Chapter 17
Research on the Treatment and Rehabilitation of Drug Addicts
Medical research is an important part of Hong Kong's effort in the development of treatment and rehabilitation programmes for drug addicts. On many occa- sions, the Government has collaborated with voluntary agencies concerned to carry out research for new techniques and methods.
Research on methadone treatment
2 At the end of 1975, the Hong Kong Discharged Prisoners' Aid Society (HKDPAS) completed a three-year pilot scheme on methadone maintenance. The scheme, sponsored by the Action Committee Against Narcotics (ACAN), was designed to gauge the feasibility of treating heroin addiction with methadone maintenance in Hong Kong.
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One hundred hard-core heroin addicts, who were also ex-prisoners, were selected for the scheme. They were divided into two groups-a treatment group and a control group. The treatment group was given straight methadone main- tenance with daily dosage ranging from 30 to 130 milligrammes, depending on the needs of individual patients. On the other hand, the control group started with 30 milligrammes a day and the dosage was gradually decreased. Treatment for both groups was conducted on an out-patient basis and was supplemented with social counselling and supportive services to assist the patients in their personal and family problems.
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4 Results of the pilot scheme confirm that methadone maintenance is a practicable and attractive means of treatment for hard-core heroin addicts in Hong Kong. Fifty-six per cent of the patients in the treatment group were successfully retained at the end of the three-year period. In the control group only one out of the 50 patients succeeded in becoming completely drug-free.
It is particularly encouraging to note that there was a significant decrease in criminal offences of patients on methadone maintenance. Prior to methadone maintenance, their criminal records averaged 1.23 offences per person per year. This dropped to 0.3 during the three years they were with the scheme. Similarly, unemployment also dropped from about 30 per cent to less than 1.5 per cent during the period.
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At the early stage of methadone maintenance, many patients continued to use illicit heroin simultaneously, particularly during the fourth month when 60 per cent of them were found to be doing so. However, the percentage began to drop thereafter and finally became stable at about 30 per cent for the rest of the three-year period. This tends to suggest that in most cases, it takes four to five months for hard-core heroin addicts to get used to methadone main- tenance and to begin achieving long-term abstinence from heroin.
7 As far as the adverse effects of methadone were concerned, only minor side-effects were diagnosed among some of the patients, and no serious illnesses or deaths were reported at all. Another interesting finding is that the dosage
required to maintain older addicts with a longer history of heroin addiction was generally smaller, indicating that methadone maintenance was particularly suitable for addicts of this kind.
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Le s learned from this pilot scheme are undoubtedly of great value, particularly with regard to future improvements to the existing methadone maintenance and methadone detoxification programmes. A full report on the results of the scheme is expected to be submitted to ACAN in the near future.
Acupuncture and electro-stimulation
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During the year, active consideration was given by the Government to the possibility of sponsoring a pilot study to determine the efficacy of acupuncture and electro-stimulation in the treatment of drug abusers in Hong Kong.
10 Experiments using this new technique were started in Hong Kong in late 1972 by two doctors in the Neurosurgical Unit of the Kwong wah Hospital, in collaboration with the Society for the Aid and Rehabilitation of Drug Addicts. The modus operandi is to suppress withdrawal symptoms by applying electro-stimulation through a pair of acupuncture needles which are inserted sub-cutaneously into the concha of both ears of the patient. It has been found that about 90 per cent of the patients treated in this method obtained relief from their craving for heroin. (See illustration on p. 66.)
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The experiment has only been conducted on a small, in-patient basis so far. More research will clearly have to be carried out if the effectiveness of this type of treatment is to be fully ascertained. In this respect, the Government is looking into the possibility of sponsoring a pilot scheme jointly with the National Institute on Drug Abuse (NIDA) of the United States. If this materializes, it is hoped that the scheme will be carried out in Hong Kong on a fairly large- scale, out-patient basis for a period of one to two years.
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