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Addiction Training For Health Professionals As An Antidote To The Addiction Health Burden In Indonesia

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.

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