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.

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)

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.

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.