odvisnosti Vol XV, Supl 1, 2015 ovisnostiseea zavisnosti addictions 7TH SOUTH EASTERN EUROPEAN AND ADRIATIC DRUG ADDICTION TREATMENT CONFERENCE 14TH SEEANET SYMPOSIUM ON ADDICTIVE BEHAVIOURS 6. SLOVENSKI SIMPOZIJ O OKUŽBI Z VIRUSOM HEPATITISA C PRI OSEBAH, KI UŽIVAJO DROGE March 12th - 14th, 2015 Cankarjev dom, Ljubljana, Slovenia, EU 10 yearS of Seeanet 20 let mreže CPZOPD/CZOPD abstract book ODVISNOSTI - OVISNOSTI - ZAVISNOSTI - SEEA ADDICTIONS, Vol XV, Supl 1, 2015 Urednika/Editors Andrej Kastelic Tatja Kostnapfel Rihtar zavisnosti addictions Revija Odvisnosti je strokovna revija South Eastern European and Adriatic Addiction Treatment Network-a. Ovisnosti / Zavisnosti je stručni časopis South Eastern European and Adriatic Addiction Treatment Network-a. SEEA Addictions is the official magazine of South Eastern European and Adriatic Addiction Treatment Network. Gradivo navaja poglede avtorjev za katere ni nujno, da se ujemajo z načelnimi stališči stroke oziroma uredniškega odbora. Objavljeni radovi predstavljaju mišljenje autora i ne moraju uvijek odražavati stavove uredničkog odbora. The findings, interpretations and views expressed in this documentation are entirely those of the author(s) and do not necessarily reflect positions of the editorial board or the Sound of Reflection Foundation. Ker se revija izdaja v več jezikih, za lekturo odgovarja avtor. S obzirom da se časopis izdaje na više jezika, za lekturu odgovara autor. As the magazine is published in different languages, authors will be held responsible for language editing. Oblikoval/Designed by: Ksenija Konvalinka Založil/Izdal/Published by: Prohealth, d. o. o., Ljubljana, Slovenija Naslov uredniškega odbora /Adresa uredničkog odbora/Address of the Editorial Board Revija Odvisnosti/Ovisnosti/Zavisnosti/SEEA Addiction Društvo SEEAnet Bolkova 16, Homec, Radomlje Slovenia seea.net@gmail.com www.seea.net Naklada: 200 izvodov Tisk: Studio Orca - Silveco CIP - Kataložni zapis o publikaciji Narodna in univerzitetna knjižnica, Ljubljana 613.8(082)(0.034.2) SOUTH Eastern European and Adriatic Drug Addiction Treatment Conference (7 ; 2015 ; Ljubljana) Abstract book [Elektronski vir] / 7th South Eastern European and Adriatic Drug Addiction Treatment Conference [in] 14th Seeanet Symposium on Addictive Be- haviours [in] 6. slovenski simpozij o okužbi z virusom hepatitisa C pri osebah, ki uživajo droge, March 12th - 14th, 2015, Ljubljana, Slovenia, EU ; urednika Andrej Kastelic, Tatja Kostnapfel Rihtar. - El. knjiga. - Ljubljana : Prohealth, 2015. - (Odvisnosti ; 2015, 15. Supl. ; 1) ISBN 978-961-91390-9-7 (pdf) 1. Kastelic, Andrej, 1956- 2. Seeanet Symposium on Addictive Behaviours (14 ; 2015 ; Ljubljana) 3. Slovenski simpozij o okužbi z virusom hepatitisa C pri osebah, ki uživajo droge (6 ; 2015 ; Ljubljana) 278374656 SEEAnet BOARD Andrej Kastelic, President of SEEAnet Board of Directors: Liljana Ignjatova, Nermana Mehić Basara, Ante Ivančić, Genci Muçollari, Aleksandar Tomčuk, Nikola Vučković Tatja Kostnapfel Rihtar, General Secretary SEEAnet REPRESENTATIVES Snežana Alzac (Serbia) Vjekoslav Kovačević (Bosnia and Herzegovina) Miodrag Andjelković (Serbia) Marina Kuzman (Croatia) Argyris Argyriou (Cyprus) Philip Lazarov (Cyprus) Verica Arsenijević (Serbia) Evita Leskovšek (Slovenia) Daniela Alexieva (Bulgaria) Tatjana Maglov (Bosnia and Herzegovina) Sunčica Arsovska (Macedonia) Tanja Mandić (Montenegro) Safet Blakaj (Kosovo) Icro Maremmani (Italy) Zane Branson (Serbia) Mojca Matičič (Slovenia) Marija Cahunek Žunec (Croatia) Nermana Mehić Basara (Bosnia and Herzegovina) Ismet Cerić (Bosnia and Herzegovina) Dragan Milkov (Serbia) Jasna Čuk Rupnik (Slovenia) Katarina Mitić (Serbia) Mirjana Delić (Slovenia) Borislav Mitrić (Montenegro) Aleksandra Dickov (Serbia) Genci Mucollari (Albania) Ivan Dimitrijević (Serbia) Milena Naydenova (Bulgaria) Goran Dubajić (Slovenia) Mirjana Orban (Croatia) Vito Flaker (Slovenia) Tijana Pavičević (Montenegro) Slavica Gajdazis Knežević (Macedonia) Altina Peshkatari (Albania) Ljiljana Gajić (Slovenia) Marija Petrović (Serbia) Maria Georgescu (Romania) Flavio Poldrugo (Italy) Hajrudin Hasesić (Bosnia and Herzegovina) Marina Roganović (Montenegro) Mojca Hvala Cerkovnik (Slovenia) Slavko Sakoman (Croatia) Catalina Iliuta (Romania) Nora Stojanovik (Macedonia) Liljana Ignjatova (Macedonia) Jasmin Softić (Bosnia and Herzegovina) Ankica Ivanović (Montenegro) Bernardo Spazzapan (Italy) Minja Jovanović (Serbia) Milena Stanković (Serbia) Besnik Juca (Albania) Nuša Šegrec (Slovenia) Ivan Jurić (Bosnia and Herzegovina) Hrvoje Tiljak (Croatia) Euangelos Kafetzopoulos (Greece) Georgi Vasilev (Bulgaria) Aleksander Kantchelov (Bulgaria) Nikola Vučković (Serbia) Livio Kosina (Slovenia) Olivera Vulić (Montenegro) Mira Kovačević (Serbia) Diakogiannis Yoannis (Greece) Tajnica/Tajnica/Secretary: Tanja Bizjak 7th South eastern european and adriatic Drug addiction treatment Conference 14th Seeanet Symposium on addictive Behaviours 6. slovenski simpozij o okužbi z virusom hepatitisa C pri osebah, ki uživajo droge march 12th - 14th, 2015 Cankarjev dom, ljubljana, Slovenia, eU www.seea.net 5 OrGaNISeD By SOUtHeaSterN eUrOPeaN aND aDrIatIC aDDICtION treatmeNt NetWOrK Seeanet and COOrDINatION OF CeNterS FOr tHe PreVeNtION aND treatmeNt OF DrUG aDDICtION IN tHe rePUBlIC OF SlOVeNIa UNDer tHe HONOrary aUSPICeS OF/POD POKrOVItelJStVOm tHe mINIStry OF HealtH OF tHe rePUBlIC OF SlOVeNIa/ mINIStrStVa Za ZDraVJe rePUBlIKe SlOVeNIJe UNDer tHe aUSPICeS OF GlOBal aDDICtION aSSOCIatION INVIteD OrGaNISatIONS eUrOPeaN OPIOID aDDICtION treatmeNt aSSOCIatION - eUrOPaD eUrOPeaN mONItOrING CeNtre FOr DrUGS aND DrUG aDDICtION - emCDDa POmPIDOU GrOUP - COUNCIl OF eUrOPe WOrlD HealtH OrGaNIZatION - reGIONal OFFICe FOr eUrOPe WOrlD FeDeratION FOr tHe treatmeNt OF OPIOID DePeNDeNCe tHe CONFereNCe IS OrGaNISeD aS a Part OF tHe 20-year CeleBratION OF OrGaNISeD DrUG aDDICtION treatmeNt SerVICeS IN SlOVeNIa aND tO HONOr 10 yearS OF Seeanet 6 tHe 7th SOUtH eaSterN eUrOPeaN aND aDrIatIC DrUG aDDICtION treatmeNt CONFereNCe with 14th Seeanet SymPOSIUm ON aDDICtIVe BeHaVIOUrS and tHe 6th SlOVeNe SymPOSIUm ON HePatItIS C amONG PeOPle WHO USe DrUGS Dear Colleagues, Patients, Advocates, Stakeholders and Friends! We are happy to welcome you at the 7th SEEAnet CONFERENCE and 14th SEEAnet SYMPOSIUM ON ADDICTIVE BEHAVIOURS in Ljubljana, Slovenia together with the 6th SLOVENE SYMPOSIUM ON HEPATITIS C AMONG PEOPLE WHO USE DRUGS. You are part of the unique conference in this field within the region together with many colleagues and international friends representing the partnerships that SEEA net has developed with Global Addiction Association, European Monitoring Center for Drugs and Drug Addiction, European Opiate Addiction Association, Pompidou Group – Council of Europe, World Federation for Treatment of Opiate Dependence and others. Our main conference issues are treatment of people who use new psychoactive substances, treatment of people with comorbidity of drug dependence and personality disorders, addiction to internet and social networks, and last hepatitis C in people who use drugs. The organisers are all excited about a comprehensive conference program developed by our conference planning committee and about all of us coming together at the Welcome and Award Reception. The latter is to be held in order to celebrate ten years of SEEAnet as well as to present SEEAnet Reflection Awards and Appreciations during the 20th anniversary of organised treatment of drug addiction in the Republic of Slovenia. SEEAnet Board of Directors Andrej Kastelic, President of SEEAnet Liljana Ignjatova, Nermana Mehić Basara, Ante Ivančić, Genci Muçollari, Aleksandar Tomčuk, Nikola Vučković Tatja Kostnapfel Rihtar, SEEAnet General Secretary 7 SOUtH eaSterN eUrOPeaN aND aDrIatIC aDDICtION treatmeNt NetWOrK – Seeanet SPONSOrS teCHNICal OrGaNISerS 8 about Seeanet 9 Seeanet - SOUtH eaSterN eUrOPeaN and aDrIatIC aDDICtION treatmeNt NetWOrK During the 1st Congress of Psychiatrists of Bosnia and Herzegovina in Sarajevo, October 3rd 2003, the second meeting of the coordination committee of drug addiction treatment experts in South Eastern Europe was held. At the meeting the need for the further cooperation and the institutionalization of this need trough the network was recognized. With the agreement of all participants, ”to preserve ideas and the spirit of Poreč (Croatia) – Piran (Slovenia) during 1st Adriatic Drug Addiction Treatment Conference in May 2003 and to ensure continuity of cooperation” South Eastern European and Adriatic Addiction Treatment Network (SEEAnet) was born. SEEAnet is an informal organization of experts on addiction treatment and harm reduction from the countries all over South Eastern Europe and Adriatic coast. Each country gives 3-5 representatives. The number of countries is not limited. The Network has a president, co-president and coordinator. Techni-cal support for the Network is provided by SEEAnet Society from Slovenia. SEEAnet is “home grown” and not organised by some other international body or organization. That’s is why it is intrinsic motivated and not burdened by expectations from outside. The Network is based on professional connections and friendship. These are the arguments that allow us to believe that “SEEAnet” plays an important role in the creation of new strategies and approaches in drug addiction treatment and reduction of drug related harm in the region and broader, even globally. SEEAnet is the founder of World Federation for Treatment of Opiate Dependence (WFOTD) – together with European Opiate Addiction Association (EUROPAD) and American Association for Treatment of Opiate Dependence (AATOD) during 1st World Conference of Opiate Addiction in Ljubljana, Slovenia that was organized by SEEAnet, as well. SEEAnet is the founding member of International Drug Policy Consortium (IDPC), Drug Policy Network in SEE and is the member of EUROPAD. SEEAnet has been involved as an organization or trough the experts who are the members of SEEAnet in developing treatment and harm reduction programs in communities and custodial settings worldwide. Most of this activities have been done pro bono or trough the cooperation with major international organizations as EU, Council of Europe – Pompidou Group, UNAIDS, UNODC, WHO, OSCE, Global Found, Open Society,… Numerous trainings, workshops, study visits, meetings, conferences and symposia have been organized for governmental and non governmental organizations, treatment professionals, practitioners, volunteers, drug users, patients etc. including direct consultations. 10 SEEAnet Conferences and Symposia  1st Adriatic Drug Addiction Treatment Conference: Treatment, Hard Reduction, Rehabilitation, May 21st-22nd, 2003, Poreč, Croatia  1st SEEAnet Symposium, Sarajevo, 2003  2nd Conference & 2nd SEEAnet Symposium, May 19–21st, 2005, Kranjska Gora, Slovenia  3rd SEEAnet Symposium, May 17th, 2006, Novi Sad, Serbia  3rd Adriatic Drug Addiction Conference & 4th SEEAnet Symposium, Sarajevo, Bosna and Hercegovina  5th SEEAnet Symposium – Izazovi i odgovori na problem ovisnosti o drogama – regionalna iskustva, 17. 10. do 18. 10. 2008, Poreč, Hrvatska  4th Adriatic Drug Addiction Treatment Conference and the 6th SEEA (South Eastern European Adriatic Addiction Treatment Network) Symposium on Addictive Behaviours, May 21–23, 2009 Budva-Bečići, Montenegro  5th Adriatic Drug Addiction Treatment Conference & 7th SEEA (South Eastern European and Adriatic Addiction Treatment Network) Symposium on Addictive Behaviours, September 30 – October 2, 2010, Ohrid, Macedonia  6th Adriatic Drug Addiction Treatment Conference & 8th SEEAnet Symposium, June 21st –23rd, 2012, Tirana, Albania  9th SEEAnet Symposium, October 12th, 2012, Tuzla, BIH  10th SEEAnet Symposium, May 10th, 2013, Pisa, Italy  11th SEEAnet Symposium, May 22nd, 2013, Ohrid, Macedonia  12th SEEAnet Symposium, February 6th, 2014, Ljubljana, Slovenia  13th SEEAnet Symposium, June 26th, 2014, Rome, Italy  7th SEEAnet Conference, March 12th – 14th, 2015, Ljubljana, Slovenia  14th SEEAnet Symposium, March 13th, 2015, Ljubljana, Slovenia SEEAnet participating countries Albania Greece Moldova Austria Hungary Montenegro Bosnia and Herzegovina Italia Slovenia Bulgaria Kosovo Serbia Croatia Romania Cyprus Macedonia SEEAnet was strongly involved, as well, in developing addiction treatment programs in: Azerbaijan The Baltic countries Egypt Kyrgyzstan Taiwan Tajikistan Turkey Ukraine Joined European Union - Latin American and Caribbean project 11 Faculty 13 DIMA ABDULRAHIM (026, 037)  Abdulrahim, D., White, D.G. and Phillips, K.C. 1999 Drug de- pendent Women and the Experience of Risk, Staffordshire Uni- has been working in the field of drug mis- versity use treatment for over 20 years. She is cur-  Abdulrahim D: (1998) ‚Power, Culture and the Hard to Reach: rently working at the Club Drug Clinic the marginalisation of minority ethnic populations from HIV (Addiction and Offender Care Directorate) prevention and harm minimisation‘ in Barbour R and Huby of Central and North West London NHS G (eds) Meddling with Mythology; the social construction of Foundation Trust. Dima manages the knowledge London Routledge NEPTUNE national programme and is the  Abdulrahim D, White D, Phillips K, Boyd G, Nicholson J and first author of the NEPTUNE clinical guid-Elliott J: (1994 ) Ethnicity and Drug Use: Towards the Design of ance. She has previously worked for the Community Interventions North East Thames Regional Health National Treatment Agency for Substance Misuse, the Sub- Authority. stance Misuse Advisory Service and the University of East Lon- don. Dima was a member of the UK government’s Advisory Coun- BOJANA AVGUŠTIN AVČIN (047) cil for the Misuse of Drugs from 1991 to 2010. She is currently a member of the Independent Scientific Committee on Drugs Present Position and a sits on the editorial board of Drugs and Alcohol Today. Psychiatrist, Unit for Psychotherapy, Uni- versity Psychiatric Hospital Ljubljana Relevant publications include: 2005–2012 Training in group psychother-  Abdulrahim D, Bowden-Jones O and the NEPTUNE group apy (forthcoming March 2015) Guidance on the management of 2005; PhD in Medicine, Medical faculty acute and chronic harms of club drugs and novel psychoactive Ljubljana substances Novel Psychoactive Treatment UK Network 1996; BA in Medicine, Medical faculty Lju-  Abdulrahim D: 2008 The 2007 service user satisfaction survey of bljana Tier 4 service users in England. London NTA I have published several original scientific articles on:  Abdulrahim D: Harm reduction- findings from the National - long term group psychotherapy for patients with psychosis; Treatment Agency’s 2006 survey of user satisfaction in England. - immunological dysfunction in schizophrenia National Treatment Agency (NTA) August 2007 - on the effects of economic crisis for mental health  Abdulrahim D and Gordon D: The National Treatment Agen- cy’s 2005 survey of needle exchanges in England. 2006 London National Treatment Agency’s DANIELA CHAPAROSKA (031)  Abdulrahim D and Gordon D: Findings of a survey of needle exchanges in England. 2006 National Treatment Agency’s NTA is working as a Professor of Internal medi-  Gordon D, Burn D, Abdulrahim D and Campbell A: The National cine and Professor of Emergency medi- Treatment Agency’s NTA’s 2006 user satisfaction survey. NTA 2007 cine on Medical faculty in University Sts.  Abdulrahim D: 2004 in Beaumont B (ed) ‘Caring for drug users Ciryl and Methodious in Skopje. She re- in primary care; a harm reduction approach London Radcliffe ceived her Master degree on internal Medical Press Ltd medicine at Medical faculty in Skopje in  Wanigaratne S, Dar K, Abdulrahim D and Strang J Substance 1987, and PhD degree on medical science Misuse and Ethnic Minorities: Issues for the United Kingdom from Medical faculty in University of Bel- Drugs Education Prevention and policy 2003 vol 10 no 1 grade, Serbia, in 1994. She is the author  Abdulrahim D: 2001 Substance Misuse and Mental Health co- and coauthor of more than 120 profesinal publications.She has morbidity (dual diagnosis); Standards for mental health services also authored a number of research articles in spices of Clinical London Health Advisory Service Toxicology. She is a member of several professional organiza-  Abdulrahim D, Annan J, Custer R, Dale-Perara A, Drummond tions including Eurotox. She is teaching medical students since C, Hackland F, J, Lavioe D, A, Strang J, Ghodse H): 2002 Models 1990 and she has subsequently developed teaching and curric- of Care London National Treatment Agency and Department ulum programs and mentored both medical students and ju-of Health nior doctors at Medical faculty in Skopje.She currently teaches  Marsden J, Strang J, Lavoie D, Abdulrahim D, Hickman M, medical students master and PhD toxicology and population Scott S: 2001 ‚Drug Abuse‘ in Stevens A, Raftery J, Mant J (eds) health students in addition to coach in basic and advanced phy- Health Care Needs Assessment: the epidemiologically based sician traineers.Medical faculty,University Clinic of Toxicology, needs assessment reviews, First Series Update, Abingdon: Rad-Center for treatment of drug abuse and abuse of other psycho- cliffe Medical Press Ltd active substances, hospital Mother Teresa, Skopje,Macedonia.  Abdulrahim D, Lavoie D, Hasan S: 1999 Commissioning Stan- dards; Drug and Alcohol Treatment and Care London Health Email: chaparoskadani@gmail.com Advisory Service  Abdulrahim D: (1999)‚ Suchthilfe and ethnische Minoritat- en in Grosbritannien‘ in Salman R, Tuna S, Lessing A (eds) Handbuch interkulturelle Suchthilfe; modelle, Konzepte und An- satze der Pravention, Beratung und Therapie Griesen: Psychoso- zial-Verl. Reihe Edition psychosozial 14 JASNA ČUK RUPNIK (044) MILAZIM GJOCAJ (004, 005) She started her medical career as GP and Since 13. 07. 2013, Ministry of Health / later as a paediatrician for the area of Prison Health Department in Prishtina. 10.000 inhabitants of central Slovenia. Position: Director of Kosovo of Prison From the foundation of slovenian Centers Health Department. for prevention and treatment of addiction 01. 01. 2003–13. 07. 2013, Ministry of of illicit drugs (CPTAID) in the year 1995 she Justice of Kosovo / Kosovo Correctional started working also with drug addicts. Service – KCS in Prishtina. For the Center of Logatec she made a lot Position: Head of Prison Health System of of research in the field of opioid treat- Kosovo for KCS. ment, many of them regarding the children of drug addicted 01. 01. 2003 – 31. 01. 2006 National Insti- people. For spreading new knowledge to the general and med- tution of Public Health in Prishtina ical population of Slovenia she wrote the book »My methadone Position: Doctor on residence for Human Ecology and Public children – I love you«. From 2008 to 2012 she was also the direc- Health until graduated as specialist tor of Primary Healthe Center where CPTAID Logatec is situated. Since 2004, MPTC “Labirinti” and NGO “KEA’ Position: Medical advisor for drug addicts and TBC 2002, Institute of Public Health in Peja MIRJANA DELIĆ (036, 040) Position: Doctor on residence and responsible for Humane Ecology and Public Health for Peja Region. is the psychiatrist at the Centre for Treat- Dubrava Prison ment of Drug Addiction Ljubljana, Univer- Position: Medical Doctor and than Medical Coordinator for Du- sity Hospital Ljubljana. She earned her brava Prison Hospital. medical degree from the University of Pharmacies Sans Frontiers – CI Novi Sad in 2002 with a specialization in Position: Doctor, coordinator for monitoring drugs distribution psychiatry in 2010 from the University of and training projects for Peja Region. Ljubljana. Postgraduate training included Medicines Sans Franciers – France transactional analysis, cognitive behav- Position: Doctor, coordinator for health reorganization, mobile ioral therapy and short courses in motiva- clinics including, in Peja Region. tional interviewing, group psychotherapy and psychopatholo- UNHCR gy. She is a PhD student at the University of Ljubljana. Her main Position: Doctor, one of the supervisors of the vaccination pro-fields of interest are: dual diagnosis, cocaine addiction and gram for refugees based in Montenegro. ADHD in adults. She is regularly attending congresses in psy- 133 Brigade “Adrian Krasniqi”, Dukagjin chiatry and reserch field in her country and wordwide. Position: Medical doctor and organizator for health for solders and civilian population. UNICEF ANDREJA DREV (025) Position: Doctor, participating in the campaign for eradication of POLIO disease in Kosovo. 