Wars just produce casualties, for all sides

I READ with interest Mangai Balasegaram’s write-up about how Malaysia’s mandatory death penalty is not working to reduce illegal drug use in the country (“The mandatory death penalty doesn’t work”, Human Writes, Dec 10; online at tinyurl.com/Star2-death.)

I am an addiction psychiatrist currently undergoing advanced training in addiction and substance abuse at Turning Point Alcohol and Drug Centre, Melbourne, Australia. I totally believe that the combination of bio-psycho-social approaches is the key in managing drug and addiction problems. Speaking from the perspective of a person who has been exposed to medical treatment of drugs and addiction, I believe that medications, psychological interventions, and social support can help in disentangling the web of addiction.

In my personal opinion, harm reduction practice to manage drugs and addiction should be delivered within the proper context. This includes stopping the demand for drugs by cutting off the supply through enforcement and education. However, enforcement in the form of “a war on drugs” and persecution in the form of the death penalty and imprisonment of drug users have long been shown to be ineffective and counter-productive.

If these are effective, we should all ask ourselves why Malaysia failed to achieve its aim to be a drug-free country by 2015.

I would prefer to have the drug users being channelled to treatments (medications and psychotherapy) and improving their social support than seeing them languishing (and withdrawing from drugs) in lockups or prisons.

This approach, however, will take a lot of political willpower and a significant workforce (doctors, nurses, psychologists, counsellors, social workers) while its outcome will be slow to show up. However, countries have managed to turn things around in the past by accepting the use of a methadone programme as maintenance therapy for opioid dependents. Methadone maintenance therapy has cut down on the transmission of HIV/AIDS significantly and should be lauded in a nation that considers drugs its number one enemy.

It is imperative that public health approaches be given a fair chance in managing drugs and addiction. It’s definitely more beneficial rather than spending valuable resources in an ineffective “war on drugs”. Wars always produce casualties for all sides that are involved in them.