Different approaches to the same problem
Every country in the world has a different approach to dealing with the social and economic problems that arise as a consequence from illicit drug use, excessive drinking, and prescription medication diversion and abuse. Examples range from the decriminalization of all illicit drug possession in Spain and Portugal to the War on Drugs in the U.S.
But, what is the face of addiction treatment in Europe? And, how are Europe’s exclusive treatment centers opening their top-notch services to the global citizen?
Today, we speak with CEO Vladimir Simon, and with professional staff members Bridget Curran and Elisa Crespo Blanco from Alpine Horizon Luxury rehab center in Switzerland about the unique addiction treatment challenges and needs of affected individuals. We invite you to learn more from this interview, and post your questions in the comments section at the end of the page.
ADDICTION BLOG: Hello Vladimir, Bridget and Elisa! It’s good to have you with us today!
Let’s start by digging into the facts about who needs addiction treatment in Europe? What are the demographic for addiction/drug use disorders in Europe?
- Drug type
- Family status
ELISA CRESPO BLANCO: From the statistics we’ve found, there is an estimate that 23 million Europeans are dependent on alcohol in any one year. And the costs that come with this rate of alcohol dependence are unbelievable – 68 billion Euros a year!
Now, if we look at alcohol addiction rather than drinking levels, from the estimated 23 million Europeans, men make up 5%, while women make up 1% of the population.
At a general level, across all 25 European Union member states, alcoholic beverages are drunk at the following rates:
- Beer – 44% of all alcohol consumed
- Wine – 1/3rd of all alcohol consumed
- Spirits – < 1/4th of all alcohol consumed
Family studies have found that people with low socio-economic status are less likely to drink alcohol. But, it turns out that drinking, getting drunk, and becoming dependent on alcohol is more likely to occur among drinkers with lower income.
The number of adult binge drinkers has increased in most countries since the 1990s. In fact, young adults are becoming the group of most frequent drinkers. Young adults are also more likely to be more frequent drug users than those who are older than 35. So the proportion of young adults aged 16-24 that are frequent drug users is about 6%, which is twice as high as the proportion of all adult drug users up to 59 years of age.
Regarding drug type, there is a report that shows that almost a quarter of the adult population in the EU (which would be over 80 million) are estimated to have used illicit drug(s) at some point in their life. Most frequently they would have used:
- Cannabis – 73 million Europeans
- Cocaine – 14 million Europeans (lower estimates for use over lifetime)
- Amphetamines – 11 million Europeans
- Ecstasy – 10 million Europeans
But, in fact, cocaine is the most commonly used illicit stimulant in Europe. Most prevalently, cocaine is used in the south and the west countries of the continent. Out of all young adults aged 15-34, about 2 million have reported using cocaine in the past year.
ADDICTION BLOG: What services OTHER THAN state/government health services currently exist in Europe for the treatment of substance use disorders?
BRIDGET CURRAN: I think it can vary from country to country. And I think that not every European country, is obviously, as committed to funding those Non-Government organizations.
From a UK and Ireland perspective, there would be a lot of voluntary bodies that would be semi-state sponsored. So, they would receive a certain amount of funding by the government; and the rest would be funded through charity money, access grants, and through various channels. And, those programs would also vary. None of them would necessarily be around detox, but would be a huge push on prevention. Particularly within the younger age bracket – the 15 to 23/24 age bracket, and especially for the 15-18 year olds. The difficulty is that by that age a lot of young people are already using drugs on a regular basis, and prevention is probably a couple of year too late.
If you are looking at it in a holistic way, a comprehensive preventative program needs to be put into primary schools. That’s where it needs to go! Because by the time you are hitting 15-18, a lot of people are already using cannabis on a regular basis and a lot of them already have an addiction. So, it’s a little too late…and the money’s being pumped into the wrong channel. That is why I think that if you are really looking into preventative work, it should start from a very young age in primary school. That’s what’s missing in a lot of countries in Europe.
ELISA CRESPO BLANCO: I would like to add that regarding the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), more than half of addiction treatment clients would be receiving and opioid substitution treatment, then detoxification services, and psychosocial interventions. These services are provided in different settings such as, specialized treatment units, outpatient and inpatient centers, mental health clinics, hospitals, units in prison, etc.
