ASSOCIACIÓ RAUXA

c/ Doctor Rizal 14, bajos08006 BARCELONA

Tel. 93.415.62.98 - Fax 93.237.20.86asrauxa@rauxa.org

www.rauxa.org

Alcohol in Europe

A public health perspective.

A report for European Comission.

Anderson P. & Baumberg B. (2006). Alcohol in Europe. London.

Institute of alcohol studies

http://ec.europa.eu/health

COMMENTS

USER’S MIND

CULTURAL-TRADITIONAL MIND

DENIAL

POOR RISK PERCEPTION

PUBLICITY-BINGE DRINK

•Death <<for illness or suicide•Prison <<legal problems•Mental institution <<dementia•Homelessness <<loss of family &

labour relationships

Alcoholism,an organic-psycho-social illness, without treatment ends into:

Homeless people suffer in a great number alcohol dependence among other

diseases. In fact it is the main main illness causing marginalizationillness causing marginalization

The follow-up of chronic alcoholicschronic alcoholics for a three-year period showed that 24% became % became

skid roadskid road (Vaillant, 1979)

Many studies carried out in different parts of the world demonstrated that about 50%50% or

more of homelesshomeless people suffer from alcohol dependencealcohol dependence

Percentage of alcohol dependence / abuse among homeless population

• 51% Westchester (US)

»Psychiatric Service. 1997 Apr;48(4):504-9

• 25% London

»Addiction Research & Theory, Vol 11(4), Aug 2003.pp.245-256

• 79% Columbia University

»Dissertation Abstracts International Section A: Humanities & Social Sciences, Vol 62(12-A), 2002 pp. 4333

• 72.7% Munich

» European Archives of Psychiatry & Clinical Neuroscience, Vol 249 (1), 1999.pp. 33-44

• 82% South of Brasil

» European Archives of Psychiatry & Clinical Neuroscience, Vol 249 (3), 1999.pp.150-155

• 63.7% Mannheim (Germany)

» Addiction 2002 Dic.; 97 (12): 1593-600

National Reports FeantsaThe right to health is a Human right. Ensuring

acces to health for homeless people 2006

ALCOHOL

•Germany: not mention.

•Austria: missuse of alcohol; no numbers. •Belgium: 8 times more excessive drinkers among homeless. •Czech Republic: it is a problem, none existing medical

establishment for senescent alcoholics chronical homeless.

•Denmark: 60% alcoholic liver damage.

.

National Reports Feantsa•Estonia: 42% urgencies of homeless people are

delirium tremens.

•France: 27% alcohol dependence.

•Hungary: 50-80% alcohol dependence.

•UK: 50% alcohol reliant.

•Ireland: 54% men alcohol dependence.

•Luxemburg: the majority suffer alcohol dependence.

•Poland: just mention alcohol problems.

•Portugal: 55% alcohol abuse and addiction. •Spain: 10->50% chronic alcohol dependence.

Homelessness is a health-social emergency that needs punctualpunctual and

long-termlong-term specializedspecialized responses forresponses for

alcohol dependent, drug dependent alcohol dependent, drug dependent and mentally illand mentally ill

ASSOCIACIÓ RAUXAASSOCIACIÓ RAUXA

NGO founded in 1989 in Barcelona (Spain) with

the aim of alleviating the extreme situation of the homeless population, offering a more than two

years integral treatment of alcohol dependence

and other drugs

Integral treatment of alcohol dependence for alcoholic homeless

Phases

1.1. RAUXA VANRAUXA VAN: Street outreach resource. Detection and motivation

2.2. URBAN THERAPEUTIC COMMUNITYURBAN THERAPEUTIC COMMUNITY: Detox, Reduction of addictive habits & Rehabilitation

3.3. RAUXA FLATSRAUXA FLATS: Social rehabilitation

4.4. LABOUR INTEGRATIONLABOUR INTEGRATION: Rauxa Cooperative & “La Terrasseta” restaurant

5.5. DISCHARGEDISCHARGE

1. RAUXA VAN: Street outreach resourceDetection and motivation

•Six berths and blankets to spend the night

•Contact and interpersonal relationship

•Ameliorate personal hygiene (shower and clean clothes twice a week)

•Papers in order (ID, Health card, etc.)

