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Jakarta Post

Addicts take 12 steps to new life

Across Indonesia, thousands of kids as young as nine and 10 are starting out on the bleak backstreets that lead to drug addiction

Trisha Sertori (The Jakarta Post)
GIANYAR
Wed, March 4, 2009

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Addicts take 12 steps to new life

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cross Indonesia, thousands of kids as young as nine and 10 are starting out on the bleak backstreets that lead to drug addiction.

Kicking off on stolen cigarettes smoked furtively with friends, then moving rapidly into alcohol, marijuana and antidepressant abuse by the time they are 12; by 15 they are smacking up with heroin or losing their souls to crystal methamphetamine - known locally as sabu sabu.

Sabu sabu is horrendously easy to get - Indonesia is one of the world's largest manufacturers of the illegal drug that, in long-term users, induces severe paranoia that can lead to violence and suicide.

Some of these kids will be the lucky ones - their parents, teachers or friends will notice a radical shift in their behavior, start asking questions and get them into rehab. But for most - particularly the girls - their drug addiction will be swept under the carpet until they drop dead of an overdose or wind up in prison on drug-related charges.

Hard-core addicts will feel in prison they have made it to nirvana: Indonesia's prisons - like so many prisons around the world - offer better drugs at lower prices than on the street, says Dr Ni Luh Putu Ariastuti who, at just 25 years of age, has been working to help addicts regain lives interrupted by drugs.

"Drugs are cheaper and easier to get in prisons, but the government still closes its eyes to this. Many prisoners go to jail who are not drug users - they start in prison - so that is where one of the drug problems is," says Ariastuti.

Ariastuti is the Bali program manger for the Yakita Foundation, which has rehabilitation and drop-in centers across the country. Started in 1999 in Bogor, the foundation has to date saved the lives of close to 600 addicts in Sulawesi, Aceh, Java and Bali, thanks to its 12-step program that guides addicts back through the maze of emotional, mental and physical addiction. This method is a far cry from the Indonesian standard of placing drug addicts alongside inpatients of mental hospitals.

"Drug users are not mentally disturbed. They need treatment for their addiction. That is very different from the treatment for diseases, such as schizophrenia. The government used to place drug addicts in mental hospitals - in Bali the government still places some people in the mental hospital in Bangli," she says.

"In Aceh they are also put in mental hospitals. These addicts are then given psychotropic drugs that are specifically designed for mentally disturbed people - not for drug users. These drugs cause mental confusion - they cause people to become mentally blunted. In Aceh we had one drug user - we tried to get him out of the mental hospital and into rehab. Once we got him off psychotropic drugs he started getting better - he could again write his own name and speak."

Some drugs used to treat schizophrenia can have severe physical effects, Ariastuti explains.

"Some psychotropic drugs cause severe stiffness in the muscles and patients move like robots. Their brains are already damaged by drugs and doctors are adding to the problem with these psychotropics. The doctors do not understand drug addicts and their treatment - they are medically treating these people as they would a schizophrenic."

Ariastuti adds she has seen this method of treatment for addicts in Aceh "but not in Bangli".

The Yakita foundation instead applies the 12-step program to help addicts regain control over their lives. Much of the program is delivered by recovering addicts.

"Here the concept is addicts helping addicts with the 12 steps because only an addict can know what life is like for an addict. Only they know the pain, the fear - the physical and mental torture of addiction."

The most difficult part of recovery, Ariastuti adds, is the emotional dependence on drugs.

"The physical addiction only takes a week to pass. The physical addiction is easy to fix - the emotional addiction takes a lifetime. The 12-step program is trying to help addicts live with that emotional addiction."

The addicts that find themselves in the embrace of the Yakita Foundation are the fortunate ones. For women across the country and many Balinese men, Indonesia's paternalistic culture robs them of that embrace and its opportunity to go straight.

"In much of Indonesia if a family has a drug-addicted daughter they hide her away, or send her to study away from their hometown - out of view, but families bring their sons for rehab. This is because so many parents think its normal for boys to take a wrong turn, but a girl being bad is not seen as normal - it's seen as shameful - so they are hidden away and left untreated," says Ariastuti.

This attitude affects both men and women in Bali. Ariastuti says alcohol and drug addiction are seen as karma - a God-given syringe of misery, shame, desolation and death.

"The culture is very strong in Bali. Parents don't want their kids to have rehab because here *in Bali* parents believe addiction is someone's karma. They just pray to the ancestors for help. That is the big problem we have here - there are a lot of addicts on Bali, but it's very rare that they go to rehab," says Ariastuti, citing treatment figures for the Bali arm of Yakita - of 51 addicts treated, less than five were Balinese. Figures suggest there are almost 3,000 drug addicts across Bali.

"It's really hard to change the culture. As outreach we visit banjars and talk about addiction, but it's just like the alcoholism here. Addiction *to drugs or alcohol* is not seen as a problem for Balinese people, even when there is violence in the home because of this. It's seen as normal to be a violent drinker, even if that means beating wives and children. Again it is that paternalistic culture, which is really strong in Bali."

Drug use warning signs

Dr Ni Luh Putu Ariastuti, Bali program manger for the Yakita Foundation, says alarm bells should start ringing for parents, teachers and friends that a teenager is using drugs if they: *stop talking
*change behavior dramatically
*seek isolation
*start asking for money - parents need to find out why
*sleep to excess
*display odd behavior

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