United Nations

A/51/129


General Assembly

Distr. GENERAL  

14 May 1996

ORIGINAL:
ENGLISH


                                                  A/51/129
                                                  E/1996/53
                                                  


GENERAL ASSEMBLY                               ECONOMIC AND SOCIAL COUNCIL
Fiftieth session                               Substantive session of 1996
Item 105 of the preliminary list*              Item 5 (h) of the  provisional
INTERNATIONAL DRUG CONTROL                       agenda**
                                               SOCIAL, HUMANITARIAN AND HUMAN
*    A/51/50.                                    RIGHTS QUESTIONS: NARCOTIC
                                                 DRUGS

                                               **    E/1996/100.


            Implementation of the United Nations System-wide Action
                          Plan on Drug Abuse Control

                        Report of the Secretary-General


                                SUMMARY

      In its resolution 48/112 of 20 December 1993 the General Assembly
requested that the System-Wide Action Plan on Drug Abuse Control be
reviewed and updated on a biennial basis.  At its first 1995 session,
the Administrative Committee on Coordination requested its
Subcommittee on Drug Control to prepare a more operational plan of
action based on multi-agency sectoral and/or subsectoral plans of
action.  This new approach calls for inter-agency collaboration at the
planning stage and is an incremental process.  The present document
contains a condensed version of the first six of these plans of
action.  Further plans are being elaborated for later inclusion in the
System-Wide Action Plan.


                                   CONTENTS

                                                              Paragraphs Page

 I.   THE PURPOSE .........................................      1 - 3    3

II.   THE PROCESS .........................................      4 - 6    3

III.  THE RESULT ..........................................      7 - 12   4

IV.   THE FUTURE ..........................................      13 - 16  5

 V.   THE PLAN ............................................      17 - 94  6

      A. Drug abuse prevention in the school environment 
         (plan of action 1) ..............................       18 - 30  6

      B. Drug abuse prevention among children and youth in
         especially difficult circumstances (plan of 
         action 2) .......................................       31 - 45  9

      C. Drug abuse prevention among rural youth (plan of
         action 3) .......................................       46 - 63  14

      D. Drug abuse prevention in the workplace (plan of
         action 4) .......................................       64 - 75  20

      E. Women and drug abuse:  the gender dimension (plan
         of action 5) ....................................       76 - 84  23

      F. Assessment of drug abuse:  data collection (plan
         of action 6) ....................................       85 - 94  26

Annex.  Overview of participating agencies .............................  29


                                I.  THE PURPOSE

1.   The development of a system-wide action plan on drug abuse control
was first mandated by the General Assembly in its resolution 44/141 of
15 December 1989 aimed at "the full implementation of all existing
mandates and subsequent decisions of intergovernmental bodies
throughout the United Nations system".  The various exercises to
develop and update such a plan proved inadequate, however, and served
little useful purpose.  In recognition of this, the Administrative
Committee on Coordination, at its first 1995 session, requested its
Subcommittee on Drug Control to review, strengthen and render
operational the United Nations System-Wide Action Plan on Drug Abuse
Control through the elaboration of specific multi-agency sectoral
and/or subsectoral plans of action for drug abuse control at global,
regional and subregional levels (ACC/1995/4).

2.   The new approach to the System-Wide Action Plan has provided the
opportunity to turn it into a working document that in time, when it
is more complete, will be usable as a real planning tool.  Ideally it
will encompass all the mandates and policies of the United Nations
system related to drug abuse control and reflect these through
commonly agreed-upon, forward-looking strategies under the various
major components.  Specific activities will ultimately be formulated
by individual agencies or groups of agencies to achieve the specified
objectives and fill the gaps that become apparent in the process, at
the same time avoiding duplication and identifying opportunities for
synergy.

3.   It is envisaged that connections will also be drawn between the
System-Wide Action Plan and other planning tools used by both
Governments and international organizations, in order to synchronize
activities and focus on varying priorities around the globe.  The
further development of the System-Wide Action Plan should therefore
take into account not only policies and plans of the individual
agencies involved but also the existing and emerging country strategy
notes, national, regional and subregional programme frameworks and the
individual masterplans of the cooperating Governments.  The assistance
provided to national authorities would thereby acquire a spearheaded
focus on requirements rather than ad hoc interventions by the various
parts of the system.


                               II.  THE PROCESS

4.   Acting on the recommendation of the Administrative Committee on
Coordination, its Subcommittee on Drug Control, at its third annual
session in July/August 1995, began the process by identifying initial
themes to be developed into plans of action for incorporation into the
System-Wide Action Plan.  Rather than representing highest priority
areas, the choice of these particular themes was based on ongoing
collaborative activities; subject-matter that was obviously attractive
to several agencies; and themes that appeared to be relatively easy to
formulate quickly with minimal resource requirements.  As a result of
these criteria and given the nature of the various participating
agencies in the health, education and social fields, the initial plans
of action are all on demand reduction.  Themes on supply reduction and
other sectors and subsectors will follow in due course as the System-
Wide Action Plan develops.  The constant updating of the System-Wide
Action Plan in the future will ensure that it becomes a living
document rather than merely a status report.

5.   For each theme, a multi-agency task force, complete with task
force manager, was established.  In each case the task force manager
prepared an initial draft and circulated it to the other members of
the task force.  These drafts were then amended and recirculated
within the task forces until agreement had been reached by all
members.  The final drafts were then submitted to the United Nations
International Drug Control Programme, as secretariat of the
Subcommittee, for clearance by the Subcommittee.  It is worthy of note
that this process did not entail the convening of a single meeting
between the task force members as all communications were by
electronic means.  Furthermore, as each agency was preparing that area
within a specific plan of action dealing with its own perspective of
the problem and related activities, additional resources were not
required.

6.   The plans of action reflect the different perspectives and
priorities of the agencies.  These blend to a whole that goes beyond
the mandates of the United Nations International Drug Control
Programme and the Commission on Narcotic Drugs - e.g., by including in
some cases alcohol and tobacco.  This is necessitated by the very
nature of the mandates of the various agencies and will eventually
contribute to the provision of a complete picture of drug abuse
control, enriched by reference to related phenomena.


                               III.  THE RESULT

7.   The result of this first step in the process of renewing the
System-Wide Action Plan is provided in section V below.  The picture
provided is far from  complete as it consists merely of the initial
six plans of action.  Through the elaboration of subsectoral plans of
action that will eventually form a comprehensive plan covering all
aspects of drug abuse control, the System-Wide Action Plan itself has
become a process rather than a static document.  The activities in the
plans of action will constantly be updated as new ones are formulated
and old ones become obsolete, and it may even be found that the
objectives will change over time as:  (a) the drug abuse situation
changes; and (b) there are changes in policy direction in one or more
of the participating agencies.  

8.   In general, the plans follow a common pattern agreed upon by the
Subcommittee, consisting of a statement of the problem being addressed
and a list and description of the desired objectives to be achieved. 
This is followed by a detailed breakdown of activities being
undertaken or planned in specific areas, indicating the responsible
agencies and status of funding in each case.  Recently completed
activities have in some cases been included in order to present a more
complete picture and show the ongoing and planned activities in
context.  With regard to the planned activities, estimates of costing
have been provided where possible.  However, this denotes no
commitment on the part of any agency either to provide the required
funding or, indeed, to carry out these activities.  Emerging ideas
that have not yet been approved by all concerned parties are
identified as such.

9.   At this initial stage, the System-Wide Action Plan reflects a
survey of existing activities and plans and establishes a basis in
reality.  The exercise has provided the participating agencies, as
well as others, with the opportunity to become acquainted with each
others' activities.  Building on the present status, the system is now
in a much better position to initiate cohesive and targeted planning,
both individually and jointly, with the commonly agreed objectives in
mind.

10.  In order to adhere to United Nations regulations on the length of
documentation, the System-Wide Action Plan is being submitted without
the details of activities.  The plans of action reproduced below
therefore comprise only the problem statement and objectives, with an
indication of the agencies involved.  The complete plans of action,
with detailed listings of activities by agency and status of funding
reports, will be made available by United Nations International Drug
Control Programme upon request.

