Ra. Lawal et al., REHABILITATION OF HEROIN AND COCAINE ABUSERS MANAGED IN A NIGERIAN PSYCHIATRIC-HOSPITAL, East African medical journal, 75(2), 1998, pp. 107-112
Eighty patients, managed primarily for heroin and cocaine dependence a
t the Drug Rehabilitation Unit of Psychiatric Hospital, Yaba, Lagos, w
ere followed up monthly for a period of 12 months post-discharge and a
ssessed with regard to continued substance use, employment status and
illegal activities. The management package included full assessment, d
etoxification, treatment of associated physical conditions, group ther
apy sessions, occupational and vocational rehabilitation, The sample w
as predominantly male (91%), young adults (mean age 29.1 years; SD 5.9
9) and single (58%), Although 95% had some formal education, many were
school drop-outs, and only 31.3% were gainfully employed. The majorit
y (84%), used a combination of heroin and cocaine, almost all on a dai
ly basis, mainly by smoking and ''chasing the dragon'' (95%). Other su
bstances reportedly used preadmission were alcohol (22.5%), cannabis (
76.3%) and tobacco (97.5%), Less than one half (43.8%) completed the m
inimum one month required for inpatient treatment. Only seven (8.7%) a
ttended the follow-up clinic regularly, but all defaulters were assess
ed in their homes. The level of heroin, cocaine and cannabis use, as w
ell as report of illegal activities, dropped sharply from the first mo
nth post-discharge, but started to rise again (albeit slowly) by the s
econd half of the follow-up period. There was only a slight insignific
ant gain in employment status of patients during the follow-up period.
The community-based management approach is strongly advocated as a wa
y of addressing the several factors identified in this study as milita
ting against the successful management of substance abusers.