Estimating the number of problem opioid users in Poland
|
|
- Edith Elliott
- 7 years ago
- Views:
Transcription
1 Alkoholizm i Narkomania 2012, Tom 25, nr 4, E1 E8 2012, Instytut Psychiatrii i Neurologii ORIGINAL ARTICLE Estimating the number of problem opioid users in Poland Janusz Sierosławski Institute of Psychiatry and Neurology, Department of Studies on Alcoholism and Drug Dependence Polish version of this article Oszacowanie liczby problemowych użytkowników opioidów w Polsce was published in the quarterly Alkoholizm i Narkomania, 2012, 25, 4, Abstract Introduction. The aim of the study was to estimate the number of problem opioid users in Poland. Methods. The estimation was performed using the benchmark method on the basis of treatment data and data on problem opioid users collected in a population survey. Results. The number of problem opioid users in Poland in 2009 is estimated at between 10,400 19,800 persons. This estimation is lower than that for 2005, applying the same method. More than half the problem opioid users reside in three regions: Mazowieckie, Śląskie and Dolnośląskie. Conclusions. A comparison of the number of patients in substitution treatment with the estimated number of problem opioid users leads to the conclusion that the needs of substitution treatment are not satisfied, therefore the scaling-up of substitution treatment programmes ought to remain on the agenda. Key words: problem opioid use, estimation, substitution treatment INTRODUCTION The purpose of estimating the number of problem opiate users is to provide a basis for the assessment of dependency treatment requirements, including the substitution treatment addressed to that specific dependency group. This type of treatment remains behind requirements in Poland, its availability is highly unsatisfactory and, suffice it to say, we are way behind most of the rest of Europe in this area (1). An estimation of requirements here may therefore act to stimulate the development of substitution treatment availability. By problem opioid user, we mean a person who regularly uses substances from the opioid group (mainly heroin), experiencing serious problems as a result (2). One might say that this definition basically goes along with that of a person dependent on opioids if strictly medical criteria are not applied in the process of definition. Source of financing: statutory funding of the Institute of Psychiatry and Neurology and the National Bureau for Drug Prevention funding Translated into English by Emil Tchorek E1
2 Janusz Sierosławski Many local estimations have been conducted in Poland (3 8), with the first on a national scale carried out in 1994 (9). The number of problem opioid users for 1993 was estimated using the capture-recapture method in two regions: Wrocław and Kielce. The results for the two regions were extrapolated to the level of the whole country with estimation indicators defined using residential treatment as well as police data as a basis. The residential treatment data indicator was 4.6; that is, the estimated number was 4.6 times larger than the number of patients, and for the police data it was 2.4. Using these indicators, the estimated number of problem opioid users on a national scale came out as between 20 and 40 thousand people (9, 10). It ought to be mentioned that, at the time, opioid users (mainly Polish heroin ) made up the vast majority of all problem drug users (9, 10). Therefore, one can accept that the number of problem opioid users did not much differ from that of the problem drug users. Further estimates of the number of problem drug users were carried out for 2001 with the benchmark method (5). Residential and outpatient treatment data as well as that from a general population survey on problem drug users known to respondents were used. The results of this estimate indicated that the number of problem opioid users in 2001 was between 14 and 28 thousand (5). Research on the general population was repeated and data was once again gathered on problem drug users known to respondents. Here the estimates for 2005 were between 25 and 29 thousand (5). Estimates for 2005 and 2001 did not, therefore, differ a great deal as far as their upper limit was concerned. Also, it ought to be mentioned that the research for 2005 was conducted in exactly the same way as in 2001, with particular care taken to ensure comparability of results. The object of this article is the estimated number of problem opioid users for 2009 on the basis of 2010 survey data and relevant statistics. METHOD The number of problem opioid users in Poland in 2009 was estimated with the benchmark method (11), which belongs to a wider group of multiplayer method tools (12) that define the proportion of subjects featuring a characteristic on which data is being gathered (e.g. undertaking treatment, HIV infection) through the survey. This proportion serves to calculate the multiplier after multiplication by the statistically derived number, giving the estimated quantity. The estimate employed data that were gathered in a population survey conducted by the National Bureau for Drug Prevention in 2010 on a thousand-person random sample of Polish residents between the age of 15 and 64. The surveyors employed a face-to-face interview approach, with General Projekt Sp. z o.o. conducting the field data collection. Special forms were used to gather data on problem drug users personally known to respondents. In particular, information was gained on the undertaking of residential or outpatient treatment in 2009 using the nomination method (11, 12, 13). Data was gathered not on the actual respondents but on the problem drug users they knew, thus E2
