SPOTLIGHT : A SHOT IN THE ARM...OR A HEADACHE FOR THE LAW?

The Positive

THE "harm reduction" pilot programme introduced in 2005 for
intravenous dadah users is a resounding success, at least as far as
the Health Ministry is concerned.

Deputy director-general of Health Datuk Dr Ramlee Rahmat said the
majority of the addicts involved in the pilot project had kicked the habit.

He said the ministry will start recruiting more addicts in new areas.

He said the ministry had an understanding with the police and the
anti-drug agency on the expansion of the programme and on areas which
will be out of bounds to raiding parties when the programme is on.
The ministry will, however, not stop the police from arresting
addicts involved in the programme caught in criminal activities or
dadah abuse outside the programme area.

"The police have their duty to arrest those who are a threat to
national security."

The primary thrust of harm reduction is a combination of dadah
substitution therapy using methadone and a needle and syringe
exchange programme.

The idea of addicts returning used needles is to prevent the spread
of HIV/AIDS through contamination.

The ministry's needle exchange programme manager Datuk Dr Faisal
Ibrahim said all addicts in the programme received counselling to
ensure they did not return to the habit or share needles.

Some 100-odd addicts in the needle exchange programme have since
decided to switch to methadone.

"Our aim is to make sure they fully understand the programme and not
violate the rules and regulations stipulated to them."

He said a meeting was held bimonthly between the stakeholders
including the police to get feedback on the situation. According to
World Health Organisation figures, the success rate of harm reduction
programmes is usually around 70 per cent.

Dr Faisal said there were some 1,200 dadah addicts involved in the
needle exchange programme in Johor, Penang and Kuala Lumpur.

"Feedback showed that 60 per cent of those who participated in the
needle exchange programme returned used needles. This is good."

On addicts switching to methadone, he said this was a clear sign that
the harm reduction programme had achieved its objectives.

The Negative

Police feel the "harm reduction" programme has given them a headache.

Bukit Aman Anti-Narcotics director Datuk Abang Abdul Wahab Abang
Julai said the police had to release hundreds of dadah users back to
the streets as they were protected under the programme. "We have to
close an eye in the matter although they should by right be arrested.
But since it is a government initiative, we have backed the
government 100 per cent."

Abang Abdul Wahab said he had completed a paper for submission to the
government on the dadah problem and ways to curb the menace.

"There is a lot of money allocated to curb this problem but the money
should be used wisely."

He said First World countries practised the needle and syringe
exchange progra-mme (NSEP) but were governed by the Dangerous Drugs
Act like in Malaysia.

"In Australia, drug addicts are told to come to centres where a
medical assistant administers the drug into the addict using a new
needle and syringe."

Abang Abdul Wahab said this was good as addicts could not go back to
the streets to share the new needles and syringes with their friends
or even sell them.

In February last year, the government started distributing free
syringes in exchange for used ones and condoms to dadah addicts in
Kuala Lumpur, Johor and Penang.

The cabinet allocated RM100 million over five years on top of the
RM40 million annual allocation for the "harm reduction" programme
which includes NSEP and the methadone programme.

A total of 100 paramedics have also been trained at a cost of
RM600,000 to counsel and administer anti-retroviral drugs to patients.