Waal Helge, Clausen Thomas, Gjersing Linn, Gossop Michael
Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway.
BMC Public Health. 2014 Aug 16;14:853. doi: 10.1186/1471-2458-14-853.
Open drug scenes are gatherings of drug users who publicly consume and deal drugs. The authors conducted a study of five European cities that have met such scenes constructively. The aim was to investigate shared and non-shared interventions and strategies in order to increase the understanding of this type of problem.
First a description was made for the cities of Amsterdam, Frankfurt, Vienna, Zürich and Lisbon. These descriptions were sent to contact persons in each city prior to visit by the researchers. The methods and strategies in each city were discussed and core choices and efforts extracted. A report was sent to the contact group for corrections and clarifications. The paper analyses shared and non-shared traits and strategies.
All of the cities had initially a period with conflict between liberal and restrictive policies. A political consensus seems to be a prerequisite for effective action. A core shared characteristic was that drug dependence was met as a health problem and drug use behaviour as a public nuisance problem. Low threshold health services including opioid maintenance treatment were combined with outreach social work and effective policing.
Prevention, harm reduction and treatment should be combined with law enforcement based on cooperation between police, health care and social services. The aim should be "coexistence" between society and users of illegal substances and the strategy based on several years planning and conjoint efforts. The solutions are found in appropriate combinations of harm reduction and restrictive measures.
公开吸毒场所是吸毒者公开吸毒和交易毒品的聚集地。作者对欧洲五个积极应对此类场所问题的城市进行了研究。目的是调查共同和非共同的干预措施及策略,以增进对这类问题的理解。
首先对阿姆斯特丹、法兰克福、维也纳、苏黎世和里斯本这几个城市进行了描述。这些描述在研究人员到访之前发送给了每个城市的联系人。讨论了每个城市的方法和策略,并提炼出核心选择和举措。向联系人小组发送了一份报告以供修正和澄清。本文分析了共同和非共同的特点及策略。
所有城市最初都经历过宽松政策与严格政策之间的冲突时期。政治共识似乎是有效行动的先决条件。一个核心的共同特征是,将药物依赖视为健康问题,将吸毒行为视为公共妨害问题。包括阿片类药物维持治疗在内的低门槛医疗服务与外展社会工作及有效的治安措施相结合。
预防、减少伤害和治疗应与基于警察、医疗保健和社会服务合作的执法相结合。目标应该是社会与非法药物使用者之间的“共存”,且该策略应基于数年的规划和共同努力。解决方案在于减少伤害措施与限制措施的适当结合。