3 Estimating the number of problem opioid users in Poland gathering more information than if the personal experience of respondents was the object of the questions. Moreover, the probability of coming across problem opioid users in a general population survey, even one that is very large, is too low. Information on the undertaking of residential or outpatient treatment by people indicated by the respondents was gathered on special nomination forms that recorded also the gender, age, and type of drug used. The estimate benchmarks derived from medical statistics were the number of resi dential and outpatient patients treated in 2009 for abuse or dependency on opioids (14). As far as the use of medical statistics as a reference point is concerned, the biggest difficulty is identifying the opiate users. Medical statistics in our country do not contain data on drug use patterns, with only International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnosis information available. According to this classification, opioid users appear in category F11 (opioids) and F19 (other and mixed). While the first category does not raise doubts, the second does not allow for the identification of opioid users. In the 2001 and 2005 estimations, it was assumed, on the basis of local studies, that the share of opioid users among residential patients was around 60%, and 50% among outpatient patients. Now, thanks to data from a pilot programme that reported registration for treatment conducted by the National Bureau for Drug Prevention in accordance with European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) methodology (15), a better basis to this estimate has been gained. The proportion of opioid users among F19 diagnosis patients was defined thanks to these data because their range does indeed include information on drug use patterns as well as diagnosis data. Therefore, analysis of this data allows the estimation of the percentage of opioid users in the F19 diagnosis category, which in 2009 was 22% and 32% for residential and outpatient patients respectively. The estimation of the number of opioid users for each of both types of treatment was gained by summing the number of F11 diagnosis category patients and the estimated number of opioid users in the F19 diagnosis category. Analysis of the territorial distribution of the estimation was conducted by region (województwo the largest Polish regional administrative unit) on the basis of territorial allocation of patient numbers for separately residential and outpatient treatment. Data was aggregated by patient place of residence, not treatment, in the case of for residential treatment statistical data while, because of its local character, it was assumed that the region of treatment is the same as that of residence for outpatient treatment statistical data. RESULTS In table 1 we present the figures for all registered patients in the medical statistics, patient numbers from F11 and F19 diagnosis category according to the same source, with the percentage of opioid users diagnosed as F19 estimated on the basis of data from a pilot registration-for-treatment data-gathering programme of as well as the E3
4 Janusz Sierosławski Table 1. Estimation of problem opioid users in treatment in 2009 Total number of patients (ICD-10: F11-F16, F18, F19) Number of patients with diagnosis F11 Number of patients with diagnosis F19 Percentage of opioid users among patients with diagnosis F19 Total number of opioid users in treatment Residential treatment 15, % 4510 Outpatient treatment* 29, , % 8674 Source: Own calculations * Data were applied from table Number of patients with mental disorders caused by psychoactive substance use in Diagnosis, gender and age (14). estimated number of opioid problem patients being treated in Poland. The data serving to calculate the proportion of opioid users among F19 diagnosis patients came from 13 outpatient (328 people) and 16 residential (454 people) clinics, and were gathered in The estimate effectively defined the number of residential treatment opioid users at 4510 and outpatient at These figures were accepted as a reference point for estimations of the number of problem opioid users in the country as a whole. In the general population survey, 215 respondents out of 5782 knew at least one problem opioid user and so could provide essential information. From the 299 nominations gathered at this source, the estimated residential treatment percentage was 43.2%, with outpatient patients at 43.8% (table 2). Table 2. Estimation of problem opioid users in Poland in 2009 Statistical data (IPiN) Percentage of patients in the survey sample Estimate coefficient Estimates Residential treatment ,444 Outpatient treatment ,794 Since 43.2% of opioid users undertake residential treatment, it is possible to calculate that there are all opioid users together 2.32 times more than those in residential treatment. When we apply the ratio of opioid users in treatment and all affected by the problem to the statistical data of residential treatment for 2009 (4510 people), we gain an estimate of 10,444 people. The analogical multiplier for outpatient treatment data was 2.28, and applied to data from clinics in 2009, it yielded estimates of 19,794 people. It is therefore possible to assume that the number of problem opiate users lies in the range between 10,444 and 19,794, with the middle of the range at 15,119. Data on the territorial distribution of problem opiate use is presented in table 3, with concentrations in three regions, above all in Mazowieckie (4760), then Dolno- E4
5 Estimating the number of problem opioid users in Poland Table 3. Regional distribution of estimates of problem opioid users in Poland in 2009 Region Estimates on the basis Estimates on the basis of residential treatment of outpatient treatment benchmark benchmark Range midpoint Number Rate per 100,000 population Mazowieckie Dolnośląskie Lubuskie Zachodniopomorskie Pomorskie Łódzkie Kujawsko-pomorskie Warmińsko-mazurskie Podlaskie Śląskie Lubelskie Wielkopolskie Małopolskie Opolskie Świętokrzyskie Podkarpackie Missing data 282 śląskie (1888) and Śląskie (1181). The lowest numbers are in Opolskie (168), Świętokrzyskie (185) and Podkarpackie (254). Figures perfectly useful for the assessment of therapeutic requirements do not give a good reading of the extent of the threat as they depend on population size. Rates per 100,000 population that eliminate this discrepancy indicate Mazowieckie (91.1), Dolnośląskie (65.6) and Lubuskie (62.8) as the most threatened. DISCUSSION The estimate presented here is subject to reservation and attention should be paid to its limitations. Above all it is necessary to strongly underline that estimates never provide a precise and certain figure for the actual amount of problem drug users. Drug use, especially in a problem manner, belongs to a socially unacceptable category of behaviours on the fringes of the law, hence our having to deal with a hidden population. Therefore, any attempt to define its extent must have an indirect character. Among the various methods applied to this end, the benchmark method does not stand out all that badly in terms of thoroughness and precision (13, 16, 17). Its advantages include its simplicity and low cost of data collection, which may be gained, for example, in the course of general population survey. The quality of the estimate, to a great extent, depends on the quality of data used for this purpose. Residential treatment data do not raise any serious doubts as E5
