The Experts below are selected from a list of 16533 Experts worldwide ranked by ideXlab platform
Robert Ali - One of the best experts on this subject based on the ideXlab platform.
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facilitating a transition from compulsory detention of people who use Drugs towards voluntary community based Drug Dependence Treatment and support services in asia
Harm Reduction Journal, 2015Co-Authors: Pascal Tanguay, Robert Ali, Adeeba Kamarulzaman, Apinun Aramrattana, Alex Wodak, Nicholas Thomson, Gino Vumbaca, Gloria Lai, Anand ChabungbamAbstract:Evidence indicates that detention of people who use Drugs in compulsory centers in the name of Treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit Drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based Drug Dependence Treatment and support services. In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, Drug policy reform to eliminate barriers to community-based Drug Dependence Treatment and support services, and the integration of community-based Drug Dependence Treatment in existing national health and social service systems. In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results. The need to accelerate national-level transitions to voluntary community-based Drug Dependence Treatment and support services is compelling—on economic, medical, sustainable community development, and ethical grounds—as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based Drug Dependence Treatment and support services across the region, as well as the steady scale-down of compulsory centers for Drug users. Components of voluntary community-based Drug Dependence Treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use Drugs in Asia.
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Drug policy in vietnam a decade of change
International Journal of Drug Policy, 2012Co-Authors: Thu Vuong, Robert Ali, Simon Baldwin, Stephen MillsAbstract:Abstract Background Driven by the rapid spread of HIV, Vietnam's response to Drug use has undergone significant transformation in the past decade. This paper seeks to identify and analyse factors that prompted these changes and to investigate their impact on the lives of people who use Drugs. Method This policy analysis is based on a review of Vietnamese Government documents, peer-reviewed publications and the authors' knowledge of and involvement in Drug policy in Vietnam. Results The last decade has witnessed a progressive change in the mindset of political leaders in Vietnam around illicit Drug use and HIV issues. This has led to adoption of evidence-based interventions and the evolution of Drug policy that support the scale up of these interventions. However, HIV prevalence among Drug users at 31.5% remains high due to limited access to effective interventions and impediments caused by the compulsory Treatment centre system. Conclusions The twin epidemics of HIV and illicit Drug use have commanded high-level political attention in Vietnam. Significant policy changes have allowed the implementation of HIV prevention and Drug Dependence Treatment services. Nevertheless, inconsistencies between policies and a continued commitment to compulsory Treatment centres remain as major impediments to the provision of effective services to Drug users. It is critical that Vietnamese government agencies recognise the social and health consequences of policy conflicts and acknowledge the relative ineffectiveness of centre-based compulsory Treatment. In order to facilitate practical changes, the roles of the three ministries directly charged with HIV and illicit Drug use need to be harmonised to ensure common goals. The participation of civil society in the policymaking process should also be encouraged. Finally, stronger links between local evidence, policy and practice would increase the impact on HIV prevention and Drug addiction Treatment programming.
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united nations office on Drugs and crime international network of Drug Dependence Treatment and rehabilitation resource centres treatnet
Substance Abuse, 2010Co-Authors: Juana Tomasrossello, Richard A Rawson, Maria J Zarza, Anne Bellows, Anja Busse, Elizabeth Saenz, Thomas E Freese, Mansour Shawkey, Deni Carise, Robert AliAbstract:Key to the dissemination of evidence-based addiction Treatments is the exchange of experiences and mutual support among Treatment practitioners, as well as the availability of accurate addiction training materials and effective trainers. To address the shortage of such resources, the United Nations Office on Drugs and Crime (UNODC) created Treatnet, a network of 20 Drug Dependence Treatment resource centers around the world. Treatnet's primary goal is to promote the use of effective addiction Treatment practices. Phase I of this project included (1) selecting and establishing a network of geographically distributed centers; (2) conducting a capacity-building program consisting of a training needs assessment, development of training packages, and the training of 2 trainers per center in 1 content area each; and (3) creating good-practice documents. Data on the training activities conducted by the trainers during their first 6 months in the field are presented. Plans for Phase II of the Treatnet project are also discussed.
