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How can I notice the signs?

Most parents often ask this question to themselves and also to professionals who work in the sector of prevention of drug, alcohol and other related substances. Some adults, as well as parents think that they are not capable to distinguish the signs as they do not have enough awareness or knowledge to enable them to realise that there is in fact a problem.

A not so easy situation

This is a situation where even the people who studied on addiction might get some doubts especially if the person involved is a family member. It is true that often parents do not have the basic objective knowledge related to addiction of chemical substances. It is also known that some do not see seriousness the of such addiction, especially when consumption is of small amount. It is also a known fact that it is more difficult to detect the signs when one is too close to the person with the problem. Children have a way of hiding these signs from their parents.

Addiction, especially in adolescence, is difficult to detect during their developing stage. Most adolescents are preparing themselves “to leave their nest” when they are passing through their rebellious stage by unfounded arguments for self-independence. It was stated by a lecturer at the University of Tucson, USA, that excessive attitude and rebellious conversations are the alarming signs that something else is behind this attitude and are not always related to the developing stages. Mood swings are more visible than the average where substance use is involved.

Gradual Development

Substance abuse develops gradually and these can be divided into five steps:

First step: consists of the potential use leading to abuse already existing within the individual.  This includes very common factors in our society, such as children with parents using drugs or alcoholics themselves. Easy excess to these substances at home make it easier for the children to start using as well. Low self esteem in children and personality disorders are also dangerous factors in this regard. Most times, personality disorders develop from careless upbringing and unstable childhoods.

Second Step: is the experimental stage, a phase which is dramatically minimized by the person using. The person sees nothing wrong in smoking cannabis occasionally. Same applies to alcohol; one sees nothing wrong in drinking alcohol on daily basis as long as one is within the limits according to the drinking by laws.

Third Step: is when the person is exposed to what is on the market and experiments in various types of drugs and even consume with a mixture of alcohol.

Forth Step: consists of being actually addicted to substance use or alcohol. The main aim of the user would be solely to get high and feel better.

The fifth and final step: is the result of a typical drug addict or alcoholic – the physical and psychological deterioration of the individual.

It is wrong when we say that drug and alcohol abuse start during adolescence, when children reach the age of sixteen or eighteen. Various studies have shown that some sort of drug and alcohol use start during the secondary school years (as early as 11 years of age).

Patience and an open mind are highly required

If a family member is a drug or alcohol addict, you should not expect that person to be honest with another family member. Therefore, it is very important that you remain calm, patient yet strong and determined to use a positive strategy towards the issue. Addiction can be fatal and the lives of your child can be in danger. It is very important to take immediate action when you are certain that your child is abusing substances.  You must not think twice and hope that the child will come out of this addiction alone. You have to act fast!

Mistakes that should be avoided

You might ask: but what should I do? First off, you should not waste time.

ꓫ Do not pity yourself.

You can do this at a later stage, should you really want to.

ꓫ Get angry.

It will be more worth using your energy in a positive way.

ꓫ Explain and emphasize.

Nothing changes with repetitive advice.

ꓫ Blame yourself for the current situation of your child.

Parents full of guilt are not effective parents.

ꓫ Argue inside the family.

Arguments gets one nowhere.

Confrontation based on help and guidance

The best action you can take is to confront the addict, only if you are sure that there is abuse taking place, whether it relates to drugs or alcohol. You must not forget that the aim is to help your son/daughter and not create confrontation where you accuse and blame him/her for his/her own problems.

You need to be well prepared before confronting the user. One recommendation would be to get hold of four pieces of paper; on the first paper, jot down the physical and emotional signs you would notice. On the second paper, write down what you would think would be the effects of drug or alcohol abuse, such as car accident, illness, loss of money, poor examination results, excessive complaints related to work and unemployment.

On the third paper, write down your own feelings towards the situation. Simple terms should be used such as anxious, weary, angry and hurt. On the fourth paper, write down a list of consequences related to drug and alcohol abuse, which can include memory loss, unable to concentrate, failing to solve issues and physical harm. You should keep these notes as reference.

You must find the best time or moment when to talk to your son/daughter – the same applies should it be your husband/wife.

