Problems with inpatient drug users in Jeddah

Background: To identify problems associated with the treatment of inpatient drug users in Jeddah, and suggest ways of improving the delivery of health care service to these drug users. Subjects and Methods: Three hundred and two subjects with substance dependence who were admitted to the Voluntary Detoxification Unit of Al Amal Hospital, Jeddah, between January and April 1997 (inclusive) were studied. A data gathering form was designed to collect relevant information. Outcome was recorded after discharge or transfer from the unit. Results: Over half the subjects were single, unemployed, without high school education and came to the hospital unaccompanied. About 68.21% used heroin and 21.52% used alcohol. About 87.86% were intravenous drug users (IVDUs) and 54.69% started injecting from the outset. Just under half of the subjects were from outside Jeddah. There were regional variations in the choice of abused drugs. Most inpatients were on their first or second admission. The vast majority of subjects were readmitted within a year of discharge, and 44.70% gave no specific reason for their hospitalization. Unaided abstinence was reported by 42.71% and post-treatment abstinence by 57.52%. On admission, 57.14% expressed no desire to complete the program. About 54.63% were discharged after receiving medical detoxification, and 7.61 % went on to have drug rehabilitation. Conclusion: The main finding of the study was that very few drug users were committed to completing the treatment program. There is a need to review the related factors that may be responsible for this situation. Changes have to be made to improve compliance and increase retention of the inpatient program. Contractual and probationary treatment of drug users should be initiated. Current restrictions on admissions have to be eased. There should also be a decentralization and development of local services, as well as a reappraisal of addiction services.