10. 10. 1996 – 24. 03. 1999: Mother Teresa NGO National Institute of Public Health. As a Position: Doctor and coordinator in Clinics of Mother Teresa member of National Focal Point for the NGO for Istog District supported by MSF (Doctors without Bor-European Monitoring Centre for Drugs ders). and Drug Addiction (EMCDDA) she is re- sponsible for coordination and manage- Current Positions: ment of the Slovenian Early Warning Sys-  Professor at the Medical Sciences University “Rezonanca” in tem on New Psychoactive Substances and Prishtina for preparation of the National Report on  Director of Kosovo of Prison Health Department / Ministry of Drug Situation in Slovenia. She is a mem-Health ber of inter-ministerial expert working group of the national  Director of NGO “Pro Vitae” Early Warning System on NPS and taking an active part in a Eu-  Member and Deputy Head of the National Ethical Medical ropean project entitled I-SEE - aiming on strengthening infor- Board of Kosovo / Ministry of Health mation exchange between Italy, Slovenia and Croatia on New Other professional activities: Psychoactive Substances. She has participated in various sur-Thesis of the specialization: veys on drugs and youth health behaviour; at the moment she “Hygienic and sanitary conditions of the detention centers and is participating in the Survey on Drugs use in Prison. prisons of Kosova” Thesis for magister of science: “Management of Prison Health System of Kosova” 15 ALExIS GOOSDEEL (038, 039) ROK HREN (048) Head of Unit Reitox & International Coop- received his PhD in Physiology and Bio- eration, European Monitoring Centre for physics from Dalhousie University, Cana- Drugs & Drug Addiction (EMCDDA) da and MSc in International Health Policy Mr. Alexis Goosdeel is the Head of Unit (Health Economics) from London School “Reitox & International Cooperation” at the of Economics and Political Science, UK. European Monitoring Centre for Drugs & He is an Assistant Professor at the Univer- Drug Addiction (EMCDDA). He is the Coor- sity of Ljubljana and a President of ISPOR dinator of the European drug information (International Society for Pharmacoeco- network, called the Reitox network, and he nomics and Outcomes Research) Slove- is responsible for the definition and implementation of the Inter- nia Regional Chapter. Currently, he also holds the position of a national Cooperation Strategy of the EMCDDA. Managing Director of Carso, a Member of Salus Group PLC Mr Goosdeel has a Master in Clinical Psychology from the Catholic (SALR.SI). In total, his publications gathered more than 200 ci- University of Louvain (B), which he completed with a Special Di- tations in the SCI data base, excluding self-citations. ploma in Advanced Management from ICHEC Brussels Manage- ment School (B). LILJANA IGNJATOVA (018, 019, 020) SEDIN HABIBOVIĆ (012, 013) is head of the Center for Prevention and Treatment of Drug Abuse and Abuse of He graduated in psychology at the Fac- the Other Psychoactive Substances and ulty of Philosophy in Sarajevo. He pre- Assistant Professor of Psychiatry and pares doctoral thesis Experimental in- Medical psychology at the Medical fac- sights into the effects of the application of ulty of the University St.Cyril and Metho- therapy of EMDR in the hospital detox opi- dius in Skopje. ate addicts. He is Head of Department for She graduated at the Medical faculty of the Prevention and Counseling in Public University St.Cyril and Methodius in Skopje Health Institution Addiction Treatment in 1986 and completed her specialization in psychiatry in 1994. Centre of Zenica-Doboj Canton. He is She received her master degree on psychiatry in 2006, and PhD trained in the field of Transactional Analysis, Systemic Constel- degree on medical science in 2010 at Medical Faculty in Skopje. lation, EMDR-a, Mindfulness, Neuro Emotional Integration, Dr. Liljana Ignjatova is author and coauthor of more than 100 arti-Non-violent communication. He is editor of the journal Bilten cles, manuals, guidelines, brochures and leaflets in the subject of (www.zedo-ovisnost.ba). He was delegate in European Associa- drugs and addiction and has organized and participated in many tion for Transactional Analysis. He was member of organizing national and international conferences and seminars on the same committee in three international scientific and professional subject. She became a founding member of the SEE Adriatic Ad-meetings. He has published 27 article as the author or co-au- diction Treatment Network and is currently on its Board of Direc- thor. He has published chapters in four manuals. tors. She is founding member of the World Federation for the Treatment of Opiate Dependence and permanent correspondent from Macedonia for Pompidou Group, Council of Europe. HRVOJE HANDL (017) Born 29th October 1966.g., living in Za- ANTE IVANČIĆ (050) greb, being a cosmopolitan by faith, be- lieving in unconscious and that „the strug- General practitioner from Porec, Croatia. gle is not yet over“. Medical faculty and Since 1993 has been engaged in the field faculty of drama and arts, actors class, fin- of addiction treatment. Head of the Cen- ishing after so many years, specialisation tre for Addiction Treatment in his home- of psychiatry in the heart of Zagreb, in town since 1995. Psychiatric hospital „St.John“ learning One of the pioneers and promoters of from the best team. A status of candidate the Croatian model of substitution treat- in psychoanalysis earned a few years ago, finished personal ment in Croatia where ST is provided ex- analysis in 2013.g. 10 years in eating disorders as psychothera- clusively in GPs offices. pist. Now leading day hospital for eating disorders in Psychiatric Member of the expert group who wrote the “National Strat- hospital „St.John“. egy for Illegal Drug Abuse Control” and “National Methadone Guidelines” Lecturer at conferences, seminars and workshops on addiction treatment for GPs and other medical professionals in Croatia and other South-Eastern European countries. First president of the SEEA Network (South-Eastern European Addiction Treatment Network) and a member of the board of directors of EUROPAD. 16 ALExANDER KANTCHELOV (027, 028) ANDREJ KASTELIC (043, 045) Dr. Alexander Kantchelov is a specialist in Andrej Kastelic, MD, PhD, is the head of psychiatry, working in the addiction field the National Center for the Treatment of since 1993 - Professional Bionote 2015. Drug Addiction in Ljubljana (Slovenia) He serves as the President of the Bulgar- and the president of coordination of the ian Methadone Treatment Association Centers for the Prevention and Treat- and the Director of the Kantchelov Clinic ment of Drug Addiction at the Ministry of in Sofia. Bulgaria. Health of the Republic of Slovenia. He For the last 15 years Dr. Kantchelov had earned his medical degree from the Uni- invested sustained professional efforts to versity of Ljubljana in 1981, with a spe- promote and contribute for the development and extension cialization in psychiatry in 1989. of methadone maintenance treatment, as well as contempo- He works as a consultant expert specially for development rary methods of addiction treatment in Bulgaria. addiction treatment programs in communities and custodial He has collaborated in the development of the first Bulgarian setting for UNAIDS, UNODC, WHO, EU, Council of Europe – National Strategy Against Drugs, the Bulgarian National Pro- Pompidou Group, OSCE, Global Found. He has been involved gramme for Prevention, Treatment and Rehabilitation and the as a consultant and/or principal trainer in Albania, Azerbaijan, Bulgarian National Strategy for Methadone Treatment, that Bosnia and Herzegovina, Egypt, Kosovo, Macedonia, Moldova, had reconsidered the national treatment policy and put meth-Montenegro, Romania, Serbia, Ukraine, Taiwan, Tajikistan, Tur- adone maintenance as a central treatment modality. key, Baltic’s countries and the Caribbean. In 2002 Dr. Kantchelov established the Kantchelov Clinic in He has served as guest editor of European Addiction Research Sofia, the first specialized clinic for psychotherapy and addic-on Buprenorphine: Current Perspectives, as well as editor-in-chief tion treatment in Bulgaria. It has the mission to develop and of SEEA Addictions, a Slovenian magazine titled Reflection, and introduce comprehensive treatment models, implement the a series of books titled Drugs Amongst Us and as a member of state-of-the-art clinical practice, reach high clinical results, and the editorial board of European Addiction Research and Heroin be the leading face in the addiction treatment in Bulgaria. The Addiction and related Clinical Problems. He is the author of more therapeutic team of the Clinic had developed and implement- than 300 books articles on drug addiction and WHO guidelines ed the Integrative Methadone-assisted Psychotherapy Model for treating drug users in custodial settings and several manu-for heroin addiction treatment. als and leaflets for drug users and on prevention of drug use. A. As a sign of recognition for his contributions to extending Kastelic has participated in more than 300 international confer-methadone maintenance treatment and developing and ences and has offered about 900 lectures on the same subject. providing quality therapeutic models for heroin addicted pa- He serves as the president of Global Addiction Association, the tients, Dr. Kantchelov has been awarded the “Chimera Award” secretary general of the European Opiate Addiction Treatment of the European Opiate Addiction Treatment Association and Association, is the founding member of the World Federation the “Nyswander-Dole Award” of the American Association for for the Treatment of Opiate Dependence, the president of the the Treatment of Opioid Dependence. SEEA Society, and the president of the SEE Adriatic Addiction Treatment Network. He has received Dole – Nyswander Award in 2001 by American SAMIR KASPER (006, 007, 011) Association for Treatment of Opiate Dependence, Gold Reflec- tion Award 2002, Slovene Ministry Of Justice Award 2005 and 1997– Medical Faculty University of Sara- Europad “Chimera” Award 2008. jevo MD degree 1998–2005 At the Center for Mental Health and Head of Zenica ambulance for THOMAS KATTAU (014, 015) substitution treatment 2003–2007 residency in neurology and is the Deputy Executive Secretary of the psychiatry in the Cantonal Hospital Ze- Pompidou Group. The Pompidou Group is nica and Sarajevo Clinical Center the Council of Europe’s drug policy coop- 2005–2008 doctor in a clinic for substitu- eration body. Before this he held various tion treatment for addiction institute Zenica-Doboj Canton positions at the Council of Europe: he was 2008–2011 Head of department of hospital detox Institute for responsible for setting up childhood poli- Addiction Zenica-Doboj Canton cies at the Council of Europe and assis- 2008–2010 postgraduate studies in clinical medicine Medical tance programmes in Eastern Europe. In Faculty, University of Sarajevo (MSc dergree) the late 90s and early 2000 he was en- 2011 –Head of medical service and hospital detox Institute for gaged in conflict resolution and post conflict stabilization in the Addiction Zenica-Doboj Canton Balkans and North Caucasus. He took up his present position in 2011–2013 member of the expert group for the development of the field of drug policy in 2004. guidelines for the treatment of opiate addicts in the Ministry Since 2005 he is also a professor for Political Science at Syracuse of Civil Affairs BiH University in Strasbourg. 2012 –UNODC trainer trainer in the field of addictive medicine Prior to taking up duties with the Council of Europe he worked 2013–2015 Subspecialty areas addictive medicine in criminological research, taught comparative law and was a practicing attorney. 17 JELENA KAVARIĆ BRKOVIĆ (009) torica knjige »Srečanja na spletu. Potrebe slovenske mladine in spletno svetovanje«, ki jo je NIJZ izdal v letu 2014. Prim. Dr., is a head of the Department of the Section for Consultative and Thera- peutic Services and a head of the Depart- MILAN KREK (021) ment of Counceling for HIV and HCV in the Special Hospital for Addiction Dis- Milan Krek is a medical doctor and special- eases in Belgrade, Serbia (Teodora Dra- ist of public health and head of national jzera 44). focal point for drugs in the REITOX net- She finished Faculty of Medicine at the work. He is employed at the National In- University of Belgrade in 1982 and mag- stitute for Public Health. In the past he isterium in 1995. Together with two specialisations, one in clini- was one of the founders of the network cal immunology in 1992 and other in internal medicine in 1996, of the Centres for prevention and treat- she has gathered more than thirty years of working experience ment of illicit drug addiction in Slovenia. leading to clinical immunology in the field of HIV infection and In the beginning of 90’s he was started intravenous addiction as her main field of academic expertise. with methadone maintenance substitution therapy in Slove- Working on many projects related to consultative and thera- nia on the Coast region. He is a founder of the Centre for pre- peutic services and counceling for HIV and HCV, she was ap- vention and treatment of illicit drug addiction in Koper – Coast pointed member of the National Council for monitoring the region (1991). From the very beginning he started with the implementation of projects in the field of HIV / AIDS and tuber-prevention and treatment of hepatitis C and HIV. Together culosis (CCM-Global Fund) and a member of the Supervisory with his colleagues he implemented treatment of hepatitis C Board of the Council. “Expanding and enhancing the quality for drug addicts on a local level. of methadone programs in Special hospital for Addiction Dis- Later, he was a Director of the Office for Drugs at the Govern- eases” is the most recent project that she was involved in, con- ment of the Republic of Slovenia. As a director of the govern- ducted together with the Ministry of Health of the Republic of ment office he was working on better cooperation on the field Serbia, under the 6th round of the Global Fund to fight AIDS, of drugs among the Western Balkan Countries. Together with malaria and tuberculoses (2007-2014). his colleagues, he wrote the first drug strategy in Slovenia. He Most important publications include: is a researcher in the field of addictions and, as such, is actively involved in numerous professional seminars and educations at  Kavaric Brkovic, J. 2012. “Undesired Nephrology Complica- tions in the Implementation of Buprenorphine Treatment”, home and abroad. paper presented at 25th ECNP Congresse, Viena, Austria, 13 During the Slovenian Presidency of the EU he has been a Chair- - 17 October. man of the HDG the Council of Europe. He has been involved as a representative of Slovenia in pre accession negotiations  Brkovic, Ј., 2010. DPST za prevenciju HIV i HCV infekcija u pri- marnoj zdravstvenoj zastiti. Vodic za nacionalne smernice za process. He has a long term and nice experiences in coopera-lekove u primarnoj zdravstvenoj zastiti: Tretman zavisnika od tion with EMCDDA agency. Today, he is a head of the National opijata i opioida, Beograd, april 2010. Focal Point on Drugs on the National Institute of public health.  Brkovic, Ј., i Kovacevic, M., 2007. HIV i HCV infekcija. Prirucnik – bolesti zavisnosti, Beograd, str. 31. ICRO MAREMMANI (016)  Suvakovic, V., Kavaric Brkovic, Ј., Alcaz, S., Zavisic, L., Jankovic, T. i Djokic, D., 1998. Sirenje sindroma stecene imunodefici- jencije u Beogradu medju osobama koje koriste droge in- is Professor of Addiction Medicine at the travenskim putem. Srpski arhiv, sveska 11/12, godiste - 126, School of Psychiatry of the University of novembar - decembar 1998. Pisa. He graduated at the Medical School of the University of Pisa, Italy, in 1979, and went on to specialize in Psychiatry NUŠA KONEC JURIČIČ (008) taking his second degree cum laude in 1983. dr. med., specialistka javnega zdravja in He is currently on the Board of Directors socialne medicine, je zaposlena na of the Department of Psychiatry, at the Območni enoti Celje Nacionalnega Vincent P. Dole Dual Diagnosis Group, Santa Chiara Hospital, inštituta za javno zdravje. Vodi strokov-University of Pisa, Italy. no skupino za duševno zdravje na NIJIZ, He has been President of the European Opiate Addiction Treat-delovno skupino za nenalezljive bolezni ment Association (EUROPAD) since its foundation in Geneva na enoti Celje. Na področju preprečevanja (Switzerland) in 1994. As President of EUROPAD he has orga- rabe in zlorabe psihoaktivnih snovi (PAS) nized international symposia in the USA, during the Confer-in zasvojenosti je bila dolgoletna vodja ences of the American Association for the Treatment of Opiate LAS Celje in LAS Savinjske regije dela, bila je pobudnica in vod-Dependence (AATOD), and Conferences in several European ja prvega programa zamenjave igel in brizg zasvojenim z ne- cities (Saint-Tropez, 1995; Ljubljana, 1997; Arezzo 2000; Oslo dovoljenimi PAS na Celjskem. Je svetovalka mladim v spletni 2002; Paris, 2004; Bratislava, 2006; Sofia, 2008; Zagabria, 2010; svetovalnici www.tosemjaz.net, predavateljica vsebine o PAS Barcelona, 2012; Glasgow, 2014). specializantom družinske medicine na Medicinski fakulteti v He received the Dole-Nyswander Award in Washington (DC), Ljubljani in drugim strokovnim in splošnim javnostim. Je soav-USA, in 1994; he was the first non-American winner of that 18 award. In 2004 he received the “Chimera Award”, in Paris. In NERMANA MEHIĆ-BASARA (030) 1990 (Cagliari, Italy) he became a founding member of the Società Italiana Tossicodipendenze - Italian Society of Addiction Ass. professor MD, PhD Medicine (SITD-ItSAM), and is currently its Past-president. Neuropsychiatrist, Addiction specialist He is President of the World Federation for the Treatment of  Director of the Institute for Alcoholism Opioid Dependence (WFTOD), an NGO with Special Consulta- and Substance Abuse of Canton Sarajevo tive Status with Economic and Social Council (ECOSOC), since  Ass. professor at the University of Sa- 2011. rajevo, Faculty of Health Studies Saraje- He is author of the chapters on Drug Abuse and Aggression in vo, for the subject „Mental Health Care“ the second edition of the Trattato Italiano di Psichiatria. To date since 2014. he has 500 scientific publications and has given over 300 scien-  Born 1957 in Sarajevo, Bosnia and Her- tific presentations. He is Editor of Heroin Addiction and Related zegovina, where she lives and works. Graduated at the Medi- Clinical Problems, the official journal of EUROPAD and WFTOD, cal Faculty of the University of Sarajevo in 1981. Residency and board member of Journal of Maintenance in the Addictions, examination in neuropsychiatry passed in 1989 in Sarajevo. Italian Journal on Addictions, Addictive Disorders and their Treat-  Master thesis defended 2007 and doctoral dissertation with ment, and Odvinosky. title: „The Association of the Dopamine Receptor Gene Poly- morphs and Psychological Dimensions of Personality in the Development of Opiate Addiction” in 2012. MOJCA MATIČIČ (049)  The period of the war 1992-1995 spent in besieged Sarajevo and was actively involved in the work of teams for psycholog- is the Head of the Viral Hepatitis Unit at the ical assistance and support to local population and refugees. Clinic for Infectious Diseases and Febrile Ill-  National WHO Coordinator for Alcoholism and Drug abuse in nesses, University Medical