Efforts and challenges in addressing substance abuse during the year 2022 |30 December 2022

DURNS, partners conduct outreach programme at Corgat Estate ‘ghetto’ in March to coincide with Women’s Day

With an increase in other stimulant substances on the market such as cocaine and crystal meth and given that drug addiction is a chronic disease and very complex, among the challenges that the Division for Substance Abuse Prevention, Treatment and Rehabilitation (DSAPTR) within the Ministry of Health has reported is a lack of resources inclusive of human resources to better tackle the situation.

Other big challenges that the division has highlighted are stigmatisation and the lack of awareness by the general public.

The DSAPTR hopes that during the coming year it could further increase its partnership with other agencies such as employment through the re-skilling and up-skilling programmes for clients and it will step up its campaign to raise awareness of the dangers and the effects of drugs through the media.

Statistics obtained from the DSAPTR shows that a total number of 4,267 clients registered for substance use disorder treatment with the division with 179 new registered clients for treatment programme this year.

Among the 4,267 clients from Mahé, Praslin and La Digue, ninety-nine (99) have successfully completed their treatment and 49 others have died. A total of 2,771 clients (2419 men and 352 women) are currently active in following their methadone treatment while the 1,348 remaining clients (32%) corresponds to people having interrupted their treatment i.e., defaulted, lost to follow up, disciplinary discharged or relapsed clients and clients for whom outcome data is not available.

The DSAPTR offers different medically-assisted treatment programmes depending on the main substance of concern and that is in relation to maintenance programmes for opioid use disorders only, including Low Threshold Methadone Maintenance Programme (LTMMP), High Threshold Methadone Maintenance Programme (HTMMP), including the Buprenorphine maintenance programme to assisted detoxification for opioid use disorders only, the Symptomatic detoxification programme for alcohol and opioid use disorders and the relapse prevention programme (with or without naltrexone) for alcohol and opioid use disorders.

Among active clients, 2,491 (90%) are following an opioid treatment, including 82% on LTMMP and 7% on HTMMP.

From those opioid-treated clients, 3% corresponds to prisoners.

Other active clients are treated for alcohol addiction (280, 10%). Most of the active clients on opioid treatment belongs to the age groups of 35-45 and 25-35 years old (32% and 32%, respectively), followed by the age groups of 45-55 and 18-25 years old, while alcohol treatment concerns mainly the age group of 35-45 and 45-55 years old.

Opioid treated clients are most represented in the districts of Anse Etoile, Perseverance, Anse Boileau, and Grand Anse (Praslin) districts. Alcohol treated clients reside mainly in the districts of Anse Etoile, Mont Buxton, Saint Louis and Glacis.

Most of clients receiving treatment (127) are causal workers (115 males and 12 females) while 114 are self employed. 105 other clients (91 males and 14 females) are employed in the private sector with 51 (41 males and 10 females) working for the government.

A total of 609 drug tests and 36 pregnancy tests were performed on clients since January 1, 2022 (9 months) as compared to 6577 drug tests and 507 pregnancy tests and 1783 and 154 pregnancy tests conducted in 2020 and 2021.

It was announced by the Minister for Health, Peggy Vidot, in the National Assembly last month, that the ministry was working closely with the World Bank and the United Nations Office on Drugs and Crime (UNODC), to develop a better evaluation strategy for all of the DSAPTR’s rehabilitation and treatment programmes. It will also help to construct a health holistic treatment centre in the centre of Victoria, next to the English River Clinic, in partnership with a foreign partner, to address mental health and addiction from substance abuse while two substance abuse counsellors will be stationed permanently on Praslin to serve clients on the inner islands.

According to the Drug Utilisation Response Network Seychelles (DURNS), studies conducted in Seychelles over the past 10 years, indicated that communicable diseases such as HIV and viral Hepatitis are highly concentrated within this community especially people who inject drugs.  It has through a participatory approach been able to collaborate and network with various stakeholders, allies and actors, both locally and regionally, to shed more light on the issue of substance abuse in an effort to curb HIV and viral Hepatitis among people who inject drugs.

While DURNS is satisfied with the substance use disorder treatment programme, they also think that the programme should also be reviewed to provide psychological support to the clients given that the majority of them continue to go on using drugs after having taken the Methadone  given that mixing Methadone with other drugs can be dangerous.

Apart from the shown willingness and commitment on the part of the people on drugs to move away from drug abuse, DURNS thinks that they should also get the support of their families and the community, rather than be stigmatised because of the situation they are in, if they are to be successful.

The organisation is among other organisations that is advocating for the decentralisation of the communicable diseases and control unit (CDCU) to better serve people who are injecting drugs when they come forward to have their HIV and Viral Hepatitis tests.  

 The Committee for Awareness, Resilience and Education against substance abuse (Care) is another organisation that is raising the awareness among children against the use of drugs and in its message on the occasion of the International Day Against Drug Abuse and Illicit Trafficking on June 26, it stated that the drug pandemic which kills millions globally every year, lays to waste precious lives, destroying our young generation and brings untold stories of misery and suffering, including in Seychelles.

Care also made a strong appeal to all concerned, to approach the matter of legalization of cannabis “with much prudence and wisdom” given the strong debate about its legalization in the country. It also launched its school-based substance abuse prevention campaign in schools to continue raising awareness and resilience of students so they can resist pressure to use dangerous substances.

Compiled by Patrick Joubert