Because of relatively easy access and low cost, heroin is the most commonly used illegal drug in Vietnam. Jim Vetter was recently there to help train individuals to lead community-based peer support groups for recovering heroin addicts.
“One day I was sitting in on an addiction support group on a street corner café in the middle of busy Ho Chi Minh City. The next day, I was in a taxicab winding its way through small roadways and rice paddies on my way to a one-room house in Dien Bien Phu in northwest Vietnam. Once there, I sat on the floor in a circle with the members of a heroin support group. It was very powerful and moving to be invited into these different settings and have people tell me their stories about what it’s like to be addicted to heroin and to work to recover.
EDC is training those who are at the forefront in addressing Vietnam’s heroin problem—peer support leaders. Working in partnership with local staff from Family Health International and with the Substance Abuse Treatment Advisor at the U.S. Embassy in Vietnam, we are funded by the President’s Emergency Plan for AIDS Relief, the U.S. Agency for International Development, and the Substance Abuse and Mental Health Services Administration. After initially training about 60 people to lead the peer support groups for recovering heroin addicts, we’ve now trained a new group to continue these facilitator trainings. What I kept hearing from the people attending these groups is how important it is for them to have a place to come and feel honored, where the effort that they are putting in to stay clean is really respected and supported.
Until a few years ago, there were very few resources for recovering heroin addicts If people were identified as using heroin, they were typically forced into a detox center for as long as several years. Then, upon returning to the community, they faced a high level of stigma and discrimination, no support network, and no chance at employment. The relapse rates of those who had returned to communities were enormous—80 to 90 percent.
Intravenous drug use is the most prevalent route of transmission for HIV in Vietnam. So, in addition to all of the devastating consequences of being addicted to an opiate drug like heroin, a substantial number of people who are heroin addicts are also HIV positive. And a good percentage of the folks who are trainers and facilitators are HIV positive as well. As a result, the support groups have had to adjust their ground rules, such as turning off all electronic devices that might beep. This rule was modified because some group members’ phones had timers that told them when to take their next dose of antiretroviral medications to control their HIV.
Because the stigma and discrimination make it difficult for recovering addicts to find work—thus putting them at greater risk for relapse—a number of groups found that providing employment programs was key to giving people the best chance of recovering. I traveled to northeastern Vietnam to a coastal area where people from a local support group took us out in a small boat to see a clam-farming operation initiated by the support group. It was a touching experience to listen to the wife of one of the recovering addicts talk about what it was like for her husband to get the support to have a good livelihood. And she told me what a significant gesture it was for the local government to provide a small grant that enabled the group of traditionally stigmatized recovering addicts to launch the self-sustaining clam-farming jobs program. I also traveled to a northern community where I visited the father of one of the recovering addicts. He had given some of his land to the support group for recovering addicts to raise a variety of porcupine, which can be sold in Vietnam for a fairly high amount.
We have been learning a lot from group leaders about how to develop models of effective support for recovering addicts in their communities, and we are working to help cross-pollinate their efforts. What I saw—over and over again—was that more recovering addicts are coming regularly to the groups, and more members of the groups are staying clean.”
Originally published on July 20, 2011