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AWARENESS OF
OCCUPATIONAL THERAPY
ROLE IN DRUG
REHABILITATION AMONG
PROFESSIONALS AND IN
INDIVIDUALS WITH
SUBSTANCE USE DISORDER

COLLEGE OF REHABILITATION SCIENCES 

  DEPARTMENT OF OCCUPATIONAL
THERAPY

 HIBA KHAN 5-5/2018/009

HINA HAFEEZ 5-5/2018/005
NABEELA WALI 5-5/2018/002
SHARIN ROBBINSON 5-5/2018/12
DOT BATCH-I SEMESTER VIII (2021)
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 INTRODUCTION

• The Report also indicated that cocaine supply networks to

Europe are expanding, pushing costs down and standards up,
threatening Europe with future cocaine growing market. 
• COVID-19 has sparked development and adaptation in drug
diagnosis and care services through more adaptable service
delivery models. Due to the pandemic, several nations have
adopted or extended telemedicine services, which means that
healthcare personnel may now conduct counselling or early
evaluations over the phone and utilize computerized systems
to administer prohibited medications to drug users

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 • In Pakistan, heroin was not widely used until the 1980s, when it began to rise in popularity. In 2013, the Ministry
of Narcotics Control Pakistan and the United Nations Office on Drugs and Crime collaborated on a study on drug
usage in Pakistan. According to this data, cannabis is the most commonly used drug in Pakistan among those aged
15 to 64, while opiate usage is the least prevalent.
• The Drug Report (2021) also stated that cannabis potency has increased by up to four times in some parts of the
world in the last 24 years, while the number of youths who perceive the drug as harmful has decreased by up to
40%.

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 • Mental health rehabilitation is the most impacted sector, where an individual may leave the rehab centre symptomatically cured,
but reintegrating into society to resume his prior position remains an unfinished process. Social rehabilitation is frequently
overlooked, despite the fact that occupational therapy may play an important role in psychosocial adjustment from self to family,
family to community, and community to employment. 
• Clarey and Felstead (1990) wrote the first published article on the function of OT in SAR, a descriptive review in which they
classified OTs as team members with an uncertain professional position. They defined OTs' primary duty as aiding patients with
SUD during both the detoxification and rehabilitation stages by employing activities to enhance living skills for community re-
integration. 
• People who abuse or are addicted to substances state that "...occupational therapists play a significant role in the treatment in the
substance abuse rehabilitation process by facilitating clients to improve on work and social skills, create healthy habits and
routines, and start engaging in personal hobbies and experiences" 

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 PURPOSE

The purpose of the study is to identify the need, role and awareness of
occupational therapy among professionals and in individuals with substance
use disorder and to find the possible solution to maximize the number of
professionals and the extend of awareness among them.

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 HYPOTHESIS

• Awareness of occupational therapy role is significant in drug rehabilitation

among professionals and in individuals with substance use disorder.

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 MATERIALS AND METHODS

• STUDY SETTING: The data will be collected from different drug

rehabilitation centers in Karachi.
• STUDY DESIGN: Cross sectional study
• DURATION OF THE STUDY: 6 months after the approval of synopsis
• SAMPLING TECHNIQUE: Convenient sampling ( non probability)
• SAMPLE SIZE: The sample size for this study will be based on 50
participants.

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INCLUSION CRITERIA: All male and female participants with
Substance Used Disorder

EXCLUSION CRITERIA: Clients with severe mental illness

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 Continued

• DATA COLLECTION TOOL: Data will be collected from after signing

the consent from different drug rehab centers.
• DATA ANALYSIS STRATEGY: Data will be enter and analyze after the
completion on SPSS (Statistical Package Of Social Sciences)
• ETHICAL CONSIDERATION: Ethical consideration will be taken
through written and verbal consent form by the participant before starting
the data collection.

