Improvement of Treatment of Drug use Disorders in Central Asia the contribution of The EU Central Asia Drug Action Programme (CADAP)
According to 2009–2013 and 2014 – 2020 Action Plans on Drugs between the European Union (EU) and the Central Asian states it is of common interest to address drug-related concerns, to intensify cooperation and to provide assistance in the field of drug prevention and drug treatment. Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan) are experiencing drug use related problems, such as increasing numbers of drug dependents (approx. 400,000 injecting heroin users) and the threat of infection diseases such as HIV and Hepatitis among injecting drug users (with a prevalence of 4-20%, 50-70% respectively). Several harm reduction programmes had been launched, but mostly externally donor-driven.
Although the model of “narcology”, in the sense of social control rather than strengthening of self-support and respecting human rights of drug users, still exists, a common basis for improvement of drug prevention and treatment response is already on the way. Drug dependence is defined as a chronic illness and treatment is seen to be needed. The staff in the treatment and rehabilitation centres is qualified and highly motivated, but the structural barriers and lack of funding are omnipresent. There is an urgent need for exchange of experiences and trainings in psycho-social support and new methods of psychotherapy and implementing and scaling-up of Medication Assisted Treatment (MAT). Several bottlenecks and threats for further improvements of the services for drug users exist. Although detoxification and short term inpatient treatment facilities exists on the basis of the primary care system, only limited out-patient treatment facilities are working. There is only very limited access to Opiate Substitution Treatment (OST) and only limited co-operation of HIV, Hepatitis, and TB prevention services for injecting drug users and addiction treatment centres. The EU financed “Central Asia Drug Action Programme” (CADAP) is aiming at supporting the need for further qualification and trainings in psychotherapeutic methods for brief interventions, motivational interviewing, relapse prevention and social rehabilitation, and MAT. More than 2,000 experts and governmental representatives were trained between 2010 and 2012. Access to OST could be slightly increased in Kyrgyzstan, Tajikistan and Kazakhstan. In the current 6th phase of the programme the improvement of the institutionalisation of the treatment system and the WHO/UNODC International Standards of the Treatment of Drug Use Disorders will be trained and systematized, using EU best practices.