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Holistic Approach Needed To Tackle Drug Reform Efforts - Experts

22/07/2024 06:44 PM
From Nina Muslim

The knocking came suddenly and loudly, the sound of flesh meeting wood with enough force to shake the door one late afternoon in August 2020.

“Police! Open up!”

The announcement did not faze Wak Ang (not his real name). He opened the door, feeling numb. His mother had recently died, and his father had passed away in 2011. At 53 years old, he was at a loose end, with too much free time after taking care of his parents for so long.

The police stood there in the failing Ipoh light, demanding to know where the drugs were.

Thanks to the Registration of Criminals and Undesirable Persons Act of 1969, he had been listed as a drug addict since 1994, when the National Anti-Drug Agency (NADA) first arrested him and sent him to a rehabilitation centre, as required under the Drug Dependants (Treatment and Rehabilitation) Act of 1983.


Drug-users detained by the National Anti-Drug Agency (NADA) on the way to see the magistrate. Ilustrative photo. --fotoBERNAMA (2024) COPYRIGHT RESERVED

They asked him where the drugs were, accusing him of being a drug dealer. He replied that there were no drugs, but the police didn’t believe him. They searched the house.

Finding nothing, they took him to the police station, handed him a cup and showed him where the toilet was.

A few minutes later, he was under arrest. He had tested positive for heroin, his urine turning the test strip red. This meant prison, thanks to Section 5 of the 1952 Dangerous Drugs Act (DDA). Even though Wak Ang did not have any narcotics on him at the time of the arrest, he had still committed a crime by injecting himself with heroin, a Schedule I drug, the most serious listing for narcotics.

He was sentenced to three years in a prison in Tapah, where he got clean. Every time he has been detained, he has gotten clean. To date, he told Bernama he had gotten clean 13 times since he began using in 1987.

Once he got out, relapse was only a matter of time.

After his stint in prison ended in 2023, he returned to Kuala Lumpur, which he had left in 2009 to care for his ailing parents. Before long, he started using heroin again.

It is a common history that many drug addicts share. The details vary, but several points remain the same: they become addicted, they get arrested, they get clean in prison or a rehab centre, they relapse once out, despite trying their hardest. Rinse and repeat ad infinitum.

Each time, the three laws are involved. And yet, only one law is being amended under the guise of decriminalisation.

 

AMENDMENTS BACKLASH

Malaysia confirmed its intention to decriminalise drugs on March 8, 2023, when Home Minister Datuk Safiuddin Nasution Ismail told the Dewan Rakyat that small-scale possession of hard drugs, which falls under the DDA, would no longer be considered a crime. Drug addiction would be treated as an illness.

Under decriminalisation, laws and policies are supposed to shift from being punishment-oriented towards reducing harm and treating addiction as a public health issue. In doing so, Malaysia would join many other countries that have implemented similar policies, following the example of Portugal and others.


Home Minister Datuk Seri Saifuddin Nasution Ismail tabling the amendments to Drug Dependants (Treatment and Rehabilitation) 2024 for first reading at Dewan Rakyat July 2. --fotoBERNAMA (2024) COPYRIGHT RESERVED

However, something went awry on Tuesday. The amendments for the Drug Dependants (Treatment and Rehabilitation) Act of 1983, hailed as a drug decriminalisation effort, were tabled in Parliament on Tuesday. So far, they have received mainly protests, rather than accolades, from drug addiction experts, academicians, and legal experts.

“The current amendments do not align with genuine decriminalisation objectives and may exacerbate existing challenges. The government must adopt a comprehensive revision of the country's drug policies, such as the Dangerous Drugs Act 1952, the Registration of Criminals and Undesirable Persons Act, and the Poisons Act 1952,” said a group of 15 signatories, led by Chairman of the Malaysian AIDS Foundation, Prof Datuk Dr Adeeba Kamarulzaman, in a statement.

“It’s a backward step,” agreed Dr Mohd Khafidz Mohd Ishak, an addiction specialist and owner of Poliklinik Khafidz methadone clinic. “I’m very concerned about the amendments because they will be a great challenge to the concept of harm reduction and decriminalisation, which has been very successful in other countries.”

Countries that have adopted drug decriminalisation have managed to reduce prison overcrowding, reduce human immunodeficiency viruses (HIV) transmission rates among intravenous (IV) users, and see drug usage figures remain stable with no significant surge. Rehabilitation is voluntary.

As it stands, Malaysian prisons are overcrowded. As of March 2023, Malaysia had 39 prisons with a combined population of 74,459 inmates, according to Home Ministry data. The capacity is for 65,000 inmates. On July 3, Deputy Home Minister Datuk Seri Dr Shamsul Anuar Nasarah reported there were 6,450 in prison for drug offences under the DDA, including those on remand.

Experts said that the amendments will do little to address the overcrowding issue as they remain punitive in nature. Magistrates still have the option to remand drug users and addicts in prison unless they make bail, putting more pressure on the poor and worsening the overcrowding problem.

“This bill, which purports to be a decriminalisation bill, places a huge emphasis on punishment, prison sentences, and fines for people who use drugs and, in some cases, even for parents. This is not in keeping with decriminalisation principles,” commented Dr Adeeba, who is also a commissioner with the Global Commission on Drug Policy.

