Akzept Konferenzen + Projecte
Drogennotfallprophylaxe (Naloxon)
4. Nationale Substitutionskonferenz 2015
Datenbank Substitution


Drogenpolitik aktuell
national/ international


akzept ist Mitglied bei

Deutsche Hauptstelle für Suchtfragen

European Coalition for Just and Effective Drug Policies

International Drug Policy Consortium

European Network
Social Inclusion & Health


Goals: The concept of acceptance and what it means for our work
"Acceptance orientated drug policy", "low threshold drug services" and "accompanying addiction": - these have become common catchwords, and it would be hard to find a drug work concept that doesn´t use these slogans, demonstrating that this kind of "service" is in great demand in the social service sector.

This is a market now being served both by the larger, formerly abstinence orientated organisations, and also increasingly by the smaller self-help initiatives, all peddling their versions of low threshold support and acceptance. The phrase "acceptance orientated drug work" was originally coined to distinguish this method and its underlying concept from the mainstream of drug social work, whose practical and theoretical efforts were directed almost exclusively towards total abstinence.

2.Accepting everything?
Acceptance is now a key word in several areas of social work, but what exactly does it mean? For example, does it mean unconditional acquiescence in dealing with violent, right-wing teenage gangs? Or, in the field of drug work, indifference and minimising the dangers of addiction? First and foremost, acceptance means offering a dialogue between different values and ways of living, instead of adopting a policy of exclusion. This is the only foundation on which it is possible to build reciprocal understanding of conflicting lifestyles, and how they originated. For people who take illegal drugs, or who have to take them, for example, illegality is the dominating social factor in their everyday lives: living with the black market, exposure to differing, and sometimes deadly contaminants in unpredictable levels, all this leads to the health risks which we set out to alleviate, via the suggestions offered in this brochure.

Police controls are on the increase: since the mid 80´s The Federal Criminal Office can point to a growing number of offences involving drug users and dealers. In 1994, 187 000 drugs related crimes were registered - three times as many as in 1984. A considerable amount of those brushes with the police involve possession and consumption of cannabis (43%) but there has been a marked increase in offences connected with LSD and amphetamines, while heroin and cocaine related offences have stayed more or less constant. In addition, the police now register so called "first hard drugs offenders", a statistic showing drug consumers who have come into conflict with the law on counts of hard drugs usage (opiates, cocaine and synthetic drugs) for the first time. Between 1986 and 1996 these numbers rose to 17 000 - four times as high.

Drug offences are "control offences", that is, they mirror the level of law enforcement controls and don´t necessarily represent the real development in drug use. As few people report each other in this sector, the police have to rely on intensive investigation, and on informers. The increase in statistics indicates the growing intensity with which the law tries to control drug users, and means that sooner or later all users run a relatively high risk of coming into contact with the law, either through buying, possession or dealing.

Detention, prosecution, non-voluntary therapy, police interrogation - this all leads to social ostracism, followed often enough by broken contacts to friends, family, lovers and partners, thus swelling the ranks of the dispossessed and hopeless people living on the edge of society. This policy of stigmatisation cultivates a climate of non-solidarity, where drug users become the law´s spies and informers, effectively preventing them from finding common political ground; a collective stance, voice and action. It splits people up, and leads to an atmosphere of fear, mistrust and brutalisation. As the Bremen prisoners´ paper DISKUS put it, in their obituary for two people (both drug users), who committed suicide while in prison: "When the dealer heard about Wolfgang´s death, the only thing he said was `Shit. He owed me DM 20,--´" It is almost impossible to convey what living outside the law means to someone who hasn´t experienced it.

Bald statistics in the daily papers about the high rate of 'HIV infection, the spread of viral hepatitis infections, sexually transmitted diseases, tuberculosis, bacterial eco-carditis, kidney diseases and the high death toll among drug users can only give a very limited impression of what it is like to be existentially threatened in this way.
Workers in the field of drugs acceptance who are confronted daily with these diverging life patterns have learned to look more closely, to differentiate and question the media-created image of the bad guy fixer. Do drugs create this picture of misery, - or is it the result of a faulty drugs policy, of a vicious circle revolving around criminalisation and prosecution?
We notice in our daily work, that the problems caused by drugs policy are so overwhelming, that they outweigh by far any problems caused by the addiction itself. Hardly a moment goes by in drug work, which isn´t marked by the effort to cope with the consequences of illegality and prosecution (debt, wage forfeit, deterioration in health, the fight to avoid imprisonment or to be released, etc)

