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Support for Recovering Heroin Addicts

Training in Vietnam for heroin addiction recovery

Thirty support group leaders from across Vietnam sat in a circle of chairs at the beginning of the final day of a five-day training, honing their skills to facilitate groups for recovering heroin addicts. Like previous sessions, this one began with a community-building activity. Participants were asked to share one new thing that they would like to do at some point in the future. Many of them spoke about places they would like to visit or things they hoped to accomplish in their work. One woman shared something more personal.

“I am HIV-positive. My dream for the future is that I will have a baby with my husband and the child will be born healthy and I will be healthy and live long enough to raise the child,” she said. The declaration was unexpected but not unusual given the level of trust that had developed over the course of the week.

“Her choice to make this personal revelation–and the caring response of other participants–was a poignant reminder of how powerful support from a group can be,” said EDC’s Jim Vetter, the trainer and project director. The experience reflected the benefits of social support, which were not only taught to the participants but also modeled within the training.

With Family Health International (FHI) in Vietnam, EDC’s Health and Human Development Division in Asia is providing specialized training and technical assistance on facilitation skills to group leaders across Vietnam who operate community-based peer support groups for recovering addicts.

Heroin is the most commonly used illicit drug in the country because of relatively easy access and low cost. Additionally, nearly one out of four substance users who inject drugs like heroin become HIV-positive. This project aims to combat Vietnam’s heroin problem and HIV/AIDS epidemic through peer support groups, which for many addicts can mean the different between continued recovery and tragic relapse.

“While initial withdrawal can be difficult, the real challenge comes after the person has stopped using the drug,” says Vetter. “How can they succeed in staying clean over time? The main focus is all about relapse prevention.” For many people, a critical step is to find a new group of peers who understand from personal experience the challenges of heroin addiction and—rather than urging them to use again—will help them learn to handle the cravings, resist the pressure to use, and build a balanced, satisfying life. “Recovering addicts need and deserve a lot of ongoing support to do all of this successfully,” adds Vetter.

Previous treatment options in Vietnam consisted largely of forced withdrawal at special centers that provided little additional support. In recent years, methadone maintenance treatment has also become available, which functions as a drug replacement for heroin with less serious consequences. Drug addiction counseling is another option; and more recently, a movement has emerged in the country to develop ongoing peer support groups.

Vetter, along with partners at Family Health International, developed a training program to teach support group facilitators in Vietnam how to run successful, meaningful groups. Previously, group leaders had been offered instruction in the theory of effective social support. Now, with Vetter’s guidance, they are learning and practicing concrete facilitation skills that can help them to build trust, connection, and a supportive environment, and generate focused, productive discussion that can help group members in their recovery.

The participants in the 5-day training come back together several months later for on-site coaching and an additional week of training, to refine their skills and share successes and challenges they have encountered in bring these facilitation approaches back to their own communities.

Although it is too soon to know the extent to which the project has succeeded in reducing heroin relapse and HIV/AIDS infections, initial feedback has been extremely positive. The skills of the first cadre of group leaders have shown considerable improvement as a result of these trainings. Group members have also reported feeling more connected and supported through increasingly better-facilitated and well-structured meetings. And through his on-site coaching, Vetter has discovered that the approaches and techniques used in his training have already spread to other group leaders who did not participate.

Results of the initial training were so positive that there is now substantial demand to start additional support groups around the country. The next phase of this project will be to teach local non-governmental organizations how to run the training workshops for additional group leaders, allowing the program to continue to grow throughout Vietnam.

This project is funded by the President’s Emergency Plan for AIDS Relief, USAID, and SAMHSA. EDC is a sub-grantee of Family Health International, EDC’s partner for this project. For more information, please contact Jim Vetter at jvetter@edc.org