Centre Ljublja- Federation of Bosnia and Herzegovina na, and the Head of the Outpatient STI Ser-  Member of the Expert group for Community mental health vice at the same University Medical Centre. Project in Bosnia and Herzegovina Besides, she is a Professor in the field of In-  Vice President of the SEE Adriatic Addiction Treatment fectious Diseases and Epidemiology at the Network. Medical Faculty, University of Ljubljana,  Since 2007 member of the European Association for the Slovenia. She obtained her Medical Degree treatment of opiate addicts (EUROPAD - European Opiate from the University of Ljubljana where she also received her spe- Addiction Treatment Association). ciality in Internal Medicine as well as Infectious Diseases. Professor  Recipient of the Nyswander-Dole “Marie” Award from AA- Matičič completed her MD thesis on HIV/aids and her PhD thesis TOD in 2004. on hepatitis C at the University of Ljubljana. She undertook her  Published more than 50 scientific and professional articles in post doctoral training at the Middlesex Hospital and the Royal professional journals of which 18 are indexed. Author and co- Free Hospital in London, UK. Professor Matičič is a member of the author of 12 publications and books. European Association for the Study of the Liver (EASL)the Euro- pean Society for Clinical Microbiology and Infectious Diseases (ESCMID), and used to be the Slovenian representative in the In- SAMO NOVAKOVIČ (032) ternational Herpes Management Forum (IHMF). Her main focus are clinical aspects, teaching and research in vari- Prof. mat. in rač. in je zaposlen, kot strokov- ous areas of viral infections, primarily viral hepatitis, herpesviruses, ni delavec v soc. varstvu v NVO Društvo Svit sexually transmitted infections and HIV/aids. She leads the Na- Koper, kjer dela v programu za tional interdisciplinary expert group for the management of vi- zmanjševanja škode na področju drog. ral hepatitis in Slovenia and is an active member of the HIV/AIDS Sodeluje oblikovno in vsebinsko pri izdela- Committee at the Slovene Ministry of Health. She co-authored the vi časopisa »Svit« ter spletne strani svit-kp. National consensus guidelines for the management of Hepatitis org ter pri znotraj zveze NVO na področju B (2010) and Hepatitis C (1997, 2009) in Slovenia. She is also a co- zmanjševanja škode. Od leta 2013 sodeluje author of the national guidelines for the management of hepatitis pri oceni indikatorja o problematični upor- C in users from drug treatment programmes (2007) and co-organ- abi drog, kot zunanji sodelavec NIJZ. ises annual interdisciplinary national conferences on viral hepatitis in drug addicts (since 2006). Professor Matičič has published over 200 papers in national and international journals and actively par- MINA MARIJA PAŠ (001, 002, 003) ticipates at the national and international scientific meetings. Prof. Mojca Matičič, MD, PhD Dr. med., leta 2002 diplomirala na Medi- Clinic for Infectious Diseases and Febrile Illnesses cinski fakulteti v Ljubljani. Od leta 2003 University Medical Centre Ljubljana, Japljeva 2 zaposlena v Združenju DrogArt kot koor- 1525 Ljubljana, Slovenia dinatorica programov. V letu 2004 oprav- e-mail mojca.maticic@kclj.si ljen strokovni izpit s socialnega varstva. Soavtorica večih knjig in strokovnih pub- likacij s področja zmanjševanja škode zaradi psihoaktivnih snovi. 19 Trenutno specializantka Integrativne relacijske psihoterapije in versities. She currently contributes to the teaching of the doctor-vodja Terapevtskega programa za uporabnike kokaina in klubskih ate course in clinical psychology at the University of Surrey. drog, ki deluje v sklopu DrogArt svetovalnice. JASMIN SOFTIĆ (011) BLAŽ PODGORŠEK (024) He was born in 1959. in Zenica, Bosnia My name is Blaž Podgoršek and I am a third and Herzegovina. He graduated from the year medical student at the University of Faculty of Medicine, University of Novi Ljubljana. Since 2012 I lead the project ''Tea, Sad in 1984. Examination of the neuro- not tears'' which fights against alcohol psychiatry passed in 1992. in Belgrade. abuse. This time me and my colleagues Master thesis defended in 1997 at the were interested in ways which students our University of Novi Sad, 2013. doctoral university use to help them study. We used dissertation on the topic: „The differenc- an electronic survey in which students es in quality of abstinence and other were asked to indicate which substances characteristics of heroin addicts on methadone and after de-they take as a study aid. We are very proud that we are the first in toxification“ at the University of Banja Luka. Slovenia who have ever done that kind od research. He worked as a physician in Kikinda since 1984 and as a neuro- psychiatrist at the General Hospital in Kikinda from 1992 to 2006. Most of the time worked in acute psychiatry. Participated in orga- SANJA ROZMAN (022, 023) nizing a series of expert meetings of Psychiatric section of the So- ciety of Physicians of Vojvodina and showed works at meetings. MD, CSAT, TAP, Expert Council Chairman From 2006 to 2015 he worked in the Public health institution She has finished the Medical Faculty of the for addictions in Zenica-Doboj Canton, Zenica. University Ljubljana and spent 35 years He made a significant contribution in building the concept of working as a medical doctor, specialist in prevention, treatment and rehabilitation of addiction in the occupational medicine in the Rehabili-Zenica-Doboj Canton. He worked on the education of doctors, tation Institute of Ljubljana. In 1991 she medical staff and social workers from Bosnia and Herzegovi-sought help for her codependency and na in the field of substitution therapy and participated in the her former husband’s problem gambling project of introducing substitution treatment in prisons in the with dr. Janez Rugelj, the founder of socio-Federation. andragogic method and therapist in an alternative holistic thera- Author of several scientific papers in journals and a number peutic program for addictions. of popular articles related to addictions. He has collaborated Her first book »Dreaming about the Red Clouds« was published in in the development of brochures regarding the treatment of 1993 and was an exceptionally honest story about her own path addiction. of recovery from codependency. He has participated in several international congresses on ad- She has written 6 books and conducted a large number of work- diction (SEANET, EUROPAD) and conferences and professional shops and lectures on process addictions. Her basic psychothera- meetings in Croatia and Serbia. He is an active participant in peutic education is in Transactional Analysis TAP (Transactional the second and third congress of psychiatrists in BiH and Acad-Analyst - Psychotherapist), with additional training in group anal- emy of addictions. Contributed to the establishment of a sys- ysis and behavior-cognitive therapy, psychodrama. tem of reporting on addiction in BiH and was in the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) in Lisbon in 2010 and 2013. METKA SHAWE-TAYLOR (033, 034) MD, PhD, neuropsychiatrist, primarius Director of Public health institution for addictions Zenica-Doboj Canton, was born in Slovenia where she graduated Zenica, Bosnia and Herzegovina in mathematics at the University of Ljublja- na. She then studied psychology and ob- tained a PhD in psychology from Royal Hol- loway, University of London and complet- NATAŠA SORKO (035) ed her clinical psychology training at the University of Surrey. She has worked for Univ. dipl. soc. ped., dipl. ekon., je predsed- National Health Service (NHS) of England nica Društva Žarek upanja in strokovni for over 20 years. She is employed by Sur- vodja programov psihosocialne obravnave rey and Borders NHS Foundation Trust, which is a large organisa- oseb s težavami zaradi odvisnosti od alko- tion providing 140 services to people of all ages with mental hola in njihove pomembne bližnje osebe. health problems and learning disabilities. She is the Trust’s profes- Je tudi vodja programa za mladoletne sional lead for psychological therapies. Her clinical work is with otroke, ki se spopadajo s težavami zaradi adults with complex mental health problems. Metka has exten- odvisnosti od alkohola. Je strokovna delav- sive experience of teaching and training in psychological thera- ka na področju socialnega varstva z oprav- pies and has had teaching appointments at different English Uni- ljenim strokovnim izpitom iz socialnega varstva in članica razis- 20 kovalne skupine v Društvu Žarek upanja. Je avtorica več stro- work and gaining self-understanding. In her view establishing a kovnih člankov in predavateljica na strokovnih in znanstvenih positive, collaborative and friendly client/therapist relationship posvetih doma in v tujini. Avtorica prispevka je bila odlična in zau-is central in the counseling process. Among the most desirable panja vredna organizatorka več strokovnih posvetov in konferenc clinician characteristics she considers good interpersonal skills s področja zdravljenja in obravnave zasvojenosti z alkoholom, se and the capacity to meet the client where the client is. aktivno in strokovno vključuje v psihosocialno obravnavo odvis- nosti od alkohola, preventivne in raziskovalne aktivnosti. In je doktorska kandidatka na Pedagoški fakulteti, smer socialna peda- NUŠA ŠEGREC (042, 043) gogika in se izobražuje s področja sistemske družinske psihotera- pije v tujini. Dr. Segrec works as a psychiatrist. She is specialised in the field of substance abuse in Center for treatment of drug ad- BERNARD SPAZZAPAN (051) diction. Her primary professional focus is on clinical work with patients with com- Diploma v Medicini v Trstu leta 1974, spe- plex needs - drug users with comorbid cializija v Psihiatriji na isti Univerzi leta mental disorders. 1980. Več kot 20 let zaposlen kot psihiater She has presented and actively partici- v Gorici (Italija), v Centru za duševno pated at different national and interna- zdravje. Leta 1993 je postal Direktor tional conferences, trainings and seminars. She has been in-službe za odvisnosti pri Goriškem pod- volved as a trainer in trainigs for developing services for drug jetju za zdravstvene usluge. To funkcijo je users in community and prison environment in Bosnia and opravljal do upokojitve leta 2008. Od leta Herzegovina (supported by United Nations Development Pro-2000 do upokojitve je zastopal Deželo gram), Montenegro (supported by European Commission and Furlanijo-Julijsko krajino v Rimu v Državni Konzulti za probleme Global Fund) and Kosovo (supported by Global Fund), gener- ki so povezani z alkoholizmom in uporabo drog. ally, in the area of substitution treatment and for patients with Trenutno dela kot privatni psihiater v Gorici. Dela tudi v Novi comorbidities; and as a trainer for improving mental health Gorici v ambulanti za ne-kemicne odvisnosti. programs in prisons in Turkey organised by Council of Europe. V zadnjih letih se ukvarja predvsem s takozvanimi “novimi odvis- nostmi”: igre na srečo v vseh raznih oblikah, Internet in nove Center for Treatment of Drug Addiction University Psychiatric Hospital tehnologije, odvisnost od hrane, fizičnih dejavnosti, ipd. Zani-Ljubljana, Grabloviceva 48, Ljubljana, Slovenia ma ga zlasti prehajanje od ene odvisnosti v drugo ter istočasna University of Ljubljana, Faculty of Medicine, Department of Psychiatry, prisotnost raznih psihiatričnih motenj. Sodeluje pri raznih pub-Vrazov trg 2, Ljubljana, Slovenia likacijah in pri kongresih na to temo. E-mail: nusa.segrec@psih-klinika.si Via Foscolo 14, 34170 Gorica-Gorizia (Italija) Tel dom +39-0481-34672; Prenosni telefon 348-4490355 ARIJANA TURČIN (052) bspazzapan@yahoo.it MD, is a psychiatrist and the head of staff at the Outpatient Unit of the University TSVETANA STOYKOVA (029) Psychiatric Hospital. She is also the head of staff of the Liaison Psychiatric Service Tsvetana Stoykova is a clinical psycholo- provided for the University Medical Cen- gist and psychodynamic psychotherapist tre Ljubljana, and her fields of interest are with more than 15 years of experience in psychotic and affective disorders, as well the mental health treatment field. Since as psychiatric disorders that occur in pa- 2003 she has been working in a special- tients treated for somatic illnesses. She is ized addictions clinic, The Kantchelov active in teaching and research. Clinic, Sofia, Bulgaria that deals in devel- oping integrative therapeutic models and providing comprehensive treatment for TINA ZADRAVEC (046) heroin addicted patients. She is performing the duties of the Clinical Director and the Senior therapist, providing individual is a clinical psychologist, working on psy- and group psychotherapy to clients in this clinic. chotherapeutic hospital unit at the Univer- Her broad-ranging interests in psychotherapy include the ap- sity Psychiatric Hospital Ljubljana. She plication of self-psychology and dynamic treatment of chroni- works in hospital and outpatient setting cally mentally ill people. She is nondirective therapist. The most predominantly with patients with person- useful activities in her work consist in developing the therapist’s ality disorders. The treatment on the unit is internal feeling, the manifestation of empathy and the develop- based on group analytic psychotherapy. ment of hypotheses with regard to the patients’ functioning. She finished her Phd on suicidology in 2006 Her therapeutic skills involve interpreting the nature of uncon- at the Medical faculty and is cognitive-be- scious processes, assisting patients in performing psychological havioural (2012) and psychodynamic psychotherapist (2014). TIJANA ŽEGURA (053) PUBLICATIONS Prison Drug Treatment, Systems Overview, Montenegro Coun- PROFESSIONAL SUMMARY try Report Social Worker with more than 10 years of Pompidou Group/ Co-operation Group to Combat Drug Abuse professional practice in provision of social and illicit trafficking in Drugs/ Council of Europe; December and health care and support to vulnerable 2014. population in Montenegro. Experienced Authors: Tijana Zegura, Jelena Colakovic. in work with diverse population in health Drugs, harms and youth. The state of drug use and harm reduc-care, outpatients, and imprisoned, in con- tion amongst youth in European countries. flict with law, as well as ones whose hu- YODA- Youth Organization for Drug Action in Europe, Vienna; man rights were not protected by govern- March 2014. mental organizations due personal situation or affiliation. Also, Authors: Jan Stola, Luca Stefenelli, Martina Markoc, Tijana Ze-professional practice in research, management- executive and gura, et. al. financial one, fundraising. Work in national non- government Survey on HIV/AIDS related risk behavior, HIV, HBV and HCV Se-and health oriented government organizations, with lots of ex- roprevalence among injecting drug users in Montenegro in perience with prison settings and law enforcement. 2013/2011/2008. Institute for Public Health/ UNDP, CO Podgorica, Montene- CORE COMPENTENCIES gro, 2013/2011/2008. Authors: Boban Mugosa, Dragan Lausevic, Itana Labovic,  Provided group, individual and family counseling for people who use/inject drugs, sex workers, prisoners, minors in con- Zoran Vratinica, Rajko Strahinja, Tijana Zegura, et. al. flict with law, minors drug users, children of drug users, both Survey on HIV/AIDS related risk behavior among female sex in health/social care or prison institutions and in community workers in Montenegro in 2012/2010/2008. during street work. Institute for Public Health/ UNDP, CO Podgorica, Montene- gro, 2012/2010/2008.  Provided support to vulnerable population in conflict with law, as well as with exercising their rights in connection with Authors: Boban Mugosa, Dragan Lausevic, Itana Labovic, social and health care and legal issues. Zoran Vratinica, Rajko Strahinja, Tijana Zegura, et. al.  Provided support to vulnerable and marginalized population with obtaining IDs, medical documentation, refugee docu- EDUCATION mentation, as well as referral and accompanying to the ad- 2013, Bachelor’s degree in Political Science Faculty – Depart- ministrative offices. ment: Social Politics and Social Work 2004-2014, Non-formal education gained in local and inter-  Provided individual and psycho- social support during emer- gency situations regarding health. national NGOs: project management/ workshop, skills/ re- WORK EXPERIENCE search/ communication/ human rights. Jan 2009- current NGO Juventas, Podgorica, Montenegro AWARDS Title: Director of Harm Reduction Program (full time job) First Prize for Program Coordination of young professional un- Job description: Coordinating Program for reduction of der the age of 35 at “4th Adriatic Drug Addiction Treatment health, social and criminal harm among people who use Conference; 6th and 1st Montenegrin Psychiatric Days with drugs, people who sell sex and prisoners; Provision of International Participation (MPD)”, May 2009. counseling and support to program beneficiaries, their children and their families; Project proposal writing, bud- MEMBERSHIPS geting, fundraising, implementation, reporting, etc. Association Parents, Board Member since 2014, Jan 2008- Jan 2009 Board of Directors South East Europe Adriatic Addiction Treat- NGO Juventas, Podgorica, Montenegro ment Network since 2007. Title: Executive Director (full time job) Job description: Management of organization; Finance management, Program and Project development, im- plementation, evaluation, monitoring and reporting; Research Work; Advocacy and Lobbying; Work with vul- nerable and marginalized populations; Networking and Cooperation with Governmental Organizations. Apr 2004- Jan 2008 NGO Juventas, Podgorica, Montenegro Title: Program Coordinator (contract on co- operation/ full time job) Job description: Coordination of project implementa- tion; Founding of Harm Reduction Program in Montene- gro; Research Work; Advocacy and Lobbying; Work with vulnerable and marginalized populations; Networking and Cooperation with Governmental Organizations. 22 Programs 7tH SOUtH eaSterN eUrOPeaN aND aDrIatIC DrUG aDDICtION treatmeNt CONFereNCe 14th Seeanet SymPOSIUm ON aDDICtIVe BeHaVIOUrS 6. SlOVeNSKI SImPOZIJ O OKUžBI Z VIrUSOm HePatItISa C PrI OSeBaH, KI UžIVaJO DrOGe marCH 12th - 14th, 2015 CaNKarJeV DOm, lJUBlJaNa, SlOVeNIa, eU www.seaa.net 23 Klinika za infekcijske bolezni in vročinska stanja Univerzitetni klinični center ljubljana in Koordinacija centrov za preprečevanje in zdravljenje odvisnosti od drog organizirata šesti simpozij OKUžBa Z VIrUSOm HePatItISa C PrI OSeBaH, KI UžIVaJO DrOGe 12. marec 2015 Cankarjev dom, ljubljana PrOGram 09.00 – 09.15 Otvoritev srečanja 09.15 – 09.40 Matičič M: Leto 2015: ZDRAVLJENJE HEPATITISA C PRI UŽIVALCIH DROG V EVROPI IN DOMA 09.40 – 10.05 Kordiš P, Kastelic T, Matičič M, Kastelic A in sod.: SPREMEMBA ŽIVLJENJSKEGA STILA IN TVEGANEGA VEDENJA UŽIVALCEV DROG PO USPEŠNEM ZDRAVLJENJU HEPATITISA C: REZULTATI SLOVENSKE RAZISKAVE 10.05 – 10.25 Kotar T: UVEDBA NOVE DIAGNOSTIČNE METODE ZA UGOTAVLJANJE PRIZADETOSTI JETER BOLNIKOV S HEPATITISOM C 10.25 – 11.00 Matičič M: ZDRAVLJENJE HEPATITISA C BREZ INTERFERONA: MIT ALI RESNIČNOST? 11.00 – 11.30 Odmor 11.30 – 11.45 Krek J: IZKUŠNJE Z OBRAVNAVO BOLNIKOV S HEPATITISOM C V CENTRU ZA PREPREČEVANJE IN ZDRAVLJENJE ODVISNOSTI OD PREPOVEDANIH DROG 11.45 – 12.15 Kastelic A: PRISTOP K BOLNIKU, KI JEMLJE DROGE IN NE SODELUJE V POSTOPKU ZDRAVLJENJA 12.15 – 12.30 Kastelic A: OBRAVNAVA OKUŽBE Z VIRUSI HEPATITISA PRI BOLNIKIH, HOSPITALIZIRANIH V CZOPD PKL: REZULTATI NEDAVNE RAZISKAVE 12.30 – 13.00 OKROGLA MIZA (Baklan Z, Čuk Rupnik J, Kastelic A, Matičič M, Zamernik E): ALI DOSLEDNO UPOŠTEVAMO NACIONALNE SMERNICE OBVLADOVANJA HEPATITISA C PRI LJUDEH, KI JEMLJEJO DROGE? 