Side event – COPOLAD: Evidence-Based Tools and Resources Available for CELAC and EU Countries

Gisela Spreitzhofer
COPOLAD is a partnership between CELAC AND EU.
6.6 million Euros for 42 months from the EU. 

Hector Suarez
Protocol for estimating drug-use related mortality by direct and indirect causes.

Why is this indicator important? Because of the need to have reliable scientific evidence on the health impacts of harmful use of drugs, especially with regards to the most serious and irreversible consequence, which is death. Also, to identify which drugs are the most harmful. Indicator will also give us more information about the uses of emerging drugs and their health impacts. Will also help us calculate the social and economic cost associated with drug use (such a productivity losses due to premature death).

There has been poor development of such indicators in the past. There were methodological issues around this type of indicator. COPOLAD carries out surveys on training needs. In such surveys, countries recently pointed out their interest in having training on carrying out mortality indicators. Also expressed their belief in the need of comparable indicators between Latin America and the EU.

2007 – Meeting in Argentina where the first protocol was developed.

The methodology, sources of information, error margins, and possible under-reporting were later studied.

Argentina carried out a test pilot in their country in order to identify how much under-reporting there was using that methodology.

2014 – COPOLAD organized workshop by Argentina presented a protocol.

Direct Mortality – For the purposes of the protocol, the acute reaction to the use of one or many drugs. Cause of death is attributed to drug use or direct consequence of actions arising from the drug use. Indicator is related to the number of cases recorded according to this definition, which is transformed into the portion of the population studied.

Indirect Mortality – Indirect result or consequence of drug use is based on the affect of drugs on certain chronic disorders. Need more information.

 Julian Wilches
What was the aim? We wanted to share technology, procedures and methodologies for collecting information, who was in charge of it, etc. with the aim of developing a conceptual framework that would allow us to share a minimum of information regarding drug supply indicators. 

Five main items: production, judicial actions, seizures, market, and infrastructure. Market might be enormous, because there are many of them. Production, have to understand the business, what is the size; how much can be produced? Same for the market, how much is it worth? Have to know the size of the business of armed groups. State response – how much am I seizing? The same substance in different countries can be measured differently, and is therefore problematic for comparisons. Have managed to standardize the way we measure different types of substances. Infrastructure has the same problem of comparability. The first step is to agree on how to have the best information regarding drug supply indicators.

Next step that would have to be taken has to do with correctly measuring these indicators in order to overcome this problem. Coca is located and cultivated where there is no state intervention. Not only a question of reducing the cultivated area, but 73% of crops are located less than two kilometers than where they were located before eradicated. We have to address the factors that allow crops to be cultivated there. Then, we have to fight against the threat of illicit cultivation, but also reduce the vulnerabilities of those territories. The list of vulnerabilities is a long one. Today, we are agreeing on how to measure the threat. Next step, how to measure vulnerabilities in order to move forward and overcome the factors that allow illicit crops to grow in the state.

Jessica Huertas
Online training courses promote more engagement by practitioners and allow to reach people in different parts of the world. Practitioners can progress on their own time, which is important because this works in an interactive way with the users. We have a variety of teaching resources that allow for critical reflection. We want to promote engagement by the practitioners, which means exchanging their knowledge, not just continuing to learn. Teaching is not only to transfer knowledge but to create the possibility of generating new knowledge.

What kind of training do we offer? Two course: 1) Social and health care for drug dependence, starting with primary care and 2) Consumption of alcohol and other drugs. Both courses are oriented towards professionals who create policies and guidelines in public health. We have reached 136 practitioners in the first course, and 51 practitioners in the second course.

What is our success? Managed to train 187 professionals, and ensured the sustainability of the training effort. The courses are subsidized by the countries themselves, and are adjusted and modified to meet their own conditions.

Issues? Constant challenge is that the situation changes constantly. So we have to change according to the technology (ex. PC to Smartphone). Must use resources that are up to modern technology. Also, training course must cover all the issues related to drugs, not just production and trafficking. In the jungle, the illicit traffic is related to health. Young boys get diseases from the processing cocaine. Courses need to cover all the issues of damage.

Fernando Cano
We want a publication for the entire continent, and that is why the fact that COPOLAD and OPS are merging allows us to say that the Caribbean will also participate in this event that I am presenting.

Addiction is a chronic disease. Therefore, there is a repeat. Those lapses are an issue that has to do with health-care. There is the human right to treat that disease, and the state is responsible for it.

Legal consequences – in Mexico, 60% of criminal conducts are committed by people that have consumed alcohol. 90% of prison inmates consume drugs.

In the U.S., 60% to 80% of those arrested in big cities gave a positive result in screening tests for drugs. In 2012, the number of people 12 years old that needed treatment was 8 million; only 1.5 million required treatment and received it. 1 million adolescents need it, and only 130 thousand received it. We need treatment models targeting that population. People with addictions, if they have committed an offence, go to prison institution where they are not treated for the disease and therefore are not properly rehabilitated. Need models at the level of the continent. Development of publication that includes scientific evidence.

Purpose? Document becomes a reference with regard to the principles that give orientation to treatment models. Support by evidence and respect human rights.

Goals? Spread scientific evidence regarding different experiences in different countries. Legal framework currently existing needs to be reviewed. Must publish the document as an educational tool. Treatment principles are essential.

Index proposal has to do with experiences and models that are an alternative to treatment. Factors that are key for the implementation of therapeutic justice programs.

We will publish this, and the aim is to stimulate COPOLAD so that the second stage of the projects can continue.

Francisco Babin
This side event was designed to show the various tools and products that have been created in the course of the program. This all fits into a global strategy of strengthening the mechanism for cooperation and coordination between Latin America and the EU. These are not dispersed efforts, but one coherent effort.

Resources that are already available or will soon be available relating to the third component, which is training for drug demand reduction.

BIDA – Library on drugs and addiction – Shares in an accessible space all the literature that is done on the Latin American region in the field. Sometimes, there is not enough access. So we wanted to upgrade the value of these publications through this platform, so they are at the disposable of researchers, practitioners, policymakers, and the public. This is the largest collection of documents on drug addiction in Latin America. Many countries participated.

RDD – Work done to identify criteria for demand reduction programs – From different perspectives, a lot has been done to develop programs of this type, but not so much on the establishment of criteria to rehabilitate drug dependent people. An enormous range of possible criteria was submitted to experts that could be general or specific to different aspects (prevention, treatment, rehabilitation, etc.). This has allowed us to establish common criteria that are relevant to all aspects, or other criteria that are based on evidence and have some backing to improve the quality of different interventions.

Paso @ Paso – Artificial intelligence tool developed for planning purposes for drug demand reduction programs. For planning purposes, the perspective of professionals must be taken into account, but these people sometimes do not have exposure to operational or strategic planning tools. This tool helps the user to carry out a viability study of the various alternatives that are possible, and from there, the user can identify the objective and the target population, choose a model, define a plan of action, and a plan of sustainability. Generates structure strategies that are based on evidence and can be developed with a certain guarantee of success, since the variables involved have been controlled. This tool requires some training for its used, and since it is a support tool, it is going to start in the second semester of this year at various training events (in Mexico, Bolivia, and Brazil).

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