Strasbourg, 2 December 2009

P-PG/TT(2009)9

11th MEETING OF THE

“EXPERT FORUM ON TREATMENT”

Paris, France

2-3 November 2009

FINAL REPORT

DECISIONS AND ACTIONS

1. Conference on stimulants abuse treatment:

· Date and place: 10-12 May 2010, Strasbourg, France,

· The scope of the conference: treatment of different stimulants and different users’ groups,

· Target audience: policy makers and advisers, professionals in drug treatment field, users’ representatives. It is expected that the conference will be attended by 200-250 participants.

· Permanent Correspondents and Treatment Platform members will decide who will represent respective member state at the conference,

· The participation is free of charge,

· The registration form should be sent to [email protected] before 31 March 2010.

2. Follow up to the Cyprus Conference on Guidelines and recommendations:

· The final list of signals and recommendations to be presented to the Secretariat by February 2010.

4. Integrated/comprehensive/systems treatment was suggested as an overreaching topic for the Treatment Platform work in future. These includes such issues as:

· Co-morbidity (psychic and somatic)

· Systems- organisational challenges

· Human rights

· Involvement of service users

· Training of staff

· Treatment in prisons, through care, alternatives to imprisonment

· Stepped care *from brief interventions to in-patient care)

· Treatment of specific groups (pregnant women, children)

5. The 12^th meeting of the Treatment Platform will take place from 14:30 to 17:00 on 12 May 2010 in Strasbourg, France. The agenda will include:

· Feedback on conference on stimulants abuse treatment,

· Suggestions for the Work Programme 2011-2014.

· Contribution to the Ministerial Conference of November 2010

1. BACKGROUND

Following a Pompidou Group’s Conference “Guidelines and recommendations in drug treatment- Bridging the gap between clinical practice and evidence-based practice” (Guidelines Conference) the 10^th meeting of the Pompidou Group (PG) Expert Forum on Treatment (Treatment Platform) took place on 13-14 May 2009 in Nicosia, Cyprus. The following topics were considered at the meeting:

Feedback on the Guidelines Conference, review of its results and outcomes,
Treatment of stimulants addictions (e.g. addictions to cocaine, crack cocaine, amphetamines, Methamphetamine etc.),
Preparation for the conference on stimulants addiction treatment in Strasbourg in May 2010,
Platform contribution to the Ministerial Conference in November 2010 (signals and recommendations) as well as suggestions for the next Work Programme 2011-2014.

The 11^th meeting of the treatment Platform was attended by 12 platforms members, 2 representatives of the Secretariat and 2 resource persons with a good balance between North/South and East/West of Europe (see Appendix 4 for List of Participants).

2. Pompidou Group’s guidelines CONFERENCE

Dr Gabrielle Welle Strand (Norway) presented a draft summary of the Cyprus conference on guidelines and recommendations in drug treatment (see Appendix 1, P-PG/TT (2009) 8 Draft). After discussion which followed the Platform members agreed to review the summary and present a list of signals and recommendations from the Cyprus Conference to the Secretariat in January 2010. Dr Welle Strand thanked the Secretariat for preparation of the abstracts publication and a website of the conference: http://www.coe.int/t/dg3/pompidou/Files/nicosia_en.asp)

DECISIONS AND ACTIONS

Present a list of signals and recommendations to the Secretariat in January 2010.

3. STIMULANTS TREATMENT OVERVIEW AND CONFERENCE ON STIMULANTS TREATMENT

In Germany there is a gap between early intervention and treatment of young people consuming drugs. Often young people fail to go to treatment. Working with police helps to feel this gap and refer young people to treatment. Judiciary system is one of the access path to reach young people along with internet and school system.

Dr Theo Wessel, Germany

Early interventions for young people is an issue in many countries and as such should be in the agenda of discussions on drug treatment. In general, stimulants users represent population which are often difficult to reach with treatment services. German experience in this respect is interesting and useful.

Lilly Sofie Ottesen (Chairperson, Norway),

commenting presentation of Dr Wessel

Attracting stimulants users is an issue in treatment. Contingency treatment shows certain positive effect. The idea is to start with contingency to attract patients and continue later one with psychological interventions to maintain treatment.