13.00 Kosilo 24 7th SOUtH eaSterN eUrOPeaN aND aDrIatIC DrUG aDDICtION treatmeNt CONFereNCe and 14th Seeanet SymPOSIUm ON aDDICtIVe BeHaVIOUrS 6. SlOVeNSKI SImPOZIJ O OKUžBI Z VIrUSOm HePatItISa C PrI OSeBaH, KI UžIVaJO DrOGe march 12th – 14th, 2015 Cankarjev dom, ljubljana, Slovenia, eU www.seea.net PrOGram Thursday, March 12th Štih hall/Štihova dvorana 09.00 – 13.00 6. SLOVENSKI SIMPOZIJ O OKUŽBI Z VIRUSOM HEPATITISA C PRI OSEBAH, KI UŽIVAJO DROGE – v slovenščini (glejte prosim prilogo) 6th SLOVENE SYMPOSIUM ON HCV INFECTION AMONG DRUG USERS - in Slovene Seeanet CONFereNCe 14.30 – 16.30 NEW PSYCHOACTIVE SUBSTANCES (NPS) Štih hall/ Štihova dvorana Chairs: Liljana Ignjatova, Andrej Kastelic Alexis Goosdeel (EMCDDA): THE CHALLENGE OF NPS IN EUROPE (38) Mina Paš (Slovenia): THE USE OF NPS IN SLOVENIA (3) Dima Abdulrahim (UK): NOVEL PSYCHOACTIVE TREATMENT UK NETWORK (NEPTUNE): DEVELOPMENT OF CLINICAL GUIDANCE ON THE MANAGEMENT OF ACUTE AND CHRONIC HARMS OF CLUB DRUGS AND NOVEL PSYCHOACTIVE SUBSTANCES (26) Mina Paš (Slovenia): OUTPATIENT THERAPEUTIC PROGRAMME FOR NPS USERS (2) Andreja Drev (Slovenia): EARLY-WARNING SYSTEM ON NEW PSYCHOACTIVE SUBSTANCES (25) 16.30 – 17.00 COFFEE BREAK 25 17.00 – 19.00 OTVORITEV 7. SEEAnet KONFERENCE Štih hall/ Štihova dvorana 7th SEEAnet CONFERENCE OPENING SESSION Chairs: Liljana Ignjatova, Tatja Kostnapfel, Nermana Mehić Basara, Ante Ivančić, Alexander Kantchelov, Andrej Kastelic, Aleksandar Tomčuk Ministry of Health of the Republic of Slovenia: OPENING OF THE CONFERENCE Thomas Kattau (Pompidou Group, Council of Europe): WELCOME Alexis Goosdeel (EMCDDA): WELCOME FROM EMCDDA Icro Maremmani (Italy): WELCOME FROM WFO AND EUROPAD PRESIDENT Andrej Kastelic (Slovenia): 20 YEARS OF DRUG ADDICTION TREATMENT IN SLOVENIA, 15 YEARS OF SEEA net ADDICTIONS JOURNAL AND 10 YEARS OF SEEAnet (45) Jasna Čuk (Slovenia): HOW DOES TREATMENT WORK IN PUBLIC HEALTH NETWORK OF CENTRES FOR PREVENTION AND TREATMENT OF DRUG ADDICTION (44) Mirjana Delić (Slovenia): FACTORS ASSOCIATED WITH OUTCOME OF OPOID ADDICTION TREATMENT AT CENTRE FOR TREATMENT OF DRUG ADDICTS, UNIVERSITY PSYCHIATRIC HOSPITAL LJUBLJANA (36) Nuša Šegrec, Andrej Kastelic (Slovenia): TREATMENT OF PEOPLE WHO USE DRUGS WITH COMORBID MENTAL HEALTH DISORDERS (43) Thomas Kattau (Pompidou Group, Council of Europe): ADDICTED SOCIETIES – A CHALLENGE FOR POLICY MAKERS (15) BUSSINESS ACCELERATOR - PODJETNIŠKI POSPEŠEVALNIK 19.00 AWARD SESSION and WELCOME COCTAIL Friday, March 13th 09.00 – 10.30 INVITED LECTURES Štih hall/ Štihova dvorana Chairs: Liljana Ignjatova, Alexander Kantchelov Alexis Goosdeel (EMCDDA): EMCDDA SUMMARY REPORT ON THE DRUG SITUATION IN THE WESTERN BALKANS (39) Thomas Kattau (Pompidou Group, Council of Europe): WEB-BASED DRUG DEMAND REDUCTION (14) Icro Maremmani (Italy): DOES THE PROMINENT PSYCHOPATOLOGY OF HEROIN ADDICTS ExIST? (16) 10.30 – 11.00 COFFEE BREAK 11.00 – 13.00 COMORBIDITIES: PERSONALITY DISORDERS AND DRUG USE Štih hall/ Štihova dvorana Chairs: Nuša Šegrec, Aleksandar Tomčuk Tina Zadravec (Slovenia): PERSONALITY DISORDERS - CLINICAL AND PSYCHODYNAMIC ASSESSMENT AND THERAPEUTIC IMPLICATIONS (46) Bojana Auguštin Avčin (Slovenia): THE NEUROBIOLOGY OF PERSONALITY DISORDERS: IMPLICATIONS FOR TREATMENT (47) Metka Shawe-Taylor (UK): CO-OCCURRENCE OF PERSONALITY DISORDER AND SUBSTANCE DEPENDENCE: IMPLICATIONS FOR TREATMENTS (33) Sanja Rozman (Slovenia): CHILDHOOD TRAUMA, PERSONALITY DISORDERS AND ADDICTIONS (23) 13.00 - 14.00 LUNCH 26 13.45 – 14.15 HOT TOPIC SYMPOSIUM Štih hall/ Štihova dvorana Rok Hren (Slovenia): PHARMACOECONOMICS-DO WE NEED IT? (48) 14.15 - 16.30 Štih hall/ Štihova dvorana Seesion room M1 14th SEEAnet SYMPOSIUM: HEPATITIS C IN SE EUROPE Chairs: Mojca Matičič, Nermana Mehić-Basara Mojca Matičič (Slovenia): RECOMMENDATIONS FOR WORKSHOP 1 TREATMENT OF HEPATITIS C: WHAT IS NEW IN 2015? (49) Metka Shawe-Taylor (UK): STEPPS Nermana Mehić-Basara (Bosnia and Herzegovina): ANTIVIRAL PROGRAMME FOR TREATMENT OF THERAPY APPLICATION IN CHRONIC HEPATITIS C AMONG BORDERLINE PERSONALITY DISORDER (34) OPIATE ADDICTS WITHIN THE OPIATE SUBSTITUTION TREATMENT (OST) (30) Daniela Chaparoska (Macedonia): HEPATITIS B AND HEPATITIS C VIRUS RELATED CHRONIC LIVER DISEASES IN SELECTED TOPICS INTRAVENOUS DRUG ABUSERS (31) 15.30 Milan Krek (Slovenia): SOME EPIDEMIOLOGICAL DATA AND Mina Paš (Slovenia): CHEMSEx: IS THE HIGH ExPERIENCES IN TREATMENT OF HEPATITIS C IN CPZOPD (21) RISK PHENOMENON ALSO PRESENT IN Milazim Gjocaj (Kosovo): HEPATITIS C IN KOSOVO’S PRISONS SLOVENIA? (1) AMONG IMPRISONED DRUG USERS DURING YEAR 2014 (4) Blaž Podgoršek (Slovenia): SUBSTANCES THAT Tijana Žegura (Montenegro): HEPATITIS C AMONG DRUG MEDICAL STUDENTS FROM UNIVERSITY OF USERS IN COMMUNITY AND PRISON IN MONTENEGRO (53) LJUBLJANA USE TO HELP THEMSELVES TO STUDY (24) Samir Kasper (Bosnia and Herzegovina): HEPATITIS C TREATMENT-WHERE IS THE BORDER OF ADDICTOLOGY? (7) DrogArt: REDUCER Alexander Kantchelov (Bulgaria): INTERDISCIPLINARY TEAM Samo Novakovič (Slovenia): THE USE OF PARTNERSHIP AND PSYCHOLOGICAL INTERVENTIONS PRESCRIPTION DRUGS AMONG IDUS: IN TREATING HEPATITIS C IN METHADONE MAINTAINED COLLECTING DATA AMONG USERS OF HR PATIENTS (28) PROGRAMS IN SLOVENIA (32) 16.30 – 17.00 COFFEE BREAK 17.00 – 18.00 Štih hall/ Štihova dvorana Seesion room M1 SELECTED TOPICS: OST TREATMENT IN SEEA REGION Chairs: Jasna Čuk Rupnik, Milazim Gjocaj Alexander Kantchelov (Bulgaria): DOSE ADEQUACY AND WORKSHOP 2 BEYOND (27) Dima Abdulrahim (UK): THE CLUB DRUG Liljana Ignjatova (Macedonia): COMORBIDITY AMONG HIGH CLINIC: ExPERIENCE AND MODEL OF THRESHOLD PATIENTS IN METHADONE MAINTENANCE CARE OF THE CENTRAL AND NORTH WEST PROGRAM (20) LONDON NHS FOUNDATION TRUST (37) Samir Kasper (Bosnia and Herzegovina): DEPRESSION IN OPIATE ADDICTION DISEASE OR SYMPTOM? (6) 18.00 SEEAnet MEETING 27 Saturday, March 14th 09.00 – 10.15 SELECTED TOPICS: ExPERIENCES FROM SEEA REGION Štih hall/Štihova dvorana Chairs: Mirjana Delić, Jasmin Softić Ante Ivančić (Croatia): OST IN GP SETTINGS (50) Milazim Gjocaj (Kosovo): CHALLENGES FOR METHADONE MAINTENANCE TREATMENT PROGRAM AT KOSOVO PRISON HEALTH SYSTEM (5) Jasmin Softić (Bosnia and Herzegovina): HEROIN ABSTINENTS USE ALCOHOL AFTER DETOxIFICATION FROM METHADONE (11) Tsvetana Stoykova (Bulgaria): DRUG AND DRINKING PROBLEMS IN WOMEN WITH BORDERLINE PERSONALITY – PRECONDITIONS AND PSYCHOTHERAPEUTIC MECHANISMS OF CHANGE (29) Karmen Kajdiž (Slovenia): ASSOCIATION OF PERSONALITY TRAITS AND OUTCOME OF HOSPITAL TREATMENT OF OPIOID ADDICTION (40) 10.15 – 10.45 COFFEE BREAK 10.45 – 12.45 INTERNET, NEW TECHNOLOGIES, SOCIAL NETWORKS AND ADDICTION Chairs: Arijana Turčin, Hrvoje Handl Miha Kramli (Slovenia): DO WE PREPARE YOUNG PEOPLE TO USE NEW TECHNOLOGIES? Sanja Rozman (Slovenia): CAUGHT IN THE NET (22) Hrvoje Handl (Croatia): SELFIE OF FACEBOOK IN THE LIGHT OF NARCISSISM (17) Bernard Spazzapan (Italy): HOW TO SUPPORT PEOPLE ADDICTED TO NEW MEDIA? (51) Arijana Turčin (Slovenia): EVIDENCE BASED MEDICINE VS. FORUM BASED MEDICINE (52) Nuša Konec Juričič (Slovenia): THE NEEDS AND DILEMMAS IN THE FIELD OF DRUGS WHICH ADOLESCENTS CONFIDE TO WEB COUNSELLORS (8) 12.45 CONCLUSIONS and SEE YOU AGAIN AT GLOBAL ADDICTION ASSOCIATION AND SEEEAnet JOINED CONFERENCE IN BELGRADE, SERBIA, JUNE 1st - 3rd, 2015 28 abstracts 29 001 When working with NPS users it is crucial, that the professional CHemSeX: IS tHe HIGH rISK PHeNOmeNON working with the client has a great knowledge about different NPS that are used in Slovenija and is well acquainted with the alSO PreSeNt IN SlOVeNIJa? risks, connected to the use of NPS. This is crucial in order to focus on reducing the specific risks, connected with NPS use, because the majority of patients are not able to achieve absti- Mina Paš nence at once, and for many of them, reducing the risks is the first step to more controllable use and abstinence. The use of stimulant drugs and GBL for sex is a phenomenon Association DrogArt that is getting bigger throughout Europe, especially in the mina@drogart.org MSM population. Typical chemsex session consists of two or more days of using drugs (mainly cathinones, other stimulants and GBL) and having multiple sexual partners. Under the in- 003 fluence of drugs there is much bigger risk of unprotected sex tHe USe OF NPS IN SlOVeNIa and the sexual practices connected with chemsex (multiple partners, using of sexual toys without condoms, damage of anal and oral mucosa, because of rough sex and the use of stimulants …) carry with them a very big risk of Hepatitis, HIV Mina Paš transmission and transmission of other STDs. In United King- dom they are already faced with rapidly growing numbers of In the abstract I will present the main findings of a survey on Hepatitis C infections among gay men, the main reason for it, NPS use in Slovenija, which was made by Association Drog-being chemsex. Art (NGO) between september 2013 and september 2014. The Chemsex is happening also in Slovenija and MSM that enrol survey consisted of quantitative and qualitative part and was in this kind of sexual practice are of great risk for transmission focusing on the patterns of NPS use, the risks, connected to of HIV, Hepatitis and other STDs. The population requires spe-their use and needs for specialised therapeutic and harm re- cial approaches of harm reduction strategies, that’s why it is duction programmes, targeting the NPS users. very important for the professionals who come in contact with Cathinones are the most widely used NPS in Slovenija, the this population to be well acquainted with high risk situations most popular among them being 3MMC. Users use NPS by na-in order to inform the chemsex population about the specific sal or oral route, injecting of NPS is not common in Slovenija. risks and harm reduction measures. They also need special The main perceived risks, are mixing NPS with other drugs, us-counselling and therapeutic programmes, which would en- ing large quantities of NPS in one binge and problems regulat- able them to talk openly about their sexual practices and help ing the use of NPS. The users are well acquainted with harm re- the establish a less risky, but satisfying sex life. duction strategies and also use them in considerable percent. One of the main general conclusions of the survey was that Association DrogArt we have a very colourful NPS market in Slovenija, which is mina@drogart.org rapidly changing, which is the reason why wee need to con- nect the programmes for the users of psychoactive substanc- es that already exist and thus create a multidisciplinary net- 002 work, that will adequately and quickly respond to the needs OUtPatIeNt tHeraPeUtIC PrOGramme of NPS users. FOr NPS USerS Association DrogArt mina@drogart.org Mina Paš 004 In the last three years we experience an increasing number of HePatItIS C IN KOSOVO’S PrISONS NPS users in DrogArt Outpatient counselling and therapeutic amONG ImPrISONeD DrUG USerS centre. NPS users come from very different user groups: mi- nors, occasional NPS users, whose use has become problem- DUrING year 2014 atic, ex opiate users, users in abstinence based programmes who use NPS to avoid positive urine testing, gay men who use NPS to enhance and prolong sexual pleasure. Milazim Gjocaj Because of the sparseness of the user group it is impossible to have a uniform therapeutic programme for NPS users. That’s why we work with this users the same as we work with oth- Objective: Identifying, treating and following their clinical sta- ers: the key worker lines out a treatment plan for each user, tus within the prison health system of inmates at the first med-in which we combine different therapeutic interventions (indi- ical examination with HCV. vidual work, group work, working together with the in-patient Prevention of the new infections with HCV among other in- programmes, social services, families, school counsellors, etc.), mates which were not identified as infected at the first medical based on the needs and motivation of the client. examination. 30 Making possible the equal medical treatment, in cooperation and specifically at prison system. Not enough experience and with the public health system of the country for the infected support by public health system. Sustainability of the program inmates with HCV. was not strongly guarantied as permanent program. Methodology: Is based at clinical examination of all inmates at Initially 0.05 % of depending inmates from 5 % of them which the admission, laboratory testing with rapid tests of the sus-are verified as drug users participated at the program. pected cases, health promotion and training of the infected Conclusions and Recommendation: There is necessarily for more and non-infected inmates that use drugs and enforcement of professional attitude and cooperation between the health data collection in all Prison health units overall Kosovo. sector in the interest of sustainability and adequate treatment Results: From the 4,981 inmates at the first medical examina- for inmates on need and wish for the program. tions, 289 were drug users and 19 of them were infected with Ministry of Health was not completely ready to mange MMT HCV; 0.38 % of all the total number of inmates and 6.57 % of Program overall Kosovo, especially to inmates at new current the inmates that use drugs had HCV infection. status of Prison Health system as part of Ministry of Health. Discussion: The rate of HCV infections among the inmates that Prison health stuff needs to have more commitment and pro-use drugs has doubled as compared to the year 2013 when the fessional training for more qualitative service within the MMT rate of inmates with HCV infection was 0.17 % of total number Program. and 3.26 % of the inmates that used drugs. The sensitive professional training to the inmates for under- HCV is increasing among the inmates that use drugs in Koso- standing and participating to the program for their benefit vo. There are no new cases of infection within the prisons. All and avoid of transmit ions diseases. the infected inmates received the infection before their admis- Keywords: Methadone, prisoners, procedure, maintenance sion in the prison. treatment, depending; Risk awareness of the spread of the disease to the other per- sons exists between the infected inmates. Dr. Milazim Gjocaj, Mr. Sci. Conclusions and recommendations: There is an immediate Director of Prison Health Department, Ministry of Health, Kosovo need to conduct the wide research for HCV among the drug Professor at University of Medical Science “Rezonanca” in Prishtina users and start professional and organized health promotion Address; Street: “Zagrebi” pn, Ministry of Health, nr. 204, 10000 Prishtinë, Kosovo, Email; Milazim.Gjocaj@rks-gov.net, phone: +377 44 158 671; for harm reduction with main focus in drug users in Kosovo. Keywords: Hepatitis C, inmates, drug users, infection, health promotion 006 Dr. Milazim Gjocaj, Mr. Sci. DePreSSION IN OPIate aDDICtION Director of Prison Health Department, Ministry of Health, Kosovo Professor at University of Medical Science “Rezonanca” in Prishtina DISeaSe Or SymPtOm? Address; Street: “Zagrebi” pn, Ministry of Health, nr. 204, 10000 Prishtinë, Kosovo, Email; Milazim.Gjocaj@rks-gov.net, phone: +377 44 158 671 Samir Kasper, Jasmin Softić, Hassan 005 Roushdy Awad CHalleNGeS FOr metHaDONe One-year – retrospective-prospective , analytical qualitative study maINteNaNCe treatmeNt PrOGram at conducted in opiate addicts who are treated at the Institute of Zenica. In that period, the change in the emotional state of patients KOSOVO PrISON HealtH SyStem through the relevant psychological instruments and undertaken appropriate therapeutic interventions. Criteria for inclusion in the study were : opiate addiction,opiate susptitution treatment Milazim Gjocaj in Cantonal Institute for Addictions Zenica.Criteria for exclusion in study were:nonopiat addictions and non OST treatment in our institutionBy these criteria the study included 270 patients . The Objective: Identifying and managing the procedural and pro- vast majority of patients at some stage of the treatment had a de- fessional challenges for MMT program at Kosovo Prison Health pressive symptom. These symptoms are most often pointed to the System. inadequacy of doses of OST or the imminent recurrence. Only 13 Methodology: Is based at observation, monitoring and regular, percent of patients had symptoms that would indicate a major de- periodic data collection. pressive disorder . The aim of the study was to try to contribute to Results: Since 01 September 2013, when MMT program started the differential diagnosis of co-morbidity with opiate addiction, as to be implemented at Kosovo Prison Health system, 20 clients well as guidelines for better and more adequate treatment. were part of the program. 12 of them left the program during this period. Cantonal Institute for Addictions, Zenica Difficulties to start program were very big as a consequence of Bosnia and Herzegovina not having before the program, pressure of drug sellers of the samir.kasper@hotmail.com prison to prevent other inmates to participate at the program and propaganda against the program as something to dam- age inmates from the prison side. Discussion: The beginning of the program was very difficult. The program was new method of treatment at all in Kosovo 31 007 An overview of age groups shows that those aged 10-13 years HePatItIS C treatmeNt-WHere IS tHe mainly ask questions on tobacco and alcohol, and on exces- sive use of computer. The questions in the age group 14-17 BOrDer OF aDDICtOlOGy? years are mostly related to alcohol and marihuana, which are followed by tobacco. Adolescents ask these questions to search advice for them- Samir Kasper, Jasmin Softić, Hassan selves, their friends, schoolmates, or even for their parents. They wish to learn about the effects of drugs simply out of cu- Roushdy Awad riosity or because they are already using them. Some of these adolescents already have their own opinions on drugs, while Among the population of drug addicts in BiH Hepatitis C is a some of them are only just forming theirs, and are confused by major problem. The size of this problem is still not precisely de-contradictory information on particular sort of drug. Among fined. Here are the experiences in working with HCV + drug in seekers of information are those who do not wish to use drugs, our health center. Every addict before or during the implementa-but are afraid that they will not be able to resist peer pressure, tion of OST is tested for hepatitis and HIV. With positive patients is and those who are tempted to try drugs but are at the same undertaken advisory work and more detailed diagnostic testing. time aware of their consequences. Among them are also the If necessary, patients are hospitalized and implemented thera-adolescents for whom drugs are no longer an occasional at- peutic procedures on stabilization of liver status.In our institution traction, but a refuge from problems they do not know or can- is not carried antiviral therapy. The paper presents the five-year not resolve. experience of our institution in the treatment of HCV positive pa- tients, and examines the obstacles and barriers that exist in their National Institute for Public Health, Regional office Celje, Slovenija; adequate treatment, as well as the importance of cooperation nusa.konec-juricic@nijz.si with specialized institutions. Our experience shows that these services are of great importance. in retaining patients in the OST as well as for the implementation of potential detoxification. 