HARM REDUCTION: PART II: NEED FOR MORE REALISTIC, COMPASSIONATE PUBLIC

According to Octavery "Very" Kamil, head of the Injecting Drug Users
Intervention Unit at Aksi Stop AIDS! (ASA) of Family Health
International-Jakarta, a major challenge in the battle against the
negative health and societal problems of drug abuse is the heavy
stigma placed on users of any kind of illegal drug -- when in fact
there are many different kinds of drugs, some of which are more
likely to lead to addiction and other problems.

The National Police campaign, which uses slogans implying that any
use of any kind of drug will ruin one's life, is neither accurate nor
effective, according to Very.

For example, Very relates an interview with an injecting drug user
(IDU): "In 2000, (the user) had already seen ads and posters about
(the National Police campaign). But he had already tried ganja
(marijuana) and ecstasy by then and felt no addiction or problem, so
he didn't believe the message. So then he tried heroin, and
eventually became an addict."

The issue of drug abuse thus concerns both the availability of the
drugs and the dissemination of incomplete or inaccurate public
education messages.

Asked for a better, alternative message, Very replied: "What is
addiction? It doesn't happen in a moment. It's a process."

More realistic information is the key -- and people need to know
about the different types of drugs available.

Heroin and shabu-shabu (methamphetamine), Very says, were more likely
to leave one with withdrawal symptoms, and thus more likely to lead
to addiction and associated problems. This includes HIV infection,
due to the tendency to use these drugs by injection to get a faster
and more cost-efficient hit.

Very suggested that more efficient approaches might include "life
skills education" programs at schools or in youth groups that teach
young people skills for making better decisions in life.

Overall, he says, drug prevention programs (the demand reduction side
of the equation) in Indonesia are generally still weak. While some
very good programs exist, including those implemented by Yayasan
Cinta Anak Bangsa (YCAB) and Yayasan Kita (Yakita), their reach is
not yet broad enough.

"Drug education for students and young people is important," he said,
"but it must be non-stigmatizing, and it must not ignore the fact
that many high school students have already used drugs."

A 2002 behavioral survey among high school students in Jakarta,
implemented by the Health Ministry with technical and financial
support from the ASA, reported that 34.2 percent of boys and 6.3
percent of girls had never used any drugs, while 2.5 percent and 0.6
percent, respectively, reported use by injecting. Surprisingly,
alcohol use was lower, at 29.8 percent and 4.3 percent, respectively.

Very is emphatic that, despite campaign messages implying that anyone
who tries drugs has ruined their life, "We must not give up on those
people". Information must be given to young people about what to do
if a friend or sibling is using and needs help.

He added that while in the United States, the old "Just Say No!"
approach to drug education had been replaced by a more moderate
"Safety First" approach, Indonesia's approach was still largely
modeled on "Just Say No!".

Determining the success rate of supply reduction and demand reduction
efforts here is difficult, since various indicators can be used to
judge this. According to Very, however, these efforts are still very minimal.

"The fact is, drugs are still a big problem in Indonesia. Actually,
internationally this is also the case," he said. "As yet, there has
been no mainstream global policy on drugs that has demonstrated success."

It thus seems clear that harm reduction is an important and necessary
component of efforts to tackle both the problem of drug abuse and the
HIV/AIDS epidemic.

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MORE INFORMATION AND HELP

* Family Health International (FHI) www.fhi.org

* National Narcotics Agency (Badan Narkotika Nasional) www.bnn.go.id

* Komunitas AIDS Indonesia www.aids-ina.org

* Yayasan Cinta Anak Bangsa (YCAB) www.ycab.org Hotline:
0-800-1-NO-DRUG (663784)

* Yayasan Harapan Permata Hati Kita (Yakita) www.yakita.or.id

Hotlines: Jabodetabek (0251) 243069, 243077; Aceh (0651) 23213; Bali
(0361) 465203; Bogor (women's center) (0251) 244375; Kupang (0380)
821425; Makassar (0411) 873658; Surabaya (031) 5039228