Social rehabilitation and reintegration of drug addicts in community – experience from EU Dr. Josef Radimecký, Ph.D., MSc. UN International Day against Drug Abuse and Illicit Trafficking June, 26, 2013, Belgrade

21 February 2016 page 2seminar four Structure of presentation Social integration Drug users with dependency entering drug treatment How to respond to their needs? Types of services of social reintegration and rehabilitation: Integrated within drug services Specific services for social reintegration and rehabilitation

Social reintegration (EMCDDA, 2012) “any social intervention with the aim of integrating former or current (problem) drug users into the community. 3 pillars of social reintegration: 1. housing 2. education 3. employment (incl. vocational training) + other measures: counseling, leisure activities… supportive measures to overcome personal and structural-level barriers to obtain employment & to increase personal employability – KEY” 2/21/2016page 3seminar four

Treatment vs. reintegration Treatment & rehabilitation – emphasis on relationship between an individual and drug use Social reintegration – concerned with the position of the individual in wider society Being employed ≠ social reintegration! Non-work related spheres of life – equally important supportive social network & relationships with significant others (family, friends, colleagues) ability to lead a life that is free from stigma and discrimination well-being – self-realization of DAs Activities supporting social reintegration – should be integral to treatment 2/21/2016page 4seminar four

Drug users entering drug treatment EU level in 2011 (EMCDDA, 2013): unemployed (47 %) 1 in 10 lacked stable accommodation (9 %) low educational attainment: 36 % completed only primary education 2 % not even achieving this level of education destroyed “health” relationships (family, friends non UD) commitment of property crime lack of social skills (communication, forms, letters - institutions, PC skills, CVs, application for jobs) debts (executions) 2/21/2016page 5seminar four

Social reintegration vs. directives Aim of the EU drus action plan ( ): “to significantly reduce the prevalence of drug use and to reduce social and health damage caused by the use of and trade in illicit drugs.” Social reintegration contributes to achievement this aim It is included in the national drug strategies of 22 Member States UN – 1961 Single Convention, para 1, Article 38: “The Parties shall give special attention to and take all practicable measures for prevention of abuse of drugs and for early identification, treatment, education, after- care, rehabilitation and social reintegration of the person involved and shall co-ordinate there efforts…” 2/21/2016page 6seminar four

Approaches to social reintegration 1. General vocational rehabilitation 2. Drug treatment 3. Criminal justice system 4. Housing support 5. Education and (vocational) training 6. Employment support 7. General policy 8. Advocacy (EMCDDA, 2013) 2/21/2016page 7seminar four

When to start with social reintegration? Traditionally – social reintegration perceived as a phase that should start AFTER treatment, after being drug free. Recent evidence - social reintegration and drug treatment should be seen as integrative elements. drug treatment alone can’t address the complex needs of problem drug users. treatment alone – not sufficient to prevent social exclusion of marginalized individuals – many of which were already marginalized prior their use of drugs. without social reintegration interventions – serious danger that gains made during treatment will be lost. 2/21/2016page 8seminar four

Types of interventions Development of social skills Counseling and help in seeking of jobs Help in searching of housing Debts counseling Case management – coordination of use of external (social and health) services Legal counseling Help with transport to treatment facilities Counseling and support in family/partners’/home violence and/or abuse Sheltered housing & half-way houses Sheltered working places Care for children of clients/ stay in treatment programmes Self-help groups 2/21/2016page 9seminar four

It’s your turn…! When to start with social reintegration interventions and who should deliver them? 2/21/2016page 10seminar four When?Drug serviceSpecialized service Prior treatment (e.g. HR) Within treatment After treatment

Summary Social reintegration any intervention aiming to integrate former/current drug users into society an array of health/social interventions delivered on basis of in depth assessment of individual situation and needs of client It should be an integral part of all types of drug services: HR – treatment – after-care When drug service not able to deliver specific interventions – to assure them for clients in other social services in region (case management) 2/21/2016page 11seminar four

Thank you! for you attention & for discussion Contact: Josef Radimecky Clinic of Addictology Ke Karlovu Prague 2 Czech Republic 2/21/2016page 12seminar four