DRUG ADDICTION TREATMENT - SITUATION AND SOLUTIONS
CEDEMEX AND REQUIREMENT SATISFACTION IN DRUG ADDICTION TREATMENT
A. SITUATION AND SOLUTIONS
1. Substance and drug addiction in terms of science:
Substance and drug addiction used to be considered as a social problem. Not until 1975, when scientists discovered endogenous morphine (endorphine) in the body of a normal human, substance and drug addiction has been considered as a disease caused by three reasons:
+ Biological reason
+ Psychological reason
+ Sociological reason
In addition, for substance and drug addicts, despite of being addicted for a few years or many years, drug and substance have caused much disorders in the addicts' body, therefore, we should focus on recovering three major disorders in regimen:
+ Mental disorders: Drug changes them from normal people who are always inclined to good things, eager for progress into people who are not inclined to good ones, dissipated, not eager in working and studying, their characteristics and will change, they are irritable, often tell lies and feel low self-esteem.
+ Memory impairment: Drug addicts shall face memory impairment depending on the time and extent of drug use, if we do not recover their situation of memory impairment, they shall be unable to study and work in high-tech sectors upon drug addiction treatment, but the more important one is that they shall be easily enticed and relapsed because they longer remember the advice of their family and society.
+ Sexual ability reduction: Initially, the drug addicts are very excited about sex, however, their sex ability shall be reduced from time to time and according to drug using dosage, they cannot ensure their happy marriage, if this situation isn’t improved, they shall relapse.
2. Situation of treatment methods of drug addiction in Vietnam and all over the World:
During the last four decades, when substance and drug addiction has been considered as a disease, scientists around the world as well as Governments of countries have spent much effort and expenses on researches to find out a medicine to treat this disease, but so far it has been a difficult problem. Developed countries over the world such as USA, EU ... have still used method of methadone treatment. In terms of science, this is not a medicine because methadone is a semi-synthetic drug, a toxic chemical pharmaceutical group A, causing lots of adverse reactions to addicts, increasing liver enzymes, decreasing sex ability, etc. Time of treatment is prolonged and expensive. This is a temporary solution to reduce disorders of social security, HIV / AIDS transmission and other infectious diseases of each country. Actual result of Methadone application in some countries in the Americas, Europe does not meet expectation. In 8/2006, to be aware of the more and more serious risk of abuse, the treatment program using Methadone for persons who are addicted to drug of Opiates group was discontinued. This is experience for studying and applying Methadone to treat patients addicted to drugs of Opiates group for all countries. In Vietnam, during the last few decades, the Party, the State and relevant authorities such as Ministry of Health, Ministry of Labour, Invalids and Social Affairs, Ministry of Public Security, as well as scientists have spent much effort and expenses on preventing and fighting against this disease. However, the result was not as expected, so what is the cause? Since 1995, we have applied neuroleptic therapy (ATK) to assist treatment for addicted patients in drug rehabilitation centers nationwide. In terms of science, neuroleptic therapy is the combination of a number of sedatives including XEDUXEL - an addictive sedative. Therefore, the application of Neuroleptic therapy in the last few decades in such centers in our country is to assist addicts for detoxification, but this also causes many negative adverse reactions to patients. The Neuroleptic therapy does not tend to treat cause of addiction such as Drug cravings, Psychological dependence. Therefore, from 01 to 03 years when the term of detoxification in centers expires, and returning to the community, they still inhale and inject drugs because they are still addicts. Since the end of 2007, Vietnam has received Methadone sponsored by international organizations to carry out alternative test for some patients addicted to drug of Opiates group in Ho Chi Minh city, Hai Phong city, Hanoi and other provinces.
The above situation has explained why the Governments of all countries around the world including Vietnam have spent a lot of effort and expenses on preventing and fighting against this disease for many decades, but the results has not been as expected? The number of addicts does not reduce but tend to increase. Many addicted patients and their families are looking forward to being treated and they actually repeated their detoxification in drug rehabilitation centers or at home but these gave no result, did they? As a result, it reduces people's belief, the patients' family and even the patients... also feel fear and lose belief. So what are the causes? Scientists from Radiner have suggested three main causes:
The first cause: Because the scientists around the world have not found out a specific medicine to treat Biological and Psychological reason. The existing detoxification medicines in domestic and foreign market only tend to be an alternative method, support detoxification and reduce symptoms of the Withdrawal symptom.
The second cause: Another important cause is that we have been lack of comprehensively scientific information about this disease, especially in countries having underdeveloped science and economy, this disease has been considered as a social problem, a bad habit, accompanied by dysfunctions caused by drug addiction such as: mental disorders that cause addicts who are always inclined to good things, into people who are not inclined to good one, dissipated, not eager in working and studying, changing characteristics, telling lies, memory and sexual ability impairment, causing unsafe feeling to their families and society. Due to poor knowledge of the nature of drug addiction disease for several decades, the treatments have been organized unscientifically, along with the inability of science, the number of addicts does not decrease but tend to increase. This is inevitable.