3. Differentiated Understanding of Addiction
Acceptance also means not regarding users of illegal - or legal - drugs as a priori being in need of counselling, treatment, or in any way as "objects of therapeutic desire", nor does it view them in the light of society´s need to punish or banish them. This school of thought (a mixture of criminal law and counselling/therapy) is still alive and well and claims that the "end" (abstinence) justifies any "means" available, for example the baby phase theory, in which the sinner has to start again from scratch, or confrontation sessions in long term in-patient therapy, in which participants are supposed to yell violently at the patient until he reaches the "rock bottom" and can be helped to rebuild his life afresh with a new orientation, new friends, new clothes etc. - A dark chapter in recent therapeutic and psychiatric history.
Acceptance drug work differentiates between regarding drug consumption as a conscious consumer decision either for pleasure, self medication, or as a lifestyle; or rather as an illness - needing adequate forms of aid or therapy. The self definition of the individual takes precedence in our form of drug work, and not the cosy "We know what´s best for you" attitude, with its patronizing style of caring.
This means that we support self help, providing room (- and rooms -)for self help initiatives to promote consumer safeguard measures (for example safe use of party drugs), find ways of political articulation or exchange practical help. For us, it is important to support the forces of self healing and enable competence in the people affected,. In this way we hope that drug users will create their own political platform to voice their needs, and go from powerlessness to autonomy.
This does not mean that professional help is superfluous; it becomes necessary whenever a greater degree of knowledge or ability is called for, or when a more neutral kind of aid is needed than can be provided in a self help setting. Acceptance also means speaking out about the dominant drug policy of repression, with its current practice of dismantling the drug scene and drug based prostitution, with no regard to the health and social risks involved. The law and order policies favoured by local government, and their treatment of the "open drugs scene" completely ignore the fact that drug users, especially those further down the scale of neglect, need some kind of space to communicate and exchange help. Forcibly dispersing visible groups of drug consumers is nothing but social cosmetics, and probably won´t even help raise the level of perceived security among the general public; the consequences are already all too visible in our cities.
Acceptance drug work takes the health requirements of drug consumers seriously. Under conditions of partial prohibition this means helping to minimise the risks entailed in black market drugs, and living in illegality, such as safer consumption through needle exchange and dispensing, injection rooms, living space and job offers with no conditions of abstinence imposed. First and foremost we need to prevent irreparable harm such as HIV infection. In this connection, consumer safeguarding means taking all possible steps to avoid additional harm caused by criminalisation.
This is especially important within the prison system, where between 10,000 and 20,000 drug using inmates are obliged to cope without hygiene. For more than 10 years now, the word on the streets has been "harm reduction" and "safer use", but once inside they can forget they heard it..
4. Problem Areas of Acceptance Drug work

"Only help helps!" - Is that all that helps?
"Only help helps!" was the heading on a Frankfurt AIDS-Help Association pamphlet. But is it true? Shouldn´t the dialogue method of acceptance drug work described above be extended to include residents, school children, the Police, legal institutions and politics? To defuse clashes with local government we need acceptance drug work representatives at the round table, - together with user participation, - to argue for more humane drug policies. That public order policies and health policies don´t have to occupy opposing corners has been demonstrated by concepts developed by local branches of "Akzept". In Bremen the "Utrecht Modell" for better conditions for people working in drug based prostitution was discussed. Health rooms and advice shops would also fit both agendas. It can´t be stressed often enough that there is no single easy course of action, either for drugs policy or drugs aid, and that it is far more important to expose and do away with the negative symbols beloved of traditional drugs policy, such as "demon drug", "foreign drug pushers" etc.

