Assessment of the work of municipal substance abuse centers

Substance-addiction and its consequences, unlike many diseases that negatively affect human health, do not only affect the substance addict. Substance dependence is a public health issue and a social fact that affects every layer of the society. For this reason, only individual treatment of substance users is not sufficient to solve the problem. State policies to reduce the use of drugs and preventive measures are at least as important as treatment. Researches clearly show that there has been a marked increase in substance use rates in our country and in the world in recent years. In line with this increase, there has also been a need to increase treatment and rehabilitation services. However, it is not possible for a single public hospital to respond to this need, depending on many different reasons. The bed capacities of the AMATEM clinics of the hospitals affiliated to the Ministry of Health can not meet the need for treatment. The number of qualified professionals to work on the field is insufficient. Private substance addiction clinics are not preferred by all segments of society because of costly treatments. The municipalities are public institutions that citizens can access most easily because they are institutions that serve at the local level. The functions of the municipalities are not limited to physical arrangements such as reconstruction, infrastructure, transportation, and logistics. Especially the recent concept of social municipality expresses that municipalities are obliged to carry out preventive, rehabilitative services in social problem areas. The municipalities are also likely to play a key role in support of treatment and rehabilitation services, especially in the coming years, in the matter of drug addiction. It is not possible to establish a clinic that does hospitalization and medical treatment because of its cost, especially for small-scale municipalities. However, the substance abuse treatment process includes psychosocial support programs as well as medical treatment. The aim of this study is to evaluate the treatment and rehabilitation services of substance dependence which is being carried out at the level of local governments developing in our country in recent years. Qualitative research method has been used in this research to suit the purpose of the study. A total of 11 centers providing daytime services during the time that the research is conducted constituted the universe of the research. Since two of these centers did not agree to participate in the survey, the study group consisted of 9 centers and a total of 16 personnel working in these 9 centers. The data of the study were collected from December 20, 2016 to January 15, 2017 through semi-structured, in-depth interviews. Verbal consent was obtained from each participant before the interviews. All of the participants approved the voice recording. After the voice recordings were transferred to the computer environment, they were read by three different people –one of whom is a social worker- using the return reading method and the themes were created by subjecting the data to content analysis. The findings of the research are presented in two main themes.The first part contains data on what the municipal services are in the field of substance abuse. In the second part, employees'evaluations of services provided at the center are included. As the themes pointed out, the opinions of the interviewed professionals regarding their personal perceptions about the field, the evaluations of the services provided and the evaluations carried out at the level of local government were emerged as the theme. Substance dependence is a field where treatment and rehabilitation are difficult. Yet, in this field, it seems that the centers opened by local governments do not have a certain physical and service standard. Because centers are affiliated to local governments, it has been determined that occupational employees sometimes face political pressure while giving service. However, participants stated that the provision of these services in local governments is important because of the limited availability of drug addiction services in the country. In this respect, it has been suggested that the advantages of local government services are more than disadvantages. It has been also suggested that as the process of treatment of substance abuse is long and comprehensive, it is necessary to carry out medical treatment and social rehabilitation together. Participants also stated that they are experiencing high job satisfaction, but they are not satisfied with the low wage policies that local governments apply. It is seen that social workers are not employed at any of these centers.However, in terms of its reasons and results, substance dependence is a field where the functions of social service are important. This research is expected to shed light on studies to develop drug addiction treatment and rehabilitation service model to be formed at the level of local administrations. Key words: Substance dependence, local government, social work