Part 3 – Staying Sober: Fighting Drug Addiction

Substance abuse is not a ‘ghetto disease’ that afflicts only the poor or marginalized in society. Rather, it is a widely misunderstood disease and one which various governments are grappling with in their respective countries. Ironically, many famous people continue battling addiction or have died from it.

Heath Ledger, the iconic actor who immortalized the role of the ‘Joker’ in the “The Dark Knight,” had six drugs in his system when he died in 2008 at age 28. Philip Seymour Hoffman, another veteran actor died of combined drug intoxication in 2014 at 46. Recently the death of the legend Prince from an accidental fentanyl overdose rocked the word in 2016. While the struggles of such celebrities become public, many others continue to battle the disease of addiction all over the world including Singapore.

Beneath the façade of economic prosperity and First World status, the Singapore prison system boasts a mind-boggling third highest prisoners-per-population rate of 219 per 100,000. Notably, about 70 per cent of Singapore’s prison population (12,394) in 2015 was doing time for drug-related offences.

Singapore’s Tough Drug Stance

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Singapore’s prison system is upfront about its punitive and deterrent approach for repeat drug offenders. While it claims that the system provides for a rehabilitative approach for first and second-time abusers, repeat drug offenders face years behind bars. Recalcitrant abusers with two prior drug records for consumption of cannabis, cocaine or opiates as well as New Psychoactive Substances are liable for long-term imprisonment under the Long Term (LT) Imprisonment Regime if convicted. In this regime, they face a minimum sentence of at least 5 years with 3 strokes of mandatory caning and a maximum sentence of 7 years imprisonment and at least 6 strokes of the cane.

Such offenders are classified as having gone through LT1. Offenders who relapse after their LT 1 regime can expect a minimum sentence of 7 years and 6 strokes of mandatory caning to a maximum sentence of at least 13 years with 12 strokes of the cane under the LT 2 regime. Today, offenders have gone through both LT1 and LT2 and currently serving “LT3” which in popular lingo is known as the “Bracket” sentence!

Our recidivism rate for drug offenders was around 30.1 per cent in the 2014 release cohort and today, we have drug offenders who are already imprisoned for their 3 rd Long-Term Detention for drug abuse. It is evident that once addiction has taken root in the individual’s system, it is a lifelong battle. Recovery is a journey till death; never a destination.

What is drug addiction?

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Addiction to drugs is a chronic disease which is characterized by a compulsive need to use drugs. Within a few weeks or even days, a user becomes physiologically addicted and faces painful withdrawal symptoms if he refrains from using the drug. Hence, despite the knowledge that another jail-term could be lengthy, an abuser continues his drug-taking to feed the addiction. It is also not uncommon to find addicts resorting to peddling the drugs they abuse in order to feed their own addiction. Although the initial decision to take drugs is voluntary, chemical changes in the brain due to repeated abuse interferes with an individual’s ability to reason and leads to greater dependency on the drug.

For repeated offenders, this cycle is shortened and they can get addicted within days of abusing the same drugs they once used to abuse before their incarceration. When a person takes drugs, they affect the brain’s reward circuit, causing euphoria. It also fills it with the chemical dopamine. Dopamine has a powerful effect on many physical and cognitive functions, which include movement, motivation and memory and is also responsible for the feelings of reward and pleasure. Due to this, it is often considered as “the pleasure neurotransmitter. Drug taking introduces surges of dopamine in the reward circuit and this causes the reinforcement of “pleasurable” drug-taking behaviour. Thus, addicts continue to repeat this behaviour again and again.

Certain drugs such as heroin also cause severe withdrawal symptoms such as cold sweats, diarrhoea and stomach cramps. Due to the fear of withdrawal, addicts seek drugs to just “feel normal again”. Due to such chemical changes in the brain that affects a user psychologically as well as withdrawal symptoms that cause physiological effects, drug addiction is considered a disease and the possibility of relapse remains high even after being sober for a lengthy period of time.

We need to accord the medical recognition that is due to drug addiction and treat it similar to other chronic conditions. Treatment should be an ongoing process and intensified especially for repeat offenders; many of whom relapse due to family problems as well as self-esteem issues stemming from limited employment opportunities. Some fail to realize the severity of the disease they are grappling with and carry the false notion that they can continue to dabble in drugs once in a while to enjoy the feeling of “high” even after they are released from prison.

Treatment of Drug Addiction in Singapore

People who mount the moral high horses in society lampoon drug addicts as people who lack ethical principles or the willpower to refrain from such a debilitating habit. In fact, willpower alone or the belief that religious faith would provide the moral compass to fight drug addiction is a false notion. Freedom from drug addiction is a lifelong battle and many relapses even after being sober for years.

Drug addiction is a complex disease which requires more than just a strong will to refrain from drugs. As such, incarcerating repeat offenders for years in Singapore robs them of coping skills when they are released into mainstream society. The leap from a drab and spartan lifestyle to a dizzying array of
technological advancement often leaves ex-offenders with the daunting prospect of adjusting to a fast-evolving society. Coupled with limited employment opportunities upon release, ex-offenders first relapse psychologically. The return to escapism via substance abuse happens shortly after and before they realize it, they return to the vicious cycle of addiction and incarceration. Leading productive lives upon release remains only a dream to many drug offenders in Singapore.

Today, the prison system in Singapore only provides two chances theoretically to addicts to reform and recover from their addictions after which, they are subjected to a highly punitive LT regime. While it is envisaged to be a deterrent for addicts due to the heavy sentences, the fact that we have inmates serving their 3 rd LT regimes stands testament to the fact that drug addiction cannot be treated in the same vein that one would treat a rapist or robber. Why do we remove the light of rehabilitation from addicts and serve them such crippling sentences when upon release, they become further removed from the current standards of living in society and fail to integrate?

Can we win the ‘War on Drugs’ in Singapore?

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The first step towards a victory over this societal scourge is to treat it like a chronic disease and acknowledge the fact that ex-drug offenders will continue to be at risk of relapse for their whole lives. Imprisoning them for years at end will only rob them of their coping abilities upon release as well as make them less employable. The system unwittingly sets up such offenders for relapse upon their release from prison.

Rather, drug rehabilitation should continue for offenders even if the re-offend for the 3rd time unlike now where they are subjected to the LT regime which cannot reduce the recidivism rate. Our treatment approach should not be a ‘one-size-fits-all’ kind. Rather, they should be tailored to suit the individual’s needs, family background and risk assessment of relapsing which includes the medical as well as the psychological background of the offender. Most importantly, outreach programmes tailored to reach out to our youth can prevent a future generation of susceptible individuals falling prey to this scourge.

Lumping addicts together with offenders who have committed crimes such as rape, robbery or even gang-related offences will not help rehabilitate them. Rather, offenders in prison will only end up ‘doing time’. Upon release, they return to the same drug-taking patterns that led to their ruin in the first place. Every human life is sacred. In the same breath, every effort spent in helping drug offenders lead sober lives would not only reduce our recidivism rates but also equip them with life skills to combat the disease of addiction. Drug addicts are patients; not criminals.

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