Home' Australian Pharmacist : Australian Pharmacist April 2016 Contents Australian Pharmacist April 2016 I ©Pharmaceutical Society of Australia Ltd.
BY ANDREW DANIELS
The number of people seeking treatment for prescription addiction
is increasing according to Clinical Psychologist Dr Philip Townshend,
the Treatment Director at DARA Thailand.
He told Australian Pharmacist that the
majority of clients (70-80%) at DARA
Thailand drug and alcohol rehabilitation
centre had some prescription medicine
component to their substance use.
‘At one time rehab was focused on
alcohol and heroin however now most
clients, certainly most from Australia
have some component of prescription
drug use in their substance use
Dr Townshend said there were a variety
of reasons for this increase. One was
that most people with SUD had high
levels of anxiety and often suffered
with depression and were likely to
self-medicate with various substances.
They often found the strong anxiety
relieving effects of benzodiazepines too
hard to resist.
‘Sometimes these will be prescribed and
sometimes off-street drugs. Also the
effects of a SUD make it likely that
people will have sleep, depression and
anxiety disorders so they are more likely
to be prescribed these, often the doctor
scripting these meds is unaware of the
underlying SUD,’ Dr Townshend said.
He said about a third of Dara’s clients
were from Australia.
‘ This seems to be a combination of our
availability – that is we can get people
in within a week to 10 days – our price,
the entry level here is about A$7,000,
which is about half the cost of inpatient
in Australia, and the quality of the
accommodation here is much higher.
‘Most clients could come here and
stay 6–8 weeks and still have change,
compared to what they would have to
pay for rehab in Australia.’
The most common prescription
medicines addictions Australian clients
present with are benzodiazepines
‘In Australia, the relative availability of
low cost street opioids means that a lot
of our Australian clients have opioid
problems. Often, our clients see the
doctor and pharmacist as only one
channel for obtaining medications
and are likely to swap meds with other
people and also to buy off the street.
‘ They often have an inflated view of
the level of knowledge they have
about drugs and are unrealistically
confident about making decisions to
take prescription drugs themselves –
often with consequences of addiction or
in the worst case, overdose.
‘While not a prescription drug, we
see plenty of methamphetamine and
cannabis use amongst our Australian
clients as well, which seems to be due to
the availability of these in Australia.
‘We see more codeine use from other
countries, when compared to Australia.
However, I think the availability of
stronger opioids in Australia means that
by the time people get here they have
moved beyond codeine.’
Dr Townshend believes the recovery
rate at Dara is about 80%. However, he
emphasised that as recovery is different
for every person, and they often take
a combination of several episodes of
rehab as well as outpatient support to
achieve an enduring recovery, it can
sometimes take several years.
DARA Thailand provides drug and
alcohol rehabilitation to clients from
more than 50 countries. It uses a mix of
proven methods for treating addiction
at its two centres located on Koh
Chang (Elephant Island) and in rural
Chanthaburi (City of the Moon).
The facilities are registered in
Thailand, and DARA is in the process
of applying for CARF accreditation, the
US-International accreditation process.
As well, clinical staff are registered in the
countries they come from as an extra
level of QA.
Both facilities, DARA utilises an
Integrated Behavioural Treatment
Model. Components, include, cognitive
behavioural therapy, rational emotive
therapy, dialectical behavioural therapy,
transactional analysis, schema therapy,
relapse prevention therapy (including
relapse prevention track), intensive
behavioural therapy and motivational
Clinical Psychologist Dr Philip Townshend
Dara drug & alcohol rehab clinic, Thailand
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