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Speech by Maria Larsson, Minister for Public Health, Sweden at the 2^nd World Forum Against Drugs, Stockholm 24 May 2010

Your Excellencies an distinguished guests.

I am very happy to be among those who welcome you to the Forum this year.

We meet in an era where there are several interesting things happening. In the field of health we can see a big and growing interest in how we take care of our health - How to feel better, how we can live healthier and longer. How to eat and exercise. I am of course – as minister for public health – very pleased with this broad and general interest in health issues.

On the other hand – there is a movement which likes to pave the way for increased use of narcotic drugs. We see it in several European countries, in the United States and in international cooperation.

My conclusion is that the scientific evidence of what is good for your health needs to be more widely spread.

Some say that what I choose to do as an adult is my own responsibility. But that is wrong – dead wrong. All our lives are intertwined. We interact and live together and we cooperate and act together. In fact – this is what we call a society, and the people most affected by our actions are the children.

Children have rights and needs. And it is our moral obligation to protect our children, and to see that they get as good conditions as possible. Being affected by adults using narcotic drugs - or being involved in production or trafficking of drugs – is not in accordance with good living conditions. And even less so when they use narcotic drugs themselves.

The right to your family, to education and to food – is expressed in the UN Convention on the rights of the child. Children also have a right to be protected against certain specific threats according to the convention: For example sexual exploitation, armed conflicts - and drugs.

I think we can use the Convention on the right of the child much more in this respect.

The Convention is the only UN Human Rights Convention that has explicit statement about narcotics and drugs.

Protection against drugs is therefore unquestionably a human rights issue. Protecting children from illicit use, from production and from trafficking of drugs - is not an option for States Parties, it is an obligation.

Young people have access to an increasingly wide range of substances and are sometimes using them in combination with alcohol. The majority of young people in the European Union have never used illicit drugs. But - among those who have - cannabis is the most frequently used drug. In general, the likelihood of young people being offered cannabis, or other illicit drugs, as well as their willingness to try drugs, increases sharply with age.

Evidence suggests that early experimentation with psychoactive substances is associated with an increased risk of developing drug problems later in life.

The most ineffective way to deal with narcotic drugs is to deny it. It is better to offer treatment and care. Better than that is to try to stop it and curb it. And the best way to deal with it is to prevent it.

Sweden is definitely not good enough – but in the area of prevention – I am convinced that we are on the right track. Using narcotic drugs is considered not acceptable, by professionals in medicine, by health authorities and by people in general. There is a widespread recognition that using psychoactive substances is not compatible with living a healthy, independent and moral responsible life.

There are of course several reasons why this is the case in my country: One of the most important ones being all the voluntary organizations who work in this field.

I am actually meeting representatives for the voluntary sector this afternoon to start the discussion on how to prevent drug abuse in the future.

Getting as much involvement as possible - from as big parts of the society as possible – is a cornerstone of preventive tactics.

One reason Sweden has a preventive approach is our experiences during the 1960`s.

Sweden was actually among the first countries in Western Europe to experience a large-scale drug problem among young people. Several drugs were seen as non-addicting and had widespread clinical use at the time.

Swedish physicians and authorities thought it would be a good idea to prescribe them, not only stimulants but also opiates and in huge quantities. Several million doses were given out legally, but the result was that they were spread illegally over Sweden. It came to an abrupt end after the death of a 17 year old girl who had been offered drugs by a patient in the prescription program.

Nils Bejerot, who we are honoring today, saw this at the time and managed to turn it around - with the help of others.

From experiences like this grew recognition that the use of narcotic drugs has an epidemic character. And that once you use it – the effort it takes to be able to live without it is enormous. For many it overtakes your life. And for some – it ends your life. It is like playing with a baby crocodile in your plastic pool. They say it is a nice experience in the beginning.

But when the crocodile grows bigger it will eat you, and it will chew your pool.

Preventing drug use before it begins is a cost effective, commonsense way to build safe and healthy communities. Prevention science has made great progress in recent years. Many interventions are being tested in “real-world” settings so they can be more easily adapted for community use. Scientists are studying a broader range of populations and topics. They have identified, for example, effective interventions with younger populations to help prevent risk behaviour before drug abuse occurs. Researchers are also studying older teens that are already using drugs to find ways to prevent further abuse or addiction.

During the Swedish Presidency of the European Union last fall, we also managed to increase the European Union work with prevention. The Council conclusions, which were adopted, promotes universal prevention and EU-member states also agreed to offer parental support  and family management programmes.

The well-known saying proves to be right: “An ounce of prevention is worth a pound of cure.”

Looking at the present drug discussion - there are efforts undertaken to legalize narcotic drugs; primarily marijuana. Pro-drug messages of different kinds are being spread worldwide. This promotion is aimed directly at young persons.