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Questionnaire: 
• Evaluating role competency and training for reintegration again in the community.
• Assisting individuals with SUD to participate in recreational activities.
• Assisting and providing vocational training for future employment when discharged. 
• To help individuals with SUD in finding different healthier ADL’s which distract them from involving again in previous patterns.
• To re-educated client for their ADL’s.
• To make them attend and participate in educational activities (trainings, workshops, webinars, seminars) on psychiatric and mental
health related to SAR.
• To make the client learn (techniques to conserve energy, pain management, building positive mindset, relaxation techniques)
• To support health and active participation of client with SUD making developing sleep-rest program.
• To link the concerned agencies and authorities to individuals with SUD and advocating their rights which would help support their
legal appearances.
• To promote ‘peer mentoring’ group strategies to make the client speak their heart out and express in front peers who are recovered.
• To promote physical exercises for health lifestyle and healthy physiological health during and after the time of recovery from SUD.
•  To link the individual with SUD to specific services like (psychiatrist or psychologist for assessment and psychotherapy.
•  To spread awareness in society about the effects, nature and consequences of drug and give possible education on this topic.13 To
educate the local community about the nature of addiction and its consequences.

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 • Educating families about addiction an it’s future setbacks.
• Building insight among the victims of SUD and awaring them about the consequences on sexual activities and
possible STDs.
• conducting researching which mainly focuses on improvising already present programs on psychiatric health.
• To conduct researches focused on improving programs in mental health and SAR.
• To assist clients with SUD in identifying alternative and healthier daily activities that do not involve drug use
and abuse.
• To advocate the human rights of clients with SUD by connecting them to agencies that can support their
legal representation.
• To collaborate with other health and social care professionals, e.g., psychiatrists, pharmacists, psychologists,
nurses, social workers, special educators, anthropologists, policemen.
• To evaluate and train job-related skills set for possible employment upon discharge.
• To facilitate self-management skills among clients (e.g., pain management, energy conservation, thinking
patterns, stress management, trauma care, and relaxation).
•  To educate family members about the nature of addiction and its consequences.
•  To collaborate with dentists for oral care and hygiene in relation to clients’ social and occupational goals.
• To assist clients with substance use disorder to engage in leisure pursuits (hobbies).
•  To assist clients with SUD to transition into school placements after discharge (high school, vocational, or
college education).
• To use body-mind treatment and mindfulness approaches (e.g., yoga meditation, food diet).
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• To assist in compensated work therapy program where clients can be provided part- or full-time employment during recovery. 
• To evaluate and train job-related skills set for possible employment upon discharge.
• To educate family members about the nature of addiction and its consequences.
•  To evaluate and adapt clients’ actual physical environment (home, school, work place, neighbourhood) and social environment (relationships
with family, peers, and coworkers) to promote controlled use or non-use of drugs.
• To provide “assertiveness training” in a group setting to train clients to state their own views and desires and act confidently in daily living and
social situations
• To assist clients with SUD in identifying alternative and healthier daily activities that do not involve drug use and abuse.
• To provide counselling through the use of motivational interviewing and storytelling to clients with SUD and family members.
• To advocate the human rights of clients with SUD by connecting them to agencies that can support their legal representation.
• To train for “home and community activities” (instrumental activities of daily living).
• 11 To assist clients with substance use disorder to engage in leisure pursuits (hobbies).
• To evaluate and provide management on motor skills, sensory skills, and cognitive skills.
• To facilitate self-management skills among clients (e.g., pain management, energy conservation, thinking patterns, stress management, trauma
care, and relaxation).
• To facilitate Asian-based activities to promote health, relaxation, and social interaction (e.g., qi gong, tai-chi). 
• To  facilitate “music therapy” where clients engage in active (creating sound or music) or receptive (listening to sound or music) musical
expressions to improve health  

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 PUBLIC HEALTH SIGNIFICANCE

• The study will be significant to identify OT role as perceived by health

authorities in the country, which may possibly explain to some extent why
OTs cannot secure jobs, develop practice, create research in SAR practice.

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 LITERATURE REVIEW

The need for occupational therapy in multidisciplinary team of

drug rehab can be analysed by reviewing the data of ANF (anti-narcotics
force), which states that about 7 million of Pakistanis are involved in taking
Drugs, amongst which 4 million use Cannabis while 2.7 million use Opioids.

