Treatment, Day 3, Track 3, 13:30-15:00

Presented as part of the Uniting the global community to face the challenge of addiction event, in-person on 14th May, 2022

Presentations:

• Treatment in Chile: new findings and directions - Pablo Carvacho
• A qualitative investigation of patient dropout in methadone maintenance clinics in Ho Chi Minh City - Vu Thi Tuong Vi, MPH
• Addiction nursing in Arab region - Dr. Samya Al Mamari
• Treatment of Individuals with Stimulant Use Disorder: 2022 - Richard Rawson, Ph.D.

Abstracts:

• Treatment in Chile: new findings and directions - Pablo Carvacho

Between 2017 and 2020, the CJS conducted an evaluation of the Treatment and Rehabilitation Programmes delivered by the National Service for the Prevention and Rehabilitation of Drug and Alcohol Consumption (SENDA) in Chile. For this purpose, a cohort of adult population users of treatment programs in residential and outpatient-intensive modalities was followed up. Interviews at the beginning of their treatment (n=612), 12 (n=465), and 18 months later (n=400) were carried out. The results show interesting findings for Chile, and useful learnings for the Latin American context. The research provides future directions to ensure better standards of quality treatment for problematic consumers.

• A qualitative investigation of patient dropout in methadone maintenance clinics in Ho Chi Minh City - Vu Thi Tuong Vi, MPH

Background: Patients who are receiving MMT for opioid dependence have a lower risk of relapse and blood borne disease transmission, and a better quality of life. However, over 20% of methadone patients in HCMC dropped out of treatment in the first year of the regimen. The purpose of this qualitative study was to identify reasons for patient dropout in order to improve treatment delivery.

Methods: Semi-structured interviews were conducted with 14 patients, 6 health care workers, and 1 peer educator.

Results: Reasons for treatment dropout were classified into individual, program, and external factors. Individual factors included patient perceptions that they could not change their substance use, despite treatment, and a misconception that methadone would lead to addiction and worse withdrawal symptoms. A program factor included the requirement that patients visit the clinic daily to receive their dose. Lengthy distance to the clinic and restricted clinic hours were external factors that emerged. Patients reported using both heroin and methadone, and using a lower than prescribed dose of methadone in response to the factors they noted.

Conclusion: Implications of this study include educating patients and health care providers about methadone, and providing methadone outside of work hours to reduce barriers to access. 

• Addiction nursing in Arab region - Dr. Samya Al Mamari

Nurses constitute the vast majority of the mental health workforce in the Arab world, compared to psychiatrists, psychologists and social workers (WHO, 2018). Nurses are key professionals in drug and alcohol addiction treatment centres globally. Nurses are frequently the first professionals that patients with Substance Use Disorder (SUD) see in any health facility. In rehabilitation settings, nurses work as educators, counsellors as well as providing physical care. How nurses can be a key profession in delivering the public health agenda in tackling SUD will be outlined. The presentation explores the role of the nurse in SUD care and the workforce needs in the Arab region for trained nurses in the field. Ways of addressing the workforce gap and specializing nurses in addictions will be presented. The role nurses could play in opioid treatment, overdose prevention and harm reduction will be outlines. The need for nursing research in addictions and ways of advancing nursing research will be discussed. A regional strategy to develop addiction nursing with internationally recognised training will be suggested.

A cross-sectional study of smoking patterns of patients in treatment at the National Rehabilitation Center Abu Dhabi

Objectives

• To investigate smoking patterns among a clinical population receiving treatment at a specialized facility (NRC).
• To gather data about specific Tobacco products (Midwakh and Shisha) and their use.
• To study patient’s health knowledge and perceptions about the harms of Smoking.

Rationale

A previous study at the NRC found out that 98% of patients at the NRC smoke Tobacco. Due to such a high prevalence, this study aims to investigate the patterns, attitudes and health related knowledge of tobacco smoking among the clinical population.

Methodology

A survey questionnaire was developed based on the WHO Global Adult Tobacco Survey (GATS) alongside an Arabic version of the Hospital Anxiety and Depression scale (HADS).

Data were collected from 56 patients who volunteers to participate in the study.

Results

Preliminary analysis of the data will be presented with implications for intervention both in terms of prevention and treatment.

• Treatment of Individuals with Stimulant Use Disorder: 2022 - Richard Rawson, Ph.D.

Individuals who use stimulants are challenging to engage and retain in treatment and they present unique clinical issues in treatment.  Stimulant intoxication, withdrawal and psychosis have accepted treatment strategies.  There are a collection of harm reduction interventions/services that can be life-saving.  There are no FDA-approved medications for treatment of stimulant use disorder, although several are promising.  Behavioral treatment, especially the use of contingency management (and other approaches with supportive evidence), has by far the best evidence of effectiveness. The presentation will review these topic areas of importance to clinicians treating individuals with stimulant use disorder.