join forces to develop their common territory together, to create and share the benefits or costs.

The towns in the pact choose common fields (e.g., teenagers, drug addiction) and share out tasks, determine the location of a service intended for the entire population (such as a drug addiction treatment centre), and coordinate professionals operating in the same field to create truly intermunicipal teams.

To better grasp the subjects of concern preoccupying policymakers on the one hand and professionals on the other, we analysed the factors impeding intermunicipality and, conversely, those that justified it.

Many obstacles work against intermunicipality. For policymakers they may be: - ideological outlooks at variance - political balances that may change in the intermunicipality - a tendency to give precedence to one town’s interests or reputation over those of the other - financial obstacles - elected officials’ difficulty in sharing power - difficulties in communicating and discussing differences - lack of the time and means to share a diagnosis

36

-

differing appreciation of priorities lack of clarity in the objectives set

For professionals: - administrative complications - resistance to change - a lack of training - an unwillingness to develop new relations - difficulty in finding new points of contact - shortage of staff - foot-dragging in decision-making On the other hand, the policymakers’ motivations for intermunicipality may be: - a better understanding of the problems to be faced - resource optimisation - a better service offering - more complete, more sophisticated projects - economies of scale (cost sharing) - greater citizen involvement Professionals may be motivated by: - exchange as a solution-finding tool - the multiplication of resources through pooling, building on experience through sharing - curiosity - more in-depth knowledge - the professionals’ mobility - the enhanced means All of the partners stressed the need for co-ordination, institutional clarity, partnership management training, and good methodology.

37

EXPERIMENT IN INTERMUNICIPALITY IN OURTHE-AMBLEVE (Belgium) To understand this experience, a little history is required, some background on past events.

For several decades, groupings of Belgium municipalities in “intermunicipalities” have existed, often on a large scale and handling a lot of money. The city of Comblain-au-Pont is part of one such intermunicipality, supplying water, gas and electric power, processing wastes, managing economic growth and more. However, these powerful intermunicipalities, in which provinces have made considerable investments, are managed by boards of administration composed mainly of political representatives of the provinces and major cities.

“The rural regions, not well represented, reap a fairly slim harvest (primarily dividends) from these intermunicipalities and, when they demand a larger share in their management, they are accused of wanting to “Balkanise” them.

In light of this fact and its first consequence - economic underdevelopment - our region decided to take its fate into its own hands. This commitment gave birth, in the early seventies, to a syndicate aimed at boosting the economies of the Ourthe and Amblève valleys, known as GREOA. It was the fruit of joint study and thinking by the regional business community and the Christian workers’ movement.

GREOA, a non-profit organisation, developed its activities in the first fifteen years through selective actions to open up the region and maintain existing jobs. It gradually took on more structured form by collecting fees from the towns, businesses and individuals in order to generate funds. As a result, workers were hired in line with regional programmes to reduce unemployment. Thus nine municipalities freely joined together, accounting for a population of some sixty thousand.

The success of this partnership prompted the organisation of regional actions in new directions, including integrated prevention. In the 90s, phenomena until then generally overlooked by public authorities suddenly surged to the fore: drugs and their contagion in rural areas, insecurity, the explosion of petty offences, the phenomenon of social exclusion.

On an initiative by the association, “La Teignouse”, and certain municipal officials with a particularly keen sense of social awareness, politicians are beginning to pay attention to all of the proposals advanced by the Federal or regional authorities on these issues. Conscious of how small our towns are and of the relatively modest budgets earmarked for them, Comblain-au-Pont submitted projects which had already obtained the backing of some of the Region’s burgomasters (others asked to join us later on). This was to be the starting point for the “drugs and fight against drug dependence” plan, the prevention contract, the fight against social exclusion, prevention in schools, Parents-Sécours, the youth centre and spaces for young people.

The idea was to establish a complete range of prevention actions. It succeeded to due the complementary interaction of community organisations and public authorities and their mutual respect for each other’s skills and work.”

38

INTERCOMMUNALITY IN PAGANI The territory known as “Agro Nocerino-Sarnese” covers 13 municipalities and totals a population of 324,000.

Three years earlier, the mayors in that territory met together and signed a Pact on land use and development of the area.

