The Bhutanese Leading the way.
The Bhutan Narcotic Control Agency (BNCA), as of June this year, has treated a total of 23 people highly dependent on prescription drugs and another 100 people suffering from chronic alcoholism, since the pilot project began in August 2015.
The Opioid Substitution Treatment (OST) is an initiative to support a person who is highly dependent on drugs where the person is given Buprenorphine as a substitute medicine. Disulfiram is the substitute medicine given for chronic alcoholism.
Of the 23 patients who came forward for OST one is a woman according to BNCA officials. Some are still undergoing the treatment while 8 people came out of treatment because they have gotten over the addiction.
The age range for OST patients is between 20 to 35 years and 25 to 60 years for chronic alcoholism. Overall the OST patients were few either because people are unaware of the treatment or because of the stigma since patients have to visit psychiatric ward for treatment.
BNCA Director General Phuentsho Wangdi said the main objective of the initiative is to help get over dependence on drugs and alcohol.
He said Bupernorphine is also a drug, however, it has an addiction ceiling whereby a person will not have a severe craving and a person can function normally.
He also said that there are repeat offenders who do not want to go back to rehabilitation center and can try taking this drug to get over addiction. “It is not a take home drug or medicine, if a person wants to go for this treatment, than an individual must come to hospital to get daily dosage because this is a controlled drug,” he said.
He also said that they do not want to make this initiative very common as they want a person to go back normally as this is only for those who are strongly addicted.
“We have been receiving fund and technical support from UNODC whereby now, we also get support from Global Fund but gradually if this works well, than we will put it in our normal budget,” he said.
As a pilot project they will assess and see the result and if this goes well, than they might even authorize every hospital on this treatment.
It would be a good back up for rehabilitation centers in the country.
Meanwhile, the director said Buprenorphine is a long acting medicine whereby if a person consume once a day, it lasts minimum for 24 hours whereas if a person takes Spasmoproxyvon (SP) they have to take every after four to five hours.
Buprenorphine is of 0.2 mg, 0.4 mg and 4 mg and they have been using 4 mg most of the time.
He also said that they do not provide treatment unless prescribed by a psychiatrist. “Accordingly we plan their dosage and with time their withdrawal will subside,” he said.
He also said a person who is on-and-off drugs is not taken under OST a person can get addicted to the substitute drug which contains Opioid.
“The dosage depends on the dependency of a person and it will take a minimum of three months,” he added. He also said that some people drop the treatment half way due to lack of support from family.
