The EATI is a European training institute, supported by an international network of twelve major European institutions for addiction care and research. The EATI was founded in 1994 by the Jellinek, Amsterdam, The Netherlands.

• ISO certificate and diploma course
• Seminar on methodological and statistical aspects of Addiction Research
• Crossing Western European borders
• Training Eastern European young health professionals
• A practical guideline for policy makers and trainers
• EATI training courses 1999

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Seminar on methodological and statistical aspects of Addiction Research

From 10 to 12 May the Seminar on Methodological and Statistical Aspects of Addiction Research was organised by EATI on a nice location in Vienna. 14 Participants from different European countries, including Austria, Belgium, Germany, Ireland, Italy, the Netherlands, Portugal and Wales joined the course. Although the seminar was intended for researchers in the field of Addiction, there were also participants working in the practical field of addiction who wanted to get acquainted with doing research in their clinical working area. The heterogeneity of participants made the seminar interesting as problems were approached critically from different points of view. Attention was given not only to the methodological and statistical but also to the practical aspects of doing research and the tension between everyday life and meeting the requirements of doing research properly (i.e. politics, finances, limited amount of time that is available and the fact that it is a turbulent working field.)

The first day was planned for Dr. Michael Gossop of the National Addiction Centre in the United Kingdom. He told us about treatment evaluation and spent quite some time presenting results of his National Treatment Outcome Research Study (NTORS). Interesting was the rather broadly defined assignment. We had to develop a research-design in which three treatment options for chronic highly criminal addicts that cause a lot of social damage, could be evaluated. Personally, this assignment, and the evaluation afterwards was the most educational aspect of this day, as we encountered several problems in setting up the design, which were discussed later on.

The second day Dr. Alfred Springer of the Ludwig Boltzman Institute for Addiction Research in Vienna, was invited to give an overview of the Addiction and Prevention Research in Austria. After his informative speech, the rest of the day was reserved for the statistical lecture of Dr. Maarten Koeter, working at the Amsterdam Institute for Addiction Research. The rather abstract matter became concrete because of the examples he gave, based on a gambling study he had conducted. Whereas the different backgrounds of the participants definitely have their positive aspects, on this day it appeared to be a drawback: for some persons it was difficult to keep up with this important, but difficult lecture about logistic regression, because of the limited familiarity with statistical methods.

On the last day Dr. Vincent Hendriks, researcher of the heroin project and also working at Parnassia treatment centre in the Netherlands, gave an introduction to Survey Research, with emphasis on snowball sampling in hidden populations. Here again the assignment in the afternoon was very instructive. By working together in small subgroups we had to bring in practice the information Vincent gave us about snowball sampling. In the evaluation of the proposed solutions, it was clear that beside the general aspects, every group had brought in something unique and useful.

Although each day was rather a course on itself (fairly isolated from the other two days) it was all in all an educational seminar, with a nice group and a good atmosphere. It was that much motivating, that some of us had the fantasy to set up our own research institute !

Eveline Rietdijk
Amsterdam Institute for Addiction Research .

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Drug prevention training in Belarus

Crossing Western European borders

Substance abuse problems have increased in Central and East European countries and in particular in the Newly Independent States. Professionals and key-persons working in health care and welfare sectors and the mental health field, (should) play a significant and active role in prevention and early recognition of problems of substance abuse. It is of utmost importance that those professionals are exposed to, informed and trained on all aspects of substance abuse. On the initiative of the Jellinek a training and education project to innovate and improve the prevention and treatment of substance abuse problems, started March 1995 in the Republic of Belarus.

Ever since the start of the nineties there has been a growing use of illegal drugs in the Belorussian Republic. Without outside support, neither the addiction care services nor the authorities knew what to do. In 1995 a Belorussian delegation visited the Jellinek which was the beginning of a series of training programmes. During the last four years several special training programmes have been developed for the Belorussian professionals. After the first training on New Approaches in Training and Education in Substance Abuse the Belorussian professionals were trained in developing treatment and prevention programmes. A series of prevention training sessions started in 1998.

The first two training sessions on prevention were focussed on needs assessment and the creation of a national network of prevention workers, called "healthy choice". The third training session was aimed at how to design and implement a prevention project. The training sessions took place on the compound of a psychiatric hospital with more that 2800 beds. The participants were prevention workers from eight different regions of Belarus. They formulated a project proposal to be implemented in the next twelve months. The lectures on project management were very practical, with reference to their own project plans. The majority of the project plans however were rather ambitious and needed to be redesigned. The participants were offered the EATI planning instrument "the Logbook" to formulate their planning linked to a timetable and financial budget.

In April 1999 all local project proposals will be finalised and send to the local co-ordinating Health Information Centre. After approval by the Centre the project will be subsidised by the Dutch government in order to implement the project in Belarus.

The tailor made basic guide on prevention, developed by EATI, which outlines concepts, methodologies and project management for health and drug educators is being translated into Russian.

The main problem in Belarus is the alcohol misuse under teenagers. Alcohol use is culturally very accepted. Since there is a lack of well developed appealing material, adequate information is required. So one of the objectives was to discuss the educational material from the European Union in order to publish them in Russian. The Alcohol and Tobacco brochures are being piloted in the regions. The people were very enthusiastic about the brochures and eager to have them for their schools. The brochures will be adapted to make them more socially acceptable in the Belorussian society. A discussion took place on the educational videos: produced in Europe, are they suitable in Belarus? Most of the participants felt that for example the (Dutch) prevention video "Inventors" shows a too positive image of drug using. The children look too healthy and too happy. In Belarus people don’t talk so openly about their substance use.

The seminars did meet the objective of how to design and implement a prevention project. There was a high degree of knowledge transfer, (by) a high degree of participation and active learning by working in small groups. Using their own project proposals as illustration on the lectures, people were very involved.

Implementing this project in Belarus is a real challenge for EATI (and the Jellinek). Not only in intellectual, managerial and professional respect, but also from a human point of view. As a result of implementing this project in Belarus, close relationships have been established with our Belorussian colleagues and with many institutes in the field of addiction care. Once more it was proven that positive results can only be achieved when a solid basis for co-operation and involvement can be enhanced.

Deborah Voordewind

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Action plan for 'Kasha' Community

Training Eastern European young health professionals

Kasha is the name of a fictive local community which deals with social and economic problems as well as with substance abuse. For this community, a group of young health professionals from countries in Eastern Europe were trained by EATI in developing an action plan for the prevention and treatment of drug problems. This practical training programme seemed to be very effective for the participants.

The special training seminar on prevention and treatment of substance abuse was organised by the Geneva Initiative on Psychiatry (GIP), an international network of mental health reform, founded in 1980. Funds were made available by the Open Society Foundation with support of EATI training consultants. The hosting city was Prague, Czech Republic, where participants from Central Eastern European Countries and Newly Independent States, gathered for a practical training seminar in March 1999. The 30 participants, aged between 20 and 35, came from Kyrgistan, Kazachstan, Russia, Belarus, Ukraine, Georgia, Armenia, Bulgaria, Romania and the Baltic States. The main aim of the training was to form a network of young professionals in the field of substance abuse, mental health and psychiatry and to train them in innovative approaches and methodologies in community based treatment and prevention. In addition the intention was to assess the priorities of training needs of the participants for the near future. EATI provided the young trainees with a questionnaire to indicate their main educational needs.

After introductory lectures on modern treatment approaches and new developments in drug policy and harm reduction, the participants were divided into four multinational project groups. The local community Kasha, which is affected by social and economic problems, including problems of substance abuse was introduced. The project groups were instructed to outline action plans to solve the drug problems in the Kasha community. All project groups started with a community needs assessment to acquire an actual overview of existing problems and available resources in Kasha. The next step was to formulate priorities and draft plans in the field of prevention, treatment, community involvement and harm reduction. The active contribution of training participants was highly appreciated. The project groups designed their final plans, supported by the seminar drug consultants, and presented them during a plenary session.

The participants visited a centre of drug services in Prague where they were able to collect information about the Czech way of working. Drug experts answered all kind of questions which the participants were eager to ask. The whole training seminar seemed to be an outstanding opportunity for the young participants of so many different countries to create their own network.

