ASSOCIACI RAUXA c Doctor Rizal 14 bajos 08006

ASSOCIACIÓ RAUXA c/ Doctor Rizal 14, bajos 08006 BARCELONA Tel. 93. 415. 62. 98 - Fax 93. 237. 20. 86 asrauxa@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

Alcoholism, an organic-psycho-social illness, without treatment ends into: • Death • Prison • Mental institution • Homelessness <<for illness or suicide <<legal problems <<dementia <<loss of family & labour relationships

Homeless people suffer in a great number alcohol dependence among other diseases. In fact it is the main illness causing marginalization

The follow-up of chronic alcoholics for a threeyear period showed that 24% became skid road (Vaillant, 1979) Many studies carried out in different parts of the world demonstrated that about 50% or more of homeless people suffer from alcohol 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 Feantsa The 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 punctual and long-term specialized responses for alcohol dependent, drug dependent and mentally ill

ASSOCIACIÓ 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. RAUXA VAN: VAN Street outreach resource. Detection and motivation 2. URBAN THERAPEUTIC COMMUNITY: COMMUNITY Detox, Reduction of addictive habits & Rehabilitation 3. RAUXA FLATS: FLATS Social rehabilitation 4. LABOUR INTEGRATION: INTEGRATION Rauxa Cooperative & “La Terrasseta” restaurant 5. DISCHARGE

1. RAUXA VAN: Street outreach resource Detection 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 illness Relapse Prevention Ameliorate hygiene Develop everyday habits Prepare for labour market Personalized training Be able to handle their personal budget Stimulate 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 Reintegration 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 -21 h, 152 suppers

RAUXA TEAM 1 1 4 3 3 1 1 Medical Doctor Nurse Auxiliary Nurse Psychologist Coaches specialised in substance abuse issues (former patients rehabilitated) Social Workers Administrative assistants Social Educator Accountant + 41 Volunteers

FUNDING MEMBERSHIP FEES PRIVATE DONATIONS –People –Entities –Donations in kind –Prizes SUBSIDIES. PUBLIC GRANTS –Local authorities –Regional Authorities –State authorities (Ayuntamiento de Barcelona) (Generalitat) -Health Department -Welfare and Family Department -Employment Department (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 Zeroset. Bcn 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