Wednesday, October 13, 2010

Drug and Alcohol Practice, Policies and Research in Europe, ISAM, 2010

Dr. Uchtenhagen, at the 12th Annual International Society of Addiction Medicine Conference, Milan, Italy 2010, presented on the Drug and Alcohol Practice Polices and Research in Europe. He made a strong point that the history of Europe had resulted in progressive and humanistic laws in this regard. There was no unified drug legislation across Europe though most nations conformed with UN conventions. Possession was sanctioned with only fines in 6 countries and admonished in another 7 countries. 25 to 90% of countries didn't have sanctions.
The EU Drug Strategy 2005-2012 set frameworks for Drug Action Plans aiming at reduction in the prevalence, harm and availability. When these were evaluated there was increasing focus on harm reduction. There was also noted a gap between public policy and public behaviour and a knowledge gap regarding drug supply. The EU Drug Action Plan 2009 to 2012 had specific actions encouraging support groups such as European Citizens Alliance on Drugs and specific action 21 which systematically aimed to provide access and improve coverage of harm reduction strategies.
The EMCDDA 2006 showed no single format on drug strategy in EU. The trend was to shift from substance use to addressing the consequence of substance use. There was further shift from abstinence only to moderate use options. The diversified treatment models included opioid replacement which clearly showed prevention of blood borne infection. Evaluation showed 27 members have diversification. The recommendations were for drug free treatment as well as appropriate substitution treatment. Opioid substitution showed overall coverage as very diverse across Europe from 5% to 83% with available substitution even lower in prison populations. Further there was further divergence around availability of syringes and condom and availability at most in 18 states. Supervised consumption rooms developing in 1986 at the height of the Aids epidemic showed 62 rooms in 36 European cities.
In 2007 it was noted that harm reduction as a concept was accepted now as part of a balanced approach. Follow up studies of harm reduction showed that they lead to decrease in AIDS in users and no harm to greater community. Opiod Substitution Treatments were shown by the WHO 2004 and 2008 to reduce mortality and morbidity and be most cost effective.
Peer approach interventions were part of the Harm Reduction programs IRETREA was such an example.
The Seventh Framework Program (FP7) was a key pillar for European Research Area and had an open call for research in the area of drug and alcohol abuse and treatment.

Dr. Uchtenhagen has published his ethical perspectives in Intern. Rev. Psych 22, 2010

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