•Medical check-up: (anamnesis, physical exploration, analysis, X-rays, PPD, OH history according to DSMIV-TR criteria)

•Motivation to start treatment

2. Urban Therapeutic Community

•Social and health resource (14 beds)

•Treatment free of drugs and addictive behaviours

•Detoxication, Reduction of addictive habits & Rehabilitation through cognitive, behavioural and motivational techniques. Individual and Group Therapy

Aims : Raise awareness of illnessRelapse PreventionAmeliorate hygieneDevelop everyday habits Prepare for labour market

Personalized trainingBe able to handle their personal budgetStimulate leisure activities and personal hobbies

3. RAUXA FLATS: Social rehabilitation

•Rented flats (shared between 3 patients) 7 of 3 beds

and 1 of 9 beds

•The patient must have capacity to detect and report

destabilisation or relapse symptoms of their own

and /or of their flatmates

•Economical advantages

•Integration in the neighbourhood

4. Labour 4. Labour Reintegration Phase Phase

•Labour integration in an alcohol free environment•Face everyday problems without alcohol•Multiplier effect: health, social and solidarity with other homeless•Motivate and gain new patients

PATHWAYS:

•Occupational workshop: drawing & wood work•Vocational training

•Job search (CV, job interview)

•Stay in the job (relation with others, explaining illness or not, to who & how, manage stress, say no)

•LABOUR COOPERATIVE RAUXA Canteen of two high schools / Painting,masonry,cleaning...

•LA TERRASSETA Cafeteria and Restaurant

Daily menu (for the general public) /Soup Kitchen 18-21h, 152 suppers

RAUXA TEAM

1 Medical Doctor 1 Nurse1 Auxiliary Nurse1 Psychologist 4 Coaches specialised in substance abuse

issues (former patients rehabilitated)3 Social Workers3 Administrative assistants1 Social Educator1 Accountant

+ 41 Volunteers

FUNDING

MEMBERSHIP FEES

PRIVATE DONATIONS

–People–Entities–Donations in kind–Prizes

SUBSIDIES. PUBLIC GRANTS

–Local authorities (Ayuntamiento de Barcelona) –Regional Authorities (Generalitat) -Health Department

-Welfare and Family Department

-Employment Department

–State authorities (Ministry of Social and Employment -from taxes-)

TOTAL BUDGET: 800.000 euros per annum

RAUXA IS MEMBER of

•FCVS Catalonian Federation of Volunteering

•FDC Federation against Drug addiction

•EUROCARE European Alcohol Policy Alliance

• TABLE OF THIRD SOCIAL SECTOR IN CATALONIA

Awards•Award Ciudadanía Asociación de Vecinos Dr. Robert (1991)•Declared of “Utilidad Pública” by the Central Government (1997) •Award “Rafael Piñol” (1998)•Award “Memorial Lluís Companys”(1998)•Award “Nacional de Drogodependencias Reina Sofía” (2000)•Award de la “Promoción de la Salud” de Agrupació Mutua (2000)•Selected by Voluntariado Internacional at the UNESCO meeting (2001)•Selected as “Good Practice” Award Dubai of United Nations (2002)•Award for the Human Values, Fundación Social Universal (2002)•Award ”Voluntariat i Diversitat Cultural”. Agrupació Mutua (2004)•Selected as “Best Practice” Award Dubai of United Nations (2004&2006)•Award VII Labour Health Barcelona City Hall (2007)•Award for Civil Right Defense (2007)•Award Esteve “United for patient care” (2006)•Selected one of the 100 best spanish practices Dubai Award United Nations (2007)•Delivery Health Merit Medal “Josep Trueta 2007” (2008)•Award “Fundación Paco Candel 2009” (2010)•Rauxa’s Project has been one of the most votes by ZerosetBcn Association in 2009/2010

Rauxa´s Rehabilitated Alcoholics Association

• Created in 2002

• Monthly Meetings at the restaurant “La Terrasseta”

• Self-helping groups

• Activities as volunteers in Rauxa and other centers

• Part of The Rehabilitated Alcoholics Catalan

Federation with active participation

TOBACCO DEPENDENCE TREATMENT 2006-2007-2008 ASS. RAUXA

(N=69)

32 (46%)

37 (54%)

DISCHARGES

RELAPSES

TOBACCO DEPENDENCE TREATMENT 2006 ASS.RAUXA (N=19)

10 (53%)9 (47%) DISCHARGES

RELAPSES

TOBACCO DEPENDENCE TREATMENT2007 ASS.RAUXA (N=26)

12 (46%) 14

(54%)

DISCHARGES

RELAPSES

TOBACCO DEPENDENCE TREATMENT 2008 ASS.RAUXA (N=24)

13 (54%)11 (46%) DISCHARGES

RELAPSES

ALCOHOL + TOBACCO + COCAINE 2007 - 2008

ASSOCIACIÓ RAUXA (N=50)

38, (76%)

12, (24%)

COCAINE+OH+TOBACCO

OH+TOBACCO

COCAINE+ALCOHOL+TOBACCO ASSOCIACIO RAUXA

(N=12)

2; (17%)

10; (83%)

RELAPSES

DISCHARGES

ALCOHOL+TOBACCO+COCAINE 2007-2008 ASSOCIACIO RAUXA (N=50)

0

20

40

RELAPSES 21 2

DISCHARGES 17 10

OH+TOBACCO COCAINE+OH+TOBACCO