Treatment and Rehabilitation

Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technique. However, its clinical application for cannabis use disorder (CUD) remains underexplored.

Aims: This study aimed to evaluate the efficacy of high frequency rTMS targeting the left DLPFC in reducing cannabis craving and dependence, severity of CUD, frequency of cannabis use and abstinence in individuals with CUD. It also compared if there were similar efficacies from three different rTMS treatment schedules, ranging from two to five weeks of rTMS treatments.

Method: This interventional study employed a two-phase, three-arm, prospective, open-labelled design over a 12-month period. Outcomes including MCQ-SF, SDS, severity of DSM-5 defined CUD, frequency of cannabis use, days of abstinence from cannabis use, CPQ, BAI and BDI-II were assessed by investigators at baseline, post rTMS treatment schedules, 3rd, 6th and 12th months.

Results: Eighteen participants (12 males, mean age 25.92; 6 females, mean age 22.83) with moderate to severe CUD were randomized into three groups. rTMS was well tolerated. Across all treatment groups, rTMS significantly reduced cannabis craving, psychological dependence, severity of CUD, frequency of monthly cannabis use and problems related to cannabis use (all ps < 0.05) throughout the whole 12-month study period. No significant differences were revealed over rTMS treatment efficacy between the three different rTMS treatment schedules over time.

Conclusion: 20-session high frequency rTMS over the left DLPFC is a well-tolerated and promising intervention for individuals with moderate to severe CUD in reducing cannabis addiction and related problems.

• Executive Summary
• Full Report

Background: Long-term ketamine abuse is known to be associated with impairments in various cognitive functions and lead to bladder contracture and severe lower urinary tract symptoms, clinically called ketamine‐induced cystitis (KIC). A clinical empirical Chinese medicine formula (CECMF) contains 12 Chinese herbal medicines. Most of the constituents of CECMF have been reported to have potential neuroprotective effects against cognitive deficits in animal or in patients, and have been widely used to treat acute cystitis in clinic.

Aims: In this follow-up investigation, we endeavored to illuminate the potential benefit of CECMF on long term ketamine-induced cognitive damages and cystitis in Sprague-Dawley (SD) rats and decipher the mechanism of action.

Method: SD rats intraperitoneally injected with ketamine (40-80 mg/kg) once daily for 49 consecutive days was used to explore the improving effects of CECMF the cognitive deficits and cystitis induced by ketamine. Behavioral tests and metabolic cage were used to determine the learning and memory functions and urinary frequency of the rats. Then, the brain and bladder tissues were harvested for in-depth mechanistic studies. Acute and sub-chronic toxicity studies were used to evaluate of the toxicological profile of the CECMF.

Results: The results illustrated that CECMF treatment significantly ameliorated cognitive impairments induced by ketamine in both adult and neonatal male rats. CECMF markedly increased the expressions of B-cell lymphoma-2 (Bcl-2) and reduced the level Bcl-2-associated X protein (Bax) and cleaved caspase 3 in ketamine treated rats. CECMF treatment also evidently ameliorated the synaptic transmission plasticity in ketamine treated rats, enhanced expressions of N-methyl D-aspartate receptor subtype 2A (GluN2A), N-methyl D-aspartate receptor subtype 2B (GluN2B), AMPA-selective glutamate receptor 1 (GluA1), AMPA-selective glutamate receptor 2 (GluA2), postsynaptic density protein 93 (PSD93), postsynaptic density protein 95 (PSD95), and synapsin 1 (SYN1), synaptotagmin (SYT) in the hippocampus of ketamine-treated rats. Moreover, CECMF modulated Ca2+/CaM dependent protein kinase II β/extracellular signal-regulated kinase 1/2 /nuclear factor kappa B (CaMKIIβ-ERK1/2-CREB/NF-κB) pathway in brains of ketamine-treated adult and neonatal rats. Secondly, our results demonstrated that CECMF could obviously relieved frequent micturition, reduced the levels of nitric oxide (NO) and antiproliferative factor (APF) and improved the levels of and glycoprotein 51 (GP51) in KIC rats. CECMF also overtly lowered urothelial monocyte/macrophage infiltration, lessened interstitial fibrosis deposition, and reduced inflammation (interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and cyclooxygenase-2 (COX-2) and fibrogenesis (intercellular cell adhesion molecule-1 (ICAM-1), transforming growth factor-β1(TGF-β1), Type I collagen, Type III collagen and fibronectin) in the bladders of KIC rats. CECMF treatment significantly attenuated urothelial neuroreceptors alteration, decreased the levels of transient receptor potential vanilloid 1 (TRPV1), muscarinic acetylcholine receptor M2 (M2-mAChR), M3-mAChR, purinergic receptor P2X1, P2X2, and P2X3 in the bladders of KIC rats. Furthermore, CECMF prominently activated nuclear factor erythroid 2–related factor 2/heme oxygenase-1 (Nrf2/HO-1) and suppressed nuclear factor kappa B (NF-κB) pathways in bladders of KIC rats. Finally, the results of the acute toxicity demonstrated that CECMF at up to the dose of 128 g/kg, which was the maximum tolerable dose of CECMF in mice, did not exert any overt toxicity. The results of sub-chronic toxicity study demonstrated that CECMF (5, 10 and 20 g/kg) did not affect the body weight, relative organ weights, the functions of liver and kidney and hematological analysis in male and female rats after treatment with CECMF for 90 days or 30 post drug withdraw.