11.  Each full plan of action also contains a standard paragraph on
monitoring and evaluation, to the effect that:  responsibility for
monitoring and evaluating individual initiatives under the plan of
action lies within the agency responsible for the initiative and will
be carried out in line with that agency's own procedures.  The
Subcommittee on Drug Control has responsibility for monitoring the
progress in carrying out the plan of action as a whole and proposing
any evaluations that may be needed.  As secretariat for the
Subcommittee, the United Nations International Drug Control Programme
will collect the necessary information from agencies involved in the
plan of action to permit the Subcommittee to monitor progress and make
adjustments in the plan of action as required.  Since the Subcommittee
itself has no funds at its disposal, it is not in a position to
undertake evaluations of individual plans of action.  It may
nevertheless recommend to United Nations International Drug Control
Programme or other participating agencies that such an evaluation be
undertaken and may suggest the possible focus for such an evaluation.

12.  The complete version of the System-Wide Action Plan, including
details of activities and availability of funding, was made available
to the Commission on Narcotic Drugs at its thirty-ninth session as a
conference room paper.  The Commission found that encouraging progress
had been made and noted with satisfaction the approach adopted by the
Subcommittee in elaborating the revitalized System-Wide Action Plan. 
The Commission also recommended that the Economic and Social Council
endorse the approach adopted, and call upon relevant agencies within
the system to participate actively in the preparation of the System-
Wide Action Plan and to integrate it fully into their planning and
programming process.


                                IV.  THE FUTURE

13.  The following plans of action constitute the embryo of the new
System-Wide Action Plan.  It is expected that agencies will use the
System-Wide Action Plan as a planning tool, helpful in assessing the
level of activities in a given area and identifying priorities to be
jointly addressed.  With regard to additional plans of action, those
already identified by the Subcommittee are to be prepared by their
task forces in the course of 1996.  Upon clearance, these will then be
incorporated into the System-Wide Action Plan.
          
14.  At its fourth annual session, scheduled for 4-6 September 1996,
the Subcommittee will review the whole process of plan of action
preparation and the System-Wide Action Plan.  It will also identify
the next set of themes to be prepared.  Subsequently the System-Wide
Action Plan will be an ongoing process with activities within the
plans of action added and deleted as appropriate and new plans of
action added until the whole spectrum of drug abuse control is
adequately covered.  The Subcommittee will also address the challenge
posed by the need to ensure full recognition, acceptance and use of
the System-Wide Action Plan as a vital planning tool by all relevant
agencies.

15.  It is anticipated that in due course the need will arise to
evaluate the entire System-Wide Action Plan process, particularly its
design and monitoring and the level of success in achieving the
objectives.  The Subcommittee will therefore also be called upon to
examine modalities for implementing such an evaluation.

16.  The plans of action are expected to prove useful in fund-raising
activities, as potential donors will have an oversight of activities
and will easily be able to identify areas requiring funding and which
they would wish to support.  


                                 V.  THE PLAN

17.  The following is the initial group of plans of action constituting
the new United Nations System-Wide Action Plan on Drug Abuse Control. 
It consists of six subsectoral plans of action addressing various
aspects of demand reduction.  As subsequent plans of action touching
this and other sectors are prepared, they will be grouped within a
framework reflecting the areas of substantive concentration in
international drug control.


              A.  Drug abuse prevention in the school environment
                  (plan of action 1)                             

18.  The United Nations Educational, Scientific and Cultural
Organization (UNESCO) served as task force manager for the preparation
of this plan of action in collaboration with the United Nations
International Drug Control Programme and the World Health Organization
(WHO).


              1.  Statement of the issue/problem to be addressed

19.  It is generally acknowledged that drug abuse can no longer be
explained as an individual problem, it has become a societal
phenomenon that tends to destabilize the economic, political and
cultural fibre of communities.  Over and above personal
responsibility, it is the responsibility of society as a whole to
participate in promoting a life where drug abuse has no place.  This
should aim at preventing exclusion, including exclusion from
educational opportunities and thus from participation in
decision-making, which is an essential factor for building democracy,
and also at preventing violence from festering and, eventually,
exploding throughout a society.

20.  The abuse of drugs among young people is increasing in countries
of the North as well as of the South.  There is a diffusion of
substance abuse and substance abuse behaviours among countries and
regions which may be attributed to many factors, including the impact
of external intervention programmes, global supply factors, mobility
of populations and/or social modelling.

21.  Children and young people are particularly vulnerable to drug
abuse; the transition between childhood and maturity often leads to
experimenting with certain ideas and practices, including drug-taking. 
But youth is also a period during which knowledge, beliefs, attitudes,
values and skills are acquired, and it is necessary to behave in ways
conducive to good health and well-being and to avoid situations likely
to lead to taking up the use of drugs.

22.  Education is vital to healthy and sustainable human development. 
Education is the domain in which social cohesion and feelings of
belonging to a community can be restored and "learning to be" can be
the blueprint for the future. Following international efforts in
promoting access to and quality and relevance of education, more than
80 per cent of school-age children worldwide now enrol at primary
school level and 70 per cent complete at least four years of
education.  Educational innovation and change are under way, showing
that all countries can take up the challenges of devising educational
programmes to fit their means, needs and aspirations.

23.  The development of effective education programmes that will help
achieve individual practice of excessive risk reduction behaviour is a
primary avenue for the prevention of drug abuse and other
health-related problems among school-age youth.  Research and pilot
experiences show that school-based health and preventive education
interventions can serve as an effective strategy to help young people
to acquire health-related knowledge, values, skills, and practices, to
pursue a healthy lifestyle and to work as agents of change for the
health of their communities.  To be efficient, preventive education
should be formative and not simply informative, using methods and
techniques that are learner-oriented, task-oriented and
situation-oriented, and strive towards providing opportunities to
learn decision-making and communication skills, both for young people,
parents and the community at large.  Tobacco and alcohol, drugs which
are legal in most countries, have often been shown to be precursors to
the use of illicit substances, and demand reduction strategies should
therefore also include education that focuses on delaying and
preventing the onset of tobacco and alcohol consumption. 

24.  Education for the prevention of drug abuse is a long-term process
that should run in parallel to drug supply reduction programmes and
crop control programmes.  It has to be assimilated within and become
an integral part of education systems and life-long education. 
Efficient actions, unfortunately often limited in time and space, must
be institutionalized at national and local levels, and the major
challenge to achieving this goal is the development of curricula to
facilitate the learning of appropriate skills for health promotion and
primary prevention.

                                2.  Objectives

25.  Schools have a unique position for promoting the positive values
inherent in accepting healthy lifestyles and quality of life for all
people.  The challenge is enormous but reachable if the objectives
enumerated below are met.

Objective 1.  Development and implementation of policy

26.  Establishing a drug-related school policy as part of an overall
school health promotion policy is fundamental to the successful
involvement of schools in the prevention of drug abuse among young
people.  Governments will therefore be encouraged to establish or
improve policies for integration of school-based preventive and health
education within an age-appropriate and skills-based context, to
describe a unified direction and approach, providing a strategy for
implementation notably as concerns programming and development of
curricula, defining ways of addressing the issue, and providing
appropriate training for school personnel.  This policy should in
every aspect take into consideration the Convention on the Rights of
the Child.

Objective 2.  Comprehension of the nature of preventive education

27.  To be effective, preventive and health education and health
promotion must go further than imparting knowledge only.  It must be
directed towards skills development to forestall non-healthy
lifestyles, and should in this respect reach children before the
occurrence of excessive risk-taking behaviours. Educational
institutions and teaching personnel will be sensitized to orient
teaching styles towards problem-solving, communication and
interaction, and to adapt them to the age of the students and to the
socio-cultural context.

Objective 3.  Integration of preventive education into established
curriculum

28.  Institutionalization and integration of preventive and health
education into the curriculum greatly enhances its chances for
survival and helps to avoid its becoming an additional burden on an
already overloaded curriculum and heavy workload of teachers. 
Educational institutions will be assisted in designing and
implementing preventive education and health promotion programmes to
be integrated into a comprehensive health education context covering
both physical and psycho-social health, addressing cognitive factors,
attitudes and skills, emphasizing the individual and group behaviours
that put a person at risk, both as concerns drug abuse and other
health-related problems.