Rather than sending drug users or people with small quantities of drugs on their person to prison, the amendments would require users or addicts to be brought to the magistrate and attend mandatory rehab. If caught using drugs during rehab, violators may be required to do community service, be imprisoned or whipped.

One of the amendments also makes parents responsible for their children’s rehabilitation or face a fine of up to RM5,000.


Malaysian AIDS Foundation (MAF) Prof Datuk Dr Adeeba Kamarulzaman. File photo. --fotoBERNAMA (2024) COPYRIGHT RESERVED

The group also expressed “particular apprehension” that the amendments will grant NADA officers, rather than medical officers, the authority to determine whether a user is an addict and decide on treatment options. Magistrates will be required to take rehabilitation officers’ recommendations into account when deciding on the user or addict’s fate.

The amendments would also require medical doctors to report all users, not just addicts seeking treatment, to the Director-General of NADA, something that gives addiction specialists pause. Several told Bernama it may prevent users and addicts, who have managed to escape detection, from seeking treatment.

 

DON’T STOP AT ONE

Addiction is defined as “a chronic, relapsing disorder characterised by compulsive drug seeking and use despite adverse consequences,” according to the National Institute of Drug Abuse in the US. Experts consider it a brain disorder because it involves changes to brain circuits involved in reward, stress, and self-control.

Drug addict Abdul Rahim, 49, can attest to this half-life. He has been to prison seven times and whipped three times.

“Whipping hurts,” he told Bernama. And yet it didn’t deter him from falling off the wagon after being clean for over a year while on methadone.

“I thought I was cured (when I didn't relapse a month after stopping methadone) but then I missed heroin,” he said. The lorry driver had planned to go back on treatment when he relapsed. Two days later, police officers showed up at his factory and arrested him.

He has a court date in November. He is worried about going to prison again, but hopes that the magistrate will allow him to continue methadone therapy outside of prison.

Asked if he preferred going to court-mandated rehabilitation, instead of prison, should the amendments pass, he said he preferred to stay at home and continue working.


Addiction specialist Dr. Mohd Khafidz Mohd Ishak preparing methadone for a patient. Drug addicts undergoing treatment require a daily dose to keep their craving at bay. Credit: Nina Muslim/Bernama

Experts term this – allowing addicts to live their lives outside although they may do drugs – as harm reduction, because going to prison may be more harmful to their physical and mental health, and pose negative consequences to their families.

Proper drug decriminalisation, based on the tenets of harm reduction, would allow possession of small amounts of drugs and testing positive for drugs, neither of which would be a criminal offence. Addiction and drug reform experts support police and enforcement officers giving users referrals to voluntary rehab, instead of the nearest jail cell.

To do so means revising two major laws on drugs, namely the DDA and Drug Dependents Act, which address consumption and self-administration.

“If we truly believe addiction is a relapsing illness, then we must also understand the circumstances of addiction and the realities of a dependent person. We cannot decriminalise a person’s use and then jail them for carrying the small amount of the substance they are addicted to,” said Palani Narayanan, Malaysia AIDS Foundation Director of Drug Policy.

Human rights lawyer Abdul Rashid Ismail agreed, saying drug reform requires a holistic approach, requiring amendments to all legislation that involve drug use and offences.

“For example, (look into) the provision in connection with the Registration Act, where essentially, a conviction resulted in that individual having a criminal record for drug use,” he said.

Abdul Rashid, who is also the past president of the National Human Rights Society (HAKAM), said true reform could not go forward when users and addicts’ future are ruined forever due to their drug use conviction – despite being completely rehabilitated.


Drug-users undergoing mandatory rehabilitation at a Narcotics Addiction Rehabilitation Center (PUSPEN). File photo. --fotoBERNAMA (2024) COPYRIGHT RESERVED

Users and addicts with records told Bernama they have had a hard time securing a job and making ends meet. They seem committed to staying clean, but they worry that the stigma, financial pressures, and lack of options will tempt them into relapsing.

One way of resolving this would be a Clean Slate law, which requires non-violent drug offenders to stay out of trouble for three years or so, at which point their record will be expunged or sealed. New York is the latest state in the United States to pass the law.

Palani said it may be something Malaysia should consider.

 

A CLEAN FUTURE

For Wak Ang, a Clean Slate law would have likely changed the trajectory of his life if it had existed.

For one thing, he may never have relapsed in 2007 after being clean for 12 years. When he got married in 2001, he had been clean for six years. He had a good job. Life was good. But soon, cracks appeared. He and his then-wife started arguing. And each time, she would hurl his past as a drug addict and his arrest at his face.

Finally, in 2007, at his lowest point, he started taking drugs again. He remembers those days with regret, thinking he should have fought harder to stay sober.

Now at 57, he is tired and broke, having used up his Employees Provident Fund (EPF) savings for drugs. He now lives with his sister and takes care of his special needs niece. 

Clean for about a year, he vows never to use heroin again. 

"I’m so tired and I just can’t take it anymore. There’s no end, no life. This means depending on it (heroin). To do anything, it must be there. Only then can I move, work, or do anything. We are its slaves," Wak Ang said.

 

Edited by Salbiah Said

 

--BERNAMA

 

 


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