Rehab centers help local drug addicts
In this and related articles on Pages 2 and 3, The Jakarta Post's Santi W.E. Soekanto and contributors Nuraini Razak and Deka Kurniawan explore the question of drug rehabilitation centers in Indonesia.
JAKARTA (JP): Peer pressure got "Andi" into drinking alcohol, smoking marijuana and eventually taking putauw (low-grade heroin). He was only 13 at the time.
"Because it was the trend at the time and everyone was doing it, and if I didn't do it I would have been considered old- fashioned," Andi, who is now 21 years old, said as he explained how he became involved in drugs. With the help of his beeper, a delivery of heroin to his high school was only a phone call away.
Andi was expelled during his first year of high school after a drug test given by the school showed he was using heroin. He enrolled in another school, and was again expelled after being caught using drugs on school grounds.
His parents then decided to enroll him in a high school in Adelaide, Australia, and for the first time in years Andi was clean and sober for a month. But that was before he made friends with the local Vietnamese drug dealers.
As soon as his parents found out he was again using drugs, he was immediately brought home. Back in Jakarta he enrolled in another high school, was expelled and enrolled in yet another school, where he didn't even go to any of his classes because he was so heavily addicted.
"At the time, I mugged ladies coming out of ATM machines, taking their money, jewelry, mobile phones or anything that I could sell. At one point, I even slept on the streets of Blok M, with no money in my pockets and no place to stay, just putauw and my junkie friends," Andi said.
He eventually quit school and bought himself a fake high school diploma. His parents forced him to go to a private school in Nilai, Malaysia, hoping to isolate him in a country known for hanging its drug dealers.
At the school, Andi quickly made himself "comfortable" with fellow students in his dorm and, before long, was again taking putauw. "People thought I would be weaned off drugs in such a deserted place as that village, but they were totally wrong. You can find drugs anywhere," Andi said. "But I never used any needles."
Andi's mother then took him to Pengasih, a well-known drug rehabilitation center in Kuala Lumpur that has treated many Indonesians. After a number of arguments, Andi agreed to join the center's day-care program, not knowing that it was actually a set up that would force him to remain in the center. His mother quietly departed for Jakarta.
The rehab center is just minutes from the highway and is not surrounded by high fences. It is simply an open-air area in the heart of Kuala Lumpur. In the first two months of treatment, Andi and a number of his fellow residents had tried to run away several times.
Indeed residents of the center can easily run away, but they are also easy to find because most of them do not have anywhere else to go and have no passport in a foreign country.
Andi eventually finished the nine-month program, and then the pre-reentry and reentry programs in Malaysia. He was soon back in Jakarta, where he joined Masyarakat Anti-Narkoba, or the Anti- Narcotics Community.
Andi has now been clean for two years. He had a relapse briefly because his girlfriend was a user, he got her pregnant and soon married her. The stress of his personal problems caused him to use putauw again.
At his own initiative, he joined Harapan Permata Hati Kita, a self-help, 12-step rehabilitation program in Bogor, West Java. Andi was in the program for a month and then became a peer educator at the rehab center. "I'm more stable now that I have my wife and my baby boy. I'm trying to pursue a normal life," he said with a smile.
Andi is now training at the Kusuma Wicitra center to become a Certified Substance Abuse Counselor, and also working at Titian Respati, a rehabilitation center in Sawangan, Bogor.
Waste
"Ari", 23, is a former addict who started using drugs at the age of 14 and was using putauw by the time he was 16. He stole money from his family, sold things from his parents' house and even stole millions of rupiah from the angpaw (money gift) box at his sister's wedding.
After realizing that he was an addict and was getting worse, his family sent him to the only rehabilitation center they knew about: Pengasih, Malaysia.
"My parents deceived me! They only told me that it was a nice and beautiful rehab center, and I believed them," Ari said with a laugh. He was at the center for 16 months and stayed in Malaysia to study at an art institution.
Ari has now been clean for more than four years and is currently studying psychology at the University of Indonesia.
Andi and Ari can be considered "lucky" because their parents were able to "shop around" for good rehabilitation centers, even those outside of the country. But thousands and thousands of parents can only grieve when their children become drug addicts, unable to bear the cost of sending them to good rehabilitation centers.
Indeed, there are now many good rehab centers in the country, but often they are simply too expensive for families whose resources have been bled dry by their children's habit. Dr. Al Bachri Husin, a psychiatrist renowned for his work with drug addicts, established Wisma Adiksi knowing that many parents cannot afford expensive treatments.
