Local Needs Assessment and Drug Treatment Policies at the City Level

INTER-AMERICAN DRUG ABUSE CONTROL COMMISSION C I C A D Secretariat for Multidimensional Security DRUGS SUMMIT EUROPEAN, LATIN AMERICAN AND CARIBBEAN MAYORS AND CITIES April 21 23, 2010 Lugo, Spain OEA/Ser.L/XIV.4.1 CICAD/DREU-LAC/doc.26/10 5 May 2010 Original: English LOCAL NEEDS ASSESSMENT AND DRUG TREATMENT POLICIES AT THE CITY LEVEL Rodrigo Portilla Catholic University, Santiago, Chile Winston De La Haye, The University of the West Indies, Kingston, Jamaica EU-LAC DRUG TREATMENT CITY PARTNERSHIP Local Needs Assessment and Drug Treatment Policies at the City Level Rodrigo Portilla Catholic University, Santiago, Chile Winston De La Haye, The University of the West Indies, Kingston, Jamaica

EU-LAC DRUG TREATMENT CITY PARTNERSHIP Descriptive Report Status of Drug Treatment at the Local Level (Cities) Information from 19 cities from Europe, Latin America, and the Caribbean If governments are fully aware of the magnitude and importance of the problem..our governments will be able to take the next step, which is to guarantee the resources necessary for those policies to be implemented José Miguel Insulza OAS Secretary General -Report (CICAD 45)

Introduction Improving drug treatment services Magnitude of the problem Importance of the problem Inform policy Assessment of the problem Instrument for the Rapid Assessment of the Status of Treatment for Addressing Drug Use Problems at the Local Level (Cities)

Purpose of the Study Gather and systematize the information needed for a rapid assessment of the current status of treatment in cities Information to be elicited from the competent sources for each area addressed Coordinate with the various sources Purpose of the Study To ensure that we have sufficient, reliable, and timely data Identify needs, priorities and available resources Can serve as a basis for policy decisions

Countries Barbados Bahamas Bulgaria Guyana St. Kitts Suriname Sweden Greece Argentina Brasil Chile Costa Rica El Salvador España México Perú Uruguay General Description of the Instrument

Section I - Identification General data on the city concerned The person responsible for providing the information Section II - Context Variables Describes the context in which the problems arise and solutions are tested Variables corresponding to structural, social, and cultural factors affecting drug use and abuse Positioning of local institutions and their relations with central government Degree of political and financial autonomy of the city or municipality concerned

Section III - Health Variables Describes the public health sector in the city The local government s spheres of competence Principal health care issues Health indicators Availability of health care resources Section IV -Drug-Related Problems Specific information on drug use, its repercussions Local resources available to attend to the affected population Resources available for care -specialized treatment agencies Number of treatment and rehabilitation centers, availability and accessibility

Limitations Information Methodological limitations External factors: A (H1N1) Results

Strengths and weaknesses in providing treatment for dependence on drugs Information systems Strengths and weaknesses in providing treatment for dependence on drugs

Responsibility of the city with respect to public health Country Policy Budgeting Planning Carrying Making out Actions Barbados Total Total Total Total Bahamas None None None None Guyana Partial Partial Partial Partial St. Kitts Partial Partial Partial Partial Suriname Total Total Total Total Sweden Partial Total Total Partial Factors influencing treatment Specific jurisdiction of the city with respect to drugs Degree of autonomy Regulating care provided Specialized services for treatment of dependence Access Infrastructure Human resources (training) Social Integration (sistemas recuperacion)

Central Local Autonomy / Dependence Joint Responsibility Comments Development and application of programmes City involvement Transfer of power (ability to manage resources, monitor) Risk Gothenburg Model Standardized treatment Min. standards Public Private Networking of facilities physical and mental Information systems Utility Comments 1. Fast, easy and flexible assessment of treatment situation 2. Orienting and exploring areas of study (what to watch and where to go) 3. Starting Point Plan Local Drug Development 4. Baseline 5. To account for actions 6. Public Agenda 7. Managing resources 8. Assessment and Monitoring of Quality of Service: neighbour's opinion

Critical steps in conducting an assessment of the status of local treatment services 1. Identify issue 2. Establish core RAS team 3. Conduct initial community consultation 4. Identify parameters of the RAS 5. Establish community consultation process 6. Build and train RAS team 7. Fieldwork (triangulation) 8. Results -reports Substance Misuse in EULAC A predator in paradise! Thank you