6 Janusz Sierosławski a reference point in terms of comprehensiveness. Also, the system of collecting and processing data eliminates the problem of double counting of people if they register for treatment more than once a year. Outpatient treatment data are prone to the double counting error in the case of a patient using more than one outpatient clinic per year. Furthermore, not all clinics offering outpatient treatment are covered by the statistics system, hence the completeness of the data leaves a lot to be desired. It is however worth noting that each of these limitations have opposing influences on the estimation results, so may at least be partly tolerated. The making of reliable estimations of the extent of problem opioid use faces obstacles as far as data availability is concerned. While in survey information on opioid use is gained through users being indicated by respondents, data of this kind is not available in medical statistics, which are treated as a benchmark to conduct estimations. Medical statistics include information only on medical diagnosis, which does not give a basis for unambiguous identification of opioid users, hence the necessity of further estimation, and this increases the margin for possible error. As many authors have pointed out, estimates of problem drug user numbers ought to be treated with great caution, and be seen more as an identification of the scale of the problem, and less as a reading of concrete numerical values (18). The 2009 estimate of 10,400 19,800 problem opioid users is less than the 25,000 29,000 estimate of 2005, suggesting a fall in the number of problem opioid users in the last four years, with a similar tendency observed in the majority of European countries (19). Despite the noted falling tendency, it ought to be stressed that the number of problem users of these substances is still significant, with over half of the population remaining outside any kind of treatment. The results of the estimation convince us that the level of treatment requirement satisfaction, especially for substitution treatment, is far from optimal. In 2009, substitution treatment availability in Poland amounted to 22 programmes, five of which were conducted at penitentiary units; 1945 people received treatment within these programmes in 2009 (20) which means that only around 13% (10 19%) of problem opioid users benefitted from substitution treatment. European Union countries that provide estimates of problem opioid users have an analogical average of 50% (1, 21). In Germany, at the head of the ranking, probably more than 80% of problem opioid users received substitution treatment. Despite the declining tendency in the incidence of problem opioid use, there still remains a need to increase both the number of substitution treatment programmes and the number of places in these programmes. Opioid substitution treatment is recommended by the World Health Organisation and other specialised UN agencies like UNAIDS, UNODC, as well as European Commission agencies, as a method the effectiveness of which is well documented (22). The priority position substitution treatment enjoys in international organisation policy, as it does in the majority of developed countries, was established during the HIV epidemic, which in many countries of our region appeared earliest among injecting opioid users. Experience gained internationally over the last decades confirms E6
7 Estimating the number of problem opioid users in Poland the effectiveness of this method, especially as far as limiting the risk of infection and death from HIV and HCV (23, 24, 25) is concerned. Conclusion and recommendation. The number of problem opioid users in Poland, according to 2009 estimates, is in the range of 10,400 and 19,800. The number of patients receiving substitution treatment is 2000, indicating a lack of requirement satisfaction in this area. Further development of the substitution treatment availability therefore seems to be necessary. The 2009 estimation does not stand out as especially accurate. Further work on estimation with the aim of increasing result accuracy and reliability is therefore recommended. A promising direction of development is working out a dynamic model that takes into account changes in the size of the researched population (26). REFERENCES 1. EMCDDA (2010) Annual Report The state of the drug problem in Europe. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. ( 2. Okruhlica L, Sierosławski J (2006) Definitions of dependency and recreational, regular, problematic, harmful drug use. In: Young People and Drugs. Care and Treatment. Strasbourg: Council of Europe Pompidou Group, Sierosławski J (2000) Problem drug use in Poznań, Poland: a qualitative approach to needs assessment. In: Fountain J (ed.) Understanding and responding to drug use: the role of qualitative research. Lisbon: EMCDDA, Sierosławski J (2006) Problem narkotyków i narkomanii w Warszawie część I [Drugs and drug abuse problems in Warsaw. Part one]. Remedium, 12 (166), Sierosławski J (2007) Oszacowanie liczby problemowych użytkowników narkotyków i analiza wzorów używania narkotyków oraz związanych z tym problemów [Estimating the numbers of problem drug users and analysis of patterns of use and related problems]. Warszawa: Instytut Psychiatrii i Neurologii. ( 6. Moskalewicz J, Bujalski M, Sierosławski J (2006) Dostępność programów substytucyjnych w Warszawie [The availability of substitution programmes in Warsaw]. Warszawa: Instytut Psychiatrii i Neurologii. (Raport opracowany na zleceniu Urzędu Miasta st. Warszawy) 7. Bujalski M (2006) Lecznictwo substytucyjne w Warszawie. Wybrane działania Samorządu Warszawskiego w zakresie przeciwdziałania narkomanii oraz HV/AIDS wśród dzieci i młodzieży [Substitution treatment in Warsaw: selected activity of the Warsaw City Council in the area of drug abuse and HIV/AIDS prevention among children and young people]. Remedium, special edition, Sierosławski J (2010) Oszacowanie popytu na leczenie substytucyjne buprenorfiną w Warszawie [Estimating demand for buprenorfina substitution therapy in Warsaw]. Serwis Informacyjny Narkomania [Drug-Addiction Information Service], 1 (49), Moskalewicz J, Sierosławski J (1995) Zastosowanie nowych metod szacowania rozpowszechnienia narkomanii [Application of new methods of estimating the prevalence of drug addiction]. Alkoholizm i Narkomania, 4 (21), Sierosławski J, Zieliński A (1997) Comparison of Different Estimation Methods in Poland. In: Stimson GW, Hickman M, Quirk A, Fischer M, Taylor C (eds) Estimating the Prevalence of Problem Drug Use in Europe. Lisbon: EMCDDA, Taylor C (1997) Estimating the prevalence of drug use using nomination techniques: an overview. In: Stimson GW, Hickman M, Quirk A, Fischer M, Taylor C (eds) Estimating the Prevalence of Problem Drug Use in Europe. Lisbon: EMCDDA, E7