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 According to POTA (Pakistan occupational therapy Association)
there are about 40 registered occupational therapists working in Pakistan. This
highlights a very surprising result that there’s only 1 occupational therapist for
100,000+ individuals with SUD in Pakistan, that too only if the therapist have the
potential and interest of working in Drug Rehabilitation Centre.

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 Occupational Therapy Intervention Areas (Webb, Shakeshaft, Sanson-Fisher, &
Harvard, 2009).

CBT(Challenge the distorted thinking that accompanies the addiction process)

Learn to avoid the drug-related sensory stimuli that can act as triggers for priming
and relapse
Build new roles, activities, habits, and routines that are not associated with past
substance use
Stress management
Acquire appropriate social skills that can replace maladaptive behaviors learned
from drug seeking and obtaining
Vocational training

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In SUD, OT facilitate occupational participation applies to all areas of occupation
(i.e., activities of daily living, instrumental activities of daily living, rest and sleep,
education, work, leisure, and social participation) (American Occupational
Therapy Association, 2014).
According to a research, OT interventions in addiction treatment are supportive to
reduce the harm associated with addictive behaviors in clients.
 OT appears to be a good fit within most addiction treatment settings and that
occupational therapy interventions are most supportive when intervention goes
beyond the teaching of skills, to prioritize occupational engagement. (Pauline
Boland and Deirdre Anne Ryan, 2021)
However, it was found that the adoption of new roles by occupational therapy
associated with advocacy and altruism facilitated the recovery process (Rawat,
Petzer and Gurayah, 2021).

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 1.  Sy, M.P., Ohshima, N. and Roraldo, M.P.N.R., 2018. The role of Filipino occupational therapists in substance
addiction and rehabilitation: A Q-methodology. Occupational Therapy in Mental Health, 34(4), pp.367-388. 

2,  Shahzadi, M. and Abbas, Q., Case Series.

3.  https://www.unodc.org/unodc/press/releases/2021/June/unodc-world-drug-report-2021_-pandemic-effects-
ramp-up-drug-risks--as-youth-underestimate-cannabis-dangers.html

REFERENC 4.  https://www.who.int/health-topics/drugs-psychoactive 

ES 5.  Darawsheh, W.B., 2018. Awareness and knowledge about occupational therapy in Jordan. Occupational
therapy international, 2018.

6.  https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-02-01-004_Final_508.pdf

7.  http://ojs.zu.edu.pk/ojs/index.php/pjr/article/view/713/2866

8.  http://anf.gov.pk/ddr_matrc.php
9. https://soar.usa.edu/cgi/viewcontent.cgi?article=1005&context=capstones

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9.  Gutman, S.A. (2006). Why Addiction Has a Chronic, Relapsing Course. The Neurobiology of Addiction. Occupational Therapy in Mental Health, 22(2), pp.1–29.

10.  Bell, T., Wegner, L., Blake, L., Jupp, L., Nyabenda, F. and Turner, T. (2015). Clients’ perceptions of an occupational therapy intervention at a substance use rehabilitation
centre in the Western Cape. South African Journal of Occupational Therapy, 45(2), pp.10–14.

11.  Rawat, H., Petzer, S.L. and Gurayah, T. (2021). Effects of Substance Use Disorder on Women’s Roles  and Occupational Participation. South African Journal of Occupational
Therapy,51(1), pp.54–62.

12.  Byrn, H., Davila, D., Green, S., Kendall, M., Larson, S. and Prentice, A. (2021). Adolescent Substance Use and Occupational Therapy Interventions: A Rapid Systematic
Review.

13.  Ryan, D.A. and Boland, P., 2021. A scoping review of occupational therapy interventions in the treatment of people with substance use disorders. Irish Journal of
Occupational Therapy.

14.  American Psychiatric Association (2013). DSM-5 TM. anf.gov.pk. (n.d.). ANF :: Quick Facts.

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 BUDGET

EQUIPMENTS/TEST REQUIREMENT COST TOTAL

Consent forms 500
Questionnaires/Scale 800
Miscellaneous 200
Total Budget 1500

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