THE LESSER EVIL

WITH a relapse rate as high as 70 per cent, it had become evident
very early in the longstanding war against the country's public enemy
number one that the regimen of cold turkey detoxification,
paramilitary discipline and counselling in Pusat Serenti had been a
less than smashing success.

However, in the absence of other proven methods, the strategy had
been to build even more rehab centres and incarcerate as many addicts
as possible.

But with some 250,000 addicts on the official register, and with drug
users making up 75 per cent of the 73,000 HIV-positive cases, the
point had been reached where there was a dire need for fresh
directions. As a result, over the last two years, we've explored
alternative methods of rehabilitation and experimented with
drug-substitution therapy.

While it is too early to tell, the results of this drug-substitution
method so far look promising. But like the "harm reduction"
programmes to contain the spread of HIV/AIDS, where drug users
exchange dirty needles for clean syringes and get free condoms, the
idea of treating drug addiction with drugs appears to have run into
some resistance.

While at least 2,000 of the 12,000 general practitioners in the
country are required, fewer than 500 have registered for the
drug-substitution programme. The "drug pusher" label that is said to
stick to those doctors who have no qualms about prescribing a patent
drug seems to indicate that this is somehow deemed unethical.
Although methadone and the other replacement drugs are admittedly
themselves addictive, since the results of the drug-substitution
therapy appear encouraging, this should put a whole new perspective
on whatever moral dilemma is raised. After all, many prescription or
over-the-counter drugs are addictive, or can become so if misused. In
a situation where methadone or other substitute drugs are being used
to address the addiction to psychotropic drugs such as heroin and
Ecstasy, they should perhaps be regarded as simply the lesser evil.

But the stigma apparently attached to drug-substitution therapy
within the medical fraternity speaks volumes about the bias and
prejudice that addicts face in their fight to kick the habit. They
are shunned by their families and ostracised by society when what
they need most is a lot of support and tender loving care.

We need to break down the medical, mental and social barriers
towards addiction if we are to make any progress towards a drugs-free
society.