Country Presentation: State of Progress of the TDI by country in 2004 Annual Expert Meeting on Treatment Deamnd Indicator, September 2004 – EMCDDA Lisbon

Austria (1) National Expert: Name Martin Busch No National Working Group in place Validation study conducted: N. staff working on TDI: 3 (parttime) Yes – several groups Expert based in NFP: Yes

Austria (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /Now/ /___/ /___/ /Future/ /Now/ /___/ /___/ /Future/ /___/ /___/ /Now/ /___/ /Now/ /___/ /____/ /Future/ /Now/ /___/ /___/ /Future/ /____/ /___/ /___/ /___/ Other important issues The concept of primary drug is not applyable – different solutions are under discussion Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Belgium (1) National Experts: Tinneke DE CLERCQ, Francis SARTOR No National Working Group in place Validation study conducted: N. staff working on TDI: 1 Yes Expert based in NFP: Yes

Belgium (2) Types of centre covered: - No national, meaningful, figures can be derived from the more than 10 different systems reporting treatment data, including or not treatment demands. - The global coverage of the different types of treatment centres present in the systems, is not known in the majority of the systems. Its moreover different according to availability of certain types of treatment centres, different interpretations of the inclusion criteria of the EMCDDA protocol and pragmatic reasons. Other important issues: Drafting of a Belgian version of the EMCDDA protocol Future steps:- development and implementation of a common unique identifier for Belgium - detailed inventory + information on the « registration status » of the different treatment centres Compatibility with the EMCDDA Protocol: Differences between different treatment reporting systems: types of treatment centres, external coverage, internal coverage, multiple countings, variables and continuity of registration variability of compatibility according to the treatment reporting system

Belgium (3) Project: Belgian version of the EMCDDA protocol: - AIM: To adapt the EMCDDA protocol to the Belgian situation and to develop in this way a theoretical framework for uniform and standardized data collection, as a first step towards reliable and comparable national figures for Belgium - EXPERIENCED DIFFICULTIES : * definition and classification of the types of treatment centres to include * interpretation of the options of the variable « labour status » * determination of the primary drug - NEXT STEPS: * approval by the Health Policy Drug Cel * approval by the Interministerial Conference on Health * operationalisation

Bulgaria (1) National Expert: Momtchil Vassilev No National Working Group in place Validation study conducted: N. staff working on TDI: 3 persons – not only on TDI Yes Expert based in NFP: Yes

Bulgaria (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ / X / /___/ /___/ /___/ /___/ / X / /___/ / X / /___/ /___/ /___/ /___/ /___/ Other important issues Data collection is based on a special Registration Form / Questionnaire, filled in by doctors, psychologists, nurses etc. Compatibility with the EMCDDA Protocol Fully compatible

Cyprus (1) National Expert: Name _Ioanna Yiasemi No National Working Group in place Validation study conducted: N. staff working on TDI: N. /_2__/ No Expert based in NFP: Yes

Cyprus (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /_7__/ /___/ /___/ /_x__/ /__2_/ /___/ /___/ /__x_/ /__0_/ /__x_/ /___/ /___/ /_0__/ /___/ /___/ /_x__/ /__0_/ /_x__/ /___/ /___/ /__0_/ /___/ /___/ /_x__/ Other important issues The EMCDDA Protocol has been implemented in April, Compatibility with the EMCDDA Protocol 51-90%

Czech Republic (1) National Expert: Name Bela Studnickova No National Working Group in place Validation study conducted: N. staff working on TDI: N. /4/ Yes - in NFP Expert based in NFP: No – Drug Epidemiology Headquarters HS

Czech Republic (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_X__/ /_X__/ /___/ /___/ /___/ /___/ /___/ /___/ /_X__/ /___/ /_X__/ /___/ /___/ /_X__/ /___/ /___/ /___/ Other important issues State-wide coverage (more then 300 T/C centres) Data about problematic drug users (EMCDDA definition) and other treated drug users (canna- binoids, hallucinogens, volatile solvents, other medicaments users) Compatibility with the EMCDDA Protocol = 1. 1.Yes, fully compatible % % 4.No

