scholarly journals Kekambuhan pada Pasien Penyalahguna Narkotika, Psikotropika, Zat Adiktif (Napza) Pasca Rehabilitasi: Kebijakan dan Program Penanggulangan

2020 ◽  
Vol 30 (2) ◽  
pp. 183-198
Author(s):  
Raharni Raharni ◽  
Sri Idaiani ◽  
Yuyun Yuniar
Keyword(s):  
Mental Health ◽  
Drug Abuse ◽  
Round Table ◽  
Rehabilitation Program ◽  
Medical Rehabilitation ◽  
Round Table Discussion ◽  
Ministry Of Health ◽  
Cross Sectional ◽  
Social Rehabilitation ◽  
Relapse Rates

Abstract Narcotics, Psychotropic, and Addictive Substance Abuse (NAPZA) is a problem in Indonesia, one of the consequences is relapse. Relapse is a process where someone has been declared abstinence (recovered) and returns to using drugs. Relapse rates also still high in some countries. Drug users experience a relapse between one month to one year after leaving the treatment program. The aim of this research was to find out the policies and programs related to handling of NAPZA relapse in rehabilitation centers. The study design was cross sectional with qualitative study by conducting round table discussion (RTD) with stakeholders from the National Narcotics Agency (BNN), Drug and Food Control Agency (BPOM), Directorate for Prevention and Control of Mental Health and Drug Problems Ministry of Health, Drug Addiction Hospital, psychiatric practioners, volunteers, and confirmation to the rehabilitation center. The results of study showed that there was no national minimum standard for handling NAPZA relapse. The various relapse definition caused differences in relapse rates. Relapse rate according to Directorate Mental Health and NAPZA of the Ministry of Health in 2018 was 24.3% as rough figures (claim data). NAPZA relapse rates in the National Narcotics Agency, prior to the post rehabilitation program, was 90%, and decreasing to 30% after conducting post-rehabilitation program. While relapse rate in Rehabilitation and Therapy House, Lido Bogor was around 7%. There is no national standard for how many times a drug user is considered a victim or categorized as criminal action. In conclusion, there is Ministries/institutions of egocentrism in handling NAPZA relapse. Ministry of Health emphasizes medical rehabilitation, Ministry of Social emphasizes social rehabilitation, while BNN more comprehensively covering medical rehabilitation, social rehabilitation, and post rehabilitation. Narcotics, psychotropic, and comprehensive precursor control is carried out by the BPOM comprehensively, from imports, production, distribution, delivery and the use. The existence of E-NAPZA, administrative sanctions and criminal sanctions will reduce illicit trafficking and drug abuse. Indonesian Presidential Instruction No. 6 of 2018 concerning the National Action Plan for the Prevention of Eradication of drug abuse and Circulation (P4GN), in ministries/institutions is expected to decrease the number of NAPZA relapse. Abstrak Penyalahgunaan Narkotika, Psikotropika, dan Zat Adiktif (NAPZA) merupakan masalah di Indonesia yang salah satu akibatnya yaitu kekambuhan (relapse). Relapse merupakan suatu proses dimana seseorang telah dinyatakan abstinence (pulih) dan kembali menggunakan NAPZA. Angka relapse masih tinggi di beberapa negara. Pengguna NAPZA mengalami kekambuhan antara satu bulan sampai dengan satu tahun setelah keluar dari program pengobatan. Tujuan penelitian adalah untuk mengetahui kebijakan dan program yang terkait dengan penanggulangan relapse NAPZA di panti rehabilitasi. Desain penelitian berupa cross sectional dan studi kualitatif melalui round table discussion (RTD) dengan para pemangku kepentingan yaitu Badan Narkotika Nasional (BNN), Badan Pengawasan Obat dan Makanan (BPOM), Direktorat Pencegahan dan Pengendalian Masalah Kesehatan Jiwa dan NAPZA Kementerian Kesehatan, Rumah Sakit Ketergantungan Obat (RSKO), praktisi kejiwaan, dan relawan, serta konfirmasi ke panti rehabilitasi. Hasil penelitian yang diperoleh menunjukkan belum ada standar minimal nasional untuk penanganan relapse NAPZA. Definisi relapse yang beragam menyebabkan perbedaan angka relapse. Angka relapse di Direktorat Jiwa dan NAPZA Kementerian Kesehatan tahun 2018 yaitu 24,3% sebagai angka kasar (data klaim). Angka relapse NAPZA di BNN sebelum adanya program pasca rehabilitasi yaitu 90% dan setelah ada program pasca rehabilitasi menjadi 30%. Angka relapse di UPT Rumah Rehabilitasi dan Terapi NAPZA, Lido Bogor sekitar 7%. Belum ada standar secara nasional sampai berapa kali seorang penyalahguna NAPZA dianggap sebagai korban atau masuk kategori tindakan pidana. Kesimpulan penelitian menunjukkan adanya egosentrisme di masing-masing kementerian/lembaga dalam melakukan kebijakan penanganan penyalahgunaan NAPZA. Kebijakan Kementerian Kesehatan lebih menekankan pada rehabilitasi medis, Kementerian Sosial menekankan pada rehabilitasi sosial, sedangkan kebijakan BNN lebih komprehensif meliputi rehabilitasi medis, rehabilitasi sosial, dan pasca rehabilitasi. Pengawasan narkotika, psikotropika, dan prekusor komprehensif dilakukan oleh BPOM, mulai dari hulu sampai hilir yaitu dari impor, produksi, penyaluran, penyerahan, dan penggunaan. Aadanya aplikasi E-NAPZA serta sanksi administratif dan pidana dapat mengurangi peredaran gelap dan penyalahgunaan NAPZA. Melalui Instruksi Presiden Republik Indonesia No. 6 Tahun 2018 tentang Rencana Aksi Nasional Pencegahan Pemberantasan Penyalahgunaan dan Peredaran NAPZA dan Prekusor (P4GN) di kementerian/lembaga diharapkan membantu menurunkan angka relapse NAPZA.