Objective 4.  Recognition of the decisive role of teachers

29.  The training of teachers is a crucial component of preventive
education and health promotion.  Teachers are in a unique position to
interact with young people, but need adequate pre- and in-service
training.  Educational and teacher-training institutions will
therefore be sensitized to provide appropriate training to teachers,
and to involve them in every stage of the planning, implementation and
evaluation of preventive education programmes.  Students, and parents,
should also be encouraged to participate in the process.

Objective 5.  Promotion of community outreach activities

30.  Schools are well placed not only to reach their personnel and
students through formal education, but also the wider community via
outreach activities. Educational institutions will be encouraged to
enhance extra-curricular actions, to provide communication skills for
students to act as health promotion agents for prevention of drug
abuse, notably among out-of-school children and adolescents through
coordination and cooperation between formal and non-formal education. 
Collaboration with the media will also be encouraged to ensure
coherent messages in the community at large.


       B.  Drug abuse prevention among children and youth in especially
           difficult circumstances (plan of action 2)                  

31.  The World Health Organization (WHO) served as Task Force Manager
for the preparation of this plan of action in collaboration with the
United Nations International Drug Control Programme, the United
Nations Children's Fund (UNICEF), UNESCO, the United Nations
Interregional Crime and Justice Research Institute (UNICRI), the Joint
United Nations Programme on HIV/AIDS (UNAIDS) and the International
Labour Organization (ILO).


              1.  Statement of the issue/problem to be addressed

32.  Adolescence is a time of experimentation, exploration, curiosity
and identity search.  Part of such a quest involves some risk taking,
including the use of psychoactive substances (including all substances
such as alcohol, tobacco, pharmaceuticals, indigenous psychoactive
plants, inhalants and illicit drugs).  Most young people who initiate
substance use do not develop significant problems; with
experimentation, a variable pattern of use and cessation is quite
common.  However, it is generally believed that young people from
problematic backgrounds are more vulnerable and more likely to
continue or escalate their substance use.

33.  There is a strong correlation between other behaviours, such as
precocious sexual activity, crime and educational failure, and the
earlier than average onset as well as continuation of substance use. 
These are also associated with  such environmental variables as: 
family disintegration, poverty, lack of accessible and useful
recreational activities, lack of suitable alternative accommodation if
the child cannot stay at home, relocation, oppression and
discrimination.  Substance use is also more likely to occur among
young people from families that have inconsistent and low quality
support of their children; provide a model of substance use; approve
of substance use (explicitly or implicitly); lack closeness and
involvement in the children's activities; have low educational
aspirations; exert weak control and discipline; and emotionally,
physically or sexually abuse their children.

34.  The term "children and youth in especially difficult
circumstances" covers a broad range of populations at risk of
developing health and other problems.  Within this group may be
considered street children, working children, refugee and displaced
children, indigenous and minority youth, children and youths with
mental and physical disabilities, youths in institutional care (such
as orphanages and detention centres), young offenders, victims of war
and civil unrest, child soldiers, children and youths from poor
communities, individuals with learning difficulties and school
"drop-outs", survivors of natural disasters, children of dysfunctional
and abusive families (including those where substance use has been a
problem), and those who have been sexually exploited.

35.  The common denominator for all these groups is that the children
and youths involved are exposed to higher levels of stress, both acute
and chronic, than their peers of the same age living in the same wider
community.  Furthermore, it is more likely that these young people
have few, if any, positive attachments, and few positive role models. 
They are also likely to be marginalized within their communities and
have fewer opportunities to learn healthy life skills and access
resources, including those for the prevention and treatment of
substance use problems. 

36.  In a stressful environment, psychoactive substances are used by
these young people in many circumstances to perform a function. 
However, while such substances can be used to keep awake for work,
maintain alertness to possible violence, to sleep, to relieve hunger,
or to anaesthetize physical or emotional pain, their use increases
health risks and other problems, including high levels of exploitation
and violence.  The substances used by children and youth in especially
difficult circumstances are usually those which are most readily
available and cheap, for example, glue in market places, solvents in
industrial areas, coca products in the Andean region, opiates in opium
producing areas and, almost universally, various forms of inhalants,
alcohol, tobacco, cannabis and pharmaceutical products.

37.  The consequences of substance use are diverse, including acute and
chronic health problems, disruption to interpersonal relationships
(particularly within families), social marginalization, criminal
behaviour, school failure, vocational problems and failure to achieve
normal adolescent milestones.  Whereas these complications are not
limited to children and youth in especially difficult circumstances,
their impact on these vulnerable young people is much greater. 
Furthermore, the behaviours adopted during childhood have an impact on
their health as adults and the health of their children.

38.  Owing to the imprecise definition of children and youth in
especially difficult circumstances, the heterogeneity of these risk
groups and the hidden nature of substance use within these populations
it is difficult to estimate the extent of the problem.  In 1992 it was
estimated that 40 per cent of the world's population was 19 years of
age or under, with 19 per cent aged between 10 and 19 years.  Of those
under 19 years, 86 per cent lived in developing countries.  Globally
it is estimated that there are approximately 100 million street
children.  ILO has estimated that in 1995 approximately 85 million
children under the age of 15 years were working.  Other estimates put
this figure closer to 200 million.  In developing countries over
26 per cent of students entering school are estimated to drop out
before completing primary education.  Over 100 million indigenous
children and youth live in over 70 countries around the world, many
displaced from their traditional lands.  Over 130 million children,
almost two thirds of them girls in developing countries, have no
access to primary school education.  Each year, several million more
drop out of school without the knowledge and skills that they need for
a healthy and productive life.  Today 885 million adults from the age
of 15 and up are estimated illiterate, with women as their silent
majority representing 565 million (over 63 per cent).  It is estimated
that from 5 million to 10 million children under the age of 10 years
will be orphaned by the end of the 1990s as a result of deaths related
to the acquired immune deficiency syndrome (AIDS), with 90 per cent of
these children living in Africa.  Furthermore, as much as 75 per cent
of human immunodeficiency virus (HIV) transmission takes place before
the age of 25 years in the mature epidemics of eastern and southern
Africa.

39.  As the umbrella term children and youth in especially difficult
circumstances covers a wide range of disparate target groups, it is
evident that  no single strategy will be effective in preventing or
responding to the problems of substance abuse to which they are
exposed.  However, it is recognized that in planning a response,
interventions need to be comprehensive, multifaceted and appropriate
for the target population.  Substance use prevention and treatment
programmes should not stand alone but should be integrated with other
programmes and services that promote the healthy development of young
people and address all risk behaviours.  The overriding principles for
any approach should be based on the Convention on the Rights of the
Child, which calls for the right of children to information and
skills, education and health services, a safe and supportive
environment, and protection from the illegal use of drugs and
involvement in drug production and trafficking.  

40.  A comprehensive programme of action should include the following
elements:

     (a)  Outreach-based interventions.     The basic concept of outreach
is to locate interventions in settings where out-of-school, high risk
and other hidden youth populations can be found (for example on the
streets, in marketplaces, in the home or in places of work).  Peers
can be used as effective outreach workers.  In responding to the
overall needs of dislocated and homeless youths, interventions should
link those at risk with survival services and positive role models;

     (b)  Community involvement, action and organization.      Community
involvement, action and organization is a strategy that involves the
establishment of appropriate community infrastructures and mechanisms
utilizing all agents of change in the community in efforts to prevent
and respond to substance use problems and to promote the healthy
development of young people.  Participants in this approach should
include children and young people, teachers, parents, health and
welfare workers, community leaders, employers, employees'
organizations, youth serving and other social service agencies, law
enforcement and policy makers;

     (c)  School-based interventions.    Although many children and youth
in especially difficult circumstances are out of school, many others
are in contact with both informal and formal education systems.  Such
systems need to be sensitized to the special needs of children and
youth in especially difficult circumstances and incorporate effective
school-based substance prevention interventions.  Interventions should
not be limited solely to the school setting, but rather the school
should serve as the focal point for coordinating multiple activities,
including but not limited to family and community involvement and
training;

