New research on drug treatment in Indonesia

Thousands of heroin users have switched to crystal meth (locally referred to as Shabu) in Indonesia. During a stakeholders’ meeting in Jakarta on 12 September 2017, researchers of three different studies presented their preliminary findings related to recent developments around drug use and drug treatment in Indonesia.

In recent years, the price of heroin has skyrocketed in Indonesia. According to outreach workers of the local harm reduction organisation Karisma Foundation, a gram of heroin now costs up to 400 dollars. As a result, more and more heroin users have recently switched to crystal meth. Although much good work is done, government and local drug treatment organisations are struggling to offer suitable and effective services.

Growing number of crystal meth users

Mainline has supported two of the three studies and facilitated the discussion on the 12th of September. The new evidence stimulated positive and fruitful discussions about effective drug treatment, the need for more synergy and the need to adjust existing services to the growing number of people who use crystal meth. One of the studies was conducted by the Atma Jaya Catholic University of Jakarta. The study concerns an impressive bio-behavioural survey with a sample size of almost 1,500 people who use crystal meth. They measure the prevalence of HIV, Hepatitis B and C and Syphilis in combination with behavioural risks.

Respondents from six different cities in Indonesia are included. The results of the study are currently translated into English. Mainline will report about this in detail, as soon as the full report is available. 

A short preview:

  • Crystal meth users don’t consider their use to be problematic.
  • They score high on drug dependency.
  • There is limited desire to access drug treatment.
  • Because of the mandatory reporting system, people are reluctant to enter rehabilitation services.
  • People who use meth are hardly ever redirected into rehab after arrest.
  • 95% of meth users serve a prison sentence after arrest.
  • Rehab is not accustomed to meth users and applies a one size fits all model. 

‘One size doesn’t fit all’

The complexities of the rehabilitation system in Indonesia have been analysed in a descriptive study by the legal rights institute LBH Masyarakat. The study takes stock of the different drug treatment options under the Ministry of Health, the Ministry of Social Affairs and National Drug Authority (BNN). The different government agents have separate budget lines and services. Methods vary from community based to religious approaches, from medical to social, and from in-patient to out-patient. The third study presented at the stakeholder meeting looked into the effectiveness of BNN drug treatment for people who use crystal meth. 

One of the conclusions is that the one-size model does not fit the needs of meth users.

Various meeting participants called for introspection.

The representative of the Ministry of Social Affairs: “We need to improve and synchronise the quality standards for drug treatment. We should always consider local circumstances to set up appropriate services. Meanwhile, we must systematically entwine this local expertise with scientific evidence.”

The director general of prison rehabilitation:

“More funding is needed to address the limited access to drug treatment in prisons. There is a need for a ‘grand design’ for drug treatments in Indonesia. Such a comprehensive policy would consist of a continuum of care of services for drug users, including harm reduction.”

Arif R. Iryawan from PKNI:

“We need a national action plan, and we need to standardise our methods on drug treatment.”

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