Prompted by an awareness that their towns had made very few advances in social and health policy, the Mayors broadened the scope of the Pact and added a protocol for the development of social and sanitary policies. The deputy mayors implemented co-ordination with deliberative and executive powers. Decisions taken by the deputy mayors’ co-ordination are implemented by professionals in the Pact’s member towns, who also coordinate their work. The towns selected five fields which are co-ordinated both politically and functionally: Drug addiction, disability, the elderly, the mentally ill.

The professionals meet and work together in groups on specific topics.

Relations between the towns are not always easy, because sometimes one town will seek to have its own interests, visibility and prestige prevail over those of the others.

In the area of drug dependence, various towns took responsibility for setting up services for the entire territory.

One of the municipalities in the Pact took charge of the rehabilitation programmes, in addition to a centre set up to provide support and reduce risks, and all of the towns work on prevention.

The thirteen towns work together by political choice, and each of them contributes financially. Other partners, such as trade unions and businesses, joined with the Pact to play their part in developing the territory.

39

2-2-9 Assessment “Prevention” long referred to any action addressing young people, so it was on the whole a fuzzy, ill-assorted concept.

It has become obvious today that the scope of prevention, its ultimate or interim objectives and its processes need to be better defined, in order to assess the consistency between objectives and actions and to judge the results.

The field of research is vast; it extends from micro-analysis of small areas to macro social analysis, from detailed studies of specific aspects (drug dependence, space for young people, etc.) to attempts at grasping complex issues, in order to pinpoint trends or recommend orientations. Such a scope and diversity no doubt require particular efforts of intellectual discipline, but are not an obstacle to delimiting the field concerned by local policy.

In actual fact, what is really needed the most is a preliminary diagnosis, drawn up at the outset of the project, in order to evaluate changes in the situation in light of the actions conducted and the aims of prevention.

When a diagnosis is made, it is frequently too vague to be able to track changes in relevant indicators with any accuracy.

Equally important, the objectives are expressed in terms of praiseworthy intentions (promoting rehabilitation, creating social bonds, reconciling generations, developing awareness of the fight against AIDS, and so forth), not in terms of achieving results. It is true that the stakes are high, as is the temptation to set vast ambitions. Likewise, the fact is that the results to be expected are uncertain. Nevertheless, there needs for willpower to take a stand on specific effects: as Seneca taught us, “there is no favourable wind for he who knows not where he goes”.

Another final question is raised: who should make the assessment? A distinction needs to be made between the followup assessment, that can be handled by the operators, and the impact assessment, which calls for more hindsight and objectivity.

However, the most difficult task is seemingly that of involving the population, as well as those whom the action or policy addresses, in the assessment process. Several experiences were reported that can serve as inspiration, but not really as models.

Our intention in describing the limits and obstacles to assessment is not to be discouraging but rather to show that they can be overcome such important issues do not necessarily have to be dealt with by trial and error! While the difficulties are very real, this only means they should be given sufficient care and thought.

40

3 - TRAINING GUIDELINES

3 - 1 Description of the Approach This document draws on the proceedings of four seminars organised by the European Forum for Urban Safety, as part of the European programme “SECUCITIES-DRUGS”, between January and September 2001.

The seminars were attended by elected officials and professionals from medium-size and small towns in four countries (Belgium, Spain, France and Italy). A major city took part in each seminar as a “sponsor”, to share its experiences (Barcelona, Marseilles, Liege and Turin). Each of the subjects discussed at the seminars was noted and incorporated into an outline, according to the stage reached in the development and management of drug dependence-related prevention and follow-up policies.

The proceedings were aimed, first, at determining what training was required to devise and conduct those policies and, second, at building a pilot network through which the training could be implemented in other towns.

The issue of drug dependence particularly emphasises the crucial need for inter-institutional work in urban areas. It also forcefully raises the question of the place held by the civil society in public policy and the place of different categories of citizens in the city: are drug addicts just as much citizens as others? If the answer is yes on principle, then how does that translate into facts? Furthermore, the adult world, and particularly among those adults representing the institutions, are faced with a major educational responsibility for young people, considered a population at risk.

In this area, it is thus especially important to clarify certain fundamental philosophical positions: what is the drug addicts’ status as citizens? What responsibility is up to local and regional authorities? What kind of adults do we want our children to become? What should be the professionals’ code of ethics?

