Directive No. 32/CT-TTg on intensifying the treatment of opiate substance addiction through substitution therapy

DIRECTIVE

VPromoting the treatment of opiate addiction with substitute drugs

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The treatment of opiate addiction with substitute drugs (hereinafter referred to as substitute treatment) plays a crucial role in preventing and controlling HIV/AIDS, reducing the demand for drug use and related drug-related criminal offenses, contributing to ensuring social security, economic and social development of localities and the whole country.

The Government has issued Decree No. 96/2012/NĐ-CP dated November 15, 2012 on the treatment of opiate addiction with substitute drugs (hereinafter referred to as Decree No. 96/2012/NĐ-CP). Relevant ministries and sectors have issued guidelines and mobilized resources to support localities in implementing it, focusing on expanding the treatment of opiate addiction with Methadone.

However, as of October 15, 2014, only 38 out of 63 centrally governed cities and provinces had implemented Methadone treatment for 21,613 opiate addicts, reaching 27% of the target of treating 80,000 people by the end of 2015, accounting for 12% of the number of drug users under management records. The main reasons for the slow implementation of substitute treatment are mainly due to the lack of attention, investment, and resource mobilization from many local party committees and administrations, still having a reliance mentality, waiting for support from the central government, while international financial aid is rapidly decreasing and state budget investment is limited; communication work has not been truly emphasized.

To accelerate the progress of substitute treatment in the context of reduced funding, the Prime Minister requests relevant ministries, sectors, and localities to promptly and strictly implement substitute treatment according to the provisions of Decree No. 96/2012/NĐ-CP, effectively implement the relevant contents of Resolution No. 74/NQ-CP dated October 4, 2014 of the Government, intensify communication work, enhance resource mobilization, management, and effective use of resources, and focus on implementing several urgent tasks as follows:

1. People's Committees of centrally governed cities and provinces:

a) Directly instructing to promptly review and update the actual number of opiate addicts in the locality as the basis for planning the establishment of facilities for treating opiate addiction according to Clause 2, Article 31 of Decree No. 96/2012/NĐ-CP;

b) Promptly build plans while ensuring balance and thoroughly integrating material infrastructure, equipment, human resources, and funds to organize the implementation of Methadone treatment plans to achieve assigned targets according to Decision No. 1008/QĐ-TTg dated June 20, 2014 of the Prime Minister on assigning targets for patients to be treated with Methadone substitution therapy in 2014 and 2015; urge Methadone treatment facilities that have been established to speed up the reception and treatment of patients according to the guidelines of the Ministry of Health;

c) Directly instructing to intensify communication work, raise awareness at all levels about the significance and importance of substitute treatment; intensify information and propaganda about substitute treatment to all strata of the population, prioritizing groups of drug users to participate in the treatment program;

d) Directly instructing Chairpersons of People's Committees at all levels to simplify administrative procedures, quickly confirm applications for participation in opiate addiction treatment with substitute drugs for those in need; direct relevant agencies to inspect and supervise the selection of patients participating in substitute treatment facilities according to the provisions of Section 1, Chapter II of Decree No. 96/2012/NĐ-CP, ensuring objectivity, transparency, and reducing waiting time;

đ) Directly instructing the Department of Home Affairs to coordinate with the Department of Health and relevant agencies to advise the People's Committee of the province on arranging and mobilizing existing human resources for public treatment facilities for opiate addiction;

e) Directly instructing the Department of Labor, Invalids and Social Affairs to coordinate with relevant agencies to actively convert or integrate substitute treatment activities at detoxification centers and social facilities under their jurisdiction; implement comprehensive psychological counseling, health improvement, life skills education, vocational training, and career counseling activities to create suitable jobs, helping patients participating in treatment to stabilize psychologically and prevent relapse into drug use;

g) Directly instructing the Provincial Police and the Department of Labor, Invalids and Social Affairs not to apply compulsory detoxification measures against individuals participating in substitute treatment if they do not violate the provisions of Clause 2, Article 21 of Decree No. 96/2012/NĐ-CP.

2. The Ministry of Health:

a) Directly instructing, guiding, and urging localities, especially key provinces regarding drugs and HIV/AIDS, to immediately establish Methadone treatment facilities according to the provisions of Clause 2, Article 31 of Decree No. 96/2012/NĐ-CP;

b) Taking the lead and coordinating with the Ministry of Finance to promptly develop and issue a framework for the service fee for the treatment of opiate addiction with Methadone substitute drugs, allowing the inclusion of external labor costs (contract labor) in the Methadone treatment service fee;

c) Taking the lead and coordinating with relevant ministries, sectors, and agencies to ensure the supply of Methadone to meet the needs of localities;

d) Completing professional guidance; supporting localities in organizing training for staff working at opiate addiction treatment facilities from mobilized resources;

đ) Serving as the focal point to urge, inspect, supervise, and evaluate the implementation of substitute treatment in localities; regularly reporting to the Prime Minister on the situation and results of implementation, particularly the results of Methadone treatment targets.

3. The Ministry of Finance shall take the lead and coordinate with the Ministry of Planning and Investment to ensure sufficient funding for purchasing Methadone; guide localities in mobilizing resources for implementing substitute treatment; direct the General Customs Department to cooperate with relevant agencies to strengthen management and combat smuggling of drugs into the country.

4. The Ministry of Labor, Invalids and Social Affairs shall take the lead and coordinate with relevant agencies to develop guidelines for implementing substitute treatment and organize its implementation in detoxification facilities and social facilities under their management; accelerate the progress of implementing the Project to Reform Drug Detoxification Work in Vietnam until 2020 as stipulated in Decision No. 2596/QĐ-TTg dated December 27, 2013 of the Government Chairman.

5. The Ministry of Public Security shall take the lead and coordinate with relevant agencies to develop guidelines for implementing substitute treatment and organize its implementation in facilities under their management; guide localities to strictly comply with regulations on administrative measures for compulsory detoxification facilities as prescribed in the Law on Handling Administrative Violations and Decree No. 221/2013/NĐ-CP dated December 30, 2013 of the Government on the system of administrative measures for compulsory detoxification facilities; direct forces to resolutely combat drug-related crimes and prevent drug smuggling into the country.

6. The Ministry of National Defense shall instruct the Border Guard Command to cooperate with relevant agencies to resolutely combat drug-related crimes and prevent drug smuggling into the country.

7. The Ministry of Information and Communications shall instruct information and communication agencies at all levels to innovate communication methods, focusing on prevention; concentrate on high-risk individuals, key areas, remote regions, and ethnic minority areas. Vigorously provide information about substitute treatment programs to all strata of society, especially prioritizing drug users and their families.

8. The National Committee for HIV/AIDS Prevention and Control and Drug and Prostitution Prevention shall instruct the effective implementation of the coordinated communication program on HIV/AIDS prevention and control and drug and prostitution prevention signed between the National Committee and Vietnam Television, Voice of Vietnam Radio, and Vietnam News Agency.

9. It is requested that the Vietnam Fatherland Front and political-social organizations at central and local levels take the initiative to participate and actively coordinate with relevant agencies and departments to vigorously implement substitute treatment nationwide.

The Ministers, Heads of Ministries equivalent to Ministries, Heads of Government Agencies, and Chairmen of Provincial People's Committees directly under the Central Government are responsible for organizing and directing the strict implementation of this Directive./.