An EMCDDA view on recovery
Roland Simon
Head of Unit Intervention, Best Practice, and Scientific
Partners
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
dead
In substitution
From that:
8,1%
70.4%
stable
Instable
Unclear
not In substitution
From that:
abstinent
7.1%
In abstince oriented facility
Ongoing residential
Prison
Drop-out
unclear
Sources: Wittchen, Bühringer, Rehm (2010)
PREMOS Final report to the Federal Ministry for Health
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Social situation of drug users (TDI)
Education
• Primary level of education
• Primary level not completed
37%
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
social reintegration
Recovery
Recovery
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“Recovery” stands for ..
State
• Personal (mental) health
Well-being
• Drug free
• Social functioning
Process of individual development
• towards the state of “recovery”
Policy objective
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Recovery and policy
•
•
•
•
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
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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: MSs
Assessment mechanism: EMCDDA
Action 9.
Agree and commence EU minimum quality
standards, also on recovery
Responsible: COM
Assessment mechanism: EMCDDA Best Practice
Portal
Over arching indicator 12
12. 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
characteristics
The availability of TC in Europe today
TC-practices in selected EU-countries:
United Kingdom – France – Sweden - Belgium
Spain – Poland - Czech Republic
Review of the effectiveness of TCs for addictions
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TC standards and guidelines
Recent 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.
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