Efforts are also being made to play down the risks associated with drug abuse and above all to portray cannabis and some of the synthetic drugs as safe and harmless.

It is evident that we need to work effectively to build a political consensus to create broad public support for a comprehensive and restrictive drug policy based on the UN Conventions.

We need to reduce both the supply side and the demand side of narcotics. We need to focus more specifically on prevention, treatment and control - three equally strong pillars.

And we need to keep our vision of a drug-free society.

Illicit drugs must continue to be … illicit. The respect for human dignity and the protection of children demands this. And at the same time we must tackle the negative social and health consequences of narcotic drug use.

This can be done together. And looking at all of you I am convinced it is a struggle we will win. Welcome and I hope for a successful forum.

Thank You.

Opening Statement before the 2nd Annual World Forum Against Drugs, Stockholm Sweden

Delivered by R. Gil Kerlikowske Director oF National Drug Control Policy, United States – May 24, 2010

Thank you, Mr. Carlsson. It is my great pleasure to be with you here today to represent the United States. I would like to congratulate you on your second convention and on the establishment of this forum which the United States so strongly supports. I would also like to thank the leadership and staff of the WFAD board for their fine work in support of your efforts.

Throughout my 37-year career in law enforcement, I saw first-hand the terrible toll drugs take on individuals, families and communities. Drugs are a huge threat to all of our citizens, one that is ignored at our peril. I am very appreciative of the tireless work the individuals and organizations represented here have conducted, not only to provide desperately needed direct help to those seeking to turn around their lives, but also to ensure that our nations do not take the serious consequences of drug use for granted.

In the United States, two weeks ago, President Obama released our new National Drug Control Strategy, which represents a new direction in U.S. drug policy. This policy forcefully addresses the enormous public safety threat posed by transnational criminal organizations and activities which supply drugs to our citizens. It also addresses the public health threat posed by drugs by emphasizing the need to invest in prevention, treatment, and recovery support, ensuring the addicted get the help they need. This balanced approach requires the coordinated and complementary efforts of prevention, treatment, and law enforcement professionals.

The United States’ commitment to reducing drug use and its consequences in the United states and around the world is exemplified by the President’s FY 2011 Budget request. We have increased our investment in vital demand-side programs, while maintaining the long-term commitment to disrupting drug trafficking organizations at home and abroad. Key themes of our Strategy, reflected in President Obama’s Fiscal Year 2011 Budget request, are:

Community-Based Prevention: Preventing drug use before it begins is a cost-effective, commonsense way to build safe and healthy communities. Research on adolescent brain development shows there is an at-risk period for the development of substance use disorders; people who reach the age of 21 without developing a substance abuse problem, in most cases, will never do so. For this reason, the largest percentage increase in anti-drug funding in the Obama Administration budget – over 13% - is for prevention.

Early Intervention: Substance abuse costs over $50 billion in health care spending annually, with most of these funds expended on avoidable, catastrophic consequences of addiction, such as emergency room visits, rather than its treatment. It is time to integrate care for substance use disorders into the rest of the health care system. This includes an expansion of screening and brief intervention and referral to treatment programs in an array of settings. Screening programs have repeatedly proven to be extremely cost-effective by interrupting drug-use patterns before severe addiction develops.

Treatment and Recovery

Addiction treatment should be readily available and of high quality. We must integrate addiction treatment into mainstream medicine, and we must ensure care is guided by the best scientific evidence. Treatment must also offer the continuing support required to provide a reliable pathway not only to short-term stabilization, but also to sustained recovery – meaning a full, healthy, and responsible life for persons who once struggled with addiction. It is also important to focus on vulnerable populations, such as addicted women who have dependent children. In these cases, family-based treatment programs can accommodate the needs of both mothers and children.

Drugs and Crime:

Drug use is often interwoven with criminal behavior that disrupts family, neighborhood, and community life in fundamental and long-lasting ways. The criminal justice system plays an important role, therefore, in reducing drug use and its consequences. The results from long-standing initiatives, such as drug courts, and newer alternatives to incarceration, including “smart” programs which incorporate swift, certain, but modest sanctions, have been extremely encouraging. An excellent example of this is the HOPE project, which will be presented in the late special session this afternoon. We must now expand such initiatives so all those for whom diversion from prison is appropriate, can participate. These innovative programs break the cycle of drug use, arrest, release and re-arrest and and much more cost-effective than long-term incarceration.

