[Methadone treatment of narcotic addicts--can it be defended?].
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Biomedical subjects
Publications and source records attributed to H Waal.
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The Norwegian policy on methadone maintenance is restrictive. Support is given to needle dispensing programmes, HIV testing and drug rehabilitation programmes. In contrast, the central health authorities have opposed any methadone treatment except for methadone maintenance for HIV infected drug abusers with immune deficiency and in need of AZT treatment. "Akuttinstitusjonen" (The detoxification unit in Oslo) and the Infectious Diseases Unit at Ullevål Hospital have developed a model for treatment programme in cooperation with the local health and social services. We describe six cases, and discuss experiences in relation to the Norwegian policy on drugs. We conclude that the positive factors outweigh the negative. Basically, it should be possible to apply the model throughout Norway. In Oslo the case load creates a need for specialized therapeutic team.
Drug taking behaviour(DTES), psychiatric condition(DSM-III-R) and physical health were evaluated in 44 HIV-positive inpatients at a detoxification unit for drug addicts during the period October 1987 to December 1988. The investigation revealed marked psychopathology, especially in terms of personality disorders. The patients were followed up at the end of April 1989. At this time ten patients were abstinent, though all of them remained under care. 26 patients had relapsed to heavy abuse. Four had died. An unfavourable outcome seems to correlate with heavy abuse and poor physical health. We discuss the consequences for existing provisions for treatment, as well as alternative solutions.
Adolescents with serious behavioural disorders are often met with pessimism and neglect. Too often the prisons become the caretaker. The paper presents a follow-up study from a five year project in Buskerud county. The aim was to find alternatives for adolescents under 16 years of age with serious behaviour problems. The project included 70 youngsters aged 13-16. After a follow-up period of 3-7 years, 61% were found to be in a good situation without criminality or drug abuse. Child care communes and special foster homes were found to be most effective with a success rate of 80%.
Adolescent behavioural disorders represents serious problems in present day society. Several social systems are involved, and the treatment system thus becomes fragmented into several parallel systems. The Buskerud project tried out an integrated model, built as a chain of treatment from municipal to county level. The paper presents the model, and describes the development in the Norwegian counties that to a large extent is influenced by the model.
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