NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

Giovanni Serpelloni – Department for Antidrug Policies - PCM Teodora Macchia – Istituto Superiore di SanitàCarlo Locatelli – Poison Control Center, Pavia

Elisabetta Simeoni – Italian National Focal Point - Department for Antidrug Policies – PCM Claudia Rimondo – N.E.W.S. Operative Coordination Unit (contact person)

NATIONAL EARLY WARNING SYSTEM

N.E.W.S.SISTEMA NAZIONALE DI ALLERTA PRECOCE E RISPOSTA RAPIDA PER LE DROGHE

www.allertadroga.it ewsita@governo.it

NA

TIO

NA

L E

AR

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AR

NIN

G S

YS

TEM

N.E.W.S DIRECTION

Giovanni Serpelloni

Head of the Department for Antidrug Policies Presidency of the Council of Ministers

Teodora Macchia

Toxicological area director Istituto Superiore diSanità

Elisabetta Simeoni

Italian National Focal Point Department for Antidrug Policies

Presidency of the Council of Ministers

Carlo Locatelli

Clinical area director Poison Control Center Pavia

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

CollaborativeINPUTunits

CollaborativeOUTPUT

units

Staff InformationCommunication

Technology (ICT)

Early Expert Network(EEN)

Management Board-Coordinator-Members

OperativeCoordination

Group

U.O. U.O.U.O. U.O.Double function

U.O. U.O.U.O.

Informative network Response network

ORGANIZATIONAL STRUCTURE

National Focal Point EMCDDA

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

EARLY EXPERT NETWORK

Ministry of Health

Customs AgencyScientific

InvestigationSection

Istituto Superioredi Sanità

Forensic toxicologiesforensic medicine

laboratories

ToxicologicalUniversity

laboratoriesResearch centers

Poison controlcenters

N.E.W.S.

ScientificPolice

Service

DCSA - CentralDirection for

Antidrug Services

AddictiondepartmentsContact Units

Law enforcement agencies

Health system

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

Teodora MacchiaDipartimento del FarmacoISS

Diego PetriccioneUfficio Centrale Stupefacenti

Pietro CanuzziDirezione Generale della Prevenzione Sanitaria – Ufficio VIIMin. Salute

COLLABORATIONS

Franco TagliaroTF Università degli studi di Verona

Franco LodiTF Università degli studi di Milano

Mauro IacoppiniIstituto di Medicina Legale - Università “La Sapienza” di Roma

Roberto Gagliano Candela TF dell’ Università degli Studi di Bari

Santo Davide Ferrara, Franca CastagnaTF Università degli studi di Padova

Marcello Chiarotti, Nadia FucciTF Università Cattolica del Sacro Cuore di Roma

Renata BorrielloTF dell’ Seconda Università degli studi di Napoli

Elia Del BorrelloTF dell’ Università degli studi di Bologna

Elisabetta BertolTF dell’ Università degli studi di FirenzeTossicologie Forensi e Istituti di Medicina Legale

Clara VolpeCentro Antiveleni Ospedale Cardarelli, Napoli

Sandro RussoCentro Antiveleni Policlinico Umberto I, Roma

Carlo LocatelliCentro Antiveleni di Pavia, Centro Naz. Informazione Tossicologica –– IRCCS Fond. Salvatore Maugeri

Mario LattereCentro Antiveleni Ospedale Gaslini, Genova

Maria Luisa FarinaCentro Antiveleni di Bergamo, Azienda Ospedali Riuniti

Franca DavanzoCentro Antiveleni Azienda Ospedaliera Ospedale Niguarda Cà Granda

Primo BottiCentro Antiveleni – Azienda Ospedaliera Universitaria Careggi, Firenze

Alessandro BarelliCentro Antiveleni Policlinico Gemelli, RomaCentri Antiveleni

Pietro PapaLaboratorio Tossicologia Analitica - IRCCS Policlinico San Matteo di Pavia

Marco MacchiaDipartimento di Scienze Farmaceutiche - Università degli studi di Pisa

Roberto BarontiLaboratorio Tossicologia Clinica Azienda Sanitaria FirenzeLaboratori tossicologici universitari / Laboratori ASL

Alessandro PropositoLaboratorio chimico di RomaAg. delle Dogane

Luigi RipaniArma dei Carabinieri - Reparto Investigazioni Scientifiche di Roma

Egidio LumacaDirezione Centrale Anticrimine della Polizia di Stato – Servizio Polizia ScientificaLaboratori F.O.

Paola Ulivi Direzione Centrale per i Servizi Antidroga – III ServizioDCSA III Servizio

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

NATIONAL EARLY WARNING SYSTEM: PURPOSES

• Early detection of potentiallydangerous phenomena in relation to the appearance of new drugs and new patternsof consumption.

•Activation of rapid responseactions through the active and well-timed involvement of thoseorganizations aimed at protectingand promoting public health.

