Drug Abuse in the Global Village

Treatment and Rehabilitation in Africa

Burkina Faso
In 1990, 14 drug abusers, received treatment in a non-specialized hospital. Of these, 4 were treated
due to amphetamine and 10 due to cannabis abuse, 10 were in treatment for the first time (CMO 1991). 
      
      In Burkina Faso, there are two psychiatric and nine general hospitals which serve also as treatment
facilities for drug abusers.  No drug related data have been reported (U.N. 1993).

Chad
Drug abusers in treatment are either attached to their beds or given tranquilizers. However, drug
abusers are usually cared for privately, by their families. The organization "Action International
Contre la Faim" took care of young drug abusers between the ages of 10 and 15 until 1989.  Imprisoned
drug abusers are not treated (U.N. 1989).

Cote D'Ivoire
Drug abuse treatment is provided in two general hospitals. In 1989, 52 emergency room drug related
cases were reported. Relapse is reported common (DAA 1990). A rehabilitation center was in planning
(U.N. 1989).

Egypt
The number of drug dependent abusers receiving treatment in psychiatric hospitals has increased from
157 abusers in 1982, to 1,193 in 1988, and decreased to 995 in 1989, according to the Ministry of
Health, Mental Health Department (U.N. 1990). 
      
      In 1990, 308 opiate abusers and 134 abusers of other drugs were treated. Treatment is based on the
motivation to quit drug abuse (U.N. 1989a). 
      
      Government treatment services are available in Alexandria and Cairo. Each city has two treatment
facilities, one free of charge and the other at a reasonable cost. Each facility has 70 beds. A newly
established unit has also been opened, with treatment being offered at a reasonable cost.
Non-governmental treatment is also available through the Central Association for Addressing Alcohol and
Drug Addiction, where treatment is offered at very low cost. Arrested drug abusers can be sentenced to
compulsory treatment at one of the governmental treatment facilities (U.N. 1989b).

Ethiopia
One psychiatric hospital provides treatment for drug abusers (350 beds).  In addition, 2 psychiatric
nurses are available in each regional health care centre.  Two detoxification centres for drug
dependent abusers provide treatment services. Drugs such as Librium are used for detoxification (EFDR
1993).

Gabon
Treatment services to drug abusers are available in the psychiatric unit of a provincial hospital near
Libreville and at a private clinic.  Home based treatment is available, in cases where the family
reputation would be damaged.  Demand for treatment usually comes from family members.  In many cases,
traditional treatment is sought before turning to Western medical treatment (Mounguengui 1990). 
      
      A centre for treatment and rehabilitation of drug abusers "Centre d'Accueil pour Soins et Reinsertion
pour Toxicomanes" (C.E.R.T.A.) was established (Gabon 1992b).

Ghana
Treatment and rehabilitation is provided by the Mental Health Unit of the Ministry of Health.  It is
the policy of the Ministry to provide treatment and rehabilitation facilities outside psychiatric
hospitals (U.N. 1993). 
      
      During 1993, 126 drug abusers received treatment or rehabilitation services; 16 of the cases were due
to opiates abuse, 9 were related to cocaine, 85 were due to cannabis and 16 stemmed from polydrug abuse
 (U.N. 1993). 
      
      Detoxification treatment (appropriate for youth and adults), drug free counselling (most appropriate
for youth) and self-help groups (mainly for adults) constitute the types of treatment programmes
available to drug abusers.  Detoxification, an in-patient programme lasting from 5 to 14 days, is
available at 3 psychiatric hospitals and some general hospitals (U.N. 1993). 
      
      Counselling services for ex-abusers are provided by psychiatrists and community psychiatric nurses
(U.N. 1993). 
      
      Three public institutions provide rehabilitation services to drug dependent abusers in the psychiatric
hospitals at Accra, Pantan (Accra) and Ankaful (Central Region).  Among the rehabilitation measures,
patients are taught various skills, such as cane weaving, carpentry and sewing.  In three private
psychiatric institutions, two emphasize clinical treatment and one uses occupational therapy, as part
of its rehabilitation programmes for drug abusers (PDE 1993).

Kenya
According to a 1994 rapid assessment, treatment is offered by social and health services practitioners
within the framework of existing general health services. In general, it is considered inadequate. 
Most clients in treatment are alcohol dependent, 43 out of 97 were admitted to treatment involuntarily
by relatives, police, NGOs courts or community or provincial officials. Treatment is funded by the
government in most cases (66%), but funds are limited. Some treatment services are free but others are
based on a fee for service basis and paid for by the client in need of treatment. Counselling appears
to be the most frequent treatment, but it is lacking due to lack of privacy during counselling.
"Detoxification" is provided to 21 out of 50 clients. The use of methadone is rare. Further,
representatives of prison authorities acknowledge that not much is done in prisons to treat drug
dependent inmates (Mwenesi Abdullah Halima 1995).

