Audit of Substance Abuse Treatment Facilities in ... - SA HealthInfo

speciality services (Durkin, 2002; Friedman, Alexander, & D’Aunno, 1999). Findingsfrom this study tend to confirm this explanation with only 43.8% of facilities employing apsychologist and 18.8% of facilities with a psychiatrist on staff.4.2.2. Provision of ancillary health servicesIn comparison to the proportion of facilities providing core addiction and aftercareservices, a smaller proportion of facilities provide ancillary medical and health services.Although this is in keeping with findings from previous audits of substance abusetreatment facilities (Myers & Fakier, 2007; Myers, 2004; Myers & Parry, 2003), thesefindings are cause for concern as many substance-abusing individuals experiencesubstance-related health concerns. The provision of ancillary health services (of both apalliative and preventative nature) is thus an important aspect of quality substance abusetreatment (Friedman, Alexander, & D’Aunno, 1999).Similar to findings from previous studies, facilities are more likely to conduct medicalassessments than provide clients with substitution medication and/or detoxificationservices. More specifically, less than 40.0% of facilities provide clients with access tosubstitution medication - despite the evidence that substitution medication isinternationally acknowledged to be a useful tool for limiting the harms of substance abuseand for retaining clients in treatment. The provision of substitution medication is alsointernationally recognised as one of the key principles of effective substance abusetreatment (NIDA, 2006). Similarly, only 56.3% of facilities report providing clients withon-site detoxification services. The limited availability of these services within treatmentfacilities is cause for concern as treatment facilities that do not provide detoxificationservices often require clients to have completed a hospital-based detoxification prior toentering treatment. This acts as a barrier to treatment entry due to the scarcity ofhospital-based detoxification services (Myers, 2007).Findings also show that only a small proportion of facilities conduct interventions toreduce the health risks associated with continued substance use. For example, a quarterof the facilities test for and conduct interventions to reduce the risks of substance-relatedinfectious disease (such as hepatitis) or conduct interventions to reduce the health risksassociated with injection drug use. While the latter may be due to the fact that only a68