Taiwan Paper on Drug Abuse, Surge in AIDS Cases
Excerpt from report by Taiwan News, Supplements writer/Ma Kang- yao from the “Society ” page, headlined: “To prevent AIDS, don’t get hooked on drugs”, carried in English by Taiwan News website on 13 December; subheadings as published
Drugs and HIV/AIDS in Taiwan
According to statistics from the Ministry of Justice, in 2004, the drug cases reported were 68,713, 14,000 more than the previous year and a 26.5 per cent increase. In the first quarter of 2005 the number was 22,121, a 45.7 per cent year-on-year increase. The drugs criminals in the first quarter of 2005 are 13,346, an increase of 59.3 per cent compared to the same period in 2004.
The most commonly used drugs in Taiwan, according to the information collected by the National Bureau of Controlled Drugs are Heroin, Amphetamines, FM2, MDMA and glue.
At the same time, according to the Centre for Disease Control, Taiwan faces a surge in AIDS cases. In 2005, 2,849 new cases occurred, nearly twice of last year. Every day nearly 10 new infections are reported. The number of people infected with HIV/ AIDS is just over 10,000 since the first case found in 1984.
From January to October 2005, among the reported cases of HIV/ AIDS infections, drugs addicts accounted for 63 per cent, which means that two out of three HIV/AIDS victims are drug addicts. The reason is mostly due to their habit of needle-sharing, use of lacquer thinner and containers. It is a looming threat to the transmission of HIV/ AIDS. The drug addicts may surpass homosexuals to become the most dangerous group of HIV/AIDS carriers. According to the CDC, homosexual behaviour accounts for 12.8 per cent of all cases this year.
Looking at the means of taking drugs, we find addicts usually take drugs by injection. Especially after 2001, the number increased sharply. From 2002 to 2004, injection was around 50 per cent of the means to take drugs.
Meanwhile, injection with needle-sharing got severe after 2002. In 2003 and 2004, 15 per cent of drug injection was with needle- sharing. The point is that injection with needle-sharing is extremely easy to spread HIV/AIDS, Type B and Type C hepatitis and other diseases transmitted through blood.
War on drugs
The National Bureau of Controlled Drugs (NBCD), Department of Health, is comprised of four divisions – Licensing and Regulation, Audit and Inspection, Epidemiology and Education and Drug Testing and Certification. They are responsible for implementing a licensing and reporting system, enforcing inspection to control drug flow and use; promoting drug abuse prevention and education programmes with non-government resources, constructing a complete reporting and drug abuse surveillance system, studying the toxicity evaluation indicators and the testing methods of controlled drugs; providing timely toxicity information for the formulation of preventive counter measures, implementing official policy for non-government testing laboratory certification system, establishing good laboratory manufacturing practices and supplying controlled drugs of first and second schedules for medical use.
Drug abuse is a common problem in modern societies. The management of controlled drugs is an important part of drug abuse prevention. In addition to the management of controlled drugs, NBCD actively participates internationally to minimize the hazards of drug abuse, and to maintain social order and national health. As the problems of drug abuse are profound and involve many aspects, the government and society must work together to achieve substantial results.
The number of narcotics seized totalled more than 8,500kg last year, up 2.7 fold from 2002, as statistics compiled by the Department of Health show. Officials said that not only has the size of the narcotics haul increased sharply, but also the types have become more varied, and the use of marijuana has grown by nearly 10 fold. Amphetamines made up half of the drugs seized last year, followed by ketamines, heroin, ecstasy and marijuana.
NBCD acting director-general Chien Chun-sheng says that generally the anti-drug tasks can be categorized into three dimensions- supply reduction, demand reduction and harm reduction. Supply reduction can be further divided into legal drugs and i llegal drugs. “We classify and manage legal drugs to prevent them from entering the public domain. For illegal drugs, cutting the production and reducing smuggling are the priorities. For this part, we cooperate closely with the Ministry of Justice.”
In demand reduction, NBCD tries to decrease the number of novice drug abusers and help drug addicts receive treatment with new measures such as substitution drugs like Methadone as part of a “pilot study” programme implemented in four areas (Taipei City, Taipei County, Tainan County and Taoyuan County). In addition, reducing abuse of illegal drugs and misuse of legal drugs are critical. Chien notes that, “It is important to educate the public on the concept that the use of any drug for a medical or recreational purpose when other alternatives are available is inappropriate.” He adds that,” As people take drugs for curing their illness they merely focus on the efficacy but neglect the side effect of drugs, namely the potential for addiction. For this part, we strengthen education of doctors and people.”
