Download Country Overview Guidelines

Country Overview Guidelines
Revised April 2016
TABLE OF CONTENTS
INTRODUCTION ................................................................................................................................... 3
W HAT IS A COUNTRY OVERVIEW ? ....................................................................................................... 3
W HAT IS THE PURPOSE OF A COUNTRY OVERVIEW ? ......................................................................... 3
W HAT IS THE PERIODICITY ? ................................................................................................................ 3
W HAT IS THE BASIC STRUCTURE OF THE COUNTRY OVERVIEW ? ...................................................... 3
W HAT IS THE AVERAGE LENGHT OF THE COUNTRY OVERVIEW ? ....................................................... 3
W HAT ARE THE AIMS OF THESE GUIDELINES ?..................................................................................... 3
W HERE ARE THE COUNTRY OVERVIEWS PUBLISHED? ........................................................................ 3
1.
SOCIAL DEMOGRAPHIC OVERVIEW ..................................................................................... 4
2.
DRUG USE AMONG THE GENERAL POPULATION AND YOUNG PEOPLE ................. 5
3.
PREVENTION ................................................................................................................................ 5
4.
HIGH-RISK DRUG USE (FORMERLY – PROBLEM DRUG USE) ....................................... 6
5.
DRUG TREATMENT DEMAND .................................................................................................. 7
6.
DRUG RELATED INFECTIOUS DISEASES ............................................................................ 7
7.
DRUG RELATED DEATHS ......................................................................................................... 8
8.
TREATMENT RESPONSES ........................................................................................................ 8
9.
HARM REDUCTION RESPONSES ........................................................................................... 9
10.
DRUG MARKETS AND DRUG RELATED OFFENCES .................................................. 10
11.
NATIONAL DRUG LAWS ...................................................................................................... 10
12.
NATIONAL DRUG STRATEGY ............................................................................................ 11
13.
COORDINATION MECHANISM IN THE FIELD OF DRUGS........................................... 11
15.
DRUG RELATED RESEARCH (OPTIONAL) .................................................................... 11
16.
LIST OF REFERENCES ....................................................................................................... 12
USE THE “HARVARD SYSTEM” FOR REPORTING REFERENCES. TERMINOLOGY AND
GLOSSARY OF TERMS .................................................................................................................... 12
Country Overview Guidelines
Introduction
What is a Country overview ?
A Country Overview is a structured synopsis of the trends and characteristics of the national
drug problem and responses to it. Country Overviews are available for the 28 EU Member
States, Norway and Turkey, as well as for IPA beneficiaries, selected ENP countries and
countries within CADAP project. See link http://www.emcdda.europa.eu/publications/countryoverviews.
What is the purpose of a Country Overview ?
The main purpose of the Country Overview is to provide policy makers, researchers,
journalists and the general public with a brief synopsis of data, trends and core characteristics
of the state of the national drug problem and responses to it. As such it is not intended to be
used for comparison of data across Member States, which is provided by other EMCDDAdesigned products.
What is the periodicity ?
For 28 EU Member states, Norway and Turkey the reporting period of each Country
Overview is based on the latest National Reports, Standard Tables and Standard
Questionnaires submitted by National Focal Points on a yearly basis. For other countries,
drafting of the country overview and periodicity for updates is agreed on bilateral bases.
What is the basic structure of the Country Overview ?
The structure of the Country Overview is based on a standard reporting template which is
made up of 15 chapters. Chapter 1 to chapter 9 gives an overview on the drug situation and
the (public) health, social and legal responses to drug use in the country. Chapter 10 to
chapter 15 give an overview on drug markets, law and coordination mechanism, drug-related
public expenditures, as well as research developments in the field of drugs.
What is the average lenght of the Country Overview ?
In total the Country Overview should be approximately 8 to 10 pages long.
What are the aims of these guidelines ?
These guidelines aim to provide a clear and structured step-by-step process to facilitate the
process of drawing up the first Country Overview. Furthermore, these guidelines aim to
ensure that all country overviews have a consistent structure and outline.
