YOUNG PEOPLE AND DRUGS INDONESIA
Background
As part of the preparation of the Youth Sessions in the International Harm Reduction Conference, representative of UNICEF along with its partners in Indonesia has conducted a preconsultation with young people in Indonesia. The pre-consultation involved 40 young people at Yayasan Harapan Permata Hati Kita (Yayasan Kita), a drug treatment and recovery community center and at a meeting of eight young people hosted by Badan Narkotika Nasional (BNN) a government agency working with young people in drug prevention activities.
Summary of Youth Respons
Part One: Young People’s Views on the Nature of Drug Use
Why do young people begin using drugs?
• Curiosity and a desire to experiment
• Lack of information and experience
• Personality types which make some youth vulnerable to drugs
• Poor personal characteristics including poor decision making
• Pressure from self to fit in
• It was available, offered by a friend
• Felt pressured by friends, mainly at school
• Following other people’s lifestyles (adopting ready made lifestyles) that looks cool
• Trying to find something new
• Parents used drugs
• Poor communication with parents
• To gain parental attention
• Angry at parents
• House servants were using
• Availability of alcohol at home
• Early initiation with alcohol
• No alternatives to drug use for enjoyment
• Coping with difficulty in sleeping
• Experimenting at first, abusing next, addicted after
Why do some young people continue to use drugs?
Self
• Problem avoidance, such as stress, loneliness• Avoiding reality• To get attention, especially that which is not received from family• Improved ability to socialize• Liked the enjoyable effects and sensation of drugs• Felt that drugs was the whole world and that drugs had became one’s best friend Friends • Wanting to have fun with friends• Because a significant other (boyfriend/girlfriend) was also using• Because friends also continued to use
Family
• Parents could not control young person’s behavior, provided too much freedom, or are too soft
Lifestyle
• Because it felt right• Began to enjoy the lifestyle• Wanting the freedom of self expression• It gave a sense of self confidence• Wanting to be cool
The Nature of Drugs
• Did not know how to stop• Didn’t have information on how to stop• Using became a need; once they started heroin, they had to use to avoid withdrawal symptomsWhy do some young people stop using drugs?
Personal Feelings
• Tired and bored of an addicted lifestyle, tired of being tired• Stressed out, desperate, feeling guilty and depressed• Having a will to stop• Feeling that they have damaged the family by lying, stealing and cheating
Because of Others
• Parents by far are the strongest forces of change that can help addicts find help and stop use• Most significant others: parents or boyfriend/girlfriend found out and forced them to stop• Loss of good friends• Thinking about the negative effects drug use to family and siblings Risks Involved in
Continued Use
• Began to look into the future• Increasing risk of HIV• Already have HIV and HCV• Risks of overdose (already overdosed)• Risks of getting caught by police• Always had problems• Thinking about the possibility of having drug addicted kids• Life has become unmanageable• Decline in their general state of health
Financial Reasons
• Difficult to continue to support the habit financially
Part Two: How Young People Feel About Current ApproachesWhat are some of the options for young people who want to stop using drugs?
Medical Approach • Attend an outpatient clinic and be treated by doctors and psychiatrists• Detox through inpatient programs (including mental hospitals)• Go to a counselor at a drug dependence hospital
Home Therapy • Cold turkey (isolating oneself at home)• Geographical move (moving to a different neighborhood or city)• Substituting the use of other drugs• Imagining the future• Finding activities and staying busy
Rehabilitation • Go to rehabilitation centres (religious, therapeutic community, police rehabilitation, bootcamps)• 12 Step programs: trying to be clean just for today, one day at a time• Find a support group
Alternative Healers • Herbal medicine• Shaolin approaches
Religious Approach • Go to a religious boarding houses• Go to a religious leader to be exorcised and prayed forWhat problems have young people encountered in finding help to stop using?
Basic Problems • Did not have much information as to where to go for help; had to ask friends who were addicts• The services provided were pathetic and inadequate• Bad experiences and treatment from providers, i.e. discrimination, stigmatized as addicts• There were no facilities available that were good for addicts• No information was ever provided on HIV, HCV, effects, transmission and prevention
Medical Community • Medical community only knew about giving medicine, conducting detox and tending the body• Medications are too high in dosage• Did not provide counseling or information on drugs, harm reduction or viruses• Doctors do not have accurate information on substance abuse and addiction• Addicts end up disliking the service providers because their service were minimum and uncaring• Not professional in providing services• Testing for HIV without consent• Providing naltrexone and rapid detox to HCV positive addicts• Service providers do not really care, only how much addicts pay
Religious Community • Religious people only knew how to give advice without having information on substance abuse• Addicts end up disliking the service providers because their service were minimum and uncaring• Not professional in providing services• Harsh treatment and violence
Police Related Community • Violence• Punishment
What support do young people need to stop using drugs?