NA

TIO

NA

L E

AR

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AR

NIN

G S

YS

TEM

MAIN FEATURES

WELL-TIMED SPECIFICITYSPECIFICITY

SENSIBILITY SENSIBILITY

EFFICACYEFFICACY

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

INDICATORSWELL-TIMED SPECIFICITY

SENSIBILITY EFFICACY

Time between the first appearance of anintoxication synthomatology or notifications on anomalous conditions and the time to activate:

1) alerts

2) actions for protection

Capability to give trusteful and representative information

% of valuable notifications

Capability to catch not explicit synthomsand conditions

% of synthoms or conditions related to a real danger

Real capability to prevent or keep down negative effects of grug related phenomena

Number of avoided/avidable intoxications

VS

Numer of registered intoxications

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

OBSERVED PHENOMENA

1. Appearance of atypical unknown substances

2. Appearance of unexpected synthoms after

consumption

3. Appearance of new patterns of consumption

4. Appearance of anomalous drug batches

5. Appearance of too low prices or special offers

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM AREAS UNDER OBSERVATION

USERSPOPULATION

New drugs,new patterns of consumption

DRUG TRAFFICKINGAND DEALING

ROUTES

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

RAPID RESPONSE

NOTIFYING UNITS

PH

EN

OM

EN

ON

NOTIFICATIONS’ PROCESSING AND EARLY ALERT ACTIVATION

Emergency units

Laboratories

Law enforcementagencies

Users

Outreach mobile units

SchoolsPlaces of entertainment

Mass media

MEANS OF COMMUNICATION

MULTICHANNEL COMMUNICATION

Health units, law enforcement agencies, labs

Reitox Focal Point

Input

Information tocitizensNewspapers

Body school

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

INPUT NETWORK

Emergency units Laboratories Outreach mobile units

MediaSchools

Places of entertainment Drugs usersNo profit organizations

Law enforcement agencies

Body schoolsNews papers

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

DAILY MEDIA SCANNER(regional and local news paper)

INFORMATION:

LOW SPECIFICITY

HIGH SENSITIVITY

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

OUTPUT NETWORK

InstitutionsNational Focal Point and ISS Emergency units

Laboratories Media

Drug users No profit organizations

Law enforcement agencies

Places of entertainment

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

OUTPUT COMMUNICATION

N.E.W.SATTENTIONS

(Early Expert Network)

INFORMATIVENOTES

ALERTS(different levels)

INPUT

GENERALREQUESTS

PRE-ALERT

ALERT 1

ALERT 2

ALERT 3

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

COLLECTING NOTIFICATIONS: LEVEL OF DETAIL

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

LOCATING NOTIFICATIONS

Sickness, vomit immidiately after the consumption of cocaine

Anonymous user

Cocaine-athropine

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM LEVEL OF DETAIL

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

DRUG TRAFFICKING ROUTES

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

MAP MATCHING

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

MESSAGEMESSAGE

RECIPIENTS

MESSAGE DIFFERENTIATION ACCORDING TO RECIPIENTS

Text 1 Laboratories

Text 2 Law enforcementagencies

Text 3 Health units

Text … Other outputunits

Text 4 Media

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

RESERVED AREA

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

HARBOURS

AIRPORTS

BOUNDARY PASSES

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

INTERNAL COMMUNICATION SYSTEM

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

NEW AREA UNDER OBSERVATION: INTERNET

1. Online drugstores

2. Online pharmacies

3. Forum, blog, chatroom, social network, etc.

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

INTERNET MONITORING

1. Identification of new recreative drugs available on the web and the extent of information related to them (patterns of consumption, purchase, costs, etc.).

2. Collaboration with law enforcement agencies to identify specific websites and to support them in shaping controls and investigations.

3. Collaboration with international organizations and research centers expert in web mapping

NA

TIO

NA

L E

AR

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AR

NIN

G S

YS

TEM

4. Enrichment of information from the Internet with toxicological data.

5. Support to health units in better and earlier recognizing unexpected symptoms and effects.

6. In case of alert, information to consumers’population about the risks they are running.

INTERNET MONITORING

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

DB activities: •Informative notifications

•Attentions•Pre-alerts

•Alert 1•Alert 2•Alert 3

DB substances

DB behaviours

DB prices

DB notificationsfrom schoolse

EDND (EMCDDA)

DADE (DCSA)

DEA

Psychonaut

…

DB for consultation

Addendum

NEWS Report

N.E.W.S. – DATA BASE (powered by Geo Drugs Alert ©)

DB drugs on the Internet

INPUT from EWS-ITA

DB sizes

DB drug-related deaths

INPUT from NEWS-ITA

DB concealmentMethods and imagines

NationalFocal Point EMCDDA

NA

TIO

NA

L E

AR

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AR

NIN

G S

YS

TEM

CONCLUSION

1. The N.E.W.S. is a national system, not regionallyfractionated.

2. It is an early warning system, not just a surveillance system.

3. Strong and various national network: it links together laboratories, law enforcement agencies, health units, media, schools, ecc. and users as well.

4. Interactions with EMCDDA and other internationalorganizations through the National Focal Point: dataflow and information exchange.

5. No advanced technology nor special skills are required to get involved.

NA

TIO

NA

L E

AR

LY W

AR

NIN

G S

YS

TEM

NATIONAL EARLY WARNING SYSTEM

N.E.W.S.SISTEMA NAZIONALE DI ALLERTA PRECOCE E RISPOSTA RAPIDA PER LE DROGHE

THANK YOUwww.allertadroga.it