What functions undertake the EMCDDA before publishing Country Overviews?1
The country overviews should be prepared in English. The EMCDDA will provide following
services: crosschecking of information in the country overview by Reitox and External
partners unit; proofreading of English language (agreed on bilateral basis) and publishing of
Country Overview on the EMCDDA website by Communication Unit.
Where are the Country Overviews published?
The EU Country Overviews are published on the EMCDDA website through the following link:
1
Not relevant for 28 EU Member states, Norway and Turkey, as the process of preparation, validation and publishing
of country overviews is different.
3
Country Overview Guidelines
http://www.emcdda.europa.eu/publications/country-overviews. The location and format of
publishing the country overviews for third countriesa will be agreed on bi-lateral basis.
1. Social Demographic overview
Aim: To provide a general demographic data overview about the country
Year
Country
data
EU (28
countries)
–filled in by
the
EMCDDA
Source
Surface area
Population
Eurostat for EU
and selected IPA
countries only; For
others – national or
other sources
GDP per capita in Purchasing
Power Standards(2)
Eurostat for EU
and selected IPA
countries only; For
others – national or
other sources
Total expenditure of social
protection (%GDP) (if not
available for non-EU countries
Inequality of income distribution)
Eurostat for EU
and selected IPA
countries only; For
others – national or
other sources
Unemployment rate
Eurostat for EU
and selected IPA
countries only; For
others – national or
other sources
Unemployment rate of
population aged <25 years
Eurostat for EU
and selected IPA
countries only; For
others – national or
other sources
4
Country Overview Guidelines
Prison population rate (per 105 of
national population)
Council of Europe,
At risk poverty rate
Eurostat (SILC) for
SPACE I 2010
EU and selected
IPA countries only;
For others –
national or other
sources
2. Drug use among the general population and young people
Aim: To provide a brief overview on drug use in the general population, in the school
population and in youth population in general, and drug use among specifically defined
groups (such as clubbers / dance partygoers), respectively.
GPS is one of the Five EMCDDA Key Indicators, providing prevalence of drug use in the
general population.
Provide a brief overview of surveys undertaken on drug use among the general
population for the specified population – e.g. residing in a specific city, region or the
whole country) quoting target population, year of survey, sample size (net) (response
rate only in occasions of very low responses), drug use prevalence (lifetime, last year,
last month), patterns of use, attitudes to drug use and trends (focusing on 15-34 years
old group) in anything above if available. Following figures are usually cited: three most
frequently used drugs during lifetime, last year and last month among 15-34 years olds
and 15-64 years olds.
Prevalence of new psychoactive substances if available.
Provide a brief overview of surveys undertaken on drug use among young people such as
the ESPAD schools survey project and the HBSC (WHO) School Survey on health
behavior among school-aged children. If other school surveys were undertaken in the
country, quote target (age) group and geographic coverage, year, etc. (see above).
Data cited:
 life time prevalence of three most frequent drugs 15-64 and 15-34 y.o.
 last year prevalence of three most frequent drugs 15-64 and 15- 34 y.o
 last month prevalence of three most frequent drugs 15-64 and 15-34 y.o.
 gender distribution for main substance (usually cannabis) 15-34 y.o
 three most prevalent drugs among 15-16 y.o (usually ESPAD, HBSC or national level
study)
 cannabis life time use among 15-16 y.o by gender(usually ESPAD, HBSC or national
level study)
 prevalence of drugs in recreational settings (if available)
 prevalence of NPS (if available)
3. Prevention
Aim: To provide a concise overview of the prevention interventions at national level on three
main areas of intervention, namely: universal prevention, selective and indicated prevention
5
Country Overview Guidelines
Provide a general brief description and new development on substance use and other risk
behaviour prevention and indicate which sectors (governmental, NGO, private) are
involved in each prevention interventions / complex programs. Also describe how
prevention is organised (funds and responsibilities).
