Medical and Nonmedical Treatment for Narcotic Addicts: A Comparative Study from Asia

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Abstract

Narcotic addicts from Laos were treated under governmental auspices in two settings: a Buddhist monastery in Thailand, and a medical facility in Laos. Treatment at the monastery included “eold turkey” withdrawal, a herbal emetic, prayer and religious exortation. Treatment at the medical program consisted of methadone detoxification, care of associated medical conditions, counseling, education regarding addiction, and group discussions. Addicts voluntarily selected one of the alternative modalities. Cost per individual treated was $150 at the medical facility, and about one third that amount at the monastery.

Those choosing the more traditional monastery program had an older mean age and included a greater proportion of females and ethnic Lao people. Expatriate Asians (an educated, urban group) and tribal addicts (predominantly non-Buddhist) were more numerous at the medical facility. Small differences were noted in addiction history between the two groups; these were probably due to the demographic differences between the groups.

Follow-up evaluation on representative samples was conducted 6 to 18 months postdischarge using abstinence as a criterion. Correction was made for regional differences in opium availability and cost. No difference was found in abstinence rates between the monastery and medical programs.

Mortality among addicts over age 60 years was considerably higher at the monastery than at the medical facility. Subjective evaluation of the treatment experience at the temple was positive among Lao addicts (a group ethnically similar to the Thai), but negative among tribal addicts. Over time fewer addicts chose the monastery program, while the medical program became increasingly popular as a treatment resource.

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