Dr Laurent Karila, France,

regarding contingency management treatment- systematically utilizing reinforcement procedures to modify behaviours of substance abusers in a positive and supportive manner

French guidelines on cocaine treatment will be published by the end 2009. There were based on literature reviews (about 90% of which comes from the USA) and on experience of therapists and practitioners. About 150 recommendations were proposed and later reviewed by 50 experts from around France.

In stimulants treatment no substitution for drugs is possible unlike in treatment of heroin addiction. As a result this type of treatment requires substantial psychotherapy intervention. Also the issue of confidentiality is very important.

Dr Olivier Phan, France

Psychotherapy of cocaine users should be a part of the system approach to treatment. Just therapy is not enough.

There is a certain dilemma in maintaining confidentiality of treatment if, like in Denmark, drug treatment is a part of social services and as such is free of charge. This issue should be looked at while developing stimulants treatment approaches.

Dr Helle Petersen, Denmark

All young people using cocaine need treatment. Unlike adult users who could have a chance to refer themselves to the treatment, who have time to cure themselves, the young users do not have this time.

The issue of brining cocaine users to treatment requires structure which includes prevention, information and early interventions. Low threshold services are needed. It means often that therapists should come to patients themselves.

The goal is to cure addiction, not to provide treatment. Therefore, if a cocaine user could cure him/herself, they should be given this opportunity.

Dr Roberto Pirastu, Italy

Dr Theo Wessel (Germany) presented “FreD goes net” a 8-hours course (during 5 days, 750 euros/participant) which targeted young people, who have recently been caught by the police and were using drugs. The results of intervention helped to reach young people at early stages of drug consumption and in certain cases helped to change their attitudes towards drugs. The detailed evaluation of the intervention in expected in 2010. The project was financed through the EU Public Health Programme. The presentation is available at the Secretariat.

Dr Laurent Karila and Dr Olivier Phan presented French experience in treatment of stimulant users as well as recent work to develop cocaine users treatment guidelines in France. The presentation provided with information both on pharmacological and psychosocial interventions (detailed presentation is available at the Secretariat). Cocaine use is an emerging problem in France with an estimated number of cocaine user which doubled in recent few years.

The presentations were followed by round-table discussion of recent developments in the member states in the field of stimulant drug epidemiology and treatment.

Mr Andre van Gageldonk (Netherlands) informed participants that cocaine use has stabilized in the Netherlands as well as use of ecstasy. New emerging trends- sue of new “party” drugs, harmful to health (e.g. gamma butyrolactone or “GHB”).

Mrs Helle Pettersen (Denmark) reported rise in cocaine use among young people. Also, purity of cocaine is low and there are many additives harmful to health.

Dr Gabrielle Welle Strand (Norway) informed about trend of increase methamphetamine use among stimulant users in Norway. Different user groups require different treatment modalities.

Mr Jose Padua (Portugal) pointed to polydrug use pattern in Portugal- co-use of heroine and cocaine. In general, young people tend to use more stimulants in comparison with 10 years ago.

The round-table discussion was followed by presentation of the framework for the planned conference on stimulants use treatment by Dr Gabrielle Welle Strand (see Appendix 2 for draft framework). The topics for presentations as well as possible presenters and speakers were discussed.

DECISIONS AND ACTIONS

1. 10-12 May 2010- Strasbourg, France- organisation of the Conference on stimulants use treatment. 2,5-day conference will be followed by 0.5-day meeting of the Platform to summaries the results of the conference and assess results of the Treatment Platform work in view of the Ministerial Conference of the Pompidou Group in November 2010.

2. January 2010- the Secretariat should send invitation for the Strasbourg conference which will include the agenda of the conference.

4. SECRETARIAT INFORMATION

Mr Sergei Bazarya (Secretariat) updated participants on Treatment Systems Overview publication. 22 countries have submitted descriptions of their drug treatment systems. The Secretariat will provide edition of the publication so that it could receive the Council fo Europe ISBN number and be published before autumn 2010.