Now, particularly in Western Europe, there appears to be a gradual shift away from the view that drug dependence treatment is the responsibility of a fewer specialist disciplines providing intensive short term interventions, towards more interdisciplinary integrated long term approach.
BRIDGET CURRAN: And that’s the kind of primary care approach they are trying to take, which is that idea of the multidisciplinary. That would be looking at a primary care center that would deal with the multitude of difficulties, including disability, physical impairment, drug prevention, drug treatment…So, it would be on a larger scale, and the multidisciplinary team would be composed of psychologists, psychiatrists, youth workers, clinical specialists, social workers, counselors, therapists, etc.
But, you know, primary care centers are primarily state funded in most countries. And, because of the demand for services, it’s leading to the same problem – there are huge waiting lists, the interventions that people are getting are not enough, and they just get redirected and bounced from service to service because everybody is so full to capacity. Again, it’s not hitting the mark in terms of actually dealing with the issue.
ADDICTION BLOG: What are some of the advantages or disadvantages to seeking helping from private clinics?
ELISA CRESPO BLANCO: A clear advantage is that you can choose where you go, what type of treatment you receive, and what you want out of that treatment. Compared to primary care, you have more flexibility, as well as shorter wait times because in state funded centers which are almost always full you’d have to wait…sometimes even for months. While, on the other hand, you can access private clinics whenever you feel ready and then have a program specially tailored to your needs because they are not overcrowded.
As for disadvantages, the main one that I’d think about is the cost. Private clinics are generally more expensive. If we look at the USA, for example, Americans pay $200 or more for their monthly health insurance, and also here in Switzerland it’s mandatory to have a private health insurance and the least amount that you pay is $205 and with a high franchise. However, in Spain for example the cost of private health insurance is around $500 a year.
BRIDGET CURRAN: With a private clinic, the biggest advantage is accessibility. You say: “I have a problem. I need to get it resolved. So, I lift the phone and I can do that.” You don’t have that luxury in a public service.
One of the benefits around the public service is the quality of services in terms of professionals’ qualifications. You cannot work in a public service without being fully and properly qualified. Plus, in a public service you gain so much experience. I can say for my career of working in the public service that lasted for 12 years, you are exposed to a multitude and that increases your skill base.
That’s why, here (at Alpine Horizon) we are all absolutely 100% appropriately and highly qualified. This staff has experience in working in the public sector, has knowledge of it, and is bringing all of those qualifications into a private facility. So, we are basically taking with us private sector qualifications and public sector experience, which I think is a really good marriage of both.
ADDICTION BLOG: What do you think of U.S. based addiction treatment models? The good, the bad, the ugly. What do you think can/should be replicated? What can/should be avoided?
BRIDGET CURRAN: For me, to be honest, I didn’t know much about the U.S. market in terms of service providers of rehabilitation services. But, I couldn’t believe the amount of them. There is so much choice in the USA, that in itself, seems overwhelming. How do you even pick what is right for you? And what if I pick the wrong one and I relapse?.. I’ve even failed to pick the right rehabilitation treatment approach. So, it can be really discouraging for the client.
But, from reading reviews about U.S. addiction treatment services, because that’s the only experience I have with them, I saw that even the ones that are advertising themselves as smaller, more intimate, individual-based programs – aren’t. There might be some parts of the programs that might be individual, BUT the therapeutic, clinical part really needs to be individualized to meet every persons’ needs and encourage progress. So, if a person doesn’t respond well to CBT, they should not be in a CBT program.
Also, from some other reviews that I’ve read, I saw that the qualifications of some professionals on staff are not really what they say…which is one of the benefits of our public service trained and highly qualified team here at Alpine Horizon.
On the other hand, some positive things I have taken from the American based models, is that I really admire the amount of options that are available. That is really needed in terms of methodologies and treatment approaches. If there is something new on the American market, they will find it, they will find somebody who’s trained in it, and they will try it. There is no way addiction treatment programs can be static, it will always need that fluidity. So, it’s basically saying “OK, we’ve found something that works, but let’s not just stop there. Let’s keep going, learning, pushing…” I think that’s something we, in the rest of the world can take on.
ADDICTION BLOG: What’s the story behind the foundation of Alpine Horizon? Why and how did the rehab center get started?