Mali
Treatment of drug abusers is primarily carried out in the psychiatric unit of one hospital (Hospital du
Point-G).  The creation of a new treatment centre, Centre d'Ecoute, was being planned for young drug
abusers and their families (Mali - Year unknown).

Mauritius
The Trust Fund for the Treatment and Rehabilitation of Drug Addicts, established in 1986, is the
national body responsible for coordinating treatment programmes for drug abuse.  It has as its members:
6 representatives of ministries, 3 representatives of Non-Governmental Organizations, 3
representatives of religious organisations, and 3 independent persons.  Treatment and Rehabilitation is
now spread in various regions.  In 1993, 6 non-hospital residential units, 4 general hospitals and 1
specialized detoxification facility were available.  Psychiatric hospitals were reported available only
for alcoholics.  A rehabilitation centre called Lotus Centre has been recently implanted in the
carceral system.  Medical and health services are free to all Mauritians (U.N. 1993). 
      
      In 1993, 58 males and 2 females were treated in the non-hospital residential units and 562 patients
sought treatment for the first time in such facilities.  In the general hospitals, 1139 males and 83
females were treated.  And in specialized detoxification facilities, 213 males were treated in 1993. 
Data concerning the number of patients that sought treatment for the first time in these facilities is
not available (U.N. 1993). 
      
      The Trust Fund encourages traditional medical alternatives, such as acupuncture, ayurvedic and yoga as
an adjunct to treatment and relapse prevention.  The Trust Fund provides help, crisis intervention,
information, advice and directs clients to appropriate treatment and rehabilitation services.  Among
projects to be implemented are drug abuse among women and non-student youth, and treatment and
rehabilitation of drug offenders within the prison system (HONLEA 1993). 
      
      In 1992, the Trust Fund in collaboration with the Mauritius Sanathan Dharma Temples Federation
inaugurated the New Life De-addiction Centre which operates a multi-disciplinary model of treatment and
rehabilitation (EFDR 1993). 
      
      Training opportunities, counselling services for ex-abusers and families of ex-abusers, and halfway
houses are available (U.N. 1992). 
      
      Some existent non-governmental organizations are: Dr. Idrice Goomany Treatment Centre, The Mauritius
Sanathan Dharma Temples Federation, Human Service Trust, and Centre d'Accueil de Terre Rouge. 
Programmes adopted by these institutions include, among other activities, trainings utilizing skills in
community work, day-care centres, Panch Karma approach (based on an ayurvedic traditional medical
model), occupational therapy, education, and counselling (Mission 1993). 
      
      Detoxification programmes are mainly executed by the Ministry of Health at the Brown Sequard Hospital
and National Centre for Rehabilitation of Addicts for a period of 7-14 days for patients referred to
these treatment facilities (U.N. 1993).

Morocco
The treatment and rehabilitation consists of hospitalization of drug abusers, mainly in psychiatric
institutions. Detoxification is often based on drug substitution and rehabilitation. It has been
estimated that about 500 drug related patients are treated in psychiatric hospitals every year (U.N.
1993).

Namibia
A national treatment policy is being formulated by the Department of Mental Health (Ministry of Health)
by the Psychiatrist in-charge, who is also a member of the Inter-Ministerial Drug Committee.  A
network of after-care services mainly run by non-governmental organizations and churches exists
throughout the country.  A life-line telephone counselling service has been set up. In 1992, 1
psychiatric and 66 general hospitals provided treatment for drug abusers (U.N. 1992).  Detoxification,
which is carried out in neighboring South Africa, is compulsory for all drug consumers and is followed
by drug-free counselling and self-help groups (Report Forum 1993). 
      
      Some prisons provided drug dependent inmates with drug counselling, counselling on drug related
diseases, vocational training, and general education. A UNICEF project for drug education to female
prisoners and staff was undertaken in 1993. Detoxification, social reintegration and aftercare is not
provided in Namibian prisons (U.N. 1992). 
      
      Social reintegration of persons who have undergone treatment and rehabilitation programmes is
available in the form of assistance in finding employment, counselling for ex-abusers and their
families and accommodation in halfway houses.  These services are provided by a resource centre, NGOs
and organizations associated with churches (U.N. 1992).

Nigeria
As part of early intervention programming, guidelines on drug abuse counselling have been produced, 
drug-free workplace training for factory supervisors and workers was provided and employees assistance
programmes have been introduced in some companies, which include counselling (Nigeria 1993). 
      
      The Federal Ministry of Health is responsible for the treatment of drug abusers, whereas the NDLEA is
in charge of rehabilitation (U.N. 1992, 1993). A large part of the money allocated for health is spent
on treatment and rehabilitation of drug abusers. Treatment facilities include 16 psychiatric hospitals,
901 general hospitals, 4 self-help facilities, 4,578 primary care facilities, 3 specialized
detoxification facilities and 3 facilities within prison.  Drug related admissions into 28 mental
health institutions, accounted for 1,275  or 12.3 per cent of admissions in 1989. Treatment and
rehabilitation policies include voluntary and involuntary admission  to treatment, detoxification,
abstinence, treatment of illnesses associated with drug abuse, after care and rehabilitation.  Medical
doctors are responsible for the notification (U.N. 1993). 
      