Prepare yourself in advance

  • You should speak to your son/daughter when and if possible, he/she is not under the effect of substance use. It is useless to try and reason out with someone who is under the influence of substance use.
  • You should always remain calm and honest, using simple clear words during confrontation. If your son/daughter has been using for a while, it is likely that long conversations, using strong language, will not work.
  • You should not speak out of anger. To keep calm is probably the biggest challenge in this situation.
  • You should discuss only what you have observed. You should not be sarcastic or state what other people would think about this situation.
  • You should describe the dangerous repercussions when someone is a drug addict or an alcoholic. You should be clear and concise in the words being used, especially if this is advice forwarded by professionals in the field.
  • You should recommend outside help. It is important that when you refer to professional guidance, you should go together as support.

 The First Step

This is when you would realise that your son/daughter is afraid. Afraid of his/her peer group, afraid that they will be defined as weak individuals. All this fear is due to the damage he/she would have sustained through drug and alcohol abuse. If ever there was a time where your son/daughter really needed you…...NOW is the time! With your help, your son/daughter will be on his/her first steps to recovery.

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Coronavirus (Covid-19) is an infectious disease that has limited our daily activities and confined us to our homes. For some, this dramatic change in lifestyle can be tough and isolating. Those of us who enjoyed going about their daily business, now find themselves stuck at home. We all eagerly await the news that this new terror, which has forced us to stay inside, is over.

For those of you who are feeling overwhelmed with the new limitations Covid-19 has imposed on us, this article may help you to make use of this time to reap benefits for a healthy lifestyle inside our own homes. A healthy lifestyle does not merely imply being physically active, but also being aware and mindful of your mental health.

Let us therefore start with how caring for our mental health is necessary. We are social creatures and thus require human contact. It is one of our fundamental basic needs. Being unable to leave the house will limit the amount of contact we have with others and the outside world. At times, total isolation tends to leave us feeling lethargic and unmotivated, and in turn we lean towards isolating ourselves more.

This threat is even more pronounced for people who are already vulnerable to becoming isolated such as the elderly, people in care homes, those who live alone or those who are struggling with mental health issues. Thankfully, technology can be useful in this regard and it would be wise to speak with loved ones on the phone or through video calls. For those recovering addicts who also feel that this time is testing their recovery process due to the temporary shutdown of meetings and groups, make sure to keep in touch with your counsellor, sponsor or Higher Power. Remember to stay grounded and to communicate your feelings rather than allow them to get pent up and explode.

Furthermore, keep your hobbies alive, and if your hobby is virtually impossible to maintain at home, think creatively on how you can transform this hobby into something that can be done indoors. Hobbies do in fact have the power of therapy and can be used as an aid for mental peace.

This is also the perfect time to engage in new interests that you may have wished to have had the time for in the past. So, think big. Is there something you have always wanted to do? Can you do it now? Not only would you be killing boredom, but at the same time discovering new skills and interests feeds a more positive attitude. Who knows, perhaps your new way of thinking might serve as a model for others to follow.

It is important that we remain calm and focus on what we can control, rather that what is out of our control, since otherwise this would be energy lost. Time dedicated to news should be limited to reputable and reliable sources. All too often too much information can be overwhelming, and some online news can be fake and lead to panic.

If you have read this and are indeed feeling particularly lonely, do reach out to people whom you trust, or to foundations like OASI, to help you through this challenging time.

 

OASI Foundation

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The following story is a true refection of a young, married woman, who with no fault of hers, found herself in a situation where her husband became a victim of alcohol and drug abuse. She tries to find a reason and searches for help and a solution to the problem. When one reads the story and reflects well its content, one will realise what it actually means to find oneself living with someone who is a drug and alcohol dependent.

 

Here I am, in a new and confused situation, feeling at a cross road.

What shall I do? – Should I file for divorce or separate him or should I wait?

What shall I do? – Should I seek the help of Family Services or should I wait?

Where is this situation going to take me? How am I feeling right now?

What is this feeling? Is it fear of the unknown? I wonder.

I still have feelings for this man whom I married nine years ago – I still love the one with whom I shared laughter and fooled around the house with as a married couple – a young free spirit full of love. I still love the man with whom I shared my dreams, my hopes, my first love and my first steps towards the unknown.  I still love the man who spent Christmas eve expressing his emotions and trying to guess what gifts I got him for Christmas.  I still love the man who shared with me the birth of our first born, encouraging me throughout the process and finally exclaiming to everyone in the room “it’s a girl! It’s a girl!” I still love the man who used to visit me at hospital, bringing the children with him and taking care of them whenever I was ill, who cried when he saw me in that state and took care of me, fearing that he was going to lose me forever.  Oh God, where is that friend, that soul mate that I loved so much?

