Heal TH 2019 Research On Drugs Abuse - 2

HEALTH
2019
Research On Drugs Abuse
KEMENTERIAN
KESEHATAN
REPUBLIK
INDONESIA
H E A LTH
RESEARCH
OF DRUGS ABUSE EFFECTS
2019
RESEARCH, DATA, AND INFORMATION CENTER

NATIONAL NARCOTICS BOARD
THE REPUBLIC OF INDONESIA
2019
ISBN : 978-623-93034-1-9
Health Research Of Drugs Abuse Effects 2019

Copyright @2019
Editorial Board:
Supervisor : Drs. Agus Irianto, S.H., M.H., M.Si
Consultant : Prof. Irwanto, Ph.D
Head of Research : Erma Antasari, S.Si
Secretary : Dwi Sulistyorini, S.Si., M.Si
Team Members : Siti Nurlela Marliani, SP., S.H., M.Si
Sri Lestari, S.Kom., M.Si
Novita Sari, S.Sos., M.H
Sri Haryanti, S.Sos., M.Si
Plamularsih Swandari, M.Si
Quazar Noor Azhim, A.Md
Armita Eki Indahsari, S.Si
Radityo Kunto Harimurti, S. Stat
Rizky Purnamasari, S.Psi
Cover Design : Tri Sugiharto, S.Kom
Content Design : Indoyanu Muhamad
All rights reserved.

It is prohibited to quote or reproduce part or all of the contents of this book
without written permission from the Publisher.
Publisher :
Research, Data, and Information Center
National Narcotics Board of the Republic of Indonesia
Jl. MT. Haryono No. 11 Cawang, East Jakarta
Email : puslitdatin@bnn.go.id.
Call Center : 184
SMS Center : 081221675675
Email : puslitdatin@bnn.go.id
Website : www.bnn.go.id

Foreword
Assalamu’alaikum Warahmatullahi Wabarakatuh.

Best wishes for all of us.
All praises and thanks be to God Almighty,

because of His blessings and grace, Health
Research of Drugs Abuse Effects 2019 could
be well-finished on time.
Health Research of Drugs Abuse Effects

2019 is conducted based on cooperation
between National Narcotics Board (BNN) and
Atma Jaya Catholic University and National Institute of Health Research
and Development, Ministry of Health, the Republic of Indonesia. This
research is conducted in six provinces, which provides places for
rehabilitation for drug abusers, such as West Java, Riau Islands, North
Sumatra, Lampung, South Sulawesi, and East Kalimantan. The target
of this research is clients/particiants who undergo services in places
implementing narcotics prevention programs by National Narcotics
Board such as Rehabilitation Center, Post Rehabilitation Program,
Primary (Pratama) Clinic of Provincial Narcotics Board, and Community
Partners of Provincial Narcotics Board.
The main research objective is to obtain a systematic picture

of narcotics use effects on an individual and elements of socio-
cultural relations, which influence personal life. This research is one
of the National Priority Programs which are used as a reference in
implementing the national policy.
One of the obvious impacts of sustainable narcotics use in the

long term is drug addiction. Drug addiction is the root of the expansion
of negative impacts in the physical-biological, mental, and social
realms. Drug addicts frequently get one or more health problems. The
problems may be related to physical or mental disorders. Physical
disorders include lung or heart disease, stroke, cancer, and mental
health problem.
Health Research Of Drugs Abuse Effects 2019 i

Foreword
Finally, as the Head of the National Narcotics Board, we would like

to thank Atmajaya Catholic University, Ministry of Health, and all of the
parties involved in conducting this research. We hope that the result of this
research could be maximally implemented primarily by National Narcotics
Board and stakeholders in determining the policies of Prevention and
Eradication of Drug Abuse and Illicit Trafficking (P4GN). Furthermore,
we do hope that result of which could give benefits to all community in
making P4GN successful.
That is all, and thank you.

Wassalamu’alaikum Warahmatullahi Wabarakatuh.
Jakarta, December 2019

Head of National Narcotics Board (BNN)
Drs. Heru Winarko, S.H
ii Health Research Of Drugs Abuse Effects 2019

Preface
All praises and thanks be to Allah, who has bestowed His blessings
and guidance so the book Health Research of Drugs Abuse Effects 2019
could be well-finished on time. This research is based on cooperation
between National Narcotics Board (BNN) and Atmajaya Catholic
University and National Institute of Health Research and Development,
Ministry of Health, the Republic of Indonesia. This research is supported
by local partners from Provincial Narcotics Board and research teams in
six provinces.
The main research objective is to obtain a systematic picture of

narcotics use effects on an individual and elements of socio-cultural
relations, which influence personal life.
This research involves several parties starting from the BNN expert
teams to the Provincial Narcotics Board (BNNP), the BNN Rehabilitation
Centre, BNNP Pratama Clinic, and BNNP’s community component
partners in 6 Provinces. In this occasion, we would like to thank the
Head of National Narcotics Board, Drs. Heru Winarko, S.H, and Drs.
Adhi Prawoto S.H as chief secretary of National Narcotics Board, and
all staffs of National Narcotics Board for the support and cooperation
in every single step of producing this book.
We thank Research and Development Centre- Ministry of Health, the

Republic of Indonesia, and other research teams. We also thank all of our
local partners from Riau Islands, North Sumatra, Lampung, South Sulawesi,
East Kalimantan, and also local partners from BNN Rehabilitation Center,
Rehabilitation sites in Batam, Deli Serdang Medan, Kalianda Lampung,
Baddoka Makassar, and Tanah Merah rehabilitation center.
All in all, we hope this book may give useful contribution and
benefits for decision-making and Prevention and Eradication of Drug
Abuse and Illicit Trafficking (P4GN) program improvement in Indonesia,
especially at the provincial level.
Jakarta, December 2019
Editorial Board
Health Research Of Drugs Abuse Effects 2019 iii

iii
Executive Summary
Health Research of Drugs Abuse Effects 2019 is the mandate of the

National Development Planning Board (Bappenas) and National Narcotics
Board (BNN) to begin studies that may provide empirical evidence that will
be used for formulating indicators for BNN’s performance in the future.
The theoreticial framework which will be used is biopsychosocial- spiritual
to reflect a more-holistically feasible concept.
This research is a survey research/self-report involving 602 randomly-

selected respondents from the listed clients of rehabilitation institutions
under the auspices of National Narcotics Board and partners in 6 regions
(Lido; Batam; Tanah Merah; Deli Serdang; Kalianda and Baddoka) with the
total of 4.203 people. Random selection was proportionally made with an
error rate of 4% resulting in 602 respondents. However, not all respondents
are chosen randomly due to the minimal number of female respondents
and heroin users. This condition is one weakness of this research.
This research finds several problems as follows:

1. Indonesia’s drug problem is polydrug-use. The characteristic is its
young population (male of 93.9% with 90% under 39 years) experiments
with various psychoactive substances (85% use more than two
substances up to 15 types of substances) in a risky way, and tends to
consume them in long-term use (1-6 years). Most of them consume
substances before 20 years old. They are potentially to be an expensive
and serious burden of disease in Indonesia.
2. The most abused substances are crystal meth, marijuana, other
Amphetamine Type Stimulants (ATS), and pyschotropic drugs sold in
the free market. These substances are consumed by either smoked
(64.3%), swallowed (51%), or inhaled (34.9%), those are depending on
the type. While the use of a syringe (11.4%) and sublingual (4.8%) are
relatively small due to the decreased number of heroin consumers
and the number of hallucinogenic (LDS) consumers are relatively
small. Long-term narcotics abuse, especially ATS, cannabis, heroin,
hallucinogens, New Psychoactive Substances (NPS), and various over-
the-counter psychoactive drugs have serious impacts on physical and
mental-emotional health.
3. The risk of substance abuse because of the purpose or when the
substance consumed is quite alarming. As much as 73.6% of
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Executive Summary
respondents have experienced being drunk while driving and 15%

of them do it frequently. There is 39% of them as well as mixed the
substance with other substances to feel intoxication effect. While
around 75.5% of respondents abuse substances to improve their
courage and 45.8% to dare to fight against the law. A total of 63% of
respondents abuse substances for sexual purposes, and 75.1% who
have sex, who either have been married or not, do not use condoms.
4. From the physical effects, there are 59.5% of respondents have
experienced oral infections due to narcotics abuse, 22.8% of them
experienced those quite often to very often, and 52.8% claimed to
have respiratory infections. In comparison, 21.9% stated to experience
those quite often to very often. Other physical effects claimed are
dizziness/severe headache (73.4%), tooth disorders (64.1%), eye
disorders (45.5%), dehydration/paralysis (21.3%) and seizures (11.1%).
A total of 14.1% of respondents have experienced an overdose.
5. When asked about the long-term health effects, 5.8% respondents
claimed to have been infected by Hepatitis C, 6.8% had experienced
PMS, 3% had TBC, 2.7% had positive HIV, 1.5% had liver cirrhosis, 0.8%
had had a stroke, and 13.1% admitted having suffered from a mental
disorder.
6. In more detail, 86.4% of respondents experienced fear, anxiety, and
panic attacks, and 48.2% stated to have experienced those quite
often and very often. Around 80% respondents have experienced
paranoid and ostracized, 77.1% experienced memory disorders, 58%
experienced depression and despair, 56.3% experienced hallucinations
through the five senses, 46.5% experienced family violence, 41.7%
experienced violence from others, 22.3% wanted to commit suicide,
56.3% felt self-loathing, 55.7% hated the closest people to them,
72.3% felt negatively labeled by close relatives, 24.7% cut off relations
with family 77.1% of respondents also felt that their family began to
be isolated by their surrounding community, the relationship among
family members worsened, and their behavior also harmed the
family’s financial condition. In general, there was almost no difference
between the effects of the main substances used and the effects of
emotional and social disorders.
7. If the data of substance consumption and its duration are cross-
tabulated with family conditions, then there is a general tendency that
Health Research Of Drugs Abuse Effects 2019 v

Executive Summary
the duration of the consumption may worsen the family situation.

8. Regarding the relationship between narcotics abuse and the situation
at school, then 56% of respondents stated they were lazy / liked to
skip school, 53.2% had their academic achievement decreased, and
approximately one-third of respondents had their relationship with
their friends or teachers disturbed, 22.1% of respondents had been
expelled from school.
9. Narcotics abuse is also claimed by more than 70% of respondents
to have caused disharmony between themselves, families, and the
neighborhood. Percentage of 23.4% felt they were considered as
enemies of the community, and 22.1% have been reported to the
security forces.
10. Narcotics abuse also caused respondents to have dealt with the law.
More than 70% of respondents who have used narcotics have been
arrested, detained, and prosecuted in court.
11. Family is the main supporter of the recovery process. Around 47.7%
of respondents who are currently still under treatment claimed to be
encouraged through family support, and 30.1% was through personal
encouragement. School and workplace are not very much considered
by the respondents to be the parties that support the recovery process.
12. Female respondents have specific needs and further research needs
to be conducted to understand their complexities and their special
needs - especially factors which make them less likely to reach out to
professional rehabilitation services.
13. Self-assessment of the respondents as narcotics abusers who
have undergone or are undergoing rehabilitation if compared to the
respondents in the general population has a higher level of problems
in the dimensions of self-care ability, carrying out daily activities, and
facing anxiety/depression.
14. Clients of rehabilitation assessed the quality of their health in the an
average score of 85 and a middle score of 90. This is a self- expression
of how narcotics users who have been or are being rehabilitated feel
the quality of their health is now better than it was before undergoing
rehabilitation, which when was under the influence of narcotics abuse.
15. There is a serious need to develop a post-rehabilitation support
program. Especially, when families cannot give full support and when
people still stigmatize and discriminate against the users. National
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Narcotics Board rehabilitation centers for supporting rehabilitation

need to be strived to provide relevant services.
IMPLICATION OF THE FUTURE OF NARCOTICS POLICY
1. Indonesia has long been facing the adverse effects of drug abuse.
Efforts with other countries globally have been made since the
beginning of the New Order, and up to this day, the problem is still
severe. Therefore, various analyses of policy need to be carried out.
Health impacts have a significant burden on the Draft of State Budget,
but detailed studies on health costs of drug abuse have not yet been
conducted. It is time for the government, in this case, is National
Narcotics Board to seek a variety of strategic researches related to
the economic costs of health, social and other benefits, and also to
determine a more comprehensive prevention strategy.
2. National Narcotics Board’s research since 2013 has shown that drug
abuse in Indonesia has characteristics of young people and polydrug
users instead of the trend of substance abuse. This fact is a challenge
itself because polydrug users are susceptible to the substance effect
but at the same time vulnerable to interaction among substances
(Vanderplasschen, De Maeyer, Colpaert, Cogel, Rea, Dom, Sabbe &
Broekaert, http://www.belspo.be/belspo/organisation/publ/pub_ostc/
Drug/rDR55_en.pdf) which are extremely dangerous for health and life
of consumers. Therefore, polydrug users may be a costly burden burden
for health if not being taken seriously.
3. One of the discussion topics in public policy in handling and
overcoming narcotics is the sectoral authority. National Narcotis
Board, which was established under the mandate of Law No. 35 of
2009 concerning Narcotics, has any authority to supervise and control
substances contained in the list of the Act. Out of the categories
listed, especially the abuse of drugs that can be purchased in the free
market or through prescription must be monitored and controlled
by the health sector, those are BPOM and the Ministry of Health.
This sectoral debate may lead to an adverse decision if the
statement above is not being paid attention to, in which drug
abusers also abuse other substances, including over-the-counter
drugs, which are called the polydrug users. Sectoral supervision will
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Executive Summary
require complicated, coordination which has not been going well

so far. Therefore, it is necessary to formulate and to form a special
cross-sectoral criminal unit, such as is National Narcotics Board or
the police with expanded mandates or more flexible functions so they
may respond to various dynamic changes in the demand-supply chain
and its market.
4. The next issue which needs to be discussed is substance abuse as
a part of a lifestyle. The theoretical approach uses the framework
biopsychosocial-spiritual model, provides the opportunities to see
substance abuse as part of a lifestyle that is aspirated by its users
(Davies, Ellison, Ward, & Laudet, 2015; Rahman, Gupta, Suklecha, &
Khunte, 2010). Therefore, finding out the reasons for substance abuse
becomes crucial because it will determine what lifestyle the abuser
desires and its relationship between what substance is chosen and
by whom it is used. National Narcotics Board in Prevalence Survey
2015 has warned about the increased abuse of ATS, specifically
Methamphetamine (Crystal Meth and Ecstasy), besides cannabis
abuse, which has always been the most substance choice. Heroin
or Putaw abuse, which was rife in the previous years go through a
drastic decline. The improved level of economic income per capita,
along with the rise of entertainment centers and clubs, matches to the
stimulant characteristics such as ATS, more open communities, and
involves more people rather than a culture that reflects a generation of
confusion and frustration that underlies depressant abuse including
Heroin. Nevertheless, authorities who supervise substance abuse
need to be aware that no lifestyle is static. The increase of opium
production in the world (65% from 2016 to 2017) reported by The
World Drug Report (UNODC, 2018) in Afghanistan gives a signal that
opiates will come back again, perhaps in a new and cheaper form.
5. The roles of community especially schools and workplaces cooperate
with families and the Prevention Department of National Narcotics
Board, are is very crucial; they are as follows:
a. Striving for early detection of drugs and narcotics abuse.
Observations at school and at work are far more likely to find
problems in the behavior of individuals who abuse Narcotics.
Also, educational institutions need to create an atmosphere of
teaching and learning, which supports positive self-concepts
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and students’ sense of courage and ability to choose positive

