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CURE & CARE. Treatment Scenario in Malaysia Compulsory Treatment Provided for drug dependants since 1983 Drug Rehabilitation Centers (DRC) & Supervision.

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Presentation on theme: "CURE & CARE. Treatment Scenario in Malaysia Compulsory Treatment Provided for drug dependants since 1983 Drug Rehabilitation Centers (DRC) & Supervision."— Presentation transcript:

1 CURE & CARE

2 Treatment Scenario in Malaysia Compulsory Treatment Provided for drug dependants since 1983 Drug Rehabilitation Centers (DRC) & Supervision in the Community 22 DRCs – capacity of 7,000 residents Supervision - 55,000 estimated in the community How can N.A.D.A take care of the massive numbers in the community?

3 Success Rate 75% ? 50% ? 20% ? 10% ? Success Rate 75% ? 50% ? 20% ? 10% ? Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Treatment Services Programs in DRCs and those undergoing Supervision Treatment Services Programs in DRCs and those undergoing Supervision Parents, Families Stigmatized Residents – criminalized (records) Parents, Families Stigmatized Residents – criminalized (records) Changes Impact of New drugs on Clients Need for Clinical Approach Changes Impact of New drugs on Clients Need for Clinical Approach Why NADA needs to Transform? GTP & NKRA Concept of 1Malaysia GTP & NKRA Concept of 1Malaysia Success Rate 75% ? 50% ? 20% ? 10% ? Success Rate 75% ? 50% ? 20% ? 10% ? Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Treatment Services Programs in DRCs and those undergoing Supervision Treatment Services Programs in DRCs and those undergoing Supervision Parents, Families Stigmatized Residents – criminalized (records) Parents, Families Stigmatized Residents – criminalized (records) Changes Impact of New drugs on Clients Need for Clinical Approach Changes Impact of New drugs on Clients Need for Clinical Approach

4 ??? ?..what matters most to the rakyat/people or clients …what do we want to transform ….how can we touch the hearts & souls of the people or clients with big fast results…

5 Treatment Wards Registration Office– Sg. Besi Psychiatrist/ Medical Officers

6 CONCEPT OPEN ACCESS SERVICES Voluntarism or Walk-in Support from parents or family Referral Outreach / Motivate No Legal Implications No Pre-conditions No stigma Private and Confidential Options for clients Community-based Program Clients as patients

7 METHADONE MAINTENANCE THERAPY REFERRAL AND ADVOCACY Public, Family dan Clients ( Hospital, Social Welfare. TRANS CC 1-3 bulan package SCOPE OF SERVICES Psychiatric Interventions Opiate Clients Temporary transit Hypnotherapy

8 FUN, EFFECTIVE & EASY TO IMPLEMENT APPROACH

9 EARLY RECOVERY RELAPSE PREVENTION SOCIAL SUPPORT GROUPS FAMILY PROGRAM COUNSELING & GUIDANCE OUTING/EXCURSIONS MEDICAL & HEALTH EDUCATION RELIGIOUS & SPIRITUAL VOCATIONAL SKILLS TRAINING PSYCHOSOCIAL

10 MEDICAL DETOXIFICATION METHADONE MAINTENANCE PYSYCHIATRIC INTERVENTIONS HIV/HEP/TB/STI TREATMENT INHALAN DENTAL SERVICES ALCOHOL & NICOTINE IMMUNIZATION INFECTIOUS DISEASES SCREENING CLINICAL SERVICES

11 DRC VS. C&C CLINIC DRUG REHAB. CENTERS C&C CLINIC Compulsory Treatment & Admission through the Law; Criminal Records; Stigma Open Access Services – Voluntary Admission; Considered as Patients Focus on medical, psychiatric & clinical treatment Treatment-based services only Treatment for opiate-based addicts; all males and separate for women Treatment for all substance abusers (opiate, ATS, inhalant) – males, females & adolescent are separated Treatment Duration – 2 years Treatment duration – 1-3 months (inpatient), 4-6 months (outpatient) Capacity for residents in DRCs – 7,350 Number of clients that accessed services at 8 C&C Clinics – 9,041 Cost of food – RM8.00 x 30 days x 12 months /person = RM 2,880 Cost of food – RM8.00 x 30 x 3 months = RM Loss of Property caused by violence, arsonNo incidence of violence or arson