Domestic Enforcement: Drug trafficking organizations (DTOs) move large quantities of illicit drugs world-wide. Indeed, they are transnational criminal enterprises that perpetrate extreme acts of violence and intimidation, foster corruption, and destabilize democratic institutions and the rule of law. The activities of these DTOs affect the security of all Member States. These same groups often work through street and prison gangs, and frequently employ local criminal networks. It is important to seize drugs, money, and weapons from DTOs, but it is even more important to use seizures to increase our understanding of how these groups operate, so they can be disrupted and dismantled.

International Partnerships: We recognize that U.S. drug consumption directly affects many countries around the world by supporting illicit drug markets, production, and trafficking. Thus, our efforts to provide law enforcement ad interdiction assistance to many partners around the world will continue. Our multilateral collaboration will also include an increased emphasis on prevention, treatment, and recovery support to assist nations who have developed a worsening drug consumption problem due often primarily to their role as a transit nation. As noted by a U.N. Security Council Statement in late 2009, West African nations in particular have experienced the negative consequences of drug trafficking related crime and violence even though many of the drugs and illicit proceeds that transit this region are destined for elsewhere. All of us have a responsibility to assist our fellow nations, but we recognize that major consuming nations such as the U.S. have a special obligation to do so.

Marijuana

As I have already mentioned, one of the hallmarks of the Obama Administration is collaboration. We recognize that we cannot all agree on everything, but all of us most seek common ground and avoid getting side-tracked in ideological debates when there is so much vital work to do. I want to be clear about our Administration’s views on marijuana. In our country, we have seen significant consequences of marijuana use. For example, more and more people are dependent on the drug and treatment and call-in centers cite marijuana as a major reason people are presenting for help. We in the Obama Administration are opposed to legalizing marijuana or any other illicit drug. Research and experience have shown that by widening availability, we increase the acceptance and use of these drugs and the harmful consequences that go with them. As Dr. Madras described previously in her remarks, we also believe medicine should be determined by science, not popular vote.

The Road Ahead

I would like to close by emphasizing how important and beneficial the work of this Forum is to protecting citizens of all nations from the terrible consequences of drug use. It is clear that those of us that oppose drugs must work together. Those who raise their voices to promote drug legalization must hear our response, loud and clear, that making drugs more available and accessible is a path to despair and destruction. The Obama Administration is committed to opposing drug legalization, fulfilling our responsibilities to address our own drug use in the United States, and to partnering with the many organizations around standing up to overcome the challenges posed by drugs. Thank you for the opportunity to address you today and for your important work, year round, in your home countries. You have a friend and partner in the United States.

The World Forum Against Drugs will open at 10 a.m. at the City Conference Centre Norra Latin, Drottninggatan 71 B, Stockholm.

The 2^nd World Forum Against Drugs has gathered delegates from 60 countries, including a large number of diplomats. 25 embassies are represented at the Forum, including 10 ambassadors.

The 1^st Forum was held in Stockholm in September 2008, initiated by a group of Swedish anti-drug organisations. Based on the response from the 1^st Forum a new organization, World Federation Against Drugs (WFAD), was founded in June 2009.

WFAD wants to create a global network for NGOs working against the illicit use of drugs, and stands for a restrictive and balanced drug policy based on the UN Conventions on Drugs.

A major issue for WFAD will be to arrange Forums. Once again, it takes place in Sweden this year, but in the future the Forums will be arranged in other parts of the world.

The three main themes for the Forum this year are:

·         New research on cannabis

·         Drugs in Sub-Saharan Africa

·         Adult drug abuse and its influence on children

The Forum has been made possible with generous financial support from the Ministry of Health in Sweden, the City of Stockholm, and private companies that have sponsored the Forum and Music Against Drugs.

Media information

Media are invited to follow the World Forum Against Drugs & Music Against Drugs 24-26 May at the City Conference Centre Norra Latin, Drottninggatan 71 B, Stockholm and at the main stage, Kungsträdgården

Registration

For security reasons, media representatives who want to follow all sessions at the Forum are asked to register by sending an email with full name, media (newspaper, radio, television), and contact details to This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Press room

A press room is available in room 354 at the City Conference centre, where press conferences will be arranged (see below).

Media contact

Sofia Modigh +46 766 27 67 60

Monday 24 May

09.15 – 09.45 Press conference with keynote speakers (Room 354)

·    R. Gil Kerlikowske, Executive Director ONDCP, USA 
·    Maria Larsson, Minister for Public Health, Sweden
·    Antonio Maria Costa, Executive Director, UNODC, Vienna
·    Sven-Olov Carlsson, International President , World Federation Against Drugs

10.00-12.00  Official Opening (Main Hall, City Conference Centre)
Official opening with keynote speakers. Presentation of the first “Nils Bejerot Award” for international drug political work.  

18.00 Music Against Drugs ­(Main stage, Kungsträdgården, Stockholm)

Göran Hägglund, Minister for Health and Social Affairs opens Music Against Drugs 2010.

