Treatment, Day 1, Track 3, 15:30 -17:00

Presented as part of the Uniting the global community to face the challenge of addiction event, in-person on 12th May, 2022

Presentations:

Exploring stigma towards patients with major depressive & substance use disorders amongst non-specialist health workers in South Africa - Richard Goncalves, MD

Coercion or Motivation – What Works in Treatment of SUDs in Justice Involved Clients - Dr. Igor Koutsenok

Occupational Therapy as a Potent tool in Substance Use Disorders Recovery: A Case of Study of Federal School Occupational therapy Oshdi, Lagos - Lydia Ajayi

The cost-effectiveness of naloxone programmes for the treatment of heroin overdoses ‘on the street’ by non-medical staff: the Villa Maraini Foundation experience - Mauro Patti 

Abstracts:

• Exploring stigma towards patients with major depressive & substance use disorders amongst non-specialist health workers in South Africa - Richard Goncalves, MD

As mental illness-related stigma is a significant barrier to seeking and receiving healthcare, high stigma amongst non-specialist health workers (NSHW’s) towards patients with major depressive disorder (MDD) and substance use disorder (SUD) could negatively affect the provision of mental health services in South Africa. The aims of this study were to examine the level of stigma towards mental illness in NSHW’s working in primary care settings in South Africa and to assess whether there are any socio-demographic variables that are associated with raised stigma levels in this cadre of workers. 81 NSHW’s completed a self-administered questionnaire, which included a modified Bogardus Social Distance Scale to measure stigma towards a hypothetical patient with MDD, and one with SUD. A cumulative social distance scale (SDS) score was determined, with a higher score representing more stigma. The average MDD SDS score was 8.99 (SD =3.65) and the SUD SDS score was 11.65 (SD=4.37). This shows that social distance towards the patients in both vignettes was raised and significantly higher social distance was observed towards the vignette with SUD, as opposed to MDD (t(76)= -7.21, p <.001). In conclusion, there is significant stigma towards mental illness amongst NSHW’s, particularly towards those patients with SUD.

• Coercion or Motivation – What Works in Treatment of SUDs in Justice Involved Clients - Dr. Igor Koutsenok

The presentation will review some of the clinical specifics in treatment of substance use disorders in clients under criminal justice supervision. Additionally, the presentation will focus on overcoming major philosophical differences between criminal-justice systems, that value compliance and treatment systems, that value clients’ empowerment and change.

• Occupational Therapy as a Potent tool in Substance Use Disorders Recovery: A Case of Study of Federal School Occupational therapy Oshdi, Lagos - Lydia Ajayi

Introduction:

The World Federation of Occupational Therapists defines Occupational Therapy as a client-centered health profession concerned with promoting health and well-being through occupation.  

The primary goal of School Of Occupational Therapy is to enable undergraduate students learn the best modalities by using recovery capital to assist people with Substance Use Disorder to participate in the activities of daily living.

Reasons:

Lack of daily occupations can adversely affect people with substance Use Disorder because of the effects that substance addiction has on a person's physical, cognitive, and psychosocial health. 

Method:

The School of occupational therapy has graduated about 312 students since its inception in 2003 and has emerged in a unique position to help people struggling to recover from substance addiction, helping re-establish the roles and identities that are most important to them.

Occupations inextricably bring meaning to our lives; they give a description of who we are and how we feel about ourselves and community.

The effects of substance use disorders on occupational performance are quite enormous; so far, over 50 clients have been helped in recovery.

In conclusion, the roles of training the occupational therapists in Evidence Based Practice in recovery of people with substance use Disorder is enormous.   

• The cost-effectiveness of naloxone programmes for the treatment of heroin overdoses ‘on the street’ by non-medical staff: the Villa Maraini Foundation experience - Mauro Patti 

The mortality rate of opioid users is 5 to 10 times greater than that of the general population, and the most common cause of death in that case is an overdose. When treated in a timely fashion with the opioid antagonist naloxone, an opioid overdose is rarely lethal. Unfortunately, many opioid overdoses occur in isolated, hidden, inaccessible locations. To circumvent this problem, the Villa Maraini Foundation (Italian Red Cross Agency on Drug) in Rome has created a rescue team called ‘the Street Unit’ to provide basic life support and administer naloxone for the treatment of opioid overdose in urban environments, by non medical staff and former drug users. The aim is to proof the cost-effectiveness Street Unit. 

Method:

By comparing the cost of 90 overdose interventions provided by the Street Unit with the cost of those provided by the Accident & Emergency departments of the Italian National Health System.

Results:

The Street Unit not only successfully treated all overdoses, but also provided a dramatic reduction in costs, ranging from €123,367.05 (best-case scenario) to €203,377.05 (worst-case scenario).