009 PatIeNtS IN SUBStItUtION tHeraPy Cantonal Institute for Addictions, Zenica Bosnia and Herzegovina are mOre relUCtaNt tO treatmeNt OF samir.kasper@hotmail.com HePatItIS C – SPeCIal HOSPItal FOr aD- 008 DICtION DISeaSeS’ eXPerIeNCe tHe NeeDS aND DIlemmaS IN tHe FIelD OF DrUGS, WHICH aDOleSCeNtS CONFIDe Jelena Kavarić Brković tO tHe WeB COUNSellOrS ON WWW. Special Hospital for Addiction Diseases through its Counceling tOSemJaZ.Net for HIV and HCV conducts Voluntary and Confidential Counsel- ling and Testing. First testing on HCV was carried out in 1997 when 442 patients were tested out of which 55.6 % were reactive. From 2001 to Nuša Konec Juričič, Ksenija Lekić, 2003, 840 patients were tested (64.28 % reactive). From 2007 Petra Tratnjek, Marjan Cugmas to 2014, 5195 patients were tested (42 % reactive). From 2004 to 2014, 224 patients were referred to program of Hepatitis C The National Institute of Public Health published a monograph treatment out of which 183 were treated. On the methadone entitled Srečanja na spletu. Potrebe slovenske mladine in spletno maintenance program there was 210 patients (82 % reactive) svetovanje (Encounters on the Web. The Needs of Slovenian Youth and 90 patients on buprenorphine maintenance program (52 and Online Counselling) in the year 2014. It includes the images % reactive). of adolescents, which were formed in the fourteen years of For the analysis, we conducted data gathering from the medi-existence of www.tosemjaz.net online counselling service. De- cal records of our patients. Firstly, we used records of 70 pa- scribed are the experiences of online counselling and the per- tients on buprenorphine program (48 % reactive) among spectives and guidelines in the field of preventive, informative which only 8 showed interest in the treatment of hepatitis C. and counselling work with youth on the web. Furthermore, among 50 patients on methadone maintenance The analysis of over 5870 questions, which adolescents con- program (88 % reactivity) only 10 were interested in the treat- fided in the web counselling site in the years 2012 and 2013, ment. Moreover, we used records of 183 patients who were showed that the most questions were related to physical de-treated from 2005 to 2014, where 153 patients were on the velopment and physical health (33 %), relationships and men- therapy of opiate receptor blockers and only 30 patients were tal health (30 %) and sexuality and sexual health (24 %). 80 (1,4 on methadone substitution therapy program. In the end, we %) of all questions were related to drugs and addictions. Those used medical records of 68 patients (100 % reactive), who were were mainly in the field of tobacco smoking (27.5 %), alcohol preparing for the treatment of Hepatitis C through the project (23.8 %), marihuana (23.8 %), recreational drugs (7.5 %) and “From Education to Hepatitis C Treatment”. In this group, 20 about the excessive use of computer (5 %). patients were on opiate receptor blockers, 13 patients were 32 on the “provision” without treatment therapy, 10 patients on 011 buprenorphine and 25 patients on methadone maintenance. This means that more than 50 % of patients in treatment pro- HerOIN aBStINeNtS USe alCOHOl grams were without substitution. aFter DetOXIFICatION FrOm If larger population is to be motivated several causes that emerged during analysis should be tackled: gender, age, fam- metHaDONe ily situation, the frequency of arrival for check-ups, regular detection, length of heroin abuse and the complexity of the programs. Jasmin Softić, Samir Kasper, Hassan Keywords: Hepatitis C, antiviral therapy, replacement therapy, intravenous drug addicts Awad Prim. dr., Jelena Kavaric Brkovic The aim of the study is to look for differences in use of psy- Special Hospital for Addiction Diseases, choactive substances between the two groups of heroin ab- Teodora Drajzera 44, 11000 Belgrade, Serbia, stinents: abstinents on methadone treatment and abstinents jelena.brkovic@yahoo.com after detoxification from methadone. Socio-demographic in- dicators and duration of the disease and treatment were ex- 010 amined. Methodology: A prospective study was conducted during the eFFICaCy OF metHaDONe 2012th at the Institute for addiction diseases in Zenica (Bosnia maINteNaNCe treatmeNt aND and Hercegovina). The sample consists of 68 patients in meth- adone treatment and control of 52 patients abstinent after SOCIal lIFe IN metHaDONe methadone detoxification. Both groups were abstinent from heroin one year. As research instruments were used: urine test maINteNNeCe PatIeNtS for psychoactive drugs, Alco test (breath test) and AUDIT (The alcohol use disorders identification test) questionnaire. The research results There is no difference between the two Aneta Spasovska Trajanovska, groups in the prevalence by gender, average age, marital sta- tus, number of children, number of years of education and Liljana Ignjatova housing. There is no difference between the two groups in duration of Substitution therapy is one of the treatments of opioid drug the disease and treatment. addicts. Methadone treatment is useful for many opioid ad- Urine analysis shows no phencyclidine, barbiturates and bu- dicts. Long treatment with stabile dose of methadone therapy prenorphine in both groups. tends to stabilization heroin addicts. Efficacy of methadone There is no difference between the two groups in the pres-treatment may describe such as some personal and social ence of cannabinoids, ecstasy, cocaine, amphetamine, meth-characteristics ( employment, education, marital status).The amphetamine and tramadol in urine. Aim of this study was to determinate the efficacy of metha- Alco test shows that the abstinents after methadone detoxifi- done maintenance therapy in improvement the social life at cation are positive in 19,2 % and the abstinents on methadone heroin addicts. Material and methods: We determined two in 5,9 %. groups. The first group A consisted of 60 heroin addicts on AUDIT shows that the patients after methadone detoxification methadone maintenance therapy >2 years with optimal meth-use alcohol in 55,8 % and patients on methadone therapy in adone doses and second group B consisted of 60 street heroin 20,6 %. addicts. Classification variable was: age, genders, education, Conclusions: The study shows that the heroin abstinents after emolument, marital status. Data were collected by structured methadone detoxification use alcohol. This findings support interview on socio-demographic characteristic the results the theory of „masked heroinism“ in the form of alcohol use. were statistical analyzed by descriptive methods and t-test Key words: alcohol use disorder; heroin abstinents; masked for independent samples. Results: The patients in methadone heroinism. maintenance treatment have higher percentage of years in education (>8 years) then heroin addicts. The percentage of Kantonal institute for addiction diseases Zenica, patients in MMT who were employed has bigger with statisti-72 000 Zenica, Aska Borića 28a, Bosnia and Hercegovina, cal significances (p<0.05) then group of street heron addicts. jsoftic@yahoo.com The number of married patients in MMT has bigger (45 %) then heroin street addicts (36, 67 %).So methadone therapy with stabile dose tends to improve the social life in heroin addicts. Psychiatric Hospital Skopje. Marko Oreskovic 79, Skopje, Macedonia, anetas- pas@gmail.com 33 012 the Internet. The worrying fact is the increase of use and abuse tHe PreSeNCe aND PreValeNCe OF of the Internet, as well as the higher percentage of the students addicted to the Internet which we can easily see from the data INterNet aDDICtION amONG HIGH that we got from their brothers/sisters (90.9 %) and their friends too (86.4 %) and their use of the Internet. SCHOOl StUDeNtS Key words: addiction, use of Internet, addiction to Internet POSTER Public Health Institution Addiction Treatment Centre of Zenica-Doboj Canton sedinhab@gmail.com Sedin Habibović, Jasmin Softić, Meliha Brdarević, Mirnes Telalović, 013 Samir Kasper, Emina Babić, Adila INterNet aDDICtION aS a reaCtION tO a Softić, Nermana Mujčinović, Hassan traUmatIC eVeNt aND DISeaSe Awad POSTER Aim: Assess the presence and prevalence of Internet addic- tion among high school students, as well as the Internet use by parents, brothers/sisters and friends and what are the most Sedin Habibović, Adila Softić commmon activities carried out while surffing on the Internet. Methods: The research included 2081 students from the first Problem statement. Internet addiction is not so far been the fo-grade (55.1 % of them) and third grade (44.9 % of them) of cus of researchers. Addicts are rare in treatment. Many parents high schools in Zenica and Zavidovići. The research was condo not know how to use the Internet, what consequences the ducted during the period of November/December, 2014. The Internet can cause and often do not control how much time research used the method of analysis theory, respectively, rep-their child spends online. Public Health Institution Addiction resentation of the studies which have been done by now on Treatment Centre of Zenica-Doboj Canton in study from 2014. this particular topic and survery research method. Instruments found that 10.6 % students of public high school in Zenica and that were used: Questionnaire on the socio-demographic Zavidovići spent more than 10 hours a days on the Internet, dana, variables for testing the use of Internet by parents, moderate addiction among 12.9 % and serious addiction brothers/sisters and friends of the students and Young scale among 1.5 % students. Internet addiction. Dana processing was done by statistical Aim: presenting a case study regarding addictions after a trau-package SPSS 17.0, and descriptive statistic was used as a sta- matic event and diagnosis of desease Fibromyalgia (M 79.7) tistical procedure. Methods: In this case study describes a case of man 27 years Results: The research included 47.2 % of male students and old. Initially received individual treament, but after three 52.6 % of female students. The most important results are: months is involved his father and mother. Older brother did  61.8 % of students replied that a mother uses the Internet not want to come to the meetings. This is qualitative methods.  65.6 % of students replied that a father uses the Internet Results: Initial interview is conducted in the presence of father.  90.9 % of students replied that their brothers/sisters use the We found that the client has spent about 19 hours a day on the Internet Internet. He used the Internet for games and chat mainly with  86.4 % of students replied that their friends use the Internet. girls. Parent expresses helplessness and care. Client does not Parents mostly spend 1-2 hours on the Internet; 82.5 % stu- show the emotional response. Sleeping during the day only. dents said that for their mothers, and 76.5 % students said that Three months had received individual treatment but there was for their fathers. Brothers and sisters spend a bit more time no progress. After that involved parents. After three months, on the Internet so we have the result of 20.2 % that says that progress has been made. Parents are empowered to set the brothers/sisters spend more than 4 hours daily on the Inter-structure of daily time. After that he spent 6 hours a day. Fibro- net. Parents usually do their business activities on the Internet myalgia was also treated. The next step was planned work on (mother 41.7 %; father 58.7 %) and social networking (mother trauma. Before it was discovered Fibromyalgia his chief gave him 26.5 %; 15.7 % father). Brothers and sisters spend most of their a suspension. He had behavioral changes and chief concluded time playing games (32.2 %) and on social networks (29.3 %). that does not work well. And a suspension caused trauma and The research proved that the most students spend 2-4 hours dissociation of people and spending time on the Internet and a day on the Internet (37.9 %), provided that it is worrying fact fantasizing about leaving the country. Today more comes out that 10.6 % of students spent more than 10 hours a day on and socialize but not yet ready for processing trauma. The next the Internet. According to the Young scale Internet addiction: step is the application of EMDR in the treatment of trauma absence of addiction among 59.3 % students, mild addiction Conclusion: Study indicates a correlation Internet addiction among 26.4 % students, moderate addiction among 12.9 % with the traumatic event or/and diagnosis of disease and the students and serious addiction among 1.5 % students. need to incorporate family into treatment system. Conclusion: We can notice that high school students show Key words: Internet addiction, Fibromyalgia, trauma, family some signs of Internet addiction, even though they spend a lot of their free time online. Nevertheless, one should not neglect Public Health Institution Addiction Treatment Centre of Zenica-Doboj Canton the fact that 1.5 % of the students are heavily addicted to Inter-Bosnia and Herzegowina net, and that 40.8 % of them are actually in a way addicted to sedinhab@gmail.com 34 014 Furthermore is now widely acknowledged that addictions of- WeB-BaSeD DrUG DemaND reDUCtION ten go hand in hand with correlate with serious mental health problems. Either because dependency can create and trigger mental illnesses or mental illness is among the causes. In ei- ther case mental illnesses are aggravated by addictions. Thomas Kattau Even those not it addicted themselves often become victims of co-dependency in their efforts to help those of their kin For drug abuse prevention, treatment and the reduction of that suffer from an addiction. This spread the negative con-risks related to drug use, the internet‘s greatest advantage is sequences of addiction even further in society, multiplying its ability to reach potentially large groups of youth on local the numbers of those in need of support and care drastically. and global levels. Offering treatment to drug users via the Leaving these problems unattended will increase overall costs Internet is rapidly increasing. It has the potential of reaching of addictions for societies even more: personal financial ruin, groups who are currently not reached. It also can offer special-unemployment, illness, etc. ised services in remote areas and provide a cost-effective way There is strong evidence that we live in addicted societies and to support a large number of clients. A constructive debate they we will not be capable of curing this ‘disease’ at present or among professionals, government regulators and the public in the near future. We must therefore look for ways to manage on internet-based drug prevention and treatment is needed the situation in order to avoid that our societies will be held to explore the full potential. hostage by addictions. While overall, internet-based drug treatment has a lot of poten- Already scientific discussion in neuro science starts to ques- tial, there are still possible limitations that should be considered. tion if the concept of the free will of the human being. This For example, physical presence of treatment versus anonymity is touching the concept of the autonomy of man, the core online, the cost coverage by health insurance schemes and pro-of liberty and the prerequisite of a functioning democracy. fessional responsibility and accountability are some potential What if citizens cannot be responsible because of addictions confines of online treatment and intervention. not being dealt with? What will happen to the rule of law if its jurisprudence cannot rely anymore on the concept of the Dr. Thomas Kattau, Deputy Executive of the Pompidou Group, Council of Europe ‘reasonable man riding the Clapham omnibus’ because reason Professor for Political Science, Syracuse University (Strasbourg Center), thomas. is driven for many by dependency and addiction? kattau@coe.int As we can see now, addiction is not only a challenge for the treatment, care and social systems. It is an issue touches upon the fundamentals of societies: freedom, democracy and re- 015 sponsibility. aDDICteD SOCIetIeS – a CHalleNGe Thomas Kattau, Deputy Executive of the Pompidou Group, Council of Europe FOr POlICy maKerS Professor for Political Science, Syracuse University (Strasbourg Center) 016 Thomas Kattau DOeS tHe PrOmINeNt Societies struggle increasingly with the phenomenon of ad- PSyCHOPatHOlOGy OF HerOIN dictions: be it to dependency on legal and illegal drugs, licit substances like alcohol and nicotine; or addiction to gambling, aDDICtS eXISt? the internet or electronic games. Findings from all areas of relevant research create a picture that will require societies to re-consider their position vis-à-vis Icro Maremmani and Angelo addictions: Giovanni Icro Maremmani It is not a fringe phenomenon that only concerns a few. It has become a mainstream problem for the greater part of soci- Addiction is a relapsing chronic condition in which psychiatric ety. Statistics and indicators show that number continue to phenomena play a crucial role. Psychopathological symptoms increase and spread through all parts of society and all age in patients with heroin addiction are generally considered to groups. be part of the drug addict’s personality, or else to be related There are no quick solutions in sight, on the contrary: research to the presence of psychiatric comorbidity, raising doubts shows that addictions are difficult to cure and have to be about whether patients with long-term abuse of opioids ac-considered as chronic conditions just like diabetes. They are tually possess specific psychopathological dimensions. Using chronic conditions with, at best, a chance of cure; and always the Self-Report Symptom Inventory (SCL-90), we studied the with the risk of relapse. psychopathological dimensions of patients with heroin addic- The receptor and neuro transmitter systems in our brains do tion at the beginning of treatment, and their relationship to not seem to function along the same divisions based on which addiction history. This presentation supports the hypothesis we have drawn up our policies. This may already suggest that that mood, anxiety and impulse-control dysregulation are the the time of compartmentalised policies is over and the dawn core of the clinical phenomenology of addiction and should of coherent policies on substances, as a step towards an over-be incorporated into its nosology. A psychopathological clas- all policy on addictions, has begun. sification of heroin addicts may be of some interest also in the 35 identification of predictors of outcome during Agonist Opioid vince and motivate him to take prescribed neuroleptic ther-Treatment (AOT) or Residential Treatment. apy were unsuccessful, and the patient‘s condition is getting worse, as manifested by physical aggression towards family. Santa Chiara University Hospital, Department of Neurosciences, University of Thus with medical vehicle he was transported in a psychiatric Pisa, Italy, EU. hospital in another city Demir Hisar where was treated with Icro.maremmani@med.unipi.it anti psychotics, psychotherapy and socio-therapy. The metha- done was quite as it is not available in that psychiatric hospital 017 so the dependence during hospitalization wasn’t treated. After two weeks he came out of the hospital with recommen- SelFIe OF FaCeBOOK IN tHe lIGHt OF dation for treatment with neuroleptic therapy and benzodi- NarCISSISm azepines. Patient return to the Centre without symptoms of psychosis but with withdrawal symptoms, anxiety, irritability, pain in bones and muscles, nausea, sweating, fast heartbeat, depression, emotionally exhausted, crying and praying for “at Hrvoje Handl least a drop of Methadone”. Immediately Methadone was in- duced and gradually increasing to 65 mg. Starting from the invitation to this event that is understood The patient is now stable and functional in everyday life, and as a narcissistic food for a psychotherapist that so often talks regularly takes neuroleptics and methadone. Discussion and to people with eating issues this theme will have to do some-conclusion: For the treatment of opiate dependence with co thing with being present, being online, being in. That is why morbid psychosis unacceptable is termination of substitution it seems so right to take You on a journey around the social therapy. In such cases, it is needed a comprehensive treatment networks and their meaning to our psychodynamic selfie, of both conditions. Unacceptable is unavailability of substitu-our understanding of others selfies and new phenomena on tion therapy at psychiatric wards and hospitals that treated the Web. There is no intention to take a side and speak with a psychiatric co morbidities in people with opioid addiction. judgement but only to explore what Internet and social net- Neuroleptic therapy can’t solve both, psychosis and addiction. works in his context do to our minds and a way that we think Kay words: methadone, co-morbidity, mental disorder. about ourselves. 