Development of a comprehensive treatment program for chemical dependency at Al Amal Hospital, Dammam.

An experience in developing a treatment program of addiction in an Arabic Muslim Society. The three major waves of knowledge and methodology are reviewed in historical perspective. General description of Al Amal Hospital, Dammam, K.S.A, and the three phases which the hospital treatment program underwent. Drug therapy was the main line of treatment in the first phase, which resulted in a massive consumption of controlled drugs exposing patients to iatrogenic dependence. The second phase introduced a wider concept of treatment using a bio-psycho-social model in the context of the 12 steps program of the AA. This approach did not reflect positively on patients' care due to the resistance of both patients and staff. The third phase addressed the causes of this resistance and formulated the basis for a comprehensive treatment program for addiction that relies on a clear philosophy and defined treatment stages. A multitude of treatment components were introduced and monitored by a daily clinical program audit. During the three phases, hospital records showed a progressive decrease in the amount of medications consumed (> 90%) and dropouts (24%-2.8%). The overall number of patients completing the treatment program markedly increased and although the average daily census dropped, there was, in fact, an increase in the number of voluntary patients.