Bringing drug treatment to Vietnam
Still rebuilding from three decades of war, Vietnam, along with other resource-poor countries in “The Golden Triangle” of Southeast Asia, struggles with heroin addiction. Cheap, readily available and potent, heroin far surpasses marijuana as the major drug of abuse, and is the first substance most drug abusers use, even before alcohol.
Currently, there are no actual drug treatment programs in Vietnam. Drug addicts are sequestered in rural camps in the hope that ideological “re-education” and the benefits of manual labor will cure them. The relapse rate is nearly 100 percent.
“In Vietnam, people with heroin addiction are placed in what are called rehabilitation camps,” says Weiss, associate professor of Psychology. “If someone denounces you as a drug addict, the local authorities give you a urine drug test. If you’re positive, you’re sent to a camp.”
The relapse rate is, however, nearly 100 percent. Vietnamese mental health professionals are keenly aware of the limitations of this form of “treatment,” Weiss says.
With pilot funding from Vanderbilt’s Peabody College, Weiss and his colleagues are testing a cognitive-based treatment program in the central port city of Danang in collaboration with Trung Lam, M.D., vice director of Danang Psychiatric Hospital.
Called Self Management and Recovery Training or SMART, the program emphasizes motivation, recognition of craving and “rerouting” of negative thinking and underlying emotional issues that can perpetuate addiction.
Adapting a program developed in the United States to the tightly-knit Vietnamese family has been an interesting challenge, Weiss acknowledges.
In Vietnam, drug abuse is a source of shame for the addict’s parents, siblings and even the extended family. This complicates treatment because families want to hide the individual from society, which is not realistic.
“Even for young adults of 20 or 25 years old, Vietnamese families are very involved and attempt to control their lives after they come back from the camps,” he says, whereas “in the U.S., the young adults are much more likely to be on their own.” Treatment in Vietnam must be adapted to consider the family.
If SMART proves to be effective in Vietnam, Weiss hopes the Vietnamese government will fund the program and that it will be adopted by mental health care providers. The research also may yield useful information for treating addiction among Southeast Asian immigrants to the United States, he adds.
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