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effectiveness of Drug Dependence Treatment in hiv prevention
International Journal of Drug Policy, 2005Co-Authors: Michael Farrell, John Marsden, Linda Gowing, Walter Ling, Robert AliAbstract:This review considers the effectiveness of Drug Dependence Treatment in preventing HIV transmission among injecting Drug users (IDUs). Substitution programmes using agonist pharmacotherapy (e.g. methadone and buprenorphine maintenance Treatment) are available only for Drug users who are primarily opioid dependent. There are over half a million people in receipt of methadone maintenance Treatment (MMT) and it is estimated that this number will double in the coming decade. There is evidence that MMT is associated with a significant decrease in injecting Drug use and sharing of injecting equipment. Data on sex-related risk behaviour change are limited, but suggest that MMT is associated with a lower incidence of multiple sex partners or exchanges of sex for Drugs or money, but no change, or only small decreases, in unprotected sex. Studies of seroconversion, which is the toughest and most robust standard for assessing the role of MMT in HIV prevention, suggest that the reductions in risk behaviours do translate into actual reductions in cases of HIV infection. While the data on HIV risk behaviour are limited, there is strong evidence that substitution Treatment with either methadone or buprenorphine suppresses illicit opioid use. There is also evidence that substitution Treatment for HIV-positive IDUs is associated with better compliance with anti-retroviral Treatment and improved health outcomes. The only antagonist being used for opioid Dependence relapse prevention Treatment is naltrexone. There is currently insufficient evidence to draw firm conclusions as to its effectiveness. Behavioural interventions add to the effectiveness of substitution Treatment, while the effectiveness of different types of psychological therapy alone has been found to be variable. There have been few comparative studies of abstinence-based Treatment, however, available evidence indicates good outcomes for those who remain in Treatment for three months or more. All countries with a population of IDUs should aim to develop a comprehensive range of Treatments, including substitution Treatment, as a critical component of HIV prevention. © 2005 Elsevier B.V. All rights reserved.
Chaoxiong Zhang - One of the best experts on this subject based on the ideXlab platform.
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barriers to community based Drug Dependence Treatment implications for police roles collaborations and performance indicators
Journal of the International AIDS Society, 2016Co-Authors: Thomas Cai, Qingfeng Han, Huanhuan Yuan, Tingyan Luo, Guoliang Ren, Gitau Mburu, Bangyuan Wang, Olga Golichenko, Chaoxiong ZhangAbstract:Introduction : Worldwide, people who use Drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV Treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based Drug Dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods : In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based Drug Treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based Drug Dependence Treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results : We identified three challenges to community-based Drug Treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of Treatment. We also identified the take-home methadone maintenance Treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions : To overcome barriers to effective community-based Drug Treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust between them fostered, using community-based Treatment centres as mediators. The preliminary success of the take-home methadone maintenance Treatment pilot can serve as an example of how collaboration with the police and other government agencies can meet the needs of PWUD and contribute to the success of community-based Treatment. Keywords: community-based Treatment; Drug use; policy; harm reduction; police; China. (Published: 18 July 2016) Citation: Ma Y et al. Journal of the International AIDS Society 2016, 19(Suppl 3) :20879 http://www.jiasociety.org/index.php/jias/article/view/20879 | http://dx.doi.org/10.7448/IAS.19.4.20879
Anita Chopra - One of the best experts on this subject based on the ideXlab platform.
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addiction research centres and the nurturing of creativity national Drug Dependence Treatment centre india a profile
Addiction, 2013Co-Authors: Rajat Ray, Anju Dhawan, Anita ChopraAbstract:The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of Drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution Treatment in India. A nationwide database on the profile of patients seeking Treatment (Drug Abuse Monitoring System) at government Drug Treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse.