alternative activities. These things often become the reasons for
substance abuse because they want to be brave but helpless,
and sometimes they want to be creative. At home, the
individuals may isolate themselves in or outside the house so
that other people’s observations become limited. Reports on early
indications may help parents, officials, or other parties involved to
receive assistance. A balanced early detection and intervention will
help manage the client’s risky behavior, especially prevent more
substances from being used and in the long term use. Moreover,
clients can also be helped not to use substances in an intoxication
condition. For this reason, it is necessary to develop supportive
and educative policies at school and workplaces, so the fear of
reporting and asking for professional assistance may be reduced.
b. Having early preventive efforts must be made and more aggressive
as well as comprehensive - at adolescence (10 years and above).
It is a risky age for gateways drugs - the supervision of cigarettes
and alcohol is also crucial. In this case, we tend to underestimate
the existing data and facts because both two substances play a
social function that is accepted by society.
c. Supporting recovery and reintegration after rehabilitation.
Schools and workplaces are secondary environments that are
needed by rehabilitation survivors. Many addicts are arrested and
lose school opportunities because of carrying, experimenting, or
being recreational consumers. The opportunity to continue school
and work is the hope of most addicts who have completed their
rehabilitation program. Creating non discriminated school and
work culture for former addicts and individuals who have been
against the law will be an empowering environment for long-term
sustainable recovery.
6. Indonesia has long been investing in rehabilitation, especially when
The Supreme Court of the Republic of Indonesia has issued Circular
Letter No.3 of 2011 concerning compulsory reporting. Various parties
stated this new policy did not work well due to the lack of capacity
of the compulsory reporting agencies in providing professionals who
manage medical treatment programs (doctors, psychiatrists) which
sometimes have an impact on the availability of essential medicines,
and who manage psycho-social programs (social workers, addiction
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Executive Summary
counselor, psychologist, spiritual experts). This need was voiced

both by respondents, and research informants, and by professional
workers in rehabilitation institutions who felt overwhelmed because
of the small numbers of participants and did not receive serious
professional support. Furthermore, it should also be noted that
qualitative data shows that clients and their families have difficulties
in accessing rehabilitation services provided in only certain regions/
cities. Strategic and community-based expansion are needed, so the
clients and their family do not feel burdened in terms of financing.
7. About the issues above, mental health problems have become an issue
that has not yet been given much attention to, such as depression,
paranoia, anxiety, etc. This issue is caused by a lack of professional
resources, so there is a tendency to respond to those disturbing
symptoms. Increasing the capacity of staff through task and skill
shifting program in dealing with psychosocial and mental health
issues will help clients recover without any serious dependency on
medical and psychological professionals.
8. In terms of needs based on gender, qualitative data shows that female
respondents’ needs are more complex than male respondents’
needs. One of the reasons is the dependency on their partner, on family,
or relatives, their children, and multiple stigmas they may experience.
Family outreach helps the family itself or the female clients become
brave enough to receive information about available services and
reach them so the services could become an important program for
all rehabilitation agencies, either for inpatient or outpatient.
9. Having self-assessment of the respondents as narcotics abusers who
have undergone or are undergoing rehabilitation if compared to the
respondents in the general population has a higher level of problems
in the dimensions of self-care ability, carrying out daily activities,
and facing anxiety/depression. This factor not only becomes one of
the bias sources in this research but also shows the importance of
rehabilitation care.
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Table of Contents
FOREWORD i
PREFACE iii
EXECUTIVE SUMMARY v
TABLE OF CONTENTS xiii
LIST OF TABLES xv
LIST OF FIGURES xvi
CHAPTER I – INTRODUCTION 1
1.1. Background 3
1.2. Formulation of the Problem 13
1.3. Aims of Research 14
1.4. Benefits of Research 14
CHAPTER II – LITERATURE REVIEW 15

2.1. Health Impact of Narcotics Use 17
2.2. Theory of Addiction and Its implications on Health 20
2.2.1. Addiction as a Moral and Criminal Problem 20
2.2.2. Addiction as a Brain Disease 21
2.2.3. Addiction as Social Construction 22
2.2.4. Addiction as a Matter of Biopsychosocial-spiritual
(BPSS) 23
CHAPTER III – METHODOLOGY 25

3.1. Research Time and Location 27
3.2. Research Design 28
3.3. Data Collection Methods 28
3.4. Research Implementation 35
3.5. Data Processing and Analysis 39
3.6. Quality of Life / Welfare 40
3.7. Research Limitations 41
CHAPTER IV - RESEARCH FINDINGS 43

4.1. Characteristics of Respondents 45
4.1.1. Characteristics of Demography 45
4.1.2. History and Risks of Narcotics Use 46
4.1.3. Risk Due to Behavior When Using Substances 54
4.2. Relations with Physical Health 56
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Table of Contents
4.3. Relations with Mental and Social Health 60

4.4. Impacts of Narcotics Use on Friendship, School, and Workplace 69
4.5. Impacts on Neighborhood and State Apparatus 71
4.6. The Current Reason for Entering Rehabilitation 75
4.7. Sources of Support for Recovery 76
4.8. Quality of Life 79
4.8.1. Results of EQ 5D-5L Narcotics Consumers Compared
to EQ 5D-5L Data in the General Population of the
Indonesian EQ-5D-5L (2017) 79
4.8.2. Personal Health Assessment Score (EQ-VAS) 81
4.8.3. Comparison of Welfare Score Between Sex and Age
Groups 81
4.9 Post-Rehabilitation Support Needs 82
CHAPTER V - CONCLUSION 85
CHAPTER VI - IMPLICATION OF THE FUTURE OF NARCOTICS

POLICY 89
LIST OF RESEARCHERS 96
APPENDIX 97
BIBLIOGRAPHY 119
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List of Tables
Table 01: Narcotics and Penitentiary Residents Case Data

July 2012-July 2018 4
Table 02: Estimated Narcotics Consumers (National Narcotics
Board, 2017) 6
Table 03: Prevalence of Abuser in Adolescents and Youth 7
Table 04: Prospective Respondents Listed According to Year and
Location 30
Table 05: Number of Respondents Selected by Location 30
Table 06: Research Locations in Each Province 36
Table 07: Number of Respondents Each Province 37
Table 08: Distribution of Informants of In-depth Interviews 37
Table 09: General Characteristics of Respondents (n = 602) 45
Table 10: Age of First Time Use and Duration of Substance
Consuming 48
Table 11: Number of Substances Used by Respondents 49
Table 12: How to Consume and the Substances Used 52
Table 13: Experience in Health Problems (n = 602) 56
Table 14: Mental-Emotional Conditions (n = 602) 60
Table 15: Relations between Primary Substances Used and
Emotional Mental Problems 61
Table 16: Duration of Five Main Substances Abuse According to
Social Health (n = 602) 66
Table 17: Impacts of Drugs on School (n = 602) 70
Table 18: Impacts of Drugs on the Neighborhood (n = 602) 71
Table 19: Relations between Drugs-Consuming Time related
to Conflict Experience with Law Officers 72
Table 20: Supporting Factors in Recovery Efforts 76
Table 21: Domain-based Welfare Score (n = 602) 80
Table 22: Level of Problems experienced by Narcotic Consumers
from 5D-5L Results Based on Age 80
Table 23: Comparison between EQ-VAS scores in the General
Population and Narcotic Consumers Participating in
Rehabilitation 81

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List of Figures
Figure 01: Ecological Systemic Theoretic Model 24

Figure 02: 10 Most Commonly Used Substances 47
Figure 03: Ways to Consume Substances (n=602) 51
Figure 04: Risks Related to Purpose and Behavior during
Intoxication (n=602) 54
Figure 05: Long-term Impact of Drugs Consumption (n=602) 57
Figure 06: Impacts on Family Relationship (n=602) 65
Figure 07: Impacts on Family Friendship (n= 602) 70
Figure 08: Reasons for Being in Rehabilitation (n=602) 75
Figure 09: The EQ-VAS average score of Respondents as Drugs
Consumers based on Gender and Age Group 82
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I
INTRODUCTION
Rehabilitation Center of National Narcotics Board

Lido, Sukabumi
2 Health Research Of Drugs Abuse Effects 2019
Masagi Batik, Sukabumi
I
INTRODUCTION

1.1. Background
a. Global Situation
The United Nations Office on Drugs and Crime (UNODC) has

published the World Report on Situations of Narcotics Use (World Drug
Report 2018). The reader certainly expects the report will show the results
of a global effort has been spent trillions of dollars to the reduction or
improvements in the situation of the use of narcotics in the world. The
Executive Summary of the World Drug Report 2018 states:
(1) The global community needs to increase efforts to prevent and reduce
its supply because this year, Opium production is getting increased
by 65% from 2016 to 10,500 tons and becomes the highest level in
history. Likewise, cocaine production, it increases to 1,410 tons with
the appearance of Asia and Africa as new markets. The use of these
two substances which have long been consumed started to show co-
existence with the use of new psychoactive substances or NPS. This
NPS adds some complex consequences.
(2) The use of prescribed drugs by doctors not for medical purposes
caused 76% of deaths from the drug users who get substance use
disorder (SUD). Opiate-based drugs to reduce pain such as Fentanyl
and Tramadol 1 are the most common cause of serious health
problems until death due to overdose.
1
A study conducted by Irwanto et al. (2019), together with the Sangai Tunas Cilik Foundation, showed that Tramadol
had been used by street children in Jakarta’s villages. National Narcotics Board’s data (2017) also shows its users are
more than 500 thousand people in Indonesia.
Health Research Of Drugs Abuse Effects 2019 3

(3) Cannabis remains the most common type of Narcotics that consumed.
The UNODC report shows that no less than 192 million people in the
world use this substance, and over the past decade, it has increased by
16 percent. The other users of the most substances are amphetamine
and stimulant drugs prescribed by doctors (34 million), opioid users
(34 million) and opiates (19 million), ecstasy users (21 million), and
cocaine (18 million).
(4) Among younger users, there are two different usage patterns from
one country to another. Young users of high social class use more
club drugs to support night time and recreational activities. For young
people of low social class - street children around the world- widely
use inhalant substances (such as glue).
(5) Users aged 40 years and over has increased significantly, and they
often have multiple problems with the emergence of mental health
problems. Many of them have used narcotics in their teen years.
(6) Women who use doctor’s medicine for non-medical purposes are still
very problematic, and there are not lower than men, even it is higher
than men.
b. Situation in Indonesia
Along with various global efforts, Indonesia has also strived to

eradicate and prevent the use of Narcotics. Nonetheless, National
Narcotics Board’s data showed a significant increase in cases over the
last five years.
Table 01: Data on Narcotics and Penitentiary Residents Cases July 2012-July 2018
Penitentiary
Period Cases Increase per Year
Residents
per year 54,705 151,723 22.1% Case
2013 July 62,334 163,152 19.2% Penitentiary
Residents
2014 July 64,224 163,711
2015 July 68,403 174,378
2016 July 77,284 197,656 68.7% Case
2017 July 96,945 224,604 41.1% Penitentiary
Residents
2018 July 104,206 249,933
Source : Online Data of Directorate General PAS: 2018

The data revealed that the number of cases never went down and
increased from 21% (2012-2015) to 68.7% (2016 to 2018). The number of
inmates is also increasing significantly. The Indonesian Institute of Sciences
(LIPI) report for National Narcotics Board (2018) also states that in 2017,
4.71 tons of methamphetamine, 151.22 tons of marijuana, 2,940,748 pills of
ecstasy and 627.84 kilograms of liquid ecstasy, were confiscated.
Estimation data of narcotics users from National Narcotics Board

(2017) shows that the number of users is estimated to reach almost 3.7
to 4 million people. The largest number of marijuana users or cannabis
lifetime use 1.7 million people, then followed by 851 thousand people are
methamphetamine users, and 616 thousand people are prescription or
psychotropic drugs’ users in general circulation - See Table 02 below. BNN
(2015) states that the use of methamphetamine has increased 11 times
from the previous decade. An estimation carried out by National Narcotics
Board has indicated that 1 of 3 narcotics users use methamphetamine.
There are 68% of cases in 2017 related to amphetamine crystals.
Another troubling thing is the rise of new psychoactive substances

(NPS) made from synthetic substances (UNODC, 2018). In Indonesia,
74 species of NPS have been identified and only 66 species have been
regulated in the Minister of Health Regulation. These new substances
tend to be very cheap but have very harmful effects, such as desmethyl
pyrovalerone and desomorphine, are very intimidating due to physical and
psychological mental disorder they cause.
We are also quite understand that in many newspaper articles, there

is a psychoactive substance that cause of many death is locally alcohol
consumed by the poor. Not to mention the fact, that natural marijuana
is an Indonesian domestic product, also there are found many factories
that process ATS substances such as Ecstasy and Crystal Meth/
methamphetamine (Shabu).
LIPI-BNN data 2018 also presents worrying statistics to every

parent who has a teenager, both male and female. It turns out that
children aged 12-15 have experimented with Narcotics. 5 of 100 children
at that age have shown a fairly serious problem, even though it is not
explained, whether male or female.

Table 02 : Estimation Data of Narcotics Users (BNN, 2017) 2
Types of Narcotics Total Users
Marijuana 1,742,285
Shabu/SS/Crystal Meth/Methamphetamin 851,051
Overdose Headache medicines 616,507
Dextro 600,512
Ecstasy (Inex, XTC,Cece) 512,817
Tramadol/Ultram 504,416
Fly Substance 452,095
Koplo pills, BK, mboat, mboti, roda 420,651
Trihexyphenidyl/ Trihex 311,004
Drugs blend with soda 288,417
Xanex Camlet/ Calmlet (Alprazolam) 269,468
Valium 250,390
Amphetamine 244,094
Magic Mushroom 234,245
Barbiturates (Luminal, Fenobarbital) 230,370
Thorn Apple (Datura) 223,506
Nipam 215,045
A year Zenith 206,188
Rohypnol, Magadon 199,011
A year processed marijuana 186,170
Source : Data BNN, 2017
The highest prevalence number precisely at the secondary school
level is the age of 15-18 years. The prevalence shows that children who
are at the age of productive and make the transition to adulthood are the
riskiest period. The data further indicate that the prevalence of men and
women almost equally in junior high (3.40% and 3.20%), then at the high
school level men have the highest prevalence rate (5%), while women
are only half (2, 3%). In the adult working population, LIPI-BNN statistics
reported (2018) that the prevalence of under 30 years is 2.70% (Men)
and 1% (women), while those aged over 30 years are 2.80 % (Men) and
1.4% (women). As explained above, many women also use drugs that
2
No total figures obtained because a person can be poly-drug user

are not for medical purposes. In Indonesia, many women use the ATS
to manage their weight (to be thin) with sufficient medical implications
seriously.3
Table 03: Prevalence of Abuser in Adolescents and Youth
Educational Ever Used Last Year to Use

Background N % N %
Junior High School 63 4.8 % 43 3.3%
Senior High School 127 6.4% 71 3.6%
College 113 6.0% 53 2.8%
TOTAL 303 5.8% 167 3.2%
Source : Data BNN-LIPI, 2018
c. Basic Health Research Data in 2018 (RISKESDAS, 2018)
There are following data on the use of several types of Narcotics

from the Basic Health Research in 2018.
c.1. Tobacco and Cigarettes

RISKESDAS 2018 reported that 0.7% of children at the age of 10- 15
years have smoked tobacco every day. When they were older, the
prevalence of smoking increased every day to 12.7% (aged 15-19
years) and 27.3% (aged 20-24 years). Men who consume cigarettes
per day are higher (47.3%) than women (1.2%). Moreover, more people
are living in rural areas (25.8%) than those in urban areas (23.3%).
In terms of the first time using alcohol, 3.8% of children and

adolescents started smoking at the age of 5-9 years. While more girls
started early to smoke (1.3%) compared to males (0.9%). Also, more
villagers also started smoking early (1.0%) than city residents (0.7%).
c.2. Alcohol Consumption

The 2018 RISKESDAS report shows that 0.3% of the population aged
10-14 have consumed alcohol during the past month (including
alcoholic drinks like Whiskey). The prevalence of alcohol consumption
3
Drug Information, https://obat-drug.blogspot.com/2014/10/amphetamine-amfetamine.html.

