Taiwan's War on Drugs
The New Weapon – Care
Taiwan's government has waged a battle against illicit drugs for almost 20 years now, but it has little to show for its efforts. What needs to be done to win the crusade against drugs?
The New Weapon – CareBy Yu Chang Shan
From CommonWealth Magazine (vol. 498 )
Yunlin Prison in Huwei. Fifty-year-old Lin Tzu-hsiang (a pseudonym) has served out his four-year prison term. During these four years he learned to play the violin, make speeches, and master the classic Chinese board game Go. In Go, Lin has even made it to prison champion, and he has no qualms about getting up to the podium to deliver a 30-minute speech on behalf of all inmates at the Drug Abuser Treatment Center.
As a 12-year-old Lin worked as a helper at a seaside gambling establishment run by his maternal uncle in Hsinchu. One night, when he didn't feel fit enough to keep partying, the group of bad characters hanging out there convinced him take amphetamines – stimulants that keep a person awake and alert. This one-time drug experience was enough to get him hooked.
Over the past four decades, prison became a revolving door for Lin. He has entered and exited jails across Taiwan so many times that his three sons grew up completely estranged from him, in the care of his oldest sister. Lin's oldest son is already 33.
"This time, I really feel it's going to be different, I really want to make a new start. If I start to take drugs again after getting out of prison, then even living one more year wouldn't be worth it," Lin declares. He would have never imagined that he would play the violin before an audience in his lifetime. Lin's benevolent-looking current self and the violent thug with bushy eyebrows in the photograph on his ID tag – taken four years ago when he entered prison – seem to be two entirely different persons.
Yunlin Prison Warden Wu Cheng-hong believes in the benefits of the culturally oriented activities (writing, violin, Go etc.) his institution is offering. "The introduction of liberal arts education has effectively helped drug addicts to overcome their addiction. Penghu Prison tracked former inmates that had attended liberal arts classes. The recidivism rate within five years was only half as high as for those who did not attend such classes," Wu notes.
Drug Recidivism Rate Hits 80 Percent
The town of Neili, Taoyuan County. On a Friday noon, young couples line up next to the emergency room at the government-run Taoyuan Mental Hospital. Wearing motorcycle helmets and masks to conceal their identity, the young people get a dose of methadone in liquid form in what is known as replacement therapy to treat addiction to the Class A drug heroin.
"Methadone, also a restricted narcotic drug, allows them to gradually kick the habit and resume regular work," explains Tsay Wen-ing, head of the Division of Controlled Drugs in the Food and Drug Administration (FDA) under the Department of Health (DOH). With the help of replacement therapy, addiction can gradually be reduced and eventually be ended completely.
Last year, Taiwan registered a three-year high in drug use cases that went to court (Table 1). Courts at all levels handled nearly 78,000 cases of drug abuse with 43,000 offenders being indicted. Almost 36,000 of these were found guilty, representing a year-on-year rise of 7.6 percent. Among the convicted drug addicts, die-hard repeat offenders accounted for 81.9 percent.
"Therefore, many say, 'Addiction treatment is futile,'" observes Lee Thurg-hsuan, missionary for the Prison Fellowship Taichung Taiwan, a Christian volunteer organization serving prison inmates. Lee himself looks back on a life of drug use and repeated prison stints before he turned 40. In recent years, Lee has devoted himself to visiting the Taichung Prison every Friday afternoon to give courses for the inmates. "Again and again I see some familiar faces," he notes matter-of-factly.
Drug abuse is a severe problem around the globe. In comparison, the situation in Taiwan is not particularly serious.
Citing statistics by the Bureau of Health Promotion under the DOH, Chen Mei-shia, professor at the Department of Public Health of National Cheng Kung University, points out that the prevalence of drug use in Taiwan stood at 1.43 percent in 2009, which in comparison to a global prevalence of 3.5 percent is on the low side.
But if Taiwan is compared against itself, it is obvious that drug abuse is becoming more common. And for many among the general public, this is a worrying trend.
Cause for Concern
"Drug abuse" came in fourth place on a top ten of public concerns, according to a survey by the Research, Development and Evaluation Commission.
In a major survey of Taiwan's 22 counties and cities, CommonWealth Magazine found that islandwide more than 20 percent of local residents feel the drug problem is severe in the place where they live. The only exceptions were the offshore isles of Matsu, Jinmen and Penghu.
