Amid high illicit crop production figures in Afghanistan, UNODC has scaled up its work with partners to promote innovative strategies to integrate a development perspective into the country’s drug control efforts.
Recently, UNODC teamed up with the Ministry for Counter Narcotics of Afghanistan to host a two-day conference on “Promoting Afghanistan’s Alternative Development Initiatives among Regional and International partners” in Ashgabat, Turkmenistan.
Organized in the context of the 7th Regional Economic Cooperation Conference on Afghanistan, the event sought to increase awareness and identify opportunities for alternative development among neighboring countries. It also provided a platform to explore new partnerships between agencies working on drug control and development.
Yury Fedotov, UNODC Executive Director, delivering his remarks through a video message, said that “Alternative development can help transform communities, but they can only flourish where the rule of law and sustainable licit economies are strong.” He highlighted that the Government of Afghanistan, through its National Peace and Development Framework and National Drug Action Plan, has laid a strong foundation to build coordinated and integrated cooperation. “But these efforts require the strong support of the international community,” Mr. Fedotov added.
In his opening remarks, Jeremy Milsom, UNODC Senior Programme Coordinator of the Regional Programme said: “Security and development are indivisible, an understanding reaffirmed through the 2030 Agenda for Sustainable Development and the UN General Assembly Special Session on the world drug problem.”
UNODC’s 2017 Afghan Opium Survey shows that opium poppy cultivation and drug production chain generate huge profits, supporting criminality and insurgency, and ultimately resulting in greater insecurity. “There is no way to achieve a viable and sustainable social and economic development unless we tackle the drugs issue and insecurity,” Mr. Milsom stressed.
Also participating, Roland Kobia, Special Representative of the European Union to Afghanistan, defined alternative development as a long-term strategy that seeks a sustainable move away from illicit drug cultivation. “Access to markets is crucial to allow farmers to generate sufficient revenue to maintain a decent standard of living,” he pointed out.
Professor Salamat Azimi, Minister for Counter Narcotics of Afghanistan stressed that her country was truly committed to fighting narcotics. Citing an example, she said that the Government was developing national policies to support relevant Ministries in achieving this goal.
Over 70 senior officials and participants from Afghanistan and several senior officials from Pakistan, Iran, Kazakhstan, Kyrgyzstan, Tajikistan, Uzbekistan, Turkmenistan, Colombia and Thailand attended the event, funded by the European Union, Japan, the Russian Federation and the United States.
For over 40 years, UNODC has been working with Member States on alternative development, a principal pillar of the international drug control strategy. In Afghanistan, most illegal cultivation is driven by poverty, food insecurity, and the lack of land tenure. Alternative development seeks to reduce illicit crop cultivation and drug production by generating licit income and opportunities while providing a range of social services.
Hands on Peer Education, is a front-line service in Dublin’s north inner city, where those suffering with addiction and their families can get access to much needed support and treatment options. H.O.P.E. facilitates and advocates for recovery through abstinence. We also offer a wide range of advocacy services. H.O.P.E.’s free and confidential drop-in clinic is open from 10am ‘til 1pm, Monday to Friday.
Now That You’re Here
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(18/08/2016) Sean O’Rourke (RTÉ Radio 1) was joined by Professor Jim Lucey, Medical Director of St. Patrick’s Mental Health Services.
“Clearly child poverty is a negative factor for childhood development and adult wellness. This makes intuitive sense and these data are consistent with all our experience. Sometimes poverty is in the foreground but other times it is in the background where it may be less apparent, but many would argue (and I would certainly agree) that poverty is the prevalent factor underlying most of our enduring health problems.”
The appointment of a task force on mental health is an initiative that is to be greatly welcomed. It is a recognition by the government of the importance of this vital area of our lives. The membership of The Task Force includes a representative range of voices each with their own expertise. These range from the scientific brilliance of Professor Mary Cannon to the charismatic advocacy of “Bressie” and many others besides.
The Task Force members has been given a big challenge and it will be interesting to see how they go about the work and what particular agendas they decide to cover. Much will depend on their terms of reference, their methods and their ambitions.
We might consider some of these agenda over the next few weeks and consider what the literature says about these mental health issues. Doubtless the Task Force knows what it needs to look at and we should let them get on with their work and wish them well. While we do let us consider for moment some of these key mental health agenda and consider them in anticipation.
