Section Two Summary of Country Consultations

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Section Two Summary of Country Consultations Conducted in March 2003 Indonesia Papua New Guinea Thailand Vietnam The International Conference on the Reduction of Drug Related Harm April 2003 Page 40 SUMMARY
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Section Two Summary of Country Consultations Conducted in March 2003 Indonesia Papua New Guinea Thailand Vietnam The International Conference on the Reduction of Drug Related Harm April 2003 Page 40 SUMMARY OF COUNTRY CONSULTATION YOUNG PEOPLE AND DRUGS INDONESIA Background As part of the preparation of the Youth Sessions in the International Harm Reduction Conference in Chiang Mai, on 6-11 April 2003, 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. The discussions were both held on the 17 th of March Summary of Youth Responses 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 The International Conference on the Reduction of Drug Related Harm April 2003 Page 41 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 symptoms Why 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 The International Conference on the Reduction of Drug Related Harm April 2003 Page 42 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 Approaches What 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 Shamans Religious Approach Go to a religious boarding houses Go to a religious leader to be exorcised and prayed for The International Conference on the Reduction of Drug Related Harm April 2003 Page 43 What problems have young people encountered in finding help to stop using drugs? 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 The International Conference on the Reduction of Drug Related Harm April 2003 Page 44 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) Happy and hopeful about the possibility of recovering at Yayasan KITA 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 (5 th 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 The International Conference on the Reduction of Drug Related Harm April 2003 Page 45 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 how unmanageable 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 The International Conference on the Reduction of Drug Related Harm April 2003 Page 46 SUMMARY OF COUNTRY CONSULTATION YOUNG PEOPLE AND DRUGS Papua New Guinea Background Five consultations among young male drug users and ex-drug users were conducted in five different locations in Port Moresby. The consultations were carried out in the form of focus group discussions among young people aged between 14 to 26 years. The institutions which conducted the focus groups are: Port Moresby City Mission, Jesus Centre - Half Way House, National Narcotic Bureau and Stop AIDS Anglicare. The major drug the young people focused on was cannabis. The consultations took place on Sunday 9 th March The total number of participants in the consultation was 78. A Profile of the Young People Who Participated in the Consultation Characteristics Number of Boys Percentage How many boys had taken drugs How many boys had ever sold drugs How many were heavily addicted How many boys were affected mentally Gave up drugs and later resumed use Peer pressure contributed to use Family problems contributed to use Started taking drugs at school Parents reprimanded for taking drugs Parents reprimanded for drinking alcohol Number of boys involved in the following: Petty crime Serious crime Rape Murder Number of boys from broken homes Number of boys abused sexually Number of boys abused physically The International Conference on the Reduction of Drug Related Harm April 2003 Page 47 Summary of Youth Responses Part One: Young People's Views on the Nature of Drug Use Why do young people begin to use drugs? Removes boredom Makes life enjoyable Cheaper than alcohol (current users mentioned that cannabis is cheaper than alcohol and this probably had contributed to an increased use of cannabis in those provinces in the country that had banned the sale of alcohol) Part Two: How Young People Feel About Current Approaches to Drug Prevention and Treatment What are some of the current programs that address drug use? Opportunities for employment Educational opportunities Sports participation programs How do you assess the current programs for addressing drug issues? Current programs are only partially effective Not working, young people go back to drugs again What advice would you offer to service providers for working with young people? The drug problem should be addressed seriously in all schools Schools should establish counseling facilities to help those addicted to drugs Young people who are being rehabilitated by the Christian agencies would like young people to be converted into Christianity as one of the steps to stop taking drugs Use reformed drug users to assist in rehabilitation programs The International Conference on the Reduction of Drug Related Harm April 2003 Page 48 SUMMARY OF COUNTRY CONSULTATION YOUNG PEOPLE AND DRUGS THAILAND Background As part of the preparation of the Youth Sessions at the International Harm Reduction Conference in April 2003, UNICEF along with its partners in Thailand conducted a pre-consultation with young people throughout Thailand. Discussion groups were held in Nakorn Ratchasima, Yasothon, Chiang Mai, and Bangkok. In Nakorn Ratchasima participants were young people under the responsibility of the Nakorn Ratchasima Detention Center who have previously used or sold drugs. Eight youth between the ages of years old participated. In Yasothon, 12 youth between the ages of years old met at the Sutasinee Noi-in Foundation for Children and Youth. In Chiang Mai two sessions were held. The first comprised eight street children/young people between the age of years old. In this group there were seven males and only one female because the majority of street children/young people are males. The second involved a group of 11 young people (six males and five females) who are members of the WY Group (a program that serves young people who do not participate in traditional school activities). In Bangkok, ten young people (nine male, one female aged 23-25) from throughout the Central Region of Thailand participated. The consultations in Nakorn Ratchasima and Yasothon were conducted by AIDSNet-Northeastern Office. The consultations in Chiang Mai were coordinated by AIDSNet-North and conducted by The Volunteer's Group for Children Development and the WY Group. The Bangkok meeting was conducted by CARE Thailand/Raks Thai Foundation. All consultations occurred in March Summary of Youth Responses Part One: Young People's Views on the Nature of Drug Use Why do young people begin using drugs? Personal Feelings Some young people are curious, want to experiment and don t believe they could get addicted They feel lonely and upset because of all the problems that they face Unhappy, feelings of not being loved, low self-esteem Some young people felt the media promoted the message that it is cool to use drugs There is generally very little for young people to do Some young people do not believe drug use is harmful Some used to feel superior to others Some young people are not strong enough to resist the temptation to try drugs Some are bored with their lives and feel drugs will make things more exciting Some are ostracized by the community (response from street children/young people) The International Conference on the Reduction of Drug Related Harm April 2003 Page 49 Family Parents who always quarreled Living in a broken home or single parent family Bored with parents and feeling unhappy at home Family problems lead some young people to try drugs Parents show little interest and neglect them Even if a parent provides children money, if young people don t feel loved they may use drugs Peers To follow the trends of the group To be accepted as a member of the group Urged or persuaded by friends to use drugs Many people begin at the invitation of their friends In some cases it seems like everyone else is using drugs so why not you too Problems with boyfriends and girlfriends is a reason for some people If someone's boyfriend or girlfriend uses drugs, it is more likely that person will use Desired Effects To keep yourself from falling asleep To be more productive at work or school To be in good shape, lose weight, and to look beautiful as ways to increase self-esteem Increase energy to dance and stay out all night at discotheques To be a diligent person as the diligent person will be loved and accepted by others To improve your ability to do things such as sports To help increase the time before ejaculation and increase the number of sexual acts Misinformation Because of a lack of information and a misunderstanding regarding the dangers of drugs While drug use was forbidden, no one took the time to explain why it was a bad idea Why do some young people continue to use drugs? Personal Drugs let you release suppressed feelings To cope with feelings of loneliness or inadequacy as a person They imagine that they can do things that they are not able to do in real life Drugs become a way to help forget problems and stress Some young people have the money available to buy drugs and are attracted to the feelings and experiences of using drugs People feel they are still productive even when they use drugs To stimulate their imagination and help them forget their problems and difficulties After getting the first drugs for
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