Conclusion: CECMF held promising potential to be further developed into an innovative Chinese medicine-based for treatment of cognitive deficits and cystitis induced by ketamine.

• Executive Summary
• Full Report

Background: Young people with dual diagnosis of mental health and substance abuse issues face significant challenges in their daily lives, and early identification and intervention are crucial to prevent long-term negative consequences.

Aims: This study aimed to develop a risk assessment tool to identify young people at risk of developing dual diagnosis and to develop and evaluate the effectiveness of a strength-based cognitive behavioral therapy (SBCBT) program in reducing mental health symptoms and substance abuse behaviors in tandem with the improvement of resilience and drug-avoiding self-efficacy.

Method: A cross-sectional research involving 457 youth was used to develop and validate the risk assessment tool. Confirmatory factor analysis, internal reliability analysis, and criterion-related validity and convergent validity analyses were conducted. It was followed by a randomized controlled trial involving 91 youth to evaluate the therapeutic effectiveness of the SBCBT program when compared with treatment-as-usual control.

Results: The risk assessment tool demonstrated good dimensionality, reliability and validity in identifying young people at risk of developing dual diagnosis. The SBCBT program showed significant reductions in depressive symptoms, anxiety symptoms, and substance abuse tendency, and improvements in leisure quality of life, drug-avoiding self-efficacy, and resilience.

Conclusion: The findings of this study suggest that the risk assessment tool can be used to identify young people at risk of developing dual diagnosis, and that the SBCBT program is an effective intervention in enhancing resilience and reducing mental health symptoms and substance abuse behaviors in this population. The study highlights the importance of early identification and intervention in preventing long-term negative consequences and promoting positive outcomes for young people with high risk of dual diagnosis.

• Executive Summary
• Full Report

Background: Young substance abusers’ innate urge for meaning and purpose in life is usually overlooked as a significant factor for high relapse rate after treatment.

Aims: Examine the efficacy and feasibility of the meaning-centered approach for drug rehabilitation among young people in Hong Kong.

Method: The educational talks for general youth were quantitatively assessed one time with a questionnaire survey. The drug prevention groups for high-risk individuals and individual treatment cases for rehabilitating young substance abusers were assessed both quantitatively with a questionnaire survey and qualitatively with an indepth individual interview for three times at the pre, post, and 3-month follow-up periods of the interventions.

Results: To compare with the usual treatment, meaning centered approach was more effective in raising young substance abusers’ purpose in life, their perceived support from parents, and improving their stress and attitude towards drugs.

Conclusion: To prevent young people from taking drugs, the most important first step is early prevention with strong parental support and intervention to nurture them with clear purpose in life and strong sense of resilience amidst of life adversities.

• Executive Summary
• Full Report

Background: Both cocaine and methamphetamine are the top two commonest abused stimulants in Hong Kong. It is well established that stimulant use can induce psychotic disorder, and a substantial proportion of stimulant associated psychosis will convert to schizophrenia. Thus, early assertive pharmacotherapy is in utmost need. Scanty evidence is available on the suitable choices of antipsychotics that can benefit both stimulant abuse and the associated psychosis.