A brief description of the prevailing universal prevention interventions that address the
entire population (such as: national, local community, school, neighborhood) with
programmes aimed at preventing or delaying the abuse of illegal drugs accompanied by a
brief description of what approach is being used, such as development of health lifestyle
skills, or information dissemination and evaluation. Focus mostly on intervention whose
contents (what is actually being done and delivered) are reported.
A brief description of the selective prevention intervention that target subsets of the total
population that are deemed to be at risk for substance abuse by virtue of their
membership in a particular population segment, e.g. children of adult alcoholics, dropouts,
or students who are failing academically, or youth in night entertainment setting. If such
information is available, please state whether such activities are evaluated and what
approach is being used.
A brief description of indicated prevention interventions specifically targeted at individuals
who are exhibiting early signs of substance abuse (but not ICD-10 criteria for addiction)
and other problematic behavior. Please state whether such activities are evaluated and
what approach is being used.
Main results of new national research especially regarding effectiveness and outcome of
interventions. Mention the existence standards or guidelines, if any.
4. High-risk drug use (formerly – Problem drug use)
Aim: To provide an overview on high-risk drug use (HRDU)
Until 2012, the EMCDDA defined problem drug use as injecting drug use (IDU) or long
duration/regular drug use of opiates, cocaine and/or amphetamines. Ecstasy and cannabis
were not included in this category. However, in 2012 a new concept of ‘high-risk drug use’
was adapted. View details here http://www.emcdda.europa.eu/activities/hrdu .
The term ‘high-risk drug use’ means ‘recurrent drug use that is causing actual harms
(negative consequences) to the person (including dependence, but also other health,
psychological or social problems) or is placing the person at a high probability/risk of suffering
such harms. It is measured as the use of psychoactive substances by high-risk pattern (e.g.
intensively) and/or by high-risk routes of administration in the last 12 months. Please
describe:
Estimates to describe high risk drug use: ‘high-risk opioid use’ or former ‘problem
opiate use’ and ‘injecting drug use’ (if none of them available, can be substituted by
‘problem drug use estimate’ but in this case should describe the national definition
applied for the estimate);
Frequent and high risk cannabis use among 15-64 years olds (daily cannabis use in
last month from general population studies);
High-risk use of cocaine, methamphetamine or other substances (if more prevalent at
national level)
Data cited:
 estimated number of high-risk opioid use’ or former ‘problem opiate use’ and ‘injecting
drug use’
6
Country Overview Guidelines


Trend in the estimated number
Estimated prevalence of daily cannabis users (if available)
5. Drug treatment demand
Aim: An overview of the population of drug users entering or in treatment
The Treatment Demand Indicator (TDI) is one of the Five EMCDDA Key Indicators, describing
the population of drug users in treatment2.
Provide figures on the total number of treatment units existing in the country (optional are
the figures of outpatient and inpatient units) and a figure of the reporting treatment
units (optional are the figures of outpatient and inpatient units reporting TDI).
Provide figures about drug users entering in treatment centers during a given year:
o Those who start treatment in the given year for the first time in their lives
(never previously treated),
o All clients entering treatment in the given year.
List all important sociodemographic information, drug use patterns and treatment related
data about those two groups of patients in a comprehensive way: proportion (rate and
number) of males and females in each group; mean age of treatment clients in both
groups (also by main drug (if available)); three most frequent primary drugs reported by
each group.
If treatment entrant or/ treatment prevalence data reflecting the EMCDDA definition is not
available then show “registered patients,” or whatever treatment-related indicator exists
nationally. Describe ways how the people can fall under that registration; if possible,
break down according to those ways categories; if more types of data for Treatment
Demand Indicator is available, define each of them explaining differences in definition
compared to the key indicator as defined by EMCDDA.
Data cited:
 total number of treatment units and reporting treatment units
 number of all clients in treatment, number of new clients in treatment (Please note that
treatment system should be described in the section ‘Treatment response’)
 proportion of female/male clients among new/all treatment clients
 mean age of treatment clients (all and new)
 three most frequent drugs reported among new treatment and all treatment clients
6. Drug related infectious diseases
Aim: An overview of drug related infectious diseases such as HIV/AIDS, HCV and HBV
among drug users
Drug Related Infectious diseases (DRID) is one of the Five EMCDDA Key Indicators.