increases when aged 15-19 years (3.7%) and ages 20-24 years (6.4%).
Traditional alcohol plays a huge role because it is consumed by
more than 33% of the population. More men (6.1%) consume alcohol
compared to women (0.4%).
d. Narcotics Policy in Indonesia Today
The narcotics policy in Indonesia currently still focuses on moral-legal

approaches and leads to human rights-based policies, especially the right
to get medical treatment and to be healthy for addicts. The policy is set in
the several acts which underwent a change and is equipped with various
government regulations and president decree and several government
agencies. The narcotics policy at first is stipulated in Law No. 22 of 1997
on Narcotics. In the law, it mandates to establish a coordinating agency
to set a national policy in narcotics in terms of availability, prevention, and
eradication of drug abuse and illicit trafficking. This institution was given
the nomenclature of the National Narcotics Coordination Board (BKNN),
which was later changed to the National Narcotics Board (BNN) through
Presidential Decree Number 17 of 2002.
Situation circulation and use of narcotics in Indonesia prompt the

government issued new regulations to replace Law No. 22/1997 concerning
narcotics, which is considered no longer relevant. The government issued
Law 35 of 2009 concerning Narcotics. There are several objectives to
be achieved by the Indonesian government with the enactment of Law
No. 35 of 2009, namely: (1) ensuring the availability of narcotics for the
health benefit and/or the science and technology development; (2)
prevent, protect and save the Indonesian people from narcotics abuse;
(3) combating narcotics illicit trafficking and narcotics precursors; and
(4) ensuring the setting of medical and social rehabilitation efforts for
abusers and drug addicts.
However, Law No. 35/2009 concerning Narcotics rated less attention

to the rights of narcotics users. Drug users are categorized as addicts,
that is people who use or abuse narcotics and are in a dependency of
narcotics, both physically and psychologically. In article 55 paragraph
(2) states that narcotics addicts and victims of narcotics abusers must
undergo medical and social rehabilitation. Mandatory rehabilitation which

is a series of mandatory reporting, and plus criminal threats if not reporting
themselves, it has a potential to violate the right to health. Whereas, the
right to health is a guarantee given by the state in relation to information
regarding the type of service to be provided to drug users and the provision
of services or medical treatments must be based on the consent of the
person being treated.
In addition, the Law No. 35 of 2009 on Narcotics shows that the

parliament intends to defend their opinion those drug users as criminals
by setting them as narcotics abusers, namely people who use narcotics
against the law. In practice, law enforcement in Indonesia still views the use
of narcotics as a criminal offense or legal issue rather than as a health issue.
In the implementation of Law No. 35 on Narcotics, the view of addicts or
victims of narcotics abusers is more dominant as criminals compared to
health and healing approaches to narcotics dependence.
Besides the Narcotics Act, there is also Government Regulation

No. 25 of 2011 on the Implementation of Mandatory Report of Narcotics
Addicts (Regulation No. 25 of 2011). Wherein in Article 13 paragraph (3)
Government Regulation No. 25 of 2011 states that narcotics addicts
who are undergoing judicial processes can be placed in medical or social
rehabilitation. In practice, mandatory reporting program is conducted
by National Narcotics Board, Provincial Narcotics Board (BNNP), City/
Regency Narcotics Board (BNNK) or goes to the institution designated
as IPWL (Mandatory Report Recipient Institution) of the Ministry of
Health and Ministry of Social.
The impetus for using a public health approach in Indonesia in

responding to narcotics problems, prompted the Attorney General’s
Office and the Supreme Court to issue a circular letter for the placement
of narcotics victims / abusers into rehabilitation institutions. The
Attorney General’s Office issued a circular letter of the Attorney General
Number SE-002 / A / JA / 02/2013 on Placement of Narcotics Abuse
Victims to the Medical and Social Rehabilitation Institution within the
Narcotics criminal justice system”. Previously, the Supreme Court (MA)
issued SEMA 7 of 2009 on Placement of Drug Users into Therapy and
Rehabilitation Institutions (SEMA 7/2009) which coincided with the
enactment of Law Number 35 of 2009 on Narcotics. By the amendment

of SEMA No. 07 of 2009 to SEMA No. 04 of 2010, sit can be said that
the Supreme Court still acknowledges that the majority of prisoners and
detainees in narcotics cases are included in the category of users or even
victims when he/she is viewed from a health aspect, in fact those are
sick, and of course imprisonment is not a right step 4.
The next development related to narcotics policy was the signing

of a joint regulation in 2014 relating to the Handling of Drugs Addicts
and Victims of Drugs Abuse in the Rehabilitation Institution. National
Narcotics Board, the Secretariat of Supreme Court, the Ministry of Law
and Human Rights, the Attorney General’s Office, and the Indonesian
National Police (Mahkumjakpol) signed joint regulation relating to
the Handling of Drugs Addicts and Victims of Drugs Abuse in the
Rehabilitation Institution. This signing was carried out by Supreme Court,
the Ministry of Law and Human Rights, Ministry of Health, Ministry of
Social Affairs, Attorney General, Indonesian National Police, and National
Narcotics Board at the Vice Presidential Palace. At that time, BNN and
the Secretariat of Mahkumjakpol claimed this is a concrete step for the
government in suppressing the number of addicts and victims of drugs
abuse in Indonesia.
In 2014, President Joko Widodo stated that Indonesia faced Narcotic

Emergency. This statement was responded by government agencies by
increasing law enforcement and rehabilitation efforts. Law enforcement is
carried out through field operations and efforts to improve rehabilitation
access through setting rehabilitation targets for 100,000 narcotics users.
The target of rehabilitation in its implementation was carried out through
an intensified mandatory report program which proved to be less effective.
The rehabilitation program through mandatory reporting program is

considered less in accordance with the policies of the UNODC / WHO in
2012 declared it was more recommended for treatment as an alternative
than imprisonment that issued a mandatory rehabilitation. Mandatory
treatment is considered less effective because there is a coercion
element and not because of the narcotics users awareness or needs.
4
Eddyono et all. 2016. Reviewing the Rehabilitation of Narcotics Users in Judicial Practices Implementation of SEMA
and SEJA Regarding Placement of Narcotics Users in Rehabilitation Institutions in Surabaya. ICJR.

In addition, mandatory reporting is also considered less in line with the
joint commitment of the newly signed representative of the Indonesian
government in special session of the general assembly on the world drug
problem (UNGASS) in April 2016.
In the section “Treatment of drug use disorders, rehabilitation,

recovery and social reintegration ; preventing, treating and caring HIV /
AIDS, hepatitis viruses and other blood-borne infectious diseases ”, the
recommendations provided to promote effective steps in minimizing
adverse public and social health as the consequences of drug abuse.
In 2014, National Narcotics Board, the Secretariat of Supreme Court,

the Ministry of Law and Human Rights, the Attorney General’s Office, and
the Indonesian National Police (Mahkumjakpol) signed joint regulation
relating to the Handling of Narcotics Addicts and Victims of Narcotics
Abuse in the Rehabilitation Institution. This signing was carried out by
Supreme Court, the Ministry of Law and Human Rights, Ministry of Health,
Ministry of Social Affairs, Attorney General, Indonesian National Police,
and National Narcotics Board at the Vice Presidential Palace. At that time,
National Narcotics Board and the Secretariat of Mahkumjakpol claimed
this is a concrete step for the government in suppressing the number of
addicts and victims of narcotics abuse in Indonesia.
The Government decided to hold a National Action Plan for

Strengthening the Prevention and Eradication of Drug Abuse and Ilicit
Trafficking (P4GN) in 2018-2019. This is stipulated in the annex to
Presidential Instruction (Inpres) Number 6 of 2018 which was signed by
President Joko Widodo on August 28, 2018 (Link: Inpres Nomor 6 Tahun
2018)5. This Presidential Instruction as a legal umbrella for all Ministries
/ Institutions, to jointly carry out P4GN National Action Plan (NAP)
activities and contain enthusiasm, RAN will be implemented in synergy
with the National Narcotics Board together with Ministries / Institutions
and Regional Governments. Responding to the issuance of Presidential
Instruction No. 6 of 2018, prompted the Head of BNN to issue Regulation
of the Head of National Narcotics Board No.10 of 2018 regarding the
implementation of the RAN P4GN within the National Narcotics Board.

P4GN 2018-2019 classified into categories: (A) Prevention; (B)
Eradication; (C) Rehabilitation; (D) R&D of Handling Drugs Abuse and Narcotics
Precursors. Some programs of each category, described as follows:
(1) Prevention Department several National Action Plan’s to be carried out
in the prevention category including: 1) Dissemination of Narcotics
and Narcotics Precursor hazards as well as information about
P4GN to employees of the State Civil Apparatus, TNI soldiers, and
members of the Indonesian National Police with the person in
charge of National Narcotics Board the Ministry of PAN-RB, and the
Ministry of Home Affairs; 2) Implementation of International Youth
Day at central and provincial government; and 3) Establishment of
5 (five) Education Information Center of narcotics, psychotropic and
addictive substances (drugs PIE) in 5 vulnerable and susceptible
areas of Narcotics and Narcotics Precursor. Besides that, there are
another NAP programs: 1. Implementation of urine test to all
employees of the State Civil Apparatus, including a candidate of
the State Civil Apparatus; 2. The establishment of anti-narcotics task
forces / volunteers and narcotics precursors; and 3. Implementation
of anti-narcotics training of young cadres and drug precursors.
(2) Eradication Department. In this eradication sector, several National
Action Plan’s have been prepared including: 1. Rescuing assets
originating from narcotics and narcotics precursors or money laundering
related to narcotics and narcotics precursors; 2. Supervision of
narcotics correctional institutions; and 3. Establishment of a narcotic
detention house.
(3) Rehabilitation Department, several NAPs in the field of rehabilitation
in 2018-2019 include: 1. Provision of rehabilitation services in each
province, regent, and city; and 2. Coaching child victims, child
witnesses and child abusers of narcotic drugs and precursors.
e. Policy in Research and Development of Drug Abuse and

Narcotics Precursor Management.
There are some National Action Plan’s program that have been
prepared, such as: 1. Survey on the prevalence of drugs abuse and
narcotics precursors; 2. Provision of data related to P4GN; and 3. Provision
5
https://setkab.go.id/inilah-rencana-aksi-nasional-pencegahan-dan-pemberantasan-narkotika-2018-2019/

of data integration applications related to P4GN. From the various
programs listed, generally in prevention sector, dissemination of Narcotics
and Narcotics Precursor hazards and urine tests to all employees in the
Ministry / Institution are still the main programs in prevention sector. The
dissemination program of which can be carried out in each Ministry /
Institution by coordinating with the National Narcotics Board, for example
at the recruitment or promotion time. Though it is clear this urine test
program has proven to be less effective and requires a large budget.
The opportunity of cooperation with non governmental institutions

related to NAPs P4GN program is explicitly less visible. Whereas, the
involvement of civil society has developed quite large seen in research,
policy studies and programs which is directly involved in providing
services for drugs users. The role of civil society organizations could
be a government partner both as supervisors of government work and
assistances in implementing government duties.
There are some programs that need to be considered in relation

to the availability of funding and the effectiveness of implementation
program, such as establishing narcotic detention centers and providing
rehabilitation services in each province, regency, and city. Planning to
provide a rehabilitation center requires a regency and city levels but
it will answer the needs of rehabilitation centers in each region. The
strategy for establishing a rehabilitation center needs to consider the
readiness of resources and distributed data of narcotics use situations
for effective utilization of rehabilitation centers.
1.2. Formulation of Research Problem
Health is not only a matter of “not being sick” physically-biologically

and mentally, but also there is a well- being sense of social and cultural
at the same time. So, the impact of drugs use also formulated as the
influence and impact of psychoactive substances that are consumed
not for medication/ medical purposes on one’s health and well-being
physically-biologicaly, mentally-psychologically, and in socio-cultural, or
unit (family and community) where that person is lived.

The formulation implies that health issue is not only an individual
issue but also a systemic issue. It means that an individual’s experience
in using narcotics is going to be reflected not only as an individual’s
experience, but also as the most proximal systemic experience to his life.
1.3 Research Objectives
The general objective of this research is finding a systemic overview

drugs use effects to its user individually on his/her personal and elements
in socio-cultural relations with influential parties in his life. It can be
specified as follows:
1. To understand the impact of narcotics use in determining the user’s
life journey, both physically, mentally-psychologically, and socially.
2. To understand the impact of situation faced by individuals who are
consumming narcotics in their roles in friendship, family, community
and country.
3. To understand the contribution of non-physical-biological factors in
determining the severity and recovery of narcotics users
1.4. Benefits of Research
a) Providing information to the public related to drugs use effects that

are not only physical-biologically, but also psychologically, socially
and spiritually impacts.
b) Finding alternative ways to package a variety of prevention messages
based on research data.
c) Finding policy direction in the future, particularly in demand reduction
strategies and adverse effects.
d) Manifesting the role of various society elements, families,
communities, schools, and the private sector in handling narcotics.

II
LITERATURE REVIEW
Rehabilitation Center of National Narcotics

Board Baddoka, Makassar
Toraja Batik, South Sulawesi
II
LITERATURE REVIEW
2.1. Health Impacts of Narcotics Use
We define what is “healthy” meant especially the WHO version (WHO,

1946; Callahan, 1973; van Spijk, 2002) before discussing the impact of
Narcotics use on health. According to the UN health authority, HEALTH
is: “a state of complete physical, mental, and social well-being and not
merely the absence of disease or infirmity”. This definition emphasizes
the importance of expanding the notion of being healthy not only as a
condition in which an infection or the presence of certain weaknesses
or deficiencies, but also a more comprehensive condition physically-
biologically, mentally, and socially. Although it is considered quite
controversial, this holistic healthy concept endeavour to provide a healthy
condition as the humans’ ability to adapt and manage physical, mental,
and social challenges throughout their lives.
The direct impact on long-term use various types of drugs repeatedly

on the brain has been widely described in many sources. Basically,
narcotics whether depressants, stimulants, and hallucinogens directly
influence the chemicals that manage the “reward circuit” or the center
of emotions and feelings that cause a sense of “good and satisfied” (as
part of the limbic system), even various cognitive functions (thinking
and memory) of individuals, if stimulated, it will trigger a tendency for
repetitive behavior. This is important to highlight because the beginning
of the narcotics use is generally voluntary. Chemicals changes of these

sense centers trigger a tolerance 6 of substances and ultimately lead to
withdrawal symptoms followed by physical symptoms such as severe flu.
These pain and discomfort encourage individuals to find and use it

again so the pattern of substance use is no longer voluntary, but under
influence of drugs or withdrawal symptoms (sakaw). It is due to be fixated
on the pain prevention because of withdrawal symptoms , the user is not
concerned with his/her health in general, including many cases of anemia
and the spread of opportunistic infections (such as HIV / AIDS). If the
user is a pregnant mother, the baby’s brain and physic will gain serious
negative effects (Gateway, https://www.gatewayfoundation.org/faqs/
effects-of-drug-abuse/ ).
One of tangible impacts from long-term sustainable narcotics use is

addiction or drug dependence. Drug dependence or addiction is the base
of the spread of various negative impacts or disorders in the physical-
biological, mental, and social domains. People who gets drugs addiction
frequently has one or more health problems. Problems arisen can be related
to physical and mental disorders. Physical disorders are lung disease, heart
disease, stroke, cancer, and mental health conditions. Scanned images,
chest X-rays and blood tests can show long-term damaging of drug use
throughout the body. For example, tobacco smoke can cause cancer,
methamphetamine can cause severe tooth decay known as “mouth meth,”
and opioids can cause overdoses and death. In addition, some drugs, such
as inhalants, can damage or destroy nerve cells, both in the brain and the
peripheral nervous system (nervous system) outside the brain and spinal
cord).
The use of narcotics can also increase the risk of contracting Human
Immunodeficiency Virus (Hepatitis), Hepatitis B and Hepatitis C. These
infection can occur from sharing injection equipment and unsterile sexual
activity. Heart and valve infections (endocarditis) and skin infections
(cellulitis) can occur after exposure to bacteria by injection drug use.
6
Tolerance is a biological-chemical process in which in the long-term use of the biological body will require a greater
amount of substances to cause the same effect.