scholarly journals Kemandirian dan Ketersediaan Obat Era Jaminan Kesehatan Nasional (JKN): Kebijakan, Harga, dan Produksi Obat

2018 ◽  
Vol 28 (4) ◽  
pp. 219-228
Author(s):  
Raharni Raharni ◽  
Sudibyo Supardi ◽  
Ida Diana Sari
Keyword(s):  
Health Insurance ◽  
Drug Price ◽  
Raw Materials ◽  
Generic Drugs ◽  
Insurance Coverage ◽  
Round Table ◽  
Round Table Discussion ◽  
Cross Sectional ◽  
Table Discussion ◽  
The Government

National Health Insurance (JKN) is a guarantee program that provides health protection to participants to obtain health care benefits and protection in meeting the basic health needs provided to everyone who pays contributions or whose contributions are paid by the government. Health insurance coverage includes promotive, preventive, curative and rehabilitative including medicines and medical devices. Since the enactment of JKN on 1 January 2014, the demand for generic drugs has greatly increased. JKN drug independence is needed in terms of drug availability, access and affordability of JKN drug.The aimed of this research is to find out the independence and availability of drugs in the JKN era. The study design was cross sectional by conducting interviews, Round Table Discussion, and tracking secondary data documents.The results of this study obtained government policies related to JKN drug price, especially generic drugs, have not fully considered the interest of community and the interest of the pharmaceutical industry, as well as drug price control policies to ensure the availability of drugs both in number and type in the JKN era, especially generic drugs that have not been optimally accessed by the public.The government needs to encourage the independence of JKN drugs, especially generic drugs that have not been fulfilled, with the development of domestic production of medicinal raw materials to support JKN, which is currently mostly imported and the price of imported raw materials continue to rise.The priority of production of medicinal raw materials based on local extractive and fermentative. Abstrak Jaminan Kesehatan Nasional (JKN), merupakan program jaminan yang memberikan perlindungan kesehatan kepada peserta untuk memperoleh manfaat pemeliharaan kesehatan dan perlindungan dalam memenuhi kebutuhan dasar kesehatan yang diberikan kepada setiap orang yang membayar iuran atau yang iurannya dibayar oleh pemerintah. Jaminan pelayanan kesehatan meliputi promotif, preventif, kuratif, dan rehabilitatif, termasuk obat dan alat kesehatan. Sejak diberlakukannya JKN pada 1 Januari 2014, permintaan obat generik sangat meningkat pesat. Kemandirian obat JKN diperlukan dalam hal ketersediaan obat, akses, dan keterjangkauan obat JKN. Tujuan penelitian ini untuk mengetahui kemandirian dan ketersediaan obat era JKN. Desain penelitian adalah cross sectional, dengan melakukan wawancara, round table discussion, dan penelusuran dokumen data sekunder. Hasil penelitian diperoleh kebijakan pemerintah terkait harga obat JKN khususnya obat generik, belum sepenuhnya mempertimbangkan kepentingan masyarakat dan kepentingan industri farmasi,serta kebijakan pengendalian harga obat untuk menjamin ketersediaan obat baik jumlah dan jenisnya di era JKN, khususnya obat generik, belum optimal diakses oleh masyarakat. Pemerintah perlu mendorong kemandirian obat JKN khususnya obat generik yang belum terpenuhi, dengan pengembangan produksi bahan baku obat dalam negeri untuk mendukung JKN, yang saat ini sebagian besar masih impor dan harga bahan baku impor yang terus naik. Prioritas produksi bahan baku obat yaitu berbasis sumber daya lokal, ekstraktif, dan fermentatif