The areas perceived as most "heavily hit" are Taichung City, Kaohsiung City and Yunlin County, where one out of every two residents feels that drug abuse is a severe problem in his or her community. In New Taipei City and Taoyuan County, perceptions are only slightly better – 40 percent of residents consider the drug problem to be serious. (Table 2).
"More than 60,000 new offenders enter our prisons every year, 60 percent of whom are drug users. The state has allocated a budget of NT$5 billion per year to build new prisons, but there are more and more offenders," laments Yang Shu-lung, a criminologist and head of the Office of Student Affairs at National Chung Cheng University.
What Taiwan faces is the challenge of the "globalization of drugs." "Club drugs" popular in youth subcultures are currently swamping bars and dance clubs in Taiwan's metropolitan areas.
"Novel drugs are one of the greatest challenges," concludes Wang Pen-jung, president of Tzu Chi University and a staunch anti-drug activist. Unscrupulous people, including chemical or pharmaceutical experts on university campuses, alter the molecular structure of known drugs such as amphetamines by adding one or two functional groups to create new drugs. While these synthetic designer drugs have temporary euphoric effects, they are also more toxic.
"We report novel drugs such as 'meow meow' as soon as we come across them," notes Tsay in detailing her division's procedures.
In order to prevent the local creation of designer drugs, the DOH closely monitors upstream pharmaceutical ingredients. Ephedrine, a substance used in common cold remedies, for instance, can be easily synthesized into amphetamines in local labs. Therefore, pharmaceutical companies need to verify and certify every single batch of ephedrine they use and compare all incoming and outgoing quantities.
Taiwan's war on drugs is getting hotter. In 1993, the government formally declared a campaign against illicit drugs. The annual National Anti-Drug Conference, which brings together officials from the Justice Ministry, the Education Ministry and the DOH, has been convened for 18 years in a row since it was first introduced in June 1994. Taiwan's 22 county and city governments have also set up "drug abuse prevention centers." The head of the respective local government serves as convener, while the local health bureau director serves as executive secretary.
The aggregate drug-fighting budget of the various cabinet agencies amounts to NT$4.5 billion annually. So how come all these efforts still lead to more drug offenses the more the government cracks down on illegal drugs?
Reason No. 1: Decriminalization of Drug Abuse
Some believe that legal amendments which "decriminalized" addicts are to blame for exacerbating the drug problem.
In 1998 Taiwan dramatically changed its policy on drug offenses from a focus on harsh prison sentences to addiction treatment and prevention. The martial law-era Drug Control Act, which had been in place for half a century, was amended and renamed the "Drug Prevention and Control Act." During her 2008-2010 stint as justice minister, Wang Ching-fen redefined the term "drug offender." From then, convicted drug addicts were called "patient and offender."
Tainan District Prosecutor's Office chief prosecutor Chou Zhang-chin, a former deputy director of the Justice Ministry's Department of Prevention, Rehabilitation and Protection, notes that first-time offenders will first be slapped with a "rehabilitation penalty," which encompasses a period of observation in prison followed by compulsory detox treatment if deemed necessary. First-time offenders undergoing drug rehabilitation must be released within a year.
If drug offenders are apprehended a second time within five years of their release, they will be directly put on trial.
Should the repeat offense occur after a five-year hiatus, the offender is not regarded as having a "highly addictive" personality and may therefore be treated like a first-time lawbreaker.
The fine distinction between the various drug offenses aims to give drug convicts a chance to make a fresh start before falling foul of the law for a third time.
Ongoing addiction treatment is also a cause for leniency, as Chou explains: "The Ministry of Justice has specially ruled that prosecutors shall 'defer prosecution' as long as offenders under treatment produce official medical records showing they are undergoing 'replacement therapy.'"
The decriminalization process continues, as health, education, and legal experts keep designing ways out even for hard drug addicts.
Taipei City Department of Health Commissioner Lin Chi-hung cites as an example users of the "hard" Class A drug heroin. Since heroin addiction can be treated with methadone replacement therapy, prosecutors defer prosecution of such offenders.
But in contrast, users of Class B drugs such as amphetamines have not been granted deferred prosecution, for lack of a replacement therapy. "Therefore, we in Taipei City experimented for a year with 'group counseling' to grant deferred prosecution to Class B drug offenders as well," Lin explains.