Denmark (1) National Expert: Eva Hammerby No National Working Group in place Validation study conducted: N. staff working on TDI: N. 1 Yes Expert based in NFP: No (but in the same building)

Denmark (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_x_/ /___/ /___/ /_x_/ /___/ /___/ /___/ /___/ /___/ Other important issues ____________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible (except no information on referral)

Estonia (1) National Expert: Ave Talu Yes/No National Working Group in place Validation study conducted: N. staff working on TDI: At the moment only TDI expert is dealing with legal and technical aspects of DTD Registry; since January 2005, in total 3 persons Yes/No Expert based in NFP: Estonian Drug Monitoring Centre

Estonia (1) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ Other important issues By the Development Plan of Health Registries the Treatment Demand Registry must be established on 1st January EDMC will be responsible for keeping the registry. Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Finland (1) National Expert: Airi Partanen No National Working Group in place Validation study conducted: N. staff working on TDI: 1,5 person year/4 persons Yes Expert based in NFP: Yes

Finland (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /_x_/ /___/ /___/ /_x_/ /___/ /___/ /___/ /___/ /_x_/ /___/ /___/ /_x_/ /___/ /___/ Other important issues Voluntary, anonymous, statistical data collection Compatibility with the EMCDDA Protocol %

France (1) National Expert: VAISSADE Laure PALLE Christophe No National Working Group in place Validation study conducted: N. staff working on TDI: 0,8 Yes Expert based in NFP: Yes

France (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /_X_/ /___/ /___/ /___/ Other important issues OPEMA_____________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol Yes 1.Yes, fully compatible % % 4.No

Germany (1) National Expert: Name Simon Yes National Working Group in place Validation study conducted: N. staff working on TDI: N. 3 Yes Expert based in NFP: Yes 1 in NFP

Germany (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ 707 /___/ /___/ /___/ 106 /___/ /___/ /___/ 0 /___/ Other important issues Special evaluation of Prison based and low threshold units planned for 2004 Compatibility with the EMCDDA Protocol 1.Yes, fully compatible

Greece (1) National Expert: Katerina Kontogeorgiou Maria Pouloudi Reliability of drug dependents self- reports, Kokkevi A., Richardson C., Palermou B. and Leventakou V., Drug and Alcohol Dependence 45 (1997) p National Working Group in place Validation study conducted: Sub-Task 3.1. « To improve the reliability of data collected by treatment demand reporting systems » July 1997, UMHRI N. staff working on TDI: 3: - Project manager - Statistician - Secretary No Expert based in NFP: Yes

Greece (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good Other important issues More than 90% national coverage Great changes in the reporting system make trend analysis difficult Individual questionnaires Double counting controlled Compatibility with the EMCDDA Protocol Yes, fully compatible

Hungary (1) National Expert: Dr József RÁCZ No National Working Group in place Validation study conducted: N. staff working on TDI: 1 person Yes Expert based in NFP: No, Institute for Psychology, Hungarian Academy of Sciences

Hungary (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ x /___/ /___/ x /___/ /___/ /___/ /___/ x /___/ /___/ Other important issues EMCDDA TDI Protocol is under implementation Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Ireland (1) National Expert: Name Jean Long Yes, Opiate users attending methadone services National Working Group in place Validation study conducted: N. staff working on TDI: N. /2.5/ Yes, Not specific to TDI but progress included Expert based in NFP: Yes, Drug Misuse Research Division, Health Research Board, Dublin

Ireland (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /x/ /___/ /___/ /x/ /___/ /___/ /___/ /___/ /x/ /___/ /x/ /___/ /___/ /___/ /___/ /___/ Other important issues ____________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, from 2004 fully compatible

Italy (1) National Expert: NAMEAldo Polettini Yes National Working Group in place Validation study conducted: N. staff working on TDI: N. /46/ (central and regional level) Yes Expert based in NFP: No. University of Pavia

