A report from a drug policy conference in Macau, where we visited a high-tech methadone clinic, a drop-in centre, and interviewed many brave Asian activists who are working on reducing the harms of drug use and drug laws.
Macau is a former Portuguese colony near Hong Kong, it was returned to China in 1999 but remained an autonomous territory. While gambling is illegal in mainland China, it is legal in Macau, and the town is full of big casinos attracting millions of gamblers every year. This is not only the most densely populated area in the world – it has the highest GDP as well. However, there are social and health problems attached to this vibrant urban way of life: behavioural and drug dependences, risk taking in relation to sex, and drug use.
ARTM is an NGO that provides an excellent example of an integrated service model to tackle these problems. People who use drugs are guided through the system by professional helpers, adjusting services to their specific needs. They have a drop-in centre with needle exchange and outreach, an opiate substitution clinic, rehabilitation, and a halfway house to reintegrate people to the society. These services are well integrated to the general social and health care system. Drug users are still criminalised unfortunately, but service providers try to cooperate with the criminal justice system and lobby for decriminalisation.
Macau can serve as a model to other cities in mainland China – and in other countries in East Asia, where compulsory treatment and tough-on-drugs policies are still the norm. This was the concept of the organisers of the 27th IFNGO conference, to bring participants from these countries and educate them about humane alternatives to repressive drug policies. To this end they brought several speakers from Europe and North-America who challenged the views of the audience with unorthodox ideas such as harm reduction and legal regulation. But this does not mean that harm reduction is unknown to Asian people: we have talked to several brilliant activists from many countries who fight prejudices and stereotypes every day, sometimes even risking their own lives.
Even though the risk of the Duterte-disease spreading across the region is very concerning, the work these brave activists and professionals are doing gives us hope that public attitudes will change, slowly but surely. What we, Europeans, can do now, is to support these people with funding, with technical assistance, and with amplifying their voice through our communication channels.
Peter Sarosi