Dutch? Raising people above their addiction problem. Some prejudices about Holland 10/17/2013

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1 Dutch? Invoegen hyperlink: Euc Raising people above their addiction problem Addictions Nursing in the Netherlands Some prejudices about Holland Everyone is walking on wooden shoes! Some prejudices about Holland We kill our elderly by means of euthanasia (active)! Some prejudices about Holland On every corner of the street, in the local supermarket, you can buy cocaine! And coffeeshops 16,2 million inhabitants 1

2 Prevalence in the Netherlands Prevalence in the Netherlands Regular users Addicts In care Nicotine 4,000,000 2,000, Alcohol 10,000, ,000 36,203 Benzodiazepines 1,900, , Heroin 26,000 25,000* 17,000 Cocaine > 55,000 55,000* 17,500 made up of powder: 65% and crack: 35% Cannabis 408,000 not known 10,971 Addicts In care Gambling 40,000 2,673 XTC GHB 1, Internet /gaming / chatting 20, Eating disorders 183,600? * Including around 52% heroin + cocaine clients CDC: national epidemic in USA: addiction to pain killers 2010: people of 12 years and older: more than 12 million pain killers as recreative drug 2009: 500,000 men and women visited an ICU because of an overdosis: Vicodin, Oxcycontin, Opana 2010: 10,000 and more men and 6,500 women died of an OD Amongst women an increase of 400% Dutch Opium Act The Opium Act contains rules and regulations concerning drugs; Drugs are, according this law, classified into two groups based on health deterioration riskfulness; List 1: hard drugs, illegal, dangerous: unacceptable risk List 2: soft drugs, partly legal, not that dangerous, acceptable risk. 10 Opium Act Healthcare system in the Netherlands List 1: acceptable health risks Heroin Cocaine Opium LSD GHB Amphetamines List 2: acceptable risks Marijuana/hashish Grass Health Care Insurance Act (ZVW) Exceptional Medical Expenses Act (AWBZ) Supplementary Insurance Obama care Act? 2

3 Exceptional Medical Expenses Act (EMEA) EMEA based on public law Essential care for (disabled) people with congenital, physical of mental disorders Long term healthcare Contribution through payroll tax system Stagering From a tolerance problem via a control disorder to adisorder of the reward system: Obsessive compulsive disorder 12 Institutes for Addiction Treatment Estimated number of nurses: 5,000-7,000 National Guideline Opioid Maintenance Treatment Chris Loth Lisette Oliemeulen Addiction nurse Addiction Nursing Study book Ruud Rutten Chris Loth Adri Hulshoff First responsible nurse Out reaching care Triage and treatment plan / nursing assessment and diagnoses Crisis interventions Psycho education Cognitive behavioral treatments/ E health 3

4 Expert Addictions Nurse Specialist: MANP In clinical lead besides addiction physician and psychiatrist Medical and nursing assessment, diagnoses and treatment plan Consultation Research / Quality of Care Assurance Primary Health care and addiction nursing In the family doctor's practice: expert nurses lead the early identifications of alle sorts of addictions Treatment starts from out the practices: recovery and enlargement of self management Home detox alcohol Cut down of use benzodiazepine Film: DAILY ADDICTION NURSING PRACTICE IN HOLLAND Antes and nurse addiction A long life care and cure Tulips from Rotterdam Rotterdam since the Golden Age Addiction and mental health care and cure in the city Vision of organization Mental health in the stadia of live Education 4

5 Antes in environment of Rotterdam 1. A total of patients in Capacity of 519 beds (including sheltered living facilities) outpatient contacts 4. Income comes from municipal grants, health insurance, department of justice 5. Total turnover in 2012: million employees locations Addiction Addiction is a chronic psychiatric illness, based in biological vulnerability. Addiction is influenced by biological, psychological and social factors and frequently leads to (permanent) loss of autonomy in emotions, thinking and action. Intensive sheltered living For People with chronic psychiatric disorders: Who are sometimes still using substances Who sometimes have trouble living independently (low level of autonomy) Who most of the time have a long history of being homeless Vision on Education Nurse and advance nurse is working together with other professionals in practice, education and learning Learning on the job Working together with the university and professional education in scientific and practice research Education on Antes College Education to become a professional Education to keep oneself informed in the function Education in progress for example FAS syndrome Summary We work together in the Netherlands We want to work together international Shared knowledge makes better patient care 5

6 Let it not be a wish, but a reality Different in many ways But our purpose is the same Yvonne Slee Head of Education Max Euwelaan MA Rotterdam The Nethherlands Omnizorg Apeldoorn Apeldoorn Apeldoorn is a town at the heart of the Netherlands. Famous for the Royal Palace and Omnizorg. Apeldoorn 157,000 inhabitants 12th biggest town in the Netherlands 340 km2 Omnizorg Prominent building > all under one roof 140 clients Omnizorg applies an integral concept. Aimed at setting out a path to recovery together with the client 6

7 Prominent building The clients de 1. People like you and me. 2. People who have become overwhelmed by their problems, who have lost their homes and families and who are at a very low point in their lives. 3. People who have nowhere else to go or who are difficult to place can come to Omnizorg. Mensen als jij en ik People like you and me Omnizorg Integral concept: Treatment: medical treatment, heroin and methadone treatment Day and night shelter Addict rooms (alcohol and drugs) Sheltered housing and home help Work and daily activities Financial advice, etc. How Hoe does werkt it work? het? de betekenis van: Partnership From the first contact, two questions: What s wrong? What are you able and prepared to do? 1. Coordinated approach 2. Personal plan An individual programme appropriate to the client s situation and degree of motivation 7

8 Recovery: Hherstel film Antes Dagbesteding Daily activities Recovery to health Personal recovery Recovery of quality of life Worthy citizen Hope and prospects Results resultaten More nuisance reports around Omnizorg Less nuisance in town Clients spend less time on the street results vervolg Improvement of housing situation More contact with addiction services Improvement in substance use Decline in criminality Reduced debt among visitors and residents. kracht van omnizorg Strength of Omnizorg Out rendement Come Close to the client Personal Outreaching Happy with small steps Respectful and open towards client Focus on recovery Perseveres with problem client Several studies have shown that the costs for society are less and the result more sustainable due to help and treatment. People becoming more themselves and growing stronger every day. 8

9 We We zijn are waar where onze our cliënten clients zijn are 9

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