II. PRIMARY PREVENTION 27 54 7

III. SECONDARY PREVENTION 55 76 12

II. PRIMARY PREVENTION

III. SECONDARY PREVENTION

A. Participants There is considerable overlapping of secondary prevention with both primary and tertiary prevention.

State of knowledge in primary and secondary prevention

IV. RELATIONSHIP BETWEEN PRIMARY AND SECONDARY PREVENTION 77 90 17

The overlap between secondary and tertiary prevention occurs because it is difficult to draw a clear conceptual line between where secondary prevention ends and tertiary prevention begins, as is often reflected in practice.

A. The meaning and implications of primary and secondary prevention 2 6 2

PRINCIPLES AND PRACTICE OF PRIMARY AND SECONDARY PREVENTION IN DEMAND REDUCTION PROGRAMMES

The integrated approach is encapsulated in the notion that primary prevention seeks to prevent the harms that secondary prevention seeks to terminate and that tertiary prevention seeks to reduce.

Much experience has been gained, over a period of many years, regarding primary and secondary prevention approaches.

In reality there is a continuum from primary through secondary to tertiary prevention.

The World Health Organization (WHO) defines primary, secondary and tertiary prevention as follows WHO Expert Committee on Drug Dependence Twenty eighth Report, WHO Technical Report Series 836 (Geneva, 1993).

The emphasis of the present report is upon primary and secondary prevention however, in describing existing integrated programmes and approaches, it necessarily touches upon aspects of tertiary prevention.

V. CONCLUSION Considerable theoretical and empirical knowledge has developed in relation to primary and secondary approaches over many years.

Many States have developed an integrated and balanced approach utilizing aspects of primary, secondary and tertiary prevention.

Summary The present report was prepared pursuant to a request made at the thirty eighth session of the Commission for a review of the evidence available regarding primary and secondary prevention of drug abuse.

Participants in the development and implementation of primary and secondary prevention policies are from among most sectors of society.

(ii) Strengthening of preventive structures

The issue of targeting should reflect the fact that those in need will vary for primary, secondary and tertiary prevention (ICAA).

In theory, and as practised by many States, aspects of both primary and secondary prevention operate parallel to, or in conjunction with, tertiary prevention approaches aimed at reducing health risks to persistent drug abusers.

Secondary prevention includes reducing illicit demand through different forms of treatment and rehabilitation.

Secondary prevention consists of reducing drug abuse through different forms of treatment and rehabilitation.

The opportunity to intervene in primary and secondary prevention is not undertaken in most custodial institutions because of the scarcity of resources.

Secondary prevention is aimed at identifying and terminating or modifying for the better a disorder, process or problem at the earliest possible moment.

(xii) Preventive measures (article 31)

Theoretical and empirical evidence suggests that the efficacy of primary prevention is increasingly being called into question, while there appears to be evidence that secondary prevention can reduce demand, and result in abstinence, under some conditions.

The theoretical and empirical evidence available suggests that the efficacy of primary prevention is being called into question, while there appears to be evidence that secondary prevention can reduce demand, and result in cessation, under some conditions.

Within the secondary prevention approach, treatment and detoxification are sometimes followed by rehabilitation.

ii. Preventing and combating trafficking in human beings

It is therefore possible that, in some instances, the credibility of tertiary prevention techniques that seek to help reduce the health risks to individual users may provide an inroad or gateway for the implementation of secondary prevention aimed more directly at reducing the level of illicit demand.

Secondary prevention aims at helping people who are illicit drug abusers to stop doing so.

The process of synthesizing the available information relating to primary and secondary prevention demonstrated the benefit to be derived from integrating these approaches with those of tertiary prevention, since the three lie on a continuum both in principle and in practice.

Parents are extremely important participants in the prevention of drug abuse, especially primary prevention.

Responses to ATS use concentrated on primary and secondary prevention, with significant participation of the different groups involved in the youth scene.

Although they have a high relapse rate, secondary prevention strategies have been shown by different studies to be cost effective. Page

Drug testing can therefore be classified as both primary and secondary prevention since it may deter initiation and encourage cessation.

Secondly, a basic prerequisite for conflict prevention is early warning.

The implications of risk factors for the development of primary and secondary preventive approaches are outlined in the subsections on making programmes effective, contained in sec tions II and III below.

Subprogramme 3 Prevention and reduction of drug abuse

Subprogramme 1.1 Prevention, control and resolution of conflicts

Secondly, much greater emphasis is required on preventing the outbreak of conflicts.

Within their existing frameworks for collaboration, UNDCP and the World Health Organization (WHO) should identify, document and disseminate evidence based practice for primary and secondary interventions for ATS.

Efforts to develop an integrated and coordinated approach to conflict prevention