Diah - KEBIJAKAN DAN STRATEGI NAPZA-in English.pdf

NATIONAL POLICY ON

SUBSTANCE RELATED

DISORDER IN INDONESIA

DIAH SETIA UTAMI

DIRECTORATE OF MENTAL HEALTH

INDONESIA MINISTRY OF HEALTH

INTRODUCTION

Estimation of drug user in 2011 were 3.7 - 4.7

million (2,2% total population of 10 – 59 y.o):

27% experimental user

27% abuser

45% non injecting user

2% injecting drug user

Economy disadvantages (2008 survey):

Rp.32,4 Billion (2008) Rp.57,0 Billion (2013)

Resources: BNN

Introduction (cont’d)

1,75%

1,99% 2,20%

0,00%

0,50%

1,00%

1,50%

2,00%

2,50%

2004 2008 2011

Prevalence of Drug Abuser

Resources: BNN

Concept of National Strategy on

Substance Related Disorder

Prevention

Strategy

Treatment &

Rehabilitation

Strategy

To develop

Indonesian people

free from drug

abuse

• Healthy people

• Educated

people

Long term

planning

(2025)

Policy of MOH-RI on Substance

Related Disorder

Prioritising promotion of healthy life style &

preventing behaviour problems

Integrating treatment service in existing health

facilities:

Standardized management

Sustainability program

Providing comprehensive and multi-disciplines

approach in treating drug users

Policy of MOH-RI on Substance

Related Disorder (2)

Supporting community-based and user-based

recovery program :

To facilitate livelihood of drug user

To accommodate drug user capacity in treating their

peers

Protect human right and client’s safety:

Avoid stigmatisation & discrimination towards drug

users

Policy of MOH-RI on Substance

Related Disorder (3)

Reducing harmful effect of injecting drug use:

9 components (drug treatment; NSP; HIV testing &

counseling; STI prevention & treatment; Condom; IEC;

Hepatiting B & C treatment & vaccination; TB

treatment)

Balancing & coordinating multi-sector approach:

Balancing three pillars approach (supply – demand –

harm reduction)

Balancing health-welfare approach and security

approach

Policy of MOH-RI on Substance

Related Disorder (4)

8. Developing Information System:

To support evidence-based strategic planning on

substance related disorder prevention and

management

9. Legislation & Regulation

MOH Programmes

Endorsement of National Guidelines on treatment

and rehabilitation program

Improvement of drug treatment service quality

Provision of standardised assessment system related to compulsory reporting

system & decriminalization

HIV control & management among drug users

Programmes

Policy on Compulsory Reporting

Regulation

Compulsory reporting regulation is mandated by No.

35/2009 Narcotics Law, particularly through MOH &

MOSA

MOH has developed service system to accommodate

compulsory reporting regulation:

Develop standardised assessment & treatment plan system

Appoint several PHCs, General Hospitals, Drug Dependence

Hospital & Mental Hospitals in 33 provinces as compulsory

reporting treatment provider (IPWL)

Provide compulsory reporting budget claim

Framework of thinking

Copulsary

registration Criminalization

Addictive Behavior is

manageable

Minimization of infection disease and

mental health problems

Compulsory reporting system

Assesment Treatment

Plan

Treatment and

Rehabilitation

Policy on Medical Rehabilitation

Medical Rehabilitation is a terminology in No.

35/2009 Narcotics Act referring rehabilitation

program provide by MOH

Target population of medical rehabilitation is

voluntary drug users; drug users brought by their

family or sent by criminal justice system

It covers various treatment modalities: outpatient

and inpatient approach

Medical rehabilitation consist of...

Medical Rehabilitation Detoxification

Drug-free outpatient program

Medicated-Assisted Program

Short-term residential program

Long-term residential program

Sumut 4

Sumbar 1 Sumsel 2

Kepri 1

Lampung1

Riau 1

DKI 18

Banten 7 Jabar 14

Jateng 6

Jatim 9

DIY 5

Bali 6

Kalbar 3

Kaltim 1

Sulsel 5

Methadone Clinic

Mei 2013: 85 clinics in 17 Provinces

Jambi 1

Data Ditjen BUK Kemenkes, 2013

Methadone Clinic based on setting

0

5

10

15

20

25

30

35

40

45

1

26

7

1

42

5 4

RSU RSJ RSKO PKM Lapas Rutan

Data Ditjen BUK Kemenkes, 2013

Aceh 1

Sumbar 1

Sumsel 1

DKI 2

Jabar 3

Jateng 1

Jatim 2

DIY 1 Bali 1

Kalbar 1

Kaltim 1

Sulsel 1

Residential Rehabilitation

Bengkulu 1

Banten 7

NTB 1

Kalsel 1

Compulsary Registration Treatment

Provider (IPWL)

0

10

20

30

40

50

60

70

80

MH/DDH GeneralHospital

PHC Other medicalrehab

32

70 75

4

Series 1

MOH Strategies on Substance Abuse

Prevention & Management

Advocacy Community

Empowerment

Improvement of Health

Professional Capacity

Strenghten Health System

Develop model of Drug Addiction

Services

Provide budget & involve private

sector

Stakeholders in MOH on Substance Abuse Prevention

Subdit Napza

• Guidelines of IEC method for health professional; Parenting Practices;

Subdit Keswa Kel Berisiko

• Life skills education for adolescence

Dit Kes Anak

• Pedoman & Modul Penjaringan Kes Remaja (Deteksi Dini)

Dit PTM:

• Technical guidelines for smoking cessation

• Road safety due to drunk driving

Promkes:

• IEC Smoking, Substance Abuse

• Scouting: Saka Bhakti Husada

Dit PPML

• NSP for IDUs

Stakeholders in MOH on Substance

Related Disorder Management

• Endorsement of National & Technical Guidelines related to TR; Training for Health professional; Multi-sector coordination; IPWL; Claim Budgeting

Subdit Napza:

• Strengthen & support health facilities in providing drug treatment & HIV treatment services

Dit BUKR:

• Endorsement of National & Technical Guidelines related to HIV prevention & care, including for drug user (esp IDU)

Subdit AIDS: