Focus on the European Neighbourhood Policy area: news from EU4Monitoring Drugs, the EMCDDA’s new technical cooperation project

This content was published in the first EU4MD update released on 3.7.2019. This update also presents a section on partnerships and related activities, upcoming events, and a research corner.

EU4MD — Inception phase

In 2019, the EMCDDA launched a new technical cooperation project called EU4Monitoring Drugs (EU4MD). The three-year project, funded by the European Union, will involve countries in the European Neighbourhood Policy (ENP) area, supporting national and regional readiness to identify and respond to drug-related security and health threats.  

Technical assessment visits have already been conducted to Armenia, Georgia, Palestine*, Lebanon, Moldova, and Ukraine, where a team of security and health experts met with a range of stakeholders from the Ministries of Justice, Home Affairs, Internal Affairs and Health, national and international NGOs, and other international partners, such as the United Nations Office on Drugs and Crime (UNODC).

Key priorities were identified in consultation with the stakeholders. Priorities in addressing drug supply included the need for technical support in monitoring drug markets and supply, intelligence gathering, training law enforcement agents on new psychoactive substances, and monitoring of drug sales on the darknet. Priorities in addressing drug demand included technical capacity building on drug monitoring, particularly on drug monitoring tools such as general population surveys, wastewater analysis, trendspotter studies, needle and syringe residue analysis, and surveys on drug use in prison settings. Interest was also expressed in the adapted Universal Prevention Curriculum, and in enhancing monitoring of drug-related deaths by joining the EURO-DEN network.

Proposed activities will be further discussed by the project’s national counterparts during the EU4MD Advisory Committee meeting which will take place in Brussels over the summer. Project kick-off meetings in the eastern and southern ENP regions are scheduled for the following months.

 * This designation shall not be construed as recognition of a State of Palestine and is without prejudice to the individual positions of the Member States on this issue.

Spotlight on partner countries: Armenia and Lebanon

Mr Arman Ghazaryan from the Security Council Office of the Republic of Armenia and Ms Marie-Thérèse Matar from the Narcotics Department of the Ministry of Public Health of Lebanon — the EMCDDA’s counterparts in these countries — speak about their national drug situations, highlighting the main challenges and threats, and reflect on successful national efforts and their views on future cooperation.

Armenia

Mr Arman Ghazaryan from the Security Council Office of the Republic of Armenia, the EMCDDA counterpart in the country, speaks about the drug situation in Armenia, highlighting main challenges and threats, and reflecting on successful national efforts and his views on future cooperation.

What are the main drug-related challenges facing Armenia?

I would like to highlight three main issues. The first one is linked to the geographical location of our country which makes it increasingly attractive and convenient for trafficking illicit drugs, thus somehow solidifying the status of Armenia as a ‘transit country’. Afghan heroin is transited via the ‘Caucasian Route’ towards Europe. Moreover, methamphetamine seems to be produced in neighbouring Iran, and in recent years Armenian officials have noticed an increase in methamphetamine consignments destined for countries of Asia-Pacific. Our law enforcement agencies are also seeing indications of a new trend in cocaine smuggling where cocaine, originating from South America, mostly Brazil, goes through Armenia on its way to Turkey.

The second main challenge is the emerging drug trade through the internet. The first cases of internet-based drug sales in Armenia were reported about three years ago, and were linked to a Facebook page. Our law enforcement agencies made significant efforts to close the page; this had an immediate effect on the availability of drugs at the time. However, in recent years, we have also noticed sales of drugs through social networking services and applications, such as Instagram and Telegram Messenger. Internet has facilitated the availability of drugs, especially for young people.

The third aspect is the use of postal services for drug and psychotropic substance shipments, which have increased noticeably in the last years. These shipments are usually made by mail, in small quantities, and frequently involve new psychoactive substances (NPS) – all these aspects make the detection of this illegal activity difficult.

What are the main drug-related threats?

In Armenia, the narcological service has a register of drug users; by end of 2018 close to 7 000 persons were registered, about half of which indicated cannabis as their main used substance, followed by opioids. However, treatment providers increasingly see clients using synthetic cannabinoids, as well as pregabalin, while stimulant use seems to be limited, at least among those registered.

