WORK PACKAGE TREATMENT CHALLENGES

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 Kick-off Seminar Paris, 20-21 June 2008

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. THANK YOU FOR YOUR ATTENTION