ABD 7083 Dual Diagnosis Modality

Jamal b Naim (3130213)

OBSERVATIONAL FIELD STUDY AND SURVEY REPORT
1. VISIT INFORMATIONS
a. Date of Visit: 0
t!
"#$il and 08
t!
Mei% 201
b. &la'es to (isit:
1) Jalan )!o* +it
2) Jalan ,u-it ,intang
3) Met!adone )lini'% +e#ong
'. &a$ti'i#ant: 30 membe$s of Maste$ in )ounseling (.ubstan'e "buse)
d. )oo$dinato$: M$. "le/ Ng 0ei .iong
2. OBSERVATION REPORT:
2.1 "$ea 1 (Jalan )!o* +it)
1!e fi$st lo'ation is on t!e $oad t$i# )!o* +it% +uala 2um#u$. 2o'ation 1!e
fi$st of t!ese is t!e !omeless o$ t!ose *!o a$e !omeless and slee#ing on t!e
foot3#a(ement a$ound to*n Met$o#olitan Manila. Du$ing t!e tou$% a g$ou# of
(oluntee$s -no*n as 4&e$ti*i4 5oined anot!e$ 'ou#le non3go(e$nmental
o$gani6ations (N78s) a$e 'oming to feed% d$in-% and 'lot!ing and f$ee !ealt!
s'$eenings. .u$(eys and inte$(ie*s 'ondu'ted to !omeless of notable #eo#le
(sub5e'ts) t!at !a(e been identified in(ol(ed in d$ug abuse.
1!$oug! obse$(ation and 'ondu'ted on3site g$ou# t!is g$ou# of !omeless%
!ad be found f$om sub5e'ts of (a$ious age% se/% $a'e% o''u#ation% and 'ount$y
of o$igin. "t lo'ation% 9 managed to get a bum *!o is also t!e sub5e't of a d$ug
addi't. 1!e a##ea$an'e and d$ess of t!e sub5e't% !e loo-s no$mal and does
not loo- li-e an addi't. 1!$oug! inte$(ie* *it! t!e sub5e't% of notable
info$mation *e$e obtained. .ub5e't de$i(ed f$om 1$iang% &a!ang and !ad
Page | 1
ABD 7083 Dual Diagnosis Modality
Jamal b Naim (3130213)
been in t!e Met$o#olitan +uala 2um#u$ fo$ : yea$s sin'e t!e sub5e't is
$eleased f$om t!e f$uit of notable #$isons and d$ug t$eatment and $e!abilitation
'ente$.
1!e sub5e't *as in(ol(ed *it! 'annabis afte$ sto##ing out of s'!ool. Ne/t
t!e sub5e't *as in(ol(ed in !e$oin afte$ being mi/ed *it! f$iends of ot!e$
addi'ts. "''o$ding to t!e sub5e't% !e used t!e met!od o$ int$a(enous in5e'tion
needle to inse$t t!e d$ug into t!e body. .ub5e't addi'ts $egiste$ed *it! t!e
Minist$y of ;ealt! Malaysia (M8;) fo$ t!e Needle .y$inge </'!ange &$og$am
(N.<&) t!e #$og$am *as laun'!ed by t!e Minist$y of ;ealt! Malaysia in 200=
to t!e #$esent. "''o$ding to t!e sub5e't again% e(e$y mont! !e *ould go get 3
bag 'ontaining sy$inges and ea'! bag 'ontains =0 in5e'tion needles fo$ a
mont!.
1!$oug! inte$(ie*s 'ondu'ted *it! t!e sub5e't% !e !ad a s!a$e in $es#e't
of t!e ;9V disease by s!a$ing needles *it! fello* addi'ts. "lt!oug! sub5e'ts
ta-ing #$e'autions t!at do not *ant to s!a$e needles *it! ot!e$ f$iends% but
one day t!e sub5e't *as *$ongfully ta-en needle belongs to a f$iend of addi'ts
*it! ;9V "9D.. 9t so !a##ens be'ause on t!e a'tions to ta-e t!e d$ug% t!e
sub5e'ts *e$e e/#e$ien'ing att$a'tion synd$ome > *it!d$a*al is so st$ong t!at
!e *as not a*a$e of *!en you *ant to use needles belongs f$iends *it! ;9V
and "9D.. 1!e sub5e't is told t!at !e did not -no* about ;9V until t!e do'to$
told !im t!e diseases t!at 'an be fatal. 1!e sub5e't is often a medi'al
e/amination on'e a mont! to dete$mine t!e le(el of !ealt!. .!a$ing of t!e
sub5e't is 'on'e$ned *it! t!e a(ailability of !e$oin in !is body.