scholarly journals The use of pasung for people with mental illness: a systematic review and narrative synthesis

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Muhamad Taufik Hidayat ◽  
Sharon Lawn ◽  
Eimear Muir-Cochrane ◽  
Candice Oster
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Illness ◽  
Community Mental Health ◽  
Community Mental Health Services ◽  
Rehabilitation Program ◽  
Narrative Synthesis ◽  
Community Based ◽  
Cross Sectional ◽  
People With Mental Illness

Abstract Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. Methods A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment. Result Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. Conclusion The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD

scholarly journals Criminal Law Study on Narcotics Abuse Rehabilitation

2020 ◽  
Vol 5 (1) ◽  
pp. 55-62
Author(s):  
Salma Widiasyam ◽  
Oheo Haris ◽  
Siti Aisah Abdullah
Keyword(s):  
Drug Abuse ◽  
Supreme Court ◽  
Criminal Law ◽  
Medical Rehabilitation ◽  
District Court ◽  
Criminal Offence ◽  
Social Rehabilitation ◽  
Circular Letter ◽  
One Year

The purpose of this research is to determine whether the rehabilitation of the victims of narcotics abuse in the decree of the District Court of Kendari No. 236/Pid. Sus/2019/PN K has fulfilled the element of Article 54 Act number 35 year 2009. The type of research used in this study is normative research, using the Statute Approach, Case Approach, Conceptual Approach.Based on the results the authors conclude that narcotic addicts and narcotics abuse victims are obliged to undergo medical rehabilitation and social rehabilitation. The judge in the its verdict prosecute convicted because it has been proven legally and committed guilty of committing a criminal offence "narcotic abuse for himself", dropping a criminal against the defendant with imprisonment for 1 (one) year and 2 (two) months have in accordance with article 127 paragraph (1) of Law No. 35 Year 2009. However, in the ruling judge ignores article 127 paragraph (2) and paragraph (3) of Law No. 35 Year 2009 that the obligation of the judge in providing rehabilitation efforts against the defendant cases of drug abuse in line with the issuance of Circular Letter of Supreme Court No. 4 Year 2010.

scholarly journals The Impact of Social Distancing Measures on Higher Education Stakeholders

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Iryna Sergiivna Pypenko ◽  
Yuri Vsevolodovich Maslov ◽  
Yuriy Borysovych Melnyk
Keyword(s):  
Mental Health ◽  
Higher Education ◽  
Distance Learning ◽  
Round Table ◽  
Round Table Discussion ◽  
Physical And Mental Health ◽  
Social Distancing ◽  
Teaching Learning ◽  
The Impact ◽  
Education Stakeholders

Background and Aim of Study: The global CoVID-19 pandemic has affected education systems dramatically. Remote teaching/learning practices have become everyday reality across the globe. The aim of the study: to assess the level of readiness of higher education stakeholders for distance learning/remote teaching, and to evaluate the role of social distancing measures. Material and Methods: 594 stakeholders (216 teachers and 378 students) provided anonymous responses to a questionnaire. Teacher did so during the round table discussion during the 6th International Academic Conference “Psychological and Pedagogical Problems of Modern Specialist Formation” (June 2020). Students responded using Viber, WhatsApp, and Telegram. Validation by Pearson method χ2 produced statistically significant results (df=4, χ22=22.083, р<0.01; df=4, χ23=44.389, р<0.01; df=4, χ24=29.666, р<0.01). Results: 62.9% of teachers and 56.6% of students consider educational institutions ready for distance learning. The majority of teachers/students seem to be prepared for it (81.0% and 93.4% respectively). 68.5% of teachers are positive about educational outcomes (contrasted with 90.0% of students). Only 37.0% of teachers and 21.7% of students assess the impact of social distancing measures on physical and mental health positively. Conclusions: The survey results prove that social distancing measures impact on higher education is significant. The respondents assess highly their individual levels of preparedness and of satisfaction, students displaying higher levels of both. However, the view on social distancing measures impact on physical and mental health is more negative, the trend being more visible in student responses.