The guidelines given below are based on the stages by which these policies are devised and conducted, identified in the course of the four seminars’ proceedings. Eleven stages were described: 1) determination of the place and legitimacy of the town in the field of drug dependence: to voice and assume both resolute choices and legal obligations.

2) the findings: to fully understand the components in the situation 3) the philosophies of action: to clarify the reasons for considering the findings as strengths or weaknesses, as serious shortcomings or not, as high risks or not; to declare what ambition underlies the policy as well.

4) the diagnoses: they flow from the set of judgements that can be made, based on the findings, against the background of the philosophies of action, which serve as norms for judgement and assessment.

5) the indicators for an impact assessment: they help define the characteristics of the situation that needs changing; once the policy has been implemented, their variations will be evaluated.

6) the objectives: these are the results sought in light of the priorities stemming from the diagnosis.

7) and 8) the actions and their indicators of effectuality and effectiveness: these are all the actions through which the objectives become attainable, envisaged realistically and practically.

41

Effectuality indicators: these are data showing whether the planned actions were carried out and the extent to which the objectives were reached. The effectiveness indicators are used to check that the intentions were actually translated into action and did not remain merely words.

9) and 10) the resources and their efficiency indicators: the resources to be mobilised are determined on the basis of the requisite resources; the action plan may be adjusted and scheduled according to the means available.

The efficiency indicators are data from which costs, resources still available and cost-effectiveness ratios can be determined.

11) the assessment methods: the aim here is to define how the assessment shall be carried out, using the three categories of indicators defined above.

For each of these stages, we identified the main activities and the elemental activities which are required (first column).

For each of these activities, we sought to determine the knowledge (second column) and know-how (third column) to be mobilised.

The term knowledge refers to general, theoretical knowledge, on which the know-how is founded.

The term know-how covers the operational knowledge needed to act, establish relations and implement.

These guidelines are actually designed for both elected officials and professionals. Nevertheless, depending on the case, the know-how may be defined by differentiating between the two positions: elected officials must be capable of placing orders, checking, choosing between techniques, whereas professionals have to be able to enlighten the elected officials’ choices and to use the tools and techniques.

The active contribution of each of the partners made these guidelines possible. We would like to extend our warm thanks to them.

42

I- Determination of the place and legitimacy of the town in the field of drug dependence. Determination of the scope of competence, responsibility and observation.

What is the process of determination? What knowledge?

What know-how?

1-definition of the stakes for involvement of the town - this is a local structure, making the - thorough familiarity with the territory - ability to build relations in close proximity with the population actions more relevant or more closely and the population.

- ability to bring public services related to the territory than national structures (e.g., a hospital) into closer contact with the community (localisation, public transport service, counselling, hours, etc.). Ability to manage the resulting organisational changes.

- this is where public service principles are applied, including equal access to the law and defence of individual rights.

This is thus a place where cohesion is produced.

- knowledge of the population’s need for access to their rights, and especially drug addicts, which involves various aspects: geographic, time, money, symbolic, psychological - knowledge of how laws on rights are enforced locally (effectiveness) - knowledge and analysis of the divisions within the population and the drug addicts’ place today.

- direct mutual responsibility comes into play here: the relationships between elected officials and the citizenry lead to a sort of contract consisting of delegated responsibility and commitments on both sides. This is thus a sphere of citizenship.

- knowledge of how to define the - ability to implement relevant responsibilities of elected officials and methods for participation by the citizens with regard to drug dependence population, ability to supervise that participation, take action to - knowledge of the different modes of educate the population, explaining participation by the population its role and that of elected officials.

- ability to foster reflection and action on the part of the municipal council

- ability to produce individualised, tailored responses - ability to select survey methods by the type of data sought and to create a permanent observatory on the various aspects affecting access to bodies service the public ability to organise communication among the various sectors of the population, notably on the use of public spaces

43

- ability to communicate with the population in an educational, adult, motivating manner 2-definition of the sources of legitimacy for intervention by the town - responsibility towards the entire population - responsibility in drug dependencerelated fields (in Italy for example, mayors are responsible for health; in France, they are responsible for peace and hygiene) - representation of constitutional principles

- knowledge of the municipality’s laws - ability to keep municipal projects and briefs. Situate them relatively to in line with public interest priorities: enter them into the those of the region, the State, Europe. specifications for any project as - knowledge of how to convey the necessary conditions ability to convince public interest so as to move beyond representatives of particular particular interests. interests (e.g., the neighbours of a - knowledge of constitutional principles drug addict support facility protesting against its installation) - ability to tie in actions suited to special cases with public interest aims (ability to define criteria for establishing a drug addict support facility according to principles of public interest, particularly the life of the neighbourhood: go beyond the superficial reaction to drug addicts)

3-definition of the sphere of competence? (up to what point, in terms of both content and responsibilities)

What are the town’s responsibilities?