The nature of addiction not only endangers a person who uses
drugs, but also can interfere in others health. As an example, using drugs
while pregnant or breastfeeding may cause the baby gets “withdrawal”
symptoms after birth is called Neonatal Abstinence Syndrome (NAS),
while some children were exposed to drugs as a child will get problems in
behavioral development, attention and thought. Drug use also increases
the spread of infectious diseases. Excessive drug injection contributes 1
in 10 cases of HIV. Injection of drug use is also a main factor in the spread
of hepatitis C, cause of endocarditis, cellulitis, and increase the chances
of risky sexual behavior. In addition, drug use also increases the risk of
motor vehicle accidents. In the Annex we include a literature review on
substances types and their impacts on human health.
It is due to the complexity of symptoms called addiction, so addiction

diagnostic criteria are comprehensive, it is covering psychosocial and
physical health problems. The following 11 criteria are used to determine
the addiction of DSM-V, which list the various criteria, as follows:
1. The harmful ways of using drugs to theirselves or others.
2. Individuals or users experience social (relational) or interpersonal
problems due to the use of the drug.
3. Leaving aside all responsibilities and roles at work, school or home
because of the drug use.
4. When stopping to consume the drug, he/she gets very painful and
disturbing withdrawal symptoms.
5. Users are getting a tolerance that should add a dose of their use to
obtain the same effect as before.
6. The number of uses increase due to tolerance and usage over a longer
period of time
7. Tried to stop repeatedly or control usage but it never worked.
8. Too much time is wasted on drug use.
9. Began to cause physical problems (such as liver damage, lung cancer)
and psychological (depression and anxiety)
10. Many activities are usually fun to do but are no longer carried out due
to drug use.
11. Symptoms of craving arise when the effects of the drug have
disappeared

2.2. Addiction Theory and Its Implication to the Policy
a. Addiction as Moral and Criminal Issues
There are several explanatory (theories) frameworks regarding

addiction related to the drugs use not for medical purposes but for
recreational or life-style drug use. The most dominant theory is considering
that drugs use is a criminal act and contrary to morals. This view originates
from Prohibition 7 which has been applicable in several centuries ago. At
the development of Islam era in the Middle East, approximately in the
7th century AD, Islamic Sharia law forbidden the consumption of various
substances which can cause intoxication (not only alcohol, including the
use of hasish or cannabis). Even so, the practice of using hashes was
considered unlawful, especially in Egypt in the 11th century to the 14th, if
used for medicinal purposes. As it was based on Qanun’s law, intoxication
was considered criminal and infringed religious norms and morality at
once. Prohibition in Ottoman era under Emperor Murad IV (1612-1640),
even included drinking coffee which was considered as an intoxicating
drink. Another case in Europe in the same period, coffee was banned
because it was imported from Muslim Turkey as a criminal offense
In Asia, King Ramathibodi I of Thailand (1314-1369) banned the

opium trade which lasted nearly 500 years until the King Rama IV era
(1851-1868) who opened Thailand to Europeans and allowed migrants
from China to consume opium. In 1360, King Hayam Wuruk ordered Mpu
Prapanca wrote down about the adverse effects of opium in his book
Negerakertagama (Yatim in Yatim & Irwanto, 1986).
This ban emerged again as a public policy called Prohibitionism

in Western Europe and America in the 20th century 8 which ultimately
influenced the Convention on Narcotics at the United Nations called
Single Convention on Narcotic Drugs which was followed by the 1971
Convention on Psychotropic Substances. As a technical basis, the UN
agreed to the UN Convention Against Illicit Traffic in Narcotics Drugs
7
Prohibition is a period in history where the government or religious institutions prohibit the use of certain psychoactive
substances for normative and moral reasons (Wikipedia, https://en.wikipedia.org/wiki/Prohibition_of_drugs)
8
Prohibiting the use of psychoative drugs not for medical purposes was carried out in the UK through the Pharmacy Act 1868
which regulates the distribution of poisons and drugs, then Dangerous Drug Acts were issued in 1928 which caused alcohol and
marijuana become illegal in the UK and spread to all colonies including in the US.

and Psychotropics Substances 1988. This convention was triggered by
the growing demand for recreational and lifestyle drugs in the Western
Hemisphere and hence this Convention became the basis for the
regulation of the use of dangerous psychoactive substances so as not to
misused and become the basis of criminalization policies throughout the
world 9. Only a few countries provide concessions for the use of cannabis
for cultural purposes (Indian) and medical (Dutch) purposes. Indonesia
has the Narcotics Act No. 22 of 1997 that based on the three Conventions.
Legal, moral, and religious considerations in the use of narcotics

apparently do not lead to significant changes in the prevalence of use and
losses incurred to society and the country, especially as exclusion and
imprisonment indiscriminately have caused poor treatment to the users
and its approaches such as War on Drugs which costs trillions of US
dollars and takes away the millions of people lives who could have been
saved through rehabilitation and public health-based interventions. Many
countries then revised their Narcotics Acts and began to understand
the importance of saving humans through certain interventions and
rehabilitation. The old narcotics act in Indonesia was replaced by Act no.
35 of 2009 which is more based on public and mental health in which the
role of reports and treatments for addicts is more prominent than previous
act.
b. Addiction as a Brain Disease
At the same time, scientists in the United States, especially who work
for NIDA (the National Institute of Drug Abuse) disseminated addiction
theory as a problem in the central nervous system or the brain that
called as The Science of Addiction: Drugs, Brains, and Behavior10 that put
forward initially by Alan Leshner in his writings Addiction is a Brain Disease
(1998; 2001) and Margaret Munro who wrote The Hijacked Brain (2015).
This brain disease theory is based on the assumption that psychoactive
substances are used not for medical purposes, indiscriminate doses,
and mixed with various other substances that have negative effects are
not only able to enslave the brain which has the same neurotransmitter
9
Although the convention itself does not provide specific instructions for the criminalization of possession of prohibited
substances (TNI, https://www.tni.org/en/publication/the-un-drug-control-conventions#5)
10
https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface

elements with these substances, but also damage the mechanism at the
same time due to indiscriminate and lasts long use.
One of the symptoms that becomes the basic argument is the

symptoms of drug withdrawal or addiction. Addiction, which is commonly
understood as a problem of brain disease since the 1990s, is based on an
neurocentrism understanding. It is the understanding of recreational drugs
set human behavior through certain brain structures, so there is a real
difference from observations between an addicted brain and non-addicted
brain. This difference is then considered a cause of addiction and being a
target to provide treatment for that addiction. So, the programs carried out
to treat brain addictions by using pharmacology is its perspectives.
Grifell & Hart (2018) mentioned the dangerous assumption of a

sick brain theory is that any use of certain drugs (for example, cocaine,
heroin, or methamphetamine) considered be a pathology, even the use
for non-problematic social-recreational which characterized the majority
of experiences who are taking drugs at this time, seen as a problem.
Assumptions that addiction is a brain disease must be re-evaluated to
formulate a more accurate drug addiction point of view based on evidence
and emphasize the important role of psychosocial, environmental
and alternative supporting factors rather than only drugs to reduce a
problematic drug usage.
c. Addiction as Social Construction
The dissatisfaction of experts in dealing with public policies

emphasized criminalization and then took a pathological medical model
(brain disease). It encouraged experts to form a consortium of Narcotics
policies in the world called the International Drug Policy Consortium or
IDPC11 which builds new, more sympathetic narratives and supports the
development of Harm or Risk Reduction strategies. The emergence
of Harm Reduction (HR) or Risk Reduction to overcome the adverse
effects of War on Drugs is triggered by a sense of justice and more
positive thoughts about the use of narcotics. An approach that recognizes
the Narcotics usage is a socio-cultural construction in which there are
11
https://idpc.net/

structural poverty, legal injustice, and public policies that do not defend
communities whose lives have been very difficult either poverty or
because of emergencies including armed conflict. Therefore, this policy is
often called a rights-based or human rights- based policy.
HR programs are widely implemented in various countries in many

ways, such as Methadone and Buprenorphine substitution services,
syringe exchange, behavior change counseling, partner counseling, etc.
to prevent tdisease transmission carried by blood when using injection
narcotics. This is crucial when it came up sexual lifestyle used Narcotics
(stimulant) as part of the ritual and sexual satisfaction were called
Chemsex (Beg, 2017; Stevens & Forrest, 2018). In addition, the UN also
promoted an economic approach to replace Narcotics plants with Cash
Crop Substitution in lieu of growing cannabis, opium, and cocaine in
producing countries such as Thailand, Myanmar, etc.12
d. Addiction as Bio-Psycho-Social-Spiritual (BPSS)
The development of perspectives in understanding narcotic addiction

has led to the argument shifting that addiction is a problem triggered by a
single cause (such as physical/biological /brain /moral deficit /criminogen)
in a more comprehensive direction. Addiction is a complex problem
caused by various interrelated causes. UN agencies such as UNODC
and WHO are currently adopting new approaches how to understand the
issue of addiction or the use of narcotics as a Bio-psycho-social issue or Bio-
psycho-social Model of addiction. This view was presented by Dr. George
Engel (1977) who stated that a disease, whatever it is, cannot be understood
only from a biological or anatomical point of view but required a social and
cultural perspectives which became a context or “environment” of the
disease. This view was adopted by activists of addiction and rehabilitation
in the late 1990s as a solution to monolithic theory. In the context which
the spiritual problems also influenced the meaning of addiction, then the
model into Bio-Psycho-Social-Spiritual or BPSS (Frankle, Quill, & McDaniel,
2003; Borrell-Carrio, Suchman, & Epstein, 2004; Howarth et al, MentalHelp.
net). This perspective will be used in formulating research problems in this
research.
12
Asian Correspondents, 23 Dec.,2014 https://asiancorrespondent.com/2014/12/burmese-opium-farmers-seek-viable-
alternative-crops/.

As this BPSS model broadens Figure 01 : Ecological Systemic
the causality scope of addiction, so Theoretic Model
the intervention model developed
must be systemically realized into
the ecological theory of human
development from Broffenbrenner
(1994). This developmental
ecology theory shows that
humans develop from a fetus into an adult through various interactions
with factors in the micro system (family, schoolmates, playmates, teachers
etc.), meso system (various things that existed in the community where
the family life), and macro systems (various governmental institutions
and regulations that affect him and his family). An important history or
event in their personal or community life will influence the direction of
their development due to all of these systems are in a time dimension. It is
closely related to the individual as an addict with the policy direction taken
by the government.

III
METHODOLOGY
Rehabilitation Centre of BNN

Tanah Merah, Samarinda
Kembang Kenanga Batik, Samarinda
III
METHODOLOGY
3.1. Research Time and Location
a. Research Time
The research was conducted for 7 (seven) months starting from May
to November 2019. Data collection were carried out in September-October
2019 with pre-visit activities beginning in September 2019. Then proceed
it with field data collection until October 2019
b. Research Location
The research was conducted in 6 (six) provinces, as follows:

1. Batam, Riau Islands Province
2. Lampung, Lampung Province
3. Bogor, West Java Province
4. Medan, North Sumatera Province
5. Samarinda, East Kalimantan Province
6. Makassar, South Sulawesi Province
The choice of research location considers the effectiveness of the

coordination and data collection, various characteristics of respondents
and types of narcotics used. Respondents on this research were clients
who took part in rehabilitation programs at the Rehabilitation Center
of National Narcotics Board, post rehabilitation programs, outpatient
programs at Pratama Clinic and programs that partnered with community
components.

3.2. Research Design
a. Types of Research
This research is quantitative descriptive research supported by
qualitative research based on life history and experiences from informants.
Methodologically, this study is called mixed-method where quantitative
descriptive method used as the main approach. While, a qualitative
approach is used to provide more detailed explanations that are not
possible to obtain from quantitative instruments. Quantitative data were
collected through a survey using a questionnaire, while qualitative data
were obtained through semi-structured interviews by using guidelines on
topics that wanted to be explored further from informants.
b. Research Framework
Health problems are not only a matter of “not being sick” physically-
biologically and mentally, but also at the same time there is a sense of
social and cultural well- being. Therefore, the impact of the narcotics use
is formulated as the influence and impact of psychoactive substances
used not for medicinal /medical purposes on the physical and biological,
mental-psychological, and socio-cultural health and welfare of a person or
unit (family and community) where they live.
The formulation above implies that health problems are not only
individual problems but also systemic problems. It means an individual’s
experience in using narcotics will be reflected not only as an individual’s
experience, but also as the most proximal system experience in his life.
c. Ethical Clearence
The ethical clearence assessment of the research was carried out
by the Ethics Commission of the UNIKA Atmajaya Research and Service
Institute.
3.3. Data Collection Methods
Due to this research is a mixed-method, using quantitative and

qualitative approaches, thus each approach has different data collection
methods and sources of information.

a. Quantitative Approaches
1) Research Respondents
Research respondents are drug users who are undergoing
rehabilitation or post rehabilitation programs at the National
Narcotics Boardrehabilitation site or their partners.
The inclusion criteria for determining respondents in the

research sample, namely:
• Having used drugs for the past 2 years
• Having or were currently getting BNN rehabilitation
services in 2017-2019 at the Rehabilitation Center and
Workshop of National Narcotics Board, including IPWL
participants of National Narcotics Board program partners.
Priority respondents patients who undergoing rehabilitation
at Balai BNN and patients after rehabilitation.
• Ages 15 - 64 years (UNODC standard)
• Not in a condition of severe mental disorder
In this research, the researcher is not only collaborated with

rehabilitation service providers, but also with communities
organizations of National Narcotics Board program partner and
Narcotics user communities, both men and women.
2) Sampling Technique
Respondents as research samples were taken by using a sampling
technique Proportional Random Sampling (Sage Research Methods 13)
In random sampling, each group of population has an opportunity

to become a sample, but the research sampling also considers
the purpose of sample variation to be achieved.
The number of samples was calculated by using the Slovin

formula (Sevilla et. Al., 1960: 182), as follows:
Description: n: total sample ; N: total populationi and e: error tolerance
13
https://methods.sagepub.com/Reference/encyc-of-research-design/n340.xml

From the formula above, the total population (N) is the total
number of rehabilitation participant listed in 6 research locations
for period 2017-2019. Furthermore, the number of samples
obtained (n) will be divided proportionally according to the
population in each research location.
Based on data from 6 rehabilitation centers of BNN, the population

of rehabilitation participants data in 6 cities during 2017-2019 is
N = 4,203 people with distribution as follows:
Table 04: Listing Candidates Respondents by Year and Location

Year
Location
2017 2018 2019 Total
West Java (Lido) 686 716 254 1,656
South Sulawesi (Badoka) 313 304 134 751
Riau Islands (Batam) 201 233 116 550
North Sumatera (Deli Serdang) 72 87 86 245
Lampung (Kalianda) 130 122 65 317
East Kalimantan (Tanah Merah) 252 263 169 684
TOTAL 4,203
By using 4% of fault tolerance limit will be obtained the required

number of samples as many as 545 people. Taking into account
the situation in the field added 10% of respondents as a backup,
so the required total sample is 600 respondents. Distribution of
the number of respondents per Province namely:
Table 05: Number of Respondents Selected by Location
No Location Total Respondents

1 West Java (Lido) 215
2 Riau Islands (Batam) 80
3 East Kalimantan (Tanah Merah) 95
4 North Sumatera (Deli Serdang) 55
5 Lampung (Kalianda) 55
6 South Sulawesi (Badoka) 100

The sample selection is carried out through several stages including:
a) Prospective female respondents directly selected as respondents
b) Prospective respondents with experience of using opiates-heroin
directly taken as respondents
c) Another prospective respondents were selected randomly from
the list of potential respondents listed. If the selected respondent
can not participate in the research, the respondents were replaced
by other respondents. Prospective respondents were rehabilitation
clients who took part in rehabilitation programs, both inpatient and
outpatient at National Narcotics Board rehabilitation and National
Narcotics Board partners.
b. Qualitative Approach
The qualitative approach is used to explore a deeper information

from research informants, both those involved directly or indirectly in
providing assistance and caring to narcotics users as a data triangulation.
Qualitative data was collected to deeper understand the addiction

experience of the respondents and those who related to his addiction
(family members, spouses, doctors, counselors and social workers in
implementing the rehabilitation component of the community). Data
collection was carried out through semi-structured interviews. Interviewed
informants were 20 people per province. The informants’ inclusion criteria
for in-depth interviews include:
1) Narcotic Users
• Willing to be interviewed
• Ages 15-64 years
• Do not experience severe mental disorders
• Having a living history in experiencing the effects of systemic
narcotics and toughness in facing those impacts - particularly if
it contains the story of a successful recovery.
• Having a living history in experiencing the effects of systemic
narcotics and showing helplessness in preventing and
overcoming the adverse effects of narcotics use.
2) Technical stakeholders (doctors / psychiatrists, social workers)

•
Having experience in handling clients of drug users at least 1
year
3) Family of narcotics users (parents, spouse)
• Having experience / interacting directly / living at home with
narcotics users
c. Research Instrument
1) Instruments of Quantitative approach