Italy (2) Types of centre covered: Outpatient Inpatient GPs (see foot notes) Low Threshold Agencies (see foot notes) Units in Prison (see foot notes) Others No / Poor / Sufficient / Good /___/ /___/ /_X_/ /___/ /___/ /_X_/ /___/ /___/ /_X__/ /___/ /___/ /___/ /___/ /___/ /_X_/ /___/ Other important issues:Notes Reporting of treatment data in line with the TDI protocol only occurs in some Regions. In these Regions it is fully compatible and extension to other Italian Regions is in process. Compatibility with the EMCDDA Protocol) 1.Yes, fully compatible % % 4.No

Latvia (1) National Expert: Name Ieva Matisone Yes National Working Group in place Validation study conducted: N. staff working on TDI: N. 2 No Expert based in NFP: Yes

Latvia (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_+_/ /___/ /___/ Other important issues ____________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Luxembourg (1) National Expert: Name Alain ORIGER No National Working Group in place Validation study conducted: N. staff working on TDI: 2 Yes Expert based in NFP: Yes

Luxembourg (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good X Other important issues A difference should be made between ITEM COMPATIBILITY and CATEGORIES OF ANSWERS COMPATIBILITY Compatibility with the EMCDDA Protocol 1.Yes, fully compatible

Malta (1) National Expert: Name : Anna Girard __________ Yes/No National Working Group in place Validation study conducted: N. staff working on TDI: N. / 5 / Yes/No Expert based in NFP: Yes/No (where?) Yes _Ministry for the Family and Social Solidarity

Malta (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_x_/ /_x_/ /___/ /___/ /___/ /_x__/ /___/ /___/ /___/ /___/ /___/ /___/ /_x_/ /___/ /___/ Other important issues ____________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Netherlands (1) National Expert: Anton W. Ouwehand Yes in 1997 National Working Group in place Validation study conducted: N. staff working on TDI: including national system LADIS N. /6 Yes, Epid.workgroup NFP Expert based in NFP: No based in IVZ, in coop. NFP

Netherlands (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_xx_/ /___/ /_xx_*/ /___/ /___/ /_xx_/ /___/ /___/ /___/ /___/ /___/ /___/ /_xx_ /___/ /___/ /_xx_/ /___/ /___/ /___/ /___/ /_xx_/ Other important issues _*In 2005 all inpatient clinics information will be involved in LADIS. From 2006 reporting system will be covering 100 % of addiction treatment (except GP s) Compatibility with the EMCDDA Protocol 1.Yes, fully compatible

Norway (1) National Expert: Erik Iversen No National Working Group in place Validation study conducted: N. staff working on TDI: N. / 4 (13+) / Yes Expert based in NFP: No : Bergen Clinics Foundn.

Norway (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /_X_/ /_X_/ /___/ /___/ /___/ /_X_/ /_X_/ /_X_/ /___/ /___/ /___/ /___/ /_X_/ /_X_/ /___/ /_X_/ /___/ /___/ /___/ Other important issues System is under revision, linked to a national reform placing the addiction sector within the specialist health care system Compatibility with the EMCDDA Protocol 1 and 4: Yes, fully compatible, but not compatible due to data on aggregated level.

Poland (1) National Experts: Name: Boguslawa Bukowska Janusz Sieroslawski Yes/No National Working Group in place Validation study conducted: N. staff working on TDI: N. /2 - up to now/ Yes/No Expert based in NFP: Yes/No (where?) _____

Poland (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /_0__/ /___/ /___/ /___/ Other important issues TDI according to EMCDDA standards will be implemented in Poland in (Program Transition Facility - light twinning)________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Portugal (1) National Expert: Name _Fernanda Feijão No National Working Group in place Validation study conducted: N. staff working on TDI: N. 3 Yes Expert based in NFP: Yes

Portugal (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /_X_/ /___/ /_X__/ /___/ /___/ /___/ /_X_/ /___/ /___/ /___/ Other important issues TDI depends on the Treatment National Information System for Drug Users Compatibility with the EMCDDA Protocol %