- knowledge of the range of expertise of the other local players in the field of drug dependence.

- knowledge of the resources in terms of the available expertise.

- ability to establish dialogue with players in order to learn about not only their formal skills, but also those actually practised or corresponding to priorities.

- knowledge of how to make choices -

ability

to

foster

joint

44

and set objectives with regard to drug dependence: prevention, counselling, treatment, rehabilitation, support for families, etc., above and beyond regulatory skills.

-Who is responsible for the town?

consideration by elected officials and the various municipal services concerned: definition of modes of discussion, organisation of the process - lead elected officials to develop a policy stand on the town’s commitment so that it can be conveyed to the population.

- knowledge on how to define the - ability to identify elected content of a delegation or mandate for officials’ skills and motivations an elected official who will have - ability to formulate a mandate political responsibility for implementation.

-What is the town’s place and role in the system of local players as regards drug - knowledge of how to analyse the dependence? Specifically, what bearing system of players in order to identify does intermunicipality have? local strategies (system analysis and strategic analysis) and requirements: initiator, driving force, pilot, mediator, etc.

- knowledge of the diagnoses and objectives of the other players, especially neighbouring municipalities.

- knowledge of the incentives and advantages offered by intermunicipality, but also its limits.

- ability to establish a sociogram and a strategic analysis model (tools) - ability to gain acceptance for one’s role by the partners (diplomacy, negotiation, etc.)

- ability to negotiate and take the others’ strategies into account - ability to prepare an application for an intermunicipal structure if that option is chosen.

II- The findings How is the report prepared?

1- Drawing up an objective report:

What knowledge?

What know-how?

0- data on the socio-economic and - the main data on the population - ability to examine data critically (as to geographic background structure and the local situation sources, degree of reliability, limits of 1- users: who are they?

- knowledge of the factors conducive to the knowledge so acquired)

45

age, sex, socio-economic group, family status, neighbourhood of residence, etc.

2- users: what patterns of use? at parties, compulsive, regular, controlled, excessive, dependence, etc.

3- what psychological profile?

4-what background?

5- modes of consumption: in a group, family, isolated, frequency, etc.

6- products. associations 7- associated offences

the development of dependence and knowledge of the main consequences, based on theoretical analyses by physicians, psychologists, sociologists, etc.

- knowledge of the opinions and analyses of fieldworkers within the municipal or intermunicipal territory.

- knowledge of which sources of information will provide reliable answers to the questions in the objective report.

- knowledge of the products and how they change

- ability to interpret those data - ability to create a knowledge and analysis control chart from existing data or by creating new data (ability to sort out the useful data, and only those, ability to organise them in a simple, consistent manner, ability to set up a system for collecting further information. Ability to establish simple indicators.)

- knowledge of the basic psychosociological concepts of social representation, the factors involved in the perception and construction of individual and collective mental representations (theoretical aspect approached through definitions, excerpts from publications).

- knowledge of the symbolic aspects of the professional’s role in relations with drug addicts (representation of the institution, the adult world, mediation between the drug addict and society) - knowledge of the methods used to have representations expressed.

- ability to make one’s own representations explicit and to compare them with those of other people.

- ability to summarise while taking the diversity of viewpoints into account. (exercise, using the results of surveys on different viewpoints, consisting of drawing up a summary without averaging out the differences).

2- Drawing up a subjective report: 1- the trainees’ representations: - of drug dependence - of users - of the institutions concerned (police, justice, health, social work, elected officials, schools) 2- the users’ representations: - of the institutions - of the professionals in contact with them 3-the representations of drug addicts held by public service professionals (issue of access to public service) 4-the teenagers’ representations of drug dependence.

3- Assessing the availability of: 1- counselling 2- treatment 3- rehabilitation

- knowledge of the legal framework - ability to set up a repertory system of concerning benefits and mandatory the achievements and possibilities of each player involved (inventory of actions in dealing with drug addicts.