Once such key agenda is Childhood. What is the relationship between our childhood and our adult mental health. The task force will already have the benefit of new data on the prevalence of mental health problems in our young population and also their lifestyle emerging from the “growing up in Ireland’ survey but what is to be said about the relationship between childhood and the developments of a mentally healthy adult life. For this data they must choose to look further a field.
The search for real answers to these questions rests on a very small number of long term studies. Two of these data-sets are worth highlighting. One of them is from the UK and the other from the USA. Their data tells us a great deal about the importance of childhood to the task of living life well.
First let’s look at the UK Birth Cohort Studies. These have enrolled more than 70,000 people from five generations starting in 1946 before the beginnings of the NHS. The research has become the longest running study of human development in the world. The results have directly influenced much government policy in health and education but also indirectly generated important data on childhood wellbeing.
The UK Birth Cohort data were reviewed recently in a new book entitled “The Life Project: The Extraordinary Story of our Lives”. Its author Helen Pearson shows how these data highlighted the effect of inequality and poverty on childhood and also its negative impact on the trajectory of adult lives. The results showed that children born into poverty and inequality were far more likely to struggle at school and much less likely to be employed in adult life. They were also far more likely to be in poor physical health.
On the other hand, the research showed that poverty in itself did not necessarily determine a bad outcome in adulthood. Many children thrived despite disadvantaged beginnings. In some of these children the influence of parental involvement was also a protective factor. For example children whose parents read to them when they were aged 5 years and who still showed an interest in their eduction when they were age 10 were significantly less likely to be in poverty at the age 30.
Clearly child poverty is a negative factor for childhood development and adult wellness. This makes intuitive sense and these data are consistent with all our experience. Sometimes poverty is in the foreground but other times it is in the background where it may be less apparent, but many would argue (and I would certainly agree) that poverty is the prevalent factor underlying most of our enduring health problems.
What about the influence of more specific trauma in childhood? What about the question of the long term effects of childhood abuse on the formation of adult wellbeing. An invaluable source of answers to these questions has come from the ACE studies in California, USA. These important studies are continuing at a large primary care centre in San Diego. The study methods include a look back at childhood experiences and a look forward to their progression from childhood to adulthood. The basic tool is a survey called the Adverse Events in Childhood (ACE) scale. It provides a score known as the ACE score and this can be used to correlate with other health and social data collected routinely by the practice. Over fifty scientific papers have resulted and the data is of profound significance for our understanding of childhoods impact on healthy living throughout the length of human life.
The ACE scale identifies ten types of childhood trauma. Each person is asked to recall their childhood and to answer ten questions about their life before the age of eighteen years. “Did you often experience any of the these five personal experiences physical abuse, verbal abuse, sexual abuse, physical neglect and emotional neglect”. The next five ACE questions are related to the life of other members of the persons childhood family. “Did you have a parent or guardian who is alcoholic, a mother who is the victim of domestic violence, a family member in gaol, a family member diagnosed with a mental illness, or the loss of a parent through divorce, death or abandonment”.
Each factor is given a score of one and so a persons ACE score becomes very clear. For example an adult survivor of sexual abuse whose mother was the victim of domestic violence and whose father was an alcoholic would have an ACE score of 3. Any of us might try this scale for ourselves and calculate our own ACE score. This might be distressing exercise but it might be a useful one nonetheless. The question is what impact does the ACE score have on adult wellness.
The answer is a complex but compelling one. The ACE is a number used for correlation. It is nothing more and nothing less. It does not tell us anything about causes or cures. Nevertheless the ACE evidence is of a “strong graded relationship between the breadth of exposure to abuse or household dysfunction during childhood and multiple risk factors for several leading causes of death in adults. These causes include heart disease, cancer, chronic lung disease, fractures and liver disease, and these hazards are not secondary to smoking or alcohol use alone. Instead the researchers suggest they have found a real and independent correlation between childhood traumas and some of the major health problems seen in adult life.
So what about the relationship between adverse childhood experience and mental distress? The answer is that ACE is a risk factor for mental health difficulty. Estimates differ but the literature suggest that ACE events are three times more likely in those who have a major mental health problem such as schizophrenia or bipolar mood or borderline personality. Clearly ACE is a significant number but what does it really tell us?
Everyone agrees that ACE levels correlate with the emergence of serious physical and mental health problems in adulthood. The higher the ACE score the greater the likelihood of physical and mental health problems and even early death. The evidence supports the belief that childhood experience is important to our adult wellbeing. The question is whether childhood adversity is a determinant of adult ill health or just a factor.
