Presentation on theme: "Gerhard Bühringer 1,3 Michael Farrell 2, Ludwig Kraus 1, John Marsden 2, Tim Pfeiffer-Gerschel 1, Daniela Piontek 1, Krystallia Karachaliou 1, Jutta Künzel."— Presentation transcript:
Gerhard Bühringer 1,3 Michael Farrell 2, Ludwig Kraus 1, John Marsden 2, Tim Pfeiffer-Gerschel 1, Daniela Piontek 1, Krystallia Karachaliou 1, Jutta Künzel 1, Garry Stillwell 2 1 IFT Institut für Therapieforschung, München 2 National Addiction Centre, London 3 Technische Universität, Dresden Emerging drug use related research needs: claims, realities, needs, deficits and visions... Identifying Europe's information needs for effective drug policy EMCDDA, 6-8 May 2009, Lisbon
2 1. Between claims and reality in Europe 1.1 Claims “To make the EU the most dynamic and competitive knowledge- based economy by 2010” (Lisbon Strategy, 2000) Research and development policy is one of the EU priorities to boost employment and growth and to maintain its social model Increasing Healthy Life Years is vital “Well-designed social and environmental policies are themselves key elements in strengthening Europe's economic performance“ (European Parliament, 2005) “ Information, research and evaluation are key elements of an overall EU drug policy“ (EU Drugs Strategy, 2005-2012) Better understanding of the drug problem and the development of an optimal response Improving the understanding of the drug problem “through more and better coordinated research” (EU Council, 2008)
3 1. Between claims and reality in Europe 1.2 Reality I: Drug use in Europe Drug use (DU; past month) 12 million cannabis users (3.6%) 1.5 million opioid users (0.4%) 1.5 million cocaine users (0.4%) Drug-related infectious diseases 40 % of IDUs are Hepatitis C infected Drug-induced deaths between 6,500 and 8,500 (minimum estimate!) Treatment demand 360,000 cases in various types of care Drug-related public expenditure EUR 34 billion 0.3% of combined GDP of all EU Member States
4 1. Between claims and reality in Europe 1.3 Reality II: Low prominence of European DU research Author affiliation 2004-2007 in the journal “Drug and Alcohol Dependence” (pp: population size) 2 pp: 53% pp: 38% pp: 4% pp: 6% 1 1 Germany, Italy, Netherlands, UK, 2 Ritter, 2008, pers. com.; modified
5 1. Between claims and reality in Europe 1.4 Reality III: Stakeholders for DU research and monitoring MS 1 MS 27 MS 2 Responsible for research, transfer and health/ social service for DU Differences in problem situation indicators problem views research structures research priorities funding structures research programmes research budgets research utilisation publication languages access to research outcome „Drugs prevention and information“ programme (2007 – 2013) “Second Programme of Community action in the field of health” (2008 – 2013) Framework 7 Progr. (2007 – 2013), „Health“ as major theme EMCDDA Monitoring DU and European responses DG JLSDG Sanco DG RTD Complimentary role (“added value”) MS 26
6 1. Between claims and reality in Europe 1.5 The core questions Will the current structure, with the given complex system of interests and responsibilities, lead Europe to the top of DU related research in the world? Will the current structure guarantee research activities to provide the knowledge base needed for a fully informed and evidence based drug policy all over Europe?
7 2. Needs for Europe: research activities and research management 2.1 Research Questions Time/Age Reduction /Cessation Vulnerability- and risk factors (examples) Reduction/ cessation Patient factors Social context factors Treatment factors Acute risk factors Person factors Family conditions Social environment Cultural factors Early vulnerability Genetic factors Personality factors Childhood trauma Why do some DU stop without formal interventions, others not? What is the role of social context factors? Why do some people abstain after treatment, others not? Why do some people start DU and others not? Why do some people stop after experimental use and others not? Why do MS differ in DU incidence and prevalence? Onsetexperimental useregular DUsevere chronic DU
8 2. Needs for Europe: research activities and research management 2.1 Research (continued) Targets Research areas To reduce rates of onset and progression To delay age of onset and progression To early detect and terminate DU To reduce negative individual and social consequences Understanding drug use Demand reduction Supply reductionPolicy analysis Basic research Epide- miology Preven- tion Treat- ment Drug supply Interdic- tion PolicyLegal Frame works Disciplines Range of natural and social sciences Need for interdiscplinarity
9 2. Needs for Europe: research activities and research management 2.2 Research management An effective management of DU related research in Europe has to be based on: (1) Monitoring of DU indicators and related vulnerability and risk factors (2) Regular analysis of DU problems and related research needs (3) Priorisation of research activities (4) Funding programmes and structures (5) Research outcome analysis and evaluation (6) Transfer into practice (implementation and evaluation) (7) Fast feedback to all system components: “adaptive learning system” (8) Financial resources (9) Scientific and management resources for planning, implementation, monitoring and evaluation Need for a more structured process to prioritize, monitor and analyse research activities and research outcome between MS, EC and scientific community?
10 3. Deficits 3.1 Research fields Topics for improvement Understanding drug use: risk and protective factors, mechanisms of action, long-term studies on onset and course of DU Demand reduction: prevention Supply reduction: law enforcement evaluation Policy analysis: effects and efficiency of public policies General: Cooperation of medical and social sciences Source: e.g., EMCDDA Selected Issues on Research, 2008; EC, 2007 10
11 3. Deficits 3.2 Research infrastructure Topics for improvement Qualified research staff (Interdisciplinary) research networks in MS European research networks Sustained funding of networks European scientific community European research organisations Involvement of the scientific community in the analysis of research needs Source: e.g., EMCDDA Selected Issues on Research, 2008; EC, 2007 11
12 Topics for improvement Linkage of drug action plans and research planning Coordinated research prioritisation between public authorities and scientific community in MS Systematic analysis of research outcome, in order to adapt drug policy and future research needs Linkage of research outcome and MS drug policy and vice versa Coordination of MS and EC research programmes Lack of continuity of funding Research funding beyond epidemiology and monitoring (some new MS) Source: e.g., EMCDDA Selected Issues on Research, 2008; EC, 2007 12 3. Deficits 3.3 Research management
13 4. A 2020 vision for Europe to take the lead in DU related research 13 Yes, we can! (and want?) (1)A commitment of MS, EC and scientific community for a comprehensive research initiative Who cares for what? (2)An agreement of MS and EC on DU problem analyses, targets, research priorities and budgets (3)Coordinated research funding programmes at MS and EC level Specialists to the front (4)A process of constant analysis and adaption of research needs/priorities based on research outcome analyses and evaluations of new challenges Scientists of Europe, unite! (5)A European research society and European scientific community Money makes the world go round! (6)Financial resources For research funding For research capacity building For research outcome transfer and evaluation