The third cause: Sociological cause: this is the difference from diseases caused by viruses or bacteria of which the human is the main cause; they can use any way to put a normal man or a rehabilitated addict to be relapsed for profit. Patients, their family and the community are responsible for this cause.
3. Solutions to drug addiction treatment:
3.1. Medicine: To treat the disease of drug addiction, scientists must find out a type of medicine made from pharmaceutical chemistry or herb, which shall meet the following requirements:
+ In terms of safety: The medicine should not contain toxic substances, does not cause harmful adverse reactions to patients' health in short term and long term (such as impairment of liver and kidney function, hematopoietic function, affecting variation and genetics); especially it should not contain substance and is able to recover the patient's health after detoxification.
+ In term of effectiveness: In addition to the function of supporting smooth detoxification, it should be able to recover endorphin (endogenous morphine) of the addicts to eliminate Biological cause (actually, addiction is drug cravings) and it must be capable of resisting against spirit dependence (eliminating psychological cause) to anti-relapse.
- Combining treatment for rehabilitation of dysfunctions: Psychiatric, memory impairment and reduction or loss of sexual ability. Thereby we can return patients who are very normal in psychology, physiology and pathology to their family and society. Only when they are able to integrate into life to be useful for their family and society can we reduce the relapse rate.
3.2. Addicts and their family:
Must be determined to treat disease, the family must have enough conditions to take care and manage the patients to take home detoxification.
3.3. For agencies and organizations in the community:
Should advise and help patients and their families to get appropriate information about prevention and treatment of drug addiction. Help them to get jobs when they integrate into the community, etc.
B. CEDEMEX AND REQUIREMENT SATISFACTION IN TREATMENT OF DRUG ADDICTION
1. Cedemex is effective and safe in halting drug craving:
1.1. Safety of Cedemex:
- Cedemex is prepared from 17 types of Vietnamese herb, it is non-toxic, non-addictive, and its current dosage is 50 times less than the official limitation.
- Since 2004, Cedemex has been used to halt drug craving for more than 20,000 addicted patients in drug rehabilitation centers of nearly 20 provinces and cities, but no report on adverse reaction of Cedemex has been submitted, in contrary, the patients using Cedemex shall have their health recovered quickly, sleep and eat well and they have weight gain from 2-5 kg/ month.
1.2. Effectiveness of halting drug craving of Cedemex:
Cedemex was evaluated by the Council of State Science that: “Cedemex is safe and effective in halting drug craving, stabilize lots of symptoms of withdrawal symptom, especially the symptoms of Drug craving and Paraesthesiae (feeling like many maggots inside bone), In comparison with tranquillizer, Cedemex is better with P<0.05…” (Quote of minute of acceptance of the Council of State Science dated 02/08/2003).
1.3. Effectiveness of supporting drug addiction treatment of Cedemex:
Due to advantages of Cedemex, the Vietnam Ministry of Science and Technology signed a cooperation agreement with China Ministry of Science and Technology to carry out a subject on "Researching mechanism and preparation of Cedemex" under the 5th Protocol from 2004 to 2007 in order to find out effect mechanism of Cedemex in supporting addiction treatment of patients addicted to drug of Opiates group.
After experiments at level of organ, cells, molecules and genes, Chinese scientists and the Council of State Science of Vietnam dated 28/06/2013 affirmed that:
“… Vietnam Cedemex is safe and effective in halting drug craving; it does not cause spirit dependence, non-addictive to Cedemex users.
+ Vietnam Cedemex can inhibit nerve cells from apoptosis, reduce the number of nerve cells died of apoptosis, this is an important mechanism of Cedemex for persons addicted to drug of Opiates group.
+ Vietnam Cedemex is capable of accelerate hypothalamus and pituitary gland to recover concentration of β-Endorphin (endogenous morphine) as normal. Cedemex also has impact on different parts and zones of the brain (hippocampus, thalamus, Hypothalamus, VTA…) in mice addicted to Morphine increasing production of Dopamine (a neurotransmitter), the neurotransmitters are recovered as normal. This is an important mechanism of Cedemex at molecule level.
+ Cedemex is capable of inhibit the presence of CREB gene, therefore the rate of cAMP/cGMP shall return to the normal rate, Cedemex can accelerate hypothalamus and pituitary gland to present POMC gene and D2 receptor gene, thereby affecting content of Dopamine, concentration of β-Endorphin, balancing these neurotransmitters when conducting detoxification for person addicted to drug of Opiates group.