     (d)  Health service-based interventions.     Children and youth in
especially difficult circumstances have limited access to health care
services and are often discriminated against, despite the fact that
they are more likely than members of the general community to suffer
from mental and physical illnesses.  Health services should be
reoriented and health professionals sensitized to the special needs of
such children and youth.  The health sector should provide a focal
point for the coordination and promotion of prevention, treatment and
rehabilitation activities targeting problems associated with the use
of psychoactive substances among children and youth in especially
difficult circumstances;

     (e)  Mass media and advocacy.    Mass media is potentially a
powerful tool by which community attitudes may be influenced.  To
ensure the effective implementation of any intervention within a
community a supportive and safe environment needs to exist.  The mass
media can inform the general public of the particular problems and
needs of children and youth in especially difficult circumstances and
assist in the mobilization of public support for interventions. 
Community advocacy can influence policies and political commitment in
order to create a supportive wider environment, making interventions
feasible and sustainable;  

     (f)  Treatment.   A minority of children and youth in especially
difficult circumstances involved in substance use develop problems
severe enough for them to require specific substance abuse treatment. 
Where possible, such treatment should be provided within the community
and should be appropriate to age and development.  Treatment services
should be sensitive to issues of normal adolescent development and the
specific needs and circumstances of children and youth in especially
difficult circumstances.


                                2.  Objectives

Advocate for the needs and rights of children and youth in especially
difficult circumstances

41.  Action and involvement at a community level is only possible if a
supportive political and social environment exists.  Such support may
be enhanced through mass media strategies.  Links should be
established or reinforced with media to avoid the negative reporting
on children and youth in especially difficult circumstances and to
further specific messages to enhance positive, social values fostering
favourable conditions for accepting these children back into society. 
Member States should be encouraged to develop and implement policies
on children and youth in especially difficult circumstances.  The
promotion of the Convention on the Rights of the Child is core to this
approach.

Strengthen community capacity to act

42.  Children and youth in especially difficult circumstances live
within communities and it is there where interventions should be
sited.  Community development and organization are critical components
to any comprehensive strategy.  The community should be involved at
all stages of assessment, planning implementation and evaluation. 
Sustainability of programmes requires community support.  For policies
to be effective, the commitment within Governments must be founded on
a broad social commitment among the communities. 

Enhance knowledge for action

43.  In order to plan and implement appropriate responses an
understanding of the situation of children and youth in especially
difficult circumstances is required.  Children and youth in especially
difficult circumstances are mostly marginalized within communities and
often are not represented in general population or community surveys
or accessed through other research.  Both quantitative and qualitative
data are required to inform on the nature, extent and trends of
substance use among the various groups of children and youth in
especially difficult circumstances.  Particular attention should be
given to research which informs the development of interventions
including the identification of resiliency and protective factors for
risk behaviours, including substance use.  Specific research methods
need to be further developed and promoted to access these populations.

Identify and promote effective interventions

44.  Single approach strategies are likely to be ineffective in drug
prevention or treatment.  Interventions should be combined and
tailored to the specific needs of the target population as determined
through research.  The efficacy of individual interventions should be
assessed both in terms of specific methods utilized and their
contribution to an overall integrated and comprehensive strategy. 
Successful pilot and demonstration projects may be adapted for
different populations and situations.  Substance use should be
included as a component of programming for interventions along with
other priority adolescent risk-taking behaviours.   

Build networks and disseminate expertise

45.  The establishment of networks of organizations and expertise helps
to accelerate programming for action.  Such networks facilitate the
transfer of knowledge, experience and technology.  Training is a
critical component to this process.  Peer educators must be recognized
as agents which have an important role to play in the education of
children and youth in especially difficult circumstances.  The
training of educational personnel for activities aimed towards
children is crucial and has to be strengthened or established where it
is non-existent.  The educators themselves should play an important
role in the preparation of training and educational materials, and the
formulation of curricula and goal planning, in addition to assisting
these target groups in developing life skills.


                  C.  Drug abuse prevention among rural youth
                      (plan of action 3)                     

46.  This proposal has been prepared by the Food and Agriculture
Organization of the United Nations (FAO) and is included in the United
Nations System-Wide Action Plan on Drug Abuse Control as a possible
plan of action for a system-wide approach to the specific target
group.  It has not been formally approved by any of the agencies
identified as partners.


           1.  Drug abuse among rural youth in developing countries

47.  Drug abuse is increasingly becoming a problem in countries where
drugs are produced as well as in the more industrialized countries
where drug addiction and related problems have been widely recognized
for many years.  Illicit drug and alcohol abuse and other associated
problems, including HIV infection, are among the most serious problems
facing young men and women on a global basis.  Rural young men and
women aged 10 to 30 years are a particularly vulnerable group of
current and potential abusers of illicit drugs and alcohol.  They are
involved in the production of illicit drug crops, they are
increasingly used by drug traffickers and they are becoming more
heavily involved in the use of illegal drugs.  Testimony in the
Commission on Narcotic Drugs suggests that the costs of law
enforcement far exceed educational efforts aimed at preventing or
reducing the abuse of illicit drugs and alcohol by young people who
are often tempted by curiosity or subjected to peer pressure.

48.  The repercussions of drug abuse on families and communities (in
terms of loss of income, education, health and social values) are
critical and have far-reaching socio-economic ramifications.  Drug and
alcohol abuse are important factors in the spread of HIV/AIDS. 
According to the findings of a recent FAO field study in six Ugandan
villages, inhibitions often break down when young people are under the
influence of drugs or alcohol.  Few prevention initiatives to date
have tried to target rural young men and women in developing countries
before they begin using drugs.  "Some children start using drugs as
early as 10 years of age.  People use drugs when they want to gain
courage to steal or to rape", said a young villager in Kabarole
District in Uganda.  Relationships between youth and communities or
households are crucial in determining strategies for the future.  In
addition to problems directly related to drug abuse, HIV/AIDS and
early pregnancy are issues that must be included in any multisectoral
programme dealing with youth.  An inter-agency approach to addressing
these issues through formal and non-formal education and through
governmental and non-governmental channels is essential if the full
strength and comparative advantage of the United Nations system is to
be brought into play.

49.  Rural to urban migration and the resulting socio-economic changes
in lifestyle also play a key role in creating drug dependency among
young people.  More than 40 per cent of rural to urban migrants in
Latin America are young men and women between the ages of 15 and
25 years.  Targeting young men and women in the rural areas before
they migrate and enter high risk environments will necessitate new
approaches in areas where prevention activities are, at present, very
limited.

50.  In recognizing young people not as a problem, but as a valuable
human resource, society cannot afford to let them drift, unattended,
in a sea of temptation and neglect.  Wars are fought over mineral
rights and the development of any given nation's natural resources. 
It is widely recognized that these natural resources should be
guarded, nurtured and refined to their highest potential.  Why then,
should we take a short-sighted approach to developing young men and
women to their highest potential through educational programmes that
protect, nurture and develop them to their highest potential so they
can contribute to society to the greatest degree possible?


                        2.  Recognition of the problem

51.  It was reported at an international consultative meeting of the
working group for a world youth programme of action for youth towards
the year 2000 and beyond that the vulnerability of young people to
drug misuse and abuse has, in recent years, become a major concern at
all levels of society.  Initiatives aimed at reducing drug abuse among
young people were identified as a top priority.  To be effective, drug
abuse reduction programmes need to address the interests and concerns
of the individuals who are in highest risk groups.  Young men and
women between the ages of 10 and 30 years are the ones at greatest
risk.  They are mortgaging their future through drug addiction.  They
are the targets of those who stand to gain from the sales of illicit
drugs.  It is the youth audience that drug demand reduction programmes
should address.

52.  Formal education programmes through the schools and non-formal
education programmes through youth organizations and the workplace can
play key roles in seeking out high risk individuals and groups and in
designing and carrying out meaningful programmes aimed at reducing
drug abuse.  Participatory methods, group activities and the
transmission of organizational and vocational skills are critical
elements of a successful drug programme as is the training of youth
leaders in communication and counselling skills.

