The performance of a methamphetamine rehabilitation programme at De Novo Rehabilitation Centre: a descriptive study

Thesis (MFamMed)--Stellenbosch University, 2014.ENGLISH SUMMARY : Background: Methamphetamine abuse “TIK” is highly prevalent in South Africa with Cape Town recording the highest incidence. This is associated with significant health, social and economic problems in South Africa. The aim of the continually growing number of rehabilitation centres in South Africa has been to provide treatment and support for substance abusers towards abstention from substance abuse. This study looked at the performance outcome of the rehabilitation programme at the largest state funded treatment centre, De Novo, in Cape Town. Aim: This study examines the performance of the rehabilitation programme for amphetamine abuse at De Novo treatment centre in Cape Town over a period of one year. Methods: Design and setting: A quantitative, descriptive cross-sectional survey was done. The setting was De Novo treatment centre situated in Kraaifontein, Cape Town. Data was collected from 91 client folder records out of a total population of 375 who received 7 weeks in-patient treatment and varying periods of aftercare over a period of one year Measuring tools: Patient self-reporting was used in this study to assess abstinence from amphetamine use. Results: The time period of aftercare after discharge from in-patient treatment was inadequate i.e. less than 6 months. Final aftercare assessments were done too early i.e. at a mean of 3.8 months after discharge for an accurate assessment of treatment outcome to be made. This early aftercare assessment gave De Novo treatment centre a good initial performance outcome. A total of 73.6% of clients self- reported abstinence but they were assessed only at a median time of 2 months after discharge. These clients who abstained were interviewed early at a median of 2 months while those who relapsed were interviewed at a median of 5 months. The amphetamine rehabilitation performance outcome cannot be accurately determined beyond 2 months for abstainers and 5 months for those who relapsed. However Mann Whitney U analyses showed that the rate of relapse increased with time after discharge from in-patient treatment. Treatment admissions showed a predominance of male (69.2%) unemployed clients(79.1%). The outcome of rehabilitation was not affected by patient age, gender, employment status, educational level, type of referral and co-using any other substances except alcohol. Alcohol and prolonged amphetamine abuse are associated with increased relapse rates. Prolonged amphetamine use i.e. ≥7.5 years was associated with increased relapse rates. Conclusion: This study found that the provision of adequate rehabilitation from amphetamine abuse at De Novo is a major challenge due to the occurrence of early relapse and inadequate after care. Patients relapsed as early as two months after discharge from in-patient treatment. The co-abuse of alcohol and amphetamine as well as prolonged use of amphetamine for ≥7.5 years impacted negatively on the successful outcome of rehabilitation. This latter group of patients may require special attention during in-patient treatment and aftercare. The substance abuse programme at De Novo may benefit from the input of lessons learned from similar programmes elsewhere in South Africa and internationally. In particular, patients need to be followed up for at least 6 months after discharge from treatment. The median two month period of aftercare follow up of patients at De Novo was inadequate. There are no conflicts of interest.AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar