Treatment

In the field of drug demand reduction, the objective of the EU Drugs Strategy is to contribute to the reduction of drug problems in the society. The activities in the region to achieve this objective need to be evidence-based and follow the following assumptions:

A better coverage and accessibility of high quality drug treatment, both pharmacological and abstinence-oriented, and its combination with rehabilitation and reintegration is needed in CA, offering a wide range of integrated pharmacological (such as detoxification and opioid agonist and antagonist treatment) and psychosocial (such as counselling, cognitive behavioural therapy and social support) interventions based on scientific evidence and focused on the process of rehabilitation, recovery and social reintegration.

The programme is to strengthen harm reduction efforts aimed at reducing the adverse consequences of drug abuse for individuals and society as a whole, taking into consideration not only the prevention of related infectious diseases, such as HIV, hepatitis B and C and tuberculosis.

Drug Demand Reduction Programmes shall be based on the “Principles of Drug Dependence Treatment” from UNODC and WHO (2009) and the UNODC/WHO “Joint Programme on Drug Dependence Treatment and Care” from 2009 and the UNODC “Treatment Quality Standards” (2013), applied to Central Asian countries in line with their revised/or newly adapted national strategies on drug demand.

„Atlantis” drug addict treatment programmes in prison systems (“Atlantis” drug-free treatment unites) are important, but not the only option, whereas comparable treatment programmes such as Opiate Substitution Treatment (OST) shall be institutionalised in the long-run in all Central Asian countries. 

The aim is to establish an official network of professionals.

The key expected results are:

Health care and social responses to tackle drug use in the region increased.
Best practices and better quality services for drug users consolidated.

Component 4 - Work Package I: Drawing up of demand reduction models on the basis of best EU and international practices: for harm reduction, rehabilitation and social reintegration and therapeutic communities. 

Activities within WP I:

a)      A needs assessment on drug treatment models (in hospitals and out-patient), including OST, will be conducted in all Central Asian Countries;

b)      The development of handbooks and curricula on effective measures for drug demand reduction is planned;

c)      National expert working groups will be given the opportunity to exchange their experiences in order to establish a network for establishing common standards of treatment of drug dependence on a regional level, based on international standards of UNODC and WHO;

d)      Professionals involved in the subject (practitioners, psychologists, social workers, members of NGOs and other professionals of the different ministries) will be trained in internationally recognised techniques. For BC countries which use Opiate Substitution Treatment (OST), a permanent working-group on treatment standards and quality improvement in OST will be supported at a regional level to exchange the experiences in practice;

e)      At least 3 rehabilitation centres will be strengthened. Narcological centres in CA countries will be used as “model projects” for implementing a comprehensive package of treatment and rehabilitation;

f)       The “Pavlodar Republican Narcological Centre model” will be introduced in other regions of Kazakhstan and other CA countries: the Republican Narcological Centre in Pavlodar (Kazakhstan) has developed a wide range of services (in and out-patient) for (injecting) opiate users and alcohol dependents to provide care and treatment based on a differentiated diagnosis according to internationally used methods and standards. The CADAP experts in close cooperation with the CA experts will develop a proposal to use the expertise of this centre for regional trainings (“Pavlodar as regional Centre of Excellence”).

Component 4 - Work Package II: Strengthening of the NGOs' structures to develop programmes on drug dependants’ assistance.

Activities within WP II:

a)      Trainings of key players of NGOs will be conducted in order to increase their skills to develop an enabling and supportive environment for the clients and to assist them to attend and stay in treatment. NGOs play a crucial role in implementing low threshold services for the drug using population.

Component 4 - Work Package III: Study Visits

Activities within WP III:

a)      Study visits to treatment and rehabilitation facilities for drug users in EU and other countries will be conducted in order to put into practice the knowledge acquired on drug demand reduction models. Countries with comparable health systems will be taken into account.

b)      Reports on study visits will be delivered in close cooperation with the involved CA experts, who take part in the visits, with the practical recommendations. These reports will be published and provided to professionals and political stakeholders.

Component 4 - Work Package IV: Rehabilitation and social integration: Training on rehabilitation and social re-integration both in out-patient regimen and in rehabilitation centres (narcological centres)

 Activities within WP IV:

a)      On the basis of the Handbook on Psychosocial Support for Drug Dependents – developed under CADAP 5 – a working group will be established, which explores to which degree the handbook can and will be used by practitioners and how its impact might be increased.

Component 4 - Work Package V: Social Workers and Street work.

 Activities within WP V:

a)      Training curricula for social workers will be developed within working groups;

b)      Cooperation ties with social work schools/universities in Central Asia and Europe will be developed and strengthened;

c)      A plan of intervention for street work will be drafted in at least 3 countries. As social work is a non-standard tool for getting access to drug dependents who need support and/or treatment, the main focus of the trainings will be based on an assessment mission to familiarize the partners with European standards of social work with dependents and to identify vocational training schools in order to exchange experiences with European Universities for Social Work. A handbook on street work/outreach work will be prepared and delivered.

Component 4 - Work Package VI: Treatment services for drug dependent inmates.

Activities within WP VI:

a)      Institutionalisation and further development of the “Atlantis” drug addict treatment programme in partner countries, which are willing and able to adapt these programmes, will be promoted;

b)      “Atlantis” and “Clean Zone” drug addict treatment programme in prisons and the establishment of new “Half Way Houses” in each partner country, which is willing and able to implement services and training delivered to professionals in the field, will be supported by trainings using the method of 12-step models;

c)      Trainings to personnel of penitentiary institutions, judges, prosecutors, NGOs and professionals working in the field of drugs will be conducted with EU Member States’ experts; including trainings on health programmes in prison systems to prevent infection diseases (HIV, Hepatitis C) and on Opiate Substitution Treatment (OST) within prison systems;

d)      The current experiences with the model of “Atlantis” centres and “Clean Zones” will be evaluated by an independent European expert to get a broader view on the treatment options for drug dependent inmates in the specific Central Asian prison (colony) setting.