Drug recovery centers: Solution or problem?

Drug recovery centers: Solution or problem?

By David and Joyce Djaelani Gordon

JAKARTA (JP): Recently, there was an article on page 2 of The
Jakarta Post. The bold black letters read: "Government to boost
campaign on HIV/AIDS".

Jakarta and Irian Jaya were reported, and continue, to have
the highest number of new cases of HIV and AIDS now on a regular
basis.

Many of the newly infected in and around Jakarta are drug
abusers and addicts. If these "reported cases" were more closely
examined, you would find many of those infected with HIV/AIDS
were also co-infected with hepatitis C.

We are not just facing one virus and one pandemic. The threat
to Indonesians -- mostly drug users and abusers -- nationwide are
two viruses and two pandemics of HIV/AIDS and hepatitis C.

Possibly two generations of young Indonesians will be
devastated by these viruses in which hundreds of thousands, or
more, will die over the next two decades.

A worldwide warning has been issued in the last few years
stating that, when the level of HIV/AIDS positive cases reaches
and exceeds 10 percent among drug abusers, the virus then spreads
as an unstoppable force.

At Yayasan Kita Recovery Center and Community, our test
results indicate that, among the drug abusers and addicts in the
Greater Jakarta area seeking treatment at our center, over 20
percent are HIV/AIDS positive and 90 percent have hepatitis C.

Another accepted assessment is: the drug abuse and drug
addicted communities, especially the injecting drug users (IDUS),
are the number one group (ultra-high risk) for the infection and
spread of both the HIV/AIDS and hepatitis C viruses today.

*Fact: Sharing needles is the easiest way to transmit and
contract either virus!

Then, in the Post's July 15 edition, the headlines read as
"Rehab centers help local drug addicts". This is true as the
centers absolutely do help drug addicts, but most of them are not
testing for the viruses. This is not because they have never
heard about the HIV/AIDS and hepatitis C viruses, but the centers
have no idea about what to do if they have an addict who tests
positive for HIV/AIDS or hepatitis C.

*Documented Note: Yayasan Kita has verified that the most
prominent drug rehabilitation centers have yet to provide
counseling and testing for their residents. Sometimes they do,
but they don't hold the tests properly or they minimize,
miscommunicate or mask facts and results regarding HIV/AIDS or
hepatitis C.

Nine treatment and recovery centers -- which all are working
with addicts and well known to the public -- were all
confidentially asked, "if they provided counseling and testing
for HIV/AIDS and hepatitis C".

The responses varied from "no", "providing testing and some
counseling only when asked" to "HIV/AIDS can be cured and will
come out in the urine if one has better faith". Some centers even
bar addicts with HIV, AIDS and hepatitis from ever entering their
Center.

The interesting thing about the last comment is: how would
this center even confirm if anyone is HIV or hepatitis C positive
without a test?

Most centers are also not informing or counseling addicts who
come into their centers about how to reduce the risks of
contracting HIV and hepatitis. Should you have doubts about what
we are sharing, we encourage you to call some of the
rehabilitation and recovery centers yourself.

Do these centers -- along with their owners, executive boards,
management and staff -- have only the vaguest idea about drug
abusers and addicts, the recovery process or what the world of
drug addiction actually represents?

They don't understand how the HIV/AIDS or hepatitis C viruses
will negatively affect any addicts or those in the initial stages
of rehabilitation, or provide critical causes for a relapse.

Proper info

Without providing proper information and harm reduction
counseling, and being mindful of the high probability of relapse,
these centers and their entire management team and staff are
guilty of absolute and lethal negligence, not to mention naivete!

Any organization, group or individual that has opened, or is
considering opening any type of recovery or rehabilitation
center, drop-in or outreach center, drug detoxification center,
recovery aftercare community, or a facility dealing with any form
of drug abuse -- dealing with drug awareness, information,
education and outreach -- must realize that it is impossible
today to speak about the dangers and risks of drug use, abuse,
addiction or the process of recovery, without speaking about the
HIV/AIDS and hepatitis C viruses.

One of the centers, chaired by a medical doctor,
confidentially said that they "would bar anyone with hepatitis B,
hepatitis C or HIV from their center".

Another doctor who owns a center said, "we wait for 6 months,
while the addict does our recovery program, before any talk or
counseling about HIV even begins."

This same doctor also admitted, "that only a few addicts, or
their parents, even asked for a test while the addict was in
treatment, or after the six months".

Some centers are pretending or denying that these viruses are
a secondary issue within the recovery process, just like any
infected addict who tries to pretend or deny that education is
unimportant to one's intelligence.

The process of working with drug abusers and addicts is
difficult enough just to begin with, but the process of working
with a drug abuser or addict with HIV/AIDS or hepatitis C is far
more demanding and exceptionally more intense.

Harm reduction strategies and networks recognize the ultra-
importance today of being able to 'test high risk groups, and
high risk individuals with confidentiality'. Harm reduction peer
counselors are qualified to give pre and post-test counseling for
those infected and their families.

Our rehabilitation and recovery centers are harm reduction
networks just by the nature of what they do and should, in the
near future, become one of our first lines of defense against the
spread of HIV/AIDS and hepatitis C.

If any recovery center or organization admits a drug abuser
for detoxification, treatment, rehabilitation and recovery (all
of which are expensive services) but does not counsel and test
for the viruses, even though the center knows how embedded the
viruses are within the drug abusing community today, it must be
considered and held morally and ethically negligent.

What will happen if an individual relapses and then shares
needles or has unprotected sex after treatment, without ever
knowing if he or she is infected with HIV/AIDS or hepatitis C,
and infects others like your very own son or daughter?

Who must be responsible morally and ethically for the new
infections? Who will be responsible for spreading the viruses
further and faster among unsuspecting individuals and our nation?

There is no cure for HIV/AIDS or hepatitis C.

We have little choice left other than to face the truism that
the drug abuse and addicted community is openly exposed to a full
blown wildfire situation.

As the heartbreaking impact of the marriage between drug abuse
and HIV/AIDS and hepatitis C dawns on Indonesians, the fatalities
among our young people will accumulate at a rate never seen in
this nation before.

Detoxification, rehabilitation, treatment and recovery
centers, plus their support and aftercare communities, must
assume the responsibility for counseling and testing drug abusers
and addicts (and their friends and families, if needed) for
HIV/AIDS and hepatitis C, and provide the necessary support
system(s) early in the recovery process. The recovery community
has the best and most direct chance to work with those infected,
and their families.

If our recovery centers and recovery community fail to work
with drug abusers and addicts who have HIV/AIDS or hepatitis C
for whatever reasons, these centers become part of the problem,
rather than part of the solution.

-- The writers are directors of Yayasan Hati Kita.