A side event organized by Dianova International, Proyexto Hombre and Kethea, in the course of the 58th session of the Commission on Narcotic Drugs in Vienna. March 2015.
Adjusting Drug Treatment Programs for better Efficiency. #CND58 Vienna
1. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Co-Morbidity & Therapeutic
Communities
Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
www.dianova.org www.dianova.es
Adjusting Treatment Modalities for Better
Treatment Efficiency
Challenges Meet Current Tools
Gisela Rodríguez-Hansen
2. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Canada
Chile
Slovenia
Spain
Italy
Nicaragua
Portugal
Sweden
Switzerland
Uruguay
USA
Connections with Prominent International Organizations
3. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Therapeutic Communities: Original Framework
Alternative to traditional psychiatric hospitals & clinics
Drug-free (TC’s trademark identity)
Self-help and mutual help were the original tools
Peer-operated community (e.g. Synanon and Le Patriarche)
No scheduled reintegration plan
4. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
TC: Intervention Model
Holistic, biopsychosocial and educational approach
Acquisition of healthy lifestyles
Individualized educational & psychologichal goals
Average duration 6-9 months
Multidisciplinary team
Outpatient post-treatment follow-up
Adequate educational and therapeutic environment
5. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Evolution (Last Decades)
New, different clients
New substances of abuse
New psychopathological profiles
2 decades increasing % of co-morbidity in TC
Need for change or adaptation of TC
methodology
6. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Population in Dianova Italy - 2015
183 users
AXIS I disorder
diagnosis
39,9%
AXIS II disorder
diagnosis
47,5%
Axis I and II
diagnosis
12.6%
AXIS I disorder AXIS II disorder
Mood disorder 39,7% Borderline personality 32,2%
Anxiety disorder 21,9% Antisocial personality 20%
Schizophrenia 13,7% Avoidant personality 8%
Classification based on the Diagnostic & Statistical Manual of Mental Disorders (DSM IV)
7. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Our “New” Clients: Some Traits of Users
with Co-Morbidity
Low awareness of mental disorder
Passive attitude and poor autonomy in daily tasks
High cognitive and social impairment
Heavy history of hospitalization
‘Different’ reaction to frustration: less tolerance
Low adjustment to changes in daily routines
Side effects of medications interferes with daily activities
8. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Changes in the Intervention Model: Dealing with
Increasing Co-Morbidity in TCs
• Both users live in the
community
Integrative
Model
• Reserved for users
with dual pathology
Specific co-
morbidity
Model
TwoOptions
9. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Adjusting programs to new profiles
Providing specific training to multidisciplinary teams
Dealing with conflicts arising from the coexistence of both users’ profiles
High dropout rates due to sense of routine and lack of motivation
Staff burnout due to simultaneous work with both profiles
Challenges Identified to Integrative Model
10. Side Event – Commission on Narcotic Drugs – March 2015
Commitment | Solidarity| Tolerance | Internationality… A Network of Values
Changes in the Intervention for Co-Morbidity Approach
Increase in the frequency of individual tutoring
Adjustment of program’s intensity to patient's abilities and capacities
Different program schedule, pace and intensity
Phase shifts depending on the achievement of objectives
Supervision of activities including leisure time
Implementation of specific groups (i.e.medication)
11. www.dianova.org
An NGO with Special Consultative Status to the ECOSOC
Representing civil society to the Organization of American States
Official Partner of the UNESCO (Consultative Status)
Member of the European Forum on Drugs
www.dianova.es
Thank You!