Background: 'Inter-organizational collaboration' and 'partnership' have been emphasized in drug treatment and rehabilitation over the decades. Nevertheless, the synthesis of knowledge of related arrangements has been limited in scope. This study fills a gap by systematically reviewing the features, outcomes, facilitators, and barriers of inter-organizational collaborations in drug rehabilitation to propose insights to improve policy and practice. Methodology: This review is based on searches of MEDLINE, CINAHL Complete, Embase, and PsychINFO databases. All retrieved papers were independently screened and underwent quality assessment based on the protocol proposed by Peters et al. (2017). Data charting from the included sources was performed using NVivo. Results: A total of 5,631 unique records were retrieved, of which 54 were included in the analysis. Most of the papers were published between 2011 and 2019, and primarily described, or tested, a collaborative activity from a case study or survey research. Treatment services were often partnered with public health, primary care, or social service organizations. The outcomes of initiatives were commonly about the increase in service utilization or the enhancement of service provision. Facilitators and barriers to collaboration were reported by two-thirds of the papers, which primarily pertained to contextual or organizational dimensions. Conclusion This piece of evidence provides good descriptive content on what, how, and how well the interorganizational collaborations have been conducted in drug treatment and rehabilitation. Implications for promoting good practices that range from University education, staff exchange, and incentives to support by governments are discussed.
Intersectoral Collaboration ; Substance-Related Disorders ; Substance Abuse Treatment Centers

OBJECTIVE: This paper presents the experiences of, and lessons learnt from, a seven-year government-academe-civil society collaboration in the development, implementation, and evaluation of a training program for Filipino physicians and rehabilitation practitioners on the management of drug dependence.

METHODS: Review of memoranda, records, and reports relevant to the initiation and implementation of the training activity. Where relevant, we also perused internal notes and minutes of meetings written by the authors, who are also members of the training team.

RESULTS: A tripartite collaboration between government, academe, and professional organizations developed a training program on the management of drug dependence for physicians and rehabilitation practitioners. Learner-centered approaches to education were adopted in the delivery of training content. Participation in the training is a prerequisite for government accreditation as rehabilitation professionals. A ladderized approach to the training was adapted, with participants first obtaining a broad introduction to the program, followed by in-depth focus on the assessment and management of drug dependency. This was done as a response to the perception that a single, two-week training program is insufficient to fully capacitate physicians and rehabilitation practitioners with the requisite knowledge and skills necessary to manage persons with drug dependence. Future plans include an executive course for established practitioners, and a course on community-based management of drug dependency.

CONCLUSION: The current perspective on drug use and dependence is transitioning from a politico-legal issue to a public health concern. Attaining the sustainable development goals in 2030 will necessitate the development of a cadre of professionals who are, among others, capable of assessing and treating persons who suffer from drug dependence. The Philippine experience may serve as a model for other countries struggling with the drug menace.

Human ; Substance-related Disorders ; Substance Abuse Treatment Centers ; Philippines

OBJECTIVETo investigate an effective method to facilitate the physical and mental recovery of drug abusers in detoxification restoration period.

METHODSIntegrated interventions were adopted to observe the changes in the physical and mental conditions of female drug abusers who had withdrawn drugs.

RESULTSComparing behavioral changes between the two groups before and after intervention, we found that changes of score in the intervention group were all higher than those in the control group in terms of their physical symptoms or state of anxiety.

CONCLUSIONIt is necessary to help drug abusers understand the harm of drug-abuse, build up self-confidence and improve EQ through interventions. It will be beneficial for the drug addicts to refrain from drug-taking and regain a normal life. Our study has proved that positive results can only be obtained from integrated intervention projects.

Adult ; Anxiety ; Counseling ; Female ; Humans ; Self Concept ; Substance Abuse Treatment Centers ; Substance-Related Disorders ; psychology ; therapy

Background and Objectives: The Philippine Department of Health (DOH) is mandated by law to, among others, develop capacities and accredit physicians and rehabilitation practitioners across the country on the assessment and management of drug dependence. This paper describes the design and presents the outputs of an advanced course on screening and assessment of drug dependence developed by DOH in partnership with the College of Public Health of the University of the Philippines Manila, Philippine College of Addiction Medicine, and the Group for Addiction Psychiatry of the Philippines.

Methodology: Review, abstraction and synthesis of data from training-related documents and records for the training activities implemented in 2014.

