REVIEWING AND SYNTHESIZING SYSTEMATIC KNOWLEDGE ON DRUG ADDICTION TREATMENT: COMPARATIVE INSIGHTS FROM PORTUGAL, THE NETHERLANDS, AND SWITZERLAND FOR APPLICATION IN THAILAND

Abstract

This research aims to: 1) systematically review and synthesize knowledge on drug addiction treatment measures in Portugal, the Netherlands, and Switzerland; 2) identify key factors contributing to the success and failure of such measures; and 3) analyze lessons and provide recommendations for application within the context of Thailand. The study focuses on Portugal’s decriminalization policy, alongside the harm reduction and integrated service approaches utilized in the Netherlands and Switzerland. The methodology involves a Systematic Literature Review and narrative synthesis, analyzing factors influencing the success of measures at the policy, service, and community levels. This includes an assessment of Thailand’s social and cultural treatment contexts compared against the Biopsychosocial Model and the Stages of Change theory. The study employed a Systematic Literature Review methodology following PRISMA standards. A total of 23 international academic documents and reports are retrieved and quality-appraised using CASP Checklists. The findings, categorized by objectives, are as follows: 1) The synthesis of international lessons revealed that the fundamental key to success was a paradigm shift from “punishment” to “public health-led” approaches, utilizing decriminalization and harm reduction as gateways to treatment. 2) Success factors include stable political support and low-threshold service accessibility, whereas failures often stem from top-down policies lacking continuity. and 3) The application in Thailand leads to the synthesis of a novel conceptual framework, the “PHS Model,” which consists of three pillars: P (Public Health First), H (Holistic Care), and S (Social Integration). The model emphasizes decentralization to local authorities and the establishment of comprehensive sub-district rehabilitation centers to sustainably reduce recidivism. This study provides significant policy implications for fostering treatment systems that restore human dignity to patients.