Rehabilitation and Treatment

Rehabilitation

Rehabilitation is the process of assisting the drug dependent patient to find back to the society and secure his abstinence. Physiological and emotional improvements need to be maintained. In the process of rehabilitation patients are taught models and receive support in behaviours that lead to improved personal health, social function and that reduce threats to social health and safety. Ex-drug users learn and are motivated on behaviours and lifestyle changes that are incompatible with drug use.

Important components of rehabilitation are: psychosocial counselling, HIV/AIDS counselling, social/labour reintegration and self help groups.

Rehabilitation can be carried out in various settings. Long-term residential institutions have served since many years the drug rehabilitation. Therapeutic communities are a parade example of such institutions mainly ran by ex-drug users according to a very structured daily program. Day rehabilitation centres offer services as a combination of institutionalized and community settings. Halfway houses offer ex-drug users housing and some degree of health staff supervision, before they start to live on their own. Vocational training and assistance in employment is often very necessary especially for young drug users, who often lack such capacities due to early drug start of drug use.

Treatment and Rehabilitation - Activities of UNODC Iran on treatment included the following: compilation of guidelines on relapse prevention, numerous numbers of training workshops on various aspects of drug treatment, pilot project on naltrexone treatment, study tours abroad to visit best practices in other countries. Pilot projects on maintenance treatment in the community and the prison system. Most practices were further taken for mainstreaming in the country. 

Treatment

International classifications of mental disorders regard drug dependence as a mental disorder. In contrast to many diseases, this disorder entails pleasure beside suffering alike obesity and gambling. This dissimilarity is a crucial factor making drug use treatment much more challenging compared to the treatment of many other disorders. Drug dependence is usually considered as a chronic and recurrent disorder.

Drug dependence inadvertently consists of psychological dependence. Dependence on many drugs like opiates is also accompanied with physical dependence. In these cases withdrawal symptoms emerge after cessation of drugs use, encouraging drug use anew. Different medical measures namely detoxification procedures have been developed to address withdrawal symptoms, which are very important in order to enable patients abstain from using drugs. However the psychological component of dependence, the most important, is not addressed through detoxification endeavours.

Relapse prevention is the process of assisting patients in remaining abstinent after detoxification and help them identify alternate behaviours to drug use. Psychological treatment is the cornerstone of relapse prevention. However use of medication like naltrexone in the case of opiate dependence can accompany and fortify this procedure.

Treatment could be performed on an inpatient as well as an outpatient basis.  Settings for drug use treatment include specialized drug treatment centres, community treatment centres and prisons among others.

Not all drug dependent individuals can attain a state of complete abstinence. Heavy dependent individuals especially those consuming heroin (and may be Shireh) require a substitution treatment for at least some time interval as a supportive measure to achieve stabilization prior to be able to live with out medication.

As for prevention, programming large-scale drug treatment requires the establishment of a strategic framework, with the following steps to: estimate the nature and extent of the problem to be treated; consider values, goals and objectives in tackling the problem; specify the legislative framework and provisions allowing treatment; detail specific types of treatments to be provided; specify levels of financial and human resources to be mobilized; build capacity; specify expected outcomes and specify measures on monitoring and evaluation

Treatment and Rehabilitation IN Iran - Activities of UNODC Iran on treatment included the following: compilation of guidelines on relapse prevention, numerous numbers of training workshops on various aspects of drug treatment, pilot project on naltrexone treatment, study tours abroad to visit best practices in other countries. Pilot projects on maintenance treatment in the community and the prison system. Most practices were further taken for mainstreaming in the country.

• For training team to prepare training package and implement a training workshop on "Structured Relapse Prevention"
• To implement a training workshop on Sustainable Treatment Methodologies (Methadone and Buprenorphine) for Drug Abusers
• To implement workshop on Biological & Psychological Aspects of Drug Abuse
• To implement a workshop on novel pharmacological and non-pharmacological interventions in opiate abuse
• Implementation of training of trainers workshop on "Evaluation of Psychoactive Substance Use Disorder Treatment"
• Motivational interviewing training of trainers workshop
• Research Team Assessing the effectiveness of Naltrexone maintenance in Iran
• Research Team for Evaluation of effectiveness of State Welfare Organization Therapeutic Communities; The procurement of 13 cars
• Research Team Assessing the effectiveness of very low-dose, low-dose and high-dose Methadone in reducing illicit drug use and HIV risk behaviour in a group of Iranian patients seeking voluntary treatment
• Implementation of pilot Methadone Maintenance Treatment in Iran
• A study on the effectiveness of Psychopharmacological and Psychological Interventions in reducing risk behaviours of substance users in prison
• Assessment of the participation level of inmates in reducing drug use in Prisons of Kerman Province