Results: The Level 2a course is a five-day program that focuses on enhancing the skills of physicians and rehabilitation practitioners on the screening and assessment of drug dependence using team-based and practical learning approaches, and builds on learnings from the basic accreditation course. A total of 36 participants from ten Drug Abuse Treatment and Rehabilitation Centers (DATRCs) in nine regions completed the pilot implementation of the course in 2014. In general, the overall participant feedback on the training was mainly favorable based on data from 47% of participants who agreed or strongly agreed to statements on the relevance and attainment of the course aims (mean rating of 1.10±0.31, 1 = Strongly agree, 5 = Strongly disagree), and the appropriateness of its content (1.24±0.43) and design (1.18±0.39). A paired-samples t-test comparing scores for 44% of participants showed that there was a highly statistically significant difference in the pre-test (54%±13%) and post-test scores (69%±10%); t(16)=6.4240, p <0.0001.

Conclusion: Development and design of capability-building initiatives in the field of drug rehabilitation will necessitate alignment with practice standards, grounding in the real-world setting in which professionals work, and orientation towards practical learning.

Education ; Interprofessional Relations ; Substance-Related Disorders ; Substance Abuse Treatment Centers ; Physicians ; Nurses ; Psychology ; Social Workers

Background and Objectives: Tuberculosis (TB) continues to be a public health concern in the Philippines. Vulnerable populations in congregate settings such as drug abuse treatment and rehabilitation centers (DATRCs) have higher risks of TB transmission and infection. With the Duterte administration’s intensified campaign against illegal drugs, government-retained DATRCs are filled to capacity. There is an identified need to profile drug users and dependents living in DATRCs. Furthermore, national guidelines for TB management specific to this population is absent. A study was conducted to determine the profile of admitted clients diagnosed with TB, TB prevalence, treatment outcomes and choice of TB diagnostic modalities in six (6) Luzon-based DATRCs from 2013-2015. Methods: All medical records of drug users admitted in this period were reviewed. Information on the total patient census was sought from DATRC heads and used to compute for prevalence. Results: A total of 347 records were obtained. Overall TB prevalence in the study sites was 7,216 per 100,000 population. The typical individual diagnosed with TB in a DATRC was male, with a mean age of 35 years, with at least high school education, and unemployed. Weight loss and fatigue were the most common symptoms reported. The majority (79.83%) completed TB treatment in the DATRCs. Sputum microscopy and chest x-ray were both used for TB diagnosis in 92.80% (322) of the cases. Conclusion The high burden of TB in Luzon-based, government-retained DATRCs is alarming and underscore the critical need for standards and guidelines in the National Tuberculosis Control Program addressing the unique context of these facilities.
Substance Abuse Treatment Centers ; Prevalence ; Philippines ; Tuberculosis ; Psychiatric Rehabilitation ; Behavior Therapy

OBJECTIVEThis study examined the gender differences in drug-related problems and predictors of recidivism among a sample of 1444 offenders with co-morbid drug abuse and mental disorders participating in California's Proposition 36 Program.

METHODSBackground characteristics and problem severity in multiple key life areas were assessed at intake by using Addiction Severity Index, and drug treatment participation, mental health diagnoses and arrests were based on official records.

RESULTSWomen demonstrated greater problem severity than men in family relationships, health, psychological health, and sexual and physical abuse history. Men on the other hand had greater criminal history, high rates of attention disorder, and psychotic disorder. More men than women were rearrested during the year after treatment admission. Logistic regression analyses showed that for the combined sample, male, young age, cocaine use (relative to methamphetamine), drug abuse severity, methadone treatment, arrest history and fewer prior treatment history were associated with higher recidivism at 12-month follow-up; lower education, cocaine use, and arrest history were related to women's recidivism, while young age, outpatient treatment, and arrest history were predictors of men's recidivism.

CONCLUSIONAlthough the specific type of mental disorder did not seem to be predictive of recidivism, the high rates of mental health disorder and arrest of this population is problematic. Intervention strategies taking into consideration gender-specific problems and needs can improve outcomes for both.