The truth is that three quarters of adult mental health needs emerge before the age of 25 and this supports the conclusion that childhood is an important time for the development of our wellbeing. But other data suggest that a combination of factors influence our chances of remaining well. The ACE story is not the only story and it’s not simple. Nothing is. A number of important caveats need to be heard.
Childhood trauma and loss such as described by ACE events do not cause mental health problems or early death. Most people with ACE neither develop mental health difficulties nor die young. Those with high ACE scores who develop poor physical and mental health may be disadvantaged for many other reasons as well. We still do not fully understand the origins of poor health but we know this. The origins of illness are not linear. The successful pursuit of wellness is complicated by genetic effects and many other environmental factors. ACE is just one of these factors even though it appears to be an important one. Childhood adversity is a challenge but not a determinant of adult wellbeing.
The emphasis is rightly on reducing childhood adversity, so called ACE events, in the community in order to improve the overall population health. This is very understandable but even if all ACE events could be removed illness, mental distress and early death would still occur and in the majority of these people adversity would not have been a factor. The eradication of ACEs even if this was possible would not solve or prevent mental distress for many.
In any case the eradication of ACE events is not a realistic prospect. Meaningful health care proposals need to be based on facts not dreams. The ACE events are simply ten stress factors that emerged from this study in a large primary care setting. We are still struggling to reduce the volume of clinical factors contributing to ACE such as mental health problems and addiction. We must accept that violence and family breakdown and the experience of other loss in childhood is not going to go away. We are human. ACE events are not the only childhood traumas. Stress upon our youth will always exist to some degree.
Our health service responses cannot depend on wishing childhood adversity would just disappear. Prevention strategies should recognise the importance of ACE events but we also need to understand that childhood is a time that frequently includes a degree of stress and trauma. A meaningful plan for wellness cannot rest on primary prevention alone. Our childhood is valuable but it is not the only human value we possess. That is why we need to build resilience and still to provide real help for those in distress or difficulty. We must remember that being well is also about getting well again.
If you would like to talk about these issues or need more information and support about access to mental health services in Ireland please call our Information and Support line at (01) 2493 333 or our youth support line at (01) 2493 555 or check out our web site at www.stpatricks.ie or contact the Health Services Executive at www.hse.ie
You can hear the broadcast and a spoken version of this blog here.
The Mental Health of Young People in Ireland: A report of the Psychiatric Epidemology Research across the Lifespan (PERL) Group. Authors: Cannon M, Coughlah H,Clarke M,Harley M&Kelleher 1 (2013) The Mental Health of Young People in Ireland: a report of the Psychiatric Epidemology Research across the Lifespan (PERL) Group Dublin: Royal College of Surgeons in Ireland
Growing up in Ireland. National longitudinal study of children. The findings of the qualitative study
Authors: Elaine Harris, Erika Doyle and Sheila Greene. Department of Children & Youth Affairs 2011. www.growingup.ie
The Life Project: The extraordinary story of our lives. Author: Helen Pearson. Published by Penguin Books
Relationship of Childhood Abuse and Household Dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study . Authors: Vincent J. Felitti, Robert F. Anda Dale Nordenberg et al. Am J Prev Med 1998;14 (4) 1998 American Journal of Preventive Medicine
HSE Statement : Fentanyl Implicated in Overdose Deaths
Arising from a number of drug-related deaths in Dublin and Cork in recent weeks, the HSE is issuing an alert in relation to the dangers of a class of Opiate drugs known as Fentanyl. While fentanyl is a narcotic analgesic and used in both anaesthetics and for analgesia, a number of non-pharmaceutical Fentanyl have been implicated in deaths where it has been assumed to be Heroin (or in some cases possibly other drugs). Fentanyl can be up to 600 times more potent than Morphine and may be sold as ‘designer’ fentanyl or ‘synthetic’ heroin. Therefore even experienced heroin users are at risk if they take this drug.
To date, five deaths are being investigated in Ireland where Fentanyl have been implicated and it seems that the deaths have occurred after users have either smoked or injected the drug. This has occurred over the last number of years in other European countries. Overdose results in respiratory depression which is reversible with naloxone.
