1. Design of a Project “Detecting Patients with Alcohol Problems in the General Medical Network and Analysis of Forms and Methods of Specialized Care Provision” Eugenia Koshkina Director National Research Center on Addictions Ministry of Health of the Russian Federation Kirkenes, 19-20 March 2013

2. Models of Alcohol Use by Russia’s Population Habitual drinkers Moderate drinkers Don’t drink alcohol 9,0 % 6,6% 33,4% Systematic drinkers Occasional drinkers 37,9 % E.Bechtel, 1986 What has changed during 30 years? 13,1%

3. 547 081 Officially registered patients in the Russian Federation in 2010 Alcohol dependency Dependency on volatile inhalants Dependency on illicit drugs 2 573 230 547 081 33 607 2010 statistics

4. Alcohol dependency prevalence, including alcohol psychoses per 100 000 population High – 2,000 and more Medium - (1,000 -1,999) Low - (less than 1,000)

5. Prevalence of Alcohol Dependency, Including Alcoholic Psychoses (Per 100,000 population)

6. Alcohol-Related Mortality in 1999-2007 (in 1000, E. Andreev & I. Zbarskaya)

7. 547 081 74,3% 26,7% Causes of death199520002005200720082009 Occasional alcohol poisonings 29,525,628,617,7 16,9 15,0 Alcohol-related alcoholic liver diseases 1,83,410,89,29,89,2 Alcohol-related pancreas diseases 4,85,37,87,57,8 Alcohol-related mental and behavioral disorders 7,93,64,33,53,73,3 Mortality Due to Diagnoses Related to Alcohol Use in Rissua (deaths per 100,000 population)

8. Distribution of Patients with Alcohol Dependency by Age Group (%) in 2010 (according to official statistics data) years

9. SCENE Proposal to carry out a project: “Detecting Patients with Alcohol Problems in the General Medical Network and Analysis of Forms and Methods of Specialized Care Provision” in Northern Dimension countries

10. SCENE Aim: Develop mehtodology of active detection of pre-clinical alcohol dependency conditions (prodromal phase) among somatic profile patients who seek treatment at medical facilities, in order to develop recommendations to improve provision of specialized care

11. SCENE Objectives: Conducting a population survey in order to obtain prevalence of alcohol misuse among population of participating territories aged 16-64 Revealing forms of alcohol behavior among somatic patients of inpatient and/or outpatient network of treatment facilities Studying existing forms and methods of specialized narcological care provision to this group of patients – comparative analysis of different courtiers’ experience Developing recommendations to improve care provided to this group of patients

12. SCENE Methodology: 1.Population survey among general population of participating territories 2.Interviews of key informants: addiction psychiatrists (narcologists) and general practitioners 3.Survey among somatic patients of inpatient and/or outpatient facilities 4.Survey of addiction patients regarding possible somatic diseases 5.Comparative analysis of forms and methods of specialized care provided to both groups of patients in different countries

13. SCENE Expected results: 1.Detected forms of alcohol behavior among general population 2.Analysis of somatic patients’ need of specialized care related to consequences of alcohol use 3.Revealed potential opportunities of general practitioners and addiction psychiatrists (narcologists) to provide care to somatic patients with alcohol problems 4.Analysis of physicians’ capacity to carry out these activities 5.Involving general practitioners in providing care to somatic patients with alcohol problems 6.Comparative analysis of different countries’ experience 7.Developed recommendations to improve care provision to these groups of patients

14. Thank you!