HIV/AIDS and HCV in drug users should be described as a minimum; use standard
UNAIDS reporting format well known to HIV-centre in your country (socio- demography;
ways of transmission; stages of the disease; trends.
2
Please refer to the newest guidelines on Treatment Demand Indicator: Standard protocol 3.0 for definitions
7
Country Overview Guidelines
If applicable, please indicate number of new and total number of known HIV-seropositive3
drug users and those confirmed as positive.
Please give a figure of new HBV and HCV cases notified among people who use drugs
(PWID) and percentage of injecting-related HBV and HCV cases.
Indicate if any seroprevalence study in the population of drug users was performed and if
so, than how the population was (city district, city, region, nation). Please indicate the
figures, if available, of HIV, HCV, HBV prevalence among PWID in national (or
subnational) samples.
If available, include data on other diseases related to drug use in your country (such as;
Tuberculosis, Sexually Transmitted Diseases, etc.).
Data cited:
 new HIV cases notified among PWID (% of total number of notified HIV cases)
 Prevalence of HIV among PWID in national samples (or sub-national samples)
 Prevalence of HBV in national samples (or sub-national samples)
 new HBV cases among PWID
 new HCV cases among PWID
7. Drug related deaths
Aim: An overview of the number of drug related deaths.
Drug Related deaths (DRD) is one of the Five EMCDDA Key Indicators.
Show the number of known fatal overdoses, proportion of males and females among
those cases; proportion of cases which fall under age of 25 years and proportion of cases
with opiate presence.
Indicate your assessment of the quality of input data that is, the standard practice with
unnatural deaths (who issues the death certificate?), proportion of the deceased by
unnatural death undergo autopsy and proportion who are checked for presence of illegal
drugs in body tissues and/or fluids. Which substances were found?
State, if any (cohort) studies on mortality of drug users were performed in your country.
Include key concerns for DRDs
Describe most recent developments or new developments on monitoring and reporting
on DRDs (new formats; progress in reporting; links between registries etc.
Data cited:





Number of drug related death (if available, over several years)
Proportion of males/females among DRD cases
Proportion of DRD cases under age of 25 years
Proportion of DRD with opiate presence
Average age of deceased victims
8. Treatment responses
Aim: Brief overview on drug treatment comprising of institutional framework, availability of
treatment services, substitution treatment and the legal framework on substitution treatment.
3
that may be different from “confirmed HIV cases“ in some countries / situations
8
Country Overview Guidelines
Provide a brief overview of the drug treatment institutional framework comprising of
policy, organisation and financing.
o
o
o
Policy: Is there a national drug treatment policy, action plan and what are its
objectives?
Organisation: At what level is drug treatment coordinated (national/federal/local
level)? Who is responsible for coordination of drug treatment if anyone
(national/regional/local government body, public health system)?
Financing: Who provides funding for different kinds of drug treatment? Are health
insurance schemes (mandatory / governmental / private) covering it (or only some
drug treatment modalities, or none)?
Provide a brief overview on the availability of drug treatment (approx. 5 lines).
o State the availability of different types of treatment available in the country according
to:
 Outpatient and inpatient treatment centers
 Outpatient psychosocial treatment;
 Inpatient psychosocial treatment;
 Opioid Substitution Treatment,
 Detoxification treatment,
 Rehabilitation / resocialisation (describe the lengths and types of it).
Special attention should be paid to:
Brief description of treatment for specific target group drug (e.g.: migrants, adolescents
etc.)