Aims: This study aimed to compare the clinical outcomes from using aripiprazole or paliperidone to treatment-as-usual (TaU) in stimulant abusers with stimulant associated psychosis on their efficacies in treating the psychosis, stimulant dependence, and changes in mood, cognitive and functional outcomes. It also looked into the conversion rate from stimulant-induced psychotic disorder to schizophrenia after the use of early assertive pharmacotherapy among stimulant users.

Method: This study was a 24-month, two phases, three-arm, prospective longitudinal interventional study. Consented stimulant abusers with psychotic symptoms were randomized to receive either aripiprazole, paliperidone or TaU for 12 months in the single-blinded “Active Intervention” phase, followed by another 12 months open-labelled “Observation Maintenance” phase when the interventions could be continued, stopped or changed to other medications. Outcomes including BPRS-24, CGI, GASS, SDS, severity of DSM-5 defined stimulant use disorder (SUD), SOCRATES-D, BAI, BDI-II, FAB, MoCA, and ASI-Lite were assessed.

Results: 165 stimulant abusers with psychotic symptoms were randomized. At the end of the “Active Intervention” phase and the “Observation Maintenance” phase, there were no significant intervention group differences in BPRS-24, GASS, CGI-S, SDS and SUD for cocaine, SOCRATES-D, BAI, BDI-II, FAB and ASI-Lite. There could be a potential transient worsening of psychological dependence to methamphetamine when aripiprazole and paliperidone were prescribed in the first six months when compared to TaU group (p < .05). Stimulant abusers taking aripiprazole had better CGI-I scores (p < .001), and mitigated methamphetamine use disorder severity when compared to the TaU group (p < .05). Stimulant abusers taking paliperidone showed the worst MoCA scorings (p < .05) among the three intervention groups. The prevalence of schizophrenia converted from stimulant-induced psychotic disorder was 10%.

Conclusion: Clinicians should aware that early antipsychotic pharmacotherapy can help lowering the conversion rate of stimulant induced psychosis to schizophrenia. Both aripiprazole and paliperidone were well tolerated in stimulant abusers with associated psychosis. Aripiprazole demonstrated significantly better clinical improvement in stimulant associated psychotic symptoms and was able to improve the severity of methamphetamine use disorder than the other two intervention groups. When paliperidone is prescribed to stimulant abusers with associated psychosis, their cognitive function should be monitored.

• Executive Summary
• Full Report

Background: Among people who have undergone treatment for substance abuse disorders, relapse continues to be a significant problem. Preliminary studies show that mindfulness-based relapse prevention (MBRP), specifically designed for people with substance use disorders, may be a promising intervention to prevent relapse in substance use.

Aims: To evaluate the feasibility and effectiveness of MBRP among individuals with substance abuse in Hong Kong

Method: This single-blinded, randomized controlled trial randomly assigned 81 participants into two study arms: the MBRP group and the waitlist control group. Outcome measures were collected at baseline, immediately post-intervention, at 3-month post-intervention, and at 6- month post-intervention to compare the abstinence status and other emotional outcomes between the two groups. Evaluation forms, focus group discussions or individual interviews were also conducted to obtain feedback on the MBRP programme from participants after the MBRP course.

Results: The current study demonstrated a similar retention rate for course attendance and follow-up assessments compared to previous studies. The MBRP programme received highly positive evaluations using a 10-point scale. Participants found it to be important (mean=8.3) and beneficial (mean=8.2), were satisfied with the course in general (mean=8.3), and were willing to continue mindfulness practice (mean=7.3). Although no significant differences between groups were found in abstinence status across measured time points, participants in the MBRP group showed greater improvement in drug avoidance self-efficacy immediately after the intervention (score improvement from baseline: MBRP: 9.85, Control: 0.54) and in addiction severity at the 6-month post-intervention follow-up (score reduction from baseline: MBRP: 0.03, Control: 0.005). Considering the qualitative component, these practical benefits included improved emotional regulation, heightened awareness, and shifts towards more positive thinking.

Conclusion: Overall, the program was highly regarded by participants, who reported it as valuable and beneficial. MBRP was proved to be feasible. Further studies involving a larger sample size and a comparison with an active control group could provide more definitive evidence of MBRP's effects.

• Executive Summary
• Full Report

Background: Physical exercise modalities have always been used as a tool, along with other treatment methods, in drug treatment and rehabilitation services.