Today I look at this man whom I’m living with, tough and cold hearted, a man that hates my body and ignores me except when he wants to fulfill his sexual desires.

Today I look at this man, whom I wish to hug and wrap my arms around him. Instead I find a lost, drunken person. A cold, sweaty person whose arms would not hold when I try to wrap them around me as if I’m an animal trying to keep warm – So I start crying.

I pray to God to bring him back home safe and thank him every time I see him in the doorway. At the same time I curse the same moment that he is back with him not even giving me a glance and slumps himself drunken on the sofa or else swears at me for something frivolous I might have done in that moment.

Alas! Maybe if I love him more, I can help him out of this problem. If only I could help him! Look at me, begging, crying, shouting, getting angry and praying. Look at me blaming his family, God and also myself.

My God when will this story ever end? Sometimes I unload all the pain on God but then I take it all back to carry it by myself again. I love, I hate, I feel ashamed; I close up within myself feeling unloved, unwanted and alone.

But God every now and then, through his love and infinite mercy, finds a way of placing the right people in my path; good people who truly love. He listens to my prayers; He sends me love and peace to help me make it through each crisis.  Sometimes I feel Him wrapping his arms around me telling me “My child, you had enough” and I feel uplifted until the next bout of crisis comes along. And once again, I would grab my children and leave everything behind. I feel lost and confused.

I still love the man who is eventually killing himself because of his alcohol and drug addiction, yet I don’t want him to take me down with him and drown me further. I turn to God for help – for the last time, I am ready to help the man I love, this other man who is hidden, buried in the grasp of alcoholism; the man behind this crazy, irresponsible, drunk, heartless individual.

Even if I integrate well within the assistance and proper guidance of Family Services, I will still turn to God to help me go through this road of pain and uncertainty because I trust in Him.

If the man I love, the man who is hidden behind the mask of this heartless individual, pleads for help, both the children and myself will be behind him all the way and help him make it through his recovery. We will thank God for His gift, for giving us back the man, the father we have known, the real man behind that mask.

Yet, should he refuse help, I will take hold of my children’s hand in one hand and the other hand in God’s hand and day by day we will face whatever comes our way, conscious of the fact that the love we lost to alcohol and drugs, gave us the chance to learn, helped us grow and gave us the strength and the courage to go on without the man we love.  And through God we learn that the feeling of compassion is always given to those who are truly suffering yet with God’s help, they will survive.   

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Caritas Malta, the OASI Foundation, SEDQA and the Maltese Association of Psychiatry, work with people with drug dependence and their families on a daily basis.

The need was felt that these entities come together due to the fact that through their work they are seeing changes in drug culture and a substantial increase in the number of people using certain types of substances for recreational purposes. The impact of this is leaving many aches and pains not only on individuals but also on their immediate families and society at large.

Mr Noel Xerri, CEO of the OASI Foundation, spoke of the need for the entities to come together as they are concerned about the increase in the use of substances they are encountering in their work in the field of drug abuse rehabilitation. Through bringing these entities together and collaborating, their message gains more weight. "The increase we are seeing in the number of persons using substances and the mentality that this is no big deal gives us great concern, and by working together we can put out a clear message that a healthy life can be lived and appreciated without dependence on substances."

The SEDQA Director, Mr Charles Scerri, explained that it is in the interest of each organization to positively promote sound alternatives, also known as natural highs. "We see a lot of children in our prevention programmes, with whom we work on topics such as self-esteem and peer pressure, so that when they need to make important decisions, even relating to substances, they are in a position to make them in an informed way. On the other hand, in a context where cannabis is legalized for recreational use, there can be realities where parents can indirectly influence their children about substance use as a means of recreation. This is because parents greatly impact the decisions their children take. On a similar scale, one can refer to statistics which show that the use of alcohol among youths mostly happens at home, and our concern is that the use of recreational cannabis may follow the same pattern. "

Dr Aloisa Camilleri, a Psychiatrist from the Maltese Association of Psychiatry, spoke of ongoing work with people with serious dependency problems. "These people are voiceless, and we feel the need to be their voice and that of their mental health. Recreational drugs deter people from having good mental health, and together we will work so that the voices of these people in pain get heard to prevent further harm and abuse. " She added: "There is a need for greater investment in suitable services for people who have dependency together with a mental health problem."

