Dr. dr. Diah Setia Utami, SpKJ, MARS Deputy of Rehabilitation Narcotic National Board of Republic of Indonesia

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1 Dr. dr. Diah Setia Utami, SpKJ, MARS Deputy of Rehabilitation Narcotic National Board of Republic of Indonesia

2 Growing evidence in changing of usage, from natural plant substances to synthetic substances There are 68 New Psychoactive Substances (NPS) found in mid of 2017 Major drug of choice: cannabis, crystal meth, ecstasy, heroin, benzodiazepine, others (NPS)

3 Significant decrease of people who inject drugs (heroin, buprenorphine, crystal meth, benzodiazepin, fentanyl) est 2% among total drug user population 60-70% of inmates are drug-related problems (around 60% are drug user / addicts)

4 In 2016, Indonesia had 48,000 (43,000 52,000) new HIV infections. The key populations most affected by HIV in Indonesia are : People who inject drugs, with an HIV Prevalence of 28,76% Gay men and other men who have sex with men, with an HIV Prevalence of 25,8% Transgender people, with an HIV Prevalence of 24,8%

5 Number of PWHA 25000, , , , , , , , , ,0 5000,0,0 Men Women

6 Student: 27.32% Employee 50.34% Unemployed 22.34% Source: Litbang BNN, 2015

7 Strengthening border, air and sea interdiction Optimizing criminal justice system Increasing global, regional and national collaborative works Confiscating drugrelated assets for public s sake Encouraging drug users to receive treatment through Integrated Assessment Team Provided Prisons with Maximum Security

8 Enhancing community selfresilience by promotive & preventive strategy Developing early detection and intervention among community Optimizing local government & community role in drug campaign Developing continuing drug treatment & rehabilitation program Increasing accessibility of drug treatment & rehab service Increasing drug treatment quality of service

9 MoH MoSA BNN MoJHR CBTx Health Facilities Medical Rehab incl Methadone Program Soc Institution Soc Rehab T&R Centers Med & Soc Rehab Prison/ Detention based Limited Methadone program Soc Rehab Health/ Soc Institution Medical/ Soc/Faith based

10 No Services Number 1 Needle Syringe Program 194 PHC and 38 NGO 2 MMT and Integrated Harm Reduction Drugs Treatment MMT : 92 Health Facility and 9 Prison Integrated HR Drugs Treatment : 10% from CBDDT in Indonesia 3 HIV Counseling and Test 3204 Health Facility and 45 Prison 4 Sexual Transmitted Infection Services 1803 Health Facility 5 Condom Promotion for IDU and Their Partner 104 NGO, 1061 Public Health Facility 6 IEC for IDU and Prisoners 104 NGO, 1061 Public Health Facility and 148 Prison 7 ART 213 Health Facility and 462 Hospital 8 Hepatitis Vaccination, diagnosis and Therapy 9 TB Prevention, Diagnosis and Therapy 223 Health Facility Hep-C Medication Program for 6000 Patient in National Scale

11 2006: MoH Decree RI No : Minister of People and Social Welfare Regulation No : Narcotic Law WHO, UNAIDS, UNODC 2015: MoH Decree No. 55

12 Narcotics Act No. 35/2009 Drug addicts are obliged to report & get treatment to have exemption of criminalization Abusing drugs are still considered as a crime (max sentence 4 yrs) Government Regulation No. 25/2011 regarding Compulsory Reporting System for Drug Addict Term of compulsory still prioritizes selfdriven or family-driven treatment seeking Reporting system is not only reporting, but providing comprehensive assessment and develop treatment plan

13 2014 Joint Regulations among Law Enforcement and Health Welfare Agencies regarding Rehabilitation Process for Drug Addicts Regulate rehabilitation process for drug addicts who are in criminal justice system Accommodate vital role of Integrated Assessment Team to make rehab recommendation for drug addicts in criminal justice system (CJS) National Action Plan of Continuing Rehabilitation Program Has been developed since 2016 Involved 5 stakeholders of T&R Addressed to integrate rehabilitation program across stakeholders and to promote continuing rehab

14 To provide diversion opportunity for drug user by including minimum threshold of illicit drug to determine drug user instead of drug dealers To include New Psychoactive Substance (NPS) in drug law schedule To promote continuing treatment and rehabilitation instead of polarize medical and social rehabilitation including after care program To provide integrated assessment team to work independently in determining drug user in criminal justice system To include drug treatment costs as part of National Health Security System coverage To include addiction counselor as one of vital human resources in drug T & R service, apart from existing other professionals such as social worker and health professions

15 Thank You

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