Quantitative data collected was carried out through surveys using a
questionnaire. At the end of the questionnaire, there was an assessment
of motor skills - using the EURO Quality of Life QoL (5D-5L) developed
by EuroQol Group in 1990 to measure health status consisting of 5
dimensions: mobility, self-care, daily activities, illness /discomfort, and
anxiety/ depression. This tool has been adapted by Purba et al, (2017) and
made Indonesian version.
The questionnaire used in the Health Research of Drug Abuse

consists of several elements, namely:
a BLOCK I Place Description

b BLOCK II Enumeration Information
c BLOCK III Characteristics of Respondents
d BLOCK IV Experience Using Narcotics
e BLOCK V Risk Behavior
f BLOCK VI Experience of Pain Outside Drug Drops (Impact of
Narcotics Abuse on Physical, Emotional, Social and
Spiritual Conditions)
g BLOCK VII Supporting Factor / Booster
h BLOCK VIII Impact of Long-Term Use of Narcotics Experience
i BLOCK IX Dealing With Self-Assessment of the State Apparatus;
j BLOCK X Motor Ability
k BLOCK XI Self-assessment; EURO QoL (EQ-5D) Questionnaire on
holistic health
2) Instrument of a qualitative approach

instruments of data collection with a qualitative approach is in semi-

structured interview questions guide. Each group of informants has a
different instrument guide. Question topics for each informant include:
a) Drugs user
• Activities and quality of life before and after using Narcotics
• Support system received from family, friends, school/work/
community, religion teachers and experience in accessing
health and rehabilitation services.
• Other things needed to minimize drugs use effects
• Suggestions for this research recommendations.
b) Informants group of medical workers and social workers;
• Experience during treatment.
• Type of indeterminate widely experienced by clients in nursing
homes
• Support system provided by family /friends of clients handled
• Challenges and obstacles encountered in providing treatment
to clients, families, policies and existing treatment system.
• Other things needed to minimize drugs use effects.
• Suggestions for this research recommendations
c) Informants of family members /spouses of drug users
• Experience dealing with family members /clients due to drug
use, support systems provided by family /friends and types of
physical, social, mental impacts experienced by users
• Challenges and obstacles encountered in providing /seeking
help; regarding access to (information, geographical), financial,
and policy administration system and referrals.
• Other things needed to minimize drugs use effects.
• Suggestions for this research recommendations.
d. Trial Questionnaire
The instrument trial was conducted to 40 rehabilitation clients at the

Lido BNN Rehabilitation Center. The trial was conducted with the intention
that there is a legibility test and an interview eligibility test.
After the trial activities, then discussed and evaluated its trial results
of each researcher carried out. Evaluation of trial findings is used to
improve research instruments, determined appropriate interview methods
and improved research protocols.

e. Research Organization
1) Researcher Team
The research team are people who have capacities and
experience in researching and handling narcotics problems. The
Research Team was led by a researcher from BNN and supervised by
Senior Consultants and high leaders of BNN. In collecting field data,
researchers are assisted by local partners, field coordinators and
enumerators. The number of enumerators in each province is different
according to the number of respondents in the province.
2) Data Management
a. Data Collection:
• Research data were taken by enumerators who had attended
training and had special expertise in communicating with
drug abusers.
• EURO QoL (EQ-5D) data regarding self-assessment of motor
skills and self-health assessment will be filled in by each
participant / respondent accompanied by an enumerator
individually.
• The life-history interview will be conducted by the researcher
after the researcher determined that the respondent‘s “case”
falls within the criteria for the life- h i story interview. Data will
be recorded and transcribed by verbatim for analysis.
• Interviews for stakeholders will be along with life history
interviews where data and information are obtained based on
life events, especially events that determine the participant’s
life (trajectories).
b. Quality control
Data quality control is carried out in before and during the research
process. Before going on the field, enumerators and interviewers are
trained to ensure understanding of research instruments, research
methods, and other field techniques. During collecting data, the
researcher was assisted by one field coordinator whose special
task was data controlled and two local partners would check the
data before data entry. After entering data into database system,
random checking will be performed to ensure the correctness of
data entering the system.

3.4 Research Implementation
1) Technical guidance
Technical guidance is carried out at the preparation stage before
starting to collect data. Technical guidance was facilitated by two
facilitators from the research team. Technical guidance was followed
by local partners, field coordinators and enumerators. Activities in
technical guidance are to provide an understanding of the description,
objectives and research procedures, understand the instrument,
collect sample and data techniques.
2) Licensing/ Permit
Licensing activities carried out by researchers together with a local
partner of rehabilitation centers and Provincial Narcotics Board
(BNNP) to the Director of Rehabilitation Institute at the sites. This
activity carried out to promote the purpose and goals of research and
ask for referrals as well as support to the research smoothly.
3) Quantitative Data Collection

The activity start to cross-check data llisted of narcotics user that
has been prepared during the process and after technical guidance.
Based on the listed data, the researcher conducted a sampling in
accordance with the protocol.
Quantitative data collection is carried out by enumerators, controlled

by field coordinators and researchers. In special circumstances,
the Field Coordinator can assist to collect data, and to ensure the
readiness of selected prospective respondents.
The following list of institutions are places for conducting research in

each province

Table 06 : Research Location in Each Province
Research Location
No Province Directly managed by Provincial Managed by Provincial
Others
Narcotics Board Coordination Narcotics Board Partner
1 Riau • Rehabilitation Center Coaching House
Islands Provincial Narcotics Board
• Post Rehab Program
Provincial Narcotics Board
• Pratama Clinic
2 Lampung • Kalianda Rehabilitation • Ataraxis Home
Workshop • House of Serenity
• Provincial Narcotics Board
Post Rehab Program
• Pratama Clinic Provincial
Narcotics Board
3 North • Deli Serdang Rehabilitation • Charitas Foundation
Sumatera Center • Bukit Doa Foundation
• Provincial Narcotics Board • Medan Plus Foundation
Post Rehab Program • Yaomi Foundation
• Pratama Clinic Provincial • KM Rumah kita
Narcotics Board
4 West Java • Lido Rehabilitation Center • Agape

• Provincial Narcotics Board • Kapeta
Post Rehab Program • Kedathon
• Pratama Clinic Provincial • Breakthrough
Narcotics Board • Peka
• Kharisma
5 East • Tanah Merah Rehabilitation Sekata
Kalimantan Center
• Provincial Narcotics Board
Post Rehab Program
• Pratama Clinic Provincial
Narcotics Board
6 South • Baddoka Deli Serdang • YPKNM Sayang Rakyat
Sulawesi Rehabilitation Center • Siammasei Foundation Hospital, Client
• Provincial Narcotics Board • Transit Maros Clinic Referrals from
Post Rehab Program • Gaya Celebes Community
• Pratama Clinic Provincial Foundation Component
Narcotics Board • Daar Ulil Albab Institute Partners

Details number of respondents who were successfully interviewed in
each Province are listed in the following Table 07.
Table 07 : Total Respondents Per Province

No Province Total Respondent
1 Riau Island (Batam) 80
2 West Java (Lido) 215
3 North Sumatera (Deli Serdang) 55
4 Lampung (Kalianda) 57
5 East Kalimantan (Tanah Merah) 95
6 South Sulawesi (Badoka) 100
TOTAL 602
4) Qualitative Data Collection

In-depth interviews were conducted by researchers, local partners
and field coordinators. Total informants interviewed were 120 people
consisting of 60 narcotics users, 36 technical stakeholders (doctors /
psychiatrists, counselors, social workers) and 24 families.
Table 08 : Distribution of In-depth Interview Informants

Total Informant
No Province Social Total

Family /
Drug Users Workers /
Couples
Workers
1 West Java 10 5 5 20
2 Riau Islands 10 5 5 20
3 East Kalimantan 10 5 5 20
4 North Sumatera 10 6 4 20
5 Lampung 10 5 5 20
6 South Sulawesi 10 6 4 20

5) Monitoring Evaluation
Evaluation and monitoring conducted during the data collection.
During collecting data, coordination is carried out periodically by the
field team to ensure that data collected is correct and in accordance
with procedures. In addition, this stage is carried out to avoid
misunderstanding of the interviewer when the filling process
In general, evaluation and monitoring of data collection are undertaken

by all teams involved in research. Some activities as part of monitoring
and evaluation are:
a) Coordination of research team periodically
Coordination activities are taken a part periodically in accordance
with the needs in site. Coordination is used as a means to discuss
the preparation, strategy and schedule of research. It is also a
means of sharing information, discussing cases and determining
potential informants for interview.
b) Questionnaire Cross Check

Cross checking is a step that is conducted to re-check the
completeness of the questionnaire before submitting it to the
center. There are two stages undertaken in cross checking,
namely the first stage is carried out among enumerators and the
next stage is carried out by field coordinators and researchers by
showing the following:
• Completeness of filling out the questionnaire
• Appropriateness of the questionnaire flow
• The logic answers from respondents.
If the cross check findings indicate that incompleteness and

incompatibility are found in the questionnaire, then an interview
must be conducted by the enumerator to respondents recorded in
the questionnaire.
c) Spot-Check
Spot-check tasks are taken by researchers, field coordinators, and
localpartners. Spot Check is a random re-check of a number of
respondents who have been interviewed. Spot check questions

are fixed, for example age, interview time, education and several
other variables. The number of spot check respondents is around
10% of the total sample or adjusted to field conditions. If based on
the results of the spot-check enumerator found that enumerator
didn’t come to respondent but the questionnaire is filled out, then
enumerator is immediately terminated and it will be transferred to
another enumerator.
d) Supervision
Supervision performed by representatives of the Research
and Development Centre of National Narcotics Board to ensure
data collection run wel, in accordance with the design and research
protocol.
3.5 Data Processing and Analysis
Data from research findings are entered into tabulated data using
SPSS Version 23 after managing it by using Microsoft Excel. Before
it processed, the data was cleaned to check the wrong data entry
or various anomalies in the received data. Analysis of research data
through calculation of frequency distribution to check data consistency
and cross-tabulation among variables. The quantitative data will be
presented in tabular/ graphical form.
Data from in-depth interviews are presented in resumes and

interview transcriptss as basis of grouping themes or variables to
answer the research objectives. Furthermore, the data from the
interviews will complement the chart data to completes analysis in
supporting quotations.

3.6 Quality of Life / Well-being
Respondents assess their own quality of life using instruments

(EQ-5D-5L) and EQ VAS (Visual) 14. The assessment carried out on
five dimensions namely mobility, self-care ability, daily activities, pain/
discomfort and anxiety/ depression, using five levels of scale from no
problem, mild, moderate, sufficient and very problematic. Furthermore,
respondents gave an assessment of health conditions when interviewed
from a score of 1-100 using the EQ-VAS instrument (the visual analogue
scale)
The assessment of quality of life is presented in three points as follows:

a. Results from the EQ-5D-5L descriptive system as a health profile
One way to present data as a health profile is in a table with the
frequency or proportion of problems reported for each level for each
dimension. This table is divided into include proportions per sub-
group, such as age, sex and length of time used for narcotics. The
EQ-5D-5L levels will also be grouped into ‘no problem’ (i.e. level 1)
and ‘problem’ (i.e. level 2 to 5).
In addition, a comparison will be made between the EQ-5D-5L data

from the this research with data from the study15 to discuss the
value of EQ-5D-5L in general population in Indonesia.
b. Presenting the results of the EQ-5D-5Lan Reenen / Bas Janssen

index value
The EQ-5D-5L index value can be presented in the same way as
the EQ VAS data, which uses a measure of central tendency and
dispersion.
c. EQ-VAS results as a measure of overall self-health status ranking

To present all aspects of EQ-VAS data regarding the assessment of
self-health status was displayed in a measure of central tendency
and size of dispersion. It can be the average value and standard
deviation, median value and the 25th and 75th percentiles.
14
Janssen Bas, Van Reenen, EQ- %D-5L User Guide Basic Information on How To Use The EQ-5D-5L Instrument.
15
Data Self-reported health using the EQ-5D-5L descriptive system and the EQ VAS. Sumber Purba et al, The
Indonesian EQ-5D-5L Value Set. July 2017.

3.7 Research Limitations
A research certainly has research limitations no exception,

including this research. In this research, there are some limitations: First,
the research respondents is the client who was still in rehabilitation and
post-rehabilitation treatment. The research population was a client in
the home and outside home who has different characteristics.
In terms of relationships with family and relatives, for example the

distance and affordability of rehabilitation centers can determine the
quality of their relationships. Likewise in terms of general health, clients
are getting treatment and care from care taker will be better able to take
care of their health. Meanwhile outside the rehabilitation centre, there
are many challenges that can cause their health conditions not to be
optimal.
Second, due to the women participation in this research is very

small (37 people or 6.1%), recruitment of this population as a sample
cannot be done randomly and lessons learned from this population
have limitations in generalizations.
Third, this also applies to recruite heroin users. As the numbers are
small, the researchers recruit everything in the listing without random
selection.
Fourth, research methods that relied on respondents’ responses

use recollections about the thing or event being asked. This limited
the respondent’s response regarding the name of the substance used,
amount, duration, and method. It is same case with health impacts.
Respondents may not remember or do not know about certain disorders
or diseases they have been experienced. Therefore, their answers are
only an indication of their experience so far and will tend to be more
unspoken.

IV
RESEARCH FINDINGS
Rehabilitation Centre of BNN

at Batam Health Research Of Drugs Abuse Effects 2019 43
Melayu Ikan Tamban Batik, Riau Islands
IV
RESEARCH FINDINGS
4.1. Characteristics of Respondents
4.1.1. Characteristics of Demography
To get a general description of the demographic characteristics of

respondents table 09 below presents the demographic characteristics of
all respondents (n = 602).
Table 09 : General Characteristics of Respondents (n = 602)
Variabel of Demography n (%)

Sex
Male 656 (93.9)
Female 37 (6.1)
Age Group
<20 year 100 (16.6)
20-29 288 (47.8)
30-39 159 (25.6)
40+ 60 (10.0)
Educational Background
No School 12 (2.0)
Not completed in primary school 18 (3.0)
Elementary School / Islamic ES equivalent 45 (7.5)
Junior High School/ Islamic JHS equivalent 108 (17.9)
Senior High School / Islamic SHS equivalent 345 (57.3)
Academy /University 74 (12.3)

Variabel of Demography n (%)
Job Status
Student 60 (10.0)
Non-job 119 (19.8)
Households 10 (1.7)
Farmer 15 (2.5)
Fisherman 12 (2.0)
Enterpreneur/Seller 161 (26.7)
Civil Servants/Civil Army/Police/BUMN Employee 45 (7.5)
Private Sector 93 (15.4)
Freelancer 87 (14.5)
Residence
With parents 406 (67.4)
Own 81 (13.5)
Brother/relatives 113 (18.8)
Friend 73 (12.1)
Spouse 175 (29.1)
Dormitory 10 (1.7)
Prison / detention 9 (1.5)
From Table 09 above, it seems clearly the majority of respondents

in this research were male (93.9%) with ages around 20-39 years (73.4%),
mostly unmarried (54.5%), having an education level above senior high
school (69.6%), and has worked (70.2%). Although it is not equally
distributed, all types of work are represented. From the aspect of their
residence, most respondents still live with their parents (67.4%), even
though some live with a spouse (29.1%).
4.1.2 History and Risk of Drugs Abuse
To see the history of drugs abuse, there were several variables

analyzed, namely: a) the most used substances; b) age of onset and how
long to use the substance; c) how many types of substances are used,
and d) how to use the substances. A history of substance abuse is related
to health risks that occured.

a) The Most Used Substance
In the questionnaire presented 28 types of substances known by/
are often misused. This health research asks which substances have
been used. Figure 02 below explains the 10 substances that were
most chosen by respondents.
Figure 02 : 10 The most used substance
Heroin (Putaw) 11,3

Valium/Calmet/Xanax/Alprazolam 13,3
Lexotan/Dumolid/Rohipnol/Nipam 14,0
Trihex/Trihexy penidil/Pil Kuning/THP 16,3
Super Gorila Tobacco(AK47i) 16,8
Tramadol 17,3
Dextro (DXM) 17,8
Other ATS Types(Ecstasy/MDMA) 53,2
Marijuana (Cannabis) 68,4
Sabu (Crystal Methamphetamin) 93,2
0 10 20 30 40 50 60 70 80 90 100
Frequency
It is known that crystal meth is the most used of the 10th most
used substances, then followed by cannabis, other types of ATS -
specifically MDMS (ecstasy), and psychotropic substances (Dextro,
Tramadol and others). This trend was consistent with the facts in
this found in the prevalence survey of National Narcotics Board from
2014 which stated that the achievement rate of crystal meth and ATS
seizures increased rapidly.
b) Age of The First Time and Duration of Substance Abuse

The following table 10 shows there were 12 substances used by
respondents before they were 20 years old (light green). Most of these
substances are psychotropic drugs available on the public market.
The youngest average age of 14 years was Inhalants abusers. Three
substances that were considered dangerous substances also used
before the age of 20 years, namely marijuana (16.8 years), heroin (18.7
years), crystal meth or methamphetamine (19.7 years).