Dr Andrej Kastelic (Slovenia) reported the International conference on Prison Health Protection - what works in the prevention and control of major communicable diseases porgased by the WHO in Madrid on 29-31 October 2009. Dr Kastelic and with Dr Dragan Milkov (Serbia) were presenting the Pompidou Group at the conference and run a workshop on through care. The topic of drug treatment was included in the draft of the conference conclusions which should be finalized in early 2010.

5. DISCUSSION OF THE TREATMENT PLATFORM WORK IN 2007-2010 AND PROPOSALS FOR WORK PLAN 2011-2014

Mrs Lilly Sofie Ottesen presented her view of the work of the platform in 2007-2010. She recalled that the platform had decided in one of the first meetings that the plan of work which the platform received in 2007 was not realistic and had to be adjusted. In her opinion the Platform managed to achieve main objectives but for the future it would be always important to ask if the platform produces enough results in the form of advice for policy makers in view of the resources spent. One of the main advantages of the platform is establishing of expert network which was successfully achieved.

Mr Andre van Gageldonk stressed the importance of the platform meetings and conferences- in his view they clearly help to understand what is important in the field of drug treatment.

Dr Helle Petersen underlined the advantage of the platform meetings because they help to channel signals and recommendations from the treatment field directly to policy makers at European level. Therefore it would be probably more advisable to restrict the number of topics for consideration by the platform and work deeply on developing signals which are of use for policy makers.

The Platform confirmed the list of topics for the next Work Programme as discussed at the meeting in Cyprus in May 2009. Integrated/comprehensive/systems treatment is suggested as an overreaching topic for the Treatment Platform work in future. Subthemes could be some of the following:

· Co-morbidity (psychic and somatic)

· Systems- organisational challenges

· Human rights

· Involvement of service users

· Training of staff

Treatment in prisons, through care, alternatives to imprisonment
Stepped care (from brief interventions to in-patient care)
Treatment of specific groups (pregnant women, children)

The meeting concluded at 12:30 on 3 November 2009.

Appendix 1

Strasbourg, 26 October 2009

P-PG/TT (2009) 8

Conference

“Guidelines and Recommendations in Drug Treatment –

Bridging the gap between clinical practice and

evidence-based practice”

Nicosia, Cyprus, 11-13 May 2009

Elaboration of MAIN topics from the Conference

Main questions

What is crucial and should be considered (by policy makers) when developing national guidelines for drug treatment?

What should be considered (by policy makers) locally, nationally and on an international (European) level?

A. Background and basic assumptions (why guidelines?)

1. Drug treatment in European countries is still to a large extent based on tradition, belief, hope and interests of others than drug users

2. Principles of knowledge-based medicine are useful for drug treatment as in any other parts of medicine

3. Principles of knowledge-based medicine are basic for developing guidelines

4. Results of registration systems and drug research are necessary conditions for guidelines and knowledge-based work

5. Guideline development is a long-term process, requiring inputs from many kinds of expertise

B. Guidelines

1. There are different types of guidelines, e.g.:

a. Guidelines on treatment of different drugs (opioids, stimulants, cannabis)

b. Guidelines on different groups of drug users (dual diagnosis, pregnant patients)

c. Guidelines on different treatment modalities (contingency management, short intervention, detoxification, in-patient treatment, therapeutic communities, compulsory treatment)

2. Guidelines are a (logical) follow-up of the notion of knowledge-based work/practice

3. The literature shows different definitions of guidelines, but crucial aspects or parts of guidelines are:

a. Recommendations, advice, and instructions for choices in daily practice

b. Supporting professional decision making in patient care (checklist function)

c. Based on (consensus-directed) discussions about the available scientific evidence and the state-of-the-art in professional experience/expertise

i. The less there is scientific evidence, the more guidelines are (necessarily) based on professional experience/expertise

4. Guideline-based choices in drug treatment (in daily practice) should be based on the available scientific evidence and the state-of-the-art in professional experience/expertise (see B-3c) plus patient involvement

5. Scientific evidence may change over the years (e.g. by the results of new high-quality studies)

6. Thus, guidelines should be updated regularly in order to remain based on the latest insights in the available evidence