1Centre for prevention and treatment of drug addiction, General Hospital Ohrid 2Centre for prevention and treatment of drug addiction, Psychiatric Hospital Psychiatric hospital “St. John” Zagreb Skopje Day hospital for eating disorders vesnalabroska@hotmail.com Croatia liljana.kitevaignjatova@yahoo.com hrvoje.handl@gmail.com 018 019 CO mOrBIDIty OF meNtal DISOrDer IN HePatItIS C PatIeNtS IN tHe CeNtre FOr PatIeNt WItH OPIate aDDICtION-CaSe aDDICtION IN OHrID maCeDONIa rePOrt POSTER Vesna Labroska1, Liljana Ignjatova2 Vesna Labroska, Liliana Ignjatova The purpose of this paper is to describe the insufficiency of  The Attention about the dependence of Ohrid is a regional treatment system for dealing with co-morbidity of opiate ad-center attention about Southwest Macedonia. diction and mental disorder. This paper describes a patient in  treated opiate addiction with sol.Metadon methadone program at the Centre for treatment of drug ad-  for ten years of work were treated 201 patients diction, a part of General Hospital Ohrid, that besides opiate 2015-January treatment 125 patients, 114 women and 11 men dependence suffer from other mental disorder. He lives in the  Before entering treatment risky drug used 90 % community with his primary and secondary family and occa- while it was 20 % of the treatment are still injecting substances sionally works as car mechanic. He is 39 old man, married, and  The Center patients have a 70 % comorbidity with hepatitis C father of two young children who was treated with 110 mg NOTE of methadone longer than 5 years and with antipsychotic in  The 30 new patients in the period from 2013 to 2015 only 3 the outpatient psychiatric ward in the same hospital. Before HCV + admission in methadone program he used cannabis, benzo-  Only one of the patients were infected while on treatment diazepines, narcotic analgesics and heroin. After long stable  3 Patients infected while serving a sentence which is not period the patient who was calm, quiet, and correct, became available exchange program needle verbally aggressive, dissatisfied with the family and treatment at the conclusion program, threatened staff and family and become paranoid. Availability needle, methadone therapy and education reduc-This situation occurred after self initiative interruption of the es icidencata hepatitis C among people who inject drugs. neuroleptic therapy. Attempts by staff from the center to con- The diagnostic procedure is carried out in a clinic for Gastro- 36 enterology and infectious clinic in the capital Skopje and the 021 Fund for health insurance. Treatment with pegylated interferon and ribavirin is conduct- SOme ePIDemIOlOGICal Data aND ed in local hospitals and is charged to the Fund for Health eXPerIeNCeS IN treatmeNt OF Patients at the Center for Addiction Ohrid having comorbidity with Hepatitis C 60 %. On treated them with 10 % called relap HePatItIS C IN CPZOPD and conducted retretman. Only one patient has no cure and retretmanot. In January 2015 three patients treated infective separated in Milan Krek1, Jelka Mišigoj Krek2 Ohrid General Hospital and five patients in the diagnostic pro- cedure. From an epidemiological point of view, the infection with the hepatitis C among drug users in Slovenia is significantly General Hospital Ohrid Makedonija greater problem as an HIV infection. All programs for drug us- vesnalabroska@hotmail.com ers in Slovenia are systematically monitoring the incidence of hepatitis C and all programs are also carried out preventive activities to reduce new infections with hepatitis C. The objec- 020 tive is to reduce the number of infected persons and found in- CO mOrBIDIty amONG HIGH fected persons, and include as many infected drug users with hepatitis C in treatment. Staffs in the network of Centres for tHreSHOlD PatIeNtS IN metHaDONe prevention and treatment of illicit drug addiction are motivat- ing patients for testing and treatment of hepatitis C and in the maINteNaNCe PrOGram same time faced with a many problems. The key could be the fear of drug users to be infected with hepatitis C. There is also a big fear to be involved in the treatment of hepatitis C, and Liljana Ignjatova, Aneta Spasovska side effects of the treatment. The method of treating a patient Trajanovska requires a lot of commitment and perseverance and discipline in the treatment of addictions and hepatitis C. In Slovenia we are monitoring the epidemiological data in Major studies of psychiatric co morbidity in opioid users re- the Centres for prevention and treatment of illicit drug ad- ported rates of co morbidity that far exceeded general popu- diction, using Treatment demand indicator questionnaire lation estimates. Co morbidity may have prognostic value and made and standardised by EMCDDA agency. Review of the important implication of the treatment. Aim of this study is to data showed that the proportion of persons who have not determine the prevalence of co-morbidity among high thresh-yet been tested for the presence of anti-HCV were among old patients in methadone maintenance program. Material those who were re-entering the program significantly lower and methods: Out of 137 high threshold patients (117 male than among those who were entered for the first time in the and 20 female) from the day hospital for treatment of opiate program. This indicates a successful testing to hepatitis C in addiction 87 were interviewed with eight-item screening in-Centres for prevention and treatment of illicit drug addiction terview, the Standardized Assessment of Personality – Abbre- and other programmes. The proportion of positive anti-HCV viated Scale (SAPAS), 86 were examined with Zung Self-Raiting tests among users, which in recent years have been re-entered Depression Scale (SDS) and 88 were examined with Zung Self- in the program, is slightly raised. The proportion of anti-HCV Raiting Anxiety scale (SAS). Only 54 of them were examined positive was declining among those who were first entered with all tree tests. The results shows that small number of the the program. The proportion of anti-HCV positive tests in long patients have anxiety 12(13,6 %), bigger number 28(32,5 %) term users programme, were slowly increasing. By logistic re-have depression from mild to severe and the biggest number gression, we found that the greater proportion of anti-HCV have personality disorder 56( 64 %).Out of 54 tested with all positive tests was among those who did not have permanent 3 tests 15 have higher scores that normal on 2 or 3 test. Six residence and among those who have injected drugs. There have higher scores than normal on 3 test SDS, SAS, SAPAS, 8 were also more infected people among the older clients and have higher scores than normal on SAPAS and SDS, and one long term drug users. have higher scores on SDS and SAS. The Minnesota Multipha- sic Personality Inventory (MMPI) was done to 50 patients and 1. dr. med., specialist of public health, head of Slovenian national focal point for 20 of them (40 %) had higher score on Pd (Psychopathic Devi-drugs, National Institute for Public Health. Trubarjeva 2 Ljubljana. Slovenia ate) scale. Number of patients that have history of psychosis 2. dr. med.. Head of Centre for prevention and treatment of illicit drug addic-are 20(14,6 %) of 137, and only 5 (3,6 %)of them have bigger tion Koper. Health centre Koper. Ljubljanska 6 Koper, Slovenia. score and on SDS. Such results sows that even in high thresh- old methadone program number of co morbidity especially co morbidity with personality disorder is very present. Kay words: Co-morbidity, methadone program, high threshold Psychiatric Hospital Skopje, Centre for prevention and treatment of drug ad- diction Marko Orskovic 70, 1000 Skopje, Macedonia liljana.kitevaignjatova@yahoo.com 37 022 1. Impaired affect modulation (black and white thinking, im- CaUGHt IN tHe Net pulsive emotional changes, inflicting self harm and addic- tions), 2. Defense mechanisms of dissociation and illusion, trauma repetition and unhealthy relationships, Sanja Rozman 3. Problems with self-esteem: self hatred, suicidal ideations 4. Problems with body regulation, sleep, stress related and au- One cannot be addicted to internet just as one cannot be ad- toimmune diseases, dicted to bottles: smartphones, tablets, computers, television 5. Problems with identity, that is negative and developed and other electronic media are just a way of transmitting a flow around trauma (survivor!) instead of core self of information, and it is the information they convey that can 6. Violated attachment patterns, unsafe attachment become addictive. It is much more helpful to understand media 7. Addictions, chemical and non-chemical, as an outgrowth of addictions by the information that is transferred, and it could be: defense mechanisms. 1. Pornography – a sort of sex addiction Most people with chronic developmental trauma would fit 2. Internet gambling – a sort of pathological gambling into one of personality disorder categories: borderline, depen- 3. Games – internet or other dent personality disorder, dissociative identity disorder. Trau- 4. Social networks – a sort of relationship addiction ma specialists speak of complex posttraumatic stress disorder What do these different activities have in common, except that (Judith Herman) and developmental trauma (Van der Kolk). they are transferred by contemporary media? The terms known to addiction specialists are pathological If you remember how you started your computer use, you must codependency (Rozman, Mellody), adult children of alcohol- have noticed that you sometimes experienced altered states of ics (Mellody, Dayton), pathological caretaking, enablers, code-consciousness: time elapses uncontrollably (just a little bit more pendents, women who love too much, love addicts, sex ad- and I will stop …), one loses track of surroundings and becomes diction and sex anorexia (Carnes), traumatic bonding (Carnes). absorbed into the virtual world, one forgets all the troubles, no Child development specialists refer to the same as develop-awareness of physical pain, hunger, fatigue; the inability to stop mental trauma ( Van der Kolk), relational trauma (Dayton), or limit the behavior, one can easily have 500 friends and thou- unsafe attachment styles (Bowlby, Ainsworth) and projective sands of »likes« on facebook and never have to bother to meet attachment (Gostečnik). Legal systems call them victims and these people. Most people get over the beginner’s troubles in a survivors of child abuse. couple of months and learn to limit the behavior – some don’t. It is time that all these concepts are unified to better help the Fantasy, arousal and satiation are three brain mediated pro- clients in recovery. cesses that combine in the making of process addictions to Self-reported frequency of emotional, physical and sexual create a unique personal cascade of behaviors that can accel-abuse in a sample of clients of our therapeutic program for erate into an addiction cycle. New computers are capable of non-chemical addictions will be compared with the results of gathering information about the users’ preferences and can a similar program in the USA. adapt to their sexual or social templates, becoming just too good to compete with the real world. Internet is affordable, Sprememba v srcu, Zavod za psihoterapijo, Ljubljana, Slovenia accessible and anonymous (or is it?), which makes it a very sanja@spremembavsrcu.si powerful combination. More than 75 % of all people use it in Europe, and it has been known that 1-10 % of users develop addiction. Are we prepared for the tsunami? 024 SUBStaNCeS meDICal StUDeNtS FrOm Sprememba v srcu, Zavod za psihoterapijo, Ljubljana, Slovenia sanja@spremembavsrcu.si UNIVerSIty OF lJUBlJaNa USe tO HelP tHem StUDy 023 CHIlDHOOD traUma, PerSONalIty Pirnat Zala, Plevel Danaja, DISOrDerS aND aDDICtIONS Podbregar Primož, Podgoršek Blaž, Poličnik Kristina, Preskar Jasna, Milan Krek Sanja Rozman As a group of third year medical students at the University of Survivors of chronic developmental trauma suffer several Ljubljana we were interested in the substances medical stu-long-term changes in personality and are vulnerable to devel- dents use to help them study. We conducted a cross-sectional op chemical and non- chemical addictions. Early chronic inter- study using an internet survey in which students were asked personal trauma crushes the vulnerable personality of a child to indicate which substances they use as a study aid. The sur-and induces several defense mechanisms like severe dissocia- vey was anonymous and was completed by 393 medicine and tion, denial, distortions, fantasy, that all contribute to further dental care student. They were asked to specify their gender, vulnerability in the relationships of the survivor. In adult life, age (18 to 20 years; 21 to 25 years; 26 and older) and their these persons present with: grade average (less than 8; 8 and more). The students selected 38 which of the following substances they use: coffee, tea, vita- 026 min drinks, energy drinks, guarana, sedatives, homeopathic substances, marijuana, antidepressants, amphetamines, beta NOVel PSyCHOaCtIVe treatmeNt blockers, new synthetic drugs, cocaine and other (they speci-UK NetWOrK (NePtUNe): fied the substance later in the survey). We asked them to de- fine how often they use specific substances and if they believe DeVelOPmeNt OF ClINICal GUIDaNCe it is helping them. The results showed that most students use coffee (76 %) and ON tHe maNaGemeNt OF aCUte aND tee (68 %). Other more used substances are vitamin and energy CHrONIC HarmS OF ClUB DrUGS aND drinks, guarana and sedatives. Less students use homeopathic substances, marijuana, antidepressants, amphetamines, beta NOVel PSyCHOaCtIVe SUBStaNCeS blockers, new synthetic drugs and cocaine. Students are using most of the substances occasionally while coffee and tea are drunk frequently. Approximately half of the students believe Dima Abdulrahim that specific substances help them with their study. There is a slight higher percentage of specific substance use in the group with grade average of 8 or less. NEPTUNE is a project that is developing a suite of tools aimed at improving clinicians’ understanding of club drugs and novel psychoactive substances (NPS) and their confidence in man- University of Ljubljana, Slovenia, pirnatzala@gmail.com aging harms relating to acute toxicity and those linked to long term use and/or dependence. 025 NEPTUNE guidance and tools address the screening /identi- early-WarNING-SyStem ON NeW fication of club drug-related harms, the assessment of these harms and their clinical management. They are aimed at emer- PSyCHOaCtIVe SUBStaNCeS gency departments, drug treatment services, primary care and sexual health services. Phase I of the project consisted of the development of clinical guidance based on the review of the peer reviewed literature Andreja Drev and clinial consensus. The presentation will describe the ratio- nale of NEPTUNEdevelopment, the diverse ‘cultural’ contexts In the last decade the number and variability of new psycho- of club drug use and harm and presentations to a range of active substances (NPS) appearing in the EU and also in Slo- treatment services. It will also describe methodology of guid- venia is rising. In the period 2005-2013 more than 300 NPS ance development, taxonomies used and issues addressed in were reported for the first time within European Early Warning the guidance. System (EU EWS). In Slovenia, according to National Forensic The presentation will also mention phase II of the project Laboratory data 12 NPS were detected in 2013 and 90 in 2014. which has started recently and which aims at translating the As a respond to this problem Slovenia developed national comprehensive evidence into practical tools with clinical util-Early Warning System in order to early detect NPS, rapidly ex- ity. These include care bundles, E-learning modules and other change information on production, trafficking, use and on risk tools. associated with use of NPS and furthermore to rapidly inform experts working in the field of drugs and users. NEPTUNE, Club Drug Clinic; Central and North West London NHS Foundation The establishment of national EWS started in 2002 and in 2004 Trust, Club Drug Clinic five key members (National Institute of Public Health, General Po-69 Warwick Road, Earls Court, SW5 9HB lice Directorate with National Forensic Laboratory and Illicit Drug Email: dima.abdulrahim@nhs.net Section, Centre for Poisoning and Institute of Forensic Medicine) have formed the system. In 2007 the Ministry of Health formally appointed an interministerial working group of EWS and in 2009 027 a new enlarged interministerial working group was appointed; DOSe aDeQUaCy aND BeyOND representatives of the Ministry of Health and representatives of NGO’s DrogArt and Stigma have joined the system. By including non-governmental organisations into a system important step Alexander Kantchelov has been made, since these organisations represent an important source of information and also an important part in the process of passing on the information to the NPS users. Though addiction science, world leading experts and profes- In 2005 the first NPS was detected within national EWS and sional organizations clearly define the proper methodology reported to EU EWS; in 2013 national EWS took necessary mea-of opiate agonist treatment, inadequate dosing policies are sures to stop a number of serious intoxications with GHB/GBL. still existing and quite often common practice. These reflect At present national EWS is extending to regions in order to underlying basic views and professional attitudes and un-better address the growing problem of NPS. derstanding of the essence of addiction as well as the clinical characteristics of opioid agonists and specifically methadone Nacionalni inštitut za javno zdravje as a treatment tool. Trubarjeva 2, 1000 Ljubljana Besides the anti-withdrawal, anti-craving, and blocking effects andreja.drev@nijz.si of methadone, there is a probability that the medication could 39 have more effects on the opioid brain system, depending on 029 the dose. A critical reevaluation of established dosing traditions shows DrUG aND DrINKING PrOBlemS that past interpretations of adequate methadone dose and IN WOmeN WItH BOrDerlINe PerSONalIty the prescribing practices of many clinicians are no longer valid. If we believe that methadone in proper dosages has no dam- – PreCONDItIONS aND PSyCHOtHeraPeU- aging effects on the human organism, and treatment effect is dose related, than logically higher doses could have better tIC meCHaNISmS OF CHaNGe treatment impact. Clinical experience with methadone doses significantly higher than the average, as well as conceptual shifts and points of Tsvetana Stoykova view related to methadone dosing are discussed. This presentation discusses clinical characteristics of border- The Kantchelov Clinic, Sofia, Bulgaria, EU line female patients with drug and drinking problems. al.kantchelov@gmail.com Clinical interest in these women is related to their specif- ics of being the victims of extreme stigma and stereotyping, 028 and very difficult to treat. The attitude to such women is of- ten rejection, disgust, prejudice, or apathy and indifference. INterDISCIPlINary team PartNerSHIP Their basic psychological characteristics, the reasons why they use drugs and alcohol as well as the main psychotherapeutic aND PSyCHOlOGICal INterVeNtIONS IN mechanisms of change in this kind of patients are discussed. treatING HePatItIS C IN metHaDONe The presentation also provides a brief clinical example from our psychotherapeutic work at the Kantchelov Clinic in Sofia. maINtaINeD PatIeNtS The Kantchelov Clinic, Sofia, Bulgaria, EU cvetipost@gmail.com Alexander Kantchelov, Marija Dobreva, Tsvetana Stoykova, Valeri 030 Parvanov