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"Old syringes for new"
The
Star (www.thestar.com.my)
(15/07/05)
WHEN a drug dependent is desperate for a fix,
the last thing on his mind is taking a bus to a clinic and getting a clean
needle.
Drug dependents and those undergoing rehabilitation who were interviewed
said they welcomed the Government’s move in offering needles and condoms to
drug dependents. However, they felt that the effort would be futile if the
clinics involved were not easily accessible.
“Those who are desperate for a fix do not care about getting infected. All
they can think about is getting their fix. They want everything instantly,”
said a former drug dependent who wants to be known as Raja.
“For the programme to succeed, the needle exchange centre will have to be
near them,” said Raja, 52, who is now undergoing rehabilitation.
“The place should also be inconspicuous so that the public does not bother
us,” said Nik Idris Nik Abdullah, 37, who used to share needles but has
since changed to “chasing the dragon” (smoking ice or heroin in powder form)
because of the risk of HIV/AIDS.
“It’s best if we have a quiet place to exchange the syringes so that we can
have some privacy. We are ashamed to be seen. The clinic is a good place,”
said Norhisham, a bus driver who has been smoking as well as injecting
heroin for the last 20 years.
“The needle and condom distribution programme is good because some drug
users share needles and do not tell others that they are HIV+,” said
Norhisham, 42.
He added that drug users feared getting caught by the police. However, the
Health Ministry has given an assurance that this will not happen, to make
provisions for the programme to work.
“Hopefully that’s the case,” said Norhisham who buys his own needles and
does not share them with anyone.
“Those who are on drugs are likely to continue their habit,” said Alim, 35,
who has been on drugs for more than 10 years. “Those who do not like to
share needles will be able to get clean needles. Syringes should be given
out in many places. After all, one can buy them easily from shops and
pharmacies,” said Alim who works in a warung.
N.C. Chong, 37, who is undergoing rehabilitation, said that syringes should
be given out only in clinics.
“If they are given freely on the streets, it may appear morally unacceptable
in our society,” said Chong, a drug-dependent for 22 years.
E.H. Ng, 37, who has been using drugs for 15 years until recently, pointed
out that if needles were distributed on the streets, non-drug users might
take them too.
USUALLY, when a drug user does not have a syringe or new needle, he will
just walk into an alley and join others who are there for a fix. They would
flush the syringe with hot water if they can get any, if not, just with tap
water.
Syringes are easily available from shops and pharmacies although it is an
offence to carry one around. It costs only RM1.50 a syringe. If only the
needle is changed, it costs 70 sen. The needle has to be changed after two
days when it becomes blunt. Most drug dependents inject their arms or necks.
On the use of methadone in the drug substitution therapy, Richard Lee, a
former drug dependent said that he took the pill form for two weeks many
years ago but it did not work for him.
“There was no kick, and I went back to drugs,” said Lee who now runs a
rehabilitation centre.
He said what worked for him was going cold turkey and receiving counselling.
A former drug dependent who would like to be known as Thomas said that
methadone is only a temporary solution. If taken long term, a drug dependent
can get hooked.
“I know of a guy who was given methadone. Later he stopped taking methadone
and became an alcoholic. Taking methadone did not solve his addiction
problem,” said Thomas.
C.M. Wong, 41, who is undergoing rehabilitation after 20 years on drugs,
said the Government’s solution is like giving drug dependents the licence to
continue with drugs. “They all know that drugs will lead them to death. They
just don’t know how to get out of it. There must be more constructive ways
to help them get out of drugs.”
Nik Idris said the government should help former dependents to find jobs to
help them stay away from drugs.
“We should try to get them into homes and give up drugs,” said Raja. “If
there are no drugs, no syringes will be needed. Change has to come from the
inside – the anger, rebellion and addiction have to be dealt with. Turning
to God is the only choice I have. Drug addiction is a spiritual problem and
it cannot be handled by man alone.”
LEE, who also helps distribute food to street people, said that besides
having drop-in centres that are within the reach of drug dependents, the
Government should also work with NGOs that deal with drug dependents.
“We often go to the streets and we know who the addicts are, so the needles
will not fall into the wrong hands. When we give, we also counsel them and
give them a number to call if ever they are ready for rehabilitation,” said
Lee.
Pax Tan, senior director of the Prison Services, AIDS & Drug Rehabilitation
department at Malaysian Care, said the needle exchange and condom
distribution programme was only a short-term plan. It would not solve the
problem in the long run.
“It is only a means to an end. It’s basically to prevent the virus from
spreading to the drug community and the community at large,” said Tan.
Tan said that methadone does not address the addiction problem. If taken
long-term without proper supervision, drug dependents can become addicted.
“Drug therapy must be used in tandem with counselling. The therapy is only a
stop-gap measure to stabilise a drug dependent and enable him to make a
better decision about overcoming addiction.”
He said methadone had been used in Malaysia in the past on some drug
dependents and incidents of relapse were high due to the lack of follow-up
care.
“Will there be enough doctors to follow up on those who are on therapy? If
it is done without any after-care, it can lead to methadone addiction. Drug
addiction, like any other addiction, is not just a medical problem but also
a psycho-emotional and spiritual problem. We need to look into the deeper
needs of drug dependents,” said Tan.
In some countries, distribution of syringes and condoms has become a
long-term solution and little emphasis is put on achieving abstinence
because it is seen as unachievable.
“This is not good. Abstinence must be the ultimate goal in all therapies,”
said Tan.
Notes: STF -: LOH FOON FONG goes to the streets to find out from drug
dependents and those undergoing rehabilitation, whether they will come
forward for the needle exchange and condom distribution programme announced
by the Government to curb the spread of HIV/AIDS.
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