Indonesia Successfully Developing of Methadone Maintenance Treatment Services

Injecting heroin users is estimated to reach 200,000 people in 2008 of Indonesia, according to the National Narcotics Agency data. While the Ministry of Health said in 2009 there were 40.2% of 16.964 people with AIDS is caused by injecting heroin addiction behavior. They are generation aged between 14 to 30 years. Injecting heroin dependence not only causes damage to nervous system manifestation of the human brain function, but also a medium of hepatitis infections and HIV disease. Later this dependency problem cause changes in behavior that makes people easy to perform immoral acts, criminal, and even suicide.

Health problems and social aspects of injecting heroin users in Indonesia began to surface since 1997 after a drug-free trade routes passing through this territory, turned into a marketing target. The rise of injecting heroin use, or commonly known as putauw into big cities with free users among teenagers. In a 2002 study supported by WHO found that the trend of HIV transmission has changed from the problem to the use of free sex with non-sterile needles among heroin users. Consequently in 2005, the Indonesia Ministry of Health surveylens the number of HIV patients is figured 55.6% were caused by those bad habits.

So since 2006, Indonesia implementing harm reduction policy in which the main attention is directed to the victims of injecting heroin dependence. This policy is a commitment with WHO, the Ministry of Health, and National AIDS Commission to develop a methadone maintenance therapy services in hospitals, primary health centers, and prisons. Today methadone services were implemented in 10 provinces which covering 14 hospitals, 18 health centers, and 4 imprisonment. Ten provinces are major areas that have main HIV prevalence rate from 33 provinces. According to national data, this time recorded approximately 4.000 people a day are served with an average dose of 60 mg to 80 mg. For one year later, the Indonesian government has prepared 50 activation of methadone clinics again to reach 8.000 people of injecting heroin users.

Methadone maintenance therapy has a therapeutic function of two responses to injection of heroin dependence and behavioral changes taking medication injected into liquid methadone daily under the supervision of medical personnel. This therapy is also known as therapeutic substitution of liquid oral drug that has high success rates in many countries in an effort to reduce the chances of HIV infection and hepatitis. The use of methadone is given based on clinician assessment to determine individual doses taken every day at the methadone clinic. The dose will increase while undergoing the process of behavior change within a certain time period and then will decrease until it stops from drug addiction. During the treatment period, patients received methadone health services sustained observations, antiretroviral therapy for an infected HIV / AIDS, and counseling support to assist the recovery of social aspects. The success of methadone maintenance therapy services was assessed as quite satisfactory, because improving the quality of health, social functioning, and lower crime rates of the patient and its environment