7. Primary goal of guidelines is maintaining or improving the quality of care

a. Quality contains efficaciousness and effectiveness, safety, acceptability, applicability and feasibility

C. Scientific evidence

1. Scientific evidence is retrieved from the international (including - when available - the national) literature

2. This is done with international methodological standards

3. Evidence (sufficient, insufficient, et cetera) can therefore in principle most efficiently be retrieved and determined on international level, but this is rarely done

4. This is partly due to the (still existent!) differences in the grading of evidence (what is sufficient evidence?)

5. These differences in grading evidence can be due to different factors, e.g.:

a. lack of international consensus on a scientifically 'Golden method'

b. differences in grading by researchers, e.g. due to differences in methodological preferences or due to pressures based on morals or interests

6. The evidence base for guidelines

a. Type of study design for different questions

b. Predominantly research on neuroscience (indirectly) and medications used in treatment, but it is a multidisciplinary field

c. Much less research on psychological, social and other issues linked to drug use and treatment

i. We need more research on psychosocial interventions

ii. We need more qualitative research

7. Randomised controlled trials (RCTs)

a. Gold standard in medicine

b. The process of inclusion and exclusion leaves out most of the patients

c. Conclusions based on this type of research, are they relevant in the real world of treating drug dependent patients with somatic and psychiatric co-morbidity?

D. Evidence-based choices of drug treatment in daily practice

1. Knowledge-based drug treatment is based on international (and when available also national) evidence and national professional consensus on experience

2. Guidelines are reasoned action guides for choosing effective treatments

3. This implies changing behaviors/choices of management and professionals

E. The process of making guidelines – focus on these questions are necessary to ensure good processes and good quality guidelines

1. What should be the goal of making guidelines – when should we make guidelines – consider it

a. When practice varies

b. When practice is without effect/harmful

c. When practice is too expensive

2. Who should be responsible for making the guidelines – consider to involve

a. International bodies – can we find guidance?

b. Cooperation with other counties – does a neighbor have anything to contribute?

c. Governmental (national, regional, local) institutions

d. Groups of professionals

e. User representatives?

f. Private actors – pharmaceutical industry, insurance companies?

3. Define who the guidelines shall target

a. Professionals – what groups?

b. Level of care?

c. Users?

F. Implementation of guidelines or evidence-based drug treatment

1. Publishing guidelines presumes that the suggested treatments and care, the recommendations and advice are actually (or to a large extent) implemented

2. Changing choices/behaviors (of management and professionals in drug treatment) in general meets many limiting factors (see the state-of-the-art in the implementation literature)

3. Implementation seems to be easier when guidelines are on a national level (not too generally formulated) reflecting national context characteristics

4. Implementation should be facilitated by persuasion and funding

a. Persuasion and funding are interrelated: one does not work without the other

b. E.g. Persuasion of

i. decision makers of national, regional and local drug policy

ii. managers in the drug treatment field

iii. professionals with different expertise in drug treatment

c. E.g. Funding by

i. national, regional and local governments

ii. medical insurance companies

iii. professional organizations (?)

5. Revision of guidelines are as important as making them

G. Guidelines and drug laws

Existing national drug laws may limit the feasibility of implementing guideline-directed choices for instance because knowledge-based interventions (or specific pharmacological treatments) are illegal (e.g. substitution treatment for opiate users)

H. Guidelines and drug research

1. We lack knowledge about the needs concerning treatments of specific user groups

2. There is a lack of evidence for effectiveness of pharmacological treatment for addiction to other illegal drugs than opiates

3. There is a lack of qualitative research into user groups and context characteristics on local level

4. There is a lack of evidence concerning psychosocial treatment

Guidelines for guidelines

There is no international accepted standard for guideline development.

The following literature could be consulted:

NICE = National Institute for Health and Clinical Excellence – handbook for making guideline
SIGN = Scottish Intercollegiate Guideline Network
Guidelines for WHO Guidelines

The following paradoxes must be kept in mind

Paradox I

Persons with drug addiction are very diverse and are often suffering from many conditions – medical, psychological and social - requiring multiple interventions simultaneously over a long period of time. RCT and similar effect study designs are generally considered most suitable for studying the effect of simple and relatively brief interventions on clearly defined populations.

