DEVELOPMENT OF A COMPREHENSIVE TREATMENT PROGRAM FOR CHEMICAL DEPENDENCY AT AL-AMAL-HOSPITAL, DAMMAM

An experience in developing a treatment program of addiction in an Ara bic Muslim Society. The three major waves of knowledge and methodology are reviewed in historical perspective. General description of Al Ama l Hospital, Dammam, K.S.A, and the three phases which the hospital tre atment program underwent. Drug therapy was the main line of treatment in the first phase, which resulted in a massive consumption of control led drugs exposing patients to iatrogenic dependence. The second phase introduced a wider concept of treatment using a bio-psycho-social mod el in the context of the 12 steps program of the AA. This approach did not reflect positively on patients' care due to the resistance of bot h patients and staff. The third phase addressed the causes of this res istance and formulated the basis for a comprehensive treatment program for addiction that relies on a clear philosophy and defined treatment stages. A multitude of treatment components were introduced and monit ored by a daily clinical program audit. During the three phases, hospi tal records showed a progressive decrease in the amount of medications consumed (>90%) and dropouts (24%-2.8%). The overall number of patien ts completing the treatment program markedly increased and although th e average daily census dropped, there was, in fact, an increase in the number of voluntary patients.