Total makeover needed to kick the habit

PETALING JAYA: It is time for a total revamp to tackle drug and substance abuse in Malaysia, as the current methods are not bringing down the number of addicts or the damage done to their families, say experts.

Professionals who work to rehabilitate and treat addicts said a necessary core change is for the government and society to stop treating the matter as a national security problem, but as a public health issue.

This means moving agencies, personnel and funds that deal with substance abuse from the Home Ministry to the Health Ministry, which they say has the expertise and mindset required to tackle the problem.

Counselling psychologist and addiction expert Dr Prem Kumar Shanmugam said this includes moving the National Anti-Drug Agency (AADK), the primary agency tasked with addressing drug abuse prevention and rehabilitation, which receives about RM300mil in funds per year.

“The Health Ministry can then use its experts to help the AADK, while the private sector can also assist, as we have years of experience in tackling addiction,” said Dr Prem Kumar, who founded and runs a chain of rehabilitation facilities.

Jaafar Daud, from Pengasih, a rehabilitation group founded by ex-addicts, agreed, saying that AADK should not focus on law enforcement but on treatment and rehabilitation.

“AADK should be placed under the Health Ministry as it has a good track record and the right mindset when it comes to treating at-risk groups,” said Jaafar, who is in charge of the Pengasih Selangor branch.

For example, he said detection and treatment of HIV cases have brought down the number of infections.

“This was possible because the Health Ministry worked closely with community groups and NGOs. AADK must adopt this mindset of working with NGOs,” said Jaafar.

Similarly, Dr Prem Kumar said addiction is something that requires treatment, adding that the science on substance abuse and addiction has been established for decades but has not been culturally accepted, especially in Asia.

“How and why people get addicted is a combination of genetics, social, psychological and spiritual factors that require treatment,” he said.

Dr Prem Kumar also said addiction does not just occur with substances such as heroin, cocaine and methamphetamines but also with alcohol, caffeine, food, social media, sex, gambling and video games.

“If you see substance abuse as a national threat, then how can you treat it?”

But both Dr Prem Kumar and Jaafar concurred that the unity government’s aim of decriminalising possession and abuse is “a step in the right direction”.

“If we continue to punish people by throwing them in jail, we won’t solve the issue of addiction, as substance abuse in jails is already a problem,” said Dr Prem Kumar, adding that these facilities lack the resources and staff to help addicts.

Jaafar described addicts as patients and not criminals.

“They only commit crimes when they don’t have money to nurse their addiction. This is their illness. So you need to treat the illness,” said Jaafar.

In the long run, society as a whole must consider changing its attitudes towards substance abuse and addiction to align with science and successful past methods, said Dr Prem Kumar.

Instead of taking an abstinence-only approach, he said Malaysians should consider adopting harm reduction or sustainable recovery strategies.

“Good examples are the harm reduction strategies of needle exchanges and methadone substitution for heroin addicts.

“When it was first introduced, the authorities were against the strategy of giving out (sterile) needles to heroin addicts to bring down HIV transmissions among them,” he said.

But Dr Prem Kumar said authorities slowly accepted the measure because it succeeded in reducing HIV transmissions among heroin addicts exponentially.

“Heroin addiction in general is also going down because there is an acceptance that they could come forward and get methadone treatment.

“It’s not total abstinence. But we will help them stop family violence, reduce crimes and get them a job.

“Along the way, when they realise that so many positive things are happening in their lives, they will stop using. If things around them change for the better, then there is motivation to kick the habit,” he added.