Marina Kuzman, MD, PhD Croatian National Institute of Public Health

1. National Drug Prevention and Information System in the Republic of Croatia- impact of EU funded projects - Marina Kuzman, MD, PhD Croatian National Institute of Public Health

2. Preconditions for Development • Strategic documents in place • Policy, Strategy and Action Plan for Illicit Drug Abuse Prevention Organizational structure • Office for Combating Narcotic Drug Abuse • Network of the treatment facilities in health sector with stabilized financial sources Professional guidelines • Guidelines for methadone and buprenorphine/naloxone pharmacotherrapy Intersectoral collaboration • Educational sector, Ministry of Interior, Prisons/detention, therapeutic communities...

3. Organizational structure of the partners in National Drugs Information System in the Republic of Croatia GOVERNMENT OF THE REPUBLIC OF CROATIA OFFICE FOR COMBATING NARCOTIC DRUGS ABUSE ADVISORY BOARD DEPARTMENT OF NATIONAL DRUGS INFORMATION UNIT AND INTERNATIONAL RELATIONS DEPARTMENT FOR GENERAL PROGRAMMES AND STRATEGIES GENERAL POPULATION SURVEYS PROBLEM DRUG USE DRUG RELATED INFECTIOUS DISEASES DRUG RELATED DEATHS TREATMENT DEMAND DRUG RELATED CRIME DRUG DEMAND REDUCTION EARLY WARNING SYSTEM CROATIAN PUBLIC HEALTH INSITUTE MINISTRY OF HEALTH AND SOCIAL WELFARE MINISTRY OF SCIENCE, EDUCATION AND SPORTS MINISTRY OF THE INTERIOR MINISTRY OF JUSTICE STATE ATTORNEY’S OFFOCE CIVIL SOCIETY SERVICES FOR DRUG ADDICTION PREVENTION HOSPITALS, CLINICS, EMERGENCY WARDS… UNIVERSITIES AND SCIENTISTS DRUGS DEPARTMENT PRISON SERVICE FORENZIC LABORATORY MEDIA OTHER INSTITUTIONS

4. Network of the Institutes of Public Health – Drug Abuse Prevention and Outpatient Treatment Departments

5. International projects • CARDS 2004 “Strengthening Croatian capacities in combating illicit drugs trafficking and abuse”* • PHARE project “Participation of Croatia and Turkey in the EMCDDA”** • Croatian counterpart: Office for Combating Narcotic Drug Abuse

6. CARDS & PHARE Project • Activities: • Assessment of the current situation and level of harmonization with the EUacquis communautaire (EMCDDA February 2005, June 2006 + CARDS January 2007) • Development Plan – defined activities of both projects in line with real needs • Set up multidisciplinary Working Groups for KEI and other relevant areas • Organized educations, trainings, workshops • Drafted strategic documents and intersectoral memorandums of understanding • Prepared and implemented surveys in certain areas (e.g. conductedseroprevalence survey with the first PDU estimates, initiated cohort mortality study, drafted argumentation paper for GPS etc.) • Upgrade of the software and harmonization of TDI, DRD and PDU with EMCDDA

7. MOVE project Education and training on motivational interview Brief pcychoterapeutic intervention for helping people change addiction behaviour Rooted in clinical theory and empirical evidence Aims to facilitate and enhance a person’s intrinsic motivation to change behaviour in highly emphatetically supportive but strategically directed conversation about use of substances and related life circumstances and events Uses a variety of techniques to increase the intrinsic motivation for change

8. MOVE project Professionals working in PHI (drug addiction prevention and school health services department), social workers and staff in students boarding houses were educated during the project 12 Croatian educators have been trained and licenced for further education MOVE is still being disseminated, in the recent months among the school counsellors in the primary and secondary schools in the City of Zagreb (supported by the Zagreb City Government)

9. What do we know about drug use and drug users in Croatia • Since the early 80’s the Drug Abusers Register has been established in the Croatian National Institute of Public Health. • At the beginning the data were colected from hospitals only, than gradually from all health care facilities. • In the register data are collected for: • Persons seeking the treatment for drug abuse/addiction • Persons who are referred to the treatment by the court/social welfare system • Mortality data are also included

10. Information system • Working groups for each KI have been established, members being appointed by the Croatian Government • Advise Office for Combating Narcotic Drugs Abuse (OCNDA) on the generalstrategy, methods of datacollection and analysis, communicationand further development,discuss on actual trends and situation,proposeconcrete activities andmeasures, participate in drafting workingdocuments andprofessional literature • Coordinator of each Working Group is in cooperation with the OCNDAsupporting multidisciplinary and scientific approach, working on development and monitoring scientificdevelopments of respective area, participates at the EU expert meetings of theEMCDDA and other bodies and reports on the outcomes of thosemeetings

11. Collaboration with the EMCDDA • National Report on Drugs Situation inthe Republic of Croatia is being produced bythe national keypartners • The first Croatian National Report 2007,was submitted tothe EMCDDA in January 2008 • Epidemiological surveillance enchanced, indicators discussed, process of harmonization started • PDU multiplier study performed • The cohort study started

12. Other activities PLANNED BUT NOT IMPLEMENTED (documents drafted) • National sero-prevalence survey, Problem drug use estimate (capture-recapture), Follow up of the sero-prevalence study among drug users in prison, • Training course for new staff of the OCNDA working in the NFP • Special Mortality Register – training • Education in the area of biostatistics and epidemiology (DRID) • To perform afore mentioned Mortality cohort study

13. The key elements for the success National policy, strategy and organizational structure ready to support the project activities Realistic situation assessment and needs recognized, taking into account cultural and social context Vision and goals achievable within the time-frame and available resources Sustainability as a prioritet in the planning process

14. Thank you for your attention!