Travelers on the hidden path to oblivion
The challenge faced by drug abusers in getting clean can seem insurmountable but recent findings have spurred society to understand their problem more thoroughly. Honey Tsang reports.
(right) and Yip Siu-ping, registered social worker, who has counseled Wing for years, was playing basketball in Au Tau Youth Center.
He snorted his first line of ketamine a decade ago. At 17, Wing learned how to contact dealers and buy a HK$100 small bag he would share with friends. After a while, his cravings became ferocious. He’d load up on four sacks at a time. He didn’ t share with his friends any more. He’d hole up at his place and snort himself to oblivion for HK$800 a day, all on his own.
Wing was a wreck by the time he was 23. The drugs controlled his life and left him feeling very much alone. He asked for help.
He’s been in and out of rehab for four years. It’s pretty hard to shake the “monkey on his back”. Once he climbed over the wall to get out of a rehab facility, reclaiming his “freedom” so he could get a dose, craving the full-body buzz ketamine brought to him — a surreal feeling as if he was sailing aloft, easing away all his anxiety. Then a nasty hallucination would pitch him back into the depths.
For as much as he told himself he was determined to quit, he’d fall back. He knew his next relapse would come in only a matter of hours. His acquaintances remarked on his insatiable hunger for pleasure.
Last year, at 26, he made another resolve to get clean. To do that, he intended to get arrested, so he tossed a small bag of ketamine onto the street in Wan Chai. The cops came and arrested him. He’d dumped enough in the bag to get him put on probation.
“My impulse was so intense that no single thing or person could control it,” Wing said. “I had no choice but to resort to the law, and to hope the probation order would force me to quit.”
Cheung Ching-kit, a registered social worker who counsels drug addicts, said people who aren’t into the drug scene don’t really understand what’s going on. They see drug abuse as a moral failing on the part of the abuser.
In a private exchange with China Daily, Lam Ming, a consultant at the Tuen Mun Alcohol & Drug Dependence Unit of General Adult Psychiatry at Castle Peak Hospital, pointed out that drug addiction is in fact a chronic illness, not the result of a damaged psyche.
The chemicals found in drugs, he said, can alter and impair the brain’s structures and functioning. This will generate a transition from occasional drug use to a severe addiction, and makes relapses so common among addicts.
Going underground
Hong Kong’s Central Registry of Drug Abuse (CRDA) has reported a continual drop in the number of drug abusers. The CRDA is a voluntar y drug-abuse reporting mechanism monitored by the government. The reported number was 10,260 in 2013; it dropped by 11.7 percent to 9,059 in 2014; and dropped another 5 percent to 8,598 last year.
The authorities were content they had their timeline straight, believing drug abusers were dutifully reporting their history of first abuse.
Back in 2009 people were turning up to the system with just 2.1 years of using. Then in 2015, a whole new population suddenly appeared and the average time of abuse jumped to 5.8 years. Where had all these people been?
Back in 2009 when high school students were collapsing unconscious in public parks, the authorities started a major crackdown on drugs. That’s when the numbers started to skew.
“We’ve been so concerned about the hidden drug abuse problem in the city,” said Tam C hi-wah, executive director of the Society for the Aid and Rehabilitation of Drug Abusers (SARDA), a non-governmental organization which has aided drug abusers since 1961.
“The increased years of drug history is revealing of the fact that the motivation for abusers to seek help is spectacularly low. This makes it harder to discover their cases and lend help,” Tam added.
Wing , who asked for his real identity to be withheld, was one among the many young drug abusers in town who went into hiding, out of sight and out of mind of the authorities who mistakenly believed the war on drugs was pretty well won and all that remained was the mopping up.
Wing hushed up his ketamine fixation for six years. Only his family, a few friends and the dealers he used knew the truth.
Ketamine, also known as a club drug, is cheap, powdered, and easy to carr y. Its withdrawal effec ts are less debilitating than those of heroin and opium. It started showing up in town around 2000 and quickly became catnip to youngsters looking for a cheap high, Tam explained.
