Pubdate: Mon, 26 Nov 2007 Source: New Straits Times (Malaysia) Copyright: 2007 New Straits Times Contact: http://www.nst.com.my/ Details: http://www.mapinc.org/media/3734 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. - --- MAP posted-by: Derek