Paradox II

Most of the evidence base for substitution treatment concerns the pharmacological part of the treatment. Most treatment for drug abuse also comprises psychosocial interventions.

Paradox III

“Good” science rarely considers context. All human action is linked to certain contextual conditions.

Recommendations

Long term funding of national systems of patient registration (who are the clients to be treated?), monitoring (what kind of treatments are actually used?) and drug research (e.g. experiments on effectiveness of treatment interventions in national contexts) are necessary conditions for guidelines and knowledge-based choices (see A4 and H).

Guidelines are costly and need long-term funding arrangements in order to enable to fulfill their function properly (see A5, B5 and B6).

Funding rules/regulations may increase the rate of acceptance of implementation of guidelines (see E4). For instance, creating (by legal arrangements and funding) systems of monitoring, benchmarking and/or performance indicators the behaviors/choices of decision makers and professionals in drug treatment may be redirected. This should be done after persuasive activities that should alter perceptions of what kind of drug treatment is "good enough" for the clients. Persuasion can also be facilitated by increased international contacts ("hearing other songs") between management and between professionals in drug treatment. These contacts should be actively stimulated.

Application of evidence-based treatment modalities should be legal or legalized (see G).

Appendix 2

CONFERENCE ON STIMULANT ABUSE TREATMENT –

TREATMENT PLATFORM OF THE POMPIDOU GROUP

10.-12.MAY 2010

Draft Programme

(Version of 27 January 2010)

Objectives: Share experience, explore European cooperation

Venue: STRASBOURG

Date: 10. -12.May 2010 (2 ½ days)

Structure: The conference contains a mixture between plenary sessions, workshops and discussions.

Invited audience: Everybody interested in stimulant treatment/best practise in treatment of stimulant treatment in Europe.

The conference targets:

· Policy and decision makers

· Professionals of any profession within drug treatment

· User’s representatives.

Scope of conference:

Cover all stimulants
Cover different user’s groups
Main focus treatment, less on prevention

Maximum numbers of participants: 200 - 250

As a start each nation can list 10 participants (excluding lecturers), but nations can also have waiting lists of approx 10 people, as some of the member states most probably will not send 10 people.

Announcement of conference: Invitation will be sent to Permanent Correspondents and Treatment Platform members, who will decide who they should invite. In addition all speakers will be asked to help us promote the conference in their countries.

Economy: Please try to fund your own presenters. The money the Pompidou group has for the conference should be used to the countries which are less affluent.

MAY 10^TH 2010

Plenary

0900 – 1000 Registration

1000 – 1045 Addressing Stimulant Use from Policy to Practice OK

Dr.Michael Farrell UK

1045 - 1130 Neurobiology and pharmacology of different stimulants OK

Prof.Gaetano Di Chiara, Italy

1130 – 1200 Coffee break

1200 – 1245 Epidemiology of stimulant abuse and different users’ groups

Linda Montanari, EMCDDA OK

1245 – 1430 Lunch

1430 – 1600 Parallel session I

Different user’s groups/hidden populations

Problem amphetamine and methamphetamine use, related consequences and responses OK

Danica Klempova, EMCDDA

Gay communities/the rich and famous…

To be announced

The special needs of pregnant cocaine abusing women OK

Andjela Bäwert, MD

University Clinic of Vienna Austria

B. Country experience I

1. Denmark

Thomas Fuglesang OK

2. The rich and famous….

To be announced

3. To be announced

Country experience II

1. Russia

To be announced

2. Methamphetamine users in drug services in the Czech Republic

Viktor Mravcik, MD, Head of the Czech National Monitoring Centre for Drugs and Drug Addiction, Czech republic OK

