This study describes the development and outcome of a new treatment pr
ogramme for the management of heroin addiction in Bahrain. The problem
reached its peak in the early 1980s with several reported deaths and
with the involvement of many disciplines in the overall response. In 1
983, treatment of all addicts was restricted by law to the government
psychiatric hospital. The newly established specialized drug unit was
overwhelmed by the number of patients seeking treatment. The lack of s
ufficient resources and suitably trained staff forced the unit to adop
t an outpatient maintenance therapy approach for most of its clients.
In 1987, a new comprehensive treatment programme was introduced that r
elies on a cleat philosophy, safe detoxification (using objective scal
es for withdrawal manifestations) rather than maintenance therapy, fol
lowed by psychological and social rehabilitation. A national committee
for drug addiction was formed and art intensive programme of educatio
n was started at all levels. The results indicate an initial increase
at inpatient level but a marked drop of outpatient attendance. The use
of the Opioid Objective Withdrawal Manifestations Scale (OOWMS) revea
led that only a small number of our patients developed moderate or sev
ere signs of withdrawal that required detoxification, and the rate of
dispensed controlled medication was reduced by 99%. The effect a this
approach is discussed, with special reference to the need for a collab
orative effort from all disciplines in planning, implementing, continu
ously evaluating and modifying the national programmes for handling th
e serious problem of addiction.