Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
Centre for Research and Training on Substance Abuse -HIV, Hanoi Medical University, Hanoi, Vietnam.
Harm Reduct J. 2022 May 13;19(1):45. doi: 10.1186/s12954-022-00621-9.
The emergence of widespread amphetamine-type stimulants (ATSs) usage has created significant challenges for drug control and treatment policies in Southeast Asian countries. This study analyses the development of drug policies and examines current treatment program constraints in Vietnam to deal with ATS misuse. The aim was to gain insights that may be useful for national and international drug-related policy development and revision.
A desk review of national policy documents and 22 in-depth key informant interviews were conducted from 2019 to 2021. Thematic content analysis was employed to identify key themes and their connections.
Analysis identified Vietnam's 30-year history of developing policies and formulating strategies to reduce supply, demand, and harm from illicit drugs. With the increasing number of people who use ATS (PWUA), Vietnam has recently promoted harsh policy and law enforcement to deter drug use and supply. This policy trend prevails in many Asian countries. The three main constraints in dealing with ATS misuse emerged from punitive and restrictive drug policies. First, the general public believed that Centre-based compulsory treatment (CCT) is the only appropriate treatment for all types of illicit drug addiction despite its low-quality service provision. The rigid drug policy has led to social persuasion with impractical expectations for CCT effectiveness. Second, the emphasis on punishment and detention has hampered new drug treatment service development in Vietnam. CCT has become monopolistic in the context of impoverished services. Third, people who use drugs tend to hide their needs and avoid formal treatment and support services, resulting in declined social coherence.
While new drugs are constantly evolving, the current law enforcement approach potentially constrains expertise to adopt effective treatment services. This study suggests that the top-down policing mechanism presently hinders the development of an appropriate intervention strategy for ATS misuse and diminishes social support to service providers.
安非他命类兴奋剂（ATS）的广泛使用给东南亚国家的毒品控制和治疗政策带来了重大挑战。本研究分析了越南毒品政策的发展，并考察了当前治疗方案所面临的限制，以应对 ATS 的滥用问题。目的是为国家和国际毒品相关政策的制定和修订提供有用的见解。
2019 年至 2021 年期间，我们对国家政策文件进行了桌面审查，并进行了 22 次深入的关键知情人访谈。采用主题内容分析法，确定关键主题及其联系。
分析确定了越南 30 年来制定政策和制定战略以减少非法药物供应、需求和危害的历史。随着使用安非他命类兴奋剂的人数（PWUA）的增加，越南最近采取了严厉的政策和执法措施来遏制吸毒和供应。这种政策趋势在许多亚洲国家都存在。处理安非他命类兴奋剂滥用问题的三个主要限制因素来自惩罚性和限制性的毒品政策。首先，公众普遍认为，中心为基础的强制治疗（CCT）是治疗所有类型非法药物成瘾的唯一适当治疗方法，尽管其服务质量较低。僵化的毒品政策导致了对 CCT 效果不切实际的期望的社会劝说。其次，强调惩罚和拘留阻碍了越南新的毒品治疗服务的发展。在服务匮乏的情况下，CCT 已成为垄断服务。第三，吸毒者往往隐瞒自己的需求，避免接受正规的治疗和支持服务，导致社会凝聚力下降。
虽然新毒品不断出现，但目前的执法方法可能限制了采用有效治疗服务的专业知识。本研究表明，自上而下的警务机制目前阻碍了针对安非他命类兴奋剂滥用的适当干预策略的发展，并削弱了对服务提供者的社会支持。