Table 10: Age of First Time Use and Duration of Use of Substances
Age of First Time Duration of Use
Types of Substances Use (Year) (Year)
N Mean N Mean
Marijuana (Cannabis, Cimeng, Mariyuana, Gele, Daun) 419 16.80 411 4.6
Heroin (Putaw, bedak, etep) 68 18.68 63 5.4
Morfin (brown sugar) 16 22.38 12 3.8
Tramadol (Trama) 105 18.66 102 1.9
Shabu/Meth Kristal/Methamphetamine 560 19.74 557 6.5
Super gorilla tobacco/Hanoman/Ganesha/Sun Gokong/Gor, AK47i) 101 22.13 100 1.2
Lexotan/Dumolid/Rohipnol/Nipam (Magadon/BK/Pil Koplo) 83 18.57 81 3.4
Kokain (Coke, Snow, Koka, Happy Dust, Charlie) 22 22.55 22 1.1
Kodein 17 21.82 16 1.0
Opium (Candu, Poppy) 6 22.00 6 0.5
Metadon (without doctor’s prescription) 13 26.31 13 2.9
Inhalan (Volatile substances) such as Aica Glue, Goat Brand 87 14.60 87 1.3
Glue, Gasoline, Thiner, Etil, Spirtus, Markers
Dextro (DXM, Dextromethorpan) 109 16.67 106 1.3
Suboxone/burenorphine (without doctor’s prescription) 10 23.00 10 1.6
Petidin (without doctor’s prescription) 3 24.33 3 3.4
LSD (Acid, tabs, trips) 39 21.62 39 0.1
Hasish 16 22.44 16 1.1
Ecstacyi/Inex/MDMA/Happy Five/Cece/XTC/Pil Y 321 20.41 317 1.0
Valium/Calmet/Xanax/Alprazolam (without doctor’s prescription) 78 21.65 78 3.8
Trihex/Trihexy penidil/Pil kuning/THP/Double L/Pil Trek 99 17.71 98 3.2
Katinon (Kats) 3 21.67 3 2.0
Metilon (Molly) 2 23.50 2 0.4
Zenith (Camophen/Somadril/PCC/Dil Jin) 39 18.33 38 0.1
Over Consumed Headache Drugs 24 18.54 23 2.2
Mushroom/Cow Dung Mushroom 61 20.38 60 1.5
Ritalin/Prohier (without doctor’s prescription) 7 23.57 7 0.8
Flakka (zombie drug) 1 20.00 1 1.8
Table 10 data showed the duration of substances use, crystal meth was
the longest substance used with an average use (6 years 5 months),

heroin (5 years 4 months), cannabis (4 years 7 months), morphine (3
years 9 months), Lexotan and other similar types of this substances(3
years 5 months), Suboxone without a doctor’s prescription (3 years 5
months). While, other substances have been used for an average of 1
to 2.5 years.
c) Types of Substances Used

Table 11 below provides information that most respondents, regardless of
age, sex, and various other demographic variables, tends to use more than
one substance.
Table 11: Number of Substances Used by Respondents
Number of Substances Used by Respondents
Respondent’s Characteristic Mono 2-5 6-10 11-15 16+ N

drug sub- sub- sub- sub-
stance stance stance stance
Age Group
15-19 Year 18.0 66.0 16.0 0.0 0.0 100
20-29 Year 13.5 67.4 15.3 2.8 1.0 288
30-39 Year 10.4 75.3 11.0 3.2 0.0 154
40-49 Year 15.1 60.4 13.2 11.3 0.0 53
50+ 42.9 28.6 14.3 14.3 0.0 7
Sex
Male 13.8 68.1 14.0 3.5 0.5 565
Female 16.2 67.6 16.2 0.0 0.0 37
Marital Status
Unmarried 12.2 66.2 19.2 1.8 0.6 328
Married 17.5 68.4 7.8 5.8 0.5 206
Death Divorced 33.3 66.7 0.0 0.0 0.0 6
Life Divorced 9.7 77.4 9.7 3.2 0.0 62
Educational Background
No school 8.3 75.0 16.7 0.0 0.0 12
Not complated primary school 27.8 61.1 11.1 0.0 0.0 18
Elementary School/ Islamic ES equivalent 15.6 77.8 6.7 0.0 0.0 45
Junior High School/ Islamic JHS equivalent 19.4 64.8 13.0 1.9 0.9 108
Senior High School/ Islamic SHS equivalent 12.2 68.1 15.7 3.5 0.6 345
Academy/University 10.8 67.6 13.5 8.1 0.0 74

Number of Substances Used by Respondents
Respondent’s Characteristic Mono 2-5 6-10 11-15 16+ N

drug sub- sub- sub- sub-
stance stance stance stance
Job Status
Student 16.7 60.0 21.7 0.0 1.7 60
Unemployed 10.9 67.2 17.6 4.2 0.0 119
Housewife 20.0 80.0 0.0 0.0 0.0 10
Farmer 13.3 86.7 0.0 0.0 0.0 15
Fisherman 25.0 58.3 16.7 0.0 0.0 12
Private Entrepreneur /Seller 11.8 69.6 14.3 4.3 0.0 161
Civil Servants/Army/Police/BUMN Employee 26.7 68.9 4.4 0.0 0.0 45
Private employees 9.7 74.2 11.8 4.3 0.0 93
Freelancer 16.1 62.1 14.9 4.6 2.3 87
Total 14.0 68.1 14.1 3.3 0.5 602
From the data above, there is interesting information the more mature
the more substance used. From the education side, the higher education
the more substances used, especially after secondary education and
above. Thus, more than 80% of research respondents were polydrug
users or used more than 2 substances and more than 62% used more
than 3 substances. In particular, they represented young people both
students and productive workers who were the nation’s hopes. Using
and mixing more than one type of substances will risk the interaction
between substances that have an impact on death more than one
type of substance it will be a risk of the interactions effects among
substances that can be deadly (see ANNEX).
d) How to use substances

Various abused substances are presented in various forms, from
natura (leaves, flowers, seeds) to various other forms such as pills,
crystalline powder, paste, and liquid. Therefore, some substances
will tend to be used in certain ways. However, please note that many
substances are packaged differently. The way of substances used
creates its specific risk. The direct effect on the body occured when
a substance used in certain parts of the body such as injecting in a
vein, or oral cavity, throat and lungs if inhaled, smoked or inhaled. If

it injected, it will be dangerous because the remaining blood in the
syringe will last more than 12 hours and transmit the disease in the
blood if the injection used without sterilization. HIV and hepatitis (C
and B), for example, are very common infecting injected heroin users.
The same thing also happened through a hug or scratching. While,
being inhalated and smoked are also getting a risk to the respiratory
system and oral cavity. Therefore, the information in Figure 03 below
is interesting to observe.
Data of Figure 03 explains the most common method of using

substances is to be smoked, inhaled, and swallowed. The data
described types of abused substances are methamphetamine,
cannabis, other types of ATS, and psychotropic drugs. Other
substances are relatively less than 10%.
Figure 03: Ways to Consume Substances (n=602)
Sublingual 4.8
Injection and suction 6.3
Swallowed up 51.0
Inhaled 39.4
Be smoked 64.3
Injected 5.1
0 10 20 30 40 50 60 70
However, the above data cannot be directly interpreted. Not only

because of the respondents are polydrug users, but also certain types
of abuse carried out by abusers of various substances (See Table 12).
Therefore, it is interesting to know the types of substances and how
to use it. Based on the cross tabulation between how to use it and the
substance used, there were interesting facts found. This fact is shown
in table 12 there is no isolated risk to one type of substance or only
one method of use.

Table 12: How to Use and What Kinds of Substances
How To Use Substances that Used

Injected 46% heroin user
1.2% marijuana user
31% morphine user
0.7% meth user
4.8 cocaine user
16.7% methadone user
50% suboxone user
66.8% pethidine user
0.6% MDMA user
3.9% valium user
1% trihexyphenidyl user
5.1% zenith user
14% ritalin user
Smoked 13.2% heroin user
54.2% meth user
89.1% gorilla tobacco user
4.8% cocaine user
40% opium user
93.3% hasish user
66.7% cathinone user
3.3% magic mushroom user
14.3% ritalin user
Inhaled 4.9% marijuana user
20.6% heroin user
56.3% morphine user
42.5% meth user
6.9% gorilla tobacco user
76.2% cocaine user
28.6 PCP user
18.8% codeine user
40% opium user
5.3% LSD user
6.7% hasish user
Injected and inhaled 19.1% heroin user
6.3% morphine user
2% crystal meth user
14.3% PCP user
2.6% valium and others user

How To Use Substances that Used
Swallowed 6.3% morphine user
100% tramadol user
2% gorilla tobacco user
97.65% lexotan others user
14.3% cocaine user
81.3% codeine user
20% opium user
83.3% methadone user
57.1% PCP user
99.1% dextro user
10% suboxone user
33.3% pethidine user
18.7% LSD user
98.4% MDMA user
92.2% valium user
99% trihexyphenidyl user
33.3% cathinone user
100% metilon user
94.9% zenith user
100% headache drug user
91.8% magic mushroom user
85% ritalin user
100% flakka user
Sublingual 10% suboxone user
76.3% LSD (Acid) user
With the additional information above,, we will better understand that

users of methamphetamine, cannabis, morphine, heroin, suboxone
and LSD are going to face the highest risk due to many ways of
misuse. especially because of the risk of injection method that carries
the virus in the blood due to the use of unsterilized syringes. Inhaled
or smoked typical substances like cannabis/marijuana, cocaine,
methamphetamine, inhalation and others will certainly provide a risk
to oral cavity, throat and lungs. While, other swallowed substances
will provide a risk to the central nervous system due to a dangerous
mixture of substances. In other words, it is impossible to determine
the effects of certain substances specifically by using this survey
research methodology because of the complexity of substance
abuse. If you want to state more specific arguments, it is necessary to
do laboratory experimental research based

4.1.3. Risk Due to Behavior When Using Substances
Based on Figure 04 below, we need to be aware of the risky behavior

under the intoxification. Information shows that about 8.5-75.5% of
respondents have committed a variety of risky behaviors when using
Narcotics, whether injecting without sterilization, self-injuring, driving a
vehicle in a state of drunkenness, and mixing the substances they used.
The implications of the above risky behaviors not only on health but also
on the safety of the abusers and others.
This information shows although the behavior of “drunk and driving”

are relatively small numbers, it is realized that 17.9% stated sometimes
did it and 14.6% stated very often but overall 73.6% of respondents had
done this risky behavior.
Figure 04: Risks Regarding Goals and Behavior

During Detoxification (n=602)
Drug drinking
Blend any substances
To break the law
To brave
For Sex
Self injury
Sex without condom
Non-sterile injection
0 10 20 30 40 50 60 70 80
Sometimes Very often Yes, Total
By interviewing informants, there are various reasons why they

perform such risky behaviors

QUALITATIVE FINDINGS
Some of the goals recognized by Narcotics users as follows:
“…Well, maybe it could be more likely that you want to be more

socially accepted..” (21004, M - 36 years)
“…after using it, I actively earn money, then I am smart to prank

people” (41005, M – 30 years)
“...Yes, in my opinion, when I used drugs, I felt confidence to go to

school. For example, when I learned Social Studies, I tried to ask
something, sitted in the front of the class, so be confident at that
time I used drugs ... I also asked to the teacher, oh my God, you
are the most active student here, he said. Wow, I said cool, I was
the most active in class. At that time, I was appointed to be the
chairmen of class president, Im proud of myself .......next day...I
said it again....I become the class president, how should I do. Let
me be with my
friends the next day, but I can’t finish it, just buy it……”
( 11008, M - 28 years).
“… Firstly, it is originally due to my weight, my weight was up to 120

kg, so my friends offered this, I asked him, if i used it, I could get
weight loss he said,” (31002, Klien. M - 39 years)
“… my client also works ... as a laborer he felt that he is able to lift up

to tens of kilos at that time if he used it (substances), But if he did
not use it, he couldn’t lift it, so he thought he has to use it. Then there
is also the case of my client that he worked on the ship. He used it
for five days. Then, he worked for five days as then limitation of it
worked without slepping, Then he doped and used it continually.”
(52002, Conselour M - 27 years)

4.2. Relationship With Physical Health
After studying the various risks related to abused substances, this

research will try to find the effects of the abused substance on multiple
aspects of an individual’s health and well-being. Table 13 below explains
what health risks experienced of respondents, at least once in their lives.
Table 13 : Experience of Health Disorders (n = 602)
Cumula- Min 1 x Some- Often Often Very

Variable (%) tive times enough often
Illnes/Disease Yes
Infection of Respiration 52.8 9.0 21.9 10.0 6.6 5.3
Infection of Skin 24.1 7.1 8.3 3.8 3.0 1.8
Infection of Mouth 59.5 13.8 17.9 11.5 9.3 7.0
Overdose 14.1 9.5 2.7 0.7 1.0 0.3
Other Physical Impact
Dizziness/Heavy Headache 73.4 10.5 21.3 16.8 14.6 10.3
Convulsions 11.1 4.0 3.2 1.5 2.0 0.5
Dehydration / Paralysis 21.3 9.1 5.3 3.7 2.5 0.7
Tooth Disorder 64.1 15.0 18.3 14.3 9.8 6.8
Oral Cavity Disorder 60.1 9.6 19.6 11.5 13.6 5.8
Eye Disorder 45.5 7.5 17.1 7.8 9.0 4.2
Unstable menstruastion(p) 2.8 0.0 1.0 0.7 0.5 0.7
Vaginal Discharge(p) 2.8 0.5 0.8 0.5 0.5 0.7
In general, Table 13 above shows the various physical complaints

of respondents related to the use of abused substances. If we look at the
cumulative answers, so oral cavity and throat disruption were the most
frequent complaint, where oral infections complaints attained (59.5%),
respiratory problems (52.8%), skin disorders (24.1%), and overdoses
(14.1%). Other physical effects they got are severe dizziness (73%), tooth
disorders (64.1%), and oral disorders (60.1%) were the most common
complaints with variations in the frequency of occurrence.

Respondents also mentioned the long-term effects of abused
substances as shown in Figure 05. At least about 35 respondents (6%)
stated that they had long-term health problems such as hepatitis C and
others. It was estimated that the health effects above related to the
most widely used substances are ATS and cannabis/marijuana, as well
as various psychotropic substances that are analgesic, sedative, and
antidepressant that affected memory and mental disorders. It should be
underlined that this answer depended on the respondent’s knowledge
and memory. Many respondents may not know or do not care about their
health even after seeing a doctor.
Figure 05: Long-term Impact of Narcotics Use (n=602)
Other disease
Stroke
Psychiatric disorders
AIDS
Hearth valve leakage
TBC
Sexualy Transmitted
Liver cirrhosis
Hepatitis C
0,0% 2.0% 4,0% 6,0% 8,0% 10.0% 12,0% 14,0% 16.0%
Based on the figure above, the long-term physical impact often

experienced by respondents is 13.1% psychiatric disorders. Secondly,
sexually transmitted diseases by 6.8%; thirdly, hepatitis C is 5.8%; fourthly,
TBC is 3.0%. Other diseases are liver cirrhosis (1.5%), stroke (0.8%), heart
valve leakage (0.2%), and other diseases 14.6% (depression, hallucinations,
bipolar disorder, various forms of anxiety, and difficulty sleeping).