8 Janusz Sierosławski 12. EMCDDA (2004) Recommended Draft Technical Tools and Guidelines. Key Epidemiological Indicator: Prevalence of problem drug use. Lisbon: EMCDDA, July. 13. Korf DJ (1997) Comparison of different estimation methods in the Netherlands. In: Stimson GW, Hickman M, Quirk A, Fischer M, Taylor C (eds) Estimating the Prevalence of Problem Drug Use in Europe. Lisbon: EMCDDA, Zakłady psychiatrycznej oraz neurologicznej opieki zdrowotnej. Rocznik statystyczny 2009 [Psychiatric and neurological care facilities. Statistical Yearbook 2009]. Instytut Psychiatrii i Neurologii, Zakład Organizacji Ochrony Zdrowia, Warszawa ( RS/2009/title.html) 15. EMCDDA (2007) Guidance for the measurement of drug treatment demand. Global Assessment Programme on Drug Abuse (GAP). Toolkit Module 8. UNODC, Vienna: EMCDDA, March. 16. Hartnoll R (1997) Cross-validation at local level. In: Stimson GW, Hickman M, Quirk A, Fischer M, Taylor C (eds) Estimating the Prevalence of Problem Drug Use in Europe. Lisbon: EMCDDA, Fischer M, Hickman M, Kraus L, Mariani F, Wiessing L (2001) A comparison of different methods for estimating the prevalence of problematic drug use in Great Britain. Addiction, 96, Uhl A, Seidler D (2001) Prevalence estimate of problematic opiate consumption in Austria (second revised edition). Scientific Report of the LBISucht, Vienna ( 19. EMCDDA (2011) Annual Report The state of the drug problem in Europe. Lisbon: European Monitoring Centre for Drugs and Drug Addiction. ( 20. Malczewski A, Bukowska B, Jabłoński P, Kidawa M, Struzik M, Sokołowska E, Strzelecka A, Radomska A, Chojecki D, Bajerowska B, Jędruszak Ł, Muszyńska D, Krawczyk W (2010) Annual Report 2009 Poland: Drug Situation. Warsaw: National Bureau for Drug Prevention. ( emcdda.europa.eu/) 21. Farrel M, Howes S, Verster A, Davoli M, Solberg U, Greenwood G, Robertson K (2000) Reviewing current practice in drug-substitution treatment in the European Union. Lisbon: EMCDDA. 22. WHO (2004) WHO/UNODC/UNAIDS position paper. Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention. 23. Pollack H, Heimer R (2004) Cost-effectiveness of needle and syringe programmes and methadone maintenance. In: Jager J, Limburg W, Kretzschmar M, Postma M, Wissing L (eds) Hepatitis C and injecting drug use: impact, costs and policy options. Lisbon: EMCDDA, Kimber J, Palmateer N, Hutchinson S, Hickman M, Goldberg D, Rhodes T (2010) Harm reduction among injecting drug users evidence of effectiveness. In: Rhodes T, Hedrich D (eds) Harm reduction: evidence, impacts and challenges. Lisbon: EMCDDA, Darke S, Degenhardt L, Mattick R (2007) Mortality amongst illicit drug users. Cambridge: Cambridge University Press. 26. Augustin R, Kraus L (2004) Changes in prevalence of problem opiate use in Germany between 1990 and European Addiction Research, 10, Correspondence to Department of Studies on Alcoholism and Drug Dependence Institute of Psychiatry and Neurology Sobieskiego 9, Warszawa, Poland tel. (48 22) sierosla@ipin.edu.pl Submitted: 03 November 2011 Accepted: 31 October 2012 E8
Program Prevention of HCV infections
Program Prevention of HCV infections The main objective of the Program is to provide a basis for planning a longterm strategy for preventing HCV and combating hepatitis C in Poland. PROGRAM SUPPORTED BY
More informationProgram Prevention of HCV infections
Program Prevention of HCV infections The main objective of the Program is to provide a basis for planning a longterm strategy for preventing HCV and combating hepatitis C in Poland. PROGRAM SUPPORTED BY
More informationPOLAND New Development, Trends and in-depth information on selected issues
2010 NATIONAL REPORT (2009 data) TO THE EMCDDA by the Reitox National Focal Point POLAND New Development, Trends and in-depth information on selected issues REITOX 1 Krajowe Biuro ds. Przeciwdziałania
More informationHeroin Addiction.. Reaching Out!
Miss Seychelles another world 2016 Contestant Number 6 Rita-Maria Durup CONTESTANT PROJECT PROPOSAL Heroin Addiction.. Reaching Out! TABLE OF CONTENT Introduction Page 4 and 5 Objectives Page 6 Expected
More informationWe include a series of recommended questions for the Swedish delegation at the end of our letter.
United Nations Committee on Economic Social and Cultural Rights Palais Wilson CH 1211 Geneva 10 Switzerland 2 October 2008 Re: Review of Sweden s fifth periodic report, 41 st Session of the Committee on
More informationUNODC World Drug Report 2016:
UNODC World Drug Report 2016: Launch in Geneva on 23 June 2016 Briefing to the Member States and Civil Society Organizations Remarks by Aldo Lale-Demoz, Deputy Executive Director, UNODC UNODC is honoured
More informationResources for the Prevention and Treatment of Substance Use Disorders
Resources for the Prevention and Treatment of Substance Use Disorders Table of Contents Age-standardized DALYs, alcohol and drug use disorders, per 100 000 Age-standardized death rates, alcohol and drug
More informationDeveloping the Guernsey treatment system for substance misusers: Phases One and Two. Helen Baldwin Linda Prickett Adam Marr Jim McVeigh
Developing the Guernsey treatment system for substance misusers: Phases One and Two Helen Baldwin Linda Prickett Adam Marr Jim McVeigh Roles and responsibilities of the LJMU research team Helen Baldwin
More informationMETHADONE SUBSTITUTION THERAPY PROGRAM AND TOXICOLOGICAL STUDIES
METHADONE SUBSTITUTION THERAPY PROGRAM AND TOXICOLOGICAL STUDIES Halina MATSUMOTO, El bieta WO NY, Anna DZIKLIÑSKA, Ma³gorzata ABRAMOWSKA Laboratory of Psychopharmacology, 1st Department of Psychiatry,
More informationAnnual report 2009: the state of the drugs problem in Europe
Annual report 2009: the state of the drugs problem in Europe International Conference: New trends in drug use: facts and solutions, Parliament of the Republic of Vilnius - 5 November 2009 Dagmar Hedrich
More informationPriority axis II SUPPORT FOR THE ENVIRONMENT AND CAPACITY OF ENTERPRISE FOR R&D&I ACTIVITY... 53
Table of contents 1. STRATEGY FOR THE OPERATIONAL PROGRAMME S CONTRIBUTION TO THE UNION STRATEGY FOR SMART, SUSTAINABLE AND INCLUSIVE GROWTH AND TO THE ACHIEVEMENT OF ECONOMIC, SOCIAL AND TERRITORIAL COHESION...
