Drug Abuse in the Global Village
Drug Abuse in Asia

Treatment and Rehabilitation in South Asia

Detoxification is provided to drug abusers in Dhaka through the three privately operated centres and the one managed by the Department of Narcotics Control. Some beds are also available at a Mental Health Hospital and in eight medical college hospitals (DNC 1991). Treatment available consists of modified "cold turkey" method, prescribing tranquilizers (chlorpromazine and haloperidol), vitamins and a good diet, behavioural therapy, group therapy, social skill learning and occupational therapy. Results of the success of these treatment programmes have not been assessed due to the lack of follow up services. In 1990, a total of 807 abusers were treated for opiate addiction, 49 for psychotropic substances addiction and 20 for cannabis addiction (U.N. 1990).

No programmes are in operation for social reintegration of former drug abusers (U.N. 1989). No other information reported by 31st December 1993.

Treatment is provided on a voluntary basis in most cases. Many hospitals offer treatment, as part of their psychiatry services. The Ministry of Welfare is encouraging continuity between services such as counselling, de-addiction and aftercare (Singh, Dr. H. 1993).

            It is reported that there were 144 counselling centres, 95 de-addiction centres and 15 aftercare centres in 1993, affiliated with the Ministry of Welfare, providing services to more than 270,000 registered addicts, a significant increase from 12,000 in 1987/88. More than 50 per cent of the addicts are alcohol dependent (Singh, Dr. H. 1993).

No information is reported by 31st December 1993.

The existence of a separate specialized centre for the treatment of alcohol or drug addicts is not reported. Treatment for addicts is carried out in the psychiatric hospital, a general hospital and the St. Xavier Social Services Centre which is run by an NGO. The Drug Abuse Prevention Association of Nepal (DAPAN) had run (from 1989 to 1992) a 20 bed treatment centre in Kathmandu, which was closed down due to lack of funds. Generally, only the addicts for whom community based treatment has failed are admitted to the psychiatric hospital (Nepal 1993a).

            Acupuncture is used for detoxification by one centre since 1986 and is reported as more successful and cheaper than the previous method using neuroleptic drugs, and is said to provide more relief from withdrawal symptoms (Nepal 1993a).

            It is reported that since rehabilitation services are virtually absent in the country, more than 90 per cent of the detoxified addicts relapse within 3 months of treatment. Only one rehabilitation centre is reported in operation (Freedom Centre). Services provided include individual counselling, group dynamics, job placements and family meetings. The cost of these services to the ex-addicts is small as most expenses are borne by the centre itself. Methadone maintenance is reported being considered as a treatment modality (Nepal 1993a).

There is no provision for compulsory treatment of drug dependents in Sri Lanka. Treatment is entirely on a voluntary basis. Courts of Law, however, often refer accused/convicted persons for treatment. The National Dangerous Drugs Control Board, Government Hospitals, Prisons Department, Social Service Department, Ayurvedic Research Institute, and several NGOs are involved in treatment and rehabilitation of drug abusers (Sri Lanka 1993).

            In view of the large number of persons voluntarily seeking treatment, a Short Term Action Plan will be drawn up by the Ministry of Health to deal with the immediate problem. On a long term basis the Department of Health will be responsible for co-ordinating and giving guidance to the development and maintenance of a comprehensive national treatment programme for drug dependents. The active co-operation and collaboration of the non-governmental sector and the community will be encouraged. Treatment services will be free of charge. Health care professionals will be given training in treatment of drug abusers. Legislation will be enacted and facilities will be provided for compulsory treatment where appropriate (U.N. 1992).

     Treatment/detoxification will be supported with counselling, educational and other social measures (U.N. 1992). The NDDCB Project Office's programmes assist in obtaining re-employment and in obtaining vocational training for former drug abusers (U.N. 1989).