Respondent 31006, F, 22 years - who has undergone rehabilitation

twice (in 2017 and 2019) at the same rehabilitation institution,
she has been married and divorced twice, with three children, but
they are cared for by ex-husband family.
“after using it, I become lazy and just wants to sleep”
“become thin, my weight is 45 (kg) from 50-55 (kg) “(within 1

(one) year).
Respondent 31007, F - After using narcotics, she got unnatural

and no quality in life. There were many complaints physically,
insomnia, and hard to eat. Schools dropped out because they
often skipped classes, were not trusted by extended families, the
main family was broken, children stayed away, there were are more
fellow users who became my friends.
“... After using drugs, the quality of life is ruined and very
messy, morals are not maintained, up to me, do not care
about other people, do not care about who you are, who I am.
Physical health feels bad, insomnia, difficulty in eating, and
unwell.”
Respondent 51005, F, 24 years -- She finally returned to

prostitution because of living with drugs. Many of the negative
changes she felt after using drugs, including changes in physical,
mental, and social. She also admitted having 14 husbands
(unregistered married ) in her black world. Until the time of the
interview, her family did not know whereabouts her since she
went to prison.
Physical disorders felt by informants after using drugs

(methamphetamine): the body becomes thin, vomiting blood.
The body feels weak when not using meth. In contrast, worked
diligently, when she used meth. Mental disorders felt by informants:
hallucinations, easy to forget, more sensitive (irritable), paranoid.

According to The Doctor 32011, F, 32 years
“…….Clients usually do not want to eat more and are getting

insomnia. They feel full of confidence, do the maximum activity,
they were not sleepy instead of staying awake, as long as three
days, sometimes they do not eat well, in contrast, their activities
are full... “
“... If the methamphetamine causes coughs anyway ..., it similar

to cannabis, and also cigarettes ... it causes respiratory problems,
while if they got hepatitis, it might be infected as HIV. Crystal meth
is usually used for sex, increasing sex passion, free sex can be a
risk of transmission due to viruses ... “
“.... marijuana and crystal meth causes have many similar

symptoms, yes psychotic symptoms, psychotic is hallucinations,
delusions ...”
According to The Doctor 52001, M, 34 years
“The common effects of methamphetamine are infection

problems in the upper respiratory system. Hence, clients who are
still detoxifying, sometimes there are complaints of coughing,
breathlessness, maybe there was a history of aggravating, for
example, clients have asthma, used methamphetamine and
also stimulant continually so that it aggravated them. If they do
not have a history of withdrawal, sometimes chest tightness,
palpitations, sometimes dizziness in vary… their complaint is
usually headaches, which is intermittent ... “.
“... The effect of (using gorilla) is like being overcrowded by a

burden, it’s hard to do everything, such as getting oppression, but
its withdrawal isn’t heavier than meth withdrawal,”
“... The glue is usually used by underage, and their economic level
is middle. Beginners….they tend to do hallucinations sometimes
also breathless, the mental disorders from methamphetamine
is mostly hallucinations…. hallucinations of vision and hearing,
some delusions cannot be broken .. “

Especially for Female
“….The physical disorders of men and women are more or less the
same, but it’s just because of women’s menstruating, so it starts
to be disturbed, then there is a physiological problem. Sometimes
there are not getting menstruation for 1-3 months. Whereas,
normally there is no problem, no complaints...” (Doctor 42017,
M-38 Years)
“...A woman ….has unstable emotions, so there is a difference with

a man who is still possible to do this. Again, if it’s a woman, her
mood swing is very easy to change, especially if a visit time, then
she will miss her child, she wants to go home, asks to go home….
asks for going and returning home…” (Doctor 52020, M-34 Years).
4.3. Relationship With Mental and Social Health
The relationship between the respondents and their family, relatives,

and other people around them are an important part of their social welfare.
If we refer to Table 14 below, the use or abuse of substances is one of the
factors considered by respondents having the following effects:
Table 14: Mental-Emotional Conditions (n=602)
Cumula- Min 1 x Some- Often Often Very
Variable (%)
tive times Enough Often
Fear, worry, panic 86.4 11.6 26.6 20.1 14.3 13.8
Excommunicated, paranoid 80.0 10.5 19.8 19.3 16.3 14.1
Depession, hopeless 58.0 14.0 17.8 10.8 9.1 6.3
Wanted to commit suicide 22.3 13.0 4.2 3.3 1.3 0.5
Cut off with family 24.7 10.0 7.3 2.2 2.5 2.7
Violence experiencing 46.5 13.5 14.6 8.1 6.6 3.7
Getting violence from other people 41.7 15.4 12.5 8.6 2.8 2.3
Memory disorder 77.1 11.0 19.9 20.3 16.4 9.5
Hallucinations of the five senses 56.3 12.8 15.8 7.3 6.8 4.7
Self-loathing 56.3 14.6 20.4 9.5 7.8 4.8
Hate those closest to you 55.7 16.9 14.5 7.1 4.8 2.3
Feeling labeled negative by close relatives 72.3 14.8 20.3 14.3 13.5 10.5

Table 14 above shows that more than 50% of respondents
experienced a variety of mental and emotional problems and negative
emotional relationships with their closest people. Even, there were 2 out
of 10 users (22.3%) ever wanted to end their own lives.
Another important question considered is regarding the emotional-

mental health of the respondents itself based on abused substances.
Table 15 below explains the effects of the abuse of substance on various
mental, relational, and emotional aspects of respondents.
Table 15: Relations between Primary Substances Used and

Emotional Mental Problems
Primary Substances Used
Emotional Problems Crystal Marijuana Ecstacy/ Dextro Tramadol NPS
Meth MDMA Syntetic
N sample 561 412 320 107 104 101
Dear, worry, panic 86,8% 88,1% 86,6% 90,7% 86,5% 88,1%
Excommunicated, paranoid 80,9% 83,3% 80,6% 85% 79,8% 81,2%
Memory disorder 77,5% 83,5% 79,1% 86,9% 71,2% 84,2%
Negatively labeled by relatives 74,5% 79,4% 79,1% 81,3% 73,1% 76,2%
and friends
Depession, hopeless 59,4% 64,1% 67,2% 68,2% 62,5% 66,3%
Self-loathing 58,6% 61,7% 61,3% 63,6% 51% 56,4%
Getting violence from other people 47,8% 50,2% 48,1% 60,7% 41,3% 46,5%
Hallucinations of the five senses 47,1% 50% 50% 62,6% 58,7% 62,4%
Hate parents and siblings 46,7% 48,3% 49.1% 46,7% 42,3% 43,6%
Violence experiencing from others 42,6% 46,4% 47,8% 52,3% 47,1% 49,5%
Wanted to commit suicide 23,2% 23,8% 26,3% 33,6% 32,7% 29,7%
Cut off with family 25% 26,2% 25,6% 32,7% 27,9% 14,9%

In general, there are almost no different effects between the main
substances used and emotional disorders. Dextromtrophan (Dextro)
users, it is cough suppressants having relatively high rates of almost all
disorders, even the highest in suicidal ideation. Likewise, Tramadol users,
that is pain killers as opiate derivative. Pharmacologists are needed to
explain these results. It should also be underlined, that respondents are
polydrug users, so the relationship between substance abuse with mental-
emotional and social symptoms as above is still proxy and associative
rather than causative.
Interviewing informants of research respondents, parents, doctors,

and psychologists show the use of narcotics abuse on mental health is
a real and serious problem. For women, the impact is more complicated
because of the greater disgrace and stigma.
Mental / Psychological Impact
“... the definite impact of mental disorders depends on the

duration and intensity of abuse, how often he uses it, the dose,
and whether there is genetic susceptibility or no, so that it means
he has genetically a talent to experience mental disorders, it may
be descendants of his family who have mental disorder….so well,
he used the drugs to trigger it, so it appeared, whereas, if he didn’t
use drugs, it did not appear “ (42017, Doctor M-38 Years)
“.. some people ,who counseled me, tell about an example…

ma’am.. such as when they used it, they were always haunted by
the scared feeling of arrested. So… when they used it in a room, if
there was someone who suddenly opened the door, sometimes
it appeared in their minds, it seems to be the police who came
in…feeling scared to be arrested. It happened to my some clients.
(52002, Conselor, M-27 Years)
“... If you commit suicide, there is a mental disorder, it most often

like depression to suicide.” (42017, Doctor M, 38 Years)

“... now there are precisely a lot of psychiatric problems ...
the average abuse is also a lot of synthetic, ultimately it more
influences their behavior and psychiatric. In the past, because of
the misuse of heroin/putaw, it was a physical impact ... “ (41015,
Nurse, F, 30 Years)
Canabis and Synthetic Canabis User Experience
“... What I felt when I used it to my body, I was being thin and then
forgetful, having a sensitive feeling to other people, then they felt a
shadow of people who were talking about me” (510015, F, 24 Years)
‘“.. This gorilla makes me hallucinate, but in fact, I am forced to

think even though it looks like runny so...” (41005, M)
‘“.. marijuana and crystal meth are many similar symptoms,

psychotic symptoms, psychotic hallucinations, delusions” (Doctor
42017, M-38 Years).
Dextro user experience::
“‘.. in Mangkutana (Luwu), for the price of 75 thousand two seeds,

the effect is calm love..but also makes it paranoid ... “Feelings are
on the body, just like illusions ...” (61002, F-18 Years)
... I feel like I want to keep on using it, bro, for example, when I
don’t use, I continue to see the family so sad, bro, when I use it I
am happy, cool, I don’t think, then when the dosage goes down it
becomes sad again, bro, oh why am I like this, I see. The problem is
that I have been thinking about my family, I finally drank mosquito
repellent and seven glasses of rat poison in my room to kill myself,
but I don’t know, when I was in middle school in 3rd grade, the
effect was just nausea, nausea, vomiting, bro,“ (41002, F).
Glue and Methamphetamine
Doctor, 52001, M 34 Years

... Glue is usually a minor, their usual economy. Beginners ... they

tend to be sometimes hallucinated too tight. If the mental disorder,
from crystal meth is mostly hallucinations, hallucinations of vision
and hearing, some insights can not be broken. “
Stigma in Women
..the population of women is not willing to rehab. Finally, they

told me that outside it is not easy sis for us to ventured into
rehabilitation because we have been labeled as women, not to
mention labeled women who use, not to mention labeling women
who wear and rehabilitate. Stigma is double, so care may be more
to how to restore their functions as
women “ (52004, Psychologist, F-33 Years)
‘... because women are usually more strict, even though there are
many cases ... because here they are ashamed, when they are
rehabilitated, families are also ashamed, men are normal ... so
women usually take care” (32011, F)
‘... Challenges to women, the stat of women facilitates female

clients, because they have to facilitate in terms of their emotions
too. The problem of addiction is then added to the emotional
condition that is more sensitive than men, not to mention the
problem they are stigmatized because they are women ... “ (52004,
Psychologist, F-33 Years)
‘..If a woman is emotionally unstable, so there she is different, if a

man can, this is it, but if it’s a woman, her mood swing is very easy
to change, especially if you’ve already visited, I will miss you, if you
want to go home, you want to go home, you want to go home “
(52020-Doctor 2, M-34 Years)

Specifically, this research also wants to understand the impact of
narcotics abuse on the relational quality of the respondent’s family. As
explained earlier in the theoretical part of this research, what is meant by
being healthy is physically, mentally, socially, and spiritually healthy. The
family is a crucial part of the healthy ecology of each respondent. Healthy
relationships with family members have meaning and a significant impact
on the welfare of the respondent’s life. Likewise, the harmony of spouses
relationship. Figure 06 give information as follow :
Figure 06: Impacts on Family Relationship (n=602)
The family is approved from the closest community 77,1

Harmonious parents get worse 61,6
Relationships with spouse become out of harmony 53,7
Divorced / separated from spouse 53,7
Financial bankruptcy 52,2
Family uses narcotics 51,2
Parents fight a lot 40,4
Conflict with siblings 32,1
A satisfied family from a large family 29,4
One or both parents are sick 25,6
Become a scapegoat 23,1
Conflict with parents 22,4
0 10,0 20,0 30,0 40,0 50,0 60,0 70,0 80,0 90,0
According to Figure 06, there are some serious effects of narcotics

abuse. They felt their families were isolated from the closest community,
there were no harmonious relationships with parents, and relationships
with spouses become disturbed. Respondents also believed that the use
of narcotics had caused disharmony between families, both with parents
and siblings. The reader needs to be careful in interpreting this data
because the data is not presented in the form of cause and effect. Does
family disharmony become a result or cause of drug abuse. Respondents
felt that their status as narcotics abusers had an association with family
conditions and other social relationships.

In the following Table 16, a test is carried out to find is there an
association between the duration of respondents misused various types of
Narcotics and the quality of family, partner and close relative relations. In
general, there is a linear relationship between the conditions of relations with
family and close relatives. Even so, the effects of the substance are not seen.
It means, in all substance abuse, there is a tendency the longer of respondent
uses a substance, the greater proportion that recognized the problem.
Table 16 : Duration of Five Main Substances Abuse According to

Social Health (n = 602)
Marijuana Tramadol Crystal Meth Dextro Ecstacy
Family Relationship/
N= 412 N=104 N=561 N=107 N=320
Time Used Sub-
stances (years) <2 2-5 5 <2 2-5 5 <2 2-5 5 <2 2-5 5 <2 2-5 5
years years years years years
N sampel
Parents fight a lot 41.9 56.3 53.8 38.4 47.4 50.0 36.4 46.5 49.4 54.3 70.6 37.5 44.4 43.2 41.7
Conflict with parents 19.5 28.1 13.6 27.4 10.5 30.0 28.0 24.1 18.0 16.0 17.6 12.5 20.5 16.2 23.6
Parents who are 31.6 32.8 30.3 23.3 31.6 10.0 25.8 32.4 30.6 30.9 47.1 25.0 23.4 35.1 40.3
already out of
harmony, it is getting
worse
Conflict with siblings 65.6 64.1 69.7 64.4 63.2 60.0 52.3 66.5 69.4 69.1 76.5 75.0 63.2 75.7 73.6
You become a 60.9 48.4 58.3 38.4 42.1 50.0 43.9 61.8 58.4 58.0 76.5 62.5 49.7 67.6 58.3
scapegoat for all
problems in the family
One or both of your 56.7 50.0 53.8 52.1 47.4 50.0 50.0 57.6 52.9 61.7 70.6 75.0 55.0 52.7 52.8
parents is sick
Family financial 40.0 39.1 45.5 37.0 42.1 50.0 28.0 44.7 46.7 54.3 35.3 50.0 39.2 52.7 44.4
bankruptcy
The family is 74.9 71.9 70.5 75.3 78.9 50.0 80.3 74.7 68.6 72.8 82.4 50.0 75.4 68.9 72.2
approved from the
closest community
Harmonious parents 24.7 25.0 25.0 17.8 26.3 40.0 18.2 24.1 26.7 22.2 29.4 25.0 22.2 28.4 22.2
get worse
Relationships with 54.4 57.8 70.5 38.4 31.6 70.0 37.9 54.7 67.5 55.6 58.8 62.5 57.3 59.5 70.8
spouse become out of
harmony
Divorced / separated 32.6 37.5 41.7 20.5 36.8 60.0 25.0 28.2 40.8 33.3 17.6 25.0 41.5 31.1 44.4
from spouse
Children/other fam- 20.5 31.3 28.0 21.9 21.1 10.0 12.1 27.6 24.7 29.6 41.2 37.5 21.1 18.9 31.9
ily members used
narcotics because of
influenced by others

