The rapid spread of HIV/AIDS in Taiwan has forced the government to introduce the Methadone Maintenance Treatment (MMT) -- in use in Hong Kong for 30 years -- to help heroin addicts reduce or even put an end to their addiction.
The Taoyuan Mental Hospital in which I work is the first hospital in the country to offer this treatment. The program has been rewarded with good results, but some obstacles still need to be overcome.
Currently, 70 percent of HIV infections are acquired through heroin injection. So why are drug addicts still willing to take the risk of using heroin? The answer is simple: Addiction is hard to overcome by willpower alone.
Think about it: Those of you who crave a cup of coffee in the morning, how would you feel if you didn't get that life-giving cup? Similarly, will a lady with a closet full of brand-name purses remain unmoved when passing by yet another Louis Vuitton store?
It is really not easy to break a habit, let alone an addiction. We therefore hope that it will be possible to discuss the issue of heroin addiction from a perspective similar to that of treating chronic disorders.
In this way, heroin addicts will be given plenty of time for the methadone treatment while avoiding the time pressure that results from the myth that addiction can be eliminated as soon as it is treated.
The public has not yet reached a general consensus on the question of whether heroin addiction is an illness, but I believe no one opposes the provision of treatment for individual heroin addicts. The government initiated the MMT program in February to help drug addicts reduce their heroin use during treatment.
And I see the efficacy of MMT in the response from returning heroin addict outpatients. MMT lets them begin normal lives and become more capable of taking up routine jobs, which means that their lives no longer are centered around drugs. Their families are also happy and willing to accept them again. Clearly, MMT is effective in reducing the speed of the spread of HIV/AIDS.
The methadone treatment can control addictive behavior and reduce the frequency of HIV/AIDS infections from heroin injection. The public and the families of heroin addicts should not only encourage individual users to seek medical treatment, but also assist them by eliminating the obstacles that have prevented them from seeking out such treatment in the first place. One of the obstacles is that heroin addicts often regarded as criminals are as well as patients.
On the one hand, the patient-criminal status suggests that a heroin addict has the right to seek medical treatment. On the other hand, it serves as a warning sign suggesting that the person should be arrested and thrown in jail.
Given their criminal status, heroin addicts get defensive because they worry that they are being followed and watched even in the hospital. Under such circumstances, how could they feel safe and at ease when seeking treatment?
Meanwhile, according to current laws and regulations, the police also have a role to play.
Conditions have improved somewhat, as social workers and medical practitioners have communicated with the police about the issues involved.
As the nationwide implementation of MMT is nearing, we hope police intervention in health care will not be an obstacle.
Therefore, the most fundamental solution is to decriminalize drug use by addicts who do not sell drugs.
As a clinical health care worker, I frequently defend individuals addicted to alcohol, tobacco, the Internet, shopping and so on by saying that they still have their freedom of action despite the fact that their behaviors are not accepted by society. The question must be asked: Why is it necessary to label drug addicts as criminals?
Their condition should be looked upon from the perspective of addiction, rather than criminality. In this way, they will not have to be afraid of impromptu police inspections and throw away used needles that may be infected with the HIV/AIDS virus.
This would also prevent drug addicts from being afraid to buy drugs when the craving sets in and instead run the risk of sharing needles. This measure would make it easier to control HIV infection among heroin addicts.
Take this statistic: from June last year to June this year, 80 percent of HIV/AIDS patients were drug addicts. The question now is whether our society wants to see HIV/AIDS continue to spread because drug addicts are afraid of seeking treatment, or do we want to decriminalize drug use and return the issue to the health care system?
The second option would give us the opportunity to improve the drug addiction situation. It would also make it possible to keep the spread of HIV/AIDS from becoming uncontrollable.
Frankly speaking, it is high time that we give careful consideration to these urgent issues.
Lin Fang-fang is a social worker at the Department of Health's Taoyuan Mental Hospital.
Translated by Lin Ya-ti
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