An EMCDDA view on recovery
Roland SimonHead of Unit Intervention, Best Practice, and Scientific Partners
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Trends end of the 90s in Europe
Drug related death
HIV infection
Criminal behaviour
Drug market size
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Some doubt about the success remained
• How many drug addicts reached abstinence? • What where their levels of social functioning?• How is the clients’ well-being?
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But: Long term perspective sometimes missing
Sources: Wittchen, Bühringer, Rehm (2010) PREMOS Final report to the Federal Ministry for Health
dead In substitution
From that: stable
Instable
Unclear
not In substitution
From that: abstinent
In abstince oriented facility
Ongoing residential
Prison
Drop-out
unclear
8,1%70.4%
7.1%
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Social situation of drug users (TDI)
Education
• Primary level of education 37%• Primary level not completed 2%
Labour status• Regular employment 30%
Accommodation status• Unstable accommodation 8%
Sources: EMCDDA (2012). Social reintegration and employment: evidence and interventions for drug users in treatment. Luxembourg: Office for Publications
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Recovery: Reintegeration is crucial
Addiction Stabilisation Abstinence Integration
RecoveryRecovery
social reintegration
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“Recovery” stands for ..State
• Personal (mental) healthWell-being
• Drug free• Social functioning
Process of individual development• towards the state of “recovery”
Policy objective
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• Recovery stands for a re-focussing of treatment and drug policy - an answer to short-comings in practice
• Social reintegration core element of recovery• Not a minority position, but explicit and implicit in national
policies• Most explicit in UK and Ireland
Recovery and policy
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Recovery in EU policy papers
• 2012: EU Drug Strategy 2013-2015 elements of drug demand reduction:
• Prevention• Early detection/ intervention• Treatment and harm reduction treatment• Rehabilitation and social reintegration• Recovery
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Recovery in the EU Drug Action Plan 2013-2016
Action 6. Expand the provision of .. recovery services Responsible: MSsAssessment mechanism: EMCDDA
Action 9. Agree and commence EU minimum quality standards, also on recoveryResponsible: COM Assessment mechanism: EMCDDA Best Practice Portal
Over arching indicator 1212. Evidence based interventions on prevention, treatment, social integration and recovery and their expected impact on drug use prevalence and problem drug use (EMCDDA Best Practice Portal)
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The EMCDDA contributions
EMCDDA (2012):
Social rehabilitation and employment: evidence and interventions for drug users in treatment.
Luxembourg: Publications Office of the European Union.
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EMCDDA contributions
Coming out soon:
Therapeutic communities for addictions in Europe: evidence, current practices and future challenges of a treatment approach
Therapeutic communities: definition, history and key characteristicsThe availability of TC in Europe todayTC-practices in selected EU-countries:
United Kingdom – France – Sweden - BelgiumSpain – Poland - Czech Republic
Review of the effectiveness of TCs for addictions
TC standards and guidelinesRecent developments and future challenges
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EMCDDA contributions
Coming out soon:
Therapeutic communities …
Conclusions:
TC programmes for the rehabilitation of drug users are established in many European countries and play a role as part of the national addiction treatment systems.
There is some evidence for the effectiveness of TCs in terms of reduced substance use and criminal activity, at least in the United States and a culture of TC research is being developed in Europe.