Making Drug Treatment Work : Opportunities and Challenges towards an Evidence- and Rights-Based Approach

Wegman, Martin P. ; Altice, Frederick L. ; Kaur, Sangeeth ; Rajandaran, Vanesa ; Osornprasop, Sutayut ; Wilson, David ; Wilson, David P. ; Kamarulzaman, Adeeba

World Bank, Washington, DC

关键词: SUBSTANCE ABUSE TREATMENT;    DRUG TREATMENT CENTERS;    DRUG DEPENDENCE;    WORLD HEALTH ORGANIZATION;    DRUG ABUSE;   

RP-ID  :  126313

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Compulsory drug detention centers(CDDCs) are common throughout Asia. However, medicaltreatments for substance use disorders, such as opioidagonist treatment (OAT), are generally unavailable in thesesettings. In this report, the authors compare theeffectiveness of CDDCs with voluntary drug treatment centers(VTCs) offering OAT in Malaysia. Positive urine drug testing(UDT) after release confirmed opioid relapse in both groups.Specifically, the authors measure the timing of relapse,that is, the authors compare when patients that have beendischarged from CDDCs and VTCs relapse to opioid. Theauthors conducted a study on opioid dependent individualsfrom Malaysian CDDCs and VTCs from August 2012 to September2014. Baseline (at the starting point of the study) andsemi-monthly behavioral assessments and UDTs were conductedfor up to one year after release and discharge. Relapserates between the groups were compared using advancedstatistical analysis. Screening occurred in 168 CDDCattendees and 113 VTC in-patients, with 89 (CDDC), and 95(VTC) of these individuals, respectively, having a baselineinterview and at least one UDT. The authors found thatopioid-dependent persons that have been released from CDDCsrelapse to opioid use significantly faster than those fromVTC services. This suggests the services provided by CDDCshave little role in the treatment of opioid use disorders.