Societal change not rehab centres will stop drug abuse

REHABILITATION from drug and alcohol abuse is a lengthy process that gobbles up resources-medical and non-medical, but what is needed is societal change, support and the will to change by the victim, a health expert has noted. While the success rate for drug rehabilitation is very low the world over, there have been calls for interventions locally to assist the population of drug and substance abuse victims. Public institutions that are assisting with psychiatric interventions in the country include Ingutsheni Psychiatric Hospital in Bulawayo, Sally Mugabe Psychiatric Unit in Harare, Parirenyatwa Annex Psychiatric Unit also in Harare and Ngomahuru Hospital and Halfway House in Masvingo.

Ingutsheni Psychiatric Hospital clinical director Dr Wellington Ranga said there was a serious drug and substance abuse challenge in Zimbabwe which cannot be solved by rehabilitation alone.

“In the whole confusion of what is going on there is a reality that we have to face. Number one is that generally drug rehabilitation does not work. When I say this people always wonder why. What is the efficacy of drug rehabilitation at these centres, what is the chance of it working in a human being? The best in the world like Cape Town and San Francisco their efficacy is less than 10 percent. That is a fact known by everyone in the discipline, less than 10 percent as most of those people who are admitted there relapse eventually and go back into it. Why, because drug abuse is a habit but, in our world, we say it’s a disease which if people do not admit that they have a problem, it will not work.”

Dr Ranga said treatment of any kind should be efficacious, adding value to the person receiving it.

“Take an example of Tuberculosis treatment, we use four drugs in the treatment because we have proved that it works in more than 80 percent of them. If you were to then come to me with TB and I tell you that I will give you this drug but it has a 10 percent chance of assisting you, would you take it? Chances are low. Again, from a Public Health Point of view, if we advocate for a drug that is less than 10 percent effective is it fair for people, that more than 90 percent of that population is not going to get better.

“But for drug rehabilitation that is what we do, we are prescribing things that we know are ineffective, because it is talked about, because people have this belief, they are talking of detoxification and so on. They still think they will get to a place to be given a drug that will clean their system, and get rid of the drug. That is not true. We are getting to the ancient times where society thought a person with mental health problems meant that the brain has a problem and they would open up the brains and some even thought they could take our evil spirits.

“We are going back to that where the problem is clear to you that the challenge is not a structural problem in the brain which you sort out by giving medication to take away alcohol or whatever. A person takes beer because of other things that are going on in their emotions which we are not thinking about. We are just advocating that the person goes for detoxification and they come back fine.”

He said society’s behaviour needs to change in order to effectively see drug addiction being eradicated, saying rehabilitation centres were not entirely the solution to the problem.

“In our minds we are saying let’s clear this person’s brain of drugs, but it is not the drugs that are making them behave in the way they do, it is their behaviour which took them there. So, in essence we are not changing anything. People are advocating that we have state of the art rehabilitation centres but internationally, try and look at the number of people that recovered from drug abuse, a few, if you abuse drugs, you deteriorate depending on your support system, and you can die. We have to sort out the behaviour, we have to sort out the community first,” he added.

Dr Ranga said in the Zimbabwean situation a majority of people were not addicts but were physiologically addicted.

Most of them, he said, if they go for two or three days without taking drugs they will be alright.

“We cannot then blame lack of habilitation facilities, that is not where the problem is. At Ingutsheni we just keep you where there are no drugs until you are ok and we send you back home. As long as people know where to find drugs in a community, we can build a 12-storey facility and call it a drug rehabilitation centre, but it is not going to stop the sale of drugs,” he said. @NyembeziMu