Drug use, Treatment, Rehabilitation and HIVIssues and Challenges

Gray SattlerCountry Adviser HIV

4 August 2010 Jakarta

The UNODC mandate

Three bodies which all report to the UN Economic and Social Council (ECOSOC)

• The Commission on Narcotic Drugs (CND) is the central policymaking body within the United Nations system dealing with drug-related matters.

• The Commission on Crime Prevention and Criminal Justice is the central body within the United Nations system providing policy guidance on crime prevention and criminal justice.

• The Programme Coordinating Board (PCB) of UNAIDS, (of which UNODC is a Co-sponsor) on HIV.

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6. Sustainable livelihoods

Human Security:Integrated

programmes of work will lead

to measurableoutcomes and

results

Health and Development

Rule ofLaw

1. Illicit trafficking

2. Anti-corruption

3. Criminal justice

5. HIV/AIDS

4. Drug demand

reduction

Programme structure based on UNODC mandates

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Why are we concerned with drug dependence treatment and rehabilitation?

• 30 million people incarcerated each year in prisons only;

• 50-80% of deaths in prisons reported to be due to TB (WHO)

• Proportion of IDUs, can be very high (80%)

• HIV prevalence in prisons can be very up- to 65%;

• No evidence that incarceration reduces long term drug use

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HIV prevalence in prison higher than in the community

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

HIV Prevalence rates in general population and in prisons in selected countries

General adult population

Up-to in prison population

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HIV prevalence in women’s prisons almost always higher than in men’s prisons.

0%

5%

10%

15%

20%

25%

30%

HIV prevalence rates in women / men prisons in selected countries

HIV Prev Women in prison

HIV prev Men in Prison

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UNODC Position

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Drug Use – Drug Dependence

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Drug Dependence – Treatment

• Drug dependence is a chronic, relapsing medical condition

• Like any chronic condition – a range of treatment options, based on their effectiveness, should be offered

• May require long term treatment, not necessarily in one treatment modality

• A continuum of care: detoxification, treatment, rehabilitation

• In-patient (residential), out-patient, evidence based , psychological and pharmacological alternatives

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UNODC Support for expanded treatment and rehabilitation

• Integrated drug treatment and HIV prevention, treatment and care services project • Steering Committee which includes BNN, other

government authorities, community representatives and technical expertise

• Translation and adaptation of treatment guidelines • Training in 5 Provinces • Model projects in 3 Provinces

• Technical support for BNN activities, including study tours and regional initiatives

Antonio Maria Costa, Executive Director, UNODC15th May 2008

“Drug control has focused mostly on law enforcement …

Public health – which is the first principle of drug control – has been pushed to the background …

It is time to go back to the roots of drug control and put health at the centre stage …”

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THANK YOU THANK YOU

Acknowledgements:Dr Fabienne Hariga, UNODC Vienna