CLOSING ADDRESS BY THE HON. LAWRENCE GONZI, DEPUTY PRIME MINISTER AND MINISTER FOR SOCIAL POLICY, AT THE CONFERENCE ?CO-ORDINATING THE FUTURE' ORGANISED BY THE MINISTRY FOR SOCIAL POLICY AND THE NATIONAL COMMISSION ON THE ABUSE OF DRUGS, ALCOHOL AND OTHER

Ladies and Gentlemen,

The National Commission for Drugs, Alcohol and other Dependencies was constituted last October and has been now functioning for a period of one year, with its members appointed on the basis of their professional, personal competence and their expertise in the Dependency field. The Commission's responsibilities in the main are to advise the Minister on Policy issues, however these must be evidenced based.

This Conference per se is the second initiative in a series that aims to have all the views of those working in the field before attempting to construct such policies. In addition, it is imperative that the Commission provides a forum through which all agencies are able to work together in order to provide the user with the most comprehensive and structured treatment possibilities and the general population with the most up to date preventive information. The first initiative, which has been running since March, involves the collection and collation of data related to those seeking treatment. To date three monthly reports March April & May have been produced and all the agencies concerned have provided necessary feedback to make possible more detailed reports for the months of June to October. It is envisaged that an annual report on those seeking treatment in Malta & Gozo will be produced at the end of the year and forwarded to all for comments before publication.

It has been brought to my notice that this Conference has been an effective and fruitful vehicle through which you have been able in the first instance to listen to the directors' views of the respective agencies on their current operations, problems associated with these, and their directions and aspirations for the future. This afternoon you have been busy airing your own views in one of the four respective workshops, Supply Reduction, Demand Reduction, Risk/Harm Reduction and Policy. These workshops have indicated that a proactive policy response can only be achieved through (a) a comprehensive national strategy that emphasises the exchange of knowledge and expertise; and (b) the implementation of treatment, prevention and research approaches that do not compartmentalise the problem as merely a medical or an enforcement issue.

It is important that we uphold an evidence-based understanding of dependency that is non-restrictive and takes into account the problem's multi-faceted aspects. In society's attempt to rationalise the problem of substance abuse we seem intent on focusing on illicit drug-taking without putting into perspective the problems associated with other forms of addictive behaviour such as, gambling, alcohol and tobacco use and the abuse of licit drugs, including benzodiazapines and inhalants.

We have to secure treatment modalities that cater for divergent client groups, prevention rationales that focus on the various sources of addictive behaviour and specific prevention programmes targeting the needs of different population categories. National policy in this regard should be spurred by a multi-pronged effort at community, national, regional and international level, which focuses on the person in his/her complexity, with effective consideration of the impact dependency has on the psycho-social, emotional and physical make-up of the individual. Moreover, it is also crucial that we locate dependency prevention efforts within the wider ambit of social policy. The primary aim of dependency professionals, services and prevention programmes should remain the fostering of social cohesion, and the facilitation of a social environment that nurtures and reaps the harvest of individual empowerment and emancipation. We must combine the respect for, and active defence of, diversity with the importance of building and enhancing a solidarity, which is principally the means of sanctioning the requisite social mesh for recognising everyone's right to build him/herself as a person. Contemporary social praxis necessitates a policy ethic that places the individual and his or her psychological, physical and social needs as the focus of social intervention.

It is certainly reassuring that today's discussions have shown that this perspective has also permeated into the addictions sector. The socially inclusive society that we all aspire to cannot be nurtured through myopic solutions where addicted persons or other individuals with psychosocial, health or criminogenic problems are either institutionalised or isolated in the peripheries of our health or criminal justice system or left to meander in the outskirts of normative, mainstream society. Our unfortunate tendency to politicise the scourge of drug abuse has often prompted the call for an efficient criminal justice response as the cogent deterrent to illicit drug use. On the other hand, the medical model that is forwarded to counter this argument tends to emphasise various treatment and rehabilitative regimes as the only effective response to habitual patterns of substance abuse.

One can easily identify strong merits and defaults in both of these lines of argumentation. Moreover, such dichotomies also denote that the development and implementation of a comprehensive addictions policy based on the participation of the key social stakeholders, including NGO's is now imperative. Undoubtedly, the Maltese experience of NGO's in the social sector epitomises how flexible yet resolute

structures assist and complement government agencies in the development of a more effective response to the myriad needs of socially emarginated persons. Caritas and OASI's endeavours in the addictions field crystallise the important role non-governmental, voluntary agencies play in truly building a welfare society which reverberates the tenets of solidarity, subsidiarity and community/individual empowerment I have already referred to.

