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Jakarta Post

Therapy prevents HIV among drug users

Addiction:: Reza Almusafi, 28, an inmate at Cipinang Penitentiary, pours himself a drink laced with methadone

Elly Burhaini Faizal (The Jakarta Post)
Jakarta
Thu, June 28, 2012

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Therapy prevents HIV among drug users

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span class="inline inline-left">Addiction:: Reza Almusafi, 28, an inmate at Cipinang Penitentiary, pours himself a drink laced with methadone. JP/Elly Burhaini FaizalIt was around 10 a.m., dozens of inmates at the Cipinang Narcotics Prison stood in lines behind a steel gate leading to the prison’s health clinic to get their substitute therapy.

Shortly after the gate opened, everyone rushed in and queued at the veranda. Each of them brought a file folder and a small plastic mug with his name written on it.

One by one, they entered the clinic to get a cup of syrup containing methadone. A health worker poured a dose of the synthetic opiate into each mug. Then, the health worker mixed it with the syrup to sweeten the bitter tasting methadone.

“It’s very helpful to deal with my addiction to ‘putauw’ [low-grade heroin],” Kevin, a 29-year-old prisoner, told The Jakarta Post in a recent visit to the narcotics prison. He has been in jail since 2010 after police caught him red-handed consuming heroin. He was sentenced to four years and one month.

During his first days at the prison, Kevin was aware that he could not beat his addiction to the drug. This drove him to attend the replacement therapy offered in the prison. Every morning, he comes to the clinic to get his methadone treatment.

Kevin is one of 49 inmates at the Cipinang Narcotics Prison in Cipinang, East Jakarta, who currently participates in the Methadone Therapy Program (PTRM). Overall, there are 2,792 prisoners held in the prison. Since the PTRM program was established in December 2006, 277 inmates have participated.

With support from the Global Fund, the prison has delivered a wide variety of treatments, including replacement therapy, to help keep prisoners off drugs both during incarceration and after release.

“Only inmates with an opiate addiction can receive the replacement therapy. Once they are released, they still can obtain the treatment from community health centers we refer them to,” said Finnahari, a physician at the prison’s methadone clinic.

Rehabilitative therapies such as PC Therapy, Criminon Rehabilitating Therapy, and Narcotics Anonymous Therapy, as well as spiritual therapy, are available for those who can stop using drugs.

“But if they cannot stay off drugs, the replacement therapy is the most effective solution,” she said.

With the therapy inmates can get off their addictions to stronger opiates while avoiding painful withdrawal symptoms. They can also protect themselves better from HIV infection mostly caused by the shared use of needles.

It was not easy for Bun Nganga, known as Anga, a 34-year-old inmate, to break his heroin addiction as he had been an intravenous drug user since 1997. He was sentenced to six years imprisonment in 2011.

Drug abuse caused physical and financial hardship. Before taking replacement therapy, he used to suffer from withdrawal symptoms once every three hours, forcing him to take heroin at least four times a day.

“Every time I woke up in the morning, I always had bad withdrawal symptoms,” said Anga. He was also infected with Hepatitis C because he used to share needles with other drug users.

Anga said drug abuse had ruined him financially. “Using drugs just ate through my pocket,” he said.

Running his own T-shirt printing business, the father of two (aged 13 and 10 years) used to earn around Rp 8 million (US$856) to Rp 9 million per month. He wasted most of the money on drugs, however. He would buy four packages of ‘putauw’ per day at about Rp 100,000 per package.

As methadone is effective for approximately 36 hours, Anga finds that his drug use has changed
significantly.

“I have a more productive life as compared to stronger opiates, such as heroin, the methadone has a longer period of withdrawal,” he said.

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