Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS CARDS 2004, Component 4 Early Warning System Tim Pfeiffer-Gerschel National Focal Point for the EMCDDA, Germany Tim Pfeiffer-Gerschel National Focal Point for the EMCDDA, Germany

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Different perspectives  National needs and interests  European requirements

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Different perspectives  National needs and interests  European requirements

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Again: Background… 1995: Joint Action on the information exchange, risk assessment and the control of new synthetic drugs 2005: Council decision on the information exchange, risk assessment and the control of new psychoactive substances

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Council decision – extended scope Extension Inclusion of biogenic drugs Inclusion of misuse of pharmaceutic drugs Cooperation EMCDDA - EMEA Limited reactions Risk assessment no longer mandatory

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Consequences on national level Increasing role of information from the toxicological centres Inclusion of the national system on misuse of pharmaceutics Increasing cooperation with regional networks Define the limitations together with the national policy and EMCDDA

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Different perspectives  National needs and interests  European requirements

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS General approach Local Panel Comparision with existing information Risk: Overinterpretation Chance: Sensitivity Information Validation Coordination: NFP

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Key elements – national level Health and Epidemiology Others Treatment sources Law enforcement sources Outreach sources National Focal Point (validation, notification) Laboratories

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Routes of reporting European Police Office (Hague) Information on the manufacture, traffic and use, possible medical use EMCDDA (Lisbon) Federal Criminal Police, BKA REITOX Focal Point European Commission (EC) European Medicines Agency (EMEA) Report New psychoactive substance from police sources New psychoactive substance from health/care system

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Problems…  Delays in toxicological analyses  Difficulties in providing a fast response  High costs and efforts for chemical analyses  Restricted application  Exchange of information between police, treatment system and NFP  Problems with operational data  Problems to link effects and (new) substance

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS  No Pill-testing: political, legal and technical aspects  Systematic data collection nearly exclusively by police  Limited feed-back to treatment system  Additional input:  Toxicology information centres  Regional EWSs in Hamburg and Frankfurt Framework

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS But… Active network, experts from…  Treatment centres (Frankfurt)  Regional monitoring systems (Frankfurt, Hamburg)  Police (Federal Criminal Police)  Emergency hotlines  Federal Institute of Pharmaceutical Devices  Representative of Länder-level

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Complementary elements „Minimal solution“ Re-analyses of existing data Optimisation of analyses and information workflow Establishment of an additional network Link to existing data sources Broad Concept (2)(1)

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS What has happened during CARDS 2004?

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Aim… (Intervention logic)  Assessment regarding needs and requirements for an early warning system  Development of an Early Warning System (EWS) on new psychoactive substances  Adoption by relevant ministerial and governmental commissions  Preparation of implementation through training of key staff  Practice oriented assistance in the implementation

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Steps taken  Assessment regarding existing structures and future requirements for EWS Management System  Multidisciplinary working group formed (Ministry of Interior: Police Directorate and Forensic Laboratory, Ministry of Health and Social Welfare, Institute of Public Health, Medical University, State Attorney Office, Treatment Centres)  Draft of new EWS developed based on own experiences, EMCDDA requirements and experiences from MS: Protocol and interministerial agreement  Study visit to Austria and Germany  Adoption of EWS model by governmental institutions  Assistance in the implementation, training of key persons

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Sources of information  Experiences from different Croatian partners:  Forensic lab of Ministry of Interior and other forensic medicine labs (clinical hospitals) – toxicological information  Ministry of Health and Social Welfare – additional information e.g. on medical products  Police – more qualitative information from street level  Harm reduction projects – more qualitative informa- tion from street level  Centres for Prevention and Treatment  Institute of Public Health  Experiences in MS

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Experiences  Good cooperation between care and criminal justice system, willingness to share information  Participants adequate in number and qualification  Professional work  Utilisation of existing networks  Very good starting point, clear structure and well elabo- rated concept

Tim Pfeiffer-Gerschel, DBDD Dubrovnik, Jan 2008CARDS EWS Perspective  A network depends on its partners  Active participation is a key for further de- velopment and access to new information  The ground has been prepared…