To open a door for people addicted to heroin, the National Bureau of Controlled Drugs yesterday announced that it was embarking on a buprenorphine maintenance program which will treat heroin addicts as patients, not criminals.
"Buprenorphine represents a major step forward in the treatment of heroin addiction," the bureau's director-general Li Jih-heng (
The program will wean addicts off heroin with buprenorphine, a less addictive opiate. As of next year, patients who qualify for the program will receive counseling and psychological therapy in addition to being weaned off heroin with buprenorphine.
"We offer buprenorphine, you [people with heroin addiction] come in to kick the habit," Lee said.
The program "allows society to view drug addiction as a chronic, relapsing and treatable disease. It allows physicians to treat people who have the disease in the same way that people are treated for other chronic illnesses, such as diabetes or high blood pressure," Lee said.
According to Article 21 of the Statute for Narcotics Hazard Control (毒品危害防治條例), people who consume heroin will not be prosecuted if they opt to enter rehabilitation centers or hospitals authorized by the Department of Health. Under the law, which was passed in 1998, drug users in Taiwan are treated as "patient-criminals."
"The concept of a `patient-criminal' is a compromise between the Singapore-style, iron-fisted judicial clampdown on drug addicts and the European, progressive gesture toward a decriminalization of drug use," Lee said.
Referring to the US' experience with buprenorphine treatment, health officials said that patients stabilized on adequate, sustained dosages of buprenorphine can function normally.
"They will be able to hold jobs and avoid the crime and violence of the street culture," Lee said.
The program itself is a primary harm-reduction service, according to health officials. Apart from reintegrating former heroin addicts into society, the program is also geared toward curbing the spread of HIV/AIDS. Over the past two years, the spread of HIV has quickened among drug users. While 66 people were reportedly infected with HIV due to sharing needles last year, the figure soared to 248 by October, according to statistics from the Center for Disease Control.
The Department of Health is set to recruit hospitals and rehabilitation centers to study the program's viability and to evaluate the cost-effectiveness of buprenorphine.
Lee quoted a US government survey that said it costs from US$2,000 to US$4,000 per person for an annual methadone maintenance treatment.
"The price will be high," Lee said, "but the social cost for not implementing it will be higher."
Buprenorphine, like methadone, can prevent heroin withdrawal symptoms and help reduce cravings in people dependent on heroin. Due to its milder toxicity, buprenorphine is 10 times more expensive than methadone in the pharmaceutical market. The US Food and Drug Administration approved buprenorphine in 2002.
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