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Thursday 23 April 2009 – DAY FOUR –
Daily Update
– 3
The number of Thai military drug centres was on the rise – yet
no meaningful evaluation of them had been carried out, Karyn
Kaplan told delegates, while presenting her research on
compulsory drug treatment experiences of injecting drug
users in Bangkok.
With a team of trained peer researchers, Ms Kaplan had asked drug
users directly about their experiences. Despite Thailand's official policy
of treating drug users as 'patients instead of criminals', 32 per cent of
respondents had experienced compulsory drug treatment. More
tellingly, 96 per cent of those with a history of compulsory drug
treatment had injected during the week they had been interviewed for
the survey – 'an alarmingly high post treatment relapse rate' said Ms
Kaplan. 'The theory is that keeping them away from drugs as long as
possible solves the problem, but this is totally unrealistic,' she added.
The survey had revealed embedded stigma and brainwashing
about how people are supposed to behave – a 'yes I want to quit'
auto response from drug users. 'Compulsory treatment is certainly
not meeting its goal,' commented Ms Kaplan. 'Almost all go back to
using drugs, and sanctions expose them to exploitation and
substandard treatment.'
Apinum Aramrattna of Chiang Mai University, presenting research
at the same session, found very high rates of HIV infection from his
research with drug users and had looked at ways of using peer
intervention to promote risk reduction in social networks.
Researching at two locations, Chiang Mai and Philadelphia, he had
witnessed a substantial decline in risky injecting behaviour in both
locations and recommended more rigorous research on involving
drug users in behaviour change.
Dr Hannah Cooper reported on her work on syringe exchange
programmes (SEPs) in New York – a substantial eleven-year study
involving 42 health districts. Easy access to local SEP sites was
found to positively influence people's likelihood to attend, and had
resulted in injectors reporting that they were less likely to practise
unsafe injecting.
Ensuring a flow of sterile syringes to high arrest districts and
networks within those districts was equally important, said Dr
Cooper, alongside 'shifting funds from arrest and incarceration to
public health'.
The session's chair, Swarup Sarkar, emphasised the issue of
negative drug-related policing that had surfaced throughout the
presentations, and asked delegates to consider how the police's role
could be better defined in increasing harm reduction.
Research reveals physical and mental
barriers to harm reduction
Engage with us, parliamentarians urge NGOs
Civil society needs to think about how it
communicates with parliamentarians,
delegates at yesterday’s parliamentary
panel discussion on the decriminalisation
of drug use heard.
‘If you really want a change in the legal
status of drugs, the only people with a
mandate to change it are parliamentarians,’
said chair of Pakistan’s HIV/Aids parliament-
ary sub committee Dr Donya Aziz. ‘If you’re
not talking to them you’re not going to get
anywhere,’ she said. ‘You’re preaching to
the converted and telling each other what
you already know – you need to engage
with the countries that are hindering your
cause the most.’
Organisations also needed to make sure
they communicated in a language that
parliamentarians understood, she stressed. ‘If
you speak to parliamentarians about IDUs and
MSMs they won’t know what you’re talking
about.’ The situation in her country was further
complicated by its strong bureaucracy – a
legacy of British colonial rule – its proximity to
Afghanistan, and worsening security situation
and ongoing battles with extremists. ‘Social
issues tend to get left behind,’ she said.
Deputy speaker of the Indonesian
government’s upper house, Dr Laode Ida, said
that his country had more than 2m regular
drug users and about 40,000 people in prison
without access to treatment. Criminalisation of
drug users was not ‘human treatment’ he
acknowledged, but at the moment the
government and people of Indonesia would
not be willing to embrace decriminalisation
because of fears it would lead to an increase
in use. In the meantime the country would
focus on improving the quality and quantity of
rehabilitation facilities and improving collabora-
tion between government and NGOs, he said.
Cambodia’s prime minister had pledged to
‘extend a hand’ to drug users and treat them
as patients who needed help rather than
criminals, said Cambodian MP Dr Ouk Damry.
There was a need for an ‘enabling
environment – an appropriate legal structure
under which assertive harm reduction facilities
can be implemented.’
‘We know what we have to do but we need
your help,’ Thai senator Dr Pinit Kullavanijaya
told delegates. ‘We need reliable data and the
best evidence – then I can brainwash my
colleagues, in a nice way.’