We can define psychoactive substances as any natural or artificial substance which, by their physical or chemical nature, modifies the functioning of the central nervous system (CNS), depressing it, stimulating it or disturbing it; that is, changing the sensations, mood, consciousness or other physiological and behavioral functions, and that can be used for various purposes. The psychoactive substances can be legal or illegal and, with regard to prevention, it is essential to work the ones considered legal, such as alcohol, drugs, caffeine, and not just illegal drugs.
The use of both licit and illicit substances has been known to mankind since ancient times. In the past their use was present in the regions of their origin, but today the use of these substances is widely spread all around the world, especially in the Western society (United Nations Office on Drugs and Crime, 2010).
June 17 marks the 44th anniversary of President Richard Nixon’s war on drugs. American’s longest war has destroyed millions of lives and turned the US into the world’s leading incarcerator with less than 5% of the world’s population but nearly 25% of its prisoners (Newman, 2015).
Instead of the “drug free” world promised by this war, drugs are available as ever. The Balkan Route – once the world’s most prolific drug highway - passes right through Zagreb, taking millions worth of heroin from the opium fields of Afghanistan to the veins of Western Europe via Croatia. Although the major market for the heroin is Western Europe, much gets sold along the way to people within the transit nations. According to Croatia Week (2015) it is estimated that Croatians inject over three tonnes of heroin a year, and heroin is the most widely used drug within the nation after cannabis (which is also shipped along the Balkan Route).
Situation in Croatia
In Croatia drug control is mainly covered by two legal acts: the Law on Combating Drugs Abuse, and the Criminal Code. The Law on Combating Drugs Abuse (LCDA), passed in November 2001 and updated since, regulates the conditions for the manufacture, possession of and trade in drugs, substances and precursors. It prohibits unauthorized drug cultivation, possession and trafficking, and provides fines for legal entities in breach of drug trading regulations, and for individuals who cross the border without declaring psychoactive medicines. More serious offences are prosecuted under the Criminal Code. Discarding syringes and failure to notify the police of suspicious events are also specific offences. It also outlines a system for the prevention of drug addiction and assistance for addicts and sporadic drug users (EMCDDA, 2015).
On 1 January 2013 new amendments to the Criminal Code came into force. Possession of small quantities of drugs for personal use is now no longer a criminal offence but instead is classed as a misdemeanor under the LCDA, punishable by a fine of EUR 650–2 600. The judgment on whether the quantity can be classed as ‘small’ is made by the state prosecutor or court in each case. Illicit production and processing of drugs with no intention to sell is punishable by six months to five years in prison. Illicit production, processing, possession, import and export with intention to sell are punishable by 1–12 years in prison, which under defined aggravating circumstances, including the involvement of children or organized groups, or serious health damage, may increase to three or even 5–15 years. Precursor trafficking carries a penalty of six months to five years in prison (EMCDDA, 2015).
At the same time, the new Criminal Code urges the court to use a number of alternative measures to imprisonment, such as fines, community service, probation and treatment, for cases when a prison sentence of up to six month is prescribed. Compulsory treatment may be prescribed for up to three years and time spent in treatment is included in the sentence.
The European School Survey Project on Alcohol and Other Drugs (psychoactive substances) has been conducted nationwide regularly since 1995. The first general population survey was implemented in Croatia in 2011 (reported in 2012). A total of 16% of respondents reported consumption of any illicit drug (cannabis, amphetamines, ecstasy, LSD, cocaine or heroin) at least once in their lifetime. Cannabis was the most prevalent drug, reported by 15.6 % of respondents, followed by amphetamines (2.6 %) and ecstasy (2.5 %). About 5 % of respondents had used cannabis in the last 12 months and 2.9 % in the last 30 days. Illicit drug use was more frequently observed in larger cities and among younger respondents. Reported recent cannabis use was found to be higher in younger age groups, and was highest among 15- to 24-year-olds (EMCDDA, 2015).
In 2009 Zagreb became the fourth city in the world to measure the quantities of illicit drugs in communal wastewater to determine the trend of drug use. Data were collected again in 2011. According to the results of both studies, cannabis remained the most widely used drug in the city. Although heroin was the second most widely detected substance in 2009, in the 2011 study more cocaine than heroin was detected (EMCDDA, 2015).
Prevention in Croatia
Prevention programs in the Republic of Croatia are being implemented primarily at the local community level as multidisciplinary activities with the participation of different sectors such as education, health, social care, non-governmental organizations (NGOs) and the media. In 2010 the first National Addiction Prevention Programs for Children and Youth in the Educational Setting and Social Welfare System was adopted.
Universal drug prevention is mostly organized and implemented within the education system under the oversight of the Ministry of Science, Education and Sports. School-based prevention is primarily aimed at motivating young people to adopt healthy lifestyles, developing their self-esteem and social skills, offering alternative activities for leisure time and thus eventually reducing young people’s interest in experimenting with addictive substances. In 2011 the web portal preventivni was launched to provide teachers with information and resources for preparing and implementing school-based prevention programs. In 2013 a module-based health education curriculum was introduced in all elementary schools and high schools.
