UNODC:CommissiononNarcoticDrugs(CND)

62ndSession18th–22ndMarch2019,Vienna

Report

OpeningRemarks

TheOrganizationof theFamiliesofAsiaandthePacific (OFAP)has theprivilege toattendthe62ndSessionoftheCommissiononNarcoticDrugs(CND)Conference.Mr.NunoMariaRoqueJorge,theOFAPPresident,andMr.AugustoNogueira,theOFAPVice-President,attendedtheCNDConferenceinVienna,Austriaon18th–22ndMarch2019.The CND 62nd Session topic is Ministerial Segment 2019: taking stock of theimplementationofthecommitmentsmadetojointlyaddressandcountertheworlddrugproblem,inparticularinthelightofthe2019targetdate.

ExecutiveDirectorUNODC,YuryFedotov(inthemiddle)attheMinisterialSegment2019

“Drugchallengesareamongthemostcomplexproblemsweface,withwide-rangingimpactsonhealthandwell-being,familiesandcommunities,securityandsustainabledevelopment”–UNSecretary-General,AntónioGuterres

“Drugpoliciesmustmostofallprotectthepotentialofyoungpeopleandfostertheirhealthy styles of life and safe development” – Executive Director UNODC, YuryFedotov

SideEvents:

DrugAbusePreventionandTreatmentv Event organized by The International Federation of Non-Government Organization

forthePreventionofDrugandSubstanceAbuse(IFNGO),RumahCemara,IndonesiaandNewZealandDrugFoundation

Speakers:Mr.AugustoNogueira–PresidentofARTM,MacauSAR

Ø ARTM explain how with the cooperation of the Social WelfareBureau of the Macau Government, SAR China has manage tosucceedforfour(4)consecutiveyearszeronewinfectionamongthePWID.

Mr.SubhanHamonangan–NationalRepresentative,RumahCemaraØ RumahCemara focus in theirHIV/AIDSpreventionwork,mainly

among thePUDsandhowthey succeed to increase thegeneralsociety knowledge in Bandung, West Java through sport fordevelopment and advocacy process into restorative justice forPUDs. Mr.AugustoNogueira(OFAPVice-

President)

Ø Three (3) Reasonswhywe choose sport as Our Entry Point to reduce stigma andDiscriminationamongPLHIVandPUD:1. Acceptable2. Accessible3. UniversalLanguage

ProgressinAsiainreducingHIVamongpeoplewhoinjectdrug:

• TheAsiaandPacificregionwashometoanestimated5.2millionpeoplelivingwithHIVin2017

• China,IndiaandIndonesiaaccountforalmostthree-quartersofthetotalnumberofpeoplelivingwithHIVintheregion

• AmongthosediagnosedwithHIVwereontreatmentandwerevirallysuppressed• There are two (2) programs that have been contributed to increase the general

societyknowledgeandespeciallyamongthePUDs• This programs are possible due to the intensive cooperation between the

GovernmentsandtheCivilSocietyActionsBeingDone:

1. MaintenanceprogramforpeoplelivingwithHIV(PLWHIV)• Buprenorphinemaintenance• Methadonemaintenance

2. Special team for people that injectdrugsandwereHIVpositive

• ProfessionaltrainednurseforHIVcounseling

• Financialnutrition&emotionalsupport

3. Harmminimization• Freecondomdistribution• Outreacheducation• Freebloodtestsforpeople

whousedrugs4. Communication

• Trainingactivity,posterandbooklet

Advocacy:

1. PeerSupportforPLHIV2. DrugTreatmentandCaseManagement3. SportsforDevelopmentProgram4. CommunitySpace

Mr.NunoJorge(OFAPPresident)

What is Family Therapy and why use it with teens with substance usedisorders?

- Theteachingprocesswewilluseare lecture,discussion,demonstration,skillpractice,learningactivitiesandcaseexamples

- Generaltopicstobecovered:• Theoretical foundations of family

therapy1. Familysystemstheory2. Ecologicalsystemstheory3. Socialconstructiontheory4. Sociallearning/behavioraltheories

• Coreassumptionsoffamilytherapy1. Adolescence(WHO:10-19)isanimportant

transitiono Transitionbetweenchildhoodand

adulthoodo Physicaldevelopmento Cognitivedevelopmento Egocentrismo Socio-emotionaldevelopment♦ One important fact ….. “Many believe

that teens begin drug use simply topursue pleasure. However, according toscientific evidence, there are factors such as exposure to drug use,neglect, violenceandother family factors that lead to vulnerabilitiestoinitiatedruguse.”