Romania (1) National Expert: Name: Madi SURUGIU, MD No National Working Group in place Validation study conducted: N. staff working on TDI: N. /__2_/ Yes Expert based in NFP: Yes

Romania (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /_X__/ /___/ /___/ /__X_/ /___/ /___/ /__X_/ /___/ /___/ /___/ /___/ /___/ /__X_/ /___/ /___/ /___/ Other important issues The monitoring system will be improved starting with 2004 and the RMCDDA will develop its own database Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Slovakia (1) National Expert: Name: Imrich Steliar No National Working Group in place Validation study conducted: N. staff working on TDI: N. /1+4*/ No Expert based in NFP: Yes *staff working on data collection and processing at the Institute of Health Inf.&Statistics

Slovakia (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others ( Min.of transport.-hosp. of railways) No / Poor / Sufficient / Good /___/ /___/ /___/ /_X_/ /_X_/ /___/ /___/ /___/ /___/ /___/ /___/ /_X_/ Other important issues ____________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No

Slovenia (1) National Expert: Miljana Vegnuti No National Working Group in place Validation study conducted: N. staff working on TDI: 4 Yes Expert based in NFP: Yes

Slovenia (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /1 / /___/ /___/ /18 / /___/ /___/ /___/ /___/ /___/ /6 / /___/ /___/ Other important issues The evaluation of treatment programmes in Slovenia will start next year as soon as the appropriate data on low threshold agencies will be available_________________________ ____________________________ ____________________________ Compatibility with the EMCDDA Protocol 1.Yes, fully compatible

Spain (1) National Expert: Luis Royuela 1988 Rev San Hig Púb 1993 Vol 67 Nº 5 Pag National Working Group in place Validation study conducted: N. staff working on TDI: Regional level N. 19 Yes Expert based in NFP: Delegación del Gobierno para el Plan Nacional sobre Drogas National level N. 2

Spain (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No Poor Sufficient Good Other important issues *Source of referral * Living status ( With whom ) *Living status (where ) *Nationality *Frequency of use. Compatibility with the EMCDDA Protocol 1.Yes, fully compatible % % 4.No X X X X X X In 2003 begun collecting data of items:

Sweden (1) National Expert: Roger Holmberg Yes National Working Group in place Validation study conducted: N. staff working on TDI: 6 Yes Expert based in NFP: No - Nat. Board of Health and Welfare

Sweden (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /_X_/ /___/ /___/ /_X_/ /___/ /___/ /___/ /___/ /___/ /_X_/ /___/ Other important issues Participation is voluntary Insufficient double-counting control Compatibility with the EMCDDA Protocol 1.Yes, fully compatible

Turkey (1) National Expert: Nesrin DİLBAZ Yes National Working Group in place Validation study conducted: N. staff working on TDI: Yes Expert based in NFP: Yes

Turkey (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ /_X_/ /_X_/ /___/ /___/ /___/ /___/ /___/ /___/ /_X_/ /_X_/ /___/ /___/ /___/ /___/ /___/ Other important issues prisoner is checked by doctors working at prison and doctor calls an expert if he/she determines an user or addict Compatibility with the EMCDDA Protocol We didnt finish to check it. But it looks as 3

United Kingdom (1) National Expert: Name: Patsy Bailey Yes National Working Group in place Validation study conducted: N. staff working on TDI: N. /___/Staff in England, Wales, Scotland and Northern Ireland; NTA, staff at all levels of data collection etc Yes Expert based in NFP: No. But in Department of Health, London, with NFP

United Kingdom (2) Types of centre covered: Outpatient Inpatient GPs Low Threshold Agencies Units in Prison Others No / Poor / Sufficient / Good /___/ /___/ /___/ Other important issues _Major changes in collection process in England Consistency across the UK New emphasis on performance ____________________________ Compatibility with the EMCDDA Protocol % - Around 60% (8/20) % 3.Yes, fully compatible 4.No