      Invariably relatives or Law Enforcement Agents take patients with drug related problems to mental
health institutions.  The public appears to have changed its attitude towards drug abusers, from
rejection to acceptance of drug abuse related psychosocial problem.  The change is attributed to
increased drug education and availability of treatment and rehabilitation facilities (U.N. 1993). 
      
      Approximately 5 per cent of the total prison population consist of drug abusers.  Some prisons offer
general medical care, drug counselling, vocational training, general education, social reintegration
and after care (U.N. 1993).  Workshops for prison staff on how to effectively rehabilitate and provide
after-care services for convicted abusers and traffickers have been organized (Nigeria 1993). 
      
      Social reintegration services include special assistance in finding employment, accommodation and
counselling services for ex-abusers and families of ex-abusers (U.N. 1993).

Rwanda
Drug abusers who have undergone treatment are integrated into cooperatives or artisans associations
(CMO 1989).

Senegal
The strategy for treatment and rehabilitation is reported hampered by financial difficulties. 
      
      A treatment Centre in Dakar is planned to begin operation in 1993 (Senegal 1993).

South Africa
Treatment and rehabilitation services are based on a "holistic" approach.  Treatment facilities include
5 general hospitals, 4 psychiatric hospitals, 1 specialized detoxification facility, 28 treatment
centres, and most provincial hospitals, all of which provide detoxification facilities (U.N. 1993). 
      
      In 1992, 9,217 persons were treated in 28 treatment centres and 410 in specialized detoxification
facilities; the majority of patients in both cases were males (U.N. 1992). Around 87% of the white
abusers treated in State and other registered rehabilitation centres were for alcohol-related problems.
About 4% were treated for other drug-related problems and 9% were treated for a combination of alcohol
and other drug-related problems (U.N. 1992). 
      
      Detoxification, drug-free counselling, outreach programmes, self help groups, support to families of
drug abusers and emergency aid centres are offered to drug abusers, drug dependent abusers and members
of their families. The staff working with drug abusers include social workers, psychologists, doctors
and nurses, all of whom have undergone drug related training. Social reintegration services include job
finding, and/or accommodation in halfway houses and elsewhere in the community, counselling services
to former drug abusers and their families (U.N. 1993). 
      
      All prisons provide general medical care, detoxification, counselling on drug related diseases,
general education, social reintegration and religious care (religious services, small group work,
personal interviews) to drug abusers.  Some prisons provide drug counselling, vocational training and
psychological treatment for alcohol and drug abusers (U.N. 1993).

Sudan
Only small and limited treatment facilities are available, which are free of charge.  No other
information concerning treatment programmes and facilities has been reported (CMO 1991).

Uganda
The treatment policy followed in Uganda is mainly curative, and is conducted through the National
Mental Hospital and related regional units. A total of 12 treatment facilities, including 8 general
hospitals, 2 non-hospital residential units, one psychiatric hospital, and one self-help facility are
available for treatment of drug abusers.  A total of 258 abusers were treated in the psychiatric
hospital, more than half for cannabis abuse (CMO 1991). 
      
      Treatment programmes include detoxification of opiate and cannabis dependent abusers, drug free
counselling for school and street children, outreach programmes for school and street children as well
as college students, self help groups and counselling by church groups. Some prisons offer general
medical care, detoxification and counselling on drugs and related diseases (CMO 1991). 
      
      A national community based rehabilitation policy is being developed. Concerned NGOs, through their
general rehabilitation centres, assist in the rehabilitation of street children.  Social reintegration
programmes include counselling services for ex-abusers and their families (CMO 1991). 
      
      Government hospitals have psychiatrists, doctors, and social workers whose tasks are to provide
treatment and mental rehabilitation to patients, arising out of drug and substance abuse.  Cases
arising out of tobacco, cannabis, petrol and prescription drugs have been treated in major hospitals
(EFDR 1993).

United Republic of Tanzania
The psychiatric unit of the general hospital of the capital provides treatment and rehabilitation
services to drug abusers (Forum 1993).

Zambia
In Zambia there is no legislation pertaining to drug abuse. Dependent abusers are treated in hospitals
among other patients (EFDR 1993). 
      
      In 1990, Zambia introduced, in conjunction with the International Labour Organisation (ILO), a
programme of action on the establishment of rehabilitation Resource Centres designed for six countries
in the Southern Region.  The National Education Campaign Division (NECD), which is also referred to as
the National Resource Centre for Drug Addicts, has programmes sponsored by the government as well as by
 ILO (EFDR 1993). 
      
      Since the National Education Campaign Division (NECD) does not have detoxification services, abusers
are referred to a mental hospital for treatment. After discharge, abusers are referred to NECD for
counselling and aftercare support (EFDR 1993).  Volunteer organizations work closely with NECD (Report
Forum 1993).

Zimbabwe