An EMCDDA view on recovery

Roland SimonHead of Unit Intervention, Best Practice, and Scientific Partners

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Trends end of the 90s in Europe

Drug related death

HIV infection

Criminal behaviour

Drug market size

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Some doubt about the success remained

• How many drug addicts reached abstinence? • What where their levels of social functioning?• How is the clients’ well-being?

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But: Long term perspective sometimes missing

Sources: Wittchen, Bühringer, Rehm (2010) PREMOS Final report to the Federal Ministry for Health

dead In substitution

From that: stable

Instable

Unclear

not In substitution

From that: abstinent

In abstince oriented facility

Ongoing residential

Prison

Drop-out

unclear

8,1%70.4%

7.1%

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Social situation of drug users (TDI)

Education

• Primary level of education 37%• Primary level not completed 2%

Labour status• Regular employment 30%

Accommodation status• Unstable accommodation 8%

Sources: EMCDDA (2012). Social reintegration and employment: evidence and interventions for drug users in treatment. Luxembourg: Office for Publications

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Recovery: Reintegeration is crucial

Addiction Stabilisation Abstinence Integration

RecoveryRecovery

social reintegration

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“Recovery” stands for ..State

• Personal (mental) healthWell-being

• Drug free• Social functioning

Process of individual development• towards the state of “recovery”

Policy objective

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• Recovery stands for a re-focussing of treatment and drug policy - an answer to short-comings in practice

• Social reintegration core element of recovery• Not a minority position, but explicit and implicit in national

policies• Most explicit in UK and Ireland

Recovery and policy

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Recovery in EU policy papers

• 2012: EU Drug Strategy 2013-2015 elements of drug demand reduction:

• Prevention• Early detection/ intervention• Treatment and harm reduction treatment• Rehabilitation and social reintegration• Recovery

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Recovery in the EU Drug Action Plan 2013-2016

Action 6. Expand the provision of .. recovery services Responsible: MSsAssessment mechanism: EMCDDA

Action 9. Agree and commence EU minimum quality standards, also on recoveryResponsible: COM Assessment mechanism: EMCDDA Best Practice Portal

Over arching indicator 1212. Evidence based interventions on prevention, treatment, social integration and recovery and their expected impact on drug use prevalence and problem drug use (EMCDDA Best Practice Portal)

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The EMCDDA contributions

EMCDDA (2012):

Social rehabilitation and employment: evidence and interventions for drug users in treatment.

Luxembourg: Publications Office of the European Union.

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EMCDDA contributions

Coming out soon:

Therapeutic communities for addictions in Europe: evidence, current practices and future challenges of a treatment approach

Therapeutic communities: definition, history and key characteristicsThe availability of TC in Europe todayTC-practices in selected EU-countries:

United Kingdom – France – Sweden - BelgiumSpain – Poland - Czech Republic

Review of the effectiveness of TCs for addictions

TC standards and guidelinesRecent developments and future challenges

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EMCDDA contributions

Coming out soon:

Therapeutic communities …

Conclusions:

TC programmes for the rehabilitation of drug users are established in many European countries and play a role as part of the national addiction treatment systems.

There is some evidence for the effectiveness of TCs in terms of reduced substance use and criminal activity, at least in the United States and a culture of TC research is being developed in Europe.