Assessment of the Quality of Services Offered to Heroin Users Under Methadone by the Dakar Center for Integrated Addiction Care (CEPIAD)

Abstract

Drug addiction is a major public health problem in Senegal. One of the responses has been the establishment of a Center for Integrated Addiction Care in Dakar (CEPIAD). The objective of this study is to evaluate the quality of services offered to heroin users under methadone substitution treatment. This is a descriptive cross-sectional study based on a systematic sampling of one hundred (100) heroin users under methadone substitution treatment who had given their consent. Individual interviews were conducted with patients regularly followed at the center from December 16, 2016 to February 17, 2017. Data were entered and analyzed using Epi-info and Excel software. There was a male predominance with 92 males and 8 females (sex ratio of 11.5). The average age was 48.8 years with a standard deviation of 9.7. The vast majority of respondents were Senegalese (99%), with 78% living in the city and 22% in the suburbs of Dakar. The vast majority were single, divorced or widowed (61%). The level of education was relatively high; 11% had a university level, 47% a high school level, 31% an elementary school level, and only 1 person had no schooling. Among the respondents, 39 were unemployed, 1 was a housewife, 5 were retired; the other 55 had an income-generating activity, including 42 in the informal sector. All of the respondents were satisfied and had access to risk reduction materials for sexually transmitted infections (RDR). The 80 respondents participate regularly in social activities such as talks, community meals, etc. The other 20 do not have the time to participate. Methadone is delivered from 9:00 a.m. to 1:00 p.m. on weekdays. Only 57 respondents were satisfied with the schedule. The 28% of heroin addicts said they were very satisfied with the methadone program and 70 were moderately satisfied and asked for the possibility of taking a week's supply. The single use of the cups reserved for the oral administration of methadone was requested by 2% of patients. Heroin addicts are generally satisfied, but it is necessary to insist on awareness raising, information and withdrawal. It is important to extend CEPIAD's activities to other regions and, above all, to help heroin addicts get a socioprofessional reintegration.