Brief (up to 10 lines) description of substitution treatment (if not available, state it and
briefly describe discussion/s about its introduction or its absence):
o Methadone and/or buprenorphine, year of introduction of treatment which each
substance;
o A brief description of the legal framework and practice of substitution treatment
initiation (who is allowed to initiate substitution treatment, e.g.: any medical doctor or
only specialised medical doctors or only doctors in specialised treatment centres). Is
this stipulated in the national law or guidelines (quote law or guidelines);
o If available, include the number of patients/clients in substitution treatment for the
year of reporting and trends (by substitution drug, if possible). Is there any
substitution register existing?
Data cited:
 number of all clients on OST, number of clients on MMT and HDBT
9. Harm reduction responses
Aim: An overview on harm reduction responses and the sectors which are involved in harm
reduction
Describe the number, coverage and modalities of harm reduction responses
(needle/syringes exchange/distribution, education of users about safer ways of drug use,
number of harm reduction sites and NSP4 sites in the country.
If available: describe the number of harm reduction beneficiaries in the country and the
origin of the number (methodology how it was reported / estimated).
4
There may be a difference between the number of harm reduction sites and the number of needle and syringe
sites, which would depend on definition of harm reduction applied for the services in a country.
9
Country Overview Guidelines
If possible, provide estimated number of needles/syringes distributed to the injecting drug
users.
State which sectors (governmental, NGOs, private) are involved in treatment responses
and how.
Data cited:
 Number of syringes distributed (most recent year)
 Number of HR clients
 Number of units providing NSP (fixed locations, pharmacies, vending machines, units
providing only outreach and mobile units)
10. Drug markets and drug related offences
Aim: To provide overview of major trafficking routes, drug related offences, and street price
and purity of drugs.
o
o
o
o
A brief description of major drug trafficking routes (from and towards the country).
Major developments such as first discovery of clandestine laboratory, or seizures of
cannabis plantations.
The quantity per drug in terms of number of seizures and quantity of seizures by drug,
with particular focus to number and quantities of following drugs seizures: cannabis
resin, herbal cannabis, heroin, cocaine, amphetamine, ecstasy. If some of drugs are not
significant for the national market, they could be excluded, while if another illicit drug, to
is more prevalent in the national market, it should be described as well.
Price and purity per drug at street level.
Provide available trends for on drug law offences (relevant for third countries only):
(police) arrests,
cases brought to court,
sentenced criminals,
inmates;
for each of the above, state source of the data, numbers and trends; where important,
some socio-demographic data of offenders may be shown.
If available, please cite three most prevalent drugs related to all drug offences
Data cited:
 total number of drug related offences registered
 three most prevalent drugs related to all drug offences, by order of importance
 number of cannabis resin seizures
 quantities of cannabis resin seizures
 number of herbal cannabis seizures
 quantities of herbal cannabis seizures
 number of heroin seizures
 quantities of heroin seizures
 number of cocaine seizures
 quantities of cocaine seizures
 number of amphetamine seizures
 quantities of amphetamine seizures
 number of ecstasy seizures
 quantities of ecstasy seizures
11. National drug laws
10
Country Overview Guidelines
Aim: An overview of national drug laws related to drug use, drug trafficking and possession of
drug/s
What are penalties for different types of drug crimes?
Is use or possession regarded as a criminal offence or decriminalised?
Describe any important milestones in the law (changes of law)
Are laws and penalties the same for all illegal drugs, or are different drugs classified
differently (similarly to UK, Belgium or other countries)? What is the position of cannabis
in this context?
12. National drug strategy
Aim: An overview of the national drug strategy
Does your country have a national drug strategy?
If yes, when was it approved?
By whom?
Time frame?
What are the objectives?
Is it the first national drug strategy?
Are there regional drug strategies?
Will it be evaluated?
13. Coordination mechanism in the field of drugs
Aim: A brief overview of the overall coordination mechanism in the field of drugs
Who is responsible for implementing the national drug strategy? If no strategy exists, is
there any subject responsible for coordination of drug related intervention / policy?
(governmental body, state institution, etc.)
Is this tasks shared by several institutions?
Is there an overall coordinating body or is this done by regional authorities?
Who will be responsible for the evaluation of the strategy / drug related intervention/s?