12 C&C CLINICS CLIENTS REFERAL AND ADVOCACY TOTAL INPATIENTOUTPATIENT SG.BESI KOTA BHARU BKT MERTAJAM TAMPOI KUCHING PAPAR TAMPIN JERANTUT KARANGAN TOTAL ACCUMULATIVE TOTAL ,933 ACCUMULATIVE TOTAL ,855 OUTPUT ( NO OF CLIENTS)

13 OUTCOME STUDY AT C&C CLINIC

14 94.4% 90% 61% Reduced by 37.1% Injecting drug use 46% to 8.9% Confident of not using drugs in the near future Clients satisfied with services Ready to recommend the clinic to family and friends OUTCOME STUDY AT C&C CLINIC

15 Drug use history Substance 30 days BEFORE first visit to C&C Past 30 days Heroin67.1%4.8% Benzos; Dormi, Clona, Valium, Xanax 12%2.0% Syabu, Meth, Ice13.9%2.1% Pil Kuda3.3%2.2% 3 or more substances in the same day 10.8%1.7% OUTCOME STUDY AT C&C CLINIC

16 In general, how satisfied are you with the medical attention you receive for your health problems (other than drug addiction) at the Cure and Care Clinic? Satisfied 69.3% Very satisfied 23.9% Not very satisfied 5.6% Health status, needs and access OUTCOME STUDY AT C&C CLINIC

17 Qualitative analysis: Opinions and feedback on C&C program and services. Overall, happy with the C&C concept C&C encourages voluntary and ambulatory care and rehabilitation MMT is seen as a stabilizer giving 2 nd chance Programs offered by C&C were well received Good support from C&C staff, Counselors and Medical Team OUTCOME STUDY AT C&C CLINIC

18 Example text METHADONE MAINTENANCE PROGRAMME CCSC 1024 CCRC 0 Klinik C&C 0 Jumlah 1024 CCSC 1380 CCRC 21 Klinik C&C 351 Jumlah CCSC 1530 CCRC 40 Klinik C&C 1735 Jumlah (67.8%) clients employed in 2011 compared to 543 (53%) clients in OUTCOME STUDY AT C&C CLINIC

19 56.3% Helped maintain jobs 42.7% Helped get into government support services 54.3% Continued education 77.6% Improved family relations 72.1% Obtained permanent homes 75.9% Prevented arrest into prisons OUTCOME STUDY AT C&C CLINIC

20 73.8% Prevented admission into Compulsory DRCs 78.3% Helped family or friends to get treatment and rehabilitation 76.7% Access to medical care 94.9% Very satisfied with the methadone maintenance programme 94.4% Reduced drug cravings 65.4% Obtained skill training KAJIAN KEBERKESANAN PROGRAM KLINIK C&C OLEH UNIVERSITI MALAYA OUTCOME STUDY AT C&C CLINIC

21 CRIME HISTORY InstitutionBEFORE C&CSince coming to the C&C Lock-up Prison1.060 PUSPEN0.610 Average number of times inpatients and outpatients have been sent to prison, lock up, or PUSPEN KAJIAN KEBERKESANAN PROGRAM KLINIK C&C KOTA BHARU OUTCOME STUDY AT C&C CLINIC

22 Mental Health KAJIAN KEBERKESANAN PROGRAM KLINIK C&C KOTA BHARU OUTCOME STUDY AT C&C CLINIC

23 AFTERCARE SERVICES AFTERCARE Options for Aftercare Services after discharge from C&C Clinic : as outpatient with the same C&C Clinic or other facility; or CCSC (Cure & Care Service Centres); or CCH (Community Caring House) CCVC (Cure & Care Vocational Centre) – vocational skills training TransCC – Transitional Cure&Care facility Outpatient CCSC CCH CCVC TransCC NADA District Offices

24 We Care, We Serve


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