ABSTRACT
Introduction
Programmes and experiments
Dissemination of knowledge
Author: BADR-EL-DIN ALI
Pages: 3 to 7
Creation Date: 1991/01/01
The International Prisoners Aid Association (IPAA) is concerned with the rehabilitation of offenders, including drug offenders. IPAA does not have the financial and human resources to establish working programmes for drug abuse control or for the treatment of drug-dependent persons. It does, however, contribute to efforts at the international level to combat the drug problem by supporting non-governmental agencies in different countries involved in the rehabilitation of drug-dependent persons and the prevention of drug abuse, by disseminating knowledge and information on current developments in the field among concerned members of the world community and by promoting and publishing cross-cultural research dealing with the drug problem at the preventive/control and treatment levels. IPAA has participated in international and regional conferences and seminars dealing with drug abuse, and numerous items on drug- related issues have been published in the IPAA Newsletter and in occasional reports. The present article provides a brief overview of the work of IPAA as it relates to drug control.
The International Prisoners Aid Association (IPAA) was founded in 1950 by voluntary groups in North America involved in providing after-care to prisoners and other related activities. Over the years, its membership has grown to some 40 organizations located in about 30 countries. Member agencies deal with offender rehabilitation and/or crime prevention at the federal, national or local level. Since 1964, IPAA has held consultative status with the Economic and Social Council. Early in 1971, the Council of Europe granted consultative status to IPAA, and in 1972 it became a member of the Alliance of Non- Governmental Organizations on Crime Prevention and Criminal Justice.
The purpose of IPAA is to help non-governmental organizations in different countries to become more effective in their efforts to rehabilitate offenders and prevent crime; to provide for the international dissemination and exchange of information, ideas and experiences regarding offender rehabilitation and crime prevention; to seek worldwide improvement in correctional services while fostering firm law enforcement and sound administration of justice; to encourage the establishment and growth of local and national non- governmental agencies that render needed services to offenders and their families; and to promote cross-cultural correctional research and facilitate contact among correctional workers throughout the world [1] .
Under the broad umbrella of IPAA functions and activities, emphasis is given to the treatment and rehabilitation of drug victims in correctional and specialized institutions or in community centres and services. Over the last three decades, several IPAA member agencies have conducted different programmes and experiments in their home countries to help in the rehabilitation and readjustment of drug-dependent persons and/or the counselling of young people who are prone to drug abuse. While many projects were established in more developed countries, several were initiated in less developed countries. The knowledge and expertise gained from those cross-national programmes and their outcome have often been disseminated to other parts of the world through IPAA channels. Through such world-wide communication, it has become feasible for different societies to benefit from each other's successes and failures in dealing with the drug problem, despite the fact that an effective programme in one country may not necessarily fit well in another. IPAA has also been concerned with criminological and correctional research connected with youth involvement in drug abuse, means of rehabilitating drug- dependent persons and preventive measures against illicit drug trafficking.
There are probably hundreds of projects and programmes around the world that have dealt in one way or another with drug abuse control at the international, regional, national or local level. A few examples of these are reviewed briefly in this section, with emphasis placed on those that have been supported and/or reported through the years by IPAA. A few experiments and programmes that play a role in combating the drug problem in both developed and developing countries are mentioned. The multiple treatment programmes described below may not be applicable in other countries unless they are adapted to the prevailing socioeconomic and cultural circumstances in those countries.
By its very nature, the work of public health nurses brings them into contact with many people at a stage where early intervention can be effective. In private offices, nurses often spend more time with patients than physicians do. If such nurses are properly trained, they may be able to spot addiction problems before any physical symptoms appear. In many societies, nurses are given a role of trust and often have opportunities for having direct contact with the public (e.g. school or industrial nurses). This may place them in a unique position in relation to the prevention, detection and treatment of, as well as the provision of information on, addiction. Realization of this fact led to the establishment of the American Association of Nurses in Alcohol and Drug Dependence in the United States of America in 1976, followed by the establishment of a similar association in Switzerland. Two years later, an international Group of Nurses was formed under the auspices of the international Council on Alcohol and Addiction [2] .
The Hong Kong Discharged Prisoners Aid Society, a long-standing member of IPAA, conducted a three-year project called the Methadone Maintenance Pilot Scheme. A group that underwent maintenance treatment with moderately high-dose methadone had significantly better results than a control group of short-term detoxification cases in terms of retention in treatment, avoidance of illicit narcotic use, and employment and slightly better results in terms of avoidance of criminal activity. There was a general trend towards decreasing methadone dosage at the end of the study; the older the drug-dependent person and the longer the duration of addiction, the smaller the dosage required for maintenance. Criminal behaviour decreased significantly among persons undergoing methadone maintenance treatment in the course of the project. The number of unemployed in a group of 68 drug- dependent persons decreased from 20 before the project began to only I following a 28-month period of continued observation. The total cost of the scheme for 100 drug-dependent persons proved to be more economical than other treatment programmes in Hong Kong [3] .