aNtIVIral tHeraPy aPPlICatION IN This presentation shares the clinical model of the Kantchelov CHrONIC HePatItIS C amONG OPIate Clinic in Sofia in interdisciplinary and institutional partnership aDDICtS WItHIN tHe OPIate of addiction treatment professionals with specialized gastro- enterology unit for the treatment of Hepatitis C in methadone SUBStItUtION treatmeNt (OSt) maintained patients. Special attention is paid to the specifics and psychological as- pects of patient experiences, related to the disease, interferon Mehić-Basara Nermana, Pokrajac treatment, prejudice and stigma (fears, ambivalence, resistance, insecurity, anxiety), and subsequent reactions to Hepa- Miloš, Grabovica Magbula titis C treatment. Therapeutic approach and a model of psychological interven- Introduction: Opiate addiction is chronic relapsing brain dis- tions focused on supporting patients and families to overcome ease, which often occurs in comorbidity with other diseases. fears and ambivalence, to enhance compliance and patient co- Representation of Hepatitis C (HCV) in a group of heroin ad- operation with gastroenterologists in applying treatment pro- dicts is up to ten times higher (30-50 %) than the prevalence cedures, as well as key components of interdisciplinary team in the general population (5 %) and therefore is greater mental partnership between the specialized gastroenterology team health impairment in this population. and the addiction treatment team are also discussed. Goal of this study is to present the results of the evaluation of hepatitis C treatment with interferon in patients who are in the The Kantchelov Clinic, Sofia, Bulgaria, EU program of opiate substitution therapy (OST). al.kantchelov@gmail.com Material and methods: This study was clinical, retrospective and prospective, which included opiate addicts who are in the OST program for a period of three years. For each addict the di- agnosis of viral hepatitis C was determined by laboratory tests of peripheral blood on anti-HCV and HCV antibody detection trough polymerase chain reaction (HCV-RNA PCR). Results: The positive results for anti-HCV test were found in 162 (41 %) patients, and after consultation with the infectious dis- ease specialist/hepatologist is indicated interferon therapy in 56 cases of which 17 (11 %) were included in this treatment during the period surveyed, for which we expect to cause changes of mental status in terms of reduction of anxiety and 40 depression, improved concentration and better aggressive- of chronic active hepatitis, or cirrhosis.HBV DNA identification ness control. in cases with negative HBcAg suggest the infection by precore Conclusion: Interferon antiviral therapy of hepatitis C in opi- mutant type of HBV, meaning more severe course and out- ate addicts in OST program is preferred, because besides to come of liver disease. the treatment of diseases of the liver, also have effect on the improvement of mental disturbances and therefore lead to a Prof.Daniela Chaparoska MD PhD better addict‘s quality of life. University Clinic of Toxicology Keywords: opiate addiction, substitution therapy, Hepatitis C, Medical faculty, University Sts Ciryl and Methodius, Skopje, Macedonia Interferon Naum Naumovski Borce 76, Skopje chaparoskadani@gmail.com Ass. professor Mehić-Basara Nermana MD PhD, Pokrajac Miloš MD, Grabovica Magbula Graduated nurse 032 Institute for Alcoholism and Substance Abuse of Canton Sarajevo, Bolnička 25, 71000 Sarajevo, Bosnia and Herzegovina, e-mail: zalcnarc@bih.net.ba tHe USe OF PreSCrIPtION DrUGS amONG IDUS: COlleCtING Data amONG 031 HePatItIS B aND HePatItIS C VIrUS USerS OF Hr PrOGramS IN SlOVeNIa relateD CHrONIC lIVer DISeaSeS IN INtraVeNOUS DrUG aBUSerS Samo Novakovič, Ines Kvaternik In recent years trends regarding drug use among IDUs have changed. The median age increased significantly, the illegal Daniela Chaparoska, Victoria drug market does not provide sufficient quantities of decent Chalovska-Ivanova quality of traditional substances, such as heroin, so drug us- ers resort to a cheap alternative. With this research we focused HBV I HCV virus infection are very common in drug users due on user of HR programs in Needle Exchange Programs, and try to the transmission of infection through te syringers that have to minimize additional burden for users and workers in pro- been previously used by an infected person. grams to collect data in the context of the existing Needle Aim of this study was to present main features of hepatitis B an exchange service record. Our purpose is to obtain the greater C virus related chronic liver diseases in patients with positive number of IDUs. We designed new collecting data tool, which history for drug abuse. contained the area of contact, gender and age, involvement in Analyses included 74 cases with chronic liver viral diseases. Rou- substitution therapy (ST) and the type of drugs intravenously tine laboratory techniques for detection of viral markers for HBV consumed.. The average age of the respondents was 36 years, and HCV were used. Identification of C viral infection was made 82.2 % of men and 78.32 % of the participants in ST. Most com-using ELISA II test for the detection of anti-HCV antibodies of monly injected in 2014 is heroin (65.91 %), followed by co-the serum.Detection of HCV RNA was made by PCR method as caine (55.19 %,) , slow-release morphine (25.97 %) and other wll as the genotyping and quantification of viral load. HBV DNA prescription drugs (29.87 %).In Primorska region the highest detection was made by dot blot hybridization and using PCR average age is observed – almost 39 years and the largest pro-method. Liver biopsy was done in order to establish the degree portion of inclusion in ST (87.38 %). Older users mostly inject of order of necroinflammation in the liver parenchyma. prescription drugs and are significantly more often included Among our patients, 64 were positive for hepatitis C virus, 1 in ST. The collected data are useful in analyzing trends among had single HBV infection, and 9 had dual viral infection (B IDUs, thus it is possible to estimate the effects and predict and C). Viral genotype 3 of HCV was present in 62/73 (85 %) some of the consequences of current drug policies and pre-and genotype 1 in 11/ 73 (15 %) patients. The leval of viraemia scription practices in ST programs. The above data collection ranged between 130 000 and 1200000 copies/ml. method has proved to be useful in the assessment of the prev- The analysis of viral markers for HBV has shown HBc Ag posi- alence of high-risk use of illicit drugs. tivity in 3 cases( one of them was a case with single HBV infec- tion), and the other 8 pts have shown presence of anti-HBc an- tibodies.HBV DNA was identified in the case of the single HBV infection and in 4 pts with dual B and C infection. Histologigal examinations showed of chronic active hepatitis in 18 cases, moderate chronic hepatitis, in 25 pts, whereas 28 pts had mild form of chronic hepatitis. The Knodell score ranged from 2 to 12. Three cases had a progressive form of liver disease with a collagen deposition, meaning development of liver cirrhosis. Our results indicate that majority of patients with chronic liver diseases related to HBV and HCV among drug abusers had HCV infection genotype 3, which is important for the treat- ment and prognosis.The presence of HBV is an additional fac- tor for poor prognosis of liver disease, especially in the stage 41 033 035 CO-OCCUrreNCe OF PerSONalIty HOW We CaN INFlUeNCe tHe attItUDe DISOrDer aND SUBStaNCe DePeNDeNCe: tOWarDS alCOHOl IN SlOVeNIaN ImPlICatIONS FOr treatmeNtS PrImary? Metka Shawe-Taylor Nataša Sorko The talk will address the relationship between personality Slovenian primary third triad were surveyed in 2009 and 2014. disorder and substance dependence. It will mainly focus on Together, we surveyed 13,585 children’s (2009: 6798 and 2014: borderline personality disorder but it will also consider anti-6787 children’s). In primary school children’s were assessed social personality disorder. It will explore the challenges that their attitudes towards alcohol. the co-occurrence of personality disorder and substance de- In the analysis of the five-year period, we note some positive pendence presents to the treatment of such patients. Some trends. Presenting the findings that we have to worry about. generic principles of such treatment will be outlined and an In our recent survey among Slovenian primary third triad aged exemplar specific psychological treatment will be discussed. between 12 and 15 years of age during the school year 2014, we found that primary school first drinking alcohol at an aver- Lead Consultant Psychologist WAA East age age of 10 years, girls somewhat earlier than boys, which is Trust Lead for Psychological Therapies at a slightly higher age than five years ago. The survey results Langley House, Church Lane, Oxted show that alcohol tried to survey more than 90 % of 15 year Metka.Shawe-Taylor@sabp.nhs.uk olds, 35 % of 15 year olds were already drunk, so more third, the fact that any drinking of alcohol-age children and adoles- 034 cents harmful and risky. In the last five years, however, we note some positive trends. StePPS PrOGramme FOr treatmeNt OF We note that a 7 % increase in the proportion of those chil-BOrDerlINe PerSONalIty dren and adolescents who have not tried alcohol. It is impor- tant to decrease (from 16 to 7 %) proportion of primary school DISOrDer children who drink alcohol at least once a week and to have a more elementary-age when buying alcohol problems are now more important problems more than five years ago. One- Metka Shawe-Taylor tenth of primary school are not able to enjoy without alcohol, which is almost twice larger share than in 2009. An important influence of parents. Effect of wet Slovenian culture is also re- The workshop will focus on the treatment of borderline per- flected in the fact that parents in greater proportion than five sonality disorder (BPD). The initial part of the workshop will allow her to drink alcohol-age children. look at the main principles behind such treatments while the To summarize the findings in the future is extremely important part will be focussed on Systems Training for Emotional Preas adequate awareness and inform adults on the dangers and dictability and Problem Solving (STEPPS) a group psycho-ed- risks and drinking-age. At the same time, it is necessary to con- ucational programme developed by Nancée Blum et al. (1995) sider how they can appropriate, healthy way recruit children, and is becoming increasingly integrated in the mental health adolescents and adults that have managed to realize the ben-systems across European countries. Evidence for its effective- efits of a healthy lifestyle and will resonate with him. ness is accruing as more studies are published. Its effective- ness with other patient groups and co-morbid presentations Association The Ray of hope, Ljubljana, Slovenia is now also starting to be investigated. natasi.sorko@siol.net The aim of the workshop is not to equip the participants with the STEPPS skills but to provide enough information about the programme to enable participants to start considering its ap- propriateness for their services. Lead Consultant Psychologist WAA East Trust Lead for Psychological Therapies Langley House, Church Lane, Oxted Metka.Shawe-Taylor@sabp.nhs.uk 42 036 037 FaCtOrS aSSOCIateD WItH OUtCOme OF tHe ClUB DrUG ClINIC: eXPerIeNCe aND OPOID aDDICtION treatmeNt at mODel OF Care OF tHe CeNtral aND CeNtre FOr treatmeNt OF DrUG NOrtH WeSt lONDON NHS aDDICtS, UNIVerSIty PSyCHIatrIC FOUNDatION trUSt HOSPItal lJUBlJaNa Dima Abdulrahim Delić Mirjana¹, Lusa Lara², Pregelj The Club Drug Clinic was established at the end of 2010, as Peter 3, 4 a response to the limited understanding by ‘traditional’ drug treatment services of the needs of the users of club drugs pre- Aims: The purpose of the study was examination of the senting for treatment. By the end of 2014, approximately 600 relationships that exist among hypothesised variables and people had undergone treatment or an intervention pathway. outcomes of hospital treatment of drug addiction treatment. Methods: A cohort of 192 patients with opioid addiction The workshop will address a number of issues, which include: consecutively admitted to a closed detoxification unit  Why club drugs have required treatment services to think between October 2011 and May 2013 were followed differently; how they should adapt existing evidence-based during one year. The research interview, the Treatment interventions Outcomes Profile (TOP), Drug Addiction Treatment Efficacy  Who is presenting for drug treatment Questionnaire (DATEQ), Circumstances, Motivation and  What type of clinical services are club drug users are presenting to, other than drug treatment services Readiness Scales (CMR) were administered during the  Partnerships, clinical and referral pathways first week of admission to the detoxification unit. Urine  Models of care and treatment interventions, including GHB/ test was administered on the day of admission and at each GBL medically-assisted detoxification follow-up point in combination with the TOP (after three,  Case studies six and twelve months). Illicit drugs abstinence during one  Treatment outcomes year after intake was selected as a treatment outcome measure. NEPTUNE, Club Drug Clinic; Central and North West London NHS Foundation Results: After 12 months 66 patients abstained from drugs, 11 Trust, Club Drug Clinic of them finished the whole 278 days long treatment. Finishing 69 Warwick Road, Earls Court, SW5 9HB Email: dima.abdulrahim@nhs.net the whole treatment or according to agreement about dura- tion was the best predictor of a positive outcome. Higher moti- vation at the beginning of the treatment and completed high 038 school were also predictors of positive outcome. Living with an addicted person, use of heroin and use of benzodiazepines tHe CHalleNGe OF NeW PSyCHOaCtIVe prior intake were predictors of negative outcome. Self-rated psychological and physical health at baseline do not seem to SUSBtaNCeS IN eUrOPe be associated with the outcome. Conclusions: Different factors may play a role in the hospital treatment outcome. To improove the treatment outcome Alexis Goosdeel more attention should be paid to treatment duration and mo- tivation for the treatment. Attention should be also paid to In 2014, 101 new psychoactive substances were notified to preparation and stablization of the patients before hospital the EU Early Warning System, bringing the number of sub-treatment. stances monitored to more than 450. Formal risk assessments are launched for substances suspected of causing significant 1 Center for Treatment of Drug Addiction, University Psychiatric Hospital, Lju- harm at the European level. Risk assessments were carried out bljana, Slovenia; mirjanadelic@yahoo.com on six substances in 2014. 2 University of Ljubljana, Faculty of Medicine, Institute for Biostatistics and An example of the challenges posed by new psychoactive Medical Informatics substances is the difficulties in determining the implications 3 University of Ljubljana, Faculty of Medicine, Department of Psychiatry, Slovenia at European level of reports from some countries of severe re- 4 University Psychiatric Hospital, Ljubljana, Slovenia actions to the use of synthetic cannabinoids. These substanc- es can be extremely potent, but are not chemically similar to cannabis, and therefore may result in different and potentially more serious health consequences. With the continuing release of new psychoactive substances on the drug market, there is concern that new or obscure sub- stances that have contributed to deaths may escape detec- tion. The high potency of some synthetic substances further 43 complicates their detection, and also has implications for law EMCDDA, Praça Europa 1 Cais do Sodré, Lisbon, Portugal, Alexis.Goosdeel@ enforcement, as even small quantities of these drugs can be emcdda.europa.eu converted into multiple doses. 1 The asterisk indicates that this designation is without prejudice to positions In recent years, more than 50 substituted cathinone deriva- on status, and is in line with United Nations Security Council Resolution 1244 tives have been identified in Europe. The best known example, and the International Court of Justice opinion on the Kosovo Declaration of mephedrone, has established itself on the stimulants market Independence. in some countries. Another cathinone, MDPV (3,4-methylene- dioxypyrovalerone), is sold on the European market predomi- 040 nantly in powder and tablet form as a ‘legal high’, but also di- rectly on the illicit market. More than 5 500 seizures of MDPV aSSOCIatION OF PerSONalIty traItS powder have been reported from 29 countries between 2008 aND OUtCOme OF HOSPItal treatmeNt and 2013, amounting to over 200 kilograms of the drug. The Internet is playing a growing role in shaping how drugs OF OPIOID aDDICtION are being sold and poses unique challenges to disrupting the supply of both ‘new’ and ‘old’ drugs. The fact that manufactur- ers, suppliers, retailers, website-hosting and payment process- Delic Mirjana¹, Kajdiž Karmen¹, ing services may all be based in different countries makes it particularly difficult to control. Pregelj Peter2, 3 EMCDDA, Praça Europa 1 Cais do Sodré, Lisbon, Portugal, Alexis.Goosdeel@ Aims and hypothesis: The purpose of the study was to describe emcdda.europa.eu the sample of 186 opioid addicted patients entered hospital treatment and assessing the differences in personality traits between abstinent and non-abstinent after one year. 039 Background: Despite different treatment approaches many pa- emCDDa SUmmary rePOrt ON tHe DrUG tients with drug addiction continue to use drugs during and after treatment. Personality traits are considered risk factors SItUatION IN tHe WeSterN BalKaNS for drug use, and, in turn, the psychoactive substances impact individuals’ traits. Method: A cohort of 186 patients consecutively admitted to the Alexis Goosdeel detoxification unit between November 2011 and May 2013 was investigated. The semi-structured research interview, the Big Five Inventory (BFI), the Treatment Outcomes Profile (TOP) were ad- This report focuses on Albania, Bosnia and Herzegovina, the ministered during the first week of admission to the detoxifica-former Yugoslav Republic of Macedonia*1, Kosovo, Montene- tion unit. Urine test was administered on the day of admission gro and Serbia — all current candidate and potential coun- and at each follow-up point in combination with the TOP (after didate countries to the European Union (EU) in the Western three, six and twelve months). Illicit drugs abstinence during one Balkans. year after intake was selected as a treatment outcome measure. The findings synthesised in the report provide a first indication Results: During one year after intake 67 (36.02%) patients ab- of the regional situation in 2013–14, and should not be consid- stained from illicit drugs. Twelve months after admission 82 ered conclusive or stable, as new studies and data collection (44.9%) patients abstained completely. Agreeable patients are tools are continually beining implemented. more likely to abstain on substitution therapy at admission (τ The situation could be characterized as follows: =0.13); also they remain in treatment longer (τ = 0.13). Extraver-  The prevalence of drug use in the general population seems sion and openness are negatively correlated with abstinence to be comparable with the situation in the EU. Cannabis is after six and twelve months (τ =-0.13; τ = -0.12). Neuroticism the drug most frequently reported as used, although at a is in negative correlation with duration of treatment, which level below the EU average. means neurotic patients are more likely to abandon treatment  Estimated population sizes of persons who inject drugs sooner than emotionally stable patients (τ = -0.15). Complete (PWID) vary in the region but are significant, as reflected by abstinence seems to