Transcript Maurice GALLA

EQUS Conference, 15-17 June 2011
EQUS Conference 2011
Building an EU Consensus for minimum quality
standards in drug demand reduction
- Setting the Scene European Commission
EuropeanJustice
Commission
Justice
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EQUS Conference, 15-17 June 2011
Basic principles EU approach on drugs…
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Balanced, integrated approach between drug demand
and drug supply reduction
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Based first and foremost on the fundamental principles
of EU Law, and;
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Upholds the founding values of the Union:
• Respect for human dignity, liberty, solidarity,
proportionality, the rule of law and human rights
European Commission
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EQUS Conference, 15-17 June 2011
EU drug policy cooperation…
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Drug policy is primarily the competence of EU Member States
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The European Commission has a complementary role in this field
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The EU Drug Strategy and Action Plans provide objectives and a
framework with actions in drug demand reduction
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Member States adapt these actions in accordance with their own
national policies, needs and culture
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Scientific research and information are important resources for
further cooperation and coherence between Member State policies
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The EU drug strategy does not prescribe national drug policy, but
promotes collaboration, exchange and convergence between
Member States
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EQUS Conference, 15-17 June 2011
Role of the European Commission
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Initiate and propose objectives and actions in EU drug policy
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Monitor and evaluate the implementation of EU drugs policy
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Initiate legislation within legislative framework of the EU Treaties
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Initiate EU control measures for new drugs based following
EMCDDA/ Europol risk assessments
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Enforce the EU laws to control and prevent the use of chemical
precursors for the manufacture of illicit drugs
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Foster European cooperation through funding
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Support data collection, exchange of information and bestpractices, e.g. through EMCDDA
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Cooperate with civil society organisations
European Commission
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EQUS Conference, 15-17 June 2011
Activities to enhance knowledge base
Information
&
Monitoring
Studies
Evaluation
Research
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EQUS Conference, 15-17 June 2011
Expanding the knowledge base… funding projects
Public Health Programme
Health promotion/ harm reduction in prisons
Promoting harm reduction cooperation
ICT Prevention targeting use of new substances
Prevention: Healthy Nightlife Toolbox/ club health
Prevention: Quality Standards in Drug Prevention
6th & 7th RTD Framework Programme
COCINEU – Needs driven support for Cocaine users
European Research Area Network (2012-2014)
Addiction ‘Alice Rap’ (2011-2015)
Driving under the Influence of Drugs (DRUID)
School-based Drug Prevention
Prevention of poly-drug use, family based
E-health interventions
Prevention & harm reduction for vulnerable groups
Innovative projects
Research
Analysis of new psychoactive substances SPICE
Harm reduction for vulnerable groups
Development standards &
guidelines
Drug Prevention & Information Programme
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EQUS Conference, 15-17 June 2011
Expanding the knowledge base…recent studies
Effectiveness of Drug Treatment & Prisons (2007)
Implementation 2003 CR Harm Reduction (2007/
2012)
Evaluation EU Drugs Action Plan 2005-2008 (2008)
Gaps in EU illicit drug research (2009)
External Evaluation EU Drugs Strategy 2005-2012
(2012)
Overview studies
Policy Evaluation
Development standards &
guidelines
EU Quality Standards Drug Demand Reduction (2012)
Further Analysis EU Illicit Drugs Market (2012)
EU Drug Policy
2013 & beyond
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EU Legal basis in drug demand reduction (1)
Lisbon Treaty
(Art. 168 (1),(6) TFEU)
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“Union Action, which shall complement national policies, shall be
directed towards improving public health, preventing physical and
mental illness and diseases (…). Such action shall cover the fight
against the major health scourges, by promoting research into their
causes, their transmission and their prevention, as well as health
information and education, and monitoring, early warning of and
combating serious cross-border threats to health”. (…)
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“The Union shall complement the Member States’ action in reducing
drugs-related health damage, including information and prevention”
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EU Legal basis in drug demand reduction (2)
Lisbon Treaty
(Art. 168 (1) TFEU)
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“Member States, in liaison with the Commission, coordinate among
themselves their policies and programmes (…). The Commission may, in
close contact with the Member States, take any useful initiative to
promote such coordination, in particular initiatives aiming at the
establishment of guidelines and indicators, the organisation of exchange
of best-practice, and the preparation of the necessary elements for
periodic monitoring and evaluation (…)”
(Art. 168 (6) TFEU)
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“ The Council, on a proposal from the Commission, may also adopt
recommendations for the purposes set out in this Article”.
