Evaluating the Implementation of Drug Abuse Screening, Treatment and Rehabilitation for Abusers according to the Narcotics Bill B.E.2564 in 5 Selected Provinces in Thailand

Abstract

This qualitative study aimed to examine the implementation related to drug abuse screening, treatment, rehabilitation, and social rehabilitation for abusers and explored the obstacle and supportive factors in 5 selected provinces. Collected data by using in depth interview and focus group. There were 44 key informants recruited with purposive sampling including professional staff from public health segments such as physicians, nurses, public health officers, social workers, psychologists and staff from interior segments and national policy agencies such as district clerks, polices, and community leaders who involved in implementation of treatment and rehabilitation for drug abusers according to the Narcotics Bill B.E. 2564 in the 5 selected provinces of Thailand including Narathiwat, Ubon Ratchathani, Mae Hong Son, Kanchanaburi, and Bangkok. Data were analyzed by using content analysis. It was found that after the enforcement of the new law, there were key findings in the 5 pilot provinces, which were categorized into 3 areas as follow: (1) inputs: integrated management, personal development, and selected area preparation, (2) process: transitional phase, active work, collaboration networks, and community based treatment (CBTx) implementation, and (3) outputs: establishing the screening centers by selecting sub-district health promoting hospitals where there were proper staff to implement the care service care, increase in the number of patients receiving care from re-X ray project, but the number of volunteer was low. Most provinces were on the process of setting up the social rehabilitation center except in Bangkok where the services were provided at district offices. The obstacle factors included limited understanding on the implementation of the new law; and the staff of sub-district health promoting hospitals did not feel convenient to refer and following up the abusers. In addition, coordinating between segments was almost absent. It is recommended that government agencies and civil societies be supported to register as screening and social rehabilitation centers covering every subdistrict and register to become case managers in order to cross-link among various segments including screening, treatment, and social rehabilitation for providing care services. In addition, e-learning courses should be developed to build capacity of professional staff to work in screening and social rehabilitation centers, and also work as case managers. Learning exchange forum should be established. Finally, local government organizations of each province should emphasize their roles to integrate the work between screening centers and social rehabilitation centers to implement CBTx in their areas.