Today's conference has also amply indicated that there seems to be strong room for further co-ordination in the implementation of both treatment services and prevention programmes and the national level. It would indeed be unfortunate if the parochial, partisan mentality that unfortunately seems to prevail in various spheres of social and political life in Malta also curtails the efficacy of the agencies undertaking such admirable work in the dependencies sector. We have to recognise that both government and non-government agencies occupy their own legitimate space, and that both, particularly, NGO's should not merely operate on wholly on state-subsidised funds. Subsidiarity - the backbone of the EU's social policy and the fundamental, uncompromising political precept, which has always guided the Nationalist administrations' forays in social policy, whilst advocating participation from the voluntary sector, also aims at instilling wider community ownership of social policy strategies. This administration, for example, has embarked on the road toward lasting and effective partnerships with the business community in its efforts to undertake various initiatives related to social accommodation. There is nothing that should impede similar undertakings in the dependency field. The critical factor here is the development of a regulating body or mechanisms that secures and upholds standards in the delivery of treatment services or primary/secondary prevention programmes.

Moreover, one should not interpret the need for increased co-ordination to imply merely closer collaboration between government and voluntary agencies in the dependency sector. There should also be increased inter-agency co-operation between diverse government agencies, which as yet, despite significant strides forward in recent years, is still far from being effectively realised. It is my view that we can tackle the problems associated with dependency, if we attempt to first analyse their potential relationship to wider social problems. The aetiology of dependency remains in part rooted deep in our society. For example, can we forego the understanding of the relationship between substandard housing, unemployment, low educational achievement and substance misuse? Similarly, can we deduce a link between child abuse and domestic violence and substance abuse? The understanding of these factors should imply that; we cannot assure an effective addictions prevention strategy without examining the relationship of addictive behaviour to current socio-cultural processes and a truly comprehensive prevention strategy entails inter-agency collaboration moulded on a concrete working inter-relationship between all welfare service providers.

In my view we are still far from achieving both these goals. We also need to improve our research capacities and increase our resource capacity in this regard. I am informed that the Commission is achieving strong headway in this regard. In addition to collecting and collating information on the number of people coming forward for treatment, a prevalence survey is to be conducted in the near future. The pilot survey I gather is near completion and augurs well for the initiation of such a project. A novel study is also to be effected with the aid of yourselves and a Dutch consultant, Mr. Bless in which it will be possible to quantify the services on offer and provide better cohesive working practices.

The Commission has also been at the forefront of Council of Europe Activities. These include a standing conference for Mediterranean countries (the first of which was held this time last year) aimed at forging a network to discuss such issues and implement evidence-based research initiatives in the Mediterranean region. The Commission chairs the group and at present a nomination survey is being prepared for the end of the year that will then be followed by a strengths, weaknesses, opportunities and threats type survey for participating countries. In the second half of next year the Mediterranean countries will join the European School Survey Project to discuss a pilot project for the Med and the next full survey to take place in 2003. It is indeed gratifying to note that Malta has been a catalyst in this regard, and has spurred our neighbouring Mediterranean countries toward concrete forms of research-based collaboration. Moreover, the Commission's proactive participation in the Pompidou (Council of Europe) Epidemiological Experts working groups also provides strong opportunities for strengthening our human resources in the dependencies sector. The basis for any successful programme/initiative is dependent on having in place dedicated and well-trained professionals. The Council of Europe has through its scheme of fellowships provided a number of you the opportunity to study overseas. However, we need our own training and continuing education programmes in place to constantly train and up date the expert staff required by the programmes on offer.

This development of the human resources deployed in the field and of the requisite scientific evidence will supplement our efforts to appraise the efficacy of our dependency prevention efforts, and to take the necessary corrective action when necessary. All the players in the field must be held accountable for their input in the sector. Given the government's thrust on ascertaining greater rigour in the meting out of public finances, we have to secure that our investment in this sector is money well-spent, that any unnecessary duplication is avoided, and that that our services and prevention programmes address the complexity of needs extant to problems of dependency.

As a concluding remark, I cannot but re-iterate the importance of evaluating services and programmes in our effort to build policy strategies that will have lasting and effective impact on the lives of dependants and society at large. Tackling or pre-empting the problems of dependency requires a sense of cohesiveness by all in the field. Today may be seen as a further step in this direction. Bringing together different experiences, expertise and resources is a sensible way for building concerted grass-roots support for on-going evaluation and closer collaboration. Yet much more remains to be done. The coming year requires us all to make an effort to see this process further down the line. It is only through effective partnerships between the voluntary and government sector, the bolstering of our research and evidence base and a comprehensive policy framework that accounts for the divergent facets of dependency that we can realise our noble aspirations of less demand for addictive substances, and a more socially-inclusive society