46

4- access to the law 5- information and education 6- fight against trafficking and against consumption 7- primary and secondary prevention

- knowledge of the areas of expertise of the various players.

- knowledge of national policy orientations.

- knowledge of drug addicts’ needs (see above) in the area of prevention, health, economic integration, social integration, protection, etc.

- knowledge of the characteristics of a prevention message targeting nonaddicts and especially teenagers.

current actions as well as projects or ideas on improving those actions, specifying the conditions under which they could be implemented). This system may take the form of a joint observatory on offerings or of periodic surveys.

- knowledge of the principles of systems analysis and strategic analysis.

- knowledge of production management tools (economics) (e.g., work responsibility schedules, process analysis)

- ability to compile data on the partners and partnerships (either survey/audit or joint auto-analysis group) - ability to use systems and strategic analysis models, work responsibility schedules and process flow charts.

- ability to ensure that this repertory system is prolonged and updated.

4- Drawing up a partnership report: - who are the players involved? who should be?

- what relationships: nature, intensity, methods?

- what interactions among the various players? what consistency in diversified offers?

- what driving force? what pilot?

- what results for the partnership?

- what citizen involvement?

III- Philosophies of action How are the principles of action What knowledge? determined?

1- draw on the laws and official briefs: - the notion of public service - knowledge of the relevant texts - the laws on exclusion, the lawfulness of substances.

What know-how?

-ability to translate legislative principles into principles of action within the territory (adaptation to needs and priorities)

47

2- define the shared values: What kind of towns do we want?

What place for drug addicts in society?: - either focusing on users - or I am addressing the civil society, including users. Where the “drug culture” has several levels.

What place for the civil society?

What stake for the partnership?

- knowledge of the various philosophies of action concerning drug dependence and prevention: eradication; tolerance; legalisation; the respective place for an increased professional focus and for responsibility to be assumed by the civil society.

- ability to recognise the philosophy of action behind options taken and practical actions.

- ability to organise a collective thought process on principles and values in order to achieve shared awareness.

- ability to implicate the population in this collective process (public debate; conference on citizenship, etc.)

- ability to argue in favour of one philosophy over another.

3- abide by professional rules: What constitutes “good work” for the - knowledge of the criteria for quality in - ability to apply these rules to the professionals involved? the professions concerned and their objectives, planned actions and codes of ethics assessments.

IV- The diagnoses How are these diagnoses made?

What knowledge?

What know-how?

A diagnosis implies making judgement on the findings, in light of the philosophies of action A diagnosis must be made for each of the aspects identified above, in the findings: - on the basis of objective data on the situation - on the basis of subjective data - on the basis of familiarity with offerings - on the basis of knowledge about the state of the partnership

- ability to determine the strong and - knowledge of the rational tools for weak points in the situation, positioning each element in the findings relatively determining priorities - knowledge of the principles of to the criteria in the philosophy of action negotiation (legality, values, ethics, etc.)

- ability to use the multicriteria analysis model to establish priorities in the conclusions of the diagnosis - ability to organise group debate in order to arrive at a diagnosis supported by both the partnership and the population.

48

V- Indicators for an impact assessment How are these indicators established?

The indicators of the initial situation stem from the diagnosis. Hence, the need to: - identify the most salient aspects of the initial situation, mentioned in the diagnosis as particularly important.

- choose the signs which most accurately and concretely characterise these aspects (figures, significant facts, etc.)

What knowledge?

What know-how?

- knowledge of the definition of the indicator - knowledge of the components of a control chart (structure of its constituent indicators)

- ability to establish reliable, easy to use and update indicators - ability to organise the information system so that data can be compiled periodically (define frequency, information sources; motivate providers of data).

What knowledge?

- knowledge of the target groups concerned (young people, population as Define counselling and accessibility a whole, public opinion, etc.) on the basis of diagnoses. objectives

What know-how?

- ability to define with precision the desirable situation to be achieved in order to overcome the weaknesses underscored in the diagnosis and to avoid the foreseen risks.

VI- Objectives How are the objectives defined?

Define prevention objectives

Define treatment objectives Define assistance and support objectives Define partnership objectives Define citizen involvement objectives

- evaluation of the type of harm if no action is taken in the field of prevention -ability to work out these objectives on a and the likelihood of that harm partnership basis in order to arrive at occurring (in other words, the risk). common objectives (for instance, what is the likelihood that x young people become drug consumers?)

