Transcript Ms Marina Kuzman, Associate Director, National Institute

National Drug Prevention and
Information System in the Republic of
Croatia
- impact of EU funded projects -
Marina Kuzman, MD, PhD
Croatian National Institute of Public Health
Preconditions for Development
 Strategic documents in place
Policy, Strategy and Action Plan for Illicit Drug Abuse
Prevention
Organizational structure
Office for Combating Narcotic Drug Abuse
Network of the treatment facilities in health sector with
stabilized financial sources
Professional guidelines
Guidelines for methadone and buprenorphine/naloxone
pharmacotherrapy
Intersectoral collaboration
Educational sector, Ministry of Interior, Prisons/detention,
therapeutic communities...
Organizational structure of the partners in National Drugs
Information System in the Republic of Croatia
GOVERNMENT OF THE
REPUBLIC OF CROATIA
OFFICE FOR COMBATING
NARCOTIC DRUGS ABUSE
DEPARTMENT OF
NATIONAL DRUGS
INFORMATION UNIT
AND INTERNATIONAL
RELATIONS
GENERAL
POPULATION
SURVEYS
PROBLEM DRUG
USE
CROATIAN PUBLIC
HEALTH INSITUTE
SERVICES FOR
DRUG ADDICTION
PREVENTION
DRUG RELATED
INFECTIOUS
DISEASES
DRUG RELATED
DEATHS
TREATMENT
DEMAND
MEDIA
DEPARTMENT FOR
GENERAL
PROGRAMMES AND
STRATEGIES
DRUG RELATED
CRIME
MINISTRY OF
HEALTH AND
SOCIAL WELFARE
MINISTRY OF
SCIENCE,
EDUCATION AND
SPORTS
MINISTRY OF THE
INTERIOR
MINISTRY OF
JUSTICE
HOSPITALS,
CLINICS,
EMERGENCY
WARDS…
UNIVERSITIES
AND
SCIENTISTS
DRUGS DEPARTMENT
PRISON SERVICE
FORENZIC
LABORATORY
OTHER INSTITUTIONS
ADVISORY
BOARD
DRUG DEMAND
REDUCTION
STATE
ATTORNEY’S
OFFOCE
EARLY WARNING
SYSTEM
CIVIL SOCIETY
Network of the Institutes of Public Health – Drug Abuse
Prevention and Outpatient Treatment Departments
International projects
 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
* 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 & PHARE Project
Activities:
 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/addiction
Persons who are referred to the treatment by the
court/social welfare system
Mortality 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 being
produced 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 performed
The 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
Thank you for your attention!