Abstract
BackgroundAlthough drug abuse has been a serious public health concern, there have been problems with implementation of treatment for drug users in Japan because of poor accessibility to treatment, concerns about stigma and confidentiality, and costs. Therapeutic interventions using the Internet and computer technologies could improve this situation and provide more feasible and acceptable approaches.ObjectiveThe objective of the study was to show how we developed a pilot version of a new Web-based cognitive behavioral relapse prevention program with tailored feedback to assist people with drug problems and assessed its acceptance and usability.MethodsWe developed the pilot program based on existing face-to-face relapse prevention approaches using an open source Web application to build an e-learning website, including relapse prevention sessions with videos, exercises, a diary function, and self-monitoring. When users submitted exercise answers and their diary, researchers provided them with personalized feedback comments using motivational interviewing skills. People diagnosed with drug dependence were recruited in this pilot study from a psychiatric outpatient ward and nonprofit rehabilitation facilities and usability was evaluated using Internet questionnaires. Overall, website usability was assessed by the Web Usability Scale. The adequacy of procedures in the program, ease of use, helpfulness of content, and adverse effects, for example, drug craving, mental distress, were assessed by original structured questionnaires and descriptive form questions.ResultsIn total, 10 people participated in the study and completed the baseline assessment, 60% completed all relapse prevention sessions within the expected period. The time needed to complete one session was about 60 minutes and most of the participants took 2 days to complete the session. Overall website usability was good, with reasonable scores on subscales of the Web Usability Scale. The participants felt that the relapse prevention sessions were easy to use and helpful, but that the length of the videos was too long. The participant who until recently used drugs was satisfied with the self-monitoring, but others that had already maintained abstinence for more than a year felt this activity was unhelpful and were bored tracking and recording information on daily drug use. Feedback comments from researchers enhanced participants’ motivation and further insight into the disease. Serious adverse effects caused by the intervention were not observed. Some possible improvements to the program were suggested.ConclusionsThe Web-based relapse prevention program was easy to use and acceptable to drug users in this study. This program will be helpful for drug users who do not receive behavioral therapy. After the pilot program is revised, further large-scale research is needed to assess its efficacy among drug users who have recently used drugs.
Highlights
EXECUTIVE SUMMARYThe World Drug Report provides an annual overview of the major developments in drug markets for the various drug categories, ranging from production to trafficking, including development of new routes and modalities, as well as consumption
- remains stable at between 16 million and 39 million people
21 The “know your customer” principle, for those who manufacture or market chemicals, is set out in the Political Declaration adopted by the General Assembly at its twentieth special session and the measures to enhance international cooperation to counter the world drug problem (General Assembly resolutions S-20/4 A-E)
Summary
The World Drug Report provides an annual overview of the major developments in drug markets for the various drug categories, ranging from production to trafficking, including development of new routes and modalities, as well as consumption. That corresponds to a prevalence of 0.27 per cent (range: 0.19-0.48 per cent) of the population aged 15-64.2 The problem is stark in Eastern and South-Eastern Europe, where the rate of injecting drug use is 4.6 times higher than the global average. UNODC, the World Bank, WHO and UNAIDS jointly arrived at a global estimate of the number of people who inject drugs living with HIV of 1.7 million persons (range: 0.9-4.8 million). That situation is pronounced in two regions of the world: South-West Asia and Eastern/ South-Eastern Europe, where it is estimated that the prevalence of HIV among people who inject drugs is 28.8 and 23.0 per cent, respectively. Addressing HIV among people who inject drugs, through the implementation of an evidence-based comprehensive package of nine interventions,[3] as a component of what is
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