53.  In order to address the root causes of drug abuse, it is important
to identify ways of incorporating drug abuse and trafficking concerns
into broad-based development strategies.  There is a need to identify
effective drug demand reduction approaches through formal and
non-formal education.  Development communication approaches are needed
in order to reach all parts of the developing countries in the most
effective manner and the sharing and dissemination of useful
information through a variety of media approaches is essential. 
Beneficiary participation throughout the entire process is essential. 
The entire urban and rural educational system should include drug
demand reduction components.  At the community level these initiatives
should be accompanied by national youth policies that include
reference to creating opportunities for the training and gainful
employment of youth.


             3.  A multi-disciplinary approach to demand reduction

54.  In a multi-disciplinary approach, collaborating United Nations
agencies would work together to gather information through base-line
studies and to execute, in a collaborative manner, components of
comprehensive programmes designed to prevent and reduce drug and
alcohol abuse among rural young men and women.  In a coordinated
approach, each specialized agency would be expected to bring its
unique strengths to bear on the overall problem.  It is recognized
that an assessment of the problems related to drugs in any given
country would have to be undertaken as an initial step in the
preparation of the programme.  Country profiles including a detailed
look at the problems affecting rural youth would have to be developed
in each pilot country.

55.  The United Nations International Drug Control Programme as the
designated lead agency would coordinate the development and
implementation of an inter-agency, cross-sectoral, multi-disciplinary
programme aimed at preventing and/or reducing the use of illegal drugs
among rural youth in the developing countries.  This audience-oriented
approach focuses on rural young men and women, the key players in a
global programme aimed at ensuring increased agricultural production
that conserves our natural resources to the greatest extent and
sustainable rural development that reduces the push of rural poverty
that exacerbates the current high levels of rural to urban migration
in many of the developing countries.  The results of the programme
activities would be jointly analysed and evaluated in order to provide
the member Governments with a consolidated set of recommendations and
suggestions for a course of action for the future.

56.  The objectives and activities of each programme component would be
compatible with the specific mandates of each agency (e.g., UNESCO,
education and literacy training; FAO, sustainable crop production and
rural development, education, extension and communication programmes;
WHO, health-related issues; ILO, vocational training and issues
related to the place of employment; the United Nations Industrial
Development Organization (UNIDO), local industries and value added
activities; UNICRI, research and documentation; Criminal Justice and
Crime Prevention Division, law enforcement patterns and information on
crime and punishment; UNICEF, working with children; the United
Nations Population Fund (UNFPA), population education and family
planning; and the International Fund for Agricultural Development
(IFAD), small business enterprises, credit schemes, marketing, etc.). 
These components would also take into consideration each agency's
implementation plan and memorandum of understanding with the United
Nations International Drug Control Programme.

57.  If followed through to a logical conclusion, a multisectoral,
system-wide programming approach could facilitate work with the
vulnerable rural youth audience by dealing with all aspects of the
drug problem through a number of simultaneous activities including
programmes in formal and non-formal education and competency-based
training, demand reduction, construction of health facilities and
addressing related health issues, law enforcement and crime prevention
issues, alternative crop production and other drug-related issues in
any given country.


          4.  Organizational approach to developing a multiple agency,
              multisectoral programme

58.  In each pilot country, the programme would operate in three
phases.  In general terms, phase one would deal with the
organizational aspects of developing a multiple agency, multisectoral
approach to the prevention and reduction of drug abuse among rural
young men and women.  Phase two would cover the execution, ongoing
monitoring and periodic evaluation of each programme component.  Phase
three would include a final evaluation exercise at the close of each
project or component plus an evaluation of the overall system-wide
approach to dealing with the rural youth audience at the end of a
five-year period.  All phases and related information concerning this
system-wide approach should be open to Governments, organizations,
agencies, non-governmental organizations, participants and interested
observers through the World-Wide Web (WWW) of shared information over
the Internet.

59.  Phase one would include:

     (a)  Identifying the collaborating United Nations agencies;

     (b)  Formation of a multiple agency coordinating team under the
leadership of a designated United Nations International Drug Control
Programme officer;

     (c)  Defining the operational aspects of a multiple agency,
multisectoral programme approach;

     (d)  Identifying pilot project countries;

     (e)  Assessing the problems and defining the issues to be covered
through beneficiary participation;

     (f)  Developing each agency component of the programme and
preparation of each agency's country-specific workplans;

     (g)  Agreement on United Nations International Drug Control
Programme funding arrangements with each collaborating agency for each
of the programme components;

     (h)  Signing of pilot project documents;

     (i)  Other related issues.

60.  Phase two would include:

     (a)  Establishment of national coordination teams (overall and
agency-specific);

     (b)  Identification of national coordinators and pilot project
staff;

     (c)  Revision of country-specific workplans;

     (d)  Execution of pilot projects according to plans of work for
each agency component;

     (e)  Monitoring and evaluation on a periodic basis including
mid-term and final reviews that involve specialized agency, government
(including beneficiaries) and United Nations International Drug
Control Programme participation;

     (f)  Final evaluation of each sectoral programme component and
discussions with government officials from each sector;

     (g)  Preparation of an overall programme evaluation and submission
of report to the host Government;

     (h)  Discussion of final report with overall national coordinating
team and other appropriate government officials;

     (i)  Examining the desirability of adapting the multiple agency,
multisectoral approach for use in other countries.

61.  Phase three would include:

     (a)  A final evaluation of the overall system-wide approach to
dealing with the rural youth audience at the end of a five-year
period;

     (b)  The preparation and dissemination of a comprehensive report
on the strengths and weaknesses of the programme plus recommendations
for future action.

62.  Development objectives would include:

     (a)  To provide proven, field-tested and sustainable responses and
support to Governments and non-governmental organizations that request
information and advice on how to deal, in a comprehensive manner, with
problems related to drug and alcohol abuse of rural young men and
women aged 10 to 25 years.  These activities would include the goal of
enhanced technical cooperation among developing countries and the
strengthening of other partnership activities;

     (b)  To create a holistic and coordinated approach to preventing
and reducing the demand for illegal drugs through the United Nations
system by bringing the strengths of each agency to bear on the complex
problem of drug and alcohol abuse among rural youth in the developing
countries;

     (c)  To provide Governments with field-tested approaches and
comprehensive recommendations on how to reduce drug and alcohol abuse
among rural youth based upon joint action from collaborating agencies
within the United Nations system.

63.  Immediate objectives and outputs would consist of the following:

     (a)  Immediate objective 1

          To design and develop agency-specific programme components
          for each of the pilot countries.

               Output 1.1

               Within the first eight weeks of the initiation of the
               umbrella programme, participating agencies would complete
               the design and development of specific programme
               components for each of the pilot countries.  Such a
               programme component would include an initial assessment
               of the situation in selected pilot countries as a first
               step.

               Output 1.2

               Within the first eight weeks of the initiation of the
               umbrella programme, participating agencies would have
               identified potential project personnel and cooperating
               organizations in each of the pilot countries.

     (b)  Immediate objective 2

          To undertake specific pilot project activities aimed at the
          prevention of drug and alcohol abuse among young men and
          women in each of the pilot countries.

               Output 2.1

               Within the first six months of the initiation of the
               umbrella programme, participating agencies would have
               initiated specific pilot project activities aimed at the
               prevention of drug and alcohol abuse among youth in each
               of the pilot countries.  Such programmes would be
               gender-specific and locally based.

     (c)  Immediate objective 3

          To develop institutional capacity in government and
          non-government organizations for formal and non-formal
          education and the dissemination of information on the
          reduction of drug and alcohol abuse among youth.

               Output 3.1

               Within the life of the project, institutional capacities
               in government and non-government organizations would be
               developed to carry out formal and non-formal education
               programmes on drug and alcohol abuse, demand reduction
               and other drug-related issues.  Such activities would
               include extension initiatives, outreach programmes from
               educational institutions and community development and
               non-governmental organization projects.

     (d)  Immediate objective 4

          To develop a multi-disciplinary framework for working with
          rural young men and women on drug-related issues in each of
          the pilot countries.

               Output 4.1

               Within the life of the project, a multi-disciplinary
               framework for working with rural young men and women on
               drug-related issues would be developed in each of the
               pilot countries.  Such a framework would be designed so
               that it can be adapted to drug demand reduction
               activities in other interested countries.


