Sure you can quit drugs - but first you have to survive

Transcription

1 Sure you can quit drugs - but first you have to survive

2 Background: Overdose fatalities Norway National Institute of Public Health

3 Political process The strategy was adopted by the Storting (parliament) in 2013 mandatet to The National Directorate of Health in 2013 launched by the Minister of Health 2013 and 2014 The strategy runs through 2017 Budget: 10 million NOK every fiscal year Prolonged 2018

4 The overdose card

5 The SWITCH-campaign

6 Pillar 1 long term Safer administration SWITCH you habits use drugs in a safer way Evidence: Change from injection to safer ways of using opiates reduces overdose mortality considerably

7 Pillar 2 - treatment Opiate Substitution Harm Reduction Expand low threshold substitution treatment Evidence: Substitution treatment reduces overdose mortality considerably

8 Pillar 3 emergency intervention Bystander naloxone Distribution of take home naloxone to users and others who are present when overdose happens Evidence: Administration of naloxone effectively prevents fatal outcome in opiate overdose

9 Method Create a network of pilot municipalities mandated to map the local overdose situation develop follow up procedures after non-fatal overdose within local health care systems develop local overdose prevention strategies within existing municipal health plans Create a naloxone network with staff in Oslo, Bergen and Trondheim and gradually invite the pilot municipalities to introduce naloxone

10 Budget 10 million NOK annually 80% of budget used on the pilots and on the naloxone project

11 Lessons learnt Users, staff and politicians have met the overdose strategy with enthusiasm especially the naloxone project

12 Lessons learnt cont We have measures that adress and reach the most important at-risk groups - but there are groups we don t reach because we know too little about who they are more research is needed

13 Lessons learnt cont A network of pilot municipalities is a good learning model Local overdose prevention strategies can be integrated in local health plans Norwegian municipalities are very diverse they do things «their way» - one size does not fit all There are important barriers to cooperation locally

14 Still far to go Norway has 426 municipalities In there were overdose fatalities in more than 200 of them The overdose strategy has so far roughly worked in only 15 municipalities

15 On the other hand Close to 50 percent of the overdose fatalities happened in the 15 municipalities where we work Naloxone is now introduced in all 15 municipalities There are close to 30 municipalities meeting in regional overdose prevention networks

16 Overdose - electronic guide to local prevention

17 World Overdose Awareness Day 2013: Observed for the first time, in Oslo 2017: Observed in 29 municipalities

18 Where do we go? Continued funding of the pilots as sponsors for new municipalities Invitation to 24 new municipalities «giving them an offer they cannot refuse» Sponsor Access to electronic guide Some funding Invitation to participation in national network Naloxone

19 Where do we go? cont Develop national procedures for the follow up after non fatal overdose («pakkeforløp») Increase focus on opiate substitution Harm Reduction SWITCH 2.0 expand focus from heroin smoking to safer use of all drugs

20 Lessons learnt from traffic safety work: Long term work give results Reduction from 570 traffic fatalities to less than : Norwegian roads are the safest globally Long term efforts Continuous efforts Dynamic efforts