scholarly journals Meta Analisis Hasil Penelitian Model-Model Rehabilitasi Narkoba oleh Lembaga Pemerintah, Masyarakat dan Pesantren di Jabodetabek

2015 ◽  
Vol 4 (1) ◽  
pp. 78-92
Author(s):  
Ismet Firdaus
Keyword(s):  
Drug Abuse ◽  
Meta Analysis ◽  
Boarding School ◽  
Rehabilitation Program ◽  
Research Report ◽  
Government Agencies ◽  
Drug Abusers ◽  
Governmental Organizations ◽  
Social Rehabilitation ◽  
Non Governmental Organizations

The rehabilitation victims of drug abuse in Indonesia is not only done by government agencies, but also by NGOs and Pesantren. With this type of study, meta-analysis of 15 analytical research report, the results illustrated that in government agencies and non-governmental organizations, program therapeutif community (TC) becomes an important part in the Social Rehabilitation to clients of drug abusers, with the support of family and interaction among clients/patients harmony in social rehabilitation program is an important factor for the improvement or cure the patient/client victims of drug abuse. Detoxification (expenditure toxins drugs to patients/clients) that exist in government agencies and NGOs about the same, while in boarding school detoxification is different, for example by drinking water prayer. Meanwhile, the rehabilitation program in Islamic schools put more emphasis on improving the client’s relationship with God through the practice of worship ritual which he believed to  be implicated in healing drug abusers clients.Keywords: Meta analisis, Rehabilitasi Medis, Rehabilitasi Sosial, Theraputif Community dan Narkoba.

Kedudukan Korban Penyalahgunaan Narkotika dalam Hukum Pidana Indonesia dan Hukum Pidana Islam

2017 ◽  
Vol 11 (2) ◽  
pp. 247-262
Author(s):  
Vivi Ariyanti
Keyword(s):  
Drug Abuse ◽  
Islamic Law ◽  
Illegal Drug ◽  
Medical Rehabilitation ◽  
Drug Abusers ◽  
Social Rehabilitation ◽  
Narcotics Trafficking ◽  
The Individual ◽  
Individual Self ◽  
Laws And Regulations

The term of drug abuse victims in the Act No. 35 of 2009 on Narcotics refers to a person who inadvertently uses narcotics, for being persuaded, tricked, deceived, coerced, and/or threatened to use narcotics. However, both addicts and the individual self-use drug abusers are in factvictims of syndicates of illicit narcotics trafficking. In addition, the spirit contained in the Narcotics Act also implies that narcotics addicts and abusers are victims of criminal acts of others in the form of illegal drug trafficking.Therefore, the Narcotics Act stipulates the obligation to undergo medical rehabilitation and social rehabilitation for addicts and self-use of drug abusers.On the contrary, Islamic law does not distinguish the term addicts, narcotics abusers, or victims of narcotics abuse. Islamic law tends to equate all these categories as perpetrators of narcotics abusers except those who are truely forced by others. In Islamic law, the punishment for them according to some scholars is the sanction of h}udu>d which is equated with the khamr (alcohol) drinkers, that is whipped as much as eighty times. While the opinion of other ulema, the penalty is ta’zir, of which form submitted to the ruler/government/judge. Thus, this type of ta’zir sanction in Islamic law is more in line with the prevailing laws and regulations in Indonesia.

Dual diagnosis: On the Way to an Integrated Treatment Model?

2017 ◽  
Vol 41 (S1) ◽  
pp. S134-S135
Author(s):  
I. Ezquiaga ◽  
Z. González Vega ◽  
P. Rossi ◽  
F. Fonseca ◽  
C. Tamarit ◽  
...  
Keyword(s):  
Mental Health ◽  
Drug Abuse ◽  
Dual Diagnosis ◽  
Clinical Sample ◽  
Descriptive Analysis ◽  
Integrated Treatment ◽  
Treatment Model ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Competing Interest