+ Thanks to model of conditioned place preference, Cedemex can resist against spirit dependence (good anti-relapse capacity)…” Quote of minute of acceptance and research in China.
1.4. Which requirements to be met by Cedemex in drug addiction treatment:
- Cedemex is prepared from herbs, non-toxic and does not cause adverse reactions with its dosage, does not contain substance and quickly recovers health.
- In addition to capacity of smoothly halting drug craving, minimizing symptoms of withdrawal symptoms, especially symptoms of Paraesthesiae (feeling like many maggots inside bone) Cedemex can also recover β-endorphin to stabilize symptoms of drug craving, resist against spirit dependence to contribute for anti-relapse.
C. RESULT OF CEDEMEX APPLICATION
I. Result of application in Vietnam
1. Support regimen for detoxification:
- Since 2004, the Institute has submitted to the Ministry of Health guidelines for detoxification by Cedemex. The Vietnam Ministry of Health has permitted to apply Cedemex in labor - social education centers in Hai Phong, Hoa Binh, Lang Son, Hung Yen, Ninh Binh, Thai Binh, Hanoi, Phu Tho, Dien Bien, Lai Chau, Ho Chi Minh city, Long An… under decision No. 90/QD-QLD, dated 27/07/2004, decision No. 173/QD-QLD dated 26/9/2005 of the Director of Drug Administration of Vietnam permitting usage of Cedemex in drug rehabilitation centers in Vietnam and Decision No. 2046/QD-BYT dated 27/7/2008 of the Ministry of Health permitting Cedemex to be used in families and the community according to support regimen for detoxification in attack period of 4 days and maintenance treatment of 10 days according to the result of clinically testing.
- Inspection conducted by relevant Departments, Services under Ministry of Health, Ministry of Labour, War Invalids and Social Affairs in centers applying Cedemex and reports of such centers sent to the Ministry of Labour, War Invalids and Social Affairs and the Critical Diseases Research and Treatment Institute, shown the effectiveness of practical application of Cedemex in halting craving for drug of Opiates group for more than 20.000 drug addicts, appropriate to the evaluation of the Council of State Science regarding the safety and effectiveness of Cedemex. Cedemex is easy to use, smoothly detoxify; no report on adverse reactions of this medicine has been found. Cedemex can be applicable in border areas and islands where there are no physician.
2. Support regimen for drug addiction treatment
To obtain a complete regimen for drug addiction treatment according to effects mechanism of Cedemex in drug rehabilitation centers in China, scientists from Radiner have introduced a five-day attacking regimen to support detoxification and eliminate the actual cause that is drug craving, to keep maintenance treatment in at least 6 months to help addicts resist against spirit dependence, eliminate cause of psychological addition, contribute for anti- relapse. Combining the treatment of recovering dysfunctions caused by drug addiction to which we have not pay attention satisfactorily. Only by this can we patients who are totally normal in psychology, physiology and pathology to their family and society. Besides, with the assistance of their family and the community, they are able to make effort to become useful for their family and society, and then we can realize our wish of reducing the relapse rate.
Since 2009, the Radiner has conducted advice and treatment for over 50 voluntarily patients addicted to drug of Opiates group and synthetic drugs from provinces nationwide according to the home regimen, the result of a survey on monitoring the rate of non-relapse 3 years after detoxification reaches 67% and 33% of them relapse due to subjective and objective reasons. Implementing the guidance of the Deputy Prime Minister Nguyen Xuan Phuc according to Official Dispatch No. 2555 /VPCP- KGVX dated 01.04.2013 of the Government Office, to evaluate comprehensively in term of science and practice about effect of drug addiction treatment of Cedemex , the Institute has collaborated with the Ministry of Health to carry out the subject "Researching the deployment, evaluation of effectiveness of Cedemex in supporting drug addiction treatment for person addicted to Opiate drug in the community" from 2013 to 2015. The Institute collaborated with People's Committees and relevant authorities of Thai Nguyen province to expand the project of supporting drug addiction treatment at home and in the community for more than 750 addicts from 2013 to 2015. From 4/2013 to 15/08/2014 Thai Nguyen province collaborated with Radiner to carry out the project; there were 443 people from 8 districts, cities and towns participating in Cedemex using. 332 people complied with commitments (quick test for negative (-) with drug) to continue using Cedemex and to support maintenance treatment, accounting for 74.95%, of which:
- 182 addicts have fulfilled the regimen of Cedemex treatment in 6 months, and it has been 16 months (since the date of participation into the project), there are 130 people did not relapse, accounting for 71.4%; 52 people relapsed, accounting for 28.6%.
According to report of Health Department of Lai Chau province, in 2009, it organized to rehabilitate for 100 addicts, the rate of person who did not relapse after 12 months is 40%, and the organization of rehabilitating for 335 addicts in border provinces has gained the rate of person who did not relapse after 12 months of 50%.