Aims: The overall aim of the study is to provide drug treatment and rehabilitation service providers in Hong Kong with updated scientific evidence regarding physical exercise interventions delivered for drug-dependent populations in the treatment and rehabilitation settings.

Method: A comprehensive literature search was conducted in five databases: Cumulative Index to Nursing and Allied Health Literature (CINHAL) (EBSCO), MEDLINE (Ovid), Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI). The databases were searched from inception to September 2022. A combination of keywords “yoga, qigong, tai chi, physical activity, physical exercise, aerobic exercise, resistance training, weight training, addiction, substance abuse, substance use disorder, relapse, prevention” were used as keywords to search. Additionally, the reference lists of all identified literature were manually reviewed to determine additional sources. Meta-analysis and qualitative synthesis were conducted to synthesize the data.

Results: Meta-analyses revealed that for female drug-dependent subgroup, mind-body exercise was consistently better than control in improving both quality of life and flexibility outcomes; as for the young adult drug-dependent subgroup, structured fitness, aerobic exercise, mind-body exercise, and mixture of leisure activities and exercise are the four major types of physical exercise intervention consistently found to be significantly more effective than control groups in improving several health outcomes. Qualitative synthesis revealed ten major themes describing the subjective experiences of exercise and sports participation for the drug-dependent group. They are “distraction”, “expressing true self”, “attaining a different kind of euphoria”, “establishing courage to face challenges”, “found new purpose in life”, “establishing a disciplined lifestyle”, “improved communication skills”, “engaging with a supportive social network”, “having a supportive social space”, and “re-engaging with community”.

Conclusion: The research findings of this report support anti-drug practitioner in selecting the most effective type(s) of physical exercise interventions for the young adults and female drug-dependent individuals.

• Executive Summary
• Full Report

Background: Repetitive transcranial magnetic stimulation (rTMS) is increasingly used as an intervention for treating substance addiction.

Aims: To examine the effects of high-frequency rTMS applied to the left dorsolateral prefrontal cortex (DLPFC) as an adjunct treatment of common illicit drugs addiction in Hong Kong.

Method: This is a within-subject, crossover design study enrolling adults with history of using amphetamine/cocaine currently receiving counselling or rehabilitation services from the community centres. Participants were allocated to either a 6-session (3 sessions/week) real rTMS (10Hz, 2000 pulses, 100% RMT) or sham rTMS groups to the left dorsolateral prefrontal cortex in a random order, with a 2-week washout period between 2 phases. We measured outcomes including craving scores, self-reported substance consumption, executive functioning, and mood within and across phases.

Results: Both real and sham rTMS significantly reduced the craving scores and improved performance in executive functional tests, however, only real rTMS significantly reduced the anxiety and depression levels in illicit drug users, as measured using the Depression Anxiety Stress Scales, and on increasing motivation for change.

Conclusion: Real rTMS, but not sham, appears to improve the mood and motivation for change of illicit drugs users. Future studies to determine an optimal stimulation setting for clinical application for SUD in future are recommended.

• Executive Summary
• Full Report

Background: In Hong Kong, there is a limited amount of research on the factors that contribute to relapse after release from incarceration, as well as the connection between drug abuse and criminal behavior.

Aims: To explore the prevalence of drug use among ex-offenders after their release from prison and examine the risk and protective factors influencing their drug use patterns.

Method: 247 ex-offenders were recruited based on specific criteria. Respondents completed quantitative questionnaires and interviews to gather data on drug abuse, addiction treatment, and attitudes towards drug-related crime. Established tools were utilized to measure factors such as perceived social support, well-being, adverse childhood experiences, and drug abuse.

Results: The study found that around one-third of surveyed ex-offenders were current drug abusers, with a higher prevalence among male respondents. Peer pressure and boredom were significant factors in continued drug abuse. Employment support, positive social networks, resilience enhancement, and goal-oriented life were recommended for respondents' reintegration into society.

Conclusion: The study emphasized the importance of community-based residential rehabilitation centers and employment support in preventing relapse. It recommended strategies to reduce workplace stigma, provide vocational training, and leverage peer support services to help individuals build positive social connections. Additionally, the study highlighted the need for comprehensive drug education, trauma-informed approach in social services, and preventive programs targeting youth to address the root causes of substance abuse.