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EU Drugs Strategy 2005-2012
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The EU Drug Strategy and Action Plans provide objectives and a
framework for actions in drug demand reduction
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Member States adapt these actions in accordance with their own
national policies, needs and culture
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Scientific research and information is an important basis for
further progress and coherence between policies in Member States
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The EU drug strategy does not prescribe national drug policy, but
promotes collaboration, exchange and convergence between
Member States
European Commission
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EQUS Conference, 15-17 June 2011
EU Drugs Action Plan 2009-2012
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Objectives and actions in demand reduction covering..
 Prevention (universal, selective, indicated)
 Early detection & early intervention
 Drug treatment
 Harm reduction (incl. prison settings)
 Rehabilitation and reintegration
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Key words:
 Innovation, evaluated, effectiveness, evidence-based, best
practice, accessibility, availability, coverage, quality, measurable
outcomes, needs based
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EQUS Conference, 15-17 June 2011
EU consensus on quality standards & benchmarks
in drug demand reduction (action 19)
• Develop an EU consensus on minimum quality standards
and benchmarks for prevention, treatment, harm reduction and
rehabilitation interventions and services;
• Take into account the differences between countries in terms
of drug use and drug problems and healthcare systems
• European Commission will make proposal for an EU
consensus on minimum quality standards in drug demand
interventions and services by 2013
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EQUS Conference, 15-17 June 2011
Why quality standards & benchmarks…? (1)
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Subsequent EU drug strategies and EU drug action plans since 1996
have promoted innovation, best-practice and/ or evidence-based
interventions, as well as research & evaluation
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At EU level alone, 150-200 projects and studies have been funded in
the field of drug demand reduction since 1996
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Many of them developing innovative approaches to prevention, harm
reduction, treatment; in different settings, for different groups
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A considerable number of them have identified best-practices and
evidence-base on different aspects of drug demand reduction
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EQUS Conference, 15-17 June 2011
Why quality standards & benchmarks…? (2)
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EU projects have clear added value in developing innovative
approaches, but the translation, adaptation and scaling up of the
project results is not necessarily guaranteed
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Evidence-based research findings and experiences with bestpractices at national level not necessarily disseminated and brought
into practice
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This is not unique for the EU… US ONDCP estimates that less than
5% of treatment programmes in the field of alcohol in the US are
actually evidence based; situation for drugs even worse
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Need to collaborate is not only rational but necessary
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EQUS Conference, 15-17 June 2011
Why quality standards & benchmarks…? (3)
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Findings evaluation EU Drugs Action Plan 2005-2008:
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“The setting of prevention standards (universal prevention) could be an
important step for the future developments of prevention policies at EU
level.”
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“For the most relevant vulnerable groups (…) the actual level of
implementation (of selective and indicated prevention) appears not to have
increased since 2004.”
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“(..) numerous cannabis users in Europe are treated within the same
settings as other drug users with more severe drug problems, which results
in a number of difficulties for these users.”
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“The level of drug treatment provision in prison remains low, compared
to that in the community, though the prevalence of drug use is high among
prisoners.”
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EQUS Conference, 15-17 June 2011
Why quality standards & benchmarks…? (4)
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“In 2005, 22 of 24 Member States reported that social rehabilitation
programmes for drug users were available, however none of them rated the
availability of these programmes as being very good and one third
considered the general availability of such reintegration services to be low.”
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“Despite the known connection between release from prison and druginduced deaths, few countries are systematically investing in educating
prisoners on the risk of overdose on release from custody.”
