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WORK PACKAGE TREATMENT CHALLENGES

WORK PACKAGE TREATMENT CHALLENGES. Dr.Thomas Legl Member of Executive Committee EURO –TC Director Kur- und Gesundheitszentrum Knappenhof/Austria ICAA,, Vienna NGO Committe on Narcotic Drugs. DEMOCRACY CITIES AND DRUGS II Implementation Seminar Bucharest, 22-23 January 2009. OBJECTIVES.

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WORK PACKAGE TREATMENT CHALLENGES

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  1. WORK PACKAGE TREATMENT CHALLENGES Dr.Thomas Legl Member of Executive Committee EURO –TC Director Kur- und Gesundheitszentrum Knappenhof/Austria ICAA,, Vienna NGO Committe on Narcotic Drugs DEMOCRACY CITIES AND DRUGS II Implementation Seminar Bucharest, 22-23 January 2009

  2. OBJECTIVES • To identify actual challenges in treatment • To find responses to local specifities and actual consumption patterns • To develop best strategy for the local city level • To promote exchange to other stakeholders • To make treatment easier accessible and more attractive to the persons in need

  3. PLATFORM LEADER - EURO-TC • Network of addiction treatment centers • Covers 9 european countries • Special promotion of: • Flexible therapeutic programmes fitting the patients needs • Integrated treatment programmes for special target groups • Exchange on the scientific level as well as on the level of clients activities

  4. WORK AGENDA • Implementation seminar Bucharest / establishment of scientific group and work plan • Development of a questionnaire to evaluate a status quo • Analyze the questionnaire • 2 workshops organized by the scientific group • 5 refinement meetings • Development of guidelines

  5. BACKGROUND/GENERAL GUIDELINES WITHIN THE EU • Integrative Approach • Different Problems – Different Strategies • Punishment for Trafficking & Treatment for Dependant Persons • Counseling Consumers • Decriminalization vs. Legalization

  6. SITUATION • Rapid Development of Substitution Programmes • Traditional Abstinent Treatment / Need for flexible interventions

  7. Co-Morbidity - Flow Pattern Outpatient Facility Psychiatric Hospital High Co-Morbitity Low Co-Morbitity TC High Co-Morbitity Substitution Programme Low Co-Morbitity

  8. SUBSTIUTION TREATMENT • Italy 27-29% • Spain 41-86% • 90% Methadone – 300.000 Methadone patients in Europe BEST PRACTICE • Long term basis and effective dosage • Psychosocial treatment • Excellent experience in combination with residential treatment

  9. Substitution drugs • Very different legal situation within European countries • Methadone – Buprenorphine • Heroine maintenance – “perfect administration” • Matching treatment towards clients needs special target groups / Vienna experience

  10. MATCHING TREATMENT TO THE PATIENTS NEEDS SPECIAL PROGRAMMES • Parents and Children • Dual Diagnosis • Adolescents • Gender Oriented Treatment • Ethnic Approach • Geriatric Communities

  11. CHANGE IN CONSUMPTION PATTERNS WHAT IST THE ANSWER TO • Increasing consumption of cocaine • Increasing consumption of methamphetamines • Parallel -consumption of alcohol and stimulants in substitution programs

  12. NECESSITIES • Different settings for different types • Anonymity essential • Time factor needs focusing on behavioral aspects

  13. CHALLENGES • ADAPTING TREATMENT TO PATIENTS NEEDS • Needs emerge during therapy • Matching needs as they emerge • Treatment not limited to a single inpatient intervention very clear for non-addiction diagnoses • Making treatment attractive

  14. The cities‘ individual challenges: 1. Liège • Main Topics: ▪ Cocaine treatment ▪ Long-term treatment • Challenges / needs to be done: ▪ Implementation of heroin assisted treatment ▪ adequate residential treatment and aftercare ▪ implementation of a consumption place ▪ increase cooperation to reorganisation

  15. 2. Vienna • Main topics: ▪ treatment of addicted pregnant women & young mothers ▪ treatment of children with a familial addiction background ▪ treatment of older people, as well as other people dependent on other‘s help

  16. Vienna • Challenges / needs to be done: ▪ implementation of case management ▪ work for a higher tolerance within the population ▪ Addicts in and after treatment need an ordered day structure ▪ especially young people need a more positive prospect, unemployment situation should be discussed in treatment and prevention programmes

  17. 3. Leipzig • Main topics: ▪ development of appropriate activities and preoccupation for work as well as leisure ▪ improvement of an easier/better access to target groups ▪ early intervention in somatic treatment facilities

  18. Leipzig • Challenges / needs to be done: ▪ provide sufficient psycho-social support for addicts on substitutes ▪ prevent premature prescription of medication which delay an early treatment of addiction ▪ intensify work focused on women and families

  19. 4. Central Bohemia Region (Czech Rep.) • Main Topics: ▪ high percentage of very young drug users ▪ higher drug use with Roma people and other ethnic minorities ▪ too few substitution treatment programmes offered by the towns

  20. Central Bohemia Region • Challenges / needs to be done: ▪ provide more staff specialised/trained in issues of drug treatment/therapy ▪ provide short- and middle-term treatment, as well as sufficient aftercare ▪ increase interest of politicians and raise financial contributions ▪ set up a network of regional NGO‘s dealing with these issues

  21. THANK YOU FOR YOUR ATTENTION

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