Efficacy of the treatment program for substance use disorder under the Medical Treatment and Supervision Act in Japan

In Japan, the Medical Treatment and Supervision Act (MTSA) has been in effect since 2005 as a new system for treating mentally disordered offenders. This system was anticipated to aim at treating schizophrenia, while preparing no treatment programs for Substance use disorder (SUD). However, unexpectedly 30% of the inpatients, who a court judged to be treated in this system, have co-occurring SUD in addition to mental disorders. This is the reason why we have provided the inpatients under the MTSA with the treatment program for SUD (TPSUD). The purpose of the present study is to evaluate efficacies of the TPSUD provided in the MTS Award of the Center Hospital, National Center of Neurology and Psychiatry. Subjects were the 15 inpatients admitting to this ward, who participated in had the TPSUD due to co-occurrence of SUD. A self-reporting questionnaire, which consisted of the Self-Efficacy Scale for Drug Dependence (SESDD), and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), and some clinical information, was administered before and after the program. Consequently, the subscale score of the SOCRATES, "recognition," was significantly elevated after the TPSUD in alcohol related problems, while the subscale score of the SESDD, "global change of self-efficacy for drug dependence," was significantly elevated in drug-related problems. Additionally, either rate of the subjects who started to the anti-alcohol drugs or who manifested to participate in self-help groups for SUD was also significantly elevated. Our findings suggest that the TPSUD may be effective to SUD which co-occur in mentally disordered offenders, and that this program may involve some clinical implication in forensic psychiatry practices under the MTSA. Language: ja