Strengthening care and aftercare services for individuals with substance use disorder

The National Recovery Symposium was graced by Her Majesty The Gyaltsuen on 28 June, with the aim to to help address the issues of substance use and substance use disorder, strengthen continuing care and aftercare services for individuals coping with substance use disorder (SUD) and to foster the development of a robust recovery community for those facing substance use disorder.

The ceremony, which was attended by the Prime Minister, senior government leaders, representatives from development partners, experts, and participants, recognized the contribution of volunteers whose work has impacted the lives and recovery journeys of numerous individuals. It also celebrated the achievements of recovering individuals who have overcome setbacks and obstacles to lead healthy and productive lives. 

Her Majesty presented certificates of commendation to the volunteers, comprising of counselors as well as those in recovery who have established groups and communities to help others. Awards for recognition of sobriety were presented to those who have been free from substance use for more than three years. 

The three-day event, which marked the first annual PEMA Symposium on Mental Health, had the theme “Substance Use Disorder is Preventable and Treatable, and Recovery is Possible”. The three-day event brought together groups and individuals to discuss and understand the science, social issues and effective treatment strategies for SUD, highlighting the importance of compassion and empathy for a comprehensive national response.

The three-day event organized by The Pema Secretariat brings together professionals, policymakers, community leaders, family members of individuals in recovery and the individuals in recovery to strengthen care and aftercare services for individuals with substance use disorder, and foster a robust recovery community. 

Some of the objectives of the National Recovery Symposium were to celebrate people in recovery who have overcome stigma, denial and other barriers to treatment, to increase awareness about SUD, their impacts on individuals and communities and the importance of recovery, to disseminate knowledge about evidence-based practices and effective treatment modalities for substance use recover and to bring together professionals, policymakers, community leaders, family members and individuals in the recovery to foster dialogue, exchange ideas and establish partnerships.

The participants included patients who have successfully completed the hospital-based SUD treatment and care from JDWNRH, Eastern Region Referral Hospital (ERRH) Mongar, Gelephu  Central Regional Referral Hospital(CRRH) and Phuentsholing Hospital, individuals who have completed long-term residential treatment program from within and outside Bhutan, recovering volunteers group members of Thimphu, Phuentsholing, Gelephu and Paro, Family members, services providers from SUD unit of JDWNRH, CRRH, ERRH, and Phuentsholing hospital, and school guidance counsellors, social wellbeing focal teachers and school principals of Thimphu.

The symposium featured a range of activities and engaging sessions. On the first day the session was on the recovery plenary, where Dasho Kinley Dorji moderated several impactful topics to address the diverse aspects of recovery.

Dr Chencho Dorji, Professor of Psychiatry, presented on the topic Demystifying SUD which is a science of addiction and the neurobiological aspects of SUD aiming to enhance understanding among the participants.

Dr Damber Kumar Nirola, consultant psychiatrist presented on breaking the stigma shedding light on the impact of stigma on individuals with SUD, and highlighted the need for societal change.

Chogyal Wangdi, recovering volunteer, shared the importance of peer support in recovery by emphasizing the role of peer support, including programs like NA/AA and other support groups.

Kezang Dukpa, The PEMA Secretariat, presented on family dynamics and support stating the focus on family therapy approaches and support systems which will promote healing and resilience for both individuals in recovery and their loved ones.

To help equip the participants of the symposium with necessary skills and competence, four different workshops were organized concurrently on 29 June. The workshops were on pharmacological treatment interventions for SUD, Universal Prevention Curriculum-Core course, family counselling and support and 12-Step program.

130 participants included doctors, pharmacist, clinical counsellors, teachers and principals, families and recovery individuals from Thimphu, Gelephu, Phuentsholing, Paro and Samdrup Jongkhar.

Tandin who is in recovery shared his gratitude for the opportunity to share stories with individuals from other dzongkhags and to learn lessons from each other. He has discussed with every individual to stay connected even after the workshop, so that they would be able to convey and pass the message they have learnt from the symposium.

Another recovery individual shared that providing certificates to them with an appreciation encourages and further motivates them to stay cleaner, which he states is a great initiative by the Pema Secretariat.

Dr Nirola shared, “While providing treatment for any substance or alcohol use disorder, we do not use one method but different modalities of treatment, like providing medication, counselling, rehabilitation services, social services. It is not really easy for a person to stay away from drugs if we don’t give medications, especially in the initial phase, so that individuals don’t suffer from withdrawal symptoms and relapse.”

“Medication assisted treatment is one component of this entire treatment system and that is what I am training the counsellors, nurses and doctors. Initially, we want to start a holistic kind of treatment in the eastern region, Gelephu and Phuentsholing, we have already started in JDWNRH,” he added.

The families of recovery individual shared that through this symposium they learnt ways on how to deal with their kids regrading substance abuse and addiction. They said that this workshop was no less than a life experience for them. They now know that substance addiction is as same as any other incurable disease, and how they as family members need to be with their children in the journey of the recovery and how important it was.

A counselor from one of the groups shared, “Through this workshop, we have learnt so much which we couldn’t learn in so many years. It has enriched us with rich learning experiences and has enabled us to look into ourselves and reflect and introspect on what we have been doing and what are some of the ways that we need to change from here on”.

“It also calls for better collaboration with different stakeholders for children’s education. We need to walk extra miles and no longer depend on the awareness and advocacy programs, and delve deeper into ourselves and connect with children suffering from SUD”.

With many programs coming up, like the symposium, she thinks that the youth are in the safe hands. “Till now we have been working to prevent substance use in the schools and community, in our own capacities, but after the symposium for three days, we have learnt to deal with children who are into substance use in a better way and with the better strategy, which are technically and scientifically based”.

Finally, to emphasize the progress made by the individuals in their recovery journey and the milestones they have achieved, a recovery countdown was organized on last day. Individuals were given opportunity to share their recovery stories and express their learnings from the symposium.

Furthermore, to acknowledge and celebrate their achievements, Minister of Health, Dasho Dechen Wangmo gave certificates to 64 recovery individuals as small token of appreciation and khadars and small souvenirs were arranged for the coordinators of the respective groups of four.

The PEMA Secretariat was established under the Royal Initiative of Her Majesty The Gyaltsuen to help care for the mental health and wellbeing of all Bhutanese, through improved policies and programs, multi-sectoral partnerships, and service delivery network.