2. Abasicknowledgeofdrugsandaddictionisimportanto Psychologicalcraving

Ø DealingwithcravingisimportantinmodifyingdruguseØ CravingscancontinuelongafterquittingØ Cravingcanbetriggeredbypeople,things,situations,placeor

feelingØ Cravinglosetheirpowerifnotreinforcedbysubstanceuse

o Toleranceo Withdrawalo Neglectofotherinterestso Compulsive drug seeking / taking is spite of negative

consequences3. Research evidence supports family therapy with adolescents with

substanceusedisorderso Reductionsinsubstanceuseo Pretoposttreatmenteffectso Maintainedfollow-upstudies

Mr.NunoJorgemeetswithMr.TobiasKrachler,Senior Advocacy Officer - Delegation to the U.N. in Vienna, Dominicans for Justice and Peace Order of Preachers

o Engagementandretentiono Behavior/emotionalproblemso Fewerincarcerationdaysandfewerout-of-homeplacementso Improvementinacademicfunctioningo Familyfunctioning

4. Notetoimportance:§ Thefamilyistheprimarysysteminaperson’slife§ Poorerfunctioningatthefamilylevelcanimpactfunctioningatother

levels§ Relationships with family members can contribute to whether a

member’sproblemsgetbetterorworse§ Family therapy for individual problems can also improve other

problems§ Family therapy does not focus only on the individual, but also on

familyinteractions§ Thefamilytherapistwantstointerruptproblematiccycles,ineffective

communicationandharmfulbehaviors§ Familymembersareencouragedtobepartofthesolution

• Treatmentphases,interventionsandassessmentmethods1. Engagement–buildaworkingalliance,join,validateandstimulatehope2. Family assessment – see the problem, structure& process assessment,

behavioralconcernsandidentifyrisks&strengths3. Createamotivationalcontextforchange4. Primaryfamilytherapyinterventions–communicate,intervene,problem

solving, learn useful skills and homework assignments to changebehaviors

ACRA–AdolescentCommunityReinforcementApproach5. Termination – asking questions about the observation changes, when

helpneededandensurefamilyconnection• Problemsolvingpotentialissues

1. Parents/youthportrayawell-functioningfamily–donotpushthefamilyandmaintainsteadfastempathy

2. Youthrefusestotalkinsession–inoroutofofficeactivitiesandsilenceisnotveryusefulasatoolforadolescents

3. Youtharrested–clear,non-blamingcommunicationneededandfacilitaterebuildingtrust

4. Youthwithseverementalhealthstruggles–facilitateconnectionofyouthtospecializedprovidersandhaveaprotocoltoguideintervention

5. Addressingconfidentialitywhenworkingwithyouth6. Parent with substance use / mental illness – parent participation

increaseschancesofsuccessful forchildandwillnot judgeordictatetoparents

7. Parentrefusestoallowyouthtoliveinthehome–meetalonewiththe

parent and assess the situation then negotiate meeting with theadolescentwithoutthegoalbeingtotransitionhim/herbackhome

SideEvent:InformationandEducationMaterial–DrugDependenceTreatmentandCare

DuringConferenceMeeting

Asapatient,youhavetherightto:1. Receiveconsiderate,respectfulandevidence-baseddrugdependencetreatmentand

careservices2. Receive services regardless of race, colour, ethnicity, religion, gender or sexual

orientation3. Receiveconfidentialtreatment4. Befullyinformedofyourtreatmentplanandparticipateinitsdevelopment5. Beabletosetyourownrecoverygoals,workingwiththehealthteamtodevelopa

personalizedrecoveryplan6. Respectofprofessionalandpersonalboundarieswhen interactingwithcounselors,

staffandotherpatients7. Refusetreatmentandunderstandwhateffectthiscouldhaveonyourhealth8. Discontinuetreatmentatanytime9. Begin treatment again, if your relapse. Services should welcome your continued

effortstoachievelong-termrecoveryAsapatient,youhavetheresponsibilityto:

1. Actresponsiblyandcooperatewiththestafffromyourprogramme

2. Treatstaffandotherpatientswithcourtesyandrespect3. Participateinthedevelopmentandcompletionofyourtreatmentplan,includingbut

not limitedtopursuingvocational/educationalactivitiesandrefrainingfromusingdrugs

4. Talktoacounseloraboutproblemsthataffectyourtreatmentprogressandrecovery5. Offersuggestionsonimprovingprogrammeoperations6. Talktoacounselorbeforeendingtreatment.Don’tjuststopandleave7. Askquestionsaboutanypartofyourtreatmentyoudon’tunderstand

YOUareakeypartinyourownrecoveryjourney:

• Serviceswillworkwithyourtowardsyourrecovery• Youwill set yourowngoalsanddevelopapersonal recoveryplan together

withyourcounselor• Asapatient,youwillhavetherighttobegintreatmentagain• Staffareheretosupportyourcontinuedefforts

Inthisservicewetakecareofyou:

• Drugusedisordersarenotastigma• Weknowthattheyarenottheresultoffreechoice• Therearespecialistsinthetreatmentofdrugusedisorders• Ourtherapiescanhelpyouandyourlovedones

v Drugdependenceisacomplexhealthdisordercharacterizedbyachronicand

relapsing nature that can be prevented and treated. As such, it deservesnothing less thanwhat is expected for the treatment and care of any otherdisease!

v LanguageMatters!–bearinmindthatwhentalkingaboutdrugusedisorders,stigmatizinglanguageperpetuatesnegativeperceptions.

SpeakersduringtheSideMeetingoftheConference

Ø Respect,dignityanddiscretion

Fully respect other people regardless of their race, colour, ethnicity, religion,genderorsexualorientation.Honourconfidentialityandtheprivacyofothers

Ø AutonomyAllowclientsthefreedomtochoosetheirowndestiny

Ø CompetenceandstewardshipPossess thenecessary skills tounderstand thenatureofdrugdependenceandup-to-date and evidence based-knowledge on how to treat clients effectively.Useavailableresourcesinaconscientiousmanner

Ø CompassionandhonestyFair,equalandtruthfultreatmentofpeoplearoundyou

Ø LoyaltyTheresponsibilitynottoabandonthoseyouworkwith

PRINCIPLESforsubstanceusedisorderstreatmentandcareservices:

1. Voluntary–servicesshouldvoluntaryandinformedwrittenconsentshouldbeensured

2. Respectful–servicesshouldbehumaneandprovidenothinglessthanexpectedforanyotherdisease

3. Accessible–servicesmustbelocatedconvenientlyandincloseproximitytopublictransport

4. Affordable–servicesshouldbeaffordableforallpatients

5. Unconditional–servicesshouldbeavailableregardlessofrace,colour,ethnicity,religion,genderorsexualorientation.Servicesshouldbeprovided,evenwhenthereisrelapse

6. Evidence-based–servicesshouldbeinformedbyscienceandethicalprinciples

7. Individualized–servicesshouldbeadaptedtotheindividual’sneeds.Notonetreatmentfitsall

v TIMETOACT!Ø Pragmaticandconcreteactionsforpreventionof

non-medical use of controlled substances,treatmentofdrugusedisorders,socialprotectionandhealthcareforpeopleaffected

PREVENTION:1. Supportparents

Mr.EduardoVeterewithMr.JeffreyBawaandMr.NunoJorge

- Inspireparentstodevoteundividedtotheirchildren- Promoteawarmandsupportiveparentingstyle- Encourageparentstoestablish/agreerulesinhomelifeandbeinvolvedinthelifeof

theirchildren2. Reduceschooldrop-out- Buildschools- Providefreemeals,aswellasincentivestofamiliestokeepchildreninschool- Increaseschoolconnectednessandengagement3. Trainteacherstodevelopthepersonalandsocialskillsofchildren- Prepare teachers to teachchildrenhow to recognize theiremotionsanddealwith

theminapositiveway- Inspireteacherstosupportallchildren,particularlythemostvulnerable,inrealizing

their full potential through inclusionandempowerment (no segregationor speciallessons)

4. Reliableinformation- Disseminate appropriate information concerning the use of all psychoactive

substances,includingcontrolleddrugs,tailoredtotheageofthetargetgroup5. Opportunitiesforhealthandsafedevelopment- Offeropportunities topracticeahealthy lifestyle:physicalexercise,creativity,arts,

music,etc.- ProvidefurtherpersonalandsocialskillseducationTREATMENT,CAREANDREHABILITATION:6. Outreach–provideunconditionalhealthandsocialcare7. Outpatient services – stop or reduce substance use, improve health and improve

socialfunctioning8. Smallresidentialtreatmentprogrammes9. Servicesforpregnantwomen10. CollaborationwiththejusticesectorQUALITY STANDARDS FOR THE TREATMENT AND CARE OF DRUG USEDISORDERS1. Outreach/Drop-in

• Unconditionalprovisionofbasicsupport,screening,overdose/infectiousdiseaseprevention, education and referral for those people not currently receivingtreatment

2. Outpatient• Servicesforpeoplewhodonotresideinthetreatmentfacility.Interventionsvary

considerably in components and intensity and can cover psychological,pharmacologicaltreatmentsandsocialsupport

3. Inpatient/Short-termresidential• Servicesforpeoplewithgreaterseverityofsymptoms,especiallyforthoselikely

to experience significant signs of withdrawal or for patients in crisis with co-occurringmentalhealthdisorders

4. Longtermresidential

• Services for severely affected patients who require a structured environment

over a longer period of time, as they are unlikely to control their compulsiveconditionalbehaviorconducedbydrugs

DinnerMeeting,fromleft:Ms.CelesteVong,Mr.AugustoNogueira,Ms.LeiLaiPang,Mr.EsjbornHornbergandMr.Jorge