Tuesday 25 May

10.15-10.45 Presentation of a new report -  ”The Right of Children to be Protected from Narcotic Drugs and Psychotropic Substances” (Room 354)

·   Stefan Dahlgren, lawyer, Sweden

·   Elisabeth Dahlin, Secretary General of Save the Children Sweden

·   Linnea Forsberg, International secretary JUNIS

Wednesday 26 May

 11.30-12.00  Press conference with the WFAD Board (Room 357)

Presentation of the newly elected WFAD Board

Maria Larsson, Swedish Minister for Elderly Care and Public Health, will speak at the opening of the World Forum Against Drugs. Media representatives are invited to a press conference Monday May 24 at 9.15 a.m. in room 354 at Norra Latin, Drottninggatan 71 B, Stockholm.

Participants at the press conference

Maria Larsson, Swedish Minister for Elderly Care and Public Health

R. Gil Kerlikowske, Director of the United States Office of Drug Control Policy

Antonio Maria Costa, Executive Director UNODC

The Forum opens at 10 a.m.

Terrorism continues to represent one of the greatest global challenges to international peace, stability and security. To counter this threat, States must join efforts at the local, national, bilateral, regional, subregional and international levels to deal with its various manifestations. In addition, Member States must build up an institutional structure that includes prevention, investigation, law enforcement and adequate sanctions for terrorists.

The Digest of Terrorist Cases , recently released by UNODC, is an example of such international cooperation. The handbook is a compilation of legal experiences relating to actual terrorist cases gained by high-ranking experts from several countries who have gathered at meetings organized by UNODC in Austria, Colombia and Italy. The experts share their experiences in dealing with terrorism cases, reflect on their positive and negative judicial experiences, and explain specific investigative and prosecutorial techniques used in these cases.

Further reading

Handbook on Criminal Justice Responses to Terrorism
1999 International Convention for the Suppression of Financing of Terrorism
Terrorist Financing

The authors, Daniel J. Foti, M.A., Roman Kotov, Ph.D., Lin T. Guey, Ph.D., and Evelyn J. Bromet, Ph.D., examined the relationship between cannabis use and the course of illness in schizophrenia over 10 years of follow-up after first psychiatric hospitalization.

Conclusions: Cannabis use is associated with an adverse course of psychotic symptoms in schizophrenia, and vice versa, even after taking into account other clinical, substance use, and demographic variables.

Am J Pscyhiatry (17 May 2010)

Once again it is time for Music Against Drugs, an initiative by CRIS Sweden (Criminals Return Into Society).

The Music Against Drugs performance will take place in connection with the World Forum Against Drugs in Kungsträdgården on Monday, May 24.

Performing artists will be presented at a press conference on May 20.

Further information

Catherine Carlberg, Project manager MAD +46 70 658 68 39
Christer Karlsson, Chair CRIS + 46 70 461 22 45

MAD website (in Swedish only)

Amphetamines detected in exhaled breath from drug addicts: A new possible method for drugs-of-abuse testing

Abstract

Olof Beck¹, Kathinka Leine¹, Göran Palmskog¹, and Johan Franck^2
1Department of Medicine, Section of Clinical Pharmacology and ²Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden

Testing for drugs of abuse in sample matrices alternative to urine such as blood, sweat, and saliva have received increasing attention and is needed, for example, in traffic medicine.

Human breath is known to contain a large number of substances including non-volatile molecules. We explore whether intake of amphetamines could be detected by analytical investigation of exhaled breath from drug addicts.

Exhaled breath was collected from 12 drug addict patients after recovering from acute intoxication. Self-reported intake of “amphetamine” was confirmed by analysis of urine and plasma. The compounds were trapped by filtering the air through a modified silica surface and subsequently analyzed by a combined liquid chromatography–tandem mass spectrometry method. As a control, exhaled breath was collected in the same way from eight healthy volunteers.

Here we report for the first time that amphetamine and methamphetamine are present in exhaled breath following ingestion of these compounds by drug addicts.

Both amphetamine and methamphetamine were indisputably identified by means of the mass spectrometry technique in exhaled breath samples from all 12 patients. Identifications were based on monitoring two product ions in selected reaction monitoring mode and having correct relative ratios (± 20%). Excretion rates ranged from 0.2 to 139 pg/min. No amphetamine or methamphetamine was detected in the control subjects.

This finding, using a yet non-validated sampling procedure, opens a new possibility for drugs-of-abuse testing. Collection of exhaled breath is likely to be more convenient and safe as compared to matrices presently in use.

Source: Journal of Analytical Toxicology, June 2010, Volume 34, Number 5, pages 233–237