• Executive Summary
• Full Report

Background: In Hong Kong, drug addiction among young adults has become an increasingly prevalent issue, with many turning to drug use as a means of coping with stress, mood-related problems, and boredom. Surprisingly, over 80% of young adults with drug addiction do not seek professional help or other forms of social support in dealing with problems resulting from taking drugs. Currently, most drug rehabilitation services in Hong Kong focus on reducing drug use and providing psychoeducation on drug-related mental health issues. However, there is a critical need to innovate and revamp these services to better support young adult drug abusers in coping with their addiction.

Aims: The objectives of this project were to integrate creative arts into drug rehabilitation services in Hong Kong, and explore its effectiveness, acceptability and practicality among young adult drug abusers and caseworkers. Additionally, this project aimed to promote social change by using the arts to provide support for individuals struggling with drug addiction.

Method: The program evaluation study assessed the potential benefits of the two major program components: (1) the creative arts intervention program for drug rehabilitees, and (2) the Train-the-Trainer program for frontline professionals. Evaluation for the creative arts intervention program adopted a mixed-methods, randomised controlled study design, with two assessment time points (T₀ and T₁) using quantitative and qualitative inquiry methods. For this research initiative, a total of 260 drug rehabilitees were included in the evaluation in Hong Kong and quantitative data were collected on two separate time points: baseline (T₀) and 8-week follow-up (T₁); amongst them, 132 were young adult participants aged between 21 and 35. In the focus group interview, we interviewed 30 young adult drug rehabilitees at the end of the program completion. For the Train-the-Trainer program, 30 caseworkers filled in an exit poll survey upon completion of the 4-day training and 10 of them were invited to participate in the focus group interview. All data were collected between June 2019 and May 2023. For the quantitative data of a randomised-controlled study, descriptive statistics and independent t-tests were used to assess sample homogeneity, and Repeated Measures ANOVAs with Bonferroni Test were adopted to assess the effect of the intervention. Whereas quantitative data for the train-the-trainer program, descriptive statistics were produced to obtain an overall satisfaction and perceived effectiveness of the training modules in enhancing the caseworkers' knowledge, skills, and efficacy in conducting creative arts drug rehabilitation program. For both studies, qualitative data were analysed using thematic analysis to identify the themes and sub-themes that emerged from the in-depth interview sessions for the rehabilitees and frontline professionals.

Results: Results of the randomised-controlled study yielded emerging evidence to suggest the effectiveness of the creative arts interventions in enhancing positive affect in rehabilitees (aged between 21 and 35) who participated in the creative arts intervention, compared with the treatment-as-usual condition. Findings also showed potential gains in alleviating anxiety, reducing self-defeating tendency, enhancing drug-related coping through stopping unpleasant emotional thinking, adopting problem-focused coping, as well as improving drug avoidance self-efficacy. Further exploration might be needed to understand the value of the intervention program in reducing depressive symptoms and negative affect, and improving self-soothing tendency. Similar findings were also reported in the aggregate data with participants ranging from 21 to 60, yielding additional information to support the potential benefits and effectiveness of the creative arts intervention in improving the psychosocial well-being of drug rehabilitees. Focus group interviews with rehabilitees attending the program revealed additional gains reported by the participants, including improved mood management, enhancing social relationships, cultivating self-awareness, self-confidence, and psychological flexibility. Participants regarded the non-verbal expression, embodiment and concretization of experience, as well as creativity; artistic pleasure is the key element underlying their positive changes; emphasis was placed on the facilitation skills of the facilitator to instil hope and common humanity and facilitate interpersonal learning. Evaluation of the train-the-trainer program showed that the training program was regarded as practical, insightful, and satisfying by frontline professionals who participated in the training. While the trainees regarded that the training was helpful in enhancing their knowledge competence, practice competence, and self-competence in delivering creative arts intervention to their service users, they expressed enthusiasm for further training to enhance their skills in this area and to work around the environment challenges they encountered in implementing creative arts interventions in the drug rehabilitation setting.

Conclusion: Creative arts intervention is a culturally relevant, emerging evidence, and person-centred approach to drug rehabilitation in Hong Kong. The creative arts intervention is well-received by both the service users and frontline professionals in the field – both parties found the application of creative arts in rehabilitation service effective, meaningful, and satisfying. Findings from the present study also revealed that creative arts did not only benefit young adults drug rehabilitees but also those who are older in age. Frontline professionals shared their passion for further training and their support to the furtherance of creative arts interventions as an alternative to traditional form of drug rehabilitation. Further research efforts and training resources will contribute to the course and the holistic well-being of those who are struggling with the issues of addiction.

