Social rehabilitation and reintegration of drug addicts in community – experience from EU

1. Social rehabilitation and reintegration of drug addicts in community – experience from EU Dr. Josef Radimecký, Ph.D., MSc. UN International Day against Drug Abuse and Illicit Trafficking June, 26, 2013, Belgrade

2. Structure of presentation • Social integration • Drug users with dependency entering drug treatment • How to respond to their needs? • Types of services of social reintegration and rehabilitation: • Integrated within drug services • Specific services for social reintegration and rehabilitation seminar four

3. Social reintegration (EMCDDA, 2012) • “any social intervention with the aim of integrating former or current (problem) drug users into the community. • 3 pillars of social reintegration: • housing • education • employment (incl. vocational training) • + other measures: counseling, leisure activities… • supportive measures to overcome personal and structural-level barriers to obtain employment & to increase personal employability – KEY” seminar four

4. Treatment vs. reintegration • Treatment & rehabilitation – emphasis on relationship between an individual and drug use • Social reintegration – concerned with the position of the individual in wider society • Being employed ≠ social reintegration! • Non-work related spheres of life – equally important • supportive social network & relationships with significant others (family, friends, colleagues) • ability to lead a life that is free from stigma and discrimination • well-being – self-realization of DAs • Activities supporting social reintegration – should be integral to treatment seminar four

5. Drug users entering drug treatment EU level in 2011 (EMCDDA, 2013): • unemployed (47 %) • 1 in 10 lacked stable accommodation (9 %) • low educational attainment: • 36 % completed only primary education • 2 % not even achieving this level of education • destroyed “health” relationships (family, friends non UD) • commitment of property crime • lack of social skills (communication, forms, letters - institutions, PC skills, CVs, application for jobs) • debts (executions) seminar four

6. Social reintegration vs. directives • Aim of the EU drus action plan (2009-12): • “to significantly reduce the prevalence of drug use and to reduce social and health damage caused by the use of and trade in illicit drugs.” • Social reintegration contributes to achievement this aim • It is included in the national drug strategies of 22 Member States • UN – 1961 Single Convention, para 1, Article 38: • “The Parties shall give special attention to and take all practicable measures for prevention of abuse of drugs and for early identification, treatment, education, after-care, rehabilitation and social reintegration of the person involved and shall co-ordinate there efforts…” seminar four

7. Approaches to social reintegration • General vocational rehabilitation • Drug treatment • Criminal justice system • Housing support • Education and (vocational) training • Employment support • General policy • Advocacy (EMCDDA, 2013) seminar four

8. When to start with social reintegration? • Traditionally – social reintegration perceived as a phase that should start AFTER treatment, after being drug free. • Recent evidence - social reintegration and drug treatment should be seen as integrative elements. • drug treatment alone can’t address the complex needs of problem drug users. • treatment alone – not sufficient to prevent social exclusion of marginalized individuals – many of which were already marginalized prior their use of drugs. • without social reintegration interventions – serious danger that gains made during treatment will be lost. seminar four

9. Types of interventions • Development of social skills • Counseling and help in seeking of jobs • Help in searching of housing • Debts counseling • Case management – coordination of use of external (social and health) services • Legal counseling • Help with transport to treatment facilities • Counseling and support in family/partners’/home violence and/or abuse • Sheltered housing & half-way houses • Sheltered working places • Care for children of clients/ stay in treatment programmes • Self-help groups seminar four

10. It’s your turn…! When to start with social reintegration interventions and who should deliver them? seminar four

11. Summary • Social reintegration • any intervention aiming to integrate former/current drug users into society • an array of health/social interventions delivered on basis of in depth assessment of individual situation and needs of client • It should be an integral part of all types of drug services: HR – treatment – after-care • When drug service not able to deliver specific interventions – to assure them for clients in other social services in region (case management) seminar four

12. Thank you! • for you attention • & for discussion Contact: Josef Radimecky Clinic of Addictology Ke Karlovu 11 128 00 Prague 2 Czech Republic www.addictology.org radimecky@adiktologie.cz seminar four