More informationFACT SHEET SERBIA (REPUBLIC OF)
FACT SHEET SERBIA (REPUBLIC OF) Territory: Borders: 88,509 sq. km 2,362 km (total) Hungary: 175 km, Romania: 548 km, Bulgaria: 361 km, FYR of Macedonia: 283 km, Albania: 114 km, Montenegro: 249 km, Bosnia
More informationSPATIAL DIVERSIFICATION OF FOREIGN TOURIST TRAFFIC IN POLAND
INFRASTRUKTURA I EKOLOGIA TERENÓW WIEJSKICH INFRASTRUCTURE AND ECOLOGY OF RURAL AREAS Nr 2/IV/2013, POLSKA AKADEMIA NAUK, Oddział w Krakowie, s. 5 14 Komisja Technicznej Infrastruktury Wsi SPATIAL DIVERSIFICATION
More informationNotes for an Address by. Hilary Geller. during the. General Debate on the Special Session of the UN. General Assembly on the World Drug Problem
Notes for an Address by Hilary Geller during the General Debate on the Special Session of the UN General Assembly on the World Drug Problem at the 59 th Session of the United Nations Commission on Narcotic
More informationRichard H. Needle, PhD, MPH Lin Zhao, PhD candidate (UCSF School of Nursing) CSIS Africa Program Roundtable June 10, 2010
Richard H. Needle, PhD, MPH Lin Zhao, PhD candidate (UCSF School of Nursing) CSIS Africa Program Roundtable June 10, 2010 Reference Group to the United Nations on HIV and Injecting Drug Use 2010 Mathers:
More informationPOLAND New Development, Trends and in-depth information on selected issues draft
2011 NATIONAL REPORT (2010 data) TO THE EMCDDA by the Reitox Polish Reitox Focal Point POLAND New Development, Trends and in-depth information on selected issues draft REITOX 1 Krajowe Biuro ds. Przeciwdziałania
More informationR&D Expenditures in Poland. Voivodship Perspective
Barometr Regionalny Tom 12 nr 2 R&D Expenditures in Poland. Voivodship Perspective Aleksandra Zygmunt Opole University of Technology, Poland Abstract The main purpose of the paper is R&D expenditures analysis
More informationTestimony of The New York City Department of Health and Mental Hygiene. before the
Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid
More informationMethodology Understanding the HIV estimates
UNAIDS July 2014 Methodology Understanding the HIV estimates Produced by the Strategic Information and Monitoring Division Notes on UNAIDS methodology Unless otherwise stated, findings in this report are
More informationdrug dependence treatment and care
UNODC-WHO Joint Programme on drug dependence treatment and care The vision Effective and humane treatment for all people with drug use disorders. Nothing less than would be expected for any other disease.
More informationDifferences in patterns of drug use between women and men
Differences in patterns of drug use between women and men Differences in patterns of drug use between women and men Key findings Introduction Cannabis Ecstasy Tranquillisers and sedatives Alcohol and drug
More informationDave Burrows Director
Dave Burrows Director Effects of drug policy on HIV transmission What is the Comprehensive Package of Services for People Who Inject Drugs (PWID) What is an enabling environment for addressing HIV among
More informationPERSPECTIVES ON DRUGS Trends in heroin use in Europe: what do treatment demand data tell us?
European Monitoring Centre for Drugs and Drug Addiction UPDATED 28. 5. 2013 PERSPECTIVES ON DRUGS Trends in heroin use in Europe: what do treatment demand data tell us? The current number of problem opioid
More informationMORTALITY AMONGST ILLICIT DRUG USERS
MORTALITY AMONGST ILLICIT DRUG USERS Over the past 40 years the rate of illicit drug use worldwide has risen dramatically, and with it the number of deaths reported among drug-using populations. What are
More informationDrug Abuse Trends in the Seattle/King County Area: 2013
Drug Abuse Trends in the Seattle/King County Area: 2013 Caleb Banta-Green 1, T. Ron Jackson 2, Steve Freng 3, Michael Hanrahan 4, Cynthia Graff 5, John Ohta 6, Mary Taylor 7, Richard Harruff 8, Robyn Smith
More informationdrug treatment in england: the road to recovery
The use of illegal drugs in England is declining; people who need help to overcome drug dependency are getting it quicker; and more are completing their treatment and recovering drug treatment in ENGlaND:
More informationOur work in CONNECTIONS
Our work in CONNECTIONS Collating good practices on drug treatment and harm reduction in the criminal justice system in Europe experiences from the CONNECTIONS project Cinzia Brentari EMCDDA, Lisbon, 1
More information24 Elisad annual meeting Arezzo 11-13 October 2012
24 Elisad annual meeting Arezzo 11-13 October 2012 From addiction to consumption: The evolution of the phenomenon and the interventions of services The big change:back to the late 90 and the zero decade
More informationThe Principles of Property Purchasing by Foreigners in Poland**
GEOMATICS AND ENVIRONMENTAL ENGINEERING Volume 1 Number 3 2007 El bieta Jasi ska*, Joanna Klajn* The Principles of Property Purchasing by Foreigners in Poland** 1. Introduction The Polish real estate market
More informationObjectives: Perform thorough assessment, and design and implement care plans on 12 or more seriously mentally ill addicted persons.
Addiction Psychiatry Program Site Specific Goals and Objectives Addiction Psychiatry (ADTU) Goal: By the end of the rotation fellow will acquire the knowledge, skills and attitudes required to recognize
More informationOutcomes for Opiate Users at FRN Facilities. FRN Research Report September 2014
Outcomes for Opiate Users at FRN Facilities FRN Research Report September 2014 Introduction The illicit use of opioids has reached epidemic proportions in the United States (Alford, 2007; Meges et al,
More informationA review of estimation methods on prevalence of drug abuse population in Hong Kong
A review of estimation methods on prevalence of drug abuse population in Hong Kong Executive Summary i Prepared by Policy 21 Limited February 2013 1. There is no universally accepted method to accurately
More informationAssessing the Costs of Medication-Assisted Treatment for HIV Prevention in Georgia
Assessing the Costs of Medication-Assisted Treatment for HIV Prevention in Georgia BACKGROUND While post-soviet Georgia has experienced favorable economic, political, and social change in the last two
More informationEuropean report on drug consumption rooms Executive summary
Page 1 of 7 European report on drug consumption rooms Executive summary June 2004 Dagmar Hedrich, Project Manager, P2 - Responses General public Introduction The European report on drug consumption rooms
