The following letter was submitted Joyce G., who along with her husband Dave and others, are beginning the first treatment and rehabilitation services in Indonesia.

Recovery in Indonesia

Dateline: 08/04/99

THE BEGINNINGS

Recovery work in Indonesia is only beginning just now. The situation here is still very much like it was in Akron, Ohio, 1937. Only perhaps, Bob and Bill from AA had it better. They had people like Dr. Silkworth, who had both the knowledge and the heart in doing this work in the field of addiction. People that addicts can count on to help with the detoxification process.

Indonesia, still has none. There are people with the heart to work in the field of addiction, and yet have no knowledge. And there are people with knowledge, but no heart... and there are people who have neither knowledge nor heart to work in the field of addiction. Of the latter, Indonesia has the most. As far as they are concerned, money is the only thing that matters.

Until two years ago, detoxification in Indonesia was thought to be the only work necessary to help people recover. There were practically no treatment or rehabilitation centers available. Those that were available functioned more as holding jails for the many Indonesian addicts. Among these were locked down units of religious programs or police controlled programs, but none had much idea of what addiction meant. So, people never actually recovered when they came out of these programs.

Prevalent Ignorance

Addicts were kept away from their drugs and stopped using while in 'jail', and were pronounced recovered as they came out. And with the still prevalent ignorance among the people in regards to addiction, they thought that was what recovery was about. No 12 steps programs were available to the public until recently. And 12 steps work were never part of any recovery programs either, at least until recently.

Detoxification methods in Indonesia vary from no drugs at all, to a blatant misuse or overuse of drugs. In religious programs, detoxification only meant throwing addicts into cold baths at 4 AM in the morning. In others, it involves the full cornucopia of drugs that involved very high dosages of analgesics, sedatives, anti-anxiety drugs and others in combination, enough to send people into stupor and confusion.

One local psychotherapist was in the opinion that giving high doses of medicine would help 'blank out' addicts so the psychotherapist can 'hypnotize' them into recovery under these conditions. Recently an addict jumped out of a three-story building on these prescribed meds thinking he was a bird. He died instantly.

Time to Come Together

Yet another psychotherapist used opium antagonist substances (i.e. Naltrexone, Naloxone) to work with almost any addiction. He was recently found to have done Rapid Detoxification methods with addicts addicted to methampethamine and marijuana. These people can be dangerous, and yet the public is yet to learn about this. That is why, some addicts have felt that it is time for the addicts to come together and help their fellow addicts, and make recovery possible ...

We have recently, in July 1999 established a foundation by the name of Yayasan KITA. Yayasan means Foundation. And KITA in the Indonesian language, means 'WE' … taken from the first word in the first step of the 12 Steps of Alcoholics Anonymous. It's a program run by addicts, from addicts and for addicts. Collaborating with the State Mental Health Hospital in Bogor, West Java, this program hopes to provide a recovery model to be replicated throughout the country. So far, there are 14 addicts in the program. Out of the 14, twelve were heroin addicts and only two were methampethamine addicts.

The medical staff at the Hospital has all been very helpful. They have the heart to work in this field. However, they confess that they still have plenty to learn about addiction and about detoxing people from drugs. And they hope that the addicts could train them in detoxification methods. When the first batch of addicts came in (mostly are addicted to heroin or to methampethamine), of course we faced some confusion as to how to work with the addicts. What to give, how much to give and when to stop giving them medicine.

Other Conditions

So far, addicts in the program who have already stopped using drugs have come in to help with the detoxification process by talking with the detoxing addict, using the minimum of drugs possible. Giving medicine only if there were clear indications of discomfort or pain. It has worked so far. Yet there are conditions that also quickly came into consideration.

• What should we give to people with Hepatitis?
• What about other special conditions?
• Lung problems?
• What are the safest drugs to give?
• What about drug interaction?

Of course, we cannot pretend that we know all these things.

So … we are asking you, the people who have the knowledge and the heart to help us. We need a simple outline or flowchart for working with people in detoxification and with cases of overdose. Something, that is foolproof. Something, that perhaps we can hang in the detoxification room for a quick reference. The most prevalent substances abused are as follows:

1. Heroin
2. Methampethamine
3. Marijuana
4. Alcohol

And the most prevalent accompanying conditions are:

1. Hepatitis B & C
2. Various pulmonary diseases (bronchitis, pneumonia, TBC, etc.)

More Questions

Seven out of the 14 addicts have reported having Hepatitis. Four have Hepatitis C, and the other 10 have Hepatitis B. So, the next question would go to nutritionists and dieticians. Since the program is a residential program, we would like to know:

What is the best menu for people with liver problems

Of course there are more challenges that will unfold as time passes. Our program is less than a month old now. We are still under trial run. The program will be open and announced to the public in September 9, 1999 (we just think that's a good number … 9, 9, 1999) … We know about program. Yet, we still have plenty to learn in the medical end of it. And the medical professionals are hoping that we could help in providing these information to them also.

It would be nice to get some response from the readers out there who can help us with this.

Joyce G
Yayasan KITA
Bogor State Mental Health Hospital
Jl. Dr. Sumeru 112
Bogor - West Java
Indonesia
joydave@cbn.net.id

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