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Therefore skilled medical and nursing care are essential at this time, the patients being treated in bed in the wards.

297. After some three weeks during which the physical and mental condition improves markedly and considerable weight is gained, the programme of occupational and recrcational therapy is started. Domestic work, tailoring, wood-work, shoe repairing and gardening are allocated according to circumstances and there is an incentive scheme of payments which are credited to individual accounts. Some of the money can be used for purchases of sweets and additional (oods and to support group incentives in the way of traditional dinners, operas and cinema shows. However, the major part of the payments is held as a credit, to help re-establishment expenses on discharge. Recreation in- cludes table tennis, cards, mahjong, dominoes, music parties, football, net ball, walks, outings and swimming.

298. During this period of rehabilitation the Almoner interviews patients in the ward, and builds up a basis of understanding with a view to follow up work on discharge. Contact is also made with relatives and with employers to try and ensure that the patient is given every assistance to re-instate himself when he leaves hospital.

299. After leaving hospital, patients are encouraged to come and see the Almoner once weekly for the first 3 months. If contact with the patient is not regular, a relative is asked to attend. Complaints of physical ailments, which are frequent, are referred to a general out- patient clinic and, where appropriate, the advice of the psychiatrist is sought. A club of ex-addicts has been formed which mucets once a week, the Almoner attending as an observer who is there to guide the club activities and discuss points of general importance raised by the group. 300. While in the Centre a patient may be given leave to attend to family affairs or to make arrangements about a job. If suspected of a relapse while on leave the nalline test is applied. It has been found that the judicious granting of short periods of leave has been well worth while and, on the whole, the privilege has been respected.

301. Research is proceeding into the socio-economic background and clinical characteristics of addicts in Hong Kong, into the basic nature of addiction and into the place of aversion therapy in preventing relapse. Personality studies are also being conducted in which the Chinese version of the Maudsley Medical Questionnaire was given to an un- selected group of addicts, the Questionnaire having been previously validated against psychoneurotic outpatients. While there is evidence

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that addicts are more neurotic than the average person, clinical experi- cnce shows that any specific type of addictive personality cannot as yet be clinically delineated. It is possible to say, however, that as a group they have, for varying reasons, an inability to postpone pleasure and a low tolerance for tension arising from unsatisfied desires.

302. Much useful information has been accumulated as a result of the first year of work. It is too early to reach any categorical con- clusions, but valuable experience in management has been gained. A scheme of voluntary treatment appears to fulfil a real need but it is most important to exercise a high degree of selection for admission if the limited staff and facilities available are to be put to the best use. This has been emphasized by experience of the first group of 62 addicts admitted who were entirely unselected other than the selection inherent in the fact that registration was voluntary. This group contained a number of persons, about one-third, with a bad criminal record which had not been disclosed. They were aggressive, lacking in self-discipline and at times, violent. Once the bad elements had been assessed and weeded out. much more progress was made and the patients in the centre settled down.

303. The crucial stage in treatment is after the withdrawal period is over and the patients are gaining weight and energy. They then become restless, start to worry about the future and are anxious to get back to their families. This is when a well disciplined programme of rehabilita- tion and recreation must be rigorously imposed. Material incentives and short periods of leave thereafter are valuable adjuncts to the programme, Once discharged, success depends on active follow-up and support which involves patient, employer and any relevant social agency that can contribute.

304. Treatment and rehabilitation in the Centre is a first but essential phase in a long process. The assessment of cures will have to be made very cautiously over a long period. It is much too early to say other than that a scheme of voluntary treatment is well worth while. The crux of full success is to cut off supplies of addicting narcotics at the source. Thereafter, there will be many addicts of long standing who will continue to be a social problem but there will also be a substantial number who can be rehabilitated for a return to a worth while and productive life.

305. The following table indicates the turnover of patients during 1961. The relatively short average duration of stay is largely due to the

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