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Care, Cocaina Addiction Rehabilitation Enforceable
SERVIZIO SPECIALISTICO RESIDENZIALE PER IL TRATTAMENTO DELLA DIPENDENZA DA COCAINA
 SUMMARY
CARE is a centre for the treatment of people who have a problematic use of cocaine. The CARE Centre offers a chance of specialist treatment for those who are developing the need to emancipate themselves from the use of the substance and need a period of suspension; it offers an intensive intervention - for integration to outpatient treatment and a more detailed diagnosis in a protected environment. CARE is organized in a pre-residential phase (welcoming discussions, diagnostic tests), a residential phase in a cottage that offers more or less short modules, and a post-residential phase (the course evaluation and follow-up). CARE is promoted and managed by a partnership consisting of the cooperatives: Il Cammino and Parsec by ASL RMC and RMF, the ASL Frosinone and the Province of Rome.
NAME OF THE PROJECT
CARE. Cocaine Addiction Rehabilitation Enforceable
RECIPIENTS
1. The project is aimed at primary cocaine users, or multi-drug users predominantly using cocaine, for which a short-term residential treatment is considered appropriate. The indirect target group are the public and private services for the treatment of addicts in Lazio, general practitioners and doctors from the emergency room, the families of the users and the police.
METHOD OF FINANCING
Funded by: the Lazio region
References to the Law: The National Foundation Combatting Drugs (CPR 309/90) 2011-2012
AREA OF INTERVENTION
Lazio region
BRIEF HISTORY
The data from the EMCDDA 2010 indicates that in the age group 15-64 years old there are 14 million Europeans who are lifetime users, those who consumed 4 million last year and 2 million last month. The data shows cocaine as the second most commonly used illicit drug. Lazio is one of the regions in Italy that has the highest number of users in care for the primary use of cocaine. The data of the Addiction Bulletin of the Lazio region in 2008 indicates that from a total of 10616 users in care, 1629 (15.5 %) are using cocaine as the primary substance. However, the data from the Surveillance System on Addiction of the Lazio region shows that, as of 2000, there has been an increasing trend of users who use cocaine as a primary substance, both among new users and among those already in care. In 2008, among the new users as much as 29.4% declared cocaine as the primary substance. The places most hit by the phenomenon are those dedicated to entertainment night out: from the late 90s, the school and the workplace have seen a significant presence of such consumption, which occurs more and more frequently, even at home. Faced with a reality of consumption so articulated in Lazio, it is worthless to offer short-term residential treatment that can cut off users who could otherwise be involved. The CARE Centre, created to respond to this facility deficiency, is funded by the Lazio region which, in 2011 within the framework of regional services on addictions, proposed an experiment residential centre for treatment for cocaine addicts.
OBJECTIVES
The Centre carries out its therapeutic programmess in line with the available scientific evidence and on the basis of clinical experience made in Italy and abroad. The objectives are to offer specialized individual answers, reconfigurable and repeatable care interventions that aim to avoid preventive and cronic interventions. The planned residential modules have four purposes: a study of the diagnostic phase in a protected environment, space for time-out in periods of increased risk of consumption and binges (week-end, holidays, and periods of individual crisis), intensive therapeutic intervention for integrating the outpatient/day treatment, experiential intervention targeted to feel "pleasure" in the absence of substance. Additional objectives are the development of protocols and methods of intervention integrated with outpatient services and to increase the professional competence of the industry (training and dissemination of results).
METHODOLOGY OF INTERVENTION
The project is organized in three phases. The pre-residental phase aims to identify the most appropriate programme for the individual patient for insertion into one or more of the predisposed residential modules. The diagnostic evaluation orients the composition of "homogeneous groups " in the various therapeutic modules. The residential phase is divided into therapeutic actions and experimental actions: is organized for modules that can vary from a minimum of one weekend to a maximum of three months. Reference is made to cognitive behavioural modules, group interpersonal and systemic psychotherapy for the realization of individual therapeutic interventions. The post-residential phase ensures the continuity of the treatment, as well as for the prevention and management of relapses. This phase also has the valence of follow up.
TOOLS AND ACTIVITIES
1. For pre and post-residential clinical activities, both the local offices of the ASL partners and the headquarters of the project partners of the cooperative are used. In these locations other activities not directly targeted to the end user (meetings, data processing, internal training, etc.) are also held.
The residential phase takes place in a villa located in the municipality of Morlupo, accessible by public transport, adequately furnished, with plenty of interior space and features a garden. During the residential modules there are therapeutic moments, experiential activities and games.
NETWORK AND TERRITORY
The centre works in close connection with the Outpatient Centres for cocaine of the ASL of Frosinone, the ASL RMC and with Ser.T. ASL RMF. It also works with all the Ser.T. in the Lazio region for the co-management of patients treated as outpatients who need a short-term intensive residential intervention.
CONTACTS AND PROCEDURES FOR ACCESS
The person can get in touch with the Service through three main ways: through the public service, through the private social service, directly.
Telephone: (0039) 3348364855
E-mail: info@carelazio.it
www.carelazio.it
ORGANIZATIONAL STRUCTURE
The staff of CARE consists of an operational team and a group of coordinators. The operational team is composed of psychologists, psychotherapists and social workers with experience in the field of addictions and in the management of residential services. The operators are in charge of relations with the services and follow users through all phases of the treatment. The group of coordinators is composed of physicians, psychotherapists and social scientists, and is responsible for the supervision and the evaluation and outcome of the process.
EVALUATION
The evaluation process: the logic with which this assessment is conducted is one that refers to quality, so it follows the path of the PDCA (Plan, Do, Check, Act) and must show if the intervention is reaching the target population, if the goals and the expected results provided are being reached. We use data sheets, logbooks, questionnaires, interviews, and group discussion.
1. The evaluation of the recorded results changes in individual conditions with regard to: remaining in treatment, general health, self-perception of health conditions, craving, motivation to change, consumption of substances. The instruments used are: ASI, GAF, MMPI2, TCI, IDTs, MAC, VAS.
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