                  D.  Drug abuse prevention in the workplace
                      (plan of action 4)                    

64.  The International Labour Organization (ILO) served as task force
manager for the preparation of this plan of action in collaboration
with the United Nations International Drug Control Programme, WHO, the
International Maritime Organization (IMO) and the International Civil
Aviation Organization (ICAO).


                         1.  Statement of the problem

65.  Substance abuse has long spilled over from marginalized groups
into the mainstream of society.  Abuse of substances can weaken and
tear the delicate fabric of modern community, already in upheaval and
turmoil in the face of many changes.  A microcosm of communities and
organizations, the individual workplace mirrors the malaise present in
society when it comes to drug and alcohol problems.  The direct and
indirect ramifications of substance abuse in the workplace are
numerous:

     (a)  Absenteeism is two to three times higher for drug and alcohol
users than for other employees;

     (b)  Some 20 to 25 per cent of accidents at work involve
intoxicated people injuring themselves and innocent victims;

     (c)  On-the-job fatalities linked to drugs and alcohol account for
15 to 30 per cent of all accidents;

     (d)  Employees experiencing drug and alcohol problems may claim
three times as many sickness benefits and file five times as many
workers' compensation claims;

     (e)  Studies show that some 70 per cent of people with
alcohol-related problems and more than 60 per cent of drug users are
reported to be employed.

66.  The hidden financial costs associated with alcohol/drug use, such
as lost productivity, compensation claims, or lost business
opportunities are substantial, as are the human costs such as loss of
jobs, loss of skilled workers, and strained labour relations.

67.  An important factor to remember in considering the relationship
between the workplace and drug and alcohol is that problems occur in
several ways, as a result of occasional intoxication, regular use or
actual dependence.  Dependent users may have more continuous problems,
but the occasional or moderate users may cause more problems simply
because there are very many more of them having the occasional mishap
or even serious incident.

68.  Clearly, the problem is very complex.  On the one hand, studies
show linkages between alcohol and drugs and certain working conditions
such as social pressures to drink or use drugs, freedom from
supervision, stress, precarious employment, monotonous work, shift
work and night work.  On the other hand, alcohol and drug use have
negative consequences in the workplace, which include deteriorating
health, increasing absenteeism, lowered job performance, increased
accidents and increased disciplinary action.

69.  A great deal can be done, however, to alleviate drug and alcohol
problems in the workplace, and the United Nations system has a major
contribution to make to the improvement of the understanding of the
problems at hand.  Above all, certain truths need to be observed:

     (a)  People can be sensitized to the issues through prevention
measures before they develop serious problems;

     (b)  Substance abusers can recover and lead fruitful lives;

     (c)  Work is vital to recovery, and contributes profoundly to
securing dignity and a place in the world for the recovering person.

70.  The scope and enormity of the drug and alcohol issue has led to a
global response from the entire United Nations system, the means of
action for which are as follows:

     (a)  Collect and analyse data;

     (b)  Formulate guidelines for enterprise and union policy;

     (c)  Contribute to the formulation and the revision of national
policies on drugs and alcohol;

     (d)  Elaborate resource material for workplace and community
intervention strategies and programmes;

     (e)  Promote substance abuse awareness through seminars, meetings
and symposia;

     (f)  Plan and implement staff training courses and demonstration
programmes;

     (g)  Maintain relations with concerned agencies and organizations;

     (h)  Provide technical advisory services;

     (i)  Evaluate the effectiveness of programmes.


                                2.  Objectives

71.  The abuse of drugs and alcohol is an intrinsic threat to such
basic goals as economic and social well-being, fundamental human
rights and social justice, constructive development, adequate
employment and satisfactory conditions of work and pay.

72.  The increasingly detrimental effect of drugs and alcohol on the
workplace is a problem that is gaining more and more recognition as
Governments, workers and employers agree that it is a common dilemma -
one that would require a concerted effort on the part of all three to
tackle.

73.  The United Nations system acts on a number of areas of
interrelated activities with the overall objective of developing
strategic alliances for ongoing collaboration with a maximum number of
Member States and organizations.  ILO plays an especially important
role with regard to prevention in the workplace.  The main objectives
in implementing a workplace drug and alcohol prevention and assistance
programme are:

     (a)  To protect the health and welfare of workers;

     (b)  To contribute to the containment and management of problems
associated with substance abuse in the workplace;

     (c)  To protect the performance level of enterprises by reducing
absenteeism, loss of productivity, accidents and damages;

     (d)  To promote the improvement of working conditions with the aim
of reducing factors which contribute to substance abuse;

     (e)  To promote compliance with occupational health and safety
standards;

     (f)  To ensure that workplace programmes are in harmony with and
reinforce action at the community level.

74.  The needs and interests of Governments and employers' and workers'
organizations are not incompatible when it comes to tackling drug and
alcohol issues.  In fact, a central point to bear in mind is that only
through an integrated approach will long-term and lasting reduction of
substance usage be achieved in the workplace.

75.  The existence of a wide variety of responses, from the very simple
to the highly complex, allows every entity to assess its problems and
resources and decide what approaches to take.  These decisions may be
based on attempting to find the right fit between the scope of the
actual needs, with the available enterprise or community resources,
local legislative requirements and socio-cultural factors.


                E.  Women and drug abuse:  the gender dimension
                    (plan of action 5)                         

76.  The United Nations International Drug Control Programme served as
task force manager for the preparation of this plan of action in
collaboration with WHO, UNESCO, UNICRI, UNAIDS and FAO.


                             1.  Problem statement

77.  Social attitudes to women have often led to women's substance
abuse-related problems being concealed.  However, assessment of drug
abuse from a gender perspective dispels the misconception that
substance abuse is exclusively a men's problem.  The illicit supply of
and demand for drugs are increasing in many parts of the world, and
increasing numbers of women are therefore affected by drug abuse,
whether or not they are drug users themselves.  Their lower status and
the gender roles assigned by society result in unmet needs which are
experienced both by drug-using women and female partners of male drug
abusers in various social, cultural and economic environments. 
Furthermore, it has been found that women are more likely than men to
become infected with HIV through both sexual transmission and
intravenous injection.  To understand the impact of drug abuse on
women, to identify effective preventive interventions and to design
demand reduction and rehabilitation programmes, it is essential to
focus on gender relations but not necessarily, however, to deal with
women and men separately.  Society's assigned roles and perceptions
also play a part in the way men and women are involved in illicit
trafficking; are vulnerable to punitive actions from the law
enforcement sectors; are subject to human rights violations; and are
perceived in the community.  However, the position of women in a
society is not only defined by their gender roles but, as that of men,
varies with class, age, religion and culture.

78.  Until recently, drug control approaches were not sensitive to the
gender dimension:  analysis and interventions did not consider the
impact of gender relations on the phenomenon of drug abuse or on the
processes of prevention, treatment, relapse prevention and social
reintegration.  The hidden nature of the problems of drug abuse among
women perpetuated the disregard of gender relations in drug control
interventions, and the lack of gender-disaggregated data further
minimized the issue.

79.  This situation has been changing gradually during the last years
and a joint initiative of the United Nations International Drug
Control Programme, the Division for the Advancement of Women of the
Department for Policy Coordination and Sustainable Development of the
United Nations Secretariat and WHO on gender analysis in drug abuse
has helped to make the gender-related dynamics visible in this field. 
This initiative resulted in a 1994 background paper prepared for the
Commission on the Status of Women on a United Nations system position
paper on women and drug abuse.  The accompanying technical research
reports include the following subjects:  (a) women and drug abuse:  a
gender analysis and health and policy implications, the first document
to provide a gender analysis of the drug field; (b) women and drug
abuse:  country reports (1992); and (c) women and drug abuse:  country
reports (1993).  The latter two documents consist of 27 country
situation assessments of women and drug abuse.  It was found from all
27 country studies that attention should be paid to women's needs that
are derived from the socially assigned gender roles, both productive
(e.g., income generation related matters) as well as reproductive
(e.g., child care related matters).