Opioids are primarely used by injection, and this is one of our concerns, as injecting drug use is a risk factor for the spread of blood-borne infections (viral hepatitis, HIV), and may cause vascular lesions and subsequent complications.

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

At the national level we focus on strengthening collaboration with different law enforcement agencies.  Our Customs, Police and National Security Service have implemented a number of successful joint operations, e.g. controlled deliveries of drugs, particularly of those that are imported through mail packages. Moreover, we develop our international relationships at operational and strategic levels. Here I would like to mention the cooperation with the EMCDDA and United States Drug Enforcement Administration.

A number of activities have been carried out to consolidate technical capacity on border checkpoints. The Anti-Smuggling Department of the State Revenue Committee has also established a specialised analytical division which plays a significant role in risk analysis and profiling.

In terms of responses, our drug treatment services consist of four specialised local clinics. Drug treatment is available also in prison hospitals. Around 500 patients at the four clinics in the penitentiary system currently receive opioid substitution treatment.

Where and how can the EU4MD project make a difference?

We are looking forward to intensified cooperation with the EMCDDA. Our national priority is the development of human resources and capacity; therefore we welcome any proposal that allows our experts to participate and learn from their peers abroad, whether through training or conferences.

I mentioned NPS before, and we expect to be more closely associated with the European information exchange on NPS, including their timely detection and analysis. Finally, I hope that this project can help us to further consolidate the Armenian drug monitoring system and increase available information. In this domain we would like to gain more knowledge on the use of drugs in the general population, and also focus on the improvement of data about high-risk drug use and drug-related deaths.

Lebanon

Ms Marie-Thérèse Matar from the Narcotics Department of the Ministry of Public Health, the EMCDDA counterpart in the country, speaks about the drug situation in Lebanon, highlighting the main challenges and threats, and reflecting on successful national efforts and her views on future cooperation.

What are the main drug-related challenges facing Lebanon?

The first challenge for Lebanon is to ensure good coverage, because currently there is a lack of treatment centres in some regions. We also have difficulties in reaching vulnerable populations such as women, adolescents, sex workers and men who have sex with men, and also refugees and displaced people. The problem also arises in prison where there is no specific regulation for the management of substance use. As it is, apart from a few NGOs that run programmes in prisons, there is little assistance for inmates with substance use disorders or who are exposed to substance use.

For the majority of people, accessibility is not the only problem; they often also have financial issues because opioid substitution medications are not covered by the government (buprenorphine and Suboxone, for example).

Another big issue in Lebanon is the lack of accreditation and evaluation for treatment centres and NGOs working on substance use. The first thing that needs to be done is to update our guidelines for opioid substitution treatment (OST), following expert advice and evidence-based research. 

Finally, a new challenge for us as professionals in the field is the increase in the use of new psychoactive substances. Often called ‘salvia’, these herbal blends contain various synthetic drugs, mostly synthetic cannabinoids, which are strong and can cause serious adverse effects and intoxications.

What are the main drug-related threats?

Today, the main threats are the increases in drug-related mortality (overdoses and indirect related mortality), morbidity (considering all drug-related infectious diseases), although we noticed a significant decrease in the number of patients positive to Hep C following implementation of an OST programme (5.9% in 2018 vs 27% in 2011), and criminal behaviour.

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

For now, we are trying to improve coverage by implementing a new dispensing unit in Bekaa, soon in the north, and a new treatment centre in Byblos is already implemented.
We initiated a review of OST guidelines within the task force committee. We already registered Suboxone and have organised training on overdose response in hospital emergency room units, including Naloxone administration protocols in emergency settings. Finally, we are elaborating standards for the accreditation of residential substance use rehabilitation programmes, and the implementation of prevention standards will start in 2019.

Where and how can the EU4MD project make a difference?

We would like to benefit from this opportunity to obtain support in reviewing and updating existing programmes and improving their outcomes. Mainly to increase the availability and accessibility of high-quality age- and gender-sensitive prevention and treatment services.

It could be also an opportunity to integrate a core set of substance use treatment and rehabilitation service use indicators within the national health information system, in order to gather and centralise information on drug use, but also to evaluate our own services. Overall, we would like to establish a monitoring and auditing mechanism for treatment centres.

And a last point: EU4MD could help us to organise training for professionals working in rehabilitation centres on tailored approaches for vulnerable communities, including LGBT and adolescents.

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