• Executive Summary
• Full Report

Background: The issue of drug abuse has emerged as a significant global challenge for the next decade. Consequently, there is a need to increase the availability of treatment interventions, including pharmacological, psychosocial, and rehabilitative approaches.

Aims: This study aims to explore the characteristics of offenders exhibiting drug-abuse behaviour, examine the rehabilitation process for such offenders, identify potential mechanisms to enhance rehabilitation outcomes, and estimate the reduction in social costs associated with potential improvements in the rehabilitation process.

Method: Employing a mixed-method approach, this research study involved in-depth desk research to review relevant information from various sources. The research team also analysed data from the Correctional Services Department dataset of drug addiction treatment centre (DATC) offenders aged 15 to 30 at the time of admission between 2013 and 2019 to examine the recall rate of offenders. Additionally, focus group interviews and one-on-one discussions were conducted with a total of 130 individuals, including 100 drug users and 30 stakeholders, to elicit feedback on existing drug abuse treatment and rehabilitative services.

Results: The research findings reveal that approximately 58% of DATC offenders were recalled, with drug relapse being the main reason for 78% of those recalled. The study also demonstrated that age, marital status, conviction history, attendance of rehabilitation programs, and visitation during incarceration were closely associated with recall and/or reoffending. Offenders with stronger social support networks faced a lower risk of recall. Furthermore, the study identified that while the existing system has positive aspects, such as utilizing pre-existing community resources, it also requires improvements. One area needing enhancement is the coordination between different stakeholders in the system to increase efficiency.

Conclusion: In conclusion, the research team recommended the improvements to the existing treatment and rehabilitation system to prevent the escalation and recurrence of drug problems. Implementing such improvements would not only reduce the social, medical, and economic costs associated with drug abuse but also prevent drug-related criminal activities and recurring reoffending.

• Executive Summary
• Full Report

Background: Existing studies show that life satisfaction can positively predict discontinuation of drug use, and meaningful work is associated with life satisfaction. However, there is a lack of empirical study of vocational planning services for young drug addicts in Hong Kong.

Aims: To evaluate the effectiveness of an integrative model of vocational life design in preventing relapse of youth rehabilitated from drug abuse.

Method: Young rehabilitated drug users were invited to join intervention group (N=35) and control group (N=35). Participants in intervention group experienced the integrative life design model, which involved individual vocational counselling sessions based on Savickas’ narrative life design and expressive arts groups, with motivational interviewing techniques incorporated throughout the process. A longitudinal mixed method of quantitative and qualitative research was used. In the quantitative part, participants of both groups were invited to complete standardized questionnaires in four time points to measure their changes in their drug use behaviours and their psychosocial aspects. In the qualitative research, semi-structured focus groups were conducted. Two case studies are presented to elaborate the intervention process.

Results: This integrative model can effectively reduce drug relapse and improve in psychosocial conditions. Participants in the intervention group can explore themselves in depth and their meaning in life. In addition, the research not only confirms that life satisfaction is positively related to the self-efficacy to refuse drugs, but also finds that meaning in life can positively predict the self-efficacy to refuse drugs.

Conclusion: In general, this research confirms the effectiveness of the integrative life design programme in helping young rehabilitated drug abusers to strengthen their post-treatment ability to prevent relapse.

• Executive Summary
• Full Report

Background: There is an unclear link between drug rehabilitation and the outcome effects of treatment programmes and interventions adopted for psychotropic drug users.

Aims: To explore local stakeholders’ views on programmes for psychotropic drug abusers; develop a set of programme evaluation guidelines specific to the Hong Kong context; and explore the concept of Quality of Life (QoL) to incorporate users’ overall wellness into outcome indicators.

Method: We conducted a two-wave Delphi study with 44 panellists to identify what could/should be done to improve the efficacy and effectiveness of treatment evaluation in the local context. Validation exercises were also conducted through a two-wave questionnaire survey administered to 271 psychotropic drug abusers.

Results: Panellists reached consensus on the need for a more coherent use of a combination of subjective and objective measurement tools to measure the intended outcomes of a given programme. Reducing harm could be one of the important outcome indicators for drug rehabilitation process in leading to drug abstinence. A new Need-based Quality of Life Scale (NBQoL) was also developed and validated.

