Law Enforcement and Health Care cooperation

From: “Commission on Crime Prevention and Criminal Justice – UNODC” Vienna, Austria – 18 May 2010
a Humanitarian People-Centred Preventive Approach

“… Public health – the first principle of drug control – should be brought back to centre stage. Currently, the amount of resources and political support for public security and law enforcement far outweigh those devoted to public health. This must be re-balanced. Drug dependence is an illness that should be treated like any other. More resources are needed to prevent people from taking drugs, to treat those who are dependent, and to reduce the adverse health and social consequences of drug abuse …
… protecting public security and safeguarding public health should be done in a way that upholds human rights and human dignity…
… Although drugs kill, we should not kill because of drugs …”

These are not my words. These are words of UNODC Director General, Mr. Antonio Costa.
I could not have expressed better those thoughts, which I totally agree with.
Drug abuse is such a complex phenomenon which requires actions and expertise of many actors, even faraway from each other in terms of professional skills and sensitivity. Different answers may damage each other, if they are not well harmonized and addressed to prevent dramatic consequences of drug consumption.

If the health-based approach, on one side, and the merely repressive approach, on the other side, ignore or hinder each other, the result will be negative for both and the most vulnerable groups, that is to say drug users, but also all the civil society, are those who will lose out the most.
During my 35-year experience in the field, I have been learning that violence always leads to more violence and that stigma and discrimination of drug users kill more that the substance as such.
We ought to be so clever to understand that a harmonized approach is the best option that we have.
Obviously, the repressive approach and the therapeutic approach should partially give up to their own power in order not to hinder each other.

If Police officers lie in wait to identify and file drug users when they are outside a centre for needles exchange or methadone distribution, that is a clear obstacle which might neutralize the efforts of health care providers.

If figures of law enforcement send messages to the Authorities in order to discourage humanitarian interventions based on scientific evidence, on the basis of prejudices and scarce knowledge of public health, the final result will be negative for everyone.

In order to better integrate humanitarian politics and repressive politics, it is worthwhile to train police officers and health care providers at best.

Joint seminars with Police officers and health care personnel are considered the best way to overcome prejudices and mutual mistrust, leading to improve the synergy between the two types of intervention.
Three years ago in Italy, an interesting and successful experience was made, organizing eighteen meetings, 3 days each, in all regions. Present were Italian Police forces and experts in the field of health, such as doctors, psychologists and social workers.

Another experience, which I really care about since I personally promoted and launched it, shows that integration and joint work are possible and rewarding because of their great effectiveness.
In more than fifteen years, whenever a drug user in Rome is caught and arrested, Police officers call the Emergency Unit staff in Villa Maraini Foundation, leading organization in assistance to drug users opened 24 hours a day, 7 days a week that J founded in 1976 in the framework of the activities of the Italian Red Cross.

Staff members arrive in police temporary detention centers or in jails and they meet with arrested drug user and, if deemed necessary, they give him methadone to get through the abstinence crisis.
Hundreds of such interventions have shown the effectiveness of that kind of approach, which has led to an impressive decrease in self-harming behavior and tendency to injury others. Those inclinations are very frequent in people who are limited of freedom and feel sick in their own shoes.
Over the years, a special alliance has been developed by Villa Maraini staff members and Police officers in Rome. They have realized that a humanitarian approach towards street drug users is convenient for everyone, even for comfort and effectiveness of their work.

I would like to conclude by quoting a sentence that seems to me very important from the document which is at the basis of this meeting: “This Crime Commission should launch a new and exciting dimension of law enforcement: the humanitarian, health-oriented and near-to-people dimension”.

“A comprehensive approach, fighting crime and at the same time helping children and families at risk, changing the trajectory of problematic adolescents, offering health care, social assistance and protection to the most marginalized, subtracts potential workers to criminal organizations and change the social fabric making it less permeable to unlawful behaviours”.
This is an exciting agenda for all of us.

Massimo Barra