At this time it seems most likely that Fentanyl may be sold in powder form possibly mixed with Heroin or alternatively mixed with Caffeine and Paracetamol to mimic the effect of Heroin. Therefore the drug can be snorted, swallowed or prepared for injection. By any route, this drug is very dangerous.
Fentanyl is extremely potent and even the smallest amount of the substance can cause overdose and death. Fentanyl may also be absorbed through the skin. The effects of the drug may be indistinguishable from Heroin meaning that at this time Heroin users are most at risk to unwittingly consume this substance”.
For support around drug and alcohol use the HSE Drugs & Alcohol Helpline that is available Monday to Friday, 9.30am, and 5.30pm. This confidential service has both a freephone Helpline (1800 459 459) and an email support service ([email protected]). Information is also available on drugs.ie in relation to this substance.
If anyone in the Dublin North Inner City area is in need of help,
H.O.P.E. Ltd. is here.
HOPE is very excited to hear about this attempt to solve the difficulties of drugs and gang related violence facing the area. The high levels of social inequality suffered by the communities of the NIC have been growing for decades. This investment – which has been dedicated to local sports facilities, street and building maintenance and recovery projects – is long overdue. While this endeavour has come at a great cost to the NIC communities, it is with great excitement that we welcome this new government led initiative.
The North Inner City has been victim to high levels of social inequality, which has become the centre of national media’s attention in the light of numerous criminal fatalities suffered by the community in the recent months. In the aftermath of these criminal fatalities, the four parishes that make up the community of the North East Inner City, marched together as one, in an attempt to speak out collectively against the recent surge in violence. This march, however, had fallen on deaf ears and the community suffered another criminal fatality within mere days. With the surge in criminal violence came vast swaths of media attention and a public outcry for the government to step in.
Last night, Monday 16th June 2016, Government ministers descended on the North East Inner City to open a dialogue with the local support groups in an attempt to develop a structure and a strategy for a new community task force. H.O.P.E. was present advocating abstinence-based recovery and the facilities required to provide such a service. Also present were the North Inner City Older Person’s Group advocating support for the older persons of the community and promoting tourism and vitality in the community was Terry Fagan detailing his own project, the Community Folklore walking tours.
RTÉ has reported a positive result from the Taoiseach, although the cabinet has yet to meet to discuss the results of yesterday’s meeting. Whatever their decision, the community is already preparing for the next step in developing the new Government-run task force. Next week, there will be a public meeting. All members of the community are invited to take part in the brainstorming session in an attempt to formulate options for the new community task force. The event will take place next Wednesday morning in O’Connells School, School Hall, North Richmond Street, Dublin 1. Registration will begin at 09.30 and everyone is invited. Please stay tuned for more information.
NORTH INNER CITY OLDER PERSONS’ GROUP
According to the Centre for Ageing Research and Development in Ireland, ‘‘Social engagement is key for the health, well-being and independence of older people’’. Further, ”Community projects that cater to the needs of diverse groups of older people are important in encouraging social engagement and interaction’’.
The North Inner City Older Persons’ Group is a voluntary organisation that holds a biannual day out in the summer and in the winter. Every year, around one hundred and fifty older people from the tight-knit community of the north east inner city descend on the Waterside Hotel in Donabate, North County Dublin. Over the years the group fund-raised amongst themselves and small local organisations. Through collections and raffle tickets the group funded each event themselves. This year, they would like to get funding through sponsorship.
“One of our biggest fundraisers – the late Paddy Behan – he’s gone.”–Tony Dunleavy
Each event costs in and around seven thousand euro. With transportation, food, drinks and entertainment for the evening, it works out to about 40 to 50 euro per head. A staggering amount for those only in receipt of the O.A.P. These are people who are mostly living in isolation, with little to no family. A lot of the older people in the community have lost their families to drink and drugs. All they have is themselves and their neighbours. Subsequently, for most of these older people, this is their only form of social outing!
Committee Member, Maggie O’Dea, describes how the wheelchair bound are brough up for a dance.
We would like to close with a great big thank you to everyone that has supported the group’s event in the previous years. Through the hard work and dedication of the community, we have been lucky enough to host this biannual event. This year, however, the hard work of the community is not enough and we need to go further to ensure the older people of this community can still have their day out.
The North Inner City Older People’s Group are looking for direct sponsorship or donations to help fund the biannual day out for the older people of the North Inner City. Donations can be made out to ‘The North Inner City Older People’s Group’, AIB Upper O’Connell Street, Dublin 1. NSC: 931136. ACC.: 04486042. No amount is too small, and remember, a little help can go a long way.
