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Drug Prevention and Health Branch Division for Operations Gilberto Gerra

Drug Prevention and Health Branch Division for Operations Gilberto Gerra. The drug control system: health and social implications. …from the dangerous effects of illicit drugs. Protect the health of the new generations…. …among adolescents. Prepare a future of freedom,

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Drug Prevention and Health Branch Division for Operations Gilberto Gerra

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  1. Drug Prevention and Health BranchDivision for OperationsGilberto Gerra

  2. The drug control system: health and social implications

  3. …from the dangerous effects of illicit drugs Protect the health of the new generations…

  4. …among adolescents Prepare a future of freedom, social engagement and success…

  5. ...and adolescents experimenting with drugs Change the trajectory of adolescent at risk…

  6. Develop specific treatment programs for very young drug dependent individuals Children using drugs at the age of 6-11

  7. Implement science-based drug dependence treatment programs

  8. Prevent the spread of HIV-Hepatitis-TB epidemics among drug users Treat HIV-AIDS

  9. Offer drug dependence treatment programs and HIV prevention in prison

  10. Support the families of farmers involved in crops eradication

  11. The Political Declaration 2009 confirmed the validity of the UN Conventions on Narcotic Drugs and Psychotropic Substances (unanimously) The drugs listed in the Conventions are licit only when used for medical and scientific purposes These drugs are illicit because they are dangerous, not dangerous because they are illicit

  12. Pulmonary Emboli in a User of Crack Cocaine

  13. methamphetamines

  14. heroin overdoses 1990–2006 between 6 400 and 8 500 drug-induced deaths were reported each year by EU Member States, non-fatal overdoses (estimates 50.- 60.000) EMCDDA

  15. Lancet Adverse health effects of non-medical cannabis use. increased risk of motor vehicle crashes a dependence syndrome impaired respiratory function cardiovascular disease adverse effects on adolescent psychosocial development and mental health Hall and Degenhardt, 2009

  16. Illicit Drug Use at the Global Level * Data from UNODC World Drug Report 2009

  17. Estimated coverage of drug education in schools based ONLY on information Data from selected key countries in Asia, Latin America and Africa

  18. WHAT IS WORKING IN PREVENTION training in resistance skills normative education life skills: decision making life skills: emotional communication life skills: impulse control family skills trained teacher interactive methods Faggiano et al., Cochrane 2005 Molgaard & Spoth, 2001

  19. Estimated coverage of drug education in schools that is EVIDENCE-BASED Data from selected key countries in Asia, Latin America and Africa

  20. Data from UNODC World Drug Report 2009 4.3 million receiving treatment (out from 18-38)

  21. WHAT IS WORKING IN TREATMENT Brief intervention Vocational training Motivational therapy Cognitive-behavioural therapy Contingency therapy Family therapy Self help 12 step Therapeutic community Long term opioid-agonists Slow release opioid-antagonists Alpha-adrenergic agonists Vaccine Modafinil DA D3 antagonist Antiepileptic GVG N-acetylcysteine CRF-antagonists Promising medications

  22. Estimated variety and coverage of treatment offered Data from selected key countries in Asia, Latin America and Africa

  23. ? Global Fund World Bank $ Malaria Tuberculosis HIV/AIDS Illicit drugs dependence Prescription drugs abuse Alcoholism

  24. Counteracting production and trafficking and health protection are not contradictory strategies A well balanced integrated approach

  25. Single Convention on Narcotic Drugs, 1961, Article 38 “the Parties shall give special attention to and take all practicable measures for the prevention of abuse of drugs and for the early identification, treatment, education, after-care, rehabilitation and social reintegration of the persons involved”

  26. Single Convention on Narcotic Drugs, 1961, Article 36 b “abusers shall undergo measures of treatment, education, after-care, rehabilitation and social reintegration”

  27. Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988,Article 14 (4) “…parties shall adopt appropriate measures aimed at eliminating or reducing illicit demand for narcotic drugs and psychotropic substances, with the view to reducing human suffering…”

  28. INCB Report 2007 (EN/INCB/2007/1) “with offences involving the possession, purchase or cultivation of illicit drugs for the offender’s personal use, the measures can be applied as complete alternatives to conviction and punishment”.

  29. Political Declaration, 2009 promote, develop, review or strengthen effective, comprehensive, integrated drug demand reduction programmes, based on scientific evidence including … early intervention, treatment, care, rehabilitation, social reintegration and related support services, aimed at promoting health and social well-being among individuals, families and communities and reducing the adverse consequences of drug abuse …

  30. Prevention Treatment Rehabilitation Section Improving parenting to prevent drug use, risk behaviors and crime

  31. Disseminate reliable information, prevent substance abuse, fight stigma and inspire solidarity in the workplace

  32. Prevention Treatment Rehabilitation Section

  33. UNODC treatment programme countries Europe: Albania Serbia Central Asia: Afghanistan Kazakhstan Kyrgyzstan Pakistan Tajikistan Turkmenistan Uzbekistan North Africa: Egypt Iran Jordan Lebanon Morocco United Arab Emirates South East Asia: Cambodia Myanmar Viet Nam Latin America Brazil Haiti Colombia Peru Nicaragua Africa: Nigeria, Mozambique, Cote d’Ivoire, Tanzania, Sierra Leone, Kenya, Zambia, Ethiopia, Uganda, Madagascar, South Africa, Seychelles, Cape Verde

  34. Prevention Treatment Rehabilitation Section

  35. Content of the program Serbia Albania Haiti Pakistan 4 countries UNODC-WHO Programme on Drug Dependence Treatment and care

  36. UNODC HIV Section 70 professionals in 35 countries, covering 70 countries International staff National staff September 2010

  37. Antiretroviral therapy of AIDS A comprehensive package of measures to prevent HIV in the community and in prison

  38. Sustainable LivelihoodsUnit First line social assistance to drug users in the cities Alternative development in 7 countries

  39. Moving from a sanction-oriented approach ... to a health-oriented approach

  40. A heroin addict was shackled on arrival at a detoxification shelter. The chains prevent flight when withdrawal sets in.

  41. Social exclusion

  42. re-education and working therapy

  43. Detoxification methods

  44. Drug dependence is a multi-factorial chronic disease neuroadaptive processes in the brain reward system: allostasis usurpation of emotional memory willpower dysfunction stress-induced and drug cue-induced craving states

  45. Activation of the reward/motivation system with drug related stimuli of 33 mSec. Childress et al., 2008

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