KAZAKHSTAN. National Focal Point. Drug Abuse and Drug Dependence Treatment Situation. Territory : 2,717,300 km 2 Capital: Astana BASIC DATA

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KAZAKHSTAN Territory : 2,717,300 km 2 Capital: Astana Map No. 3771 Rev. 6 UNITED NATIONS January 2004 BASIC DATA Total population (millions) 2009 15.5* Population under age15 (as % of total) 2010 23.8* Life expectancy at birth (years) 2008 65** Adult literacy rate (% age 15 and above) 2008 100** Youth literacy rate (% age, 15-24) 2008 100** GDP per capita (US$) 2009 1,863*** NOTE: The map displayed in this document serves as a reference aid only. The boundaries and names shown and the designations used on it do not imply official endorsement or acceptance by the United Nations. * UN Population Database (2010) ** UNICEF Country Statistics (2010) *** CIA The World Factbook (2010) National Focal Point Mr. Nurlan Erezhepov, Director Republic Scientific and Practical Center for Drug Problems Drug Abuse and Drug Dependence Treatment Situation According to statistical data for the year 2008: The total number of registered drug users in the country made 55 102 persons Injecting drug users (IDUs) made about 70% (38 071 persons) Mainly, people taking drugs appear to be males at the age of 15-64 years Urban population is more exposed to using drugs than those who live in rural areas Newly registered made 9 529 persons The rate of drug users among children under 15 years old made 761 persons. Most of them are solvents and inhalant users The most spread type of drugs in Kazakhstan is heroin (28 559 heroin users) Hashish and Anasha users made 8 815 persons; Opium users 5 416; Marijuana users 3 052 There are 86 governmental settings for drug dependence treatment in Kazakhstan In total there are 5 028 beds available for drug dependence treatment Drug treatment facilities in urban areas of Kazakhstan: mental healthcare hospitals specialized drug treatment facilities (inpatient and outpatient treatment) psychiatric hospitals prisons

Number of registered drug users for the years 2007-2008 in Kazakhstan 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Astana Almaty Akmolinsk region Aktyubinsk region Almaty region Atyrau region East - Kazakhstan region Zhambyl region West - Kazakhstan region Drug treatment facilities in rural areas of Kazakhstan: Qaragandinsk region Kostanai region Qyzylorda region Mangistau region Pavlodar region North - Kazakhstan region South - Kazakhstan region 2007 2008 primary health care facilities psychiatric hospitals prisons specialized drug treatment facilities The Municipalities in Kazakhstan provide funding for above mentioned drug treatment organizations listed, excluding prisons. Treatment in prisons is financed by the Ministry of Justice. The Ministry of Health invests money in psychiatric hospitals and specialized drug treatment facilities which provide inpatient and outpatient treatment. List of services: specialized drug treatment facilities with inpatient and outpatient treatment: screening; assessment; referrals for specialized services; treatment planning; detoxification; counseling; HIV prevention, testing, and counseling; HCV testing primary health care services: counseling; HIV prevention, testing and counseling; HCV testing mental healthcare services: referrals for specialized services; counseling; HIV prevention, testing and counseling; HCV testing psychiatric hospitals: specialized services; counseling; HIV prevention, testing and counseling; HCV testing social welfare services: conduct vocational trainings; job placements; social rehabilitation; linkage with community organizations; other social services & assistance prisons: detoxification; counseling; HIV prevention, testing and counseling; relapse prevention; after care; vocational training Screening, assessment, opioids maintenance therapy and family interventions are provided only in specialized drug treatment facilities.

Number of treated drug users in 2008 1400 1200 1000 800 600 400 200 0 Pavlodar center Astana Almaty Akmolinsk region Aktyubinsk region Almaty region Atyrau region East-Kazakhstan region Zhambyl region West-Kazakhstan region Qaragandinsk region Kostanai region Qyzylorda region Mangistau region Pavlodar region North-Kazakhstan region South-Kazakhstan region General number of drug users, who got treatment in Kazakhstan made 8 300 persons over the year 2008 The majority of patients in 2008 got outpatient specialized drug free treatment. 5 408 persons were first time treated patients 8 360 drug users were taken off the registry in 2008 1 244 drug users were died, including 424 who died from overdoses The majority of first time treated patients were opium users, then follow polydrug users and cannabis users. The highest number of first time treated patients in Kazakhstan got inpatient specialized drug free services and treatment at therapeutic communities. HIV/AIDS Situation HIV/AIDS situation 2008 according to the collected data: Cumulative number of HIV cases was 11,709 in Kazakhstan by January 2009. 8 595 of them were males (73%) and 3 114 were females (27%) 297 HIV positive persons were under 14 years old 8,201 HIV infected persons were IDUs, which makes 70% from the total number of registered HIV positive persons New cases made 2,335 (1652 of them were IDUs) In the year 2008, 1,930,285 persons were tested on HIV Cumulative number of patients with AIDS was 815 by the year 2008. New cases made 175. Nationwide prevention treatment and care services including prison settings: Needle and syringe exchange programs HIV Testing and counseling Antiretroviral therapy (ART) Prevention and treatment of sexually transmitted infections (STI) Condom programs for injecting and other drug users and their sexual partners Targeted information, education and communication (IEC) for injecting/other drug users and their sexual partners

Vaccination, diagnosis and treatment of viral hepatitis (HBV, HCV) Prevention, diagnosis and treatment of tuberculosis (TB) Referral for drug dependence treatment Referral for other medical and social services 633 patients with AIDS died HIV prevention, treatment and care services for injecting and other drug users: needle and syringe exchange programs; HIV testing and counseling; antiretroviral therapy; prevention and treatment of sexually transmitted infections; condom programs for injecting and other drug users and their sexual partners; targeted information; education and communication for injecting and other drug users and their sexual partners; vaccination; diagnosis and treatment of viral hepatitis (HBV, HCV); prevention, diagnosis and treatment of tuberculosis; referral for drug dependence treatment; referral for other medical and social services. Training of Trainers Current Status Trainers 9 The training for medical staff includes drug screening and short-term interventions, but also motivational interviewing and cognitive-behavioural therapy. As for the assessment of patients, it is essential to acquire a command of the procedures suggested by the Addiction Severity Index, which is part of the Treatnet Training package. The focus on psychological counselling aims at the prevention of both drug use and relapse. In this context, the staff s attention is drawn to the issue of the Emotional Burnout Syndrome and the impartment of life skills. National Counterparts Ministry of Health of the Republic of Kazakhstan Republic Scientific and Practical Center for Drug Problems I Pavlodar Treatment Centre Details Republic Scientific and Practical Center for Drug Problems 140 000 Pavlodar Phone: +7 7182 605053 Fax: +7 7182 605053 E-mail: neovitae@pisem.net

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