- identification of factors contributing to the occurrence of the risk.

- use of the same probabilistic reasoning for all the other aspects

49

VII- The actions and their feasibility What types of action?

An action plan has to be devised that fulfils several criteria: - actions chosen for their effectiveness in achieving the objectives - actions likely to involve the largest number of partners - actions fostering the involvement of the population - multidisciplinary actions - realistic actions, in light of available resources Define the pilots, the contributing partners, the institutional commitments

What knowledge?

What know-how?

- knowledge of the diagnosis of - ability to estimate the extent to which offerings (see above) each planned action contributes to achieving the objectives.

- ability to use the multicriteria analysis - knowledge of the players’ proposals to choose among several actions on the - familiarity with initiatives taken in basis of the priorities. other countries.

- ability to set up a tree structure in order to check that the action plan is consistent with the objectives and the diagnoses (set up a support diagram) - ability to draw up action data sheets.

VIII- Effectuality and effectiveness indicators How are the indicators defined?

What knowledge?

Define effectiveness indicators corresponding to the decision on the - knowledge of the definition of an indicator implementation of each action - knowledge of the definition of Assign a target value and an alert effectuality value to each objective to serve as - knowledge of the components of a “warning signals” of serious problems control chart (structure of its constituent with effectuality. indicators).

Define each player’s responsibilities in - knowledge of requirements in following up an action plan the event of readjustment of actions.

What know-how?

- ability to establish reliable, easy to use and update indicators - ability to organise the information system so that data can be compiled periodically (define frequency, information sources; motivate providers of data) - ability to organise the procedure by which actions will be followed up so as to react in the event of unexpected or incomplete results - define the procedures to be followed should the actions require readjustment

50

IX- Resources Types of resources and how to mobilise them Define the necessary resources Evaluate available resources Seek to pool resources on a partnership basis Identify possibilities for finding additional resources.

Earmark resources for priority actions.

What knowledge?

What know-how?

- the characteristics of the various types of resources: budgetary, in time, logistics, human, expertise, availability, activism, political support, experience - potential sources of resources - procedures for requesting additional resources - possibilities for improving existing resources (training of professionals; improvement of information dissemination; rationalisation of procedures, etc.)

-knowledge of methods for drawing up programmes (e.g., PERT or Gantt) - knowledge of budget rules - knowledge of resources management

- ability to determine the resources required for each action and for management of the whole - ability to define, if required, the job descriptions of persons assigned to co-ordinate the action plan or new actions that do not correspond to habitual professional activities - ability to draw up a programme - ability to define training that can help professionals evolve in their practices - ability to define working procedures or for the dissemination of new information

X- Efficiency indicators How are they determined?

Assign indicators to each resource to learn: - whether the resource is available - at what pace it is being consumed - whether it will be sufficient to carry out the action to the end - whether the contributors have kept their commitments - how much an action (or activity) costs Define rules for readjustment in the event of a problem (shortfall, delay, improper use, etc.)

What knowledge?

What know-how?

- knowledge of the definition of an - ability to establish reliable, easy to use indicator and update indicators - ability to organise the information - knowledge of the components of a system so that data can be compiled control chart (structure of its constituent periodically (define frequency, indicators) information sources; motivate providers of data) - ability to organise the way in which resources will be monitored, so as to react in the event of unforeseen or inadequate consumption - define the procedures to be followed in the event of readjustment

51

XI- Assessment procedures: How is the assessment made?

Define who is in charge of the assessment

What knowledge?

- knowledge of the bases for assessment of public policies - knowledge of the advantages and drawbacks of an independent Define the system and the necessary assessment (by experts in assessment) means and an in-house assessment (by the players themselves), respectively, and Define the stages knowledge of how to argue in favour of Define communication before, during a choice.

- knowledge of the principles of and after the assessment communication

What know-how?

- ability to draw up assessment specifications - ability to set up the system chosen: steering committee, contracting with outside contractors where needed - ability to compile the information corresponding to the indicators in the initial diagnosis (preassessment), for the impact assessment (post-assessment) - ability to formulate effectuality indicators and efficiency indicators for convenience in interpreting trends - ability to collect information for assessment of the process: how the programme developed and was implemented - ability to inform the population about the assessment - Ability to involve the population in the assessment.