• A community that can provide therapy (recovering addicts helping addicts)• A good facility with a good program that understands addicts and makes us feel comfortable• The finances to be able to go to proper treatment• Knowledge and information about addiction as well as on the best programs available• Patience and dedication on the part of service providers in working with addicts• Support groups for clients (addicts helping addicts) and support groups for families• Emotional support from family and significant others, mental serenity and a sense of faith• Help in gaining the awareness of the need to recover and a clear program to work on• Aftercare including the active involvement and support of parents• Support services such as drop-in centers and 24 hour help hotline• Support from the nation in supply reduction, demand reduction and harm reduction• Materials that are comprehensive and continuously provided to the public
What are young people’s feelings about service providers?
• Resentful, distrustful, confused and shameful• Service providers are discriminative and stigmatize addicts• Service providers don’t have the welfare of the addicts and young people in mind• Service providers don’t have information and skills and are ineffective in helping addicts thus making addicts feel pessimistic about the likelihood of ever getting better• Great because doctors give medicine that addicts can mix with other street drugs• Service providers are annoying and not professional enough to work with addicts• Angry because they misled addicts with wrong information (i.e. naltrexone and rapid detox as the magic bullet and cure or that a person would overdose if they use after these treatments)• Annoyed that medications provided created side effects• They don’t provide us with enough time to consult• Fearful (having had been beaten and sodomized at a religious center and police based center)
Were prevention or harm reduction messages provided by service providers?
• Prevention messages were never available, none• No information prior to using regarding effects and dangers of drugs• Only knew about the types of drugs available to use• Providers that addicts came in contact with did not have any information about drugs, viruses• Information received on harm reduction was so limited and vague• Only knew about overdosing and avoiding abscess, but never followed instructions• Myths were plentiful (i.e. not necessary to use new needles; alcohol would kill all germs; HIV is only infecting sex workers, squatters; to revive an overdosing addict just inject him with salt)
What advice would you offer to service providers for working with young people?
Prevention Issues • Seek effective ways to prevent the misguided curiosity of young people• Prevention must be done before exposure to drugs because once you begin you will not listen• Programs must move beyond using scare tactics to more effective approaches such as life skills• Parents need to take part in prevention, providing attention and discipline (tough love)• Schools to take a bigger part in preventive measures, as early as possible (5th grade)• Provide workshops at school level, teachers must be informed (most schools are not ready)• Programs currently have very limited penetration outside major metropolitan areas
Harm Reduction Issues • Not available and not provided; most young people do not have information on harm reduction• Service providers do not seem to have information on harm reduction, and never pass on harm reduction messages to young substance abusers when they seek help
Early Intervention Issues• Help young substance abusers to understand the risk involved with the use of drugs• Create a healthy drug-free environment in hang out places• Associate drug-using lifestyle with risk and problems, because most do not do so• Help young people learn the skill of problem solving• Provide information on how to stop drug use, what young people can do when friends are using• Encourage families to be involved and educated in how to intervene
Treatment Issues • Professionalism in dealing with addiction is still lacking• Young people feel that there’s a huge gap between their needs and the services provided• Young addicts are distrustful in general, and are distrustful and resentful of service providers• Young addicts feel misunderstood and mistreated• Harsh treatments are reported in religious and police settings, while discriminative treatment is reported in the medical communities
How to Prevent Youth from Using Drugs
• Schools can provide age appropriate information about drugs that is also culturally appropriate• Information at all levels for everyone before experimenting with substances• Specific goals and dreams for youth – support for goals and dreams• Provide good environmental factors at home• Good communication with parents who are willing to discuss sensitive issues• Use positive peer pressure and allow youth to develop programs• Greater socialization with other individuals and youth as opposed to interaction with technology• High availability of constructive, alternative options for youth (parks, community centres)• Alumni and ex-drug addicts can visit schools with drug information• Provide positive role models
How to Motivate Youth to Stop Using Drugs
• Highlight the stress and tiredness associated with living life as an addict• Help young substance abusers see the problems they are creating for themselves and howunmanageable and filled with problems their lives have become• Highlight problems associated with drug use, i.e. health issues, age, and risks• Help young substance abusers to look into the future• Highlight the financial effect of drug use
Young People, Drugs and HIV/AIDS
• Most university students understand AIDS and the relationship between drugs and AIDS• High school students have little or no knowledge or believe that it is not going to affect them• Elementary students have no knowledge at all• Most youth have serious misconceptions regarding the means of available protection• Most are not properly informed about the high possibilities of AIDS due to IDU• Many don’t know how to protect themselves or understand the proper use of condoms• Most young people are in state of denial in regards to their vulnerability to AIDS and STD
