Overall, CADAP has contributed to the improvement of the accessibility and quality of drug treatment and harm reducing services mainly through the following actions:
Capacity building in the area of treatment in order to improve the quality of services to patients.
The establishment of WG on a variety of treatment modalities in KG, KZ, TJ and UZ which have become key for sharing information and experiences among experts.
The introduction of the principles of drug addiction treatment, diagnosis and therapy of opioid addiction, guidelines on opioid substitution, opioid substitution in special situations, and abstinence-oriented treatment.
The introduction of treatment and rehabilitation methods in rehabilitation centres (KG, KZ, TJ and UZ).
Like in the prevention area, CADAP still remains highly relevant and useful in the area of treatment.
CADAP has supported the implementation of the WHO/UNODC International Standards of Treatment of Drug Use Disorders.
International treatment standards are used as training material in Central Asian treatment facilities. Atlantis centres and Clean Zones are institutionalized only in KG. Treatment and rehabilitation centres using modem methods of treatment of drug dependent persons exist in KG, KZ, TJ and UZ. They have received training and assistance from CADAP which they value very positively, but the support received is scarce in comparison with their needs (mainly in KG and TJ).
The registration of drug users in the treatment system continues to be a major obstacle for many potential clients in most countries. It remains a challenge to organize trainings on treatment of Hepatitis, psychosocial support on Methadone treatment, substitution treatment, detoxification using Methadone as medication, overdose prevention with naloxone or to support the scaling up of modem treatment services.
For CADAP 7 the following approach will be based country by country taking all the specific advancements into consideration:
The treatment and rehabilitation system is in process of integration in mental health service system. The Republican Scientific-Practical Centre of Metal Health in Almaty is the coordination body and centre of excellence. There is rehabilitation offer in Kazakhstan including outpatient service and residential rehabilitation centres. Extension of OST will be promoted and supported.
The training curriculum (PRO 1) will include OST guidelines. In the scope of model rehabilitation centre (PRO 2) rehabilitation and readaptation measures will be proposed as integrated part of OST. Extension of OST service to prison settings will be proposed (PRO 3).
The harm reduction measures are wildly available in the country. OST have long tradition in Kyrgyzstan and is relatively widely available. Abstinence oriented treatment is underdeveloped; the treatment programs are mainly focused on detoxification. One of the priorities for CADAP 7 will be to established model rehabilitation center (PRO 2).
The “Atlantis program” (social rehabilitation and integration program for drug addicts in detention) still exists in Kyrgyzstan. There was established second “clean zone” in women prison in Kyrgyzstan in the scope of CADAP 6. One of the priorities for CADAP 7 will be to support and further develop this approach (PRO 3).
Treatment system includes in-patient and out-patient offers including: inpatient detoxification, short-term rehabilitation, outpatient relapse prevention, medical and social rehabilitation and OST.
The idea of opening the “Atlantis program” (social rehabilitation and integration program for drug addicts in detention) for women will be discussed with national counterparts Turkmenistan: Officially there are no drug addicts in Turkmenistan, but there exists drop-in centre for ex-drug users. On the basis of this centre all three products/activities will be implemented. The staff of this centre and representatives of Ministry of Health, Ministry of Interior, NGOs, and academics will constitute core of working groups.
Uzbekistan has a comprehensive system of narcological assistance to people with drug addictions. Community based approach will be proposed as the best approach in the context of traditional role of Mahalla.
Social and psychological support of Mahalla Committee can be used to found re-adaptation offer for drug addicts in the community. Developing of model of such offer (PRO 2) will be discussed with BC experts.
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