Mr Anthony Gatt, director of Caritas Malta, explained how the entities work hand-in-hand on a daily basis, not so that people do not find drugs because they are controlled, but so that they do not feel the need for it. "We are concerned about how the trend is changing and the idea that a substance such as cannabis is not harmful. While there is a strong investment by the authorities in agencies that work directly with dependency, lately even in prevention, we have to be cautious that through legalization we are not taking a step against all the good work being done. There is a danger that legalization will continue to increase the view that cannabis is not harmful. The idea that legalization will destroy the black market is erroneous, and this can be confirmed because the black market remained strong in countries where this law was adopted. We must also remember that we as a society tend to be less disciplined when compared to a country such as Canada.  We empathize with the social user that is not dependent on the substance and does not want to continue to rely on the black market, but if you weigh all these aspects against each other there are more disadvantages than advantages. The 2015 Law is delivering good results , and we wish that the legislature would give more tools to the judiciary so that their hands are not tied, such as in cases where a person who is dependent is caught with a certain amount of drugs and they are constricted to having to impose a prison sentence. Prison is not the right place for persons with dependence.”

The entities will be organizing a National Conference under the patronage of the President of Malta, His Excellence Dr. George Vella, with the title I Live – A Healthy Life is Our Choice, on  March 24th at the Palace of the President of Malta Sant' Anton. Details of speakers are in the attached poster. It is important that those wishing to attend register on the email [email protected], due to space limitations.

Press Coverage:

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Over 20 years of voluntary work carried out by Maria Louisa Scicluna with the OASI Foundation have been duly recognised with the presentation of the National Award for Voluntary Work. During these years Scicluna carried out voluntary duties in administration, and gave sapport to various families. Marisa, as she is popularly known, also set up a group of some 60 volunteers to provide support to the foundation.

This National award for Voluntary Service is organised by the Council for the Voluntary Sector under the patronage of President George Vella. Dr Vella pointed out that voluntary service is important and is one of the mainstays of society. In the words of the President, the work being carried out by organisations working in various voluntary sectors is invaluable. Vella added that no society, in any country, can function unless these services are provided by voluntary organisations.

The National Award gives recognition to the work carried out by volunteers and voluntary organisations within the community and highlights these exemplary values for youths and society.

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Jump For Life & Gostra - End of the Year Challenge. This even was the idea of a drug addict who has started his recovery process to rehabilitation 18 years ago at OASI. The idea behind this event is to serve as an encouragement to persons who feel the need to change and ask for help, but still lack the courage to make that leap and JUMP.

The challenge consisted in jumping in the 14°C sea and swimming a distance of 160m, and coming out of the water facing F5 wind temperature of 10°C. The Gostra competitors did their jump several times.

However the atmosphere and the vibe generated by the crowd present and the competitors was warming and encouraging.

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The OASI Foundation has been operating int the field of addiction since 1991. We have noticed several changes in drug use scene and related trends, for which we have responded in our prevention strategies and treatment modalities to cater for such needs.

The National focal point (NFP) in its National Report on the Drug Situation in Malta 2019 shows clearly that 40% of those entering treatment for the first time do so because of their cocaine abuse and its related problems. These national figures are also reflected in our clientele, where 44% are requesting treatment for cocaine abuse, against the 25% for alcohol abuse, 16% for heroin and 9% for cannabis amongst others.

This does reflect the false perception in our society – the belief that cocaine use is not harmful. Cocaine, like alcohol and cannabis, are considered by the layman as recreational drugs. These figures clearly show that cocaine problematic use is on the increase and persons and families are becoming victims of such false belief.

The mental and financial harm caused by the use of these substances is increasingly devastating, and the severity of cases is increasing.
Our beneficiaries do report that substance use during these festive activities increases. This is also confirmed by the increased number of arrests and seizures of these substances during this time of year.

The use of the substances and even more so, the mix of these substances, cause an alteration in perception and awareness, which is directly reflected in decision making. We see the drastic negative effect of these decisions on daily bases in the persons and families we work with.
We do urge the various members of our society to re-embrace the belief that enjoyment is not being high on drugs and that drugs do not lead to enjoyment in the long run. We do encourage people to think before making use of any kind of drug and that there is professional help for persons and their families who are being affected by substance abuse. We are noticing parts of this society who are finding enjoyment and pleasures in healthy behaviors such as sports and culture.

The OASI Foundation offers professional therapy and treatment to persons and their families with addiction difficulties both on community based and residential bases, as well as offers prevention awareness and consultation to community groups, community leaders and employers.

