吸毒者要求尊严、参与和基于证据的政策
2009年6月26日新德里：国际禁毒日期间，吸毒者聚集在Shastri Bhavan外抵制"假冒伪劣"的毒瘾治疗项目，要求有意义地参与政策制订。吸毒者在抗议戒毒中心内的酷刑和残忍行为的同时，呼吁社会公正与赋权部（Ministry of Social Justice and Empowerment）"清理"毒品治疗项目，在咨询吸毒者之后引进基于证据的项目。
联合国秘书长潘基文在去年6月26日的通知中呼吁成员国确保正在与毒瘾做斗争的人能够获得健康和社会服务，并且确保没有人因为依赖毒品而被污名化和歧视。"这一通知似乎已经被忘记了。我们到这里来提醒各机构他们对毒品依赖者的责任，"吸毒者论坛（Drug User Forum）主席、抗议召集人R.K Raju说。
根据世界卫生组织的观点，毒品依赖是一种慢性疾病，需要多学科和全面的服务。但印度的毒品治疗是由某些使用未经证实、过时和不科学的治疗方法的机构提供的。"鸦片依赖患者必须要受益于美沙酮和丁丙诺啡——世界卫生组织基本药物目录上的药物。现在是提倡和确保更普遍地获得毒品替代治疗的时候了，这能够减少HIV和其他与注射有关的血液传染病，减少非法使用毒品和改善健康，"钦奈（Chennai）精神病医生M. Suresh Kumar博士建议道，他治疗毒品依赖问题超过二十年之久。目前，毒品依赖治疗服务是通过以下机构提供的：
·政府医院向住院病人和门诊病人提供保健服务，多数是戒毒服务。除了新德里的全印医学院全国毒品依赖治疗中心（National Drug Dependence Treatment Centre of AIIMS）等主要医院之外，多数政府诊所不提供鸦片替代治疗。
·NGO从社会公正与赋权部获得资助来经营让成瘾者居住15至20天的戒毒中心。NGO给予关注和咨询，但不总是按照临床方法来治疗毒瘾。
·没有登记或政府批准的私营戒毒中心。这种戒毒中心向成瘾者或其家庭收费3，000至7，000卢比。这些戒毒中心不提供专业帮助；相反，住院者由于毒瘾而受到"惩罚"。没有政府部门监督这些诊所，它们违反规定而不受惩罚。
在上述机构中，第三类是最危险的。Anil回想起他待在德里一家私营戒毒中心时的可怕记忆，他说："四十个人被锁在一个肮脏的地下室里。因为我们被迫喝脏水，一个男孩得了霍乱。中心的主人每天只让我们吃三个薄饼，如果有人要更多食物，他会被绑起来痛打。我们的头被剃光。我们被当作畜生一样对待……还不如畜生……"
"许多吸毒者由于肉体折磨和缺乏及时的医疗看护而死在这些戒毒中心里，"倡导毒品依赖者权利的NGO律师联盟（Lawyers Collective）的Tripti Tandon控诉道。《麻醉药物和精神药物管制法案》（Narcotic Drugs And Psychotropic Substances Act）要求政府开设治疗机构，但这一责任很大程度上被忽视了。"社会公正与赋权部的计划对私营戒毒中心没有约束力。急需规范治疗活动和保护吸毒者的健康和安全，"Tandon敦促道。
另一个抱怨是对吸毒者有影响的政策没有吸毒者的参与。"社群参与对扩大项目的影响必不可少。政府忽视我们太长时间了。这必须改变，"Raju要求道，他打着"没有我们参与，就不要做关于我们的决定"的横幅。
本日早些时候，全世界超过40个国际团体和专家呼吁采取行动，迫使政府对毒品政策采取人道态度，颁布以科学和医学研究为基础的措施。
Tripti Tandon
律师联盟HIV/AIDS组，印度
For immediate release:
Contact:
R.K Raju: +91-9871572298
Tripti Tandon: +91-9811013472
Drug users demand dignity, participation and evidence based policies
June 26th 2009, New Delhi: On the international day against drug abuse and illicit trafficking, drug users gathered outside Shastri Bhavan, to reject "sham" programmes for addiction and demand meaningful involvement in policies. Protesting torture and cruelty in de-addiction centres, drug users called upon the Ministry of Social Justice and Empowerment, to "clean up" drug treatment and introduce evidence based services in consultation with persons who use drugs.
In his message on June 26th last year, the United Nations Secretary General Ban Ki Moon had called on Member States to ensure access to health and social services for people struggling with addiction and that no one is stigmatized or discriminated against because of their dependence on drugs. This message seems to have been forgotten. We are here to remind various agencies of their responsibility towards persons who are dependent on drugs" said R.K Raju, President of the Drug User Forum and convenor of the protest.
According to the World Health Organisation (WHO), drug dependence is a chronic medical condition that requires multi-disciplinary and comprehensive services. Drug treatment in India, is however, provided by some agencies utilizing unproven, outmoded and unscientific modalities. "Opioid dependent patients must have the benefit of Methadone and Buprenorphine, medicines that are on WHO's list of essential drugs. It is time to promote and ensure wider access to drug substitution therapy, which reduces HIV and other blood borne infections related to injecting, lessens illicit drug use and improves health" recommends Dr. M. Suresh Kumar, a Chennai based psychiatrist who has been treating drug dependence for over twenty years. Presently, services for drug dependence are offered through:
- Government hospitals that provide inpatient and outpatient care, mostly detoxification. Barring premier centres like the National Drug Dependence Treatment Centre of AIIMS in New Delhi, most of the government clinics do not offer opiate substitution.
- NGOs, who receive grants from the Ministry of Social Justice and Empowerment to run de-addiction centres that house addicts for 15 to 20 days. NGOs impart awareness and counseling but do not always follow clinical methods to treat addiction.
- Private centres that operate without registration or government approval. Such centres charge anything between Rs 3,000 to 7,000, from addicts' or their families. There is no professional assistance; instead inmates are 'punished' for addiction. No government department monitors these clinics, which violate norms with impunity.
Of the above, the third category is the most dangerous. Recollecting horrific memories of his stay at a private de-addiction centre in Delhi, Anil said - ""Forty of us were locked up in a dingy basement. One boy fell sick with cholera because of the dirty water we were made to drink. The owner allowed us to eat only 3 thin rotis a day, if some one asked for more, he was tied up and thrashed. Our heads were shaved off. We were treated like animals…worse than animals..."
"Many drug users have died in these centres, because of physical torture and/or lack of timely medical attention" complained Tripti Tandon of the Lawyers Collective, an NGO that advocates for rights of people dependent on drugs. The Narcotic Drugs and Psychotropic Substances Act tasks the government with setting up treatment facilities, but this responsibility has largely been ignored. "Schemes of the Ministry of Social Justice and Empowerment are not binding on private centres. There is an urgent need to regulate treatment and protect the health and safety of drug users" urged Tandon.
Another grouse was the non-involvement of drug users in policies that affect them. "Community participation is essential for widening the reach of programmes. The Ministry has disregarded us far too long. This must change." – demanded Raju, flagging the banner of nothing about us, without us.
Earlier in the day, more than 40 international groups and experts worldwide issued a call to action that presses governments to adopt a humane approach to drug policy and enact measures based on scientific and medical research.
Tripti Tandon
Lawyers Collective HIV/AIDS Unit, India
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