Authors: Astri Parawita Ayu, Shelly Iskandar, Kristiana Siste, Cor De Jong & Arnt Schellekens
Publication: 2016 May 5
Addiction
Volume: 2016. doi: 10.1111/add.13407.
Link: http://onlinelibrary.wiley.com/doi/10.1111/add.13407/epdf
While Indonesian policy-makers consider various options to target the ‘national substance-use epidemic’, ranging from crocodiles to guard drug offenders in Indonesian drug-prisons to scaling-up of rehabilitation services, an academic partnership between the major universities in Indonesia and academic partners in the Netherlands launched a national postgraduate addiction medicine curriculum. Recently, Irwanto and colleagues stated that the current governmental response to the ‘national drug emergency’ is dominated by a criminalizing viewpoint on substance use disorders (SUDs) and includes mainly ineffective punitive interventions [1]. They plead for more evidenced-based approaches to SUDs in Indonesia [1].
Approximately half the drug-convicted prisoners in Indonesia suffer from SUDs. A large body of evidence indicates that such punitive interventions and compulsory detention are ineffective [2]. Several effective alternatives are available, ranging from harm-reduction strategies (including needle-exchange programmes and methadone maintenance treatment) to abstinence-directed strategies through psychosocial and pharmacological interventions [2]. These approaches need urgent implementation at a large scale to target the ‘national drug epidemic’ effectively in Indonesia.
Educating health professionals on addiction topics is key to implement these strategies [3]. Studies show that training in addiction topics is highly effective in improving knowledge, skills and attitudes towards SUD patients [3]. However, teaching hours dedicated to addiction topics are extremely limited. For instance, Indonesian medical schools typically provide addiction training as a 2-hour lecture only [4]. Without proper training in ad- diction, undergraduate medical students lack the basic knowledge and skills to detect and treat SUDs and its complications [5].
World-wide SUD patients suffer greatly from stigma and negative attitudes among the general public, policymakers and health-care professionals [6]. During medical school, students develop more negative attitudes towards SUD patients [5]. Recently, several addiction medicine training programmes were developed in Indonesia: an undergraduate addiction medicine block (Atma Jaya Catholic University), the postgraduate Indonesian Short- Course in Addiction-Medicine (ISCAN) (University of Padjajaran) and specialized addiction psychiatry training (University of Indonesia) [3]. Systematic evaluation of these ongoing training programmes indicates that addiction medicine training can target the urgent training needs of medical doctors, mainly a need for skills in assessment and basic treatment approaches of SUDs [3,4]. Such training also improves attitudes towards SUD patients.
We call upon the international academic community to collaborate on establishing evidence-based addiction train- ing for all health professionals. A well-educated, skilled academic community will be able to improve standards of care for SUD patients, inform policymakers on effective, evidence-based responses to the ‘drug epidemic’ and contribute to reducing stigma against people with SUDs.
Ke ywo r ds: Addiction, addiction curriculum, addiction medicine training, education, Indonesia, substance use.