The OASI Foundation takes this opportunity to wish everyone a clean and sober Christmas and New Year.

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Today, 18th June, the OASI Foundation together with the Naxxar Local Council organized a National Conference under the Distinct Patronage of H.E. Dr. George Vella, President of Malta, with the title Drugs...and Mental Health? Reality, Health and Prevention.  The conference was held at Villa Arrigo and was moderated by Mr. Clifford Galea.

Hon. Dr. Michael Falzon, Minister for the Family and Social Solidarity, emphasized how important it is that all service providers in the social field work together to achieve their common goals.  He stated that the involvement of the Presidency is proof of the importance of the subject in question and the Government's commitment in tackling these issues. 

Ms. Anne Marie Muscat Fenech Adami, Mayor of Naxxar, said the local council looks forward to this annual conference and commits to their continuous support of OASI and its message.

Mr. Manuel Gellel, on behalf of the National Focal Point on Drugs and Drug Addiction, Ms. Sharon Arpa, representing Sedqa, Dr. Anton Grech, Psychiatrist and Chairperson of Mental Health Services, and Prof. Richard Muscat, Director of the Centre for Molecular Medicine and Biobanking, discussed present statistics, the connection between drug use disorders and mental health disorders, and gave their recommendations on how the current situation can be improved. 

Mr. Noel Xerri, Chief Executive of OASI, emphasised that everyone has a duty to contribute so that together we can tackle the problem of drug use. He stated that whoever believes that drug use causes harm to society is a contributor and collaborator. He also mentioned that the law needs to give clear direction on these matters, and needs to be based on scientific evidence.

H.E. Dr. George Vella, President of Malta closed the conference by saying that we cannot forget that when we are mentioning statistics, we are talking about actual people, many of whom are doing their best to deal with their problems. He also mentioned that we need to reduce the stigma related to mental health and drug use disorders and certain labelling should be eliminated. Finally, he closed his speech by addressing the issue of cannabis stating that we need to learn from experts and other countries and that as a medical doctor and a father he doesn’t believe that recreational cannabis should be legalised and its use should be limited only to medical one.

Read H.E. the President's full address here.

The audience was an active participant in the National Conference, and included representatives from diverse fields, including government agencies, non-governmental organizations, educators, persons working with youths and students. 

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The Maltese Association of Psychiatry and OASI Foundation, together with other professionals have been studying the drugs scene as part of our daily work. We have witnessed changes, not only in the variety of new drugs available on the market but also in quantity and quality of drugs, namely more potent forms of psychoactive substances being available on the market. Of greater concern is the change in pattern of drug use and the fact that this is often tagged as recreational despite obvious repercussions on users’ well-being.  These findings are compared against international data and studies.

We are concerned with the increased availability of drugs. Treatment demand indicators proof an increase in recreational drugs and drug use, mostly cocaine and cannabis. We have also noticed a decrease in new onset heroin use. Drug use, nowadays, is not tied to any social strata or cohort, but treatment demands arrive from persons of all social levels and standards, most with no family history of substance use disorders or other mental health problems.

We have registered a change in the manner by which users approach drugs, especially those kinds that are looked upon as recreational ones. Most users are not conscious nor cautious of the substances they make use of. Most of the harm caused by drugs is gradual and covered by its euphoric and relaxing effect. It is only visible in time.

Drug use has been with us for ages, and it will remain with us. Consenting and approving it is different from acknowledging its existence and devise strategies to heal it.

We remain wholly committed to providing care and treatment for persons with substance use disorders and their families. We believe that punishing illegal use is often counterproductive, although we have encountered cases where law enforcement was a motivator towards a more satisfying and fulfilling life away of all substance abuse. We do not want to stigmatise users or discriminate against them – we work with these persons day in day out and we base our practices on ethical standards.

We have also stated in the past that we do agree with the use of cannabis for medicinal purposes, under scientifically proven practices and strict protocols.

In view of the proposal to legalise cannabis for recreational purposes, we feel the responsibility to make our position clear, as we did several times in the past, more so when such a proposal is labelled as a harm-reduction strategy. If the legalisation of cannabis will see new individuals starting cannabis use then definitely this cannot be labelled as a harm reduction strategy.