More informationSelected economic factors impacting tourist travel in Poland between 2000 and 2012 and a forecast for 2013 2017
Geotourism 1(36) 2014: 25 32 http://dx.doi.org/10.7494/geotour.2014.36.25 Selected economic factors impacting tourist travel in Poland between 2000 and 2012 and a forecast for 2013 2017 Paweł Kućmierz,
More informationWorld Health Organization
myths and facts for policy makers responsible for substance dependence prevention, treatment and support programs World Health Organization Myth 1. Drug dependence is simply a failure of will or of strength
More informationEN 1 EN COMMUNICATION FROM THE COMMISSION. to the European Parliament and the Council on a EU Drugs Action Plan (2005-2008) Introduction
MUNICATION FROM THE MISSION to the European Parliament and the Council on a EU Drugs Action Plan (2005-2008) Introduction The drugs phenomenon is one of the major concerns of the citizens of Europe and
More informationHow To Understand The Cost Of Jangalak Drug Addicts Hospital
2013 Islamic Republic of Afghanistan Ministry of Public Health General Directorate Policy, Planning and International Relations Health Economics and Financing Directorate Cost Analysis of Jangalak Drug
More informationAdult drug treatment plan 2009/10. Part 1: Strategic summary, needs assessment and key priorities
Birmingham Drug and Alcohol Action Team Adult drug treatment plan 2009/10 Part 1: Strategic summary, needs assessment and key priorities The strategic summary incorporating the findings of the needs assessment,
More informationSIXTY-SEVENTH WORLD HEALTH ASSEMBLY. Agenda item 12.3 24 May 2014. Hepatitis
SIXTY-SEVENTH WORLD HEALTH ASSEMBLY WHA67.6 Agenda item 12.3 24 May 2014 Hepatitis The Sixty-seventh World Health Assembly, Having considered the report on hepatitis; 1 Reaffirming resolution WHA63.18,
More informationTypes of Turystykamiejskajestro and Its Uses
BarbaraOstrowska * Bezpiecze stwowmiastachodgrywajcych istotn rol wturystyce (naprzykadziemiastwojewódzkichwpolsce) Turystykamiejska Whistorirozwojuturystykimiastazawszeodgrywa ybardzowan rol, bdcgównymcelempodróylubmiejscemzatrzymywaniasi
More informationMacomb County Office of Substance Abuse MCOSA. Executive Summary
Macomb County Office of Substance Abuse MCOSA Executive Summary This report marks the second data profile of alcohol and illicit drugs burden in Macomb County. The first report produced in 2007 detailed
More informationOrganization and Financing of Mental Health Care in Poland
The Journal of Mental Health Policy and Economics J. Mental Health Policy Econ. 3, 77 81 (2000) Organization and Financing of Mental Health Care in Poland Wanda Langiewicz* and Elzbieta Slupczynska-Kossobudzka
More informationPresentation on universal prevention of the drug phenomenon and public education in this field
Presentation on universal prevention of the drug phenomenon and public education in this field Artur Malczewski Reitox Focal Point National Bureau for Drug Prevention in Poland International Conference
More informationNATIONAL BUREAU FOR DRUG PREVENTION
NATIONAL BUREAU FOR DRUG PREVENTION Pathological gambling and behavioural addiction prevention in Poland Warsaw, 25-26 November 2014 Legal framework Problem Gambling Fund Act of 19 November 2009 on gambling
More informationCapital City of Warsaw Prevention of drug addiction policy. SOCIAL POLICY OFFICE WARSAW, May 29th, 2008
Capital City of Warsaw Prevention of drug addiction policy SOCIAL POLICY OFFICE WARSAW, May 29th, 2008 City organisation structure GENERAL CITY LEVEL MAYOR OF THE CAPITAL CITY OF WARSAW CITY COUNCIL SOCIAL
More informationEPIDEMIOLOGY OF OPIATE USE
Opiate Dependence EPIDEMIOLOGY OF OPIATE USE Difficult to estimate true extent of opiate dependence Based on National Survey of Health and Mental Well Being: 1.2% sample used opiates in last 12 months
More informationScience addressing drugs and HIV: State of the Art. Vienna
Science addressing drugs and HIV: State of the Art 2 nd Scientific Statement: March 2016 Vienna Context In March 2014, UNODC organized within the frame of the High-level Review of the 57 th session of
More informationAgricultural biogas plants a chance for diversification of agriculture in Poland Justyna Chodkowska-Miszczuk, Daniela Szymańska
Chodkowska-Miszczuk, J. and Szymańska, D., 2013: Agricultural biogas plants A Chance for diversification of agriculture in Poland. In: Renewable and Sustainable Energy Reviews, Vol. 20, Elsevier Ltd, pp.
More informationFRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma
FRN Research Report January 2012: Treatment Outcomes for Opiate Addiction at La Paloma Background A growing opiate abuse epidemic has highlighted the need for effective treatment options. This study documents
More informationQ&A on methodology on HIV estimates
Q&A on methodology on HIV estimates 09 Understanding the latest estimates of the 2008 Report on the global AIDS epidemic Part one: The data 1. What data do UNAIDS and WHO base their HIV prevalence estimates
More informationDevelopment of the guidelines on the pharmacotherapy of addiction case study Croatia
Development of the guidelines on the pharmacotherapy of addiction case study Croatia Croatia Marina Kuzman Dragica Katalinic Croatian National Institute of Public Health Cyprus, 2009. Drug use and drug
More informationAproved by order No 702 as of 22 12 1997 by the Ministry of Health Care
Translation form Lithuanian THE MINISTRY OF HEALTH ORDER OF THE REPUBLIC OF LITHUANIA 22 12 1997 No 702 Vilnius Conformation of the application procedure of Substitution therapy to opioid addicts In September
More informationCommunity Based Treatment and Care for Drug Use and Dependence
CBTx Community Based Treatment and Care for Drug Use and Dependence Information Brief for Southeast Asia Community Based Treatment refers to a specific integrated model of treatment for people affected
More informationIntroduction to Substance Abuse Issues in Canada: Pathways, Health Implications and Interventions
Introduction to Substance Abuse Issues in Canada: Pathways, Health Implications and Interventions Maritt Kirst, PhD Centre for Research on Inner City Health, St. Michael s Hospital OTC Summer Institute
More informationINTERNATIONAL COMPARISONS OF PART-TIME WORK
