The City has continued its work to combat drug abuse with rapid action. Residents have particularly praised rapid access to treatment and institutional detoxification.
The City has continued to work actively to tackle drug-related problems. One year ago, when the drug situation deteriorated rapidly and became more visible on the streets, the City stepped in.
Access to drug treatment was streamlined, and residents started to have access to institutional detoxification no later than the next working day.
City of Helsinki’s Substance Abuse Services Manager Pia Pulkkinen says that the City's response to the drug situation has been particularly praised for quick access to treatment and detoxification.
The threshold for seeking treatment has also been lowered, as nurses and social instructors conducting substance abuse work will assess the need for treatment wherever they meet people with substance abuse issues.
Mobile and outreach workers can also bring a person to treatment directly from the street.
The opportunities for rehabilitation have improved. There is now a medical rehabilitation unit in the Laakso Hospital area, which means that the transition from detoxification to rehabilitation can be smooth.
Recovery can be supported in substance abuse services up to and including substance-free housing services.
Public debate has brought the dangerous designer drug Alpha-PVP to the attention of Finns. The drug is still widely used.
However, since the speeding up of access to detoxification, the situation has calmed down somewhat, for example in Vaasanpuistikko in Sörnäinen.
Wastewater studies by the Finnish Institute for Health and Welfare (THL) have also shown that the use of Alpha-PVP has declined slightly from peak times.
Nevertheless, effective substance abuse work is still needed.
While there have been great benefits from rapid access to detoxification, detoxification treatment can still be accessed in a planned way, as part of a pre-planned recovery pathway.
In addition to this, institutional detoxification is not always necessary, and for some drug users, day treatment or outpatient detoxification may be more appropriate.
Detoxification and rehabilitation needs are individual. It is crucial for the success of any treatment that people also receive support for their recovery from their loved ones or peer support, such as that provided by organisations.
It is pointless to blame drug addicts for the current drug situation. Anyone can develop an addiction, but a poor socio-economic background leads to a heightened risk.
Mikko Tamminen, Director of Housing, Crisis and Substance Abuse Services in the City, reminds us of these facts.
Poor social status also exposes people to morbidity and shortens life expectancy.
Studies of drug-related deaths among young people have also shown that their fate is usually caused by difficult life events, such as being taken into care.
When benefits are cut, the problems pile up for the most vulnerable.
Pulkkinen says that a disadvantaged background needs to be counterbalanced by protective factors. These factors can also be strengthened. Beneficial factors include good relationships with parents and friends as well as free activities or even a communal classroom where no one is bullied.
It can be very tempting for a young person to enter the drug business in the hope of a quick buck and elevated social status. When there is something meaningful to do, a life of crime can lose its appeal.
Tamminen and Pulkkinen emphasise that in substance abuse prevention, special attention should be paid to poverty among families with children. If life is made more difficult for families with children, the adverse effects will be felt for a long time to come.
The City is doing its part to avoid problems now and in the future. Even the smallest things can mean the world to a family in terms of their ability to cope.
Helsinki has limited capacity to tackle the major underlying causes of substance abuse. The Finnish economy has been in recession for a long time, and unemployment has risen sharply, especially in recent years.
Very recently, we have noticed that homelessness is on the rise. The longer a person is without housing, the more difficult it is to remedy the situation. Homelessness also means a higher risk of substance abuse.
The increase in drug use is also explained by the drug market. Drugs and medicine can be ordered online for home delivery.
“It is very easy to get drugs nowadays. Before, you had to know the dealer and meet them at an agreed place. The current drug market is huge and peddles many different types of drugs, including Alpha-PVP, which has very harmful effects," Tamminen says.
Giving up is not an option, however, and the City is involved in developing new methods for the treatment and rehabilitation of drug users.
One of the new psychosocial rehabilitation methods is the reward-based treatment approach. Since the 1990s, international studies have found that rewards for not using drugs support rehabilitation.
Helsinki is currently exploring the launch of a reward-based treatment pilot at Youth Substance Abuse Service Pysäkki. In practice, a reward can mean e.g. a gift voucher when a client participates in discussion groups.
“We want to be at the front lines and involved in developing the reward-based treatment model throughout Finland," Pulkkinen says.
In addition to Helsinki, the wellbeing services counties of Southwest Finland and North Savo are also involved.
It is important that we are able to help as many people as possible on the path to recovery and moving forward in life.
“It is important that we are able to help as many people as possible on the path to recovery and moving forward in life," says Tamminen.
Effective work has not been and will not be carried out by social welfare and health care services alone. Especially when a substance abuser comes from a disadvantaged background, they have to rebuild their whole life, starting with changes in lifestyle and relationships.
The person needs to be able to justify to themselves why it is worth continuing to live a sober life. These people need communities around them to support the start of their new life.
It must be possible to live and spend time in the city regardless of the drug situation, and the streets and parks need to feel safe and the urban space pleasant to be in.
Team Manager Anna-Mari Tiitinen-Kairi from the Urban Environment Division says that sanitation has been stepped up, especially in places frequented by drug users.
Litter has been collected and bins emptied more often. Branches and dense bushes in front of street lamps have been pruned to prevent dark areas from attracting drug users.
The Municipal Engineering unit is conducting extra checks to make sure the lighting is in order.
Tiitinen-Kairi says that any littering or lighting issues in different parts of the city are usually reported fairly quickly. Messages come not only from residents, but also from other City units.
Other measures are also taken. Last autumn, the City experimented with local caretaker (aluetalkkari) activities in Franzeninpuistikko in Torkkelinmäki, and the pilot will continue at least until the autumn.
The local caretaker visits the area regularly and keeps the daycare centre yard and the adjacent park tidy at the same time.
There are separate facilities for drug users. In early August, a new Symppis day centre will open in Mäkelänkatu, as the Sörnäinen centre has been overcrowded. The Symppis centre in Sörnäinen is looking for new, larger premises.
Symppis also continues to operate in Itäkeskus.
The prevention of drug-related deaths, on the other hand, will be made easier once the pending legislation is enacted and the antidote Naloxone can be distributed much more easily for opioid overdoses.
The City receives funding for health care and social welfare services, including substance abuse services, from the state. From next year onwards, this funding will be significantly reduced.
“We need to think more carefully about how to allocate the money so that we can make the most of it in terms of benefit and impact," says Tamminen.
He is pleased that the joint efforts of the whole City organisation in tackling the drug situation have been strengthened.
The City Board is expected to discuss the Helsinki substance abuse strategy before the summer break.
It will not cripple the drug market, but it will help plan the City's work, as the strategy will set out the objectives and measures for future substance abuse work.
Text: Kirsi Riipinen