Saturday, November 22, 2008, 10.53 PM
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Saturday, November 22, 2008, 10.53 PM |
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He was hardly recognisable.
The year before he had been a chubby 15-year old with a middle parting.
Something was clearly amiss, I thought, as he sat in a corner by himself instead of talking to us.
He was sullen, withdrawn, and gaunt.
Later that night my distraught aunt broke the news to us.
He had been smoking heroin for the past year and was barely attending school.
My aunt and uncle had tried almost everything -- punishment, pleading, praying.
He was insistent that he had his drug use under control.
Over the next few days, the adults called contacts who might be able to help, enquired about rehabilitation facilities and offered monetary support.
After an emotional shouting match with his parents, my cousin reluctantly agreed to enter treatment.
Today he is a liberal arts student at a public university in Australia and is now glad that his parents intervened before he had progressed to injecting the drug.
Treatment gave him a window of opportunity to turn his life around. And he did.
Four years ago, I learned two things: that there is no such thing as a "typical" drug addict and that treatment works.
Society is rife with stereotypes about drug addicts.
These can oversimplify a problem and make us feel superior to the person or group being stereotyped.
A study last year by the Malaysian Crime Prevention Foundation revealed that 91per cent of new drug addicts registered in Malaysia are those who have jobs, some even in managerial positions.
The statistics also indicated that many 13 to 15-year-olds are trying drugs for the first time and that 71 per cent of new drug addicts are youths aged between 19 and 39.
Slowly, we are waking up to the fact that drug addiction is no longer a problem of the degenerate or unemployed.
Some people may be operating machinery and driving our buses and trains while high.
The drugs abused are no longer just heroin or marijuana.
The newer generation of drugs has taken the shape and form of capsules that resemble anything you can get at the neighbourhood pharmacy.
In just one gulp, these pills are capable of delivering hours of delirium and with the same blow, irreversible brain damage.
Parents are now realising that the threat of drug use among the youth is very real, and is probably here to stay.
For years, drug addiction was mainly treated as a law enforcement issue. But in view of alarming relapse rates of over 70 per cent at correctional institutions as well as the steady rise in the number of detected addicts and HIV-positive cases through intravenous drug use, the government made a bold policy shift at the start of 2005 to introduce harm reduction measures and to pilot a treatment programme under the purview of the Health Ministry.
A new frontier was opened to the medical community and we began to see a paradigm shift away from "catch and lock up" to a treatment-based approach.
There are now signs that drug addiction in this country is trending downwards.
The latest figures from the World Drug Report show a "strong decline" in the use of heroin, one of the world's deadliest drugs.
According to the National Drug Agency, the number of new addicts and repeat offenders dropped by 37 percent in the first half of last year compared to the first half of 2006.
Meanwhile, treatment demand, as expressed in the number of drug users seeking treatment at private clinics, increased by 65 per cent from 2006 to 2007, in part due to increased accessibility of treatment facilities coupled with enhanced awareness among the public and improved data collection.
Yet our ability to contain the drug problem is far from assured.
Making treatment work is not simply a matter of ensuring that substitute medications are available.
Flooding the market with these medications without adequate control mechanisms may end up hampering efforts to move existing and emerging treatment programmes to the next level and may hurt the credibility of those charged with administering them.
Perhaps the biggest barrier to treatment efficacy lies in the fact that the treatment community in Malaysia, still in its infancy, is currently a loose conglomeration of non-governmental organisations, social workers, counsellors and doctors, and linkages between these disparate groups are weak.
Currently, many community-based treatment programmes are well meaning in their objectives but suffer from
under-funding, under-capacity, and a lack of clinical research support.
To keep our streets safe in the longer term, public health, the first principle of drug control, should be made the first line of defence.
We need to close the gap between those needing treatment for their addiction and those who actually receive help.
National strategies must integrate treatment into mainstream public health and social services. It begins with treatment programmes that are effective, backed up by adequate funding and resources within a strong institutional framework.
The current law stipulates that to be an addict is already a crime.
In the absence of a comprehensive, coherent national drug policy that allows drug users to seek treatment without fear of incarceration, the treatment community will continuously fall short of its commitment to bring hope to thousands of Malaysians who at various stages of life, and under different circumstances, become entangled in the web of drug addiction.
To improve the treatment of drug addiction and to bring drug users back into the fold, our emphasis should be on early detection and prevention.
The battle against drug addiction will increasingly be won or lost in our schools.
We must educate our children to make smart choices for themselves.
Our teachers need to be able to understand the tell-tale signs that a student may be experimenting with drugs and, more importantly, know whom to turn to for help.
We also need to find fresh and better ways to reach out to drug users, to facilitate early treatment and to prevent people from becoming marginalised.
Intravenous drug users constitute the vast majority of HIV-positive cases in this country, and vigorous intervention is needed to prevent the spread of disease through drug use.
Counseling, behaviour therapy and religious support are critical components of effective treatment for addiction, which we need to address comprehensively.
Many individuals are drawn to drugs because of underlying psychological or social problems, and long-term recovery hinges on equipping them with the knowledge and skills to replace drug-using activities with constructive and rewarding activities.
One important principle of effective treatment is that no single treatment is appropriate for all individuals.
At the moment, available treatment facilities do not have differentiated and targeted treatment strategies and settings.
For example, a centre geared to treat heroin usually is ill prepared to treat the abuse of amphetamine-type stimulants or alcohol.
More attention needs to be made to treating all forms of addiction.
Ultimately, real progress will be made when we are able to engage families, employers, the criminal justice system, the media and civil society. Drug abuse can be prevented but there are no short cuts.
We need to get serious about treatment, understand what measures actually discourage drug abuse and which are just band-aids, and invest in research that will help us tell the difference.
We have made a good start. Now let's make it better.
The writer is with the United Nations Development Programme and can be reached at lilei.chow@undp.org. Opinions expressed in this article are the personal views of the writer
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