3. Slovakia – treatment of methamphetamine users OK

Lubomir Okruhlica, MD, PhD

1600-1630 Coffee break

1630 – 1800 Parallel session II

Somatic comorbidity

1. Title to be announced

Stephan Walcher, Germany OK

2. Health correlates of stimulant injecting in the Baltic countries OK

Estonian research team

3. Acute intoxications with stimulants/deaths due to stimulants OK

Dr Gregorio Barrio, Spain

Psychiatric comorbidity

1. Prevalence, symptoms and treatment of (meth)amphetamine psychosis

Jørgen G Bramness, Norway OK

2. To be announced

3. Stimulant use and psychiatric comorbidity

Nusa Segrec and Andrej Kastelic, Slovenia OK

Social harm caused by stimulants

1. To be announced

2. To be annonced

3. To be announced

MAY 11^TH

0900 – 0945 Psychosocial treatment of stimulant abuse

Olivier Phan, France OK

0945 – 1030 Pharmacological treatment of stimulant abuse

Dr.Laurent Karila, France OK

1030 – 1100 Coffee break

1100 – 1230 Parallel session III

Psychosocial treatment

1. CRA and vouchers

Laura Defuentes, Netherlands OK

2. To be announced

3. Group treatment of cocaine addicts – method and results OK

Development Manager Christian Solholt and senior consultant Dorrit Pedersen, Denmark, City of Copenhagen

Different treatment for different populations/attracting people to treatment

1. To be announced

2. Web site consults short residential and daily community for cocaine treatment in Italy OK

Augusto Consoli, Italy

3. Community as method; TC and collectives in stimulant abuse treatment OK

Martin Blindheim, senior adviser, Norwegian Directorate of Health

I. Pharmacological treatment

1. Pharmacological treatment in Sweden OK

Prof.Johan Franck, Sweden

2. Pharmacological strategies in young cocaine users OK

Roberto Pirastu, Italy

3. Pharmacological treatment of stimulant abuse OK

Michael Soyka, Germany

1230 – 1430 Lunch

1430 – 1530 The French guideline process – treating cocaine abuse

Dr.Olivier Phan and Dr.Laurent Karila, France OK

1530 – 1600 Harm reduction

To be announced

1600 – 1630 Coffee break

1630– 1800 Parallel session IV

Harm reduction

1. Harm reduction and stimulant abuse in Germany OK

Theo Wessel,

2. Drog Art OK

Mina Pas, Slovenia

3. Title to be announced

Jan Krul, Educare, Netherlands OK

Custodial settings

1. Stimulant abuse in custodial settings OK

Heino Stőver, Germany

2. Drug use in prison OK

Brenda José, WHO

3. Release of drug users from prison OK

Lars Møller, WHO

Country experience III

1. Title to be announced

Hungary OK

2. To be announced

3. Treating methamphetamine dependency

Dr.Laurent Karila, France OK

MAY 12.TH 2009

0900 – 0945 45 Minutes From the Other Side of the Story

Hilde Nicolaisen and Ragnar Moan, RIO – Recovered Addicts Interest Organisation, Norway OK

0945 – 1015 Break

1030 – 1200 Parallel session V

Future challanges/development

1. To be announced

2. To be announced

3. To be announced

Training of professionals

1. Training of professionals

Wim Buisman, Netherlands OK

2. Title to be announced OK

Thomas Egli, Switzerland

3. A new speciality in addiction medicine OK

Gabrielle Welle-Strand; Norway

European/international cooperation

1. MoreTreat

2. EMCDDA?

3. WHO?

4. EU commission?

1200 – 1300 Panel discussion – future challanges/ European cooperation

1300 – 1330 What are the lessons to be learnt from this conference?

– Messages to policy makers

Professor Helge Waal, Norwegian Centre for Addiction Research OK

12^th Treatment Platform meeting (members of the platform only)

MAY 12.TH 2009

1430 – 1630

Summary of the conference’s outcomes

Round table discussion- overall work of the Platform during Work Programme 2007, signals and recommendations

Round table discussion- contribution of the Treatment Platform to the Pompidou Group’s Ministerial Conference in November 2010.

APPENDIX 3

11^th Meeting of the Treatment Platform

Bureau de Paris du Conseil de l'Europe

55, Avenue Kléber, salle 1

Paris, France

2-3 November 2009

Programme

Purpose

- Collection of signals and recommendations on treatment (round table discuss on current state of affairs in the treatment field in the member States) with special focus on treatment of stimulants addictions (e.g. addictions to cocaine, crack cocaine, amphetamines, Methamphetamine etc.)