In 2015, ketamine was the third most common type of drug in Hong Kong. Methamphetamine, also known as ice, had moved into second place. Heroin still tops the list of illicit drugs, according to the latest official report on the city’s drug abuse situation.
Wing, who was a construction worker, was earning up to HK$40,000 a month. He would have been doing well if he hadn’t lavished all his money on drugs. He was also recovering from a broken relationship. He was lonely and feeling like a failure, and on top of it all he was burdened with a sense of guilt.
As happens with drug abusers, his body had become increasingly resistant to the effects of ketamine. He had to keep increasing the doses until he was taking it every few hours, a gram at a time. The highs weren’ t as good as they used to be. He no longer got “delightfully numb”, as he described it. Wing progressed up the drug ladder. In 2014, he started doing cocaine.
He said he was shooting up around HK$3,000’s worth a day. That was double his income. He took out a big loan to support his habit. Finally, he figured he’d had enough.
In most cases, abusers misuse drugs to put themselves in a mental haze, wanting to be free from all the stress and strains of unfiltered life. Only when it’s too late do they recognize they are addicted.
Research by the Census and Statistics Department in 2015 confirmed that many reported drug abusers get onto drugs because they are bored, depressed or can’t handle the stress of their day-to-day life. Only a few of them said they took drugs just to get high.
Causes of relapse
In o n e s t u d y t i t l e d “Fa c i n g Addiction in America”, published in November by Vivek Murthy, the surgeon general in the United States, researchers found out the structural changes in the brain — or neuro-adaptations — caused by prolonged drug use persist long after users have abstained from drugs. This explains why over 60 percent of patients surveyed relapsed within the first year after finishing their rehab programs.
There’s no doubt the first use of drugs is an act of free will. The report, however, argued people should show compassion for drug abusers who try and fail repeatedly to quit drugs. The trying and failing are effects of the neurobiological changes, the report suggested.
Since Wing turned himself in, he’s been committed under a probation order to Au Tau Youth Center to undergo rehab in a residential program. He’s been off drugs for over a year now, the longest stretch he’s stayed straight in over a decade.
He can’t slack off. He’s still learning to channel his stress and he’s taken up Thai boxing. He finds exercising an effective alternative to taking drugs.
“Putting a drug user with a long addiction history in rehab is similar to a toddler learning how to walk,” said Yip Siu-ping, a registered social worker and assistant to the superintendent of the SARDA . “They have to fall many times before they manage to make progress.”
Interventionist approach
Throughout 2015, 4,7 17 people were arrested for drug offenses in Hong Kong. Among them, 2,768 were caught for serious drug offenses, including drug manufacturing, trafficking or possessing large quantities of illegal drugs. The rest, 1,949 individuals — including Wing — were arrested for minor breaches, such as being caught in possession of small amounts of drugs for personal consumption.
In a bid to combat the hidden drug problem, the city’s government has focused on stemming illegal drug supplies in town, through interdicting import of illegal drugs and stepping up the patrol of some drugabuse black spots.
In 2015, the city’s two law enforcement agencies, the police and the customs, together seized 499 kg of ketamine, 356 kg of methamphetamine, 227 kg of cocaine, and 27 kg of heroin.
How people react to drug addiction has an enormous impact on whether abusers come out of the shadows. The stigma attached to addiction is incentive enough to keep the problems away from public view. That contributes to the citywide problem of hidden drug abuse, Tam said.
Seeing that the hidden abuser has little motive to come forward, family and friends of abusers should take the initiative to report suspected cases and minimize the damage through an early intervention, Tam suggested.
“Going on a detox is in fact an impossibly challenging and timeconsuming task, given your brain has been completely hijacked by drugs,” Wing said.
Wing’s life has become tamer now. He has several personal trainer certifications. He is planning to be a coach sometime later. This is a life he’d longed for, a life so clean and organized, a life he forfeited his freedom and reputation in exchange for a criminal record, just to rein in his drug jones.