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Tuesday 25 October 2011

Codeine detox in Mauritius

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Dr. Faysal Sulliman specializes in addiction. Also former head of the Center Methadone Beau-Bassin, he is currently volunteer doctor at the Centre Idrice Goomany.

● Why are young people under 18 are not they allowed to take the methadone treatment in Mauritius?
There is no scientific evidence, research evaluating the effects of methadone on the age of 16. In practice, the major young addicts, methadone should only be used as a last resort. First, the physician tries other methods, such as addiction to codeine (an opiate-based product) and symptomatic treatment, with a big psychological support for young people.
● Some of your patients, how old are the youngest and how do they get into drugs?
Personally, I treated a teenager who had used cannabis at nine years and another who started sniffing glue at about seven or eight years. Some start smoking cigarettes at eight years and then pass cannabis to 10 or 11 years, and then smoke brown sugar and even Subutex. I recall that at the base, Subutex tablets are not smokable. I believe that a child who does not smoke cigarette very young will not be tempted by the cannabis.
● How is effectively detoxify the minor that you follow to Centre Idrice Goomany?
For minors, medical detoxification codeine lasts six to eight weeks with a gradually decreasing dose. Codeine is not given directly to young parents need to supervise the administration of this drug, especially that young people do not sell codeine on the black market. Once physical dependence treated with codeine, it is important that the psychological takes over.
● How is the psychological and what are its shortcomings? The lack of funding of NGOs is it one?
Psychological follow-up is done by trained facilitators on the job and a psychologist who takes over from the first doctor, who prescribed codeine. Some leaders are very good track, but it would be necessary also that each NGO has a full-time psychologist. This is not the case now at the Center Idrice Goomany, for example.
This big lack is due in part to financial constraints, but not only! Very few psychologists have experience with drug addicts and even fewer are specialized for monitoring young patients. In Mauritius, there are many young doctors, but few people are interested in working with addicts. Same for psychiatrists, nurses ...
In addition, in addiction, relapses are common. To work with drug addicts, one must feel something deep down inside we want to ...
● Is a residential treatment would be more beneficial than a day care for minors drug addicts?
Currently, Mauritius, NGOs do what they can in the absence of a residential center dedicated to minors. A Idrice Goomany, I demand that the family is ready to provide support to patients, but it's not easy to train parents. And they must also go to work and can not provide support full-time. Some families the child lock and key in his room, but I do not recommend this form of imprisonment! Ideally, a center for young people Youth Drug supervisors and facilitators with a psychologist in charge of the various individual and group therapy.
● In the absence of the residential center for minors, what are the results of monitoring in "day care"?
A Idrice Goomany, we collect data, but we do not have the means to do scientific studies. However, it would be interesting to do. Again, the financial, but also humans, are missing. Few people have the vocation to work in NGOs.
● Is the treatment of addiction is reimbursed by health insurance, if the parents are treating their children in private?
Not really, we should work on the financial management of addiction and lead a plea to convince that addiction is a disease, a treatable disease.
● Is there any other factors that impede access to treatment?
For example, parents are struggling to support their child in a treatment center. They will not be seen as attending these environments. Taboos surrounding abuse is a barrier to care. Drug addiction is a multidimensional disease, treat the patient in various aspects, but also his family and finally all the citizens around him. To improve the rate of rehabilitation of patients, we must also address the look that the company deals with drug addicts!
Interview by Marie

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