VLADIMIR SIMON: Opening Alpine Horizon is like a dream come true. I knew the location had to be somewhere in the mountains due to the healing properties of nature. You know, mountains keep you calm, they give you more strength, and can help the process of recovery as opposed to treatment centers that are set in busy, crowded, loud cities. The Swiss Alps are a perfect location! Also, Switzerland has a high number of exceptionally trained medical and addiction professionals.
At the start I was not certain if the treatment center would be a Luxury facility or not. My initial intention always was and always will be to offer proven and successful services by exceptionally skilled staff members in safe and comfortable surroundings. When I started to look for premises that were fit for a treatment facility in Switzerland, I realized that the standard here is way higher than what you can see in most other countries of the world. The prices you pay for having a nice facility, in one of the world’s most beautiful places, hiring highly skilled professionals, and add the rest of the necessary services – in the end it has to be called a luxury treatment center.
ADDICTION BLOG: Vladimir, would you mind sharing more with our readers about your personal experience with addiction?
VADIMIR SIMON: I was working a completely different business, an advisory business. But seven (7) years ago I had problems with alcohol and I decided to go to rehab in the Caribbean. And, ever since becoming sober I had this idea in my mind that I want to do something more useful for others who are struggling with addiction. And I didn’t only want to help those who struggle with substance addiction such as alcohol, illegal drugs, or pills, but to also help their families. So, I drew a lot from my personal recovery experience when I was envisioning Alpine Horizon.
I know that not everyone is comfortable with labeling themselves as “an addict”. Many would like to control the use or the behavior, maybe try to moderate it, or try participating in a drug maintenance program. We can see this especially in people who are functioning and have not yet hit the rock bottom (if we consider rock bottom being a point where you’ve lost everything and are practically homeless).
But even after someone gets into treatment. The point is not only to be detoxed properly and not have any physical symptoms as a consequence of the addiction, but to find the right motivation to continue the recovery, stay sober, not to relapse, and to leave a better and more productive life.
Another problem that I have seen and can speak about from experience is the thin border between someone who is a hard drinker and an alcoholic, or someone who is a drug misuser and a drug addict. They may seem the same to family, friends or the public, but these people are in a completely different point in their addiction cycle. Placing a drinker in a program for alcoholics will not work most of times…and this just reinforces the self doubt and hopelessness. By the time the problem has progressed to further stages, you have to work with a client who believes their problem is incurable and has no motivation because they’ve been proven so many times that nothing works…Just because they were approached with a program plan that was not fit for their needs.
In my examples here, I am talking mostly about substance addictions, but the same goes for social networks addiction, internet addiction, mobile addiction, which can be even more complicated to treat. It can be relatively easier to say that you will never drink or use again; But how can you not use your mobile phone again?
ADDICTION BLOG: Will you be offering your knowledge and expertise to others who are outside of your client list? What might that look like?
VLADIMIR SIMON: I believe that in the addiction treatment community we all have to learn, teach, and share. It’s important not only to share theoretical knowledge, but it’s also important to share experiences of clients who are successful, as well as of those who were failed by a program.
Now, as I talk about sharing knowledge, we would also like to develop an exchange program. It would be offered to either experts from different countries, or to interns who are still students and trying to decide on a specialization field. They would come to Alpine Horizon and have a practical experience working on our program alongside our expert staff.
Also, there is a new synthetic drug invented every week. On a daily basis there are several video games that are being released. In Sweden, for example, they are now announcing the end of cash and payment cards, saying all money transfers and transactions will be happening over smartphones. But, what about people who have serious problems with internet and phone addiction to the point where it becomes detrimental to other aspects of their life? So, the addiction treatment field has to advance and shift as new challenges arise. I see communication and exchange of practical experiences as a key condition for this to happen.
ADDICTION BLOG: Would you like to add something for our readers that we didn’t cover during the interview?
VLADIMIR SIMON: Not really.
Or maybe I’d like to add that that there are a lot of people who cannot say that they are addicts, alcoholics, or have problem with non-substance addictions. Sometimes they are already down the road to developing a serious addiction issue, but they are ashamed, afraid, or don’t know how to ask for help.
It would be lovely if you don’t wait for problems to become unmanageable before you realize you are headed in the wrong direction and ask for support and guidance from professionals who can help.