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Global partners in addiction

October 26, 2011
by Danielle Wolffe
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“By recognizing that drug addiction is a treatable health condition, we have developed scientific, yet compassionate, new ways to help those affected. Slowly, people are starting to realize that drug addicts should be sent to treatment, not to jail. And drug treatment is becoming part of mainstream healthcare.”
- Antonio Maria Costa, Executive Director, United Nations Office on Drugs and Crime (UNODC) Drug addiction transcends cultural and geographic barriers, affecting approximately 5% of the world’s population. Whether the patient is a Muslim traveling thousands of miles across the Arab world to a clinic in Cairo, Egypt to confront his heroin addiction, a grandmother in a government treatment center in Orenburg, Russia battling alcohol addiction, or a teenager in Fall River, Mass., coming off OxyContin pills, the disease and the stigma that goes along with it are exactly the same.

Despite crucial shifts in policy focus toward treatment in lieu of punishment, this stigma against people addicted to drugs and alcohol persists. Accordingly, addiction treatment professionals experiencing barriers to treating clients have begun to look toward their international colleagues for support.

Global exchanges around drug and alcohol addiction have been much slower to grow than professional relationships in other health disciplines, such as cancer research. However, some formal collaborations have been launched. The United Nations Office on Drugs and Crime (UNODC) created Treatnet ( www.unodc.org/treatment/index.html), a network of 20 global treatment organizations working toward fostering dialogue to understand the disease and improve treatment.

The National Institute on Drug Abuse (NIDA) has launched its international program ( http://international.drugabuse.gov/meetings/international-forum), compiling international research around evidence-based solutions to drug addiction and building international partnerships. Exchanges such as these have paved the way for less formal collaborations to be established among treatment centers worldwide. This article will examine three results of such exchanges. First, we will look at the potential for international exchanges to stamp out the stigma of addiction for professionals, patients and their communities. Second, we will look at how professional exchanges can help countries with limited technical capacity to organize their resources to treat addiction and its related problems, such as HIV/AIDS in IV drug users. Finally, we will examine professionals’ hopes and dreams for the future of international exchanges.

Stigma

One of the most profound results of international exchanges is the emotional impact that resonates with clients and staff long after visitors have returned home. Impact on this level can work wonders in maintaining staff longevity despite practical obstacles such as funding cuts or client relapse, and in helping clients to heal.

Nancy Paull, CEO of Stanley Street Treatment and Resources (SSTAR) in Fall River, Mass., has made international exchange work integral to her facility. In her travels over the years she has been amazed to hear the words clients speak in locations as remote as Beijing, China or Cairo, Egypt, mirroring her experiences at home.

“Outside, the places we travel to can seem like polar opposites to the United States,” says Paull. “It is always a bit of a disorienting experience. Yet when I enter those conferences or facilities, over and over again when I listen to the counselors speak, I start to feel that it could be me or my staff speaking to clients at our facility. It affects you, to realize that no matter where you are in the world the disease of addiction is the same.”
Acknowledging this similarity helps to combat the idea that drug addiction is a choice or behavior.

Access to treatment, however, varies greatly based on location. The UNODC’s World Drug Report 2010 (www.unodc.org/documents/wdr/WDR_2010/World_Drug_Report_2010_lo-res.pdf) exposes a serious lack of drug treatment facilities around the world. The report estimates that only one-fifth of addicted individuals received treatment in 2007, and 20 million people who needed treatment did not receive it.

Shanthi Ranganathan, Director of the TTK Hospital in Chennai, India and a participant in Treatnet, says one of her country’s major challenges in creating more clinics is stigma and the lack of public understanding that addiction is a treatable disease. Accordingly, there is an extreme lack of treatment centers, and no licensing or certification program for counselors. Many professionals burn out because there is not enough information to draw on.

Ranganathan has seen how international visitors sharing their research help staff retain pride in their career choice. Knowledge of clients’ behavior helps them to stop feeling frustrated by the behavior, such as in the case of relapse.

“When the professionals encounter relapses repeatedly, for example, there is discontentment,” says Ranganathan. “New information on how to deal with relapses helps professionals in their day-to-day work.”

On the flip side, although addiction certainly is stigmatized in India, the community-oriented nature of the society prompts families to become more integral to treatment. Fifteen days of family therapy has been made mandatory in India. Ranganathan’s facility has been very successful in bringing family members in, helping them to understand the disease their loved one is suffering from and inspiring them to support the person in recovery.

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