Pubdate: Sat, 24 Mar 2007
Source: New Straits Times (Malaysia)
Copyright: 2007 NST Online
Contact:  http://www.nst.com.my/
Details: http://www.mapinc.org/media/3734
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

SPOTLIGHT : A SHOT IN THE ARM...OR A HEADACHE FOR THE LAW?

The Positive

THE "harm reduction" pilot programme introduced in 2005 for 
intravenous dadah users is a resounding success, at least as far as 
the Health Ministry is concerned.

Deputy director-general of Health Datuk Dr Ramlee Rahmat said the 
majority of the addicts involved in the pilot project had kicked the habit.

He said the ministry will start recruiting more addicts in new areas.

He said the ministry had an understanding with the police and the 
anti-drug agency on the expansion of the programme and on areas which 
will be out of bounds to raiding parties when the programme is on. 
The ministry will, however, not stop the police from arresting 
addicts involved in the programme caught in criminal activities or 
dadah abuse outside the programme area.

"The police have their duty to arrest those who are a threat to 
national security."

The primary thrust of harm reduction is a combination of dadah 
substitution therapy using methadone and a needle and syringe 
exchange programme.

The idea of addicts returning used needles is to prevent the spread 
of HIV/AIDS through contamination.

The ministry's needle exchange programme manager Datuk Dr Faisal 
Ibrahim said all addicts in the programme received counselling to 
ensure they did not return to the habit or share needles.

Some 100-odd addicts in the needle exchange programme have since 
decided to switch to methadone.

"Our aim is to make sure they fully understand the programme and not 
violate the rules and regulations stipulated to them."

He said a meeting was held bimonthly between the stakeholders 
including the police to get feedback on the situation. According to 
World Health Organisation figures, the success rate of harm reduction 
programmes is usually around 70 per cent.

Dr Faisal said there were some 1,200 dadah addicts involved in the 
needle exchange programme in Johor, Penang and Kuala Lumpur.

"Feedback showed that 60 per cent of those who participated in the 
needle exchange programme returned used needles. This is good."

On addicts switching to methadone, he said this was a clear sign that 
the harm reduction programme had achieved its objectives.

The Negative

Police feel the "harm reduction" programme has given them a headache.

Bukit Aman Anti-Narcotics director Datuk Abang Abdul Wahab Abang 
Julai said the police had to release hundreds of dadah users back to 
the streets as they were protected under the programme. "We have to 
close an eye in the matter although they should by right be arrested. 
But since it is a government initiative, we have backed the 
government 100 per cent."

Abang Abdul Wahab said he had completed a paper for submission to the 
government on the dadah problem and ways to curb the menace.

"There is a lot of money allocated to curb this problem but the money 
should be used wisely."

He said First World countries practised the needle and syringe 
exchange progra-mme (NSEP) but were governed by the Dangerous Drugs 
Act like in Malaysia.

"In Australia, drug addicts are told to come to centres where a 
medical assistant administers the drug into the addict using a new 
needle and syringe."

Abang Abdul Wahab said this was good as addicts could not go back to 
the streets to share the new needles and syringes with their friends 
or even sell them.

In February last year, the government started distributing free 
syringes in exchange for used ones and condoms to dadah addicts in 
Kuala Lumpur, Johor and Penang.

The cabinet allocated RM100 million over five years on top of the 
RM40 million annual allocation for the "harm reduction" programme 
which includes NSEP and the methadone programme.

A total of 100 paramedics have also been trained at a cost of 
RM600,000 to counsel and administer anti-retroviral drugs to patients.
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MAP posted-by: Beth Wehrman