80.  All these documents, which are available from the United Nations
International Drug Control Programme, reveal that gender relations
constitute an essential factor in understanding how a person
experiences the phenomenon of drug abuse in a given society.  They
provide information on how drug abuse affects and involves women in
different ways than men:

     (a)  As drug abusers:

     (i)  The physiological effects of substance abuse differ between
          women and men;

    (ii)  Women are prescribed more sedatives and tranquillizers than
          men;

   (iii)  Women are at higher risk of HIV infection than men both as
          injecting drug abusers and through sexual transmission;

    (iv)  Owing to their status in society and the social stigma
          attached to women drug abusers in many countries, the shame
          element leads to hiding the habit and the women fail to seek
          help and suitable facilities are not available to them;

     (b)  As persons affected by drug abusers:

     (i)  When the main family income generators are men, in the case
          of their incapacitation caused by drug abuse, the women in
          the family are forced to generate the entire income for
          family survival;

    (ii)  Women are at risk of HIV infection through sexual relations
          with male partners who are drug abusers and are HIV positive;

   (iii)  Women are seen as the principal care-givers in society and
          are thus more likely than men to be expected to carry the
          major share of caring tasks related to drug abuse in the
          family;

    (iv)  Women are more likely to be subjected to domestic violence
          which is often associated with substance abuse;

     (c)  As producers and mules:

     (i)  Women bearing the responsibility of ensuring the family
          income have more limited options to do so than men and thus
          might often have to revert to drug-related income sources. 
          Similarly, as drug abusers, women are more susceptible to
          becoming involved in sex work and drug peddling in order to
          finance their addiction while men rather tend to engage in
          other criminal activities, such as theft;

    (ii)  In some countries, differential (often harsher) sentences are
          delivered to women than to men for similar drug-related
          offences;

     (d)  As potential agents of change:

     (i)  Women are the traditional dispensers of health care and
          health knowledge within the family;

    (ii)  Many primary school teachers and nurses are women and give
          children their early knowledge about health and hygiene;

   (iii)  Women are often the motivators and supporters of social,
          health and development activities at the community level.

81.  At its thirty-eighth session, in 1995, the Commission on Narcotic
Drugs adopted a resolution in which it urged Member States to
"recognize, assess and take into account in their national policies
and programmes the problems that drug abuse poses for women" as well
as "to develop and test activities to respond in an innovative way" to
these problems. 1/

82.  During the Fourth World Conference on Women, held at Beijing in
September 1995, a special event on women, drug abuse and addiction was
organized jointly by UNDCP, UNICRI, the Vienna NGO Committee on
Narcotic Drugs and the Vienna NGO Committee on the Status of Women. 
The Platform for Action adopted by the World Conference, in its
section on women and health, includes provisions aiming, inter alia,
at improved treatment and rehabilitation services and prevention
programmes for women.  The Secretary-General is strongly committed to
assuming responsibility for coordination of policy within the United
Nations for the implementation of the Platform for Action and for the
mainstreaming of a system-wide gender perspective in all activities of
the United Nations system (see A/50/744, para. 93 (j)).

83.  The primary focus of this plan of action is on the need for a
consistent and concerted effort to make gender analysis results
visible.  The second area of focus is on support to the development,
dissemination and implementation of effective gender-sensitive
interventions to deal with drug control-related issues.  The third is
geared towards the empowerment of women within the community and at
decision-making levels to participate actively in reducing all aspects
of drug abuse.


                                2.  Objectives

84.  The objectives are as follows:

     (a)  Awareness raising on gender-related issues in drug control
through gender-disaggregated data collection, analysis and reporting
on the illicit production, manufacturing, trafficking and abuse of
narcotic drugs and psychotropic substances, as well as on the use and
abuse of "gateway" substances such as alcohol, tobacco and volatile
solvents;

     (b)  Development of methods to incorporate the gender dimension
into interventions related to drug abuse control;

     (c)  Increased appropriateness and availability of effective
gender-sensitive actions in all fields of drug control;

     (d)  Promotion of gender-sensitive leadership in the drug field;
providing training to identify gender issues and implications; and
increasing the representation of women at all levels of administration
involved in drug issues.


                F.  Assessment of drug abuse:  data collection
                    (plan of action 6) 2/                     

85.  This plan of action has been prepared jointly by the United
Nations International Drug Control Programme and WHO.  These are the
two entities within the United Nations system involved in the
assessment of drug abuse and the differences in their mandates should
be understood.  Although the United Nations system recognizes the
existence of linkages between illicit drug abuse and the use of other
substances such as alcohol and tobacco, the work of the United Nations
International Drug Control Programme in demand reduction is limited to
narcotic drugs and psychotropic substances as defined by the
international conventions.  The mandate of WHO is broader,
encompassing the negative health consequences of any substance use.


                             1.  Problem statement

86.  The availability of reliable and comparable data is a prerequisite
for effective interventions designed to reduce the demand for drugs. 
Interventions, whether designed to control supply of illicit drugs,
reduce demand, or to achieve both, should be based on a strategy that
assesses needs and resources both prior to and during the development
and implementation of that strategy.  The impact or success of
interventions should be assessed through monitoring and evaluation
and, where necessary, interventions should be modified or rejected. 
At all stages of this process of planning, development, implementation
and evaluation there is a need for timely and relevant data and
information.  Such information allows for the identification of drug
abuse patterns and trends to enable early and targeted interventions
and appropriate allocation of resources, assessment of the
effectiveness of interventions and measurement of outcomes.

87.  At the present time, global drug abuse data are scanty and
scattered in different forms and places.  The data that are available
are not always up to date or consistent.  Furthermore, there is a
dearth of internationally agreed upon definitions which could form a
solid basis for collecting comparable data among Member States.  The
method of data collection also varies.  In any one country, the data
collected vary by age grouping and differences in the types of
questions posed.  The range of age and segment of population where the
data are collected are even more diverse between countries.  Only a
very few countries have a comprehensive population-based longitudinal
epidemiological drug survey in place.  Even fewer countries have a
registry of drug dependents or a systematic early-warning system.

88.  Methodological difficulties in assessing the extent, nature and
consequences of drug abuse are recognized.  The stigmatized, and often
illegal, nature of substance abuse means that often such abuse is a
"hidden" activity, until such time as problems associated with it make
certain abusers visible.  For this reason, while the overall rates of
the abuse of certain drugs in the general population may be low, the
numbers of substance abusers in certain institutions (e.g., prisons,
hospital emergency rooms) appear disproportionately high.  In
addition, many drug abusers are marginalized by society.

89.  To meet the need for timely and relevant information, the
development, implementation and support for epidemiological monitoring
are required.  The development and implementation of substance abuse
assessment is a continuous process which draws upon and adapts a wide
range of tested methodologies, data, information and expertise from
established epidemiological networks as well as from social and
anthropological disciplines.  The assessment of substance abuse must
be sensitive to innovations in the field of epidemiological data
collection and also adopt alternative, supplementary techniques to
fill the gaps left by that data collection.

90.  To ensure appropriate policy formulation and planning of
appropriate responses to the growing drug abuse situation world wide,
it is essential to have systematic routine epidemiological data
collection to facilitate the verification of trends and patterns. 
This includes the assessment of patterns and trends in substance abuse
and its health and social consequences; the strengthening of country
capacity to do so; and the assessment of the health risks associated
with substance abuse.

91.  At the international level, the International Drug Abuse
Assessment System is a repository of information received by the
United Nations International Drug Control Programme in response to the
annual reports questionnaire.  It is being developed and refined in
order to facilitate use of the information.

92.  In addition, rapid assessment complements the longitudinal routine
data collection system by providing focused, in-depth, cross-sectional
situation analysis, particularly among "hidden" populations, making
quick, responsive, programmatic interventions possible.  The rapid
assessment methodology, which had been used successfully for other
purposes, has been adapted to apply to the drug abuse situation and
since 1993 it has been applied systematically for studies in a number
of countries.  The methodological procedure is now being standardized
and a draft training manual is being developed.  Regional training on
rapid assessment based on this methodology and training manual will be
conducted by the United Nations International Drug Control Programme.

