# Presentation: 126392

## Min Zhao, M.D & Ph.D.
Shanghai Drug abuse treatment center
Shanghai Mental Health Center

**Shanghai Drug abuse treatment center**
**Shanghai Mental Health Center**

**Synthesizing Promising Practices**** on the  Role Of Drug Dependence Treatment in HIV/AIDS Prevention and Care**

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Working Group Members

**  **Turning Point Alcohol and Drug Centre Inc., Australia
-   SSTAR Stanley St Treatment & Resources, Inc., USA
-   Shanghai Drug Abuse Treatment Center
-      Shanghai Mental Health Centre, China
-   Drug rehabilitation Unit
-      Mathari Hospital, Kenya
-   Laboratory of Clinical Pharmacology of Addictive States
-      Valdman Institute of Pharmacology
-      Pavlov State Medical University, Russia
**    **

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Slide 3

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Background

- Interaction between HIV/AIDS and drug abuse
- Both HIV/AIDS and drug abuse is an international public health challenge
- International collaborations are needed to address both issue
- Drug abuse treatment as a effective intervention for HIV/AIDS prevention and care
- Diversity of politics, cultures, economy in different part of the world produce different practices
- Synthesizing Promising Practices will help to address both drug dependence  and HIV/AIDS internationally

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Multidimensional objectives
	reduce dependence on drugs
	reduce the morbidity and mortality
	reduce drug related problems
	improve physical and psychological health
	reduce criminal behaviors
	facilitate reintegration into the society
	improve social functioning
	......
One of the main objectives is: reduce drug use related problem such as infectious diseases, for example HIV, HCV and TB, etc.

- 	reduce dependence on drugs
- 	reduce the morbidity and mortality
- 	reduce drug related problems
- 	improve physical and psychological health
- 	reduce criminal behaviors
- 	facilitate reintegration into the society
- 	improve social functioning
- 	......
- One of the main objectives is: *reduce drug use related problem such as infectious diseases, for example HIV, HCV and TB, etc.*

**Objectives of treatment**

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Principles of effective drug dependence treatment 

-   ......
- Treatment programmes should provide assessment for HIV, HCV, HBV, TB and other infectious diseases and provide help and means to modify risk behaviour
-  ......
**	****	****	****--A research based Guide (NIDA 1999)**** **

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Objectives of working group

- Product a promising practice document on the role of drug abuse treatment in HIV/AIDS and HCV prevention and care
- Promote sound public health policy and for practitioners to deliver quality interventions in the treatment of drug abuse
- Establish a sustainable platform for exchange on state of the art drug abuse treatment with common and shared objectives
- Establish connections with other networks working in the same area
- Dissemination of the best practice document

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Methods

- Group coordinator/lead centre
- Distribute tasks within working group: drafts, literature review, data collection, peer reviews, case studies, feedbacks, revise, etc.
- Exchange of information and ideas
- Discussions, Extensive consulting
- Physical meetings
- Monitoring, review and reporting

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Outlines of Practice Document 

- Title: “The role of drug treatment in HIV/AIDS and HCV prevention and care: promising practice”
- Brief introduction
- Definition of drug treatment (broad)
- Target group:treatment providers, Policy makers, etc.
- Treatment settings
- Core drug treatment components for effective HIV prevention and care
- Detail each core components: definition, literature review, good practice principles, case example
- Human resource development
- Monitoring, Evaluation and record keeping

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Core Components

- Pharmacotherapy treatments: methadone, buprenorphine, Natrexone, and others – substitution & withdrawal
- HIV and HCV (and other?) testing and counseling
- HIV/AIDS (and other?) education (such as safe sex and safe drug use)
- Affordable ARV’s and other relevant medications
- Clean needles and syringes

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Core Components

- Withdrawal services: residential, non-residential
- Psycho-social treatments: brief interventions, motivational interviewing, CBT, relapse prevention , etc.
- Outreach services targeting high-risk groups
- Support (wrap-around) services (eg. Vocational training, housing, financial support)
- Policy advice and advocacy

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Resources

- Already existing documents in this area
- Existing resources and experiences of working group
- Prevention programs, education
- Pharmacotherapy, harm reduction
- Community services: home based, outpatient,
- Rapid test, counseling, pre-test counseling and post-test counseling
- Withdrawal services, HIV education, training platform
- Platform to learn from each other
- Program development

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Challenges

- Get agreements on: core drug dependence treatment components for effective HIV/AIDS prevention and care
- Cultural, economical and political diversity
- Agreement of the definitions: eg. Best practices or promising/good practices?
- Potential duplication with other existing documents
- Other commitments
- Language barriers

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ

## Slide 14

- NIDA International Forum, June 16-19,2006, Scottsdale, AZ