Widespread, IDU misuse of substitute drug

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Anton Muhajir, Contributor, Denpasar | Tue, 01/27/2009 1:27 PM | Bali

Agus, an IDU (injection drug user) addict who insists on using a false name before granting an interview, injects 2 milliliters of Buprenorphine, an orally consumed substitute drug for heroin,  into his veins each day.

He grinds the pills into a powder before mixing it with water, then filtering the solution through cotton before injecting the final mixture into his veins.

“My doctor knows I’m injecting it,” he says.

“He doesn’t mind me injecting, he says it’s okay as long as I stay away from putaw *low-grade heroin*.”

Agus is just one of many IDUs in Bali misusing Buprenorphine.

His case reflects the inadequate state of drug use prevention in the province.

Testimonies gathered by The Jakarta Post show IDUs and doctors are clearly aware that IDUs continue to inject Buprenorphine instead of consuming it orally, the way the drug is meant to be consumed.

Iwan, another IDU addict who insists on using a false name, says he prefers to use Subutex (a street name for Buprenorphine) by injecting it.

“It’s the only I way I can get any sensation from it,” he says.

Injecting Buprenorphine causes intense pain and causes the veins to swell. This can prove fatal through causing veins to be blocked.

More importantly, the rampant misuse has laid waste to the core justification of the introduction of the oral substitution therapy. The therapy’s proponents remain convinced that orally taken substitution substances will stop IDUs from injecting, thus significantly lowering the possibility of their getting infected with HIV/AIDS. Needle-sharing among IDUs has been identified as the primary factor behind the surge of HIV/AIDS infections among IDUs.

Nyoman Suasta, a field operative from the Hatihati Foundation, an organization that focuses on AIDS prevention by offering users substitute drugs, says all seven of his patients inject Buprenorphine.

Suasta says he continues to remind them of the negative effects of injecting the drug, but is helpless to stop them.

Denny Thong, a doctor who provides addiction therapy through prescribing Buprenorphine, admits that most IDUs continue to misuse the drug.

“Most of them have tried. They nearly die trying to stop, but they just can’t,” he says.


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