We do not agree with the legalization of cannabis for the following reasons:

  • We do feel that legalizing cannabis for recreational purposes is giving out a very unhealthy and contradicting message, especially when combined with harm reduction purposes. We believe that the state has the responsibility to give clear messages to the general public and to our young and future generations. Studies show that cannabis use, especially long term but also dependent on the age of onset, has counterproductive effects on the memory, concentration and sensorimotor activities. Often time users are not willing to look into effects of the drug that go beyond the euphoria experienced during the period of intoxication.
  • We need stronger policies which guide enforcement based on training and educating not only frontliners in the enforcement and health care sectors (as these are the ones who face the consequences on drug recreational use), but also the general public. We are particularly in need of training of educators working with children and adolescents, these people are uniquely placed to identify youngsters with at risk behaviours and channel them to appropriate services.
  • Parents need more professional support easily available in order to be more equipped to deal with the challenges of children’s upbringing as well as education about detecting early signs of behaviours associated with drug use. Families are invariably effected by a relatives’ drug use pattern and are oftentimes the ones asking for help before the user himself / herself.
  • The same applies to the effects on the industry and work place. Employers need support and guidance on how to deal with cases of intoxication, not only with reference to machinery use, but also to how drug use effects work relations and productivity.
  • Physical activity is a must for a better mental wellbeing. Open spaces need to be more available at all times. We are surrounded by the sea which could offer a myriad of options for relaxation and sports activity (not only during the warm season), where the promotion of wellbeing could be put in practice.
  • Drug users and family members need a means of knowing what kind of drug samples they are taking through anonymity protocols. Offering them testing facilities helps them and country know what kind of drugs are available.
  • We have been advocating for a Poison Unit in our Emergency Departments to monitor intoxication cases and levels in our hospital admissions. The country needs more data captured from more data sources such as EDs in hospitals. These sources could help the law and policy makers.
  • Drug driving policies and training need to be in place and enforced.
  • We do not believe the legalization recreational purposes will eliminate cannabis illegal supply.
  • Stronger preventive strategies need also be studied and acted upon.  The Icelandic Preventive Model (to mention one model), took 20 years to produce results and included, among other strategies, removing alcohol availability from homes and from the visibility of younger generations.

Prevention should also include training for care professionals (doctors, nurses, para-medics, social workers, youth workers, teachers and learn support assistants, police and other law enforcement, etc) in how to deal with emergency cases as well as apply policies and strategies in everyday life.

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The OASI Foundation of Gozo, the Naxxar Local Council and Villa Arrigo, organized a National Conference under the Patronage of President Marie-Louise Coleiro Preca.  The topic covered in today’s conference was – Women and Addiction – Is the World of Addiction a Sexist One?

The President in her message stated that stakeholders need to have more information so as to have a better picture of the realities being faced by Maltese society. “There also needs to be less obstacles for women to find the help they need,” she said.

A number of professionals spoke about their experiences. The primary speaker, Prof. Marilyn Clark, said that women face different difficulties in regards to experiences of addiction and treatment.

She also indicated the gender gap for drug use has practically vanished. “There are various difficulties which hinder women seeking to stop using drugs more than men in the same position – these include social attitudes towards women,” said Prof. Clark.

During the first panel, Dr. Jeffrey Bonnici, who works at the Emergency Department at Mater Dei Hospital, said that people who entered the Emergency Department with issues related to recreational drug use is continuously increasing, and there is no statistical difference in relation to the drugs used by men and women.

Inspector Joseph Busuttil commented that it is difficult to gather statistics about women and addiction, as they fear that by reporting drug use they will criminalise themselves. “The only sector where a person can have an idea of the actual reality is through prostitution,” he said.

In the second panel, Dr Anna Maria Vella discussed how crucial it is to have something for women by women. She also mentioned that at times, women see prostitution as the only means to get money for drugs, even though they still end up without money.

Dr Alosia Camilleri, a psychiatrist explained that the amount of mental health problems between men and women is rather similar. The difference is what kind of mental illness they have.

She also mentioned that women face more barriers in facing treatment and getting out of this vicious cycle.

Dr Mariella Mangion talked about the problems babies face, whose mothers used drugs, and also the long term effects.

Mr Noel Xerri, Chief Executive of the OASI Foundation, emphasised how essential it is to note that there is still a lot of abuse and a lot of work needs to be done in order to achieve a better situation.

Finally Naxxar mayor Anne Marie Muscat Fenech Adam ended the conference, saying that the Naxxar local council understands the importance of social help and the NGOs, saying that it is also willing to help other non-governmental organisations. The conference was presented by Amanda Ciappara.