Heroin addiction in Bahrain: 15 years experience

Area of Science:

• Public Health
• Addiction Medicine
• Psychiatry

Background:

• Heroin addiction presented a significant public health challenge in Bahrain during the early 1980s.
• Initial treatment efforts were centralized and overwhelmed, leading to reliance on maintenance therapy.
• A shift towards a comprehensive program was necessitated by resource limitations and treatment demands.

Purpose of the Study:

• To describe the development and outcomes of a new, comprehensive heroin addiction treatment program in Bahrain.
• To evaluate the effectiveness of a detoxification and rehabilitation approach over maintenance therapy.
• To highlight the importance of interdisciplinary collaboration in addiction management.

Main Methods:

• Implementation of a new treatment program in 1987 emphasizing safe detoxification and rehabilitation.
• Utilized the Opioid Objective Withdrawal Manifestations Scale (OOWMS) to objectively assess withdrawal severity.
• Established a national committee for drug addiction and initiated widespread educational programs.

Main Results:

• Observed an initial increase in inpatient treatment followed by a significant decrease in outpatient attendance.
• OOWMS indicated few patients required significant detoxification, with a 99% reduction in dispensed controlled medication.
• The new program demonstrated reduced reliance on medication and a shift in treatment modality.

Conclusions:

• The comprehensive treatment program, focusing on detoxification and rehabilitation, proved effective in managing heroin addiction in Bahrain.
• Objective assessment scales like OOWMS are crucial for guiding treatment intensity and reducing medication reliance.
• Sustained success requires continuous evaluation, modification, and a collaborative, multi-disciplinary national strategy.