Govt scheme needed to help drug users

The Thai Aids Treatment Action Group (TTAG) yesterday called on the government to institute a comprehensive harm reduction program for drug users - providing a range of options including opiate substitution therapy such as methadone, and clean injecting equipment.

The group said many users were being denied access to treatment programmes due to the stigma of being in a criminalised group.

"Health care workers have denied many injecting drug users access to an antiviral drug and the use of methadone, which is a heroin substitute," said Karyn Kaplan, TTAG's director of development and policy.

Last week, Public Health Minister Witthaya Kaewparadai announced Thailand's highly successful programmes have slashed the spread of HIV among injecting drug users. He said local methadone programmes had also reduced the number of injecting drug users with HIV and, as a result, the nation deserved more funding from UNAIDS

Methadone treatment is now available at hospitals across the country, but many health care workers still have negative attitudes to injecting drug users and refuse to provide treatment.

"Some health care workers are asking injecting drug users to stop their heroin use before receiving treatment, which violates their human's rights," she added.

" This was why they were afraid to go to hospital and ask for medical treatment, even though they needed it to save their lives," she said.

Karyn asked the government for courage in revising the law or issuing a policy allowing injecting drug users access to life saving treatment.

Previously, the government recognised them as patients who needed medication, but nowadays many are being jailed without medication. Most are infected with the HIV and hepatitis virus.

"We want leadership from the government to implement the international standards of medical treatment for injecting drug users, without discrimination and human right violations," she added.

The compulsory treatment programme under the universal health care scheme provides methadone to injecting drug users for only 45 days, another difficulty for patients.

Karyn explained that most injecting drug users need long term treatment and the programme should end when patients are ready to go off methadone.

" The compulsory treatment was not useful and did not respond to patients' health problems," she said.

A voluntary programme is an alternative where patients are allowed to participate along with a doctor. Health care workers ask them when they are ready to receive or quit methadone.

Health care workers should provide HIV antiviral drugs along with methadone treatment and advise on the harm reduction programmes to users.

" They need more acceptance from the public and self determination for the treatment," she said. "They do not want prejudice but encouragement."

The Public Health Ministry reported more than a million Thais have developed HIV/Aids over the past 20 or so years, with about 550,000 still alive.

The health agency estimates 11,750 people will get HIV this year, mostly through unsafe sex.

In a bid to reduce new HIV/Aids cases by half within three years until 2011, the Public Health Ministry and other Aids agencies are staging the 12th National Aids Conference this week at Impact Muang Thong Thani Exhibition Centre. This theme will focus on the topic "Where we are". The prime minister will preside over the opening ceremony.