Page | 2
ABD 7083 Dual Diagnosis Modality
Jamal b Naim (3130213)
.ub5e't told t!at !e$oin ta-en by ice/methamphetamine la'ed *it! d$ugs
to get mo$e effe't. 8n t!e day of t!e inte$(ie* 'ondu'ted at a$ound ?.00 #m%
t!e sub5e't told !e !ad ta-en illegal d$ugs use needles at 7.00 #m. D$ugs
ta-en by !im *ill last until .00 am o$ :.00 am. ;o*e(e$% afte$ t!e e/#i$ation
of t!e d$ug4s effe'ts% t!e sub5e't tells !im t!at !e *ill !a(e a (e$y let!a$gi'
body.
</#e$ien'e an inte$(ie* *it! t!e sub5e't of many a lesson and ne*
-no*ledge in dual diagnosis and substan'e abuse. "mong t!e ne*
-no*ledge 'an be lea$ned addi'ts is about t!e diseases t!at affe't t!e li(es of
d$ug addi'ts f$om using d$ugs% d$ug daily life% -no*ledge of t!e dange$s and
effe'ts of d$ugs t!at lo*e$ among d$ug addi'ts. 1!e$e is also a d$ug addi't
*!o suffe$ed mo$e t!an t!$ee ty#es of deadly diseases su'! as tube$'ulosis
(1,)% !e#atitis ,% !e#atitis "% ;9V and "9D.. )oo$dinato$ of out$ea'!
#$og$ams (M$. "le/) often $emind t!e se'u$ity measu$es to #$e(ent ge$ms o$
(i$us infe'tion of t!e sub5e'ts inte$(ie*ed. 1!e initial #$e(ention is distan'ed
itself *!i'! is 2 mete$s in an inte$(ie* 'ondu'ted.
,ased on out$ea'! a'ti(ities in Jalan )!o* +it% too% 'an be #a$t of t!is
!omeless !a(e diffe$ent #e$sonalities timely. @o$ e/am#le% some among t!e
!omeless on t!e day t!ey loo- no$mal li-e ot!e$ #eo#le% some of t!em !a(e a
5ob and a 'a$ee$ as a se'u$ity gua$d% fa'to$y *o$-e$s and ot!e$s *!o 'an
su##o$t t!emsel(es and t!ei$ families. 0!en *o$-ing !ou$s% t!ese #eo#le *ill
go ba'- to #la'es li-e unde$ b$idges% t!e sides of buildings. @o$ an addi't%
t!ey *ill $etu$n to t!e nests o$ 4fo$est4 of t!e #o$t t!ey slee# and ta-e d$ugs.
Page | 3
ABD 7083 Dual Diagnosis Modality
Jamal b Naim (3130213)
.ub5e'ts also s!a$ed t!e #$in'i#le t!at t!e$e a$e among addi'ts a$ound
+uala 2um#u$. 1!is #$in'i#le is often deli(e$ed by addi'ts *!o *e$e sta$ting
#$e#a$ation till at t!e end of life is t!e st$uggle to -ee# t!e addi'ts *!o a$e
addi'ted to sto# d$ug addi'tion and d$ug addi'ts ma-e su$e not to !it ot!e$
deadly diseases su'! as ;9V and "9D. t!at 'an 'ause deat!.
