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 (contd)
Prevalence of Drug Abuser
2,50%
2,00%

1,99%

2,20%

1,75%

1,50%
1,00%
0,50%
0,00%
2004

2008

2011

Resources: BNN

Concept of National Strategy on

Substance Related Disorder
To develop
Indonesian people
free from drug
abuse

Prevention
Strategy

Treatment &
Rehabilitation
Strategy

Long term
planning
(2025)

Healthy people
Educated
people

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 clients safety:

Avoid

users

stigmatisation & discrimination towards drug

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

Programmes
Provision of standardised
assessment system related
to compulsory reporting
system & decriminalization

HIV control & management

among drug users

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...

Drug-free
outpatient
program

Detoxification

MedicatedAssisted
Program

Medical
Rehabilitation

Short-term
residential
program

Long-term
residential
program

Methadone Clinic
Mei 2013: 85 clinics in 17 Provinces
Sumut 4

Riau 1

Kepri 1

Kalbar 3
Kaltim 1

Jambi 1

Sumbar 1

Sumsel 2

Lampung1

DKI 18
Jateng 6

Sulsel 5

Banten 7
Jabar 14
Jatim 9
DIY 5
Bali 6

Data Ditjen BUK Kemenkes, 2013

Methadone Clinic based on setting

42
45
40

35

26
30
25
20
15

10

5
1

5
0

RSU

RSJ

RSKO
1

PKM

Lapas

Rutan

Data Ditjen BUK Kemenkes, 2013

Residential Rehabilitation
Aceh 1

Kalbar 1
Kaltim 1

Sumbar 1

Bengkulu 1
Sumsel 1
Kalsel 1
DKI 2
Jateng 1

Banten 7
Jabar 3

Jatim 2
DIY 1

Bali 1

Sulsel 1

NTB 1

Compulsary Registration Treatment

Provider (IPWL)
80
70
60
50
40
30
20
10
0

75

70
32

4
MH/DDH

General
Hospital

PHC
Series 1

Other medical
rehab

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

Dit Kes Anak

Life skills education

for adolescence

Pedoman & Modul

Penjaringan Kes
Remaja (Deteksi Dini)

Dit PTM:

Promkes:

Dit PPML

Technical guidelines
for smoking cessation
Road safety due to
drunk driving

IEC Smoking,
Substance Abuse
Scouting: Saka Bhakti
Husada

NSP for IDUs

Stakeholders in MOH on Substance

Related Disorder Management
Subdit Napza:

Endorsement of National & Technical

Guidelines related to TR; Training for
Health professional; Multi-sector
coordination; IPWL; Claim Budgeting

Dit BUKR:

Strengthen & support health facilities in

providing drug treatment & HIV
treatment services

Subdit AIDS:

Endorsement of National & Technical

Guidelines related to HIV prevention &
care, including for drug user (esp IDU)