marina kuzman, md, phd croatian national institute of public health national drug prevention and...
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Marina Kuzman, MD, PhDCroatian National Institute of Public
Health
National Drug Prevention and Information System in the Republic of Croatia- impact of EU funded projects
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Preconditions for Development Strategic documents in place
Policy, Strategy and Action Plan for Illicit Drug Abuse Prevention
Organizational structureOffice for Combating Narcotic Drug AbuseNetwork of the treatment facilities in health sector with stabilized financial sources
Professional guidelinesGuidelines for methadone and buprenorphine/naloxone pharmacotherrapy
Intersectoral collaborationEducational sector, Ministry of Interior, Prisons/detention, therapeutic communities...
Organizational structure of the partners in National Drugs Information System in the Republic of Croatia
MINISTRY OF HEALTH AND
SOCIAL WELFARE
HOSPITALS, CLINICS,
EMERGENCY WARDS…
MINISTRY OF THE INTERIOR
MEDIA
CIVIL SOCIETYCROATIAN PUBLIC HEALTH INSITUTE
UNIVERSITIES AND
SCIENTISTS
SERVICES FOR DRUG ADDICTION
PREVENTION
FORENZIC LABORATORY
DRUGS DEPARTMENT PRISON SERVICE
OTHER INSTITUTIONS
MINISTRY OF JUSTICE
MINISTRY OF SCIENCE,
EDUCATION AND SPORTS
STATE ATTORNEY’S
OFFOCE
GENERAL POPULATION
SURVEYS
PROBLEM DRUG USE
DRUG RELATED INFECTIOUS DISEASES
DRUG RELATED DEATHS
TREATMENT DEMAND
DRUG RELATED CRIME
DRUG DEMAND REDUCTION
EARLY WARNING SYSTEM
OFFICE FOR COMBATING NARCOTIC DRUGS ABUSE
GOVERNMENT OF THE REPUBLIC OF CROATIA
ADVISORY BOARD
DEPARTMENT OF NATIONAL DRUGS
INFORMATION UNIT AND INTERNATIONAL
RELATIONS
DEPARTMENT FOR GENERAL
PROGRAMMES AND STRATEGIES
Network of the Institutes of Public Health – Drug Abuse Prevention and Outpatient Treatment Departments
International projects
* Official Gazette L 127, 20/05/2005, P 0032 – 0037** PHARE started in June 2006 and CARDS in August 2006, duration of both was 18 months
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
CARDS & PHARE ProjectActivities: Assessment of the current situation and level of harmonization with the EU acquis 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. conducted seroprevalence 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
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
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)
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/addictionPersons who are referred to the treatment by the court/social welfare systemMortality data are also included
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 general strategy, methods of data collection and analysis, communication and further development, discuss on actual trends and situation, propose concrete activities and measures, participate in drafting working documents and professional literature Coordinator of each Working Group is in cooperation with the OCNDA supporting multidisciplinary and scientific approach, working on development and monitoring scientific developments of respective area, participates at the EU expert meetings of the EMCDDA and other bodies and reports on the outcomes of those meetings
Collaboration with the EMCDDA
National Report on Drugs Situation in the Republic of Croatia is beingproduced by the national key partners
The first Croatian National Report 2007, was submitted to the EMCDDA in January 2008
Epidemiological surveillance enchanced, indicators discussed, process of harmonization started
PDU multiplier study performedThe cohort study started
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
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