In conclusion: The guidelines highlight the need for knowledge in a number of different scientific and intellectual disciplines: - political science - sociology - psycho-sociology - psychology - statistics - probabilistic modelling - management sciences As for know-how, the requirements may be classified as:

52

-

administrative skills (procedures, specifications, management, organisation) relational skills (dialogue, communication, negotiation)

The teaching methods to be used must draw on a co-operative programme of practical case studies, inside accounts, methodological and conceptual input and real-life simulations. The training-action approach, including practical application on-site by the participants in the training session and methodological follow-up, seems to be a good set-up.

4 - TRAINING PROPOSAL IN DEVISING AND IMPLEMENTING PUBLIC POLICIES ÂŤ SECUCITIES DRUGS Âť 4-1 Teaching Objectives summarise knowledge concerning drug dependence-related phenomena exchange views on the interpretations and analyses of this knowledge pool the methods, actions and resources employed in each town as a means for sharing experiences and capitalising on what has been learned through debate and comparisons, define together the central issues in each town draw the link between demand reduction policies (the sphere of prevention and follow-up) and those to reduce supply (the sphere of dissuasion or law enforcement) applying methodological principles, identify the conditions for devising, conducting and assessing public policies on prevention and follow-up, in the area of drug dependence 4-2 Organisation of Training The training session is organised in four modules scheduled at 4 to 6 week intervals, to leave time for gathering information and organising the field work between modules. The scheduling is similar to that of training-action.

The teaching methods draw on a co-operative programme of practical case studies, inside accounts, methodological and conceptual input, real-life simulations and debates organised around exchanges on perceptions, analyses, and experiences.

The first three modules last 3 days each, while the fourth, devoted to summing up, lasts 2 days. The training session lasts 11 days in all.

53

4-3 Teaching Programmes and Methods

I)

First module: determining the town’s scope of intervention

1)

the state of knowledge and representations of the phenomenon:

establishment of a common reference system on the field, through reports by the participating towns on the situation in their area. Summary by the group leader in order to devise a comprehensive grid for classification of the knowledge exercises on the perceptions of drug dependence, drug addicts, the institutions accountable for these phenomena. Underscoring of discrepancies between situations and how they are represented identification of current means of information on the situation in the town. Comparison among the towns.

Critical analysis of this information system.

Examination of the methods enabling inhabitants to express their representations of drug dependence and drug addicts: methods by direct expression, survey methods, etc.

2)

determination of the place and legitimacy of the town or intermunicipality in the area of drug dependence:

the local authority’s scope of competence, particularly as regards health, safety and rehabilitation. On the basis of the legal texts establishing the scope of competence, analysis of inside accounts showing how greater leeway can be found to work within that legal framework.

3)

analysis of the roles and responsibilities of elected officials and their colleagues:

the role of elected officials in relations with the population and in promoting participatory approaches. Study of participatory approach methods. the role of elected officials in organising debate in deliberating assemblies with a view to working out a political commitment. knowledge of the fields of expertise of the locality’s other players. Search for complementary areas and coproduction.

Examination and discussion of the advantages of an intermunicipal approach and the conditions for its success.

II)

Second module: organisation of the partnership-based and participatory diagnoses:

1) reporting methods and tools: determination of the scope of the diagnosis: criminality and drug dependence, at the frontier between law and order and public health.

54

establishment of specifications for the information to be collected, whether objective or subjective and whether on products, behaviour, users, treatment, counselling, law enforcement or prevention structures. use of systems analysis to arrive at the partnership diagnosis comparative study of the various methods for collecting information, particularly with regard to their applicability in drawing up a joint diagnosis which can be updated for purposes of an assessment.

2)

criteria for establishing judgements and setting priorities: the philosophies of action

collective reflection, on the basis of two or three inside accounts, on the ambitions and stakes of local public policies: definition of the values which serve as the action’s guiding principles those bearing on citizenship, tolerance, respect for law, mobilisation of the civil society, professional code of ethics study on examples of charters or formal declarations examination of methods for organising public debates in order to foster genuine participation by the population.