IntroductionSubstance use disorders (SUD) with psychiatric co-morbidity (dual diagnosis) represent a challenge for both mental health and addiction networks. Dual patients present greater disorder severity and worse prognosis than those with SUD or psychiatric disorders alone. There is a lack of consensus regarding which treatment model (sequential, parallel or integrated) is the most appropriate for them. Despite integrated treatment is seen as the model of excellence, it is a standard difficult to achieve.Objectives/AimsTo describe the presence of dual diagnosis and treatment model received in a sample recruited from a drug abuse community center in Barcelona (CAS Barceloneta).MethodsCross-sectional descriptive analysis of an outpatient center for SUD clinical sample regarding psychiatric co-morbidity (DSM-IV-TR criteria), social-demographic characteristics and treatment model received.ResultsIn the moment of this study, a total of 574 SUD patients are attended at CAS Barceloneta. Of them, 300 (52%) present a dual diagnosis, 64% men, mean age = 48 (SD = 11.29). Thirteen percent (n = 40) of dual patients have psychotic disorder (PsyD) diagnosis and their SUD comorbidities are: alcohol-UD (12.5%, n = 5), cocaine-UD (7.5%, n = 3), cannabis-UD (15%, n = 6), opioids-UD (17.5%, n = 7) and multiple SUD (47.5%, n = 19). Half of dual patients with PsyD (n = 20) are attended in parallel in community mental health centers.ConclusionsOur results suggest there is an important percentage of SUD patients that present psychiatric co-morbidity treated in drug abuse community centers. Parallel treatment is mainly for PsyD patients and sometimes they get lost in the gaps. We would need to develop specific dual programs to give these patients an integrated assistance.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Suicide Attempters, Suicide Ideators, and Non-Ideators

Crisis ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 294-297 ◽  
Author(s):  
Tobias Teismann ◽  
Laura Paashaus ◽  
Paula Siegmann ◽  
Peter Nyhuis ◽  
Marcus Wolter ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Protective Factors ◽  
Suicide Ideation ◽  
Suicide Attempts ◽  
Self Esteem ◽  
Positive Mental Health ◽  
Cross Sectional ◽  
Reasons For Living ◽  
Suicide Attempters

Abstract. Background: Suicide ideation is a prerequisite for suicide attempts. However, the majority of ideators will never act on their thoughts. It is therefore crucial to understand factors that differentiate those who consider suicide from those who make suicide attempts. Aim: Our aim was to investigate the role of protective factors in differentiating non-ideators, suicide ideators, and suicide attempters. Method: Inpatients without suicide ideation ( n = 32) were compared with inpatients with current suicide ideation ( n = 37) and with inpatients with current suicide ideation and a lifetime history of suicide attempts ( n = 26) regarding positive mental health, self-esteem, trust in higher guidance, social support, and reasons for living. Results: Non-ideators reported more positive mental health, social support, reasons for living, and self-esteem than suicide ideators and suicide attempters did. No group differences were found regarding trust in higher guidance. Suicide ideators and suicide attempters did not differ regarding any of the study variables. Limitations: Results stem from a cross-sectional study of suicide attempts; thus, neither directionality nor generalizability to fatal suicide attempts can be determined. Conclusion: Various protective factors are best characterized to distinguish ideators from nonsuicidal inpatients. However, the same variables seem to offer no information about the difference between ideators and attempters.

Rorschach-CS Scores of Six Groups of Patients

2013 ◽  
Vol 34 (1) ◽  
pp. 24-55 ◽  
Author(s):  
Caspar C. Berghout ◽  
Jolien Zevalkink ◽  
Abraham N. J. Pieters ◽  
Gregory J. Meyer
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Organizations ◽  
Total Sample ◽  
Psychoanalytic Psychotherapy ◽  
Cross Sectional ◽  
Treatment Groups ◽  
Treatment Type ◽  
Psychotherapy Groups ◽  
Cross Sectional Design

In this study we used a quasiexperimental, cross-sectional design with six cohorts differing in phase of treatment (pretreatment, posttreatment, 2-year posttreatment) and treatment type (psychoanalysis and psychoanalytic psychotherapy) and investigated scores on 39 Rorschach-CS variables. The total sample consisted of 176 participants from four mental health care organizations in The Netherlands. We first examined pretreatment differences between patients entering psychoanalysis and patients entering psychoanalytic psychotherapy. The two treatment groups did not seem to differ substantially before treatment, with the exception of the level of ideational problems. Next, we studied the outcome of psychoanalysis and psychoanalytic psychotherapy by comparing the Rorschach-CS scores of the six groups of patients. In general, we found significant differences between pretreatment and posttreatment on a relatively small number of Rorschach-CS variables. More pre/post differences were found between the psychoanalytic psychotherapy groups than between the psychoanalysis groups. More research is needed to examine whether analyzing clusters of variables might reveal other results.

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