14. Drug related public expenditures (for EU, Norway and Turkey only)
Aim: A brief overview of the drug-related public expenditures
15. Drug related research (optional)
Aim: A brief overview of the on-going research in field of drugs
In this section please state main research institutions involved in the research on drugs and
relevant funding institutions and sources for the research at the national level. Please
describe the role of drug-related research in the context of a national drug strategy, and if
11
Country Overview Guidelines
applicable, indicate the role of a national drug observatory in implementation, execution or
coordination of drug-related research activities in the country, including cooperation with the
research institutions. If applicable, please name national or regional scientific journals
publishing drug related research implemented in the country. Please describe main drugrelated research projects (population based surveys, scientific studies in field of addiction or
applied research activities (evaluation of programmes etc) ongoing or planned in the country
(national or international).
If available, please provide links to electronic recourses (research institutes, scientific journals
or research articles).
16.
List of references
Use the “Harvard System” for reporting references.
12
Country Overview Guidelines
Terminology and Glossary of Terms
Clients
Refers to total number of clients during the course of the reporting year, preferably corrected
for double-counting.
Detoxification treatment
It is a medically supervised intervention to resolve withdrawal symptoms. Usually it is
combined with some psychosocial interventions for continued care. Detoxification could be
provided as inpatient as well as a community-based outpatient programme.
Drug law offences (DLO)
'Reports' of offences against national drug legislation (use, possession, trafficking, etc.) reflect
differences in law but also the different ways in which the law is enforced and applied, and the
priorities and resources allocated to specific problems by criminal justice agencies. Please
consult for details http://www.emcdda.europa.eu/stats11/dlo/methods and also
http://www.emcdda.europa.eu/policy-and-law .
Drug related death (DRD)
Refer to deaths happening shortly after consumption of one or more psychoactive drugs, and
directly related to this consumption. Often these deaths are referred as ‘overdoses’, although
equivalent concepts are also ‘deaths directly related to drug use’, ‘poisonings’ or ‘druginduced deaths’. Please consult for details http://www.emcdda.europa.eu/activities/drd .
Drug related infectious diseases (DRID)
This area develops indicators for more reliable and comparable monitoring of hepatitis B/C
and HIV in injecting drug users. This is necessary for identifying priorities for preventing
further infections, for forecasting health-care needs and costs, and for monitoring the impact
of preventive interventions. Please consult for details
http://www.emcdda.europa.eu/activities/drid .
Drug seizures data
EU countries provide data on the number of drug seizures and the quantities seized. Data are
available for cannabis, heroin, cocaine, amphetamine, LSD and ecstasy.
Drug treatment
Treatment is any activity that directly targets individuals who have problems with their drug
use and which aims to improve the psychological, medical or social state of those who seek
help for their drug problems. This activity often takes place at specialised facilities for drug
users, but may also occur in the context of in general services offering medical and/or
psychological help to people with drug problems. Please consult for details and updates
http://www.emcdda.europa.eu/activities/tdi .
EMCDDA Five key indicators
The EMCDDA five key indicators are:
 prevalence and patterns of drug use among the general population (population
surveys);
 prevalence and patterns of high-risk drug use (statistical prevalence/incidence
estimates and surveys among drug users);
 drug-related infectious diseases (prevalence and incidence rates of HIV, hepatitis B
and C in injecting drug users);
13
Country Overview Guidelines


drug-related deaths and mortality of drug users (general population mortality special
registers statistics, and mortality cohort studies among drug users);
demand for drug treatment (statistics from drug treatment centers on clients starting
treatment).
General population surveys (GPS)
General population surveys aim to obtain comparable and reliable information on: the extent
and pattern of consumption of different drugs in the general population; the characteristics
and behaviors of users; and the attitudes of different population groups towards drug use. The
information collected is then used to assess the situation, identify priorities and plan
responses. Please consult for details http://www.emcdda.europa.eu/activities/gps .
Harm Reduction
The aims of a harm reduction approach are to reduce the incidence of drug use-related
infections and overdose, and encourage active drug users to contact health and social
services.