93.  As a continuing priority, national and regional capabilities to
implement monitoring and surveillance systems should be strengthened
through the provision of training and guidance in collecting,
collating, validating and interpreting data and disseminating the
findings.  Technical assistance will be provided to Member States to
enhance their capabilities in epidemiological data collection and
rapid assessments.  Generalizable definitions, methodologies and
indicators of substance abuse will continue to be adapted, tested and
improved.  Information on drugs and related issues will continue to be
disseminated in order to improve national, regional and local
strategies in reducing substance abuse.  The nature and scope of the
task and the challenges presented ensures that both the United Nations
International Drug Control Programme and WHO will continue to
collaborate with key partners to maximize available resources both in
funding and in expertise.


                                2.  Objectives

94.  The objectives are as follows:

     (a)  To develop, test, refine and promote generalizable
definitions, indicators of drug abuse and data-collection methods;

     (b)  To assess and describe patterns and trends in the extent,
nature and social, economic and health consequences of substance abuse
as well as the effectiveness of interventions; 3/

     (c)  To strengthen national capabilities in assessing, monitoring
and evaluating substance abuse and its consequences and to permit
utilization of the information gathered in formulating appropriate
responses.


                                     Notes

     1/   Official Records of the Economic and Social Council, 1995,
Supplement No. 9 (E/1995/29), chap. XII, sect. A, resolution
3 (XXXVIII).

     2/   At the date of publication of the present document, this plan
of action had not been cleared by the Subcommittee.

     3/   Certain elements of this objective will be incorporated in
other plans of action in the future.


                                     ANNEX

                      Overview of participating agencies


1.   This overview is intended to provide an indication of the
diversity and scope of the interests and mandates of the major
collaborating agencies and how these converge in the common need to
fight drug abuse.  It is based on text prepared by the agencies
concerned; texts from other agencies will be added subsequently.


              United Nations International Drug Control Programme

2.   The United Nations International Drug Control Programme has been
designated by the General Assembly to lead and coordinate work of the
United Nations system in matters of international drug control.  It
provides secretariat support services for the Commission on Narcotic
Drugs and for the International Narcotics Control Board.  The
Programme provides advice to Member States concerning implementation
of international drug control treaties and assists States in acceding
to and implementing these treaties.

3.   The Programme addresses all aspects of the drug problem, including
measures to reduce illicit supply, traffic and demand.  It designs and
implements technical cooperation programmes relating to drug control
and assists Governments to develop programmes targeting the various
aspects of the problem.  In addition, the Programme encourages and
supports subregional initiatives to respond to problems that affect
several neighbouring countries at the same time.  It also undertakes
activities at the global level intended to develop methodologies and
to increase the knowledge base with regard to drug control issues.


                        United Nations Children's Fund

4.   As the impact of the child survival revolution is felt around the
world, UNICEF is able to devote more attention to the health of
adolescents.  Not only are the majority of adolescents included in the
definition of "child" contained in the Convention on the Rights of the
Child, but young people's health and development have a major impact
on their health and productivity as adults and on the health of their
children and on their capacity to be caring and supportive.  Young
people's health and development will therefore be central to achieving
the goals of the World Summit for Children, to activating the
Convention on the Rights of the Child and the Convention on the
Elimination of All Forms of Discrimination against Women, and to the
follow-up on the international conferences on population and
development and on women.

5.   UNICEF focuses on a group of risk-taking behaviours and problems
that have common antecedents and are linked together in terms of cause
and effect.  These include unwanted and unsafe sex (giving rise to
teenage pregnancy, HIV infection and other sexually transmitted
diseases); psychoactive substance use, including tobacco and alcohol;
violence and accidents; and poor nutrition and certain common endemic
diseases.  In order to meet young people's needs for information and
skills development, access to services and a safe and supportive
environment (both the immediate environment of family and friends and
the wider environment created by societal values and norms, policies
and legislation), UNICEF programming approaches concentrate on the
following key areas:  national plans of action; school health
programmes; youth-friendly health services; health promotion and
outreach through non-governmental organizations; and health
communication through the mass media and entertainment, into which it
is possible to integrate the drug abuse prevention message.


                  Joint United Nations Programme on HIV/AIDS

6.   UNAIDS brings together six organizations of the United Nations
system (UNICEF, UNDP, UNFPA, UNESCO, WHO and the World Bank) and has
been operational since 1 January 1996.  The mission of UNAIDS is to
lead, strengthen and support an expanded effort to prevent HIV
transmission, provide care and support, reduce impact, and alleviate
individual and communal vulnerability to HIV/AIDS.  Its major focus is
on building up national capabilities for expanded action.  Its roles
are policy development and research, provision of technical support,
and advocacy.  UNAIDS supports operational research involving
non-governmental organizations and community projects intended to
minimize HIV risk among drug users, and provides technical assistance
in the design and evaluation of prevention projects.


                       International Labour Organization

7.   The priority objectives for ILO for the coming years are:  the
promotion of democracy and human rights; the alleviation of
unemployment and poverty; and the protection of working people. 
Within this framework, the ILO programme on drugs and alcohol
therefore has the following objectives:  (a) the adoption by
enterprises of measures to prevent, contain and manage problems
associated with drugs and alcohol at the workplace; and (b) the
reduction of discrimination in employment against recovering drug
users through their enhanced access to rehabilitation services and
greater opportunities for social and vocational integration.


                    United Nations Interregional Crime and
                          Justice Research Institute

8.   The objective of UNICRI is to contribute, through research,
training, field activities and the collection, exchange and
dissemination of information, to the formulation and implementation of
improved policies in the field of crime prevention and control, due
regard being paid to the integration of such policies within broader
policies for socio-economic change and development, and to the
protection of human rights.  The Institute assists intergovernmental,
governmental and non-governmental organizations in their effort in
this regard.  UNICRI carries out research and training activities, as
well as technical cooperation in various crime prevention and control-
related issues and drug abuse prevention.

                  United Nations Educational, Scientific and
                             Cultural Organization

9.   UNESCO contributes to drug demand reduction through its preventive
education programme within the framework of the United Nations Global
Programme of Action.  UNESCO strategy is based on:  (a) coordinating
with other United Nations agencies, non-governmental organizations and
Member States; (b) undertaking social studies and
socio-epidemiological surveys; (c) reflecting on techniques and
adapting them to local conditions; (d) stressing street work and
non-formal education for children and youth in especially difficult
circumstances; and (e) linking AIDS prevention to drug abuse
prevention in comprehensive school health education programmes.  The
objectives are for it to become an integral part of both the in-school
and out-of-school educational structures, providing information and
forming and developing the personalities of children and young people
by guiding their behaviour and helping them create new social
attitudes.

10.  UNESCO:  (a) assists Member States in the implementation of pilot
projects and elaboration of strategies introducing the preventive
education element in the national or regional plans of action; (b)
organizes teacher-training workshops and seminars in pedagogical
preventive techniques and their adaptation to different contexts,
training of street educators and social workers serving street and
working children; (c) coordinates information networking and exchange
among governmental and non-governmental organizations working in the
field; and (d) gives methodological support to research activities,
promotes awareness-raising action.  It also produces written and
audio-visual material, supports contributions to and cooperation with
non-governmental organizations to develop techniques on preventive
education and pedagogical methods for rehabilitation work.


                           World Health Organization

11.  The objective of WHO is the attainment by all peoples of the
highest possible level of health.  In this context it is committed to
the prevention and reduction of the negative health, social, legal and
economic consequences of substance use; to ensuring equitable access
to health services; to the promotion and protection of health; and to
the creation of healthier lifestyles and safer environments.  Here
"environment" is interpreted in its widest sense, to include not only
the physical environment but also political, economic, social, legal
and cultural conditions.  This approach reveals that what is required
to deal with substance abuse is a process which focuses not only on
individual health or specific target groups but also on the wider
context in which substance abuse occurs.  A public health-oriented
response to the problems associated with substance abuse is a
prerequisite for effective intervention.  Such a response recognizes
that while controlling the supply of substances through law
enforcement and the criminal justice system will remain a priority for
the foreseeable future, reducing the illicit demand will have a more
important impact on the negative consequences of substance abuse.


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Date last posted: 28 December 1999 17:35:10
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