OECD Economic Studies No. 29, 1997/II INTERNATIONAL COMPARISONS OF PART-TIME WORK Georges Lemaitre, Pascal Marianna and Alois van Bastelaer TABLE OF CONTENTS Introduction... 140 International definitions
More informationHighly commercial farms in family farming in Poland
INSTITUTE OF AGRICULTURAL AND FOOD ECONOMICS NATIONAL RESEARCH INSTITUTE Highly commercial farms in family farming in Poland no 72.1 Warsaw 2007 Bożena Karwat-Woźniak Paweł Chmieliński THE ECONOMIC AND
More informationTHE DRUG DETOX UNIT AT MOUNTJOY PRISON A REVIEW
1 THE DRUG DETOX UNIT AT MOUNTJOY PRISON A REVIEW By Dr. Des Crowley, General Practitioner INTRODUCTION The Drug Detox Unit was opened in July 1996 at Mountjoy Prison in response to the escalating drug
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SPECIAL HEALTH AUTHORITY TENTH WAVE WORK PROGRAMME DRUG MISUSE. Psychosocial interventions in drug misuse
Attachment B NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE SPECIAL HEALTH AUTHORITY TENTH WAVE WORK PROGRAMME DRUG MISUSE Psychosocial interventions in drug misuse On 16 th June 2004 the Department of Health
More informationNon medical use of prescription medicines existing WHO advice
Non medical use of prescription medicines existing WHO advice Nicolas Clark Management of Substance Abuse Team WHO, Geneva Vienna, June 2010 clarkn@who.int Medical and Pharmaceutical role Recommendations
More informationEMCDDA Recommended Draft Technical Tools and Guidelines. Key Epidemiological Indicator: Prevalence of problem drug use
EMCDDA Recommended Draft Technical Tools and Guidelines Key Epidemiological Indicator: Prevalence of problem drug use EMCDDA/ July 2004 The following have contributed to the development of the guidelines:
More informationISSN 1830-7957 SELECTED ISSUE
ISSN 1830-7957 SELECTED ISSUE TREATMENT AND CARE FOR OLDER DRUG USERS2010 SELECTED ISSUE TREATMENT AND CARE FOR OLDER DRUG USERS2010 Legal notice This publication of the European Monitoring Centre for
More informationHARM REDUCTION FOR PEOPLE WHO INJECT DRUGS INFORMATION NOTE
HARM REDUCTION FOR PEOPLE WHO INJECT DRUGS INFORMATION NOTE Introduction The Global Fund supports evidence-based interventions that aim to ensure access to HIV prevention, treatment, care and support for
More informationTHEME: PROMOTING GOOD PRACTICES IN DRUG POLICY DEVELOPMENT AND IMPLEMENTATION
Page 1 AFRICAN UNION UNION AFRICAINE UNIÃO AFRICANA Addis Ababa, ETHIOPIA P. O. Box 3243 Telephone 251-11-5517 700 Fax 251-11-5517 844 website: www. africa-union.org 5 th SESSION OF THE AU CONFERENCE OF
More informationAddiction Psychiatry Fellowship Rotation Goals & Objectives
Addiction Psychiatry Fellowship Rotation Goals & Objectives Table of Contents University Neuropsychiatric Institute (UNI) Training Site 2 Inpatient addiction psychiatry rotation.....2 Outpatient addiction
More informationScientific Facts on. Psychoactive Drugs. Tobacco, Alcohol, and Illicit Substances
page 1/5 Scientific Facts on Psychoactive Drugs Tobacco, Alcohol, and Illicit Substances Source document: WHO (2004) Summary & Details: GreenFacts Context - Psychoactive drugs such as tobacco, alcohol,
More informationRecovery Outcomes for Opiate Users. FRN Research Report November 2013
Recovery Outcomes for Opiate Users FRN Research Report November 2013 Introduction Opiate use in America is at epidemic levels. The latest surveys show 4.5 million Americans using prescription painkillers
More informationREVIEW OF DRUG TREATMENT AND REHABILITATION SERVICES: SUMMARY AND ACTIONS
REVIEW OF DRUG TREATMENT AND REHABILITATION SERVICES: SUMMARY AND ACTIONS 1. INTRODUCTION 1.1 Review Process A Partnership for a Better Scotland committed the Scottish Executive to reviewing and investing
More informationFire Death Rate Trends: An International Perspective
Topical Fire report SerieS Fire Death Rate Trends: An International Perspective Volume 12, Issue 8 / July 2011 These topical reports are designed to explore facets of the U.S. fire problem as depicted
More informationModule 6 Alcoholism, Drug Abuse and Corruption
Module 6 Alcoholism, Drug Abuse and Corruption Lecture 36 Drug Abuse: Concept, Extent and Nature Concept Any substance (usually chemical) which influences our bodies or emotions when consumed may be called
More informationAnalysis of survey data on the implementation of NICE PH18 guidance relating to needle and syringe provision in England
Analysis of survey data on the implementation of NICE PH18 guidance relating to needle and syringe provision in England Geoff Bates, Lisa Jones, Jim McVeigh Contents Acknowledgements... 4 Abbreviations...
More informationFoundations Recovery Network (FRN) Announces Groundbreaking Opiate Research Study Which Yields Compelling Results
Foundations Recovery Network (FRN) Announces Groundbreaking Opiate Research Study Which Yields Compelling Results Results validate FRN s system of care approach through patient satisfaction Siobhan A.
More informationFemale drug users in European prisons EXCECUTIVE SUMMARY NOVEMBER 2004
University of Hamburg With financial support from the AGIS Programme European Commission Directorate General Justice and Home Affairs Female drug users in European prisons best practice for relapse prevention
More informationTHEME: PROMOTING GOOD PRACTICES IN DRUG POLICY DEVELOPMENT AND IMPLEMENTATION
Page 1 AFRICAN UNION UNION AFRICAINE UNIÃO AFRICANA Addis Ababa, ETHIOPIA P. O. Box 3243 Telephone 251-11-5517 700 Fax 251-11-5517 844 website: www. africa-union.org 5 th SESSION OF THE AU CONFERENCE OF
More informationHIGH SUCCESS RATE OF BUTTERY REHABILITATION PROGRAMS
HIGH SUCCESS RATE OF BUTTERY REHABILITATION PROGRAMS By treating addiction and helping people live productive, fulfilling lives, The Buttery addresses a major social and economic problem facing our society.
More informationDrug-related hospital stays in Australia 1993 2009
in Australia 1993 29 Prepared by Funded by Amanda Roxburgh and Lucy Burns, National Drug and Alcohol Research Centre the Australian Government Department of Health and Ageing Recommended Roxburgh, A.,
More informationThe story of drug treatment
EFFECTIVE TREATMENT CHANGING LIVES www.nta.nhs.uk www.nta.nhs.uk 1 The story of drug treatment The use of illicit drugs is declining in England; more and more people who need help with drug dependency
More informationHIV prevention and the wider UK population. What HIV prevention work should be directed towards the general population in the UK?