3)

construction of the diagnoses and their indicators:

based on the study on two or three cases examined previously, construction of a diagnosis in terms of strengths and weaknesses establishment of criteria for priorities between the objectives and the actions argumentation on the positions reached accordingly in order to convince partners and/or the population. joint use of problem-solving tools to foster sharing of the diagnosis

III)

Third module: from the diagnosis to action

1)

definition of the different levels of objectives:

The reference material for this work will consist of the 2 or 3 cases selected previously and familiar to all. The towns concerned could be asked to compile a file summarising their situation. search for indicators associated with the diagnosis: setting of priorities in the desired impacts on the initial situation prioritisation of objectives: use of the multicriteria analysis to clarify the order of priority according to the various partners, and organisation of inter-partner exchanges to determine common criteria for prioritisation search for the most relevant actions in achieving the objectives, drawing on the array of actions undertaken by the various participating towns (each town will have drawn up a summary of these actions during the interval between modules). emphasis on the ways of getting the population to take part in choosing the actions (concerted action and consultation methods). Ways of recognising two components of the population: drug users, to whom the action programmes are directly addressed, and the inhabitants of the town.

55

2) choice of actions and formulation of an action plan: for the principal actions on the 2 or 3 cases, formulation of action data sheets defining the ways to co-produce the action through an implementation partnership definition of procedures enabling each of the partners to translate their commitments into decisions on implementation: how can decisions reached jointly be translated into internal operation and resource allocation? search for sources of funding and for the provision of any necessary resources (investigations will have been conducted during the recess). specific search, by action, for resources available within the population: initiatives, skills, civic convictions, solidarity, conviviality, etc. establishment of action plans and application of the appropriate reasoning to set timetables (establishment of Gantt or P.E.R.T. programmes). Consideration of ways to leave room in these schedules for the various “time frames”, notably the inhabitant’s time frame, the elected official’s time frame, the administration’s time frame, or that of the user under treatment.

3) procedures for monitoring the programme’s operational performance the methods and systems for ensuring the vital functions: orientation and political validation; management; operational follow-up; expertise; networking; communication; possible organisational changes; decision-making overall responsibility for the programme and accountability of institutional representatives to their respective institutions. relationship between the programme manager and the institutional heads communication with the inhabitants throughout the follow-up period and the various stages pace of the action programme and co-ordination with the pace of decision-making and management in the partner institutions the follow-up control chart: principles behind its structure

VI)

Fourth module: assessment of the policy for continuity and mobilisation

1) indicators of efficiency, effectiveness, effectuality, and impact: the need for the indicators, defined throughout the programme definition process the information and verification procedures: what needs to be done so that the relevant institutions and services regularly and reliably pass on the necessary information for monitoring the objectives achieved and the impact produced on the initial situation? Participatory organisational methods and information to people to maintain a dependable information circuit. responsibility for readjustments: should the assessment reveal discrepancies with the objectives, delays or shortcomings, who will be empowered to see with the structure responsible for those defects that it change its working methods or the way in which its actions are implemented? What politico-hierarchical control? How to facilitate supervision of the necessary changes within each institution?

56

2) assessment procedures: the various types of assessment: in-house; independent; continuous; scientific; participatory, etc. discussion of criteria for choosing among these different types participatory assessment methods: study on examples with the participation of the target groups and that of the population. continuation of the partnership in the assessment: how to assess a structure without levelling accusations? principles for implementation of the assessment system: ability to look at the programme to be assessed from a broader perspective; degree of professionalism and experience in assessment; degree of transparency in the assessment’s conclusions. disclosure of the assessment: what should be said? How to say it? Who should say it? To whom? Use of public debate around the assessment as a vector for considering ideas collectively and as a learning process 3)

appraisal of the training:

This consists of both an evaluation questionnaire and reporting on two or three cases written up during the training session on the basis of the situation in two or three volunteer towns having served as concrete examples to illustrate the main methodological points.

5 CONCLUSION

The programme we implemented was a pilot programme. The towns’ contributions were fundamental in testing and improving the training hypothesis developed by the European Forum.

The high-level expertise of the elected officials and professionals convinced us to create a steering committee among some of the participating towns in order to pursue the work and broaden the training proposal we built together to include other towns.

The SecuCities Drugs network is not winding up its activity with this latest project but continues to promote exchanges, because actions on the prevention of drug dependence and the implementation of follow-up and treatment services for drug addicts must remain priorities for all of the towns in the European Union.

57