For harm reduction, Chien points out that, “What we say is all about forbidding the use of drugs. However, for the people who are already addicted to drugs, how to reduce their harm to society is also important. In that sense, we are working on measures such as providing clean needles or substitution remedies.”
Chien appeals to people to “avoid smoking cigarettes, eating betel nuts, drinking alcohol, and to cultivate healthy habits and ways to release pressure, as well as obtain accurate information about drug use and keep a distance from gatherings where there are likely to be drugs used.”
The efforts made by all of the relevant departments have been recognized by the removal of Taiwan from the US Department of State’s “International Narcotics Control Strategy Report” for five consecutive years as of March 2005.
Safe Sex to prevent AIDS
On the website of the Centre for Disease Control, an animation shows two adults John and Mary having sex during a one night stand. Before that, they also each had sex with three other people. If any one of them had HIV, it was possible that all of them had been infected. The animation tries to arouse people’s awareness of HIV/ AIDS, especially with sexual intercourse getting common among young people. HIV/AIDS and other venereal diseases usually come with unsafe sex behaviour.
The danger is that after getting HIV/AIDS, it doesn’t erupt immediately. It takes six months, ten years or longer to see the symptoms. If the person doesn’t get examined, he might not know he has been infected.
If one has multiple sex partners, the transmission is going to be very fast. By the end of 2004, more than 60 million people in the world had HIV/AIDS, more than 20 million deaths, leaving 13 million HIV/AIDS orphans.
In Taiwan, according to CDC, about 10,000 people are with HIV/ AIDS. What is noteworthy is that HIV/AIDS among women is getting prevalent, 47 per cent of the people getting AIDS now are women. This percentage in Asia is still increasing. They are mostly at the age of 15 to 24. Marriage is unable to protect women from getting AIDS. In effect, married women are even harder to ask to have safe sex, a crucial safeguard against HIV/AIDS.
Getting people to know that using condoms correctly and thoroughly during sex behaviour is the simplest and best way to protect themselves from getting HIV/AIDS and other venereal diseases. Most just don’t use condom in such occasions of intense emotion and some just dare to take a chance. According to the poll of knowledge about AIDS last year by DOH, only 49 per cent people use condoms when having sex with their partners.
Policies to prevent drugs and HIV/AIDS
Until now, most cases of drugs addicts with HIV/AIDS come from Taoyuan County, Kaohsiung County, Yunlin County, Taipei County and Changhua County. As for the ratio of HIV/AIDS infections among drug addicts, Yunlin Coun ty, Kaohsiung County, Nantou County, Taoyuan County and Tainan County are among the highest.
These places have more prisons than other counties and there could be a relation between the number of prisons and infections. According to Chien, 40 per cent of prisoners are addicted to drugs. But this situation also shows that drug addiction is no longer confined to urban areas. In the future, the Department of Health will try to ease the situation by requiring the use of clean medical equipment, substitution therapy and educational counselling.
Currently, the Centre for Disease Control is drafting further plans to decrease the number of drug addicts and those with HIV/ AIDS. CDC teams up with the Executive Yuan to provide clean needles, alcohol cotton cloths and medical equipment to cut off the transmission of HIV/AIDS among drugs addicts. In substitution therapy, Methadone is an option to replace the use of drugs, but due to the total cost, it is still in trial.
Other policies include:
(1) Continue investigating and monitoring drug abuse – - monitoring and updating information of drug abuse via the “Controlled Drugs Report Information System” of the National Bureau of Controlled Drugs and implementing measures to respond to the current situation.
(2) Target specific or key groups to spread information on the need to avoid using drugs with needle-sharing and to cooperate with experts, scholars, non-governmental organizations, law enforcers and health centres to transmit the idea that sharing needles is the easiest way to get AIDS and other contagious diseases. In the meantime, measures should also be applied to provide assistance to HIV/AIDS drug addicts and prisoners to quit taking drugs.
(3) Strengthen advertisement through media to tell the public the seriousness of drug addiction and needle-sharing by making short promotional films for television and movie theatres and ads in newspapers.
(4) Train volunteers and medical workers and send them to communities and high-risk places. With the participation of community pharmacologists, counsellors, social workers and doctors, we can root the anti-drug movement to the very basic level.
(5) Do research on the high-risk groups and team up with scholars, specialists, non-governmental organizations, and law enforcers to study the high-risk drug addicts’ backgrounds to help them get out of addiction. [passage omitted]