Evaluating the treatment of drug abuse in the European Union

Emcdda — European Monitoring Centre For Drugs And Drug Addiction

Description

Papers arising from an Emcdda workshop held in Athens, Greece, on 17 to 18 March 1997 : EMCDDA Monographs
Medical and biological research
Health policy
Target audience: Specialised/Technical

Sujets

• Substance dependence
• Health care system
• Therapy

Informations

• Publié par: EMCDDA-EUROPEAN-MONITORING-CENTRE-FOR-DRUGS-AND-DRUG-ADDICTION
• Nombre de lectures: 73
• Langue: English
• Poids de l'ouvrage: 18 Mo

Extrait

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EMCDDA SCIENTIFIC MONOGRAPH SERIES N°3
Evaluating
the Treatment
of Drug Abuse
¡n the European
Union
■I EMCDDA SCIENTIFIC MONOGRAPH SERIES N° 3
Evaluating
the Treatment
of Drug Abuse
in the European
Union
Papers arising from an EMCDDA workshop held in Athens, Greece, on
17-18 March 1997
PLANNING GROUP
Margareta Nilson
Anna Kokkevi
Petra Paula Merino
Monica Blum
EDITORIAL GROUP
Oswin Baker
Jane Mounteney
E.M.C.D.D.A.
European Monitoring Cenlre
for Drug* and Drug Addiction A great deal of additional information on the European Union is available on the Internet. It can be
accessed through the Europa server (http://europa.eu.int)
Information about the European Monitoring Centre for Drugs and Drug Addiction is available at
http://www.emcdda.org
Cataloguing data can be found at the end of this publication
Luxembourg: Office for Official Publications of the European Communities, 1999
ISBN 92-9168-051-6
© European Monitoring Centre for Drugs and Drug Addiction, 1999
Printed in Italy •JO
> ., c
CONTENTS
ACKNOWLEDGEMENTS
GENERAL INTRODUCTION
Margareta Nilson
PART I: THE THEORY OF DRUG-TREATMENT EVALUATION
INTRODUCTION 11
CHAPTER 1
Evaluating drug-abuse treatment: current and future perspectives
Vincent Hendriks3
CHAPTER 2
Treatment-evaluation literature
Perra Paula Merino 25
CHAPTER 3
Evaluating residential and institutional treatment
Mats Fridell9
CHAPTER 4
Methodological aspects of treatment evaluation
Fabio Mariani 37
CHAPTER 5
Applying economic evaluation in the substance-misuse field
Evi Hatziandreou 43
PART ll: TREATMENT EVALUATION IN PRACTICE
INTRODUCTION 51
CHAPTER 6
Using evaluation results in treating drug addiction
Heinrich KüfnerCONTENTS
CHAPTER 7
Treatment information systems: the Emilia-Romagna experience
Umberto Nizzoli 63
CHAPTER 8
Treatment evaluation in the UK: the National Treatment Outcome Research Study
Michael Gossop, John Marsden, Duncan Stewart, Petra Lehmann,
Carolyn Edwards, Alison Wilson, Graham Segar 67
PART III:.TREATMENT..EVALUATION, AND POLICY
INTRODUCTION 77
CHAPTER 9
The policy-maker's perspective
Elfriede Koller 79
CHAPTER 10
COST A-6's contribution to treatment evaluation
Ambros Uchtenhagen 85
CHAPTER 11
World Health Organisation Programme on Substance Abuse
Maristela Monteiro9
PART IV; WORKSHOP:. CONCLUSIONS
WORKSHOP SUMMARY 9
Anna Kokkevi
RECOMMENDATIONS 10
LATEST PERSPECTIVES 111
BIBLIOGRAPHY5
CONTRIBUTORS 127 UL.
ACKNOWLEDGEMENTS
his monograph contains the papers presented at the 'Workshop on the
Evaluation of Drug Abuse Treatment' held in Athens from 17-18 March T 1997. The volume highlights the work of the University Mental Health
Research Institute (UMHRI) in Athens - and particularly of Anna Kokkevi - in organ­
ising the workshop on behalf of the EMCDDA.
Thanks are due to the workshop speakers, and to Oswin Baker and Jane Mounteney
of the Institute for the Study of Drug Dependence (ISDD) in London who edited them
into a coherent whole.
Thanks also go to the staff of the EMCDDA, in particular to Margareta Nilson, Petra
Paula Merino, Rachel Neaman and Monica Blum, for their work on the workshop
and this monograph.
Georges Estievenart
Director
EMCDDA ou
GENERAL INTRODUCTION
Margareta Nilson
The mandate of the European Monitoring Centre for Drugs and Drug Addiction
(EMCDDA), as set out in its founding Regulation, is to collect, analyse and disseminate
objective, reliable and comparable information on drugs and drug addiction in the
European Union (EU).1 One of the EMCDDA's primary areas of focus is the demand
for drugs and reducing that demand.
Treating drug addiction is one of the main pillars of drug demand reduction. In all
15 EU Member States, specific treatment systems have developed over the last few
decades. In recent years, moreover, many of these systems have been revised and
diversified, largely in response to the spread of HIV and AIDS and to increasing
financial restraints in the public sector.
Knowledge about the actual effects of treatment - what works - has not, however,
always kept pace with these developments. As a result, it is essential to develop and
disseminate high-quality information about appropriate methods, instruments and
indicators to enhance the comprehensive evaluation of treatment programmes for
drug users, as well as to allow for comparative evaluation of different programmes.
Such knowledge not only enables policy-makers to make informed and appropriate
decisions, but also increases the quality of the work carried out by all those involved
in the drugs field. Furthermore, high-quality information can only be obtained from
evaluated treatments.
The EMCDDA is, therefore, focusing on promoting the evaluation of drug treatment
and disseminating this information to policy-makers and professionals throughout
Europe.
The starting point for this work was the EMCDDA 'Workshop on the Evaluation of
Drug Abuse Treatment', held in Athens from 17-18 March 1997. The main aims of
this meeting were:
• to function as a forum for exchanging ideas and experiences;
• to define the EMCDDA's mid-term Work Programme in the field of treatment
evaluation; and
• to raise the profile of the EMCDDA within the relevant scientific community in
Europe.
The participants were asked to tackle priority issues in treatment evaluation, such as
the conceptual frameworks of evaluation and treatment, and the aims of assessing
treatment. Methodologies and implementation were also targeted, as were ways of
1 European Council Regulation (EEC) no. 302/93, 8 February 1993. GENERAL INTRODUCTION
making evaluation information more relevant to professionals and decision-makers
and promoting communication between all those involved.
The workshop was attended by experts from Germany, Greece, Italy, the
Netherlands, Sweden and the United Kingdom. The COST-A6 working group on
evaluating treatment and the World Health Organisation (WHO)'s Programme on
Substance Abuse were also represented.2 The two-day meeting began by examining
the main areas of treatment evaluation. This was followed by a debate, and recom­
mendations for further action were then made to the EMCDDA.
This monograph is made up of the papers presented at the workshop, and is divided
into three sections:
• the theory of treatment evaluation;
• the practice oft; and
• the policy of treatment.
These sections are followed by a workshop summary, a list of the recommendations
made to the EMCDDA for its mid-term work plan on treatment evaluation and latest
perspectives on the Centre's work in this field.
2 COST A-6 is a programme run by the European Commission's Directorate General XII (Science,
Research, Development) to gain valid information concerning the impact of various drug policies and
measures on the extent, nature and consequences of drug abuse.