HEROIN-ADDICTION IN BAHRAIN - 15 YEARS EXPERIENCE

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.