Risks and Opportunities of Professionalisation

Acceptance drug work started as a political movement with a practical approach, effectively exposing the gaps in the old one-dimensional (abstinence orientated) drugs aid system. Nowadays, acceptance drug work is recognized as an effective part of work with addicts, and receives substantial subsidies (considering the process only took 10 years) under the heading of "harm reduction". But this development also entailed significant change and compromise: Sponsors expect a consistent, on the spot social service, which they will pay for, - with no ideological extras or political involvement. The image acceptance drug workers have of themselves nowadays is therefore of professional problem managers for certain peripheral social groups; that is, their involvement with their clients these days is no longer simply a matter of course, but has become a matter of method: dialogue is only possible when you get close to people. An increasing tendency towards professionalism, and to a certain extent bureaucracy, has set in, not unlike the process in the "release" movement in the early 70´s.
Apart from its uses, this process also runs the risk of giving way to its own momentum and for professional and economic reasons helping to create a pathology for its clientele. An early sign of this seems to be the "discovery" of the double diagnosis: psychiatric disorders couched in psychiatric terminology are employed in order to demand more auxiliary aids and special wards:

"Jump like a tiger. - Land like a rug??"

With the integration of practical acceptance drug work into existing care taking structures, and especially in view of the economic dependence this entails, the room for political and practical action (which often existed in a "grey area" anyway) has narrowed considerably. Dwindling municipal budgets are making life difficult for many small organisations and their workers: sponsors expect a simple social service inside a certain scope, and aren´t interested in political action, resolutions, and symbolic demonstrations against hostile narcotics legislation, which in any case seem to run contrary to economic interests. Signs of "calming down" are becoming visible among many formerly active organizations in the field of drug work in the Akzept Association. Of course they all have enough to do, running their organizations and applying for next year´s financing, but that also means less time to spend with people involved with drugs, and to work with them towards creating better drugs policy. We are in danger of falling into a rut, and would do well to keep working on viable drug policy alternatives, to keep pushing back legal boundaries, and to exposing the traditionally prohibitive system as obsolete - and expendable.

Maintaining Standards

The more acceptance orientated drug work becomes a consumer product, the more we need to react professionally to this challenge and consider it in its subject context. There has been a great demand for our first publications: "Leitlinien für die psycho-soziale Begleitung im Rahmen einer Substitutionsbehandlung" (Guidelines for Psychosocial Support during Drug Substitution Treatment) (1995), and "Leitlinien der akzeptierenden Drogenarbeit" (Guidelines for Acceptance Orientated Drug Work) (1999). We intend to follow up this work, and broaden the scientific foundations in this field.

5. What can be done?
To combat the social ostracism of such a large number of drug users, we need to draw up a drugs policy aimed at integration, which can be implemented step by step on a local and national level.
At a local level, this would mean re-integrating drug addicts into the normal social services, from which they have gradually been excluded and referred to "special" services for addicts only: with special hours for methadone maintenance (outside normal surgery hours); a special service for needle dispensing; and special clinics (because chemists and doctors refuse to treat addicts adequately, or sometimes at all). All of this creates a "special" reality for drug users, intensifying their social exclusion. But doesn´t acceptance orientated drug work reinforce the existence of just such a "special" reality? Couldn´t some of the specialized low threshold service structures be taken over, and maybe even organized better, along normal public service lines? Needle dispensing, for example, should logically be a service offered not only in contact cafés, but in normal chemists´ dispensaries, - which have longer opening hours, and are already geared to cope with needle disposal. In some cases, we also tend to integrate services which originally belonged within the normal scope of public service systems into the drugs aid system: debtors´ aid, employment and residential projects organized solely around drug users. Whereas integration means the opposite: it means ceasing to treat drug users as "clientele".
Drugs aid sponsors and self help organizations need to put an end to the "drug myth" with its prejudiced language, fuzzy concepts and unrealistic ideas on the origins, course and possible conclusion of opiate consumption. In the community, practical information is necessary, to establish effective local aid among, and with the help of residents.
On a national level, Acceptance work endeavours to rid the penal code of a distinct "Narcotics Law", and to regulate substances under the controls already afforded by the existing laws (pertaining to medicines, food stuffs, consumer goods etc).Criminal Law as an instrument to influence people´s behaviour has not only proved itself a failure, but has caused more damage than it has done good. The double standard of a partial prohibition only serves to make State drugs policy seem an arbitrary matter. Treating two identical things so differently can only be termed a policy of hypocrisy.
This unperturbed view of prohibition as being "normal" has long ceased to be anything but absurd.

This is the background against which Akzept e.V. stands for normal attitudes towards dealing with drugs, and the requirements of drug consumers in society.

Heino Stöver, 1999

Christine Kluge Haberkorn
Südwestkorso 14 D- 12161 Berlin
Telefon +49 (0)30 827 06 946 / Fax +49 (0)30 822 28 02 / akzeptbuero@yahoo.de
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