In 2013, People’s Committee of Hung Yen province nominated Department of Labour, Invalids and Social Affairs to expand the model of drug rehabilitation in the community as the one in Thai Nguyen for 45 addicted patients of the province, the result shown that after 6 months of integrating into the community, there were 25 patients who didn’t relapse, accounting for 55.60%
The initial result of applying Cedemex in 3 provinces: Thai Nguyen, Hung Yen and Lai Chau has opened a new direction in drug addiction treatment in the community, contribute to the effective anti-relapse in comparison to existing rehabilitation medicines, this model has brought into play the role of socialization in detoxification activities, helped to reduce burden of the State.
This result also brings about belief to the community that substance and drug addiction can be treated successfully if there is a full combination among the three elements Cedmex + Determination of the patient + Interest of the family and society.
3. General evaluation
a. Effect of Cedemex in supporting detoxification and treating patients who are addicted to drug of Opiates group.
- Both the patients and their family give comments that Cedemex tends to smoothly detoxify in comparison to "Non medicated detoxification” or other medicines, Cemedex is easy to use, the patients and their family only need to comply with the direction of the regimen of the Critical Diseases Research and Treatment Institute, more than 85% patients lose feel of craving for drug after 03 to 05 days of treating by attacking dosage.
- After 06 months of maintenance treatment by Cedemex and recovery treatment of dysfunctions caused by drug addiction such as: Mental disorder, memory and sexual capacity impairment or loss, the patients are no longer dependent on drug, eat and sleep well, feel comfortable; their physiological issue is recovered, their health is improved significantly; all patients gain weight (from 02 - 09 kgs), there is no report about the harmful adverse reaction of Cedemex to users to be found.
b. The Primacy of Cedemex in supporting treatment for patients who are addicted to drug of Opiates group in the community
- If using other medicine, almost “non-medicated detoxification” patients relapse after 3 to 5 days because they cannot stand hunger of drug; after 01 year, more than 95% patients relapse;
- The treatment of using Neuroleptic therapy for home detoxification is difficult to perform due to shortage of neuropsychiatric specialized doctors in the community;
- Compared with detoxification activities in previous years, Cedemex has markedly effect in supporting detoxification, drug addiction treatment in family and community, the medicine is easy and safe to use, the patient only need to comply with the direction for home rehabilitation.
- During process of application Cedemex in community, it has been found out that, in addition to the effect of supporting treatment for patients who are addicted to drug of Opiates group, Cedemex can support treatment for patients who are addicted to synthetic drug.
II. Legal base and achievements of Cedemex:
- Cedemex was licensed to be used in drug drug rehabilitation centers and in the community by the Ministry of Health according to Decision No. 2046/QD-BYT dated 2/7/2008.
- Dispatch No. 2555/VPCP-KGVX dated 1/2/2013 of The Government Office nominating the Ministry of Health to coordinate with relevant ministries, industries, provinces and Critical Diseases Research And Treatment Institute to continue implementing, performing tests and summarizing evaluation of Cedemex usage in community according to the model of Thai Nguyen province to report the Prime Minister.
- Cedemex was applied in Renovation project of rehabilitation activities in Vietnam under decision No. 2596/QD-TTg dated 27/12/2013 of the Prime Minister.
- The Ministry of Health issued Decision 5635/QD-BYT dated December 31, 2015 of the Ministry of Health recognizing the research results of the Project and allowing the application of Cedemex in Vietnam according to the protocol approved by the Scientific Council of the Ministry of Health. acceptance test.
- The Vietnam Drug Administration has issued Decision No. 253/QD-QLD dated April 24, 2018 for Cedemex drugs to be circulated in Vietnam.
- Cedemex was honored as one of top 10 science and technology events in 2012 by the Science and Technology Journalists' Club under Vietnam Journalists Association in Vietnam.
- Cedemex was voted as one of 50 gold products of Vietnam by Vietnam Intellectual Property Research Institute in 2013.
- Cedemex was recognized as one of the 10 famous brands of Vietnam in 2019.
III. Conclusion:
Drug addiction is considered as a special disease, through the achievements and experience from practices in the implementation of the expanded pilot scheme "Model of using Cedemex for supporting detoxification, treatment of drug addiction in family and community" in Thai Nguyen, Hung Yen and Lai Chau, etc. and at Radiner from 2009 up to now. Persons who are addicted to drug of Opiates group are able to have successful treatment of combining enough 3 elements: Cedemex + determination of the patient, patient's family and the interest and assistance of the community. The Institute has been studying the effectiveness of Cedemex treatment for patients who are addicted to synthetic drug and patients who use methadone for treatment.
Hanoi, October 2019
Director of the Institute
(signed and sealed)
Nguyen Phu Kieu