Joe Dowling; Treasurer, N.I.C. Older People’s Group. 018 878 404
If you or anyone you know (older persons) is at risk of isolation or loneliness, there are a number of organisations that can help.
The Senior Help Line is a confidential listening service run by older people for isolated or lonely older people for the price of a local call anywhere in Ireland. The lines are open every day from 10am to 10pm, Lo-call: 1850 440 444
ALONE supports vulnerable older people providing temporary or permanent housing and combatting isolation and loneliness in society. Volunteers and staff work with older people in ALONE’s dedicated housing projects and in the community. 016 791 032
Friends of the Elderly is an Irish charity that brings friendship and social opportunities to the elderly, especially those who live alone. Its volunteers visit the elderly in their homes in the Greater Dublin area. 018 731 855
This article in the Examiner quotes the North Inner City, specifically the area between Croke Park and Busarás as a ”no-go zone”. Irene, the manager here at HOPE provides insight as to why the area is considered a no-go area.
“We’re more interested in looking at the root causes. For me there are three main ones. There are the poor Garda relations with people in this community, they’re not developing relationships with the young people, the guards are often seen as the enemy.
“The other thing is about recovery. There is no supply without demand. The reason drugs gangs take effect is because there is demand. We feel the only way to get rid of supply is to get rid of demand.
“The third one is opportunities for young people, youth clubs are very under-resourced. There needs to be counselling for kids, proper drug and alcohol prevention, youth clubs that offer training for kids and better access to third-level education,” she says.
Mental Healthcare in Ireland has come a long way, but there are still a number of issues that need to be addressed. Psychotherapist, Anne McCormack highlights the marginalised issues in the Irish Times as part of a Future Health Summit Special Report.
Would you like your children to grow up in the shadow of a member of An Garda Síochana in full body armor and armed with machine guns? Or maybe in full view of a man being gunned down in retribution of another’s untimely end. The community of the North Inner City has come together to say enough is enough.
Dublin’s North Inner City community networks came together to discuss possible actions to deal with the growing rate of criminal fatalities and the open dealing of illicit substances (to name but a few of the variety of terminal issues facing the people of the North Inner City).
Below is the outcome of that meeting and links to the articles published after the meeting.
On behalf of the community networks in Dublin’s North Inner City, we would like to thank all those who attended the very lively and successful press conference that took place today Friday 29th April at 9.30am in Killarney Court, Dublin 1.
The Press conference was called to highlight the need for Government action to address the serious anti-community violence and drug crime that is afflicting this community, including its causes, the entrenched and intergenerational poverty, inequality and social exclusion.
The Actions that emerged from the press conference include the following;
1. A call to the Minister of Justice to meet with representatives from the community to demand meaningful actions from government to address the current serious violence and drug dealing in the North Inner city.
2. Organise an inclusive community peaceful procession and vigil to allow the community come together to support each other.
3. Continue to galvanise support within the community inclusive of residents, local community services & project and the local politicians to maintain pressure on the Government to put in place the lasting measures that will address the entrenched inequalities and poverty and break the cycle of violence, addiction and drug dealing that is so damaging to the community.
Thank you again for your support and we will keep you informed as things develop.
Dublin’s North Inner City community networks
INNER CITY ORGANISATIONS NETWORK (ICON), NORTH EAST INNER CITY COMMUNITY POLICING FORUM (NEIC CPF), YOUNG PEOPLE AT RISK (YPAR), NIC LOCAL DRUGS TASK FORCE
We would like to express many thanks to all those who joined us in celebrating the joint launch of our 2015 annual report and new digital media channels. We have been promoting recovery on the ground in the community for 12 years, and now we have expanded into the realm of digital.
We would like to give special thanks to our guest speakers – Declan “Deco” Murphy, Catherine Mangan, Kenneth Reilly and Cllr. Christy Burke.
Research from around the world is always shedding new light on the dark world of addiction! Through our new digital channels, we will be promoting evidenced based recovery research, treatments, and support from around the globe.
We support our clients to find RECOVERY through an abstinence-based lifestyle. We feel this provides the greatest quality of life for the individual, their family, and community. This point-of-view, however, is not widely held. We hope to not only promote adequate rehabilitation but to encourage discussion and debate of the best possible way to support people’s recovery from addiction.