Side event: Roads to Recovery – Quality Standards for the Treatment of Drug Use Disorders

Gilberto Gerra, UNODC, Chair: thanks board, floor and CSTF. Roads to recovery are different and varied. Each person has a unique history and needs a personalized response. Equally important is to recover good health, dignity, interpersonal relationships. No one can recover without community. This is key.

Mr. Yuri Fedeltov, UNODC: For several years the UNODC has joined with civil society and Sweden, a country with long standing commitment to prevention services, including UNODC and WHO. In recent decades many advances have been made in understanding drug use as a multifaceted health issue. Care must be provided like it is for any other disease. Unfortunately, PWUDs do not have access, far too often. The focus and priority must be the human dimension.

Mr. Michael Botticelli: Supporting and understanding recovery for substance misuse disorders is crucial. It is good to see these terms being used at the CND. The best way to stop the spread of drug use is treatment. Majority of countries are against the creation of stigma. Visibility and vocally supporting recovery will help to reduce stigma. PWUDs must be received with loving arms and positive high profile support is vital. Positive messages lead to more people receiving treatment. Will lead to more secure society. Challenges remain great. Health services are not available to those who need them. True of US and elsewhere. Obama has recently asked for largest increase in opioid dependence treatment in US history – now equally funded as supply reduction, for first time. Better cooperation between criminal justice agencies. I am grateful to the hard work of WHO and UNODC and experts. Urge countries to do as the US has and assess what services are needed for drug users. Demand reduction is as important as security and supply reduction concerns. This idea requires champions.

Mr Borislav, CSTF: I’m glad that the right language has been incorporated. I had drug dependence issues. My definition of recovery is the Scottish one recently released by UK gvt:  it is a “process”. It is good to see that we are there to enable people to be free of problem drug use. Some people may reach a fragile abstinence, but we should continue to encourage reintegration to strengthen recovery. Best practices: Successful drug use programs exists. Drug use is a recoverable condition. recovery orientated systems of care can redeem mental capital, including self esteem etc. Quitting drugs can have positive economic impacts – reducing unemployment, treatment etc. Recovery should be considered important aspect of treatment. UN states and agencies should implement effective drug policies. Finishes with second definition of recovery: “recovery is about people re-building meaningful drug free lives where individuals can realize their aspirations, and be treated with respect and dignity, and contribute to society”

Mr Vladimir Poznyak, WHO: the situation in many parts of the world is that effective treatment is not available. They are often given with a fee, which aggravates pre-existing problems of financial and social hardship. Can’t just be offered as specialized health services, but rather must be integrated: social services, psychiatric services, general medical services all need to be delivered in conjuncture. Provision of treatment services in low income countries can mean the difference between life and death. Drug disorders often lead to death in the young. Treatment must be made to look attractive. Public health polices should empower and provide ethical treatment to people.

Aldo Lale-Demoz, UNODC: Our primary objective is to stop demand and drug use. We are launching international standards at this CND, by UNODC and WHO. They are strongly linked to sustainable development agenda 3.5: to tackle drug abuse problems. Ethical and evidence based treatment is important. Services must take into account the special needs of woman and special groups. They must be integrated into existing health care services and cannot exists in isolation. Investing just $1 in treatment services can yield twice that in the reduction of crime and health costs to society. Most of us here hope that treatment will be integrated, and will have wider availability as soon as possible.

Gilberto Gerra, UNODC, Chair: Thanks Aldo for pushing so hard on this issue.

Ms Charlotta Rehnman-Wigstad: National board of health and welfare works to ensure everyone has equal access to health and welfare.  Works with both healthcare and social services to ensure this. National guidelines have been developed – 15 in total. What is the aim and purpose of these? to ensure people have access to good health and medical care. They are aimed at decision makers. They support priority settings, allocation of resources, and efficient use of resources . Evidence based practice and equal care is important. It takes a systematic process: scoping, reviewing science, recommendations,  preliminary version, final version, national assessment and evaluation. We have national guidelines for substance abuse and addiction. Our guidelines cover alcohol and other drugs. We use a ranking system: ranking 1-3 = should be used, 4-7 = can be used, 8-10 = can be used in exceptional cases. Follow up through indicators: these enable monitoring of health and social care,  a basis for comparisons of health, and they initiate action in order to improve quality  while facilitating international comparisons.

US Department of State: Drug dependence support and care has been a milestone. Wishes to echoes Mr. Aldo Demo’s comment. Our primary objective is to stop demand and drug use. We support treatment curriculum for special populations. Purpose of our training is to reach more professionals, and further expand the workforce. ICCE is in the process of training practitioners in more than 45 countries around the world. There is an international organization working for medical doctors in this field. One of the key challenges is that scientific research is not translated into practice in a clinical setting. We must confront this.

UNODC and WHO Reps: It is our pleasure to welcome Nick Danzeger who is a photographer who takes pictures of people living in challenging situations. He has documented the lives of many PWUDs. Don’t miss the exhibition, which opens at 5.30 today here at CND. Please do not take photos of the following presentation.

Nick Danzeger – (photo presentation)

Mr Michael Botticelli:  There is a prevailing belief that drug users are bad people, are doing bad things and that they require punitive punishments. Stigma plays a huge role in stopping people seeking care. We pay the price for this in higher costs to society.

Gilberto Gerra, UNODC, Chair: Closes discussion.

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