Thomas Cai - One of the best experts on this subject based on the ideXlab platform.
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barriers to community based Drug Dependence Treatment implications for police roles collaborations and performance indicators
Journal of the International AIDS Society, 2016Co-Authors: Thomas Cai, Qingfeng Han, Huanhuan Yuan, Tingyan Luo, Guoliang Ren, Gitau Mburu, Bangyuan Wang, Olga Golichenko, Chaoxiong ZhangAbstract:Introduction : Worldwide, people who use Drugs (PWUD) are among the populations at highest risk for HIV infection. In China, PWUD are primarily sentenced to compulsory detainment centres, in which access to healthcare, including HIV Treatment and prevention services, is limited or non-existent. In 2008, China's 2008 Anti-Drug Law encouraged the development and use of community-based Drug Dependence rehabilitation, yet there is limited evidence evaluating the efficacy and challenges of this model in China. In this study, we explore these challenges and describe how cooperation between law enforcement and health departments can meet the needs of PWUD. Methods : In 2015, we conducted semi-structured, in-depth interviews with all four staff members and 16 clients of the Ping An Centre No. 1 for community-based Drug Treatment, three local police officers and three officials from the local Centre for Disease Control. Interviews explored obstacles in implementing community-based Drug Dependence Treatment and efforts to resolve these difficulties. Transcripts were coded and analyzed with qualitative data analysis software (MAXQDA 11). Results : We identified three challenges to community-based Drug Treatment at the Ping An Centre No. 1: (1) suboptimal coordination among parties involved, (2) a divergence in attitudes towards PWUD and harm reduction between law enforcement and health officials and (3) conflicting performance targets for police and health officials that undermine the shared goal of Treatment. We also identified the take-home methadone maintenance Treatment model at the Ping An Centre No. 1 as an example of an early successful collaboration between the police, the health department and PWUD. Conclusions : To overcome barriers to effective community-based Drug Treatment, we recommend aligning the goals of law enforcement and public health agencies towards health-based performance indicators. Furthermore, tensions between PWUD and police need to be addressed and trust between them fostered, using community-based Treatment centres as mediators. The preliminary success of the take-home methadone maintenance Treatment pilot can serve as an example of how collaboration with the police and other government agencies can meet the needs of PWUD and contribute to the success of community-based Treatment. Keywords: community-based Treatment; Drug use; policy; harm reduction; police; China. (Published: 18 July 2016) Citation: Ma Y et al. Journal of the International AIDS Society 2016, 19(Suppl 3) :20879 http://www.jiasociety.org/index.php/jias/article/view/20879 | http://dx.doi.org/10.7448/IAS.19.4.20879
Daniel Wolfe - One of the best experts on this subject based on the ideXlab platform.
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seeing through the public health smoke screen in Drug policy
International Journal of Drug Policy, 2017Co-Authors: Joanne Csete, Daniel WolfeAbstract:In deliberations on Drug policy in United Nations fora, a consensus has emerged that Drug use and Drug Dependence should be treated primarily as public health concerns rather than as crimes. But what some member states mean by "public health approach" merits scrutiny. Some governments that espouse treating people who use Drugs as "patients, not criminals" still subject them to prison-like detention in the name of Drug-Dependence Treatment or otherwise do not take measures to provide scientifically sound Treatment and humane social support to those who need them. Even Drug Treatment courts, which the U.S. and other countries hold up as examples of a public health approach to Drug Dependence, can serve rather to tighten the hold of the criminal justice sector on concerns that should be addressed in the health sector. The political popularity of demonisation of Drugs and visibly repressive approaches is an obvious challenge to leadership for truly health-oriented Drug control. This commentary offers some thoughts for judging whether a public health approach is worthy of the name and cautions Drug policy reformers not to rely on facile commitments to health approaches that are largely rhetorical or that mask policies and activities not in keeping with good public health practise.
