Author: Asia Ashraf, VNGOC Secretary and member of the VNGOC Asia-Pacific Working Group
Health services for people with drug use disorders in Pakistan include detoxification, residential rehabilitation, psychosocial support and low threshold services such as drop-in centers and outreach services. The number of health services has not kept pace with the increase in drug use in recent years, and it is acknowledged that treatment for drug dependence needs to be scaled up to meet the current need, including the need for the treatment of mental and physical comorbidities. The lack of agreed treatment standards against which to assess the safety, effectiveness and ethical basis of drug use disorder treatment has been a factor limiting the development of a more comprehensive treatment system in line with International Standards for the Treatment of Drug Use Disorders (WHO/UNODC,2020)
In 2020, UNODC/WHO released International standards for the treatment of drug use disorders: revised edition incorporating results of field-testing. In 2021, UNODC, WHO and partner agencies released Quality assurance in treatment for drug use disorders: Key quality standards for service appraisal as a pre-publication draft. This document sets out a list of indicators, which can be used to define and assess drug treatment quality standards.
These National Standards for Drug Use Disorder Treatment and Care Services in Pakistan are based on these two documents and adapted to the situation in Pakistan by national counterparts with support from UNODC and a team of international experts, following consultations with key stakeholders, including face-to-face consultations in Karachi and Islamabad in 2022/2023.
The National Standards are intended for all those involved in the policy development, planning, funding, delivery, monitoring and evaluation of treatment services and interventions for drug use disorders. This document is based on currently available scientific evidence on treatment for drug use disorders and sets out a framework for the implementation of a comprehensive system of drug dependence treatment in line with principles of public health care. The National Standards identify major components and features of effective systems for the treatment of drug use disorders.
The process of adaptation of the International Standards was facilitated by UNODC, in partnership with the Ministry of Narcotics Control (MONC) and the National Health Services Regulations and Coordination (MoNHSR&C). Following a series of consultations in 2021 and 2022, a draft national Standards document was developed incorporating recognition of the different levels of residential treatment facilities in Pakistan. This document was revised based on further series of consultations in Islamabad and Karachi in December 2022 with psychiatrists, psychologists, health care commission representatives and drug treatment staff from Government and civil society organizations. Based on these consultations, a further draft of the Standards was developed and revised in consultation with key national stakeholders. The Ministries of Health and Counter Narcotics approved the final version in June 2023
Most recently, UNODC in collaboration with Ministry of Narcotics Control and National Health services Regulation organized training of trainers on these standards at Islamabad and Karachi respectively for 45 stakeholders by international trainers and co-facilitated by 06 national trainers. This is a big milestone for my country, Pakistan.
Looking forward for their implementation at national level.