Reforming Treatment Environment
HOW TO MAKE COMPULSORY DRUGS TREATMENT
HIV FRIENDLY
Drug User Response

Presenter: Yvonne A. Sibuea
IDUSA (Indonesian Drug User Solidarity Association)
Response Beyond Borders-Satellite Meeting
August 10, 2009

Background
In many parts of the world, national governments have focused their response to drugs largely on the criminalization of drug-related activities. The National Narcotic Board (BNN) officers stated that 1.5 % of Indonesian citizens are using drugs. It’s about 2.2 million people in numbers.

In Indonesia the death penalty is still commonly used against drug traffickers. Dependent drug users are considered as criminals and not as people suffering from a disease. PWUD are arrested and sent to prison with very limited access to HIV treatment. The fortunate drug offenders could have access to ART where availability of Harm Reduction NGO or Network of People who Use Drugs or Network of PLHIV found in that area to push on that policy or directly handle the provision of ART inside prison. Usually the NGO and/or the Networks made specific agreement with local hospital to bring the medication to prison. It rarely found that the prison institution initiates the HIV treatment for PLHIV Drug Inmates.

Some Asian countries including Indonesia have adopted particularly harsh policies in their fight against drug trafficking and use. The Narcotic Law no 22/1997 and the Psychotropic Law no 5/1997 had been a main basic for handling the Drug Related Problem in Indonesia. Chapter 47 of the Narcotic Law and chapter 41 of Psychotropic Law had mention about Rehabilitation Treatment for People who are in Drug Dependency, but during 12 years of the implementation, judges almost never uses their rights to send People who are in Drug Dependence to Rehabilitation Centre. Since there are no detailed SOP mentioned in that document regarding which institution responsible to handle this and who would pay for the cost of rehabilitation treatment. This had been the main reason why judges chose not to give rehab sanction on drug offenders.

In 2007, National Narcotic Board of Indonesia (BNN) had built the largest Rehabilitation Centre  in South East Asia. It cost about 100 billion rupiahs or 10 million US dollars. In fact, till 2009, we found the lack of interest of People who are in Drug Dependency to access the free of charge Rehabilitation Centre provided by Indonesian Government. The domination of National Police Department inside National Narcotic Board had become an obstacle to promote this rehab centre among People who are in Drug Dependency.

The long time traumatic experience felt by People who Use Illegal Drugs who were, are and still being treated with inhumane approach by the Law Enforcement, keep them away from these Government provided Rehab Treatment.

In March 2009, the National Supreme Court released a Memo to Judges in Indonesia to give a rehab sanction to People who are in Drug Dependence. The Memo mentioned Government Drug Dependence Hospital, Drug Rehab built by BNN and another rehab owned by Ministry of Social Affairs as a referral for Rehab Treatment for Drug Offender.

Problem/ Threat
This policy would soon become a seed for starting a compulsory drug treatment in Indonesia. As a result, some PWUD are sent to such centres though they may not need drug treatment therapy, since they’re just an occasional user. Several appointed Rehab Centre doesn’t make a linkage to HIV treatment in their services. It would become a threat to PLHIV Drug Offender who would be referred to appointed Rehab Centre.

The national network of People who use Drugs in Indonesia (IDUSA) addressing this as a very important issue to raise to the government. We realized that some appointed Rehab Centres provided by government are run by custodial staff, often with little involvement of trained staff or outside health agencies. It would put the life of PLHIV Drug Offender in danger.

Responds
In 2007, National Commission on Human Rights in Indonesia (KOMNAS HAM) had made a research regarding the Prison Situation and found that Drug Inmates and all inmates in general did not have access to proper Health Service.

IDUSA works in provincial level to make assessment regarding the harm of the incarceration for PUD, and the facts about the lack of government initiative to provide HIV Treatment inside Prison. And soon the shift of Drug Policy in putting PLHIV Drug Offender inside appointed Drug Rehab Centres would be just the same due to HIV Treatment provision.

Recommendation

1. Government should take initiative to control the quality of appointed Drug Rehab Centres in Indonesia.
2. Government should put a WHO standard for appointed Drug Rehab for Drug Offenders.
3. UN Bodies on Human Rights or UN Bodies on Public Health should make more research due to this lack of initiatives from government regarding  HIV Treatment inside custodial/compulsory treatment centres and make publication as an efforts to push the government on providing HIV Treatment.
4. WHO to make approach to the government to operate the WHO Standardized Drug Treatment for PLHIV Drug Offender.

*Dipresentasikan di forum International Conference on AIDS in Asia and Pacific (ICAAP) IX, Nusa Dua – Bali, 9 – 13 August 2009

Tags: DrugsTreatment