TREATMENT A LIFELINE FOR HEROIN VICTIMS

When he decided to put his past as a drug addict behind him, Zhao started
an MMT course in a clinic in Gejiu, Southwest China's Yunnan Province.

Every day, hundreds of addicts take the prescribed drug methadone - a
synthetic opiate - which is used at the clinic as a maintenance treatment
for heroin addiction.

Feeling reborn after his painstaking struggle, Zhao, in his 30s, now works
as a volunteer counsellor at the clinic to help others recover and lead a
meaningful life. It is said that once a methadone patient has successfully
shaken heroin, their appearance and lifestyle can return to normal.

Zhao is one of the success stories and he is assisted by two other
counsellors at the clinic.

Yunnan is the gateway to China for drugs from the notorious Golden Triangle.

Statistics show that HIV/AIDS is a big challenge in China now and Yunnan
has 14,905 HIV carriers - the most in the country.

In March, the province implemented its anti-AIDS regulation. One of the
strategies was to introduce and expand the MMT in communities. In
mid-April, the first provincial MMT clinic was set up in the city of Gejiu
in Yunnan.

As early as last February, a working plan to introduce the MMT was jointly
issued by the Ministry of Health, the Ministry of Public Security and the
State Food and Drug Administration.

A total of eight national MMT clinics are now operating in five provinces
and autonomous regions - Yunnan, Sichuan, Zhejiang and Guizhou provinces
and the Guangxi Zhuang Autonomous Region.

The MMT programme is providing addicts with an additional option for
getting off the needle and sharing needles, which has caused an explosion
in the number of HIV cases. Methadone is taken orally.

Min Xiangdong, director of the Gejiu Centre for Disease Control and
Prevention, said the clinic's doctors diagnose patients and then prescribe
them the necessary dosages of the methadone.

The patients take the methadone under the supervision of the doctor and
stay for another 25 minutes for observation.

The production, transportation and safekeeping of the methadone is strictly
controlled.

An increasing number of addicts are accepting the MMT programme as it is
the most cost-effective treatment available for heroin users.

Initially, the methadone costs only 5 yuan (60 US cemts) per treatment, but
the price is set to double.

The affect of methadone lasts for about 24 hours.

"The government subsidy will help the clinic make ends meet," Min added.

More than 80 people enrolled at the Gejiu clinic in the first month of its
operation.

Since then, the number of patients has increased quickly. The clinic has a
capacity of 250 to 300.

However, as methadone is an addictive narcotic drug under State control,
the procedures to apply for an MMT course are strict.

Min said not all applicants are successful in becoming part of the programme.

A successful applicant must be an intravenous user, more than 20 years old,
had at least two periods of abstinence from drugs, have a local address and
can shoulder civil liability. Those who only meet the last two conditions
but are HIV carriers are also eligible.

The benefits of MMT

Most of Gejiu's residents are in favour of the methadone treatment as it
offers another way to prevent the spread of AIDS among heroin-dependent
patients, according to a survey conducted by the disease control and
prevention centre before the clinic was set up.

That is despite objections to the MMT on the grounds that it merely
replaces one drug dependency for another.

The MMT programme, which retains all those who enroll for treatment, said
Min, substantially reduces their illicit drug use and involvement in
criminal activities, in addition to improving their health and well-being.

Although not under the national programme, Kunming, capital of the southern
province of Yunnan, is also using the MMT method

According to Liu, a former patient and now a staff member at the Yunnan
Institute for Drug Abuse, about 1,500 people have come in for consultations
since April. Among them, 15 people have checked into the inpatient department.

Although the experimental MMT programme is so far a success, it is still
facing great challenges, say experts.

Li Jianhua, deputy director of the Yunnan institute, says that methadone
treatment has long been hampered by government regulations, which require
patients to get approval from their hospital, community and public security
office.

The requirements work against patients' efforts to keep their addiction
confidential, so as not to disturb their employment and study.

It means many turn their backs on the opportunity to access the treatment.

The migrant population is excluded from the treatment because of a lack of
a local address.

However, the migrant workers are at a high risk of contracting AIDS. It
would also be too expensive for many of them.

"We can't provide the treatment for free right now," Li said.

Heroin is one of the hardest addictive drugs to kick and chronic users can
experience intense cravings for years.

Methadone is also an opiate but it blocks the "high" that heroin offers,
allowing for motivation to stop using heroin.

Essentially, the patient remains physically dependent on an opiate, but is
freed from the compulsive, uncontrolled and disruptive use seen in heroin use.

"Methadone is a useful way to curb more AIDS/HIV cases, which has been
proved for decades throughout the world, though some countries are still
conservative on this point," said Ray Yip, director of the Global AIDS
Programme-China.

He suggested all drug users adopt the methadone therapy to better control
their addiction and daily expense, and pose less threat to their families
and the whole society as well.

He said Hong Kong, which introduced the therapy in 1970s, set a good
example in methadone use in recent years.

In fact, community MMT programmes have expanded rapidly throughout the
globe in recent years. There is ample data supporting their effectiveness
in reducing high-risk injecting behaviour and in diminishing the risks of
contracting HIV.

A recent study in Sweden found that the drug dependency of 80 per cent of
methadone patients dramatically decreased, allowing them to get their lives
back on track and stay out of trouble with the law.