Adolescent ; Adult ; Crime ; Female ; Humans ; Male ; Mental Disorders ; complications ; Middle Aged ; Recurrence ; Sex Factors ; Substance Abuse Treatment Centers ; Substance-Related Disorders ; complications ; Treatment Outcome ; Young Adult

Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.
Adult ; China/epidemiology* ; Female ; Humans ; Male ; Methadone/therapeutic use* ; Opiate Substitution Treatment ; Prevalence ; Psychotropic Drugs/adverse effects* ; Substance Abuse Treatment Centers ; Substance-Related Disorders/epidemiology* ; Surveys and Questionnaires

Adult ; China ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Substance Abuse Treatment Centers ; statistics & numerical data ; Substance-Related Disorders ; therapy ; Surveys and Questionnaires ; Violence ; statistics & numerical data

OBJECTIVETo investigate the effectiveness of psychosocial services provided by social workers in reducing dropout rate and increasing treatment dosage in methadone maintenance treatment (MMT) users.

METHODSFrom May in 2009 to April in 2010, 300 MMT users were recruited from three MMT clinics in Guangzhou, and were randomly allocated into the intervention group and the control groups. The control group (152 cases) received standard MMT services while the intervention group (148 cases) received additional services provided by social workers. Methadone dosage, dropout rate, perceptions toward MMT etc. were compared between the two groups.

RESULTSThe 1-month dropout rate of the control and intervention groups were 19.7% (30/152) and 6.8% (10/148) (P < 0.05) respectively; the 6-month dropout rate of the control and intervention groups were 75.5% (115/152) and 50.7% (75/148) (P < 0.05) respectively. The intervention group had higher average treatment dosage than the control group ((56.0 ± 21.2) vs (64.4 ± 23.1) ml/d, (58.0 ± 24.0) vs (66.1 ± 26.6) ml/d, P < 0.05). At 1-month and 6-month, the intervention group had higher scores of MMT-related perception ((1.26 ± 0.68) vs (1.84 ± 0.95), (1.55 ± 0.83) vs (2.44 ± 1.23), P < 0.05), self-efficacy of maintenance ((3.68 ± 1.33) vs (4.20 ± 1.05), (3.80 ± 1.38) vs (4.43 ± 0.79), P < 0.05) and satisfaction toward MMT((4.08 ± 0.54) vs (4.15 ± 0.60), (4.01 ± 0.67) vs (4.31 ± 0.64), P < 0.05) as compared to the control group. The reverse was true for the score of negative experiences ((1.05 ± 0.86) vs (0.96 ± 0.92), (1.46 ± 0.87) vs (1.11 ± 1.07), P < 0.05).

CONCLUSIONThe psychosocial interventions provided by social workers were effective in reducing dropout rate, increasing treatment dosage and improving cognitions of MMT users.

Adult ; Female ; Heroin Dependence ; drug therapy ; Humans ; Male ; Methadone ; administration & dosage ; therapeutic use ; Opiate Substitution Treatment ; Patient Compliance ; Social Work ; Substance Abuse Treatment Centers ; Treatment Outcome

Objective: To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT). Methods: A well-developed questionnaire and urine tests were used to collect information about demographic characteristics, condition of MMT and drug abuse, family and social support of MMT clients. A 1∶1 matched case-control study was conducted, and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse. Results: A total of 212 (106 pairs) clients receiving MMT were recruited, and most of them were males (78.3%, 166/212), married or cohabitant (48.6%, 103/212) and unemployed (63.2%, 134/212). The average age of the clients was (45.1±7.2) years. The main types of abused new psychoactive substances were benzodiazepine (62.3%, 66/106) and methamphetamine (39.6%, 42/106). The proportion of abusing multi new psychoactive substances was 8.5% (9/106). Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25, 95%CI: 1.35-7.79), benzodiazepine (OR=3.25, 95%CI: 1.11- 9.47) and methamphetamine (OR=13.31, 95%CI: 1.12-158.01). Moreover, MMT for more than9 years reduced the risk of abuse of new psychoactive substances (OR=0.03, 95%CI: 0.01-0.21), benzodiazepine (OR=0.02, 95%CI: 0.00-0.36) and methamphetamine (OR=0.02, 95%CI: 0.00-0.69). Conclusion: Less new psychoactive substances abuse might be associated with longer duration of MMT treatment. And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients, especially in clients who used opioid.
Adult ; Case-Control Studies ; China/epidemiology* ; Drug Users/statistics & numerical data* ; Humans ; Logistic Models ; Male ; Methadone/therapeutic use* ; Methamphetamine ; Middle Aged ; Opiate Substitution Treatment ; Prevalence ; Psychotropic Drugs/adverse effects* ; Substance Abuse Detection/statistics & numerical data* ; Substance Abuse Treatment Centers ; Substance-Related Disorders/epidemiology* ; Surveys and Questionnaires