2.2 Jalan ,u-it ,intang
8n t!at nig!t *e also (isited t!e field su$(ey to ,u-it ,intang. "t t!is lo'ation
t!e$e a$e many ente$tainment 'ente$s su'! as #ubs% ba$s% nig!t'lubs%
-a$ao-e lounges% massage #a$lo$s and so on. 1!$oug! obse$(ation and
su$(eys 'ondu'ted% t!e ty#e of d$ug used in #la'es of ente$tainment in(ol(es
d$ugs 'alled 4$e'$eational d$ugs4 use of t!e d$ug *!en to see- ente$tainment
su'! as al'o!ol% e'stasy and e$imin fi(e. My obse$(ation of t!e be!a(io$ of
(isito$s in attendan'e to ente$tain is found t!at t!e be!a(io$ of a (isito$ t!at
*ill '!ange *!en liAuo$ 'ontaining al'o!ol into t!e body. .ignifi'ant $ea'tions
and be!a(io$ is s#ee'! and s#ee'! d$in-e$s *ill be slo* and i$$egula$. 1!ei$
mo(ement is also seen un'ont$olled and sometimes t!ey *ill a't agg$essi(e
and un$uly as !e *as unde$ t!e influen'e of al'o!ol.
Du$ing my obse$(ations as *ell as on a nig!t 'lub filled many (isito$s
found t!e$e a$e (isito$s *!o a$e too agg$essi(e and un'ont$ollable *!en a
song o$ loud musi' #layed. 9 t!in- t!ey !a(e s*allo*ed *it! a d$in- e'stasy
t!ei$ side to get t!e le(el o$ effe't of t!e ma/imum imagina$y o$ feel t!e
$!yt!m of musi'.
Page | 4
ABD 7083 Dual Diagnosis Modality
Jamal b Naim (3130213)
8bse$(ational field study and su$(ey e(iden'e at Jalan ,u-it ,intang% 9 also
gained ne* -no*ledge t!at t!e$e is also a d$ug used fo$ t!e #u$#ose of
#$ostitution. &$ostitutes *ill ta-e d$ugs to #$o(ide du$ability *!ile !a(ing se/
*it! a lot of 'ustome$s all day. My obse$(ation% t!e$e a$e #$ostitutes *!o deal
d$ugs *!ile doing #$ostitution. 1!e o(e$all 'on'lusion t!at 'an be d$a*n
based on a field study (isit of bot! #la'es a$e t!e$e a$e diffe$en'es in t!e
ty#es of d$ugs used% diffe$ent use$s fo$ ea'! a$ea% diffe$ent a'Auisition
met!ods% as *ell as simila$ effe'ts *!en ta-ing d$ugs.
2.3 Met!adone )lini'% +e#ong
8n 08t! May 201 a (isit to +endal Met!adone )lini' *as 'ondu'ted to see
t!e $eal situation of fo$me$ d$ug addi'ts *!o ta-e met!adone $e#la'ement.
1a-ing met!adone is #a$t of t!e #$o'ess of t$eatment and $e'o(e$y. 1!$oug!
obse$(ations and inte$(ie*s among fo$me$ addi'ts *!o 'ome fo$ t$eatment
t!$oug! met!adone #$og$am% t!ey s!a$e t!e e/#e$ien'e of being an addi't
and t!e !ealing #$o'ess ta-es a long time.
1a-ing met!adone by addi'ts is de'$easing in Auantity. Met!adone #$og$am
basi'ally aims to $edu'e t!e $is- of d$ug t!$oug! t!e needle *!i'! 'an 'ause
t!e $is- of t!e s#$ead of t!e ;9V (i$us. 1a-ing met!adone also is intended to
$edu'e t!e att$a'tion synd$ome > *it!d$a*al and '$a(ing fo$ t!e d$ug !e$oin.
9n t!e 'lini' *e got a lot of info$mation. Met!adone t$eatment $e'i#ients
must info$m t!e t!e$a#y info$mation *!en meeting *it! any do'to$ to a(oid
Page | 5
ABD 7083 Dual Diagnosis Modality
Jamal b Naim (3130213)
se$ious effe'ts of inte$a'tions *it! ot!e$ d$ugs. Met!adone substitution
t!e$a#y *ill be mo$e effe'ti(e *!en 'ombined *it! t$eatment met!ods of
dealing *it! medi'al #$oblems% #sy'!iat$i' and so'ial affai$s. )ounseling also
!as a #ositi(e effe't on met!adone $e#la'ement t!e$a#y.
1ea'!ing and lea$ning t!$oug! field study obse$(ations Met!adone )lini'
is e(en met!adone #$og$am is a #$og$am fo$ d$ug addi'ts to 'ome out of t!e
addi'tion% but t!e #$og$am is also able to ma-e addi'ts $ela#se o$ $etu$n 8tis
ba'- to t!e met!adone addi't.
Page | 6