Indicative prevention
Indicated prevention aims to identify individuals who are exhibiting early signs of substance
abuse (but not DSM-IV criteria for addiction) and other problem behavior and to target them
with special interventions. Please consult for details
http://www.emcdda.europa.eu/topics/prevention .
Inpatient treatment
Is treatment in which the patient spends the night in the treatment centre.
Outpatient treatment
Is treatment where the patient does not spend the night at the premises.
Prevention Intervention
Prevention intervention describes an activity that will be carried out in order to prevent
substance use behavior. Prevention interventions can be realized in different settings and
with different methods and contents. The duration can vary between one-off activities and
long-term projects running for several months or more. Please consult for details
http://www.emcdda.europa.eu/topics/prevention.
Price and purity information
Street prices of cannabis, heroin, cocaine, amphetamine, LSD and ecstasy in the different EU
countries are provided in Euro. Also data on the potency of cannabis products and the purity
of heroin (white and brown), cocaine products (cocaine and crack) and amphetamine are
presented.
Problem drug use (High-risk drug use (HRDU))
Up to 2012 the EMCDDA defined problem drug use as injecting drug use (IDU) or long
duration/regular use of opiates, cocaine and/or amphetamines. However, in 2012 a new
definition of ‘high-risk drug use’ was adopted. This new definition includes ‘problem drug use’,
but is broader (mainly in its inclusion of high-risk use of more substances) Please consult for
details http://www.emcdda.europa.eu/activities/hrdu .
Selective prevention
14
Country Overview Guidelines
Selective prevention strategies target subsets of the total population that are deemed to be at
risk for substance abuse by virtue of their membership in a particular population segment, e.g.
children of adult alcoholics, dropouts, or students who are failing academically. Please consult
for details http://www.emcdda.europa.eu/topics/prevention
Substitution/Maintenance treatment
Substitution therapy (“agonist pharmacotherapy”, “agonist replacement therapy”, “agonistassisted therapy”) is defined as the administration under medical supervision of a prescribed
psychoactive substance, pharmacologically related to the one producing dependence, to
people with substance dependence, for achieving defined treatment aims. Substitution
therapy is widely used in the management opioid dependence. (Adopted from
WHO/UNODC/UNAIDS position paper Substitution maintenance therapy in the management
of opioid dependence and HIV/AIDS prevention, 2004).
Treatment centre
A drug treatment centre/programme is any facility that provides drug treatment (including
interventions whose primary goal is detoxification; interventions whose primary goal is
abstinence; substitution treatment; specialised/structured longer term drug programmes;
interventions aimed at reducing drug-related harm if they are organised in the framework of
planned programmes; psychotherapy/counselling; structured treatment with a strong social
component; medically assisted treatment; non-medical interventions inserted in planned
programmes; specific treatment in custodial settings towards drug users) to people with drug
problems. Treatment centres can be specialised centres, focusing on the treatment of drug
users, or included in bigger centres targeting different client groups (e.g. mental health
patients, alcohol users, etc.). They can also be based within centres that are medical or nonmedical, governmental or non-governmental, public or private. (EMCDDA Treatment
Demand Indicator Protocol version 3.0, 2011).
Treatment demand indicator (TDI)
This indicator measures the yearly uptake of treatment facilities by the overall numbers
entering treatment for drug use, and by the numbers amongst these of people entering for the
first time (treatment incidence). Information on the number of people seeking treatment for a
drug problem provides insight into general trends in problem drug use and also offers a
perspective on the organisation and uptake of treatment facilities. Treatment demand data
come principally from outpatient clinics' treatment records. Please consult for details and
updates http://www.emcdda.europa.eu/activities/tdi .
Universal prevention
Universal prevention strategies address the entire population (national, local community,
school, and neighborhood) with messages and programmes aimed at preventing or delaying
the abuse of alcohol, tobacco, and other drugs. Please consult for details
http://www.emcdda.europa.eu/topics/prevention
15