"If it hadn't been for the operational costs, I would have made Wisma Adiksi free of charge," he said of the rehab center at Jl. Jati Indah I No 23, Pondok Labu, South Jakarta. As it is, the center charges residents Rp 3 million per month.
Dr. Fuadi Yatim, a psychiatrist who for the past two years has run Wisma Afiat (literally House of Health) in Bogor, West Java, agreed that treatment for drug addicts was so prohibitively expensive that many parents simply gave up.
Wisma Afiat is one of the least expensive rehabilitation centers, charging residents Rp 2.5 million per month. Located at Komplek Masjid Baitul Akhfa, Kampung Tanah, Kecamatan Bojong Gede, Wisma Afiat is now treating 11 youths.
Unlike other existing facilities, Wisma Afiat clearly states that Islam plays a large role in its program. Following a detoxification program, residents are encouraged to perform their obligatory and sunnah (additional) prayers, to read the Koran and fast.
Izfan, an engineer who is in charge of the daily operations of the center, said the nine staffers at Wisma Afiat "embrace" the residents. "We know that many people, even religious teachers, often treat drug addicts as if they were trash, filth," he said. "We treat them as friends who need help."
Approximately 100 drug addicts have been treated at the facility. "When they left the Wisma, all of them were healthy, both physically and spiritually. Many gained as much as 14 kilos," Izfan said.
Al Bachri, Fuadi and Izfan all expressed concern at the rapid growth in the number of drug addicts in the country. Official statistics put the number of drug addicts in Indonesia at four million, but experts think the real figure could be as much as 10 times higher.
This means there is a need for more drugs rehabilitation centers, more educators, staffers and counselors. "Indonesia needs about 5,000 counselors for its rehab centers, and now we only have about 100 certified counselors to treat addicts," Andi said.
Control
What are the characteristics of addiction? First is a loss of control: the addict cannot predict what will happen when he uses drugs. One day he may be able to stop after one line of cocaine, the next day he may not be able to control his use.
Another characteristic is compulsive preoccupation: the addict spends a great deal of time thinking about drugs. And then there is continued use despite negative consequences: if drug use causes problems but a person continues to use drugs, he or she is inviting addiction or is already addicted. The person has lost control over their drug use.
A nonuser or a casual user may have difficulty understanding why addicts don't just stop. The use and abuse of psychoactive (mood-altering) drugs seems to be voluntary, while addiction seems to be characterized by involuntary, compulsive use. In most cases, drug addicts don't stop because they are addicted and cannot stop on their own.
Once it was thought that a person was a drug addict only if he or she needed to use drugs daily, or went through withdrawal symptoms when he or she stopped using drugs.
But the fact is that many drug addicts do not use drugs daily, and do not experience physical withdrawal symptoms when they stop using drugs. The majority of addicted people are employed and appear to be normally functioning members of society.
The rate of addiction varies from substances to substance. Crack cocaine, for example, has a much higher potential for addiction then other drugs.
What causes addiction? There has been a great deal of controversy over the causes of addiction. Over the years, experts have said addiction was caused by a lack of willpower, poverty, moral weakness, mental illness, childhood trauma, antisocial personalities and societal problems.
And the experts continue to differ over the causes of addiction.
The addicts
Who are addicts? People who have low self-esteem have a higher rate of addiction. People with low self-esteem use psychoactive substances either to enhance or create pleasure in their lives, or to decrease the constant emotional pain they live with. The better a person feels about himself or herself, the less likely he or she will be to use or abuse psychoactive substances.
In our society, we hear mixed messages about the use of psychoactive drugs. Some drugs, such as alcohol and tobacco are accepted. While use of hard drugs is condemned. Some drug use is glamorized in the media, all of which makes it easier for people to accept drug use as "normal".
How we can help? It was once thought that an alcoholic or drug addict had to "hit bottom" before help could be offered and accepted. Or that a drug addict could only get better if he or she was motivated to change. This belief has changed as it has become accepted that skilled professional counselors can motivate addicts toward recovery. This is called intervention.
Intervention is a process that helps addicts recognize the extent of their problem. Through a nonjudgmental, noncritical and systematic process, drug addicts are confronted with the impact of their drug use on others. The goal of intervention is for addicts to accept the reality of their drug addiction and to seek help.