Tran Van Khiem does not want to enter a community-based rehabilitation program even though he has thought about quitting drugs many times.
“People have to pay to receive treatment. And to be honest, there's nothing drug users can do to find money apart from stealing," Khiem said, adding that a daily pill costs up to VND10,000, or a round 50 US cents.
“When they have money, there's this temptation because the first thing a drug user will do is to buy more drugs,” said the 46-year-old man who lives in Ho Chi Minh City’s District 4.
The number of drug users in the city has been on the rise as community-based, voluntary treatment programs are not really effective.
To make matter worse, it is easy to buy drugs in the city these days, according to users.
“You can buy them directly or just order them to be delivered to your house,” said Nguyen Ngoc Tuan, a drug user in District 8 who has been addicted for more than 10 years.
“Many people who start to use drugs often sell drugs as well,” he added.
According to HCMC Police Department, the number of drug users in the city has doubled over the past five years to more than 19,200 people.
“The number of other undocumented drug users can be 50 or 70 percent of that figure, including 5,724 people who have fled from treatment centers,” said Senior Lieutenant Colonel Nguyen Si Quang.
“There has been a rise in the use of methamphetamine, which led to serious and extremely serious crimes.”
Quang said that drug use has become very common in the service sector including bars, clubs and hotels.
Linh, a sex worker, said she moved to HCMC several years ago to work at cafés and bars, where she became a drug user.
“A co-worker asked me to try and I got addicted. Sometimes, I really want to quit but I can’t if I still work at night clubs.”
And it's a vicious cycle for Linh.
"Now I have to keep doing sex work because I need money to buy drugs,” she said.
High relapse rates
Quang said the relapse rates among drug users are high.
“Home and community-based treatment programs have low effects and a high relapse chance," he said.
According to a survey conducted by the city’s police department, nearly 78 percent of 19,200 documented drug users have been found using drugs again after rehabilitation.
Nearly 90 percent of drug users are men and more than 75 percent are either unemployed or working in unstable jobs.
More than 67 percent of drug users have been fined for administrative violations or serving criminal convictions.
Currently, about 500 drug users are being held either for criminal investigation or serving a conviction, according to the survey.
Thi Thi Tuyet Nhung of HCMC People’s Council, the municipal legislature, said that community-based rehabilitation has faced many difficulties due to limited personnel and facilities.
"A lack of doctors at medical centers at sub-district level has made it difficult to determine the addiction level of drug users.”
Moreover, relatives of many drug users have not encourage them to enter treatment, she said.
Le Van Quy, deputy director of HCMC Anti-Social Evils Agency, said discrimination in the community has prevented drug users from joining local treatment programs.
Since 2008, methadone treatment programs have received more than 22,000 among a total of 204,000 drug users nationwide. The programs are likely to fall short of the target of reaching 80,000 people by the end of this year.
Last month, Ho Chi Minh City launched a center for drug users with the use of Suboxone, the first facility in the country to offer this treatment option.
Methadone works by stemming the craving for opioids. Dr Masaya Kato, coordinator of communicable diseases group of World Health Organization, said that for the people with heroine dependence, the treatment using methadone or Suboxone is very effective.
“Many people can reduce or stop using heroine, have better social lives and thus contribute better to society, and reducing the risk of HIV infection,” he told Thanh Nien News.
Kato said that both medications are opiates and therefore addictive and that methadone and Suboxone treatment have been mostly funded by the donors.
“I understand the Ministry of Health is exploring financing increasingly by domestic resources. It is critical to identify sustainable way of financing drug dependence treatment,” he said.
“After all, drug dependence is chronic medical condition that requires treatment just as other diseases.”