During the evaluation session it seemed that the participants were very enthusiastic and they concluded that this seminar 'tastes for more'. They highly appreciated to be able to actively contribute to the process and outcome of the project groups. They also esteemed the opportunities which were offered to create their networks. The organisers of the training seminar were also very satisfied with the results. It is their intention to prepare a second training meeting for the newly created network of young professionals in substance abuse prevention and treatment.

On the basis of the outcome of the educational needs assessment, GIP and EATI are preparing Kasha II, in which the focus will be laid on project management, psychological interventions, prevention and research. EATI Newsletter will keep you informed on the further plans.

Wim Buisman

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Handbook Local Drug Policy

A practical guideline for policy makers and trainers

Policy makers have a difficult job. They have to keep all the actors happy and at the same time ensure that a good quality policy is developed. It is obvious that they require a network of professionals to define objectives as well as to implement concrete action plans. As from 1990, when the European Cities on Drug Policy was created, national governments emphasise the importance of local drug policy. Since the burden of drug abuse is felt mostly by the local community, local authorities should be in control in developing their own drug policy. EATI subsequently created tailor-made training programmes for local drug policy makers. In November 1998 the handbook, written by EATI trainer Ernst Buning and head of the EATI, Wim Buisman, has been published.

A first glance at the handbook might discourage anyone who has to develop a local drug policy. The ingredients are numerous but the reader very soon will notice that this handbook is very concrete and practical. All aspects of a local drug policy have been taken into consideration. The first part of the handbook is meant for policy makers and points out which steps have to be taken in developing a comprehensive policy plan. The second part offers a practical outline for organising a training. Every aspect of importance is considered, from a general outline up till finding a proper location, from topics up till organising a social programme. The authors have made use of resources from EATI training programmes and with this information a very useful handbook has been generated.

Every local drug policy has to pay attention to four issues which require close cooperation with the actors in the field. Interventions of the criminal justice system have to reduce supply reduction. The social culture has to be considered since there seems to be a correlation between the availability of a substance, the quantity of consumption and the amount of substance related problems. Supply reduction might be less effective in a society with a stronger emphasis on behavioural influences. Demand reduction is considered more appropriate and important. Many parties are involved in developing prevention programmes, especially for youngsters. The job of the local policy maker is to organise cooperation between all actors and to develop a logical framework. One of the practical tips is to compete with all kind of information youngsters are bombarded with. "Don't give them information which cannot be substantiated, since you will lose your credibility".

Although treatment of drug abuse eventually is only successful for 5% of the total group, drug free treatment should be part of a local drug policy. Even when the first attempt fails treatment can have a positive effect on a drug user and may ameliorate the chance of success of a second attempt. For those who don't stop eventually, harm reduction projects like methadone programmes, syringe exchange and pill-testing are measures to prevent the damage of drug abuse.

Once the framework is clear, objectives have to be defined. This process involves a number of actors, each with their own interest and agenda. Concrete information about objectives has to be presented to them. Before one can formulate the final objectives, one should know exactly what is going on in the local community. The fact finding mission can be done in a rather short period. The handbook outlines the topics which need to be observed. For a rapid assessment the WHO published a guide which helps to clarify the drug problem as well as the resources.

Many instruments are at the disposal of policy makers. They are all described thoroughly, followed by practical and strategic advice. The first part of the handbook is completed with suggestions how to implement a local drug policy. A short lesson is presented how to deal with the media and how to inform the public. Both play an important role in local drug policy.

The second part of the handbook offers a practical guideline for organising a training seminar. A series of practical steps, starting six months before the training seminar is to be given, guides the organiser through the whole process. Checklists are being presented no item of significance can be forgotten. Finally the handbook summarises issues which are important for creating an optimal climate for learning. A rather important topic is attention span. Introductions as well as lectures and presentations should be kept short. The organiser of a training has to take care of relaxing activities and organise site visits as well as a cultural programme.

The handbook is a valuable publication which offers lots of tips for beginning as well as experienced policy makers and trainers. Some of the advice seems obvious, other tips might be an eye opener. The authors have used their broad experience in the training field to present all ingredients for a local drug policy.

Ineke Hurkmans

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