Reason No. 2: Government Self-limiting, Uncoordinated
Some critics argue that the division of labor among law enforcement agencies goes too far, so that one hand doesn't know what the other is doing. Another reason for the lack of tangible progress in the anti-drug fight is that Taiwan does not have a permanent, dedicated anti-drug organization.
Presently all 22 counties and cities across Taiwan have "drug abuse prevention centers." But as Taiwan High Court Criminal Division judge Huang Rae-hua warns, "While the cabinet agencies and law enforcement agencies work together on the same cause, they don't have organic connections. The law enforcement process only takes 'one hurdle at a time,' so that cases are kicked around like balls from one agency to the next." (Table 2)
In its anti-drug drive the administrative system has imposed limitations on itself, so it should not come as a surprise that anti-drug work has come to naught.
"These are all severely ill mental patients. Getting them off their drugs for good is not easy in the first place. And then we don't have an 'integrated national framework' to deal with drug-using patients," remarks Su Lien-wen, director of the Department of Addiction Science at the Songde Branch of Taipei City Hospital.
For instance, adolescent drug offenders will meet with a probation officer once a month. But when they leave the detention center, they still return to live with their family of origin in the same community as before. "Unless government officials show concern for them on their own initiative, their problems aren't solved, and they are bound to do drugs again," warns Judge Huang.
At National Chengchi University, Jan Chung-yuang, professor at the Department of Public Administration, and Chen Chuan-hsi, a postgraduate at the Department of Management Information Systems, published a paper in October last year for which they interviewed veteran anti-narcotics officers and drug offenders nearing the end of their prison sentences about the efficacy of Taiwan's fight against drugs. They sent out 7,596 questionnaires for the survey, which had a response rate of 79.7 percent. From the survey results the researchers drew the following three conclusions:
1. Lack of an integrated, dedicated government organization
The local governments' drug abuse prevention centers are only task forces. If the convener, namely the respective county magistrate or city mayor, does not attach importance to the drug-fighting mission, the centers are not likely to achieve a lot.
2. Lack of a midway treatment mechanism
Fifty-nine percent of drug users who are released from prison need a job but can't find one. Soon they are tempted into taking drugs again by their former dealers or drug-using friends.
3. No coordinated SOP
Cabinet agencies lack an integrated drug prevention Standard Operating Procedure, which makes it difficult to pool information.
Reason No. 3: High Recidivism among Adolescent Drug Users
Aside from problems within government and with policy, drug use is concentrated among young adults. (Table 3)
Even after having been apprehended and going through rehabilitation, the problems they face with personal and family relations often drive them back down the path of drugs.
The Ministry of Education seemed to have grasped the essence of the problem. For this year's National Anti-Drug Conference, slated for June 3, the ministry has discontinued the practice of drafting stars and celebrities as spokespersons. Instead, it has enlisted the help of military education instructor Wu Yu-chou, who has ample experience working with troubled youth.
On school campuses, the campaign against drugs has also begun to shift from meting out harsh punishment to demonstrating a caring attitude.
In late February, a parent in Tainan's Hsinying District exposed to the media that during the winter break "K parties" had been thrown at the junior high school that his children attend. Here, "K" refers to ketamine, a Class C drug. Ma Yu-pin, Tainan City superintendent for the Department of Military Training Education under the Ministry of Education, immediately looked into the allegations.
Half a month later, Taoyuan County superintendent Yang You-hsien also received a report that a boy and a girl at a local junior high school had taken ketamine and that a Chun Hui ("Spring Sunshine") anti-drug program needed to be launched.
Such measures are all based on the standing operating procedure of the Department of Military Training Education. Whenever a student from a high-risk group tests positive for banned substances in a urine test, a "Spring Sunshine" program is immediately started. A senior high school military education instructor is dispatched to the junior high school in question to counsel the student one on one.
Caring attention is the new focus in Taiwan's war on drugs.
Following up on this focal point, CommonWealth Magazine has talked to five anti-drug activists from different walks of life – medicine, non-governmental organizations, judiciary, academia, and education. What they have in common is their staunch devotion to fighting this war on drugs without sacrificing the attention, care and support that drug users need.
This war is not easily won. But the ways in which these anti-drug heroes reach out to drug users show that a positive attitude and true commitment can bring about change.
Translated from the Chinese by Susanne Ganz