Drug treatments compared

Press, 11 August 1982, Page 20

Drug treatments compared

A comparison of methadone maintenance and therapeutic communities as methods of- treatment for drug addicts in New Zealand appears in a report in the latest newsletter of the Mental Health Foundation's regional groups. “The methadone maintenance programme helps the client to function in society by eliminating the side-ef-fects of heroin addiction, and the therapeutic. community programme aids to have the addict learn to live, drugfree, by .'strict rehabilitation over a long time,” says Ms Jenny Abbott, who compiled the report for the foundation on a student work- scheme earlier this year. “While therapeutic communities are less costly than imprisonment, they are expensive when compared with out-patient methadone treatment,” she says.

“Some addicts do well in the methadone treatment and others do well in therapeutic communities, and some will do well in either treatment,” she says. “It is a sad fact that there may always be a number of addicts who respond badly in all existing programmes. Their final ‘freedom’ from addiction can be death at a young age.” “Drug-treatment centres report that with increasing numbers of clients they are also dealing with relatively more heroin users and more adolescents.

“Most of the people involved in the abuse of hard

drugs live in the northern half of the North Island. Auckland province, with 43 per cent of New Zealand's population, has 73 per cent of the drug offences and 66 per cent of the drug-related admissions to hospitals — figures that highlight the need for adequate treatment facilities, especially in Auckland,” the report says. “Methadone maintenance involves the substitution of heroin addiction with dependence on methadone. In effect, the client changes one addiction for another that is free of the disturbing psychological side effects of heroin.

“The heroin cravings are removed and the client is thus given the opportunity to find employment and imErove social relationships, ut there is no major attempt to give in-depth counselling, or to change any personality pathology which may be the cause of the addiction. “The effectiveness of this treatment has been the subject of much controversy, and there seem to be as many people for as against the method. Those who criticise the treatment say that the clients are not motivated to improve their social rehabilitation,” says the report. “Some studies show a reduction in the criminal activity while others detect no change. Some critics have the idea that the treatment can be counter-productive, with fringe people using methadone maintenance as a

status symbol, or as a passport to the underground. “Encouraging outcomes have been reported in a. recent study of 26 addicts treated , with methadone at. the Auckland Drug Dependency Centre. They were interviewed three years after admission as out-patients and reported 84 per cent reduction in the use of opiates, 53 per cent abstinence from narcotics, and 96 per cent improvement in social functioning,” Ms Abbott says. Therapeutic communities aim to change the addict's personality, the report says.“The addict is removed from the environment, which, has been encouraging drug abuse, and settled into a residential community which is not only away from temptation, but run on the lines of rigid discipline and responsibility to self and others.” Ms Abbott gives the example of Odyssey House, which has recently opened in Auckland. p Because the demands of the Odyssey programme are high, there is a big drop-out rate in the initial stages of treatment, and it usually takes about two years for residents to be sufficiently rehabilitated to- leave the community and live on their own; she says. “The Odyssey House programme is a better alternative to a prison sentence for many drug abusers brought before the courts, and. is cheaper for the taxpayer,” she says. “The programme also pre-

pares the client for gradual re-entry into the community, and reduces the likelihood of relapse by helping the client to develop skills > that are necessary for coping with the stresses of society." There is no Odyssey House programme in the South Island.