The role of education in the social reintegration of drug-dependent persons has been recognized for many years in the Philippines. The Dangerous Drugs Board, the Department of Education, Culture and Sports and other drug treatment centres have jointly established school programmes within the rehabilitation centres. A pilot programme was started in the Treatment and Rehabilitation Center at Tagaytay and later expanded to include two other residential rehabilitation centres at Manila. The pilot programme, which has a four-year secondary curriculum, provides opportunities for educational, vocational and personality development. All teachers are trained in drug abuse, group dynamics, behaviour management and learning. Five hundred individuals have graduated from such school programmes; a follow-up study will be carried out to determine the impact of the programmes on the rehabilitation and social reintegration of the graduates[4] ,[5] .
Acupuncture has long been used as the principal method of treatment for drug-dependent persons at Lincoln Hospital in New York. Two hundred drug- dependent persons are received daily in a detoxification programme there. Acupuncture is believed to relieve withdrawal symptoms, prevent craving for drugs and increase the rate of participation of patients in long-term treatment programmes. The National Acupuncture Detoxification Association (NADA) supports the use of acupuncture in rehabilitating drug-dependent persons from various socioeconomic and cultural settings. NADA has helped set up a programme at Los Angeles as a potential alternative to imprisonment. It has also included acupuncture in two treatment programmes for alcohol-dependent persons. It has provided training to enable physicians at Szeged, Hungary, to establish an acupuncture programme that has benefited 60 per cent of the treated alcohol-dependent persons. It has conducted an acupuncture training programme at Kathmandu in which most of the treated drug-dependent persons have shown clear improvement. And it has begun to operate a pilot programme at San Francisco to treat some 1,000 active and potential drug abusers through acupuncture, in conjunction with other programmes for reducing drug demand. Acupuncture detoxification is particularly useful in developing countries since it does not require special preparation or intricate testing procedures [6] .
Since it was founded in the United States in 1953, Narcotics Anonymous has expanded to include over 12,000 groups in more than 40 countries. Its objective is abstinence from all substances, including alcohol. It believes that substituting one drug for another is counter-productive. Narcotics Anonymous groups meet every week. The meetings are conducted by the drug-dependent persons themselves on a voluntary basis and are held in jails, prisons, detoxification centres, psychiatric hospitals and other facilities. Narcotics Anonymous members from outside the facility participate in most meetings; in others, the participants consist entirely of drug-dependent persons from within the facility. Narcotics Anonymous publishes a newsletter for drug-dependent persons. Narcotics Anonymous groups give drug-dependent persons an opportunity to meet with persons who understand drug addiction through personal experience and who have managed to remain drug-free and are learning to lead productive and responsible lives. By holding meetings and making its literature available in correctional and detention facilities, Narcotics Anonymous helps drug-dependent persons to develop a healthy and promising affiliation with its programme. Upon their release, their continued involvement with Narcotics Anonymous meetings in their communities helps them to maintain a drug-free lifestyle [7] .
In the last 12 years, at least one issue of every volume of the IPAA Newsletter, the principal communication channel of IPAA, has dealt with the drug problem at the preventive, control or treatment level. IPAA conferences and seminars have also dealt with drug abuse and its treatment; and several board members and affiliates of IPAA have participated in professional meetings and workshops devoted to drug abuse control and the rehabilitation of drug-dependent persons. The drug-related items reported in the IPAA Newsletter include news, announcements, and/or brief articles on meetings and conferences; agencies and associations; workshops and training courses; programmes and experiments; panels and debates; research reports and publications.
R. P. Baker, International Prisoners Aid Association: The First 23 Years, IPAA publication (Fort Grant, Arizona, Fort Grant Training Center, 1975).
02International Prisoners Aid Association, "Nursing alcohol and drug dependency patients", IPAA Newsletter,vol. 29, September-December 1978, p. 3.
03International Prisoners Aid Association, "Hong Kong society launches three programmes: methadone treatment; prison prevention; volunteers scheme", IPAA Newsletter, vol. 30, January-April 1979, p. 3.
04G. Estela Ponce, The Role of Education in the Social Reintegration of Drug Users and Former Users in the Philippines (Paris, United Nations Educational, Scientific and Cultural Organization, 1979).
05G. Estela Ponce, Evaluation Report. A Toolbar the Social Reintegration of Former Drug Users in the Philippines (Paris, United Nations Educational, Scientific and Cultural Organization, 1984).
06M. 0. Smith and 1. Khan, "An acupuncture programme for the treatment of drug- dependent persons", Bulletin on Narcotics (United Nations publication), vol. 40, No. 1 (1988), pp. 35AI.
07International Prisoners Aid Association, "Narcotics Anonymous: international support group for addicts", IPAA Newsletter, vol. 39, January-April 1988, p. 1.