Family-oriented prevention activities are implemented through 19 family centers (which were merged with social welfare centers at the end of 2014) or by local organizations, and focus on developing robust parenting skills. At the community level, youth clubs and NGOs offer educational activities during young people’s leisure time, using peer education methods or proposing alternative positive behavioral models for leisure activities. There has recently been a shift in universal prevention strategies from a program of primarily information provision and mass media campaigns towards more skills-based prevention activities (EMCDDA, 2015).
In recent years well-respected international programs have been implemented in Croatia. The Life-Skills Training Program is implemented in schools in Primorje-Gorski Kotar and Zadar, and since its inception has covered about 54 000 pupils. In 2009–10 Unplugged was implemented in 15 primary schools in Zagreb and its surroundings and from 2011 the program became part of the catalogue for teachers’ professional training activities, while PATH/RASTEM was implemented in pre-schools and elementary schools in Istria, Labin, Rijeka, Vrsar and Zagreb. (EMCDDA, 2015).
Some projects undertake selective prevention with vulnerable families, such as those with imprisoned parents or parents with drug-abuse problems, minority communities, and, within the educational context, aimed at children with special needs, in children’s homes, from high-risk families or those with learning problems. These programs mainly reinforce the need for a healthy lifestyle and risk reduction, promote the role of parenting and provide alternative leisure activities for young people at high risk of substance abuse. Indicated prevention targets young experimenters in contact with social welfare centers or public health institutes. In 2010 the Office for Combating Drug Abuse launched an Addiction Prevention Program database containing data on all projects, contributing to the dissemination of information on effective and high-quality interventions. The launch of the database was followed by several training events for drug prevention experts in 2011 and 2012 to promote evidence-based prevention programs in the country (EMCDDA, 2015).
The look on the phenomenon has to meet the requirements that the complexity of psychoactive substances consumption imposes. It is a multi-determined phenomenon and is far from being explained by simplistic and linear theories. This phenomenon must be understood in an integrative model to examine the dynamics between different levels - the individual (with the biological, psychological and relational dimensions), social (including the various social systems, such as family, community, etc.) and also its socio-political and economic dimension (Teixeira, 2008).
We can conclude from all the data shown above that prevention, and particularly prevention amongst the youngsters is still at an initial stage in Croatia. These days it is increasingly argued that one should begin to prevent earlier, since it is a fact that early intervention in reducing risk factors seems to have more impact than later intervention in changing the trajectory of the young (NIDA, 2003). The intervention also in early childhood can be explained by considering that this period is easier to influence attitudes and behaviors towards the psychoactive substances. On the other hand, the fact that the young initiate the use of psychoactive substances more and more at an earlier age, legitimizes the implementation of prevention programs in schools still in pre-school and 1st years of formal learning.
The etiological studies show that there are several paths leading to initiation, use and abuse of psychoactive substances and that there is not a univocal and simple reason to justify a person's vulnerability to consume these substances (Bukoski, 1991). The design of preventive interventions requires, then, knowledge of etiologic risk factors for initiation, progression and psychoactive substances abuse. Risk factors are considered all the features or attributes of a person, group or context that increase the probability of consumption and/or abuse of psychoactive substances; protective factors are those that inoculate or protect the person and can strengthen their determination to reject or avoid substance use. Theoretically, the risk and protection factors are predictors of risk behavior: the higher the presence of risk factors, the more likely the person will develop in the future behaviors and problems related to drug use. But we know that not all children and young people growing up exposed to risk factors manifest behavior problems. This is due to the presence of protective factors which make this a resilient child, that is, reduce the effects of the risk factors.
Substance use is a tricky topic to approach with young people. Many educators focus on the worst possible outcome of substance use, and warn children and teenagers that substances are “addictive”, powerful, and can ruin their lives. However, if we truly want children and youngsters to lead productive and happy lives, have high self-esteem and have effective substance use education, we need to emphasize the fact that they are in control of their behaviors and decisions, and also that they are the ones who will stand the consequences (good and bad) of it. When fear is used to persuade (young) people to doing — or not doing — something it also sends the implicit message that people are not capable of being in control of their own choices, taking risks, or learning lessons from their own mistakes. This can be a very dangerous way to help someone approach adulthood, because it does nothing to motivate or empower, but relies on negative emotions and negative reinforcement. Instead, we should trust our kids and teenagers to make good choices and teach them how to accept the responsibility for and work through the consequences of bad choices. Thus, we consider the person to be responsible and competent to make decisions regarding their life, and we value self-awareness that each person has about his health situation and the ability to make self-determined options. Prevention seeks to base its actions on training strategies of personal development that promote the healthy growth of children and young.
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe, and states as good practices to prevent substance abuse amongst the youngsters:
Author: Joana Pereira, EVS volunteer, Youth association Alfa Albona