Community-based and hospital-social collaboration service for hidden substance abusers and their carers

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Authors (including presenting author) :
Ip CK, Chan F, Sheung WH, Ng WS, Chan KP
Affiliation :
Department of Psychiatry, North District Hospital, Hong Kong.
Introduction :
Most of the substance abusers are living in the community, but the health challenges have been increased in recent 10 years in view of increasing “hidden” years of receiving treatment and the shift on the use of illicit substances to psychotropic drugs. Community-based with hospital-social collaboration is important to tackle on this issue. Therefore a program called “Tap the hidden, Tap your talent” sponsored by Beat Drugs Fund of Narcotics Division was implemented from 8/2015 – 7/2018 in Tai Po and North District in Hong Kong.
Objectives :
 To identify and engage hidden substance abusers for treatment  To stabilize the physical and mental conditions of hidden substance abusers  To strength the motivation and success in the detox journey  To relieve carer stress for family members of hidden substance abusers
Methodology :
The program was based on the integrated and case management model with the framework of “early engagement, early assessment and early treatment”. Upon receiving referral, psychiatric nurse and peer specialist would conduct outreach assessment to hidden substance abusers, focusing on the physical, psychosocial and impact on substance use. Referral to psychiatrist for those clients who needed pharmacological interventions and more intensive service would be done then. Ongoing care focusing on the stabilization on physical and mental conditions, addiction counseling and enhancement on daytime engagement would be done with close collaboration with community resources. Supportive work in the aspects of enhancing knowledge on caring of substance abusers and resolving familial conflicts will also be performed towards distressed family members.
Result & Outcome :
216 substances abusers and 116 carers were recruited for the program. 47.9% of them abused methamphetamine and 25.6% of them are poly-substance abusers. Outcome assessments on the level of psychiatric comorbidity, level of social functioning, the motivation on quitting the use of substances as well as the frequency use of substances have been done. 72.7% of them reduced or quitted the use of substances after finishing the program and over 70% of them showed improvement in other outcome measures. Statistically significant improvements (p< 0.01) have been noted in all outcome measures among the participants In conclusion, this service model can help for better engagement, assessment and treatment for the substance abusers and their carers.

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