- Preparation of the conference on treatment of stimulants addiction (place: Strasbourg, tentative dates May 2010):

· Finalize agenda

· Prepare list of speakers/presenters

· Agree on products of the conference (publications, projects, etc.)

- Follow up to the Cyprus conference on treatment guidelines: finalizing list of signals and recommendations

- Evaluation of the Treatment Platform work in 2007-2009, suggesting activities for the new Work Programme 2011-2014 and preparation for the Ministerial Conference in 2010

Time:

MONDAY, 2 NOVEMBER

Comments

09:00

09:30

09:45

10:30

Registration

1. Welcome and introduction of participants

2. Presentation of the experience in stimulants addiction treatment:

Presentation by Dr Theo Wessel, Germany

Presentation by Dr Laurent Karila, France

3. Round-table discussion of the stimulants addiction treatment

New information from the members of the Platform

11:15

Coffee Break

11:30

3. Presentation by Dr Olivier Phan, France

followed by the discussion

12:30

Lunch Break

14:00

4. Discussion of the stimulants addiction treatment conference:

- key note speeches topics,

- workshop topics,

- list of speakers and workshop facilitators

See draft framework of the conference attached

15:30

Coffee Break

15:50

17:00

5. Summary of the discussion

END OF WORKIN DAY 1

Outcomes:

- framework of the conference finalised

- working group to organise conference is formed

TUESDAY, 3 NOVEMBER

09:30

10:00

6. Follow up to the Cyprus conference on treatment guidelines: finalizing list of signals and recommendations

7. Evaluation of the Platform work in 2007-2009- presentation by Lilly-Sofie Ottesen

8. Roundtable discussion of the work in 2007-2009

See P-PG TT-2009-8 DRAFT Guidelines and Recommendations in Drug Treatment: topics to be considered when governments develop guidelines

11:00

Coffee Break

11:20

12:00

12:30

9. Discussion of the Treatment Platform work in 2011-2014

10. Summary of the meeting including further plans and future meetings

END OF THE MEETING

Integrated/comprehensive systems treatment was suggested as an overreaching topic for the Platform work in 2011-2014. These includes such topics as:

- co-morbidity (psychic and somatic)

- systems- organisational challenges

- human rights

- involvement of service users

- training of staff

Appendix 4

List of participants

Bulgaria

Excused Dr. Emil GRASHNOV

Lagera 37A

BG-1612 SOFIA

Bulgaria

Email: [email protected]

Croatia

Excused Dr. Draga KATALINIĆ

Head of Register of Treated Drug Addicts

Croatian National Institute of Public Health

Rockefellerova 7, 10 000 Zagreb

Tel: +385 (1) 4863 240

Fax: +385 (1) 4683 011

Email: [email protected]

Cyprus

Excused Dr. Argyris ARGYRIOU

Cyprus Anti-drugs Council
Tel. +357 (22) 442966
Fax +357 (22) 305190
Email [email protected]

Czech Republic

Excused Mr. Kamil Kalina

M.D., PhD., MSc.

Executive Director of the Unit, Office of the Government of the Czech Republic

National Drug Commission, Office of the Government of the Czech Republic National Drug Commission

Nabrezi Edvarda Benese 4

118 01 Prague 1

Tel.: +420 296 153 265

Fax: +420 296 153 574

Email: [email protected]

Denmark

Ms Helle PETERSEN

Danish National Board of Health

67, Islands Brygge

DK-2300 Copenhagen S

Tel.: +45 (72) 22 77 81

Email: [email protected]

Estonia

Excused Anu HARJO

National Institute for Health Development

Hiiu 42

11619 TALLINN

Tel : +372 6593974

Fax : +372 6593979

Email : [email protected]

France

Excused Dr Ruth GOZLAN

MILDT

7 rue Saint Georges

75009 PARIS

Email :[email protected]

Dr Olivier PHAN

Médecin Psychiatre

Institut Mutualiste Montsouris

6 rue de Richemont

75013 Paris

France

Tel: +33 (0) 1 53 82 81 70

Email: [email protected]

Dr Laurent KARILA

Center for Studies, Research and treatment of Addictions, Villejuif, France

Email: [email protected]

Germany

Dr. Theo Wessel
GVS - Gesamtverband für Suchtkrankenhilfe
im Diakonischen Werk der Evangelischen Kirche in Deutschland e. V.
Altensteinstr. 51

D-14195 Berlin
Tel.: +49 30 843 123 57
Fax: +49 30 844 183 36
Email: [email protected]

Hungary

Dr. József RÁCZ

Institute for Psychology

Hungarian Academy of Sciences

Budapest

Tel : +36 (20) 925 6568

Email: [email protected]

Ireland

Excused Brion Sweeney

Consultant Psychiatrist in Substance Misuse

Clinical Director HSE Northern Area Addiction Service

Drug Treatment Centre Board,

Trinity Court,

30-31 Pearse St, Dublin2

Ireland

Tel: 00353 1 6488650

Email: [email protected]

Italy

Mr Augusto CONSOLI, MD

Dipartimento Dipendenze

Asl 4 Corso Vercelli 15

10152 TORINO

Tel : +39 (01) 12484016

Fax : +39 (01) 1237458

Email : [email protected]

Mr Roberto PIRASTU, MD

Viale Trento 28

09013 Carbonia (CI)

Email : [email protected]

Luxembourg

Excused Mr Alain ORIGER

National Drug Coordinator

Ministry of Health

Directorate of Health

L-2120 Luxembourg

Netherlands

André van Gageldonk, PhD

Senior Research Fellow

Netherlands Institute of Mental Health and Addiction (Trimbos Institute)

Da Costakade 45

P.O.Box 725

3500 AS Utrecht

Tel.: + 31 30 2959201 / + 31 30 2971100 (general)

Email: [email protected]

Poland

Excused Ms. Boguslawa BUKOWSKA

Deputy Director

National Bureau for Drug Prevention

Ul Dereniowa 52/54

PL- 02-776 WARSAW

Tel.: +48 22 641 15 01

Fax: +48 22 641 15 15

Email: [email protected]

Portugal

Mr. Jose PADUA

Ministry of Health

Praça de Alvalade, 7 - 5th to 13th Floor

1700-036 Lisboa

Portugal

[email protected]

Excused Mr. Silva Rui PEDRO

Ministry of Health

Praça de Alvalade, 7 - 5th to 13th Floor

1700-036 Lisboa

Portugal

[email protected]

Romania

Excused Mr Bogdan GHEORGE

Email : [email protected]

Excused Mrs Catalina NICULAE

[email protected]

Russian Federation

Dr Stanislav MOKHNACHEV

Head of clinical department of drug addiction

Nat.Res.Center on Addictions

Russia

Email: [email protected]

Slovack Republic

Excused Mr Lubomir OKRUHLICA, M.D., PhD.

Expert for Medicine of Drug Dependencies

Centre for Treatment of Drug Addiction

Hranicna 2

821 05 Bratislava CPLDZ

Tel : +421 2 534 17 475

Email : [email protected]

Slovenia

Mr. Andrej KASTELIC

Head of the Center for Treatment of Drug Addiction

Center for Treatment of Drug Addiction

Ljubljana

Email: [email protected]

Sweden

Excused Mrs Elisabet Aldenberg
Social Services Division
Ministry of Health and Social Affairs
Visitor's adress: Fredsgatan 8
SE-103 33 Stockholm
Tél : + 46 8 405 30 01
Email : [email protected]

Switzerland

Excused Mr Thomas Egli
Eidgenössisches Departement des Innern EDI
Bundesamt für Gesundheit BAG
Direktionsbereich Öffentliche Gesundheit
Sektion Drogen
Schwarztorstrasse 96, CH-3007 Bern
Tel. +41 31 323 80 19
Fax +41 31 324 46 48

Email : [email protected]

United Kingdom

Excused Dr. Michael J. A. KELLEHER

Marina House

The Maudsley Hospital

63-65 Denmark Hill

Camberwell - London

United Kingdom

Email: [email protected]

EMCDDA

Excused Alessandro PIRONA

EMCDDA