2 research outputs found
Kekambuhan pada Pasien Penyalahguna Narkotika, Psikotropika, Zat Adiktif (Napza) Pasca Rehabilitasi: Kebijakan dan Program Penanggulangan
Abstract
Narcotics, Psychotropic, and Addictive Substance Abuse (NAPZA) is a problem in Indonesia, one of the consequences is relapse. Relapse is a process where someone has been declared abstinence (recovered) and returns to using drugs. Relapse rates also still high in some countries. Drug users experience a relapse between one month to one year after leaving the treatment program. The aim of this research was to find out the policies and programs related to handling of NAPZA relapse in rehabilitation centers. The study design was cross sectional with qualitative study by conducting round table discussion (RTD) with stakeholders from the National Narcotics Agency (BNN), Drug and Food Control Agency (BPOM), Directorate for Prevention and Control of Mental Health and Drug Problems Ministry of Health, Drug Addiction Hospital, psychiatric practioners, volunteers, and confirmation to the rehabilitation center. The results of study showed that there was no national minimum standard for handling NAPZA relapse. The various relapse definition caused differences in relapse rates. Relapse rate according to Directorate Mental Health and NAPZA of the Ministry of Health in 2018 was 24.3% as rough figures (claim data). NAPZA relapse rates in the National Narcotics Agency, prior to the post rehabilitation program, was 90%, and decreasing to 30% after conducting post-rehabilitation program. While relapse rate in Rehabilitation and Therapy House, Lido Bogor was around 7%. There is no national standard for how many times a drug user is considered a victim or categorized as criminal action. In conclusion, there is Ministries/institutions of egocentrism in handling NAPZA relapse. Ministry of Health emphasizes medical rehabilitation, Ministry of Social emphasizes social rehabilitation, while BNN more comprehensively covering medical rehabilitation, social rehabilitation, and post rehabilitation. Narcotics, psychotropic, and comprehensive precursor control is carried out by the BPOM comprehensively, from imports, production, distribution, delivery and the use. The existence of E-NAPZA, administrative sanctions and criminal sanctions will reduce illicit trafficking and drug abuse. Indonesian Presidential Instruction No. 6 of 2018 concerning the National Action Plan for the Prevention of Eradication of drug abuse and Circulation (P4GN), in ministries/institutions is expected to decrease the number of NAPZA relapse.
Abstrak
Penyalahgunaan Narkotika, Psikotropika, dan Zat Adiktif (NAPZA) merupakan masalah di Indonesia yang salah satu akibatnya yaitu kekambuhan (relapse). Relapse merupakan suatu proses dimana seseorang telah dinyatakan abstinence (pulih) dan kembali menggunakan NAPZA. Angka relapse masih tinggi di beberapa negara. Pengguna NAPZA mengalami kekambuhan antara satu bulan sampai dengan satu tahun setelah keluar dari program pengobatan. Tujuan penelitian adalah untuk mengetahui kebijakan dan program yang terkait dengan penanggulangan relapse NAPZA di panti rehabilitasi. Desain penelitian berupa cross sectional dan studi kualitatif melalui round table discussion (RTD) dengan para pemangku kepentingan yaitu Badan Narkotika Nasional (BNN), Badan Pengawasan Obat dan Makanan (BPOM), Direktorat Pencegahan dan Pengendalian Masalah Kesehatan Jiwa dan NAPZA Kementerian Kesehatan, Rumah Sakit Ketergantungan Obat (RSKO), praktisi kejiwaan, dan relawan, serta konfirmasi ke panti rehabilitasi. Hasil penelitian yang diperoleh menunjukkan belum ada standar minimal nasional untuk penanganan relapse NAPZA. Definisi relapse yang beragam menyebabkan perbedaan angka relapse. Angka relapse di Direktorat Jiwa dan NAPZA Kementerian Kesehatan tahun 2018 yaitu 24,3% sebagai angka kasar (data klaim). Angka relapse NAPZA di BNN sebelum adanya program pasca rehabilitasi yaitu 90% dan setelah ada program pasca rehabilitasi menjadi 30%. Angka relapse di UPT Rumah Rehabilitasi dan Terapi NAPZA, Lido Bogor sekitar 7%. Belum ada standar secara nasional sampai berapa kali seorang penyalahguna NAPZA dianggap sebagai korban atau masuk kategori tindakan pidana. Kesimpulan penelitian menunjukkan adanya egosentrisme di masing-masing kementerian/lembaga dalam melakukan kebijakan penanganan penyalahgunaan NAPZA. Kebijakan Kementerian Kesehatan lebih menekankan pada rehabilitasi medis, Kementerian Sosial menekankan pada rehabilitasi sosial, sedangkan kebijakan BNN lebih komprehensif meliputi rehabilitasi medis, rehabilitasi sosial, dan pasca rehabilitasi. Pengawasan narkotika, psikotropika, dan prekusor komprehensif dilakukan oleh BPOM, mulai dari hulu sampai hilir yaitu dari impor, produksi, penyaluran, penyerahan, dan penggunaan. Aadanya aplikasi E-NAPZA serta sanksi administratif dan pidana dapat mengurangi peredaran gelap dan penyalahgunaan NAPZA. Melalui Instruksi Presiden Republik Indonesia No. 6 Tahun 2018 tentang Rencana Aksi Nasional Pencegahan Pemberantasan Penyalahgunaan dan Peredaran NAPZA dan Prekusor (P4GN) di kementerian/lembaga diharapkan membantu menurunkan angka relapse NAPZA
Efek Ekstrak Campuran Kulit Batang Pulai (Alstonia scholaris) dan Meniran (Phyllanthus niruri) pada Mencit Swiss Webster yang Diinfeksi Plasmodium berghei
Pulai and meniran is one of the medicinal plants that have been studied as a possible antimalarial drugs. This study aims to evaluate the antimalarial activity of a mixture of pulai bark and meniran extracts as antimalarial drugs. Acute toxicity tests was performed using male and female Wistar rats each 25 animals with four doses of treatment. Antimalarial test using 72 mice were divided into six dose groups: group CMC, DHP, dose mixture of 1330; 443.34; 147.78 mg/kg bw and doses of pulai groups 1330 mg /kg bw. All the mice were infected with Plasmodium berghei (D0) and given the extracts orally for 14 days. Giemsa blood stainning taken on days D1-D7 and D14 were analyzed for percentage of parasitaemia, lymphocytes, monocytes and granulocytes. Results of acute toxicity test (LD50) values obtained from extract mixture was more than 14285 mg/kg bw, are classified as non-toxic materials. The most effective dose of the test antimalarial obtained from the percentage of parasites reducing and leukocytes differential, was 147.78 mg/kg. A mixture of pulai bark and meniran extract can be considered to be used as an alternative drug in the treatment of malaria. Further research is needed to isolate and characterized the active ingredients which have the effect of antimalarial to be recommended as an antimalarial drug in the future