The abuse of substances, particularly illegal drugs, is ever changing. It is a sub-culture of attitudes and behaviours that is often shaped by the dominant culture of instant gratification and quick fixes for every situation.

We are living in times where we expect things to happen at the flick of the finger, with the accessibility to drugs and their instant satisfaction being wrongly perceived as doing just that.

Today marks the International Day against Drug Abuse and Illicit Trafficking. The illicit drug issue is essentially a social problem with health implications, particularly mental ones, though sometimes mental health issues contribute to addiction as well.

Prevention strategies and in particular educating against substance abuse is fundamental.  With this in mind, the Sedqa Agency offers an array of educational programmes for students and pupils. Considerable hours are well spent working jointly with teachers educating young people about making the right choices, while informing them about the implications of addiction.

While prevention strategies help influence attitudes against addictions and therefore should limit the future demand for harmful substances, the overall strategies for harm reduction include other important aspects, such as treatment, rehabilitation and after-care.

The European Monitoring Centre for Drugs and Drugs Addiction, in 2017,   estimated that in Malta there were about 1,400 high risk cases of individuals using illicit drugs. Most of these individuals attend daily at the Sedqa detox centre where the staff members are trained in the area of addictions. Addiction specialist medical doctors at the centre, together with the nursing staff, are indeed outstanding in their medical practice. Together with the other professionals such as social workers, psychiatrists, psychologists, therapists, care workers and others, they offer a holistic service which goes beyond the mere treatment of addiction.

In this regard, particular attention is being given to the screening and the treatment of Hepatitis C, which is prevalent particularly among heroin drug users. Since 2018, the detox centre has also been running weekly clinics where clients are invited to discuss their medical condition, blood tests are carried out and if necessary they can also be referred for further treatment at Mater Dei. Unfortunately, however, many chronic heroin addicts are not necessarily motivated to sustain a treatment regime, which makes the targets to reduce the incidence of Hepatitis C all that more difficult. That said, the long standing relationship that the professionals at the detox centre have with their clients is key to influence these clients to sustain their treatment for the whole duration of the programme.

Professionals from across different policy domains actively collaborate together to achieve a common objective. Despite the fact that the professionals come from different services and are employed by different entities, such as Mater Dei Hospital and Sedqa Agency, they all have the common objective that by 2024, Malta would have eradicated the Hepatitis C infection from the island.

Another important aspect of the prevention strategy are the support services provided in the community, for all those who have an addiction problem, but who commit to kick the habit once and for all. The services offered are various, which range from social work intervention to normalise relationships in the family to psychological services, where the individual and the family deal with the harsh experience of addiction.

On the other hand, there are also others who need more intensive programmes of rehabilitation and for a period of time they need to live under a structured way of life in a therapeutic centre. Apart from the Sedqa centre, a person may also choose to go to Caritas or the Oasi Foundation in Gozo. Both programmes follow the set Government standards upon which the funding depends. Nonetheless, all programmes work in tandem with on-going liaison and case conferences among professionals from the various agencies while detox centre doctors regularly visit the Caritas clients at base. It is here worth noting that all three centres are Government financed.

The same collaborative approach was adopted with the Courts of Justice, particularly following the changes in legislation. The ability of our society to distinguish clearly between the drug trafficker and the drug victim was critical in adjusting our strategies. Drug traffickers respond only to punitive action, and therefore, incarceration is partly the response for them, but not for the victims. The addicted person needs a different approach, where treatment and rehabilitation are the logical way forward for their recovery.

More people are now being referred by our Courts to the community social work services of Sedqa, where close monitoring of these individuals is done to help them move away from their addiction problem. This collaboration is giving us encouraging results.

Despite the fact that our services are generally in a state of readiness, we cannot be sectorial in our thinking and interventions. The increased collaboration at both the institutional and professional levels have improved considerably our early warning systems and corrective measures. That led to more effectiveness in dealing with the problem and more value for investment. Teamwork and integrated work processes was and is the way forward.

If there is an issue which needs to be tackled in this manner, it is the addictions challenge.