Conclusion: Individualised and cross-disciplinary interventions are recommended with aligned theories of change and corresponding outcome indicators.

• Executive Summary
• Full Report

Background: Sport and exercise are well known for their positive impact on health, but studies on how effective they are for the rehabilitation of drug abusers are relatively limited. This project provided opportunities for drug abusers to engage in sport training, and investigated the effectiveness of physical activity on rehabilitation of drug abusers and maintaining abstinence from drug abuse.

Aims: To measure the effectiveness of sport trainings for reducing drug use frequency among drug abusers, and the impacts on different dimensions of health and fitness.

Method: Sport training courses for drug abusers were implemented over a period of 3 years. Each course was held once a week over 10 weeks. A total of 169 drug abusers aged under 40 joined the sport training courses on a voluntary basis. They were invited to undergo physical fitness tests and to complete a series of questionnaires before the beginning of the sport training courses (pre-test). Among the 169 participants, 78 of them eventually completed the courses and underwent another physical fitness tests and questionnaires (post-test) in which changes on their level of fitness and wellness were examined.

Results: Many significant improvements were found among the drug abusers after the completion of the sport trainings, including the increase on physical activity level, flexibility, muscular strength, muscular endurance and balance, motivation for physical activity, mental, emotional, physical and intellectual levels, together with higher scores in life satisfaction, self-anchoring, drug avoidance self-efficacy, active coping for stress and challenges against drug uses.

Conclusion: Research findings of this project support that sport and physical activity as intervention treatment had positive impact for drug abusers on their resistance against and recovery from drug abuse.

• Executive Summary
• Full Report

Background: People with substance use disorder (SUD) manifest cognitive deficits which affect their everyday functioning. The research on cognitive training for SUD is limited. We developed the Mobile Functional Cognition Program (MFCP) and piloted tested in 2015-2017.

Aims: In this study, we studied the effectiveness of the MFCP. We hypothesized that participants going through MFCP would improve cognitive and everyday functioning compared to those who received social activities.

Method: The research is a randomized controlled trial. Service users at the Counselling Centers for Psychotropic Substance Abusers (CCPSAs), the Drug Treatment and Rehabilitation Centers (DTRCs), the Methadone Clinic, and the Substance Abuse Clinic at United Christian Hospital were recruited into this study. Participants’ cognitive function and everyday functioning were measured by Cognistat (NCSE) and Canadian Occupational Performance Measure (COPM) at baseline and after treatment. A repeated measure analysis of variance (ANOVA) was used to compare the treatment effect of MFCP versus social activities.

Results: A total of 134 service users have been approached. The final study sample included 53 in the experimental group (go through MFCP) and 57 in the control group (go through social activities). A repeated measure ANOVA revealed no significance between group differences in the outcomes. Schèffe test found that both the experimental and control group had significant improvement after treatment.

Conclusion: According to this study and past experience, the MFCP was practical and easy to use and have potential benefit for people with SUD. Further study using time-series design is suggested to investigate if the MFCP would lead to a better rate of improvement over social activities.

• Executive Summary
• Full Report

Background: Studies of the central nervous system demonstrated that uncaria rhynchophylla (Gouteng) interaction with ketamine appeared to improve the consolidated memory of the mice and downregulate the number of dead cells in regions of the central nervous system induced by ketamine.

Aims: To perform experiments on animal models so as to investigate the effect of Gouteng as a potential therapeutic intervention for ketamine damage, or whether it could replace ketamine as another abuse agent, and provided evidence for the underlying mechanism of effect of Gouteng on the central nervous system.

Method: Methods employed included behavioral, biochemical, immunohistochemical and histopathological studies. Toxic effects of ketamine on the liver and heart were studied via observation on histopathology and electrocardiogram (for heart).

Results and Conclusion: Gouteng showed promise as an adjunct treatment on the toxicity created by ketamine. However, it was important to note that, Gouteng, like any medicine, the long-term usage of which will lead to increase of serum transaminase and creatinine levels. Proper supervision and advice by a Chinese medicine practitioner and/or a medical practitioner in Western medicine was a must for human ketamine patients.

• Executive Summary
• Full Report
  
  

• Executive Summary
• Full Report