be less related to patients’ personality. Pa- the prevalence of drug-related hepatitis C infections. tients who are less open to new experiences are more likely to  There has been a substantial effort to develop treatment abstain from drugs 6 months after admission (τ = -0.13). options and harm reduction services in the region, but the Conclusions: There were significant reductions in heroin and coverage of these programmes remains generally too low. other illicit drugs use, injection of drugs and criminal activity  The long-term financing of such programmes by the state after one year. Personality measured with BFI correlates with remains a challenge and should be made a higher priority. treatment outcome poorly. At the same time personality has  Investment in monitoring of the drug situation and re- crucial role in responding to treatment, but one personality trait sponses to it is still at a preliminary stage, and needs to be could at the same time have protective as well as risk function. consolidated. The emergence and development of national drug strategies 1 Center for Treatment of Drug Addiction, University Psychiatric Hospital, Lju-in line with the EU Drug Strategy and Action Plans, as part of bljana, Slovenia the region’s approximation to the EU, represent significant 2 University of Ljubljana, Faculty of Medicine, Department of Psychiatry, Slovenia progress that highlights the need to build consensus between 3 University Psychiatric Hospital, Ljubljana, Slovenia the main stakeholders, and the importance of securing ade- Keywords: personality traits, opioid addiction, treatment outcome, Big Five quate human and financial resources in the long term. Inventory 44 042 044 USe OF NeW PSyCHOaCtIVe SUBStaNCeS HOW DOeS treatmeNt WOrK IN amONG PatIeNtS HOSPItalISeD at PUBlIC HealtH NetWOrK OF CeNtreS FOr UNIVerSIty PSyCHIatrIC HOSPItal PreVeNtION aND treatmeNt OF DrUG lJUBlJaNa BetWeeN SePtemBer aND aDDICtION - DOCtOr’S WOrK IN CeNter DeCemBer 2014 FOr PreVeNtION aND treatmeNt OF aDDICtION OF IllICIt DrUGS Nuša Šegrec Introduction: We can observe an increased use of new psycho- Jasna Čuk Rupnik active substances (NPS) in last few years in clinical practice. They are easily accessible, relatively cheap, often legal, giving Doctors who work in CPTAID treat patients in opioid treatment or/ the user a false feeling of safety; they are changing rapidly and and in psychosocial rehabilitation. They need and use their knowl- are mostly not detectable by routine urine tests. edge from the field of general/family medicine and their additional The data about new drugs and potential psychiatric side–ef- knowledge of addiction medicine. There are 18 such Centers in fects are very scarce. Limited data in literature describe wide Slovenia. They are all located in Primary Health Centers and include range of psychiatric symptoms associated with NPS use: agi-from less than 100 to more than 500 patients. Doctors need some tation, insomnia, cognitive dysfunction, psychotic symptoms extra knowledge from the field of psychiatry and also the knowl-with paranoid feelings and hallucinations, delirium, anxiety, edge in diagnosing and treating hepatitis C infections. They have affective disturbances and suicidality. to develop resonable cooperation with parents and partners, so- Method: Retrospective study was based on reviewing medi- cial workers, teachers, employers, policemen, lawyers, journalist, cal records of patients, hospitalised between September and politicians and organisations like Alcoholics Anonymous and Nar-December 2014 at University Psychiatric Hospital Ljubljana cotics Anonymous. Good work includes also once own researches. for use of new drugs. We checked for patients with diagnoses F11-19 (according to ICD-10) at admission or discharge from cukovi@gmail.com the hospital for use of new drugs and related psychiatric prob- lems. The use of new drugs was based on auto - or hetero-an- amnesis data. 045 Results: The results (number of patients reported NPS use, 20 yearS OF PUBlIC HealtH NetWOrK number of hospitalizations – first and re-hospitalizations-, du- ration of hospitalization, medication used, urine tests results, FOr treatING PeOPle tHat USe IllICID psychiatric symptoms associated with NPS use and informa- tion about further treatment have been compared with data DrUGS IN SlOVeNIa from literature. Discussion: Better understanding of new drugs use and their negative consequences can contribute to better recognising, Andrej Kastelic1, Tatja Kostnapfel2 understanding and better quality of treatment/ rehabilitation of patients with co-morbidity. In January 1995 the first detoxification unit was opened at the Cen- Keywords: new psychoactive substances, psychiatric disorders, ter for Mental Health at University Psychiatric Hospital Ljubljana. co-morbidity of psychiatric disorders and substance use dis- Since that year the public health network of eighteen centres for order the prevention and treatment of drug addiction have been estab- lished in Slovenia. In 2003, the Centre for the Treatment of Drug Ad- Centre for Treatment of Drug Addiction, University Psychiatric Hospital Lju- diction was founded at the University Psychiatric Clinic Ljubljana. bljana, Grablovičeva 48, 1000 Ljubljana, Slovenia, EU Substitution treatment with methadone was introduced in 1990. Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia, EU In 2004, buprenorphine and in 2005 sustained release morphine nusa.segrec@psih-klinika.si were registered, followed by buprenorphine in combination with naloxone in 2007. In 2013 in the network of centres for the preven- tion and treatment of drug addiction 3.908 patients were treated, 3.191 of them with substitution medications. Substitution medica- tions were also given to 556 persons serving a prison sentence in 2012. At the Centre for the Treatment of Drug Addiction at the Uni- versity Psychiatric Clinic Ljubljana about 1000 patients were treated in the outpatient clinic, 169 as inpatients and 98 in the day hospital. 1 Centre for the Treatment of Drug Addiction, University Psychiatric Hospital Ljubljana, Zaloška 29, 1000 Ljubljana, SLOVENIA, EU, andrej.kastelic@guest.arnes.si 2 National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, SLOVENIA, EU 45 046 volumes with an increased activation in the amygdala in re- PerSONalIty DISOrDerS - ClINICal sponse to negative emotional stimuli. Heightened impulsivity and emotional dysregulation seems to mediate object relations aND PSyCHODyNamIC aSSeSSmeNt aND in patients with BPD. Both lead to dysfunctional behaviours and psychosocial deficits. Several types of psychotherapeutic tHeraPeUtIC ImPlICatIONS modalities have been shown to be effective. Pharmacological interventions can reduce depression, anxiety, and impulsive aggression. In APD there is a strong evidence that structural or Tina Zadravec functional impairments of several areas of the prefrontal cortex and increased sub-cortical activity, for example in the amygda- la, are associated with impulsive aggression and violent behav- All treatments should begin with good diagnostic assessment iour. The failure of “top-down” control systems in the prefrontal which is the starting point for pharmaceutical and psycho-cortex to modulate aggressive acts that are triggered by anger therapeutic interventions. Patients with addictions have a lot provoking stimuli appears to play an important role. Insuffi-of comorbidities, that need to be thoroughly assessed - per- cient serotonergic facilitation of “top-down” control, excessive sonality disorders being one of the more common diagnosis catecholaminergic stimulation, and subcortical imbalances of that have major influence on the process and outcome of the glutamatergic/ gabaminergic systems as well as pathology in treatment. Patients with personality disorders have deficits on neuropeptide systems involved in the regulation of affiliative several areas (interpersonal relationships, identity, affect and behavior may contribute to abnormalities in this circuity. Of impulse regulation, moral sensibility, distress tolerance, cogni-pharmacological interventions mood stabilizers dampen limbic tion and reality testing, mentalization) that lead to poor work irritability, selective serotonin reuptake inhibitors may enhance and social functioning. In therapy this results in the slow de- “top-down” control. A psychosocial interventions which help to velopment of therapeutic working alliance, distrust and diffi- develop alternative coping skills and reinforce reflective delays culties in forming attachment, intense transference and coun- may be therapeutic. tertransference reactions, distortions in reality testing, intense emotional reactions that are poorly regulated, self-destructive and aggressive behaviour and consequently to difficulties in bojana.avgustin@psih-klinika.si adherence to therapeutic contract and to high drop-out and relapse rate. For the therapeutic purposes one should not be 048 satisfied with classifying the patient in the category of specific personality disorder, but should assess specific deficits on the PHarmaCOeCONOmICS – DO We NeeD It? before mentioned areas and adjust the treatment according to the patients’ capacities. If possible different treatment pro- grammes should be offered according to the severity of per- Rok Hren sonality disorder and in different treatment phases. Few would disagree that innovation in health care is worth- asist. dr. Tina Zadravec, univ.dipl.psih., spec.klin.psih. while; the tremendous technological success in pharmacolog- tinatina.zadravec@gmail.com ical treatment of HIV patients is a case in point. On the other hand, a relatively large number of “me-too” entries in the phar- 047 maceutical market and the diminishing productivity of R&D sector call for robust tools, which could distinguish high-value, NeUrOBIOlOGy OF PerSONalIty breakthrough products. DISOrDerS: ImPlICatION FOr treatmeNt To this end, health technology assessment (HTA) methodologies, such as pharmacoeconomics, are now widely used, how- ever, the inherent analytical design of HTA is often both under- stated and inadequately understood by critical stakeholders Bojana Avguštin Avčin within the health care, inter alia, authorities, health care pro- fessionals, and marketing authorization holders. We present possible neurobiological background of personality In this presentation, we will introduce key concepts which are disorders, particularly borderline personality disorder (BPD) and applied in pharmacoeconomics and particularly focus on cost- antisocial personality disorder (APD) and implication for treat- effectiveness (CE) analyses. Specific elements of CE study de- ment. The cause of BPD and APD is a complex dynamic system sign will be discussed in detail, such as the choice of compara-both psychologically and neurobiologically, with several fac- tor, coping with often inadequate and/or unreliable input data, tors interacting in various ways with each other. BPD and APD and determining the appropriate willingness-to-pay threshold are associated with a combination of early adverse (traumatis-that would be acceptable to a given jurisdiction/society. We will ing) childhood experiences as well as later, adolescent adverse illustrate usefulness of pharmacoeconomic modeling, which experiences, deficits in brain development and genetic poly-have proven instrumental in decision-making process by real- morphisms predominantly affecting the serotonin system and life case studies. Finally, we will discuss the importance of HTA the stress axis. In BPD structural and functional neuroimaging against the backdrop of limited resources within the health care. have revealed a hyperreactive hypothalamic-pituitary-adrenal HTA has been accepted as a critical means in quantitive assess- (HPA) axis, a dysfunctional frontolimbic network of brain re- ment of “value-for-money” that new technology brings to the gions with reduced hippocampal, orbitofrontal, and amygdala health care market, however, the implementation of HTA con-46 cepts in practice is often fraught with difficulties. The relevant of the severity of the liver disease and, above all, independent stakeholders within the health care should thus make a con-of the risk group the HCV-infectes patients belong to. scious effort in building capacities which would enable HTA to So far, the use of the DAAs has not been evaluated in PWID in live up to its full potential. particular. However, since in PWID even the treatment with pa- tient highly unfriendly PegIFN/RIBA has proved to be as safe and Institute of Mathematics, Physics, and Mechanics, Jadranska 19, University of effective as in the general population, the new waves of DAAs Ljubljana, Slovenia; rok.hren@fmf.uni-lj.si are expected to work perfectly in PWID. Nonetheless, to trans- late the promise of excellent clinical efficacy into a real-life effec- 049 tiveness, appropriate public health strategies, well designed ac- tion plans and appropriate resource allocations that all include reCOmmeNDatIONS FOr treatmeNt OF PWID are needed starting with a multidisciplinary approach to the complex management of HCV infection in PWID. HePatItIS C: WHat IS NeW IN 2015? Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Mojca Matičič Japljeva str. 2, 1525 Ljubljana. mojca.maticic@kclj.si Currently, over 180 million people worldwide live with chron- ic hepatitis C virus (HCV) infection, approximately 15 million 050 of them in Europe, where each year, 86 000 die due to HCV- related end-stage liver disease or hepatocellular carcinoma. OSt IN GP SettING Nowadays, people who inject drugs (PWID) are at highest risk for acquiring HCV infection. The prevalence of HCV in PWID varies from 18 % to up to 80 % among the European countries. Ante Ivančić In the past, treatment of hepatitis C in PWID using the combi- nation of pegylated interferon (PegIFN) and ribavirin (RBV) has OS treatment is the gold standard in tretament od opiate ad-shown to be safe and effective and sustained virological response dicts worlwide. In Croatia OST is provided exclusively in GPs (SVR) was comparable to that in general population. However, offices. More than half of all GPs sin Croatia have at least one historically the HCV treatment rate among PWID across Europe patient in ST. Croatian treatment model , results and outcomes has been extremely low due to several barriers, one of them be-as well as personal experiece in the tretament of opiate ad- ing also the use of recommended standard of care. With several dicts will be presented. and common side effects that may be even life-threatening, un- friendly treatment application and regime and overall efficacy of Croatia 54-65 % (less than 50 % in genotype 1 patients) the PegIFN/RBV ante.ivancic@pu.t-com.hr has been the only standard of care for a decade. ante.ivancic@idz.hr The last five years bore witness to a remarkable progress in the field of HCV treatment with the development of highly potent direct acting antivirals (DAAs). After the regimens con- 051 taining the first wave of DAAs, protease inhibitors boceprevir HOW tO SUPPOrt PeOPle aDDICteD tO and telaprevir, which increased the SVR by 25-30 %, but still in- cluded PegIFN/RBV, had extremely high daily pill burden, cost, NeW meDIa lengthy treatment duration as well as low safety and efficacy in treatment experienced patients, the triple therapy regimens with newer second wave DAAs combined to PegIFN/RBV have Bernard Spazzapan improved efficacy by exceeding 90 % SVR, dosing schedules, and safety profiles. They include second wave protease inhibi- tors, nucleoside inhibitors, and NS5B inhibitors and are being We have to answer first to the question, where is the border-used for both treatment naive and experienced patients. line between normal and pathological use of technological The current standard of care treatment regimens include devices, mainly Internet. From the normal use of selfies (nar-simeprevir, sofosbuvir and daclatasvir that should be individu- cissism and self-sufficiency) to derealization ( full immersion ally used in combination, with or without PegIFN and/or RBV, in a virtual world, where there is an answer for any existential and all oral IFN-free regimens combining the different DAAs need like friends, study, work, sex). When this crossing from (sofosbuvir/ledipasvir and paritaprevir/dasabuvir/ombitasvir) normal to pathological behaviour happens and what is the that have shown to achieve the SVR between 95% and 100 %, involved psychiatric category? The DSM 5 board has decided independent of the severity of diseases or previous treatment, that this disturb needs a supplement of research. Indeed, we being of short treatment duration and with no significant side- observe frequently that these are symptoms of early psycho- effects. However, the effectiveness of IFN-free regimens is not ses or depressions. optimal in previously most easy-to-treat patients with HCV How to deal with these disturbs? First of all it is necessary to genotype 3 that represents the most common HCV genotype stress the importance of preventive measures. Dealing with in PWID. Moreover, the new DAA regimens are extremely ex-persons affected by the disorder is important the early detec- pensive, thus efforts should be made to reduce costs and pro- tion, when the way back to normality is still open. These are vide universal access in all HCV-infected patients, independent usually very young persons, brought to consultation by par- 47 ents or teachers, without any motivation for change. We need decade in community, as well as information, support and ad-to speak with them about their behaviour and the need for a vocacy within prison settings. For last three years we founded change. It is necessary to find out the type of disorder through Self support groups for drug users living with hepatitis C infec- differential diagnosis and then act through all the psychiatric tion and/or HIV. therapeutic instruments Juventas, NGO, Program Director dr. med., spec. psih , Italia Marka Miljanova 42, 81000 Podgorica bspazzapan@yahoo.it Montenegro tijanap@gmail.com 052 eVIDeNCe BaSeD meDICINe« vs. »FOrUm BaSeD meDICINe« Arijana Turčin The World Wide Web is a powerful, yet inadequately controlled source of information. Health issues are much emphasized in contemporary societies, and while modern lifestyles are speeding up, the possibility of a shortcut to the quickest avail- able medical advice and/or solution is also highly appealing. Using the internet, a quick diagnosis is just a mouse-click away and no medical knowledge is needed. Individuals that use the internet to diagnose and treat their medical conditions and problems are called »cyberchonders«. Although health orient- ed internet forums may provide valuable and useful informa- tion, the lack of a more comprehensible medical knowledge can make them highly problematic. To date, there are no veri- fied studies on actual benefits (or dangers) of internet forums, and yet it may seem that the users tend to trust internet fo- rums far more than they trust their medical practitioners, cre- ating a gap in understanding of complex medical problems. In this presentation, some thoughts on this gap will be offered. Asist., dr. med., spec. psihiatrije, University Psychiatric Hospital, Ljubljana, Slovenija. arijana.turcin@psih-klinika.si 053 HePatItIS C amONG DrUG USerS IN COmmUNIty aND PrISON IN mONteNeGrO Tijana Žegura Hepatitis C is the most represented infections among drug us- ers in Montenegro. Fortunately, treatment is still free of charge for all citizens with health insurance, but we still have low per- centage of ones treating infection in relation to the total num- ber of infected. At the other hand, there are no national guidelines on treat- ment of pregnant infected drug users, neither on treatment their new-borns. Although there is existing treatment of those imprisoned, pro- cess of diagnostics and starting treatment are very long, and there are suspicions on contempt of anonymity. NGO Juventas is providing preventive services for more than 48