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“Existing data provide basic picture of the availability of quality assurance
mechanisms among MS, although they show that efforts to develop quality
standards and guidelines are being made in most countries”
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“The content and scope of these measures should be investigated further
and the development of definitions and quality models at EU level could
also be further considered.
European Commission
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EQUS Conference, 15-17 June 2011
Why minimum quality standards & benchmarks…?
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Developing and implementing quality standards is current practice in
a limited number of Member States for a limited number of services/
interventions
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Implementing the highest quality standards in every EU Member
State may require major resources, while less ambition may offer
better return on investment in the short run and have more support
from key stakeholders
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Evidence base is still underdeveloped for standards in many
services and interventions
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Implementation of quality standards requires long-term investment
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Important gains may already be made by raising the overall level
across the EU
European Commission
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EQUS Conference, 15-17 June 2011
Raising the level of quality…
Successful
implementation
Quality
+++
++
Raise the
bottom level
+
0
EU Avg
MS with
limited
resources/
know how
--
19xx
European Commission
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2009
2012
2015
2018
2021
Time
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EQUS Conference, 15-17 June 2011
But of course … what is quality?
European Commission
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EQUS Conference, 15-17 June 2011
There is more similarity than one might think..
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EQUS Conference, 15-17 June 2011
Summarizing…
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There may be scope for collaboration and exchange on quality
standards in drug demand reduction at EU level
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There are cultural, traditional and ideological differences
between Member States, but these may be more relevant for the
selection and implementation of services and interventions rather
than for basic quality standards for common drug-related health
and social problems
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The national prevention, treatment and harm reduction systems
may differ, but the range of effective services an interventions is
relatively limited
European Commission
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EQUS Conference, 15-17 June 2011
Let’s ask ourselves…?
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Does a problem drug user not have the right to the same
standard of care compared to a lung-cancer patient?
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Are these systems of comparable quality today?
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Why not?
European Commission
Justice
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EQUS Conference, 15-17 June 2011
What this conference is about …
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Discussing the need for and usefulness of having (minimum)
quality standards in drug demand reduction at national level
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Consider the proposed draft minimum quality standards, their
relevance and usefulness and acceptability for specific services
and interventions
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Discussing barriers and challenges to the implementation of
quality standards as well as models of good practice
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To make best use of the multidisciplinary audience in this
conference to exchange views and perceptions that allow for a
better understanding of these barriers and challenges
European Commission
Justice
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EQUS Conference, 15-17 June 2011
What this conference is NOT about…
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Making final decisions about the list of minimum quality standards;
the input from the conference will contribute to the consensus
building process
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Discussing which service or intervention is most effective; the
evidence presented in the conference concerns available evidence
for a given standard
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Discussing divergent views of the acceptability of specific services or
interventions; the services and interventions presented in the
conference are existing in the EU and therefore relevant
European Commission
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EQUS Conference, 15-17 June 2011
A future proposal of the Commission
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Commission will not recommend to Member States which services
and interventions should be implemented
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Possible proposal is likely to identify minimum quality standards and
benchmarks in prevention, treatment/ rehabilitation and harm
reduction relevant for different services, interventions and system
level
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Member States can use the proposed minimum quality standards
and benchmarks to improve the existing services and interventions
in their country, and/ or when considering to implement new ones
European Commission
Justice
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EQUS Conference, 15-17 June 2011
The next steps …
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Final report and deliverables of the EQUS project available by
the end of 2011, early 2012
Commission will consider proposing Council Recommendation
on minimum quality standards by end 2012/ early 2013
Further collaboration with EMCDDA
Further development of insights on minimum quality standards,
benchmarks and implementation in practice
Funding available under call for proposals 2011 Drug Prevention
and Information Programme, supporting implementation
Possible gaps in quality standards for process, intervention and
system level further researched
Member States may obtain funding from current European Social
Fund provided they make it a national priority
European Commission
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EQUS Conference, 15-17 June 2011
THANK YOU !
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