17/09/2010
Photo: Brendan Brady/IRIN
Cambodia came under fire earlier this year over its drug treatment services
Cambodia came under fire earlier this year over its drug treatment services
BANGKOK, 17 September 2010 (IRIN) - Cambodia is piloting its first methadone clinic for heroin addicts, a move welcomed by NGOs after the government was heavily criticized for its boot-camp style drug-rehab facilities.
Methadone is a heroin substitute used to assuage withdrawal symptoms and for decades has been the treatment method preferred by health practitioners in developed countries, even though it comes with its own addiction problems.
Introduced by the World Health Organization (WHO) and administered by the Ministry of Health, the year-long pilot programme officially launched this week in the capital, Phnom Penh.
"We don't have a strong history of [professional] drug treatment in Cambodia," Chhit Sophal, head of the Ministry of Health's Centre for Mental Health and Drug dependence and in charge of the programme, told IRIN. "This centre can be a model and other centres here can learn from it."
Some 60 patients are already enrolled and Chhit wants the figure to top 100 within a year.
By deterring heroin users from injecting, methadone clears the body of harmful toxins and also prevents the spread of HIV/AIDS and hepatitis from needle-sharing within this high-risk group, said Chhit.
Almost a quarter of Cambodia's estimated 3,000 injecting drug users are HIV-positive, according to the government. This rate is much higher than the national average of less than 1 percent, according to UN statistics.
Graham Shaw, a drug dependence specialist with WHO in Phnom Penh, said the new treatment could turn around the lives of heroin addicts.
"Rather than having your whole life focused on finding money to buy more heroin, you can focus on repairing relationships with family, finding jobs, and using income for things other than drugs," he said.
Shaw said the benefits of clinical treatment would unravel, though, unless other organizations stepped in to help patients find employment and avoid drug-using communities.
Progress and lingering concerns
According to a Human Rights Watch report released in January, drug users were involuntarily interned at government centres where they faced beatings and forced labour, while being deprived of effective treatment for their addiction.
The WHO reported in a publication last year that only one in 405 people in Cambodia entered a drug treatment centre voluntarily.
The methadone programme is a strong step in the right direction, said Shaw. "One of the reasons this clinic is so critical is that it's the first attempt by the government to use a voluntary [rehab] service," he said.
David Harding works with the NGOs Friends International and Mith Samlanh, which refer heroin users to the methadone clinic on a voluntary basis.
He said this more sophisticated therapy was a sign of progress but that the overall picture of the government's rehabilitation protocol remained "mixed", citing the opening of a new state provincial rehab centre that he said used "boot camp" methods.
The government's intentions aside, the country's bigger drug problem, methamphetamine use, remains far more difficult to treat clinically.
The WHO estimates there are some 40,000 methamphetamine users in Cambodia. The international medical community has yet to find a strong antidote to methamphetamine dependence, though.
"That's the Holy Grail, to find the methadone equivalent [for methamphetamine addiction]," said Shaw.
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