Medical and Nonmedical Treatment for Narcotic Addicts

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Abstract
Narcotic addicts from Laos were treated under governmental auspices in 2 settings: a Buddhist monastery in Thailand and a medical facility in Laos. Treatment at the monastery included cold turkey withdrawal, a herbel emetic, prayer and religious exortation. Treatment at the medical program consisted of methadone detoxification, care of associated medical conditions, counseling, education regarding addiction and group discussions. Addicts voluntarily selected 1 of the alternative modalities. Those choosing the more traditional monastery program had an older mean age and included a greater proportion of females and ethnic Lao people. Expatriate Asians (an educated, urban group) and tribal addicts (predominantly non-Buddhist) were more numerous at the medical facility. Follow-up evaluation on representative samples was conducted 6-18 mo. postdischarge using abstinence as a criterion. No difference was found in abstinence rates between the monastery and medical programs. Mortality among addicts over age 60 yr was considerably higher at the monastery than at the medical facility. Subjective evaluation of the treatment experience at the temple was positive among Lao addicts (a group ethnically similar to the Thai), but negative among tribal addicts. Over time fewer addicts chose the monastery program, while the medical program became increasingly popular as a treatment resource.

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