The Chinese government's response to drug use and HIV/AIDS: A review of policies and programs

Abstract

Illicit drug use has become popular in China. Acknowledging the challenge of illicit drug use, China has adopted several new policies on the management of illicit drug use in recent years. This study reviews the current policies on drug use and assesses the harm reduction interventions among drug users in China. The review documents that the new policies on drug use provide a variety of choices of detoxification treatment for drug users. The methadone maintenance treatment and needle exchange programs have been adopted as harm reduction models in China. Most of the reviewed harm reduction programs have been successfully implemented and yielded positive effects in reducing drug related risk behaviors among drug users. Although there remain barriers to the effective implementation of policies on drug use and harm reduction programs, Chinese government has shown their commitment to support the expansion of harm reduction interventions for drug users throughout the country.

International Expansion of the Use of Pharmacotherapies for the Treatment of Opioid Dependence

“…These targets greatly facilitated the scale-up of methadone treatment with the number of opioid dependent persons receiving methadone treatment rising from 8,116 in 2005 to 241,975 in 2009 [105]. This scale-up of MAT in China resulted in injection drug use falling from the primary mode of HIV transmission to a secondary mode even though the number of registered drug users increased from 70,000 in 1990 to 1.16 million in 2005 [106]. Heroin dependent individuals receiving methadone maintenance services in the Department of Health's voluntary detoxification institutions were characterized as individuals who initiated opioid use by smoking opium, were younger than 35 years of age and married with a high school education [107].…”

Dilemma of concepts and strategies for the prevention of spread of HIV in relation to human behavior, law and human rights

“…Strictly following risk reduction measures will help these people. However, this vision does not include the relapse rates of drug users under therapy (Backmund et al, 2008;Li et al, 2010;Meade et al, 2010). The rate of sustained success seems to be too low and will not really help to stop the spread of HIV and other bloodborn infections with shared routes of transmission, such as hepatitis B virus (HBV) and hepatitis C virus (HCV), in this at-risk population (Matthews et al, 2011).…”

Transition of China's drug policy: problems in practice

“…From 1990 to 2012, the numbers of drug users registered officially in China increased 30-fold from 70 000 to 2 098 000 [5]. HIV/AIDS infection fuelled by drug use has also reached an alarming level [4,6]. Developing effective drug policy is now a national priority.…”

“…For the second offence, substance abusers would be sent to compulsory detoxification centres run by the Ministry of Public Security for 3-6 months. Repeated offenders, at the most severe level, would be detained in re-education-through-labour (REL) centres operated by the Ministry of Justice for 1-3 years [1][2][3][4].…”

“…In most cases, a lay employee is appointed by the subdistrict officials to deal with the affairs of 'community rehabilitation'; these people are generally entirely untrained and incapable of assisting with effective community-based treatment for substance users [13]. Further, strong stigma and discrimination against drug users is common in the community, and applications for community programmes must be approved by local police departments [4]. Because of these issues, substance users are often reluctant to attend 'community treatments', and few people with drug use disorders are actually receiving any community rehabilitation treatment.…”