Shaping attitudes Challenging injustice Changing lives Policy briefing HIV prevention and the wider UK population September 2011 What HIV prevention work should be directed towards the general population
More informationEUROPEAN UNION COMMON POSITION ON UNGASS 2016
EUROPEAN UNION COMMON POSITION ON UNGASS 2016 UNGASS 2016 is a key opportunity for the international community to take stock of the achievements of the international drug control system to date, to elaborate
More informationDublin Declaration. on Partnership to fight HIV/AIDS in Europe and Central Asia
Dublin Declaration on Partnership to fight HIV/AIDS in Europe and Central Asia Against the background of the global emergency of the HIV/AIDS epidemic with 40 million people worldwide living with HIV/AIDS,
More informationClinical Priorities for Alcohol and Drugs in Public Health
Clinical Priorities for Alcohol and Drugs in Public Health What do we need to Measure up to? Dr Michael Kelleher Clinical Lead Alcohol and Drugs Team, Health and Wellbeing Directorate SMMGP 8 th Primary
More informationPOLAND. Thirteenth session of the UPR Working Group of the Human Rights Council Human rights violations associated with Poland s anti-drug laws
POLAND Submission of the Polish Drug Policy Network, Political Critique, the Jump 93 Association, Student Drug Policy Initiative, the Social AIDS Committee and Harm Reduction International to the UN Human
More informationDrugs and Alcohol in Primary Care Steve Brinksman Clinical Lead SMMGP
Drugs and Alcohol in Primary Care Steve Brinksman Clinical Lead SMMGP Habit is habit, and not to be flung out of the window by any man, but coaxed down-stairs one step at a time. Samuel Langhorne Clemens
More informationJohn R. Kasich, Governor Orman Hall, Director
John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic
More informationNames of authors: Lillebeth Larun, Wendy Nilsen, Geir Smedslund, Asbjørn Steiro, Sabine Wollscheid, Karianne Thune Hammerstrøm
Title registration for a review proposal: Effects of early, brief computerized interventions on risky alcohol and cannabis use among young people: a systematic review Names of authors: Lillebeth Larun,
More informationLONG-TERM TREATMENT OUTCOME: WHAT ARE THE 11 YEAR OUTCOMES OF TREATMENT FOR HEROIN DEPENDENCE?
AUSTRALIAN T R E A T M E N T OU T C O M E STUDY - N S W Funded by the National Health and Medical Research Council and the Australian Government Department of Health. ATOS NSW is a project of the Centre
More informationHulpverleningsmodellen bij opiaatverslaving. Frieda Matthys 6 juni 2013
Hulpverleningsmodellen bij opiaatverslaving Frieda Matthys 6 juni 2013 Prevalence The average prevalence of problem opioid use among adults (15 64) is estimated at 0.41%, the equivalent of 1.4 million
More informationSUMMARY- REPORT on CAUSES of DEATH: 2001-03 in INDIA
SUMMARY- REPORT on CAUSES of DEATH: 2001-03 in INDIA Background: Long-term mortality measurement by cause, gender and geographic area has been the requirement of every country. With this in view, Medical
More informationDrug-related deaths in Scotland in 2013
Drug-related deaths in Scotland in 2013 Statistics of drug-related deaths in 2013 and earlier years, broken down by age, sex, selected drugs reported, underlying cause of death and NHS Board and Council
More informationInternational Support for Harm Reduction
International Support for Harm Reduction An overview of multi-lateral endorsement of harm reduction policy and practice Prepared by International Harm Reduction Association and Human Rights Watch 19 January
More informationBaby Boomers and Substance Abuse Treatment
The Abbey Foundation Baby Boomers and Substance Abuse Treatment Punit Sharma Bettendorf, Iowa Date: August 5 th, 2009 Baby Boomers and Substance Abuse Treatment 1 Introduction The term Baby Boomer refers
More informationTrends in deaths related to drug misuse in England and Wales, 1993 2004
Trends in deaths related to drug misuse in, 1993 24 Oliver Morgan, Office for National Statistics and Imperial College London, Clare Griffiths, Barbara Toson and Cleo Rooney, Office for, Azeem Majeed,
More informationPERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment
UPDATED 4.6.2015 PERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment Psychosocial interventions are structured psychological or social interventions used to address substance-related
More informationProfile of substance misuse in Wales 2012-13. Education, health and criminal justice data
Profile of substance misuse in Wales 2012-13 Education, health and criminal justice data 1 Authors: Substance Misuse Programme, Health Protection Division, Public Health Wales. 2013 2 Contents 1.0 Introduction...
More informationPERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment
UPDATED 31.5.2016 PERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment Psychosocial interventions are structured psychological or social interventions used to address substance-related
More informationPart 1 RECENT STATISTICS AND TREND ANALYSIS OF ILLICIT DRUG MARKETS A. EXTENT OF ILLICIT DRUG USE AND HEALTH CONSEQUENCES
References to Chile Part 1 RECENT STATISTICS AND TREND ANALYSIS OF ILLICIT DRUG MARKETS A. EXTENT OF ILLICIT DRUG USE AND HEALTH CONSEQUENCES El panorama mundial Cocaína In 2010, the regions with a high
More informationCohesion Policy funding opportunities for community energy initiatives in Central and Eastern Europe
Community energy across Europe - making it happen Cohesion Policy funding opportunities for community energy initiatives in Central and Eastern Europe Markus Trilling CEE Bankwatch Network Brussels 6 October
More informationEvidence based Prevention & Treatment Options for Emerging Heroin Use in a Public Health Framework
Evidence based Prevention & Treatment Options for Emerging Heroin Use in a Public Health Framework Benedikt Fischer, PhD Professor, CIHR/PHAC Chair in Applied Public Health & MSFHR Senior Scholar Faculty
More informationChapter I: Introduction. Substance abuse is an enormous social problem in South Africa. The World Health
Chapter I: Introduction 1.1 Background of Co-Occurring Disorders (CODs) Substance abuse is an enormous social problem in South Africa. The World Health Organisation (World Health Organisation (WHO), 2004)
More informationTRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013
2013 to 2002 States: United the in Use Heroin in Trends National Survey on Drug Use and Health Short Report April 23, 2015 TRENDS IN HEROIN USE IN THE UNITED STATES: 2002 TO 2013 AUTHORS Rachel N. Lipari,
More information