To illustrate it, consider the results of the qualitative interviews
below. Informants of this interview consist of respondents, parents, and
professionals who showed various examples of disruption of social
relations. From the research respondents, there are several expressions
indicated that social relations with their family and relatives are bad before
they abused Narcotics.
Recognition of Information 31007 (F) - a housewife who is also a

narcotics user, tells how complex the relationship with the closest
people, as an anal, wife, and mother who has children
Relationships with families are not good, families don’t trust us,
in daily terms, they are stigmatized, want to ask for suspicious
venture capital. Relationships with families are destroyed. Children
also don’t trust their mothers. Children don’t want to talk the same
as his mother. In May of 2017, I entered rehabilitation and ended
in September. Enter again in March of 2018 ended in July. Enter
again in August 2019 until now. Children are disappointed, and
they choose to stay with their grandparents. My father-in-law also
asked my husband and me to divorce, because if I join, use it again.
Clients don’t work, and husbands work part-time for car seats. The
average number of users, including the nieces, is all used. Friends
who don’t use are just a little, but they aren’t close. If you use it, it
will be messier, talk carelessly. Friends who do not use goes away.
There is no respected figure other than her husband and parents,
it is also a mess, let alone the husband also uses it so even though
I respect it is still distrustful and very messy. I live independently
with my husband near the in-law’s house, but after 2016 relapses,
many quarrels, finally, I separated the house and returned to the
parents’ house. The initial repair is after sister brother in law put
me in rehab. The environment around the house when still in
use, do not want to accept, they know but do not care. It can be
concluded that the quality of life after using drugs is destroyed
and not qualified ... ‘“
Informant (31002, M-32 Years)
In the beginning, my family didn’t know yet, bro. Before getting

caught using drugs is harmonious, close, trusted, and continues
to be good- OK, but since I found out I’m not close anymore, have
rather tenuous, often lectured, told not to change like so again.
When with friends, friends don’t stay away but often given advice,
practically stopped until when you want to use, the body is gone,
but not kept away. “
Recognition of parents, children become a disgrace in the family
“... I’m actually very embarrassed by my son’s behavior,I had

wanted to run away from Makassar, feeling my problem is the
biggest and most severe. I had thought to “Ruqyah” my child,
but there is iadvice from family that have contact with Provincial
Narcotics Board to take the child to Provincial Narcotics Board
directly ... “ (63020, F - 58 Years)
Some informants already have communication barriers with their

parents:
““.. I don’t feel close to my parents ... not comfortable like that.
Sometimes we talk, but not too much... “(61002, F- 18 Years)
“If there are no important things, lazy to communicate with family

... and social ... if there is a new event join, but if for a comfortable
chat, it’s good to join with our own community .. ‘Because we
addicts feel different from another. Finally carried away bring
feelings ... (620011, F- 35 Years)
“In the beginning ... we became a very protective father, father

the good was off the mark, didn’t want to sexual relationship with
wife, don’t want to be the same anymore wants to find another
deterrent, from there we gamble again, gameling is the most do, so
if it’s longer, it wants it gambling gambling gambling and gambling
if gambling wins into girls running like that “ (41004, M, 37 Years)
“At the age of (8 years old) he talks like this” he became a righteous
person please, sorry mom waiting here crying every day “he said
just like that .... indirectly my child is growing up with not his age ..
I’m afraid there is, yes the impact of all of that is the impact of my
behavior as his father does give him a good education” (41004- M,
45 years)

The purpose of my life is falling apart ... I want to live happily with
my child .. So I always said , “don’t be far from mother, son ... if there
are you moms will be excited. When we eat together, mom is very
happy. ... if there are grandchildren ... happy to have entertainment
... “ (61004- F, 40 years)
Drug abuse affects the life of the closest people to drug users.
Family to be anxious when bringing clients to visit and withdraw
from an extended family environment due to childlike behavior
stealing not only at home but also at relatives’ homes. This thing
causes parents to visit their families rarely. There is a wife who
ultimately often gets rough treatment, both verbal and physical
from a partner who is dependent on drugs. The following is an
acknowledgment from the informant regarding the impact of drug
abuse by a cousin or close relatives:
“In that case, the first change he had earlier understood the
situation, even he used to be able to advise people or advised me
so. Because even the age is different six years, but increasingly
active, he was reacting like a child that is, whenever there is a
problem he immediately gets emotional, then he starts feeling that
way verbally and physically.“ (13019, F).
4.4. Impact of Narcotics Use on Friendship, School, and

Workplace
School is the second meaningful environment for every child and
teenager. Likewise, the workplace is an important place for working
adults. Therefore, a disruption in relations in this environment will affect
the respondents’ quality of life.

Figure 07: Impacts on Family Friendship (n= 602)
Feeling lost a close best friend

61,1
who has long been known
Having a dispute /
62,8
fighting with friends
Feeling shunned by friends

65,8
who don’t use narcotics
Having new friends who also

use narcotics
87,5
0,0 20,0 40,0 60,0 80,0 100,0
Most respondents acknowledged that drugs abuse harmed their

friendship, especially with non-drugs users. Most of them also admit
that they also make new friends who use the drug when using drugs.
Table 17: Impacts of Drugs on School (n = 602)
Cumula- Min 1 x Some- Quite Often Very

Variable (%) tive times often often
Like to skip class / be lazy 56.0 3.5 7.5 14.1 17.1 13.8
Interfere with closest friend 39.9 8.6 11.5 7.5 9.1 3.2
relationships
Interfere with relationships 33.6 7.0 9.5 7.3 5.5 4.3
with teachers / lecturers
Academic achievement 53.2 6.5 9.0 11.8 16.4 9.5
Dropped out school 22.1 9.8 2.8 2.8 2.5 4.2
Although not all respondents acknowledged the adverse effects of

drug use on academic achievement or their relationships with friends and
teachers, at least half of the respondents reported negative experiences.
Two out of ten respondents have ever been dropped out of school.

4.5. Impact on the Neighborhood and State Apparatus
The neighborhood is a support source of social, emotional, and

cultural for respondents. Table 18 illustrates drug use impacts the
relationship between an individual and his/her family in the environment.
a) Relationship with the neighborhood

Table 18: Impacts of Drugs on the Neighborhood (n = 602)
Cumula- Min 1 x Some- Quite Often Very

Variable(%) tive times often often
Do not participate in activities 74.6 10.0 15.9 12.0 14.8 21.9
Negative prejudice 73.6 11.5 19.8 15.4 16.8 10.1
Suspected by people around 72.1 10.5 20.6 15.8 14.1 11.1
Not valued/involved 45.0 8.5 10.3 9.8 7.0 9.5
Enemies with the community 23.4 5.3 8.5 4.3 3.0 2.5
Reported by security 22.1 8.3 3.3 1.3 2.7 2.2
Likewise, drugs use impact on relations in the community. Most

respondents said they had experienced various negative and
questionable experiences, especially suspected and became the
negative subject of conversation in the community, although all
respondents did not acknowledge it.
b) Conflict with law enforcement

Law enforcement officials are an integral part of the order and
security of a community. If many individuals have problems with law
enforcement apparatus, so the community certainly is having social
problems. As citizens, everyone must participate in maintaining order
and a sense of security in their environment. It is important to know
how to secure respondents with legal officers because the misuse of
substances classified as Narcotics is against the law and criminalized.
Table 19 illustrates the duration of Narcotics abuse and the quality of
the relationship between respondents and their environment.

Table 19: Relations between Narcotics-Consuming Time related
to Conflict Experience with Law Officers
DURATION/ CONFLICT Arrested by Detained Processed Imprisoned
EXPERIENCE WITH LAW the officer officer case in
court
Dura- <2 Years Frequency (N) 17 12 0 0
tion Percentage 6.4% 5.8% 0.0% 0.0%
2-5 Frequency (N) 62 46 11 15
Years Percentage 23.3% 22.3% 22.0% 22.1%
>5 Years Frequency (N) 187 148 39 53
Percentage 70.3% 71.8% 78.0% 77.9%
Total 266 (100%) 206 (100%) 50 (100%) 68 (100%)
The table above illustrates that the duration of drugs uses, the greater
tendency to deal with the law. Addicts with drug use over five years
have experienced to be arrested by officers (70.3%), detained officers
(71.8%), processed cases in court (78%), and incarcerated (77.9%). It
shows the more experienced addicts in consuming drugs, the more
likely they are dealing with the law because those who initially only
become drug users can develop to be couriers, dealers, and even drug
dealers to be able to meet their needs in consuming drugs.
Friendship
The negative impact related to the friendship above directly or

indirectly opened a new communication used by drug users. Losing,
fighting, and alienating of old friends who were previously known
by the user, the user opens a new communication with users who
has similar activity with drug use. Closed communication tends to
make users are more comfortable discussing with individuals who
are equally consuming narcotics. One of the example:

“If you meet a friend who used to be a schoolmate ... I like to hide, I
don’t want to meet them, but those who are instead looking around
... and say ...brother, never mind ... we’re already like brothers. I
want to see you smile like you used to.“ (61004, F-40 Years).
People often stigmatize the perpetrators of social deviations, not

least to narcotics users. Like the first time an individual is known
to use drugs, people usually assume they are people who make a
big mistake and dirty. This condition was experienced by one of
the informants who gave information that:
“It’s already dirty bro ... labeled as s user, shunned by people ... We
don’t even use it, but people say he is a user ...” (11008, M).
School
The use of narcotics exacerbates relationships in schools or

college - because the attention is not on academic achievement:
“... The school doesn’t know he uses it, but as there is a problem,
he likes to fight ... hit my class’s sister ... then he was given a
warning letter even though he will do the exam ... often given
warning letter previously because he likes to crash, hit my class’s
sister ...” (61002)
“... school, was dropped out, because of the crime of snatching bro.
The money is used for narcotics use and jackpot gambling. It is
more used for narcotics use especially crystal meth..” (11004, M).
“It’s just a fad ... so believe it yourself ... feels good, .. he has
repeatedly entered the counseling guidance room. I have read
later..then .. given out apparently ... “ (61002)
“when I was in grade 1st Islamic Junior High School, I can still
be top 10 as using narcotics, then after the second year begins
to decline ... I rarely go to schools, often play drugs. No more
concentration, sitting in the back of the class.” (11011, M).

“... There is no problem, the school is fine, just often runs away,
often skips school, there are almost four times a month. Then there
is money for paying a book but not paid instead used for buying
drugs. At the age of 17 years, I have used methamphetamine drug.
After consuming methamphetamine continually then finally the
drug stopped and rarely drank alcohol ... had a chance to study
Law, but it only lasted for one semester, because there were two
users as friends, so all friends do not ask me not to go to university,
then finally skipping it ... “ ( 41002, F).
Profession
Many informants have decreased performance in their work, as

stated as follows:
“... the work is disturbed, sis ... if we don’t consume it, most of
us don’t work, just sleep ... when we consume it, we can work ...
income runs out there..” (31003, M - 46 Years)
“... If there are more vacancies ... but I am sick ... so if my body is
not strong, it’s better if I stop ... if people expect us, but can’t work
... it’s better to stop ...” (61004. F-40 Years).
Even when the informant worked as a Sex Worker - this was

her confession:
“.... I, yes, he is very proud of me because I was not yet using it

before, working diligently means that I never make problems while
I was using it, so I became lazy at work, I just wanted to courtship
continuously with a man who had no money, ... who only used it
.... His germ, until I was kicked out ... I am usually a polite person,
as long as I use it, there are no manners. In fact, I continue to fight
against my bosses, denying it continuously ” (51005, F- 24 Years).

Conflict with law
This condition eventually led narcotics users or former users to

the tendency of committing criminal acts to get money. It was
stated by one of the informants that:
“If there is no more money then stolen it ... I once stole in 2 mosques.
Infaq money ,, and then go tococonut trees people. I climbed the
tree, then I took it and sold it .. “ (11020, M).
4.6. The Current Reason for Entering Rehabilitation
Because respondents were recruited from the rehabilitation center, we

explore information about their reasons for participating in rehabilitation.
Figure 08: Reasons for Being in Rehabilitation (n=602)
Others
Self interest
Spouse interest
Iniciative working place
Family Support
Legal proceedings
Recurrence
0 10 20 30 40 50 60
Figure 08 provides information that respondents who are

currently still in rehabilitation are due to personal, family, or partner
encouragement. It’s just 13% of respondents said that they were
rehabilitated this time due to recurrence or legal process. Initiatives
from the workplace were not put forward.

4.7. Support Source for Recovery
Table 20: Supporting Factors in Recovery Efforts
Cumula- Category Level (%)

No Variable (%) tive Min 1 x Seldom Quite Often Very
Of-ten of-ten
1 Family
Parents suddenly unite and 44,5 4,5 7,6 10,8 10,6 10,0
support
Parents are angry but support 86,2 3,0 6,6 13,3 23,3 40,0
recovery
Brother and sister are 86,3 2,5 3,0 9,6 23,1 48,5
supportive
Spouse is faithful and supportive 53,3 2,0 3,7 5,8 11,3 30,6
2 Working Place/School
Coworkers support 53,7 6,0 10,0 12,1 12,0 13,6
Management support 26,9 3,7 5,3 7,6 7,6 12,6
Teacher/Lecturer support 15,6 3,0 2,7 2,5 4,2 3,3
From these data, it is shown that is about 86% of respondents

received family support from parents and siblings (brother / sister). Here,
the spouse also showed high concern at 53.3%. Besides getting support
from family, many of them also received support from co-workers (53.7%).
In table 20, co-workers also showed high concern for the recovery of
the respondent, this is because they care about the lives of individual
respondents, the future of their family life, and do not want the workplace
to be affected by using drugs habit. It is not only concern to family,
coworkers, but also the school environment but also provides support
(26%), although the percentage is not too high, this can be due to the use
of drugs in the school is still covered up because of the consequences
caused by it is expelled from school.
The following interview with the respondents told about a child who
receives various supports from parents and close relatives.

Family and closest people
Support from the closest people of respondent is needed when

participating in the rehabilitation program. Their presence is
needed to motivate him/her so he/she rises again from his/her
adversity and increase self-confidence. As stated by the informant
in his interview with the researcher.
“... I feel my family very support me. I started calling both parents,
calling another family yesterday, . It’ was very supportive, bro ... so
I’ was touched, I’ also cried bro. Yes, it was natural that I cried too, I
sinned a lot, I lied a lot too, to both parents, my family. When I joined
to this rehabilitation, my family often used to get angry because I
rarely came home .. came home late at night, in the morning....got
angry. I felt that ahh... i was excluded from my family ... actually i
wasn’t..... bro. My family really loves me, bro” (41008, M)
“….I”m very happy ... to see my mother, brother and sister... happy
we could talk together..“ (31001, M -19 Years)
“... A great support from the family was given to respondents.

Sister also gives mmotivation so that respondent wants to rise up
again wants to get up again, my parents who supported me to be
rehabilitated up to 3 times so that I could recover soon, frequently
visited respondent despite the distance from home to rehabilitation
centre up to 4 hours in drive... after rehabilitation, my future plans are
backing to work as a counselor again or opening a business .....are
always supported by parents..” (31002, M)
Even the neighbours around respondent’s house also gave

support and advice when clients were taken to the rehabilitation,
the respondent’s home, by giving advice when the client will be
taken to a rehabilitation institution.
“... neighbour... they were supported me especially the neighbours

who lived next door...they said i had to listen to my mom, she

already tired, i need to be rehabilitated... also the neighbourhood
chief said that.. ...” (11004, M)
The addicts really need family in recovery process, but not all
clients get the support. As stated by one rehabilitation officer ::
“... Sometime family support came in different ways, there was

family which is very supportive and gave the client good attention,
on the other hand there was a clients who seem to be dumped by
their families
and also we found a family which is careless to the clients when

they needed to go the the doctor or health center. we already gave
them a refferece to be able to see the doctor but they didn’t take
care of it...…” (52020, M)
Among those who visited their familiy who were being rehabilitated,
there were also friends of clients visited. however it was restricted,
because they could be friends who may gave a negative impact to
the clients (PIC). As stated by the following rehabilitation officers:
“... i’m affraid that they were not just an ordinary friends of client,
but also their PIC friends., it’s dangerous. He has asked to use it.
....most of friends are rarely give them support than families ...”
(52020, M)
Self motivation
It is not only support obtained from those closest person, but also it
much needed motivation from the client itself. No matter how much
encouragement was given by the family and closest person, it will
not be able to recover the addiction without any motivation from
the client itself. But it is very difficult for addicts to get it because
the effects of addiction caused by drugs is very large, as well as
the influence of negative friends who will always overshadow the
addicts to go back to use narcotics.
However, not a few of respondents stated they joined the

rehabilitation center by their own will. This as stated previously,
it also shown from the result of in-depth interviews between
researchers and the rehabilitation clients, which is as follows :
“.... I have a father, sir, ... my father is also a drug dealer too ... then
my father was arrested. Well my “mother” ... I am thinking about
her ... she is my motivation to change ... and make my mam happy,
sir. That’s why I joined this rehab. If it just changes like that ... I
can’t ...“ (11007, M -17 Years)
“... I might feel tired, spend quite a lot of money, I think the money I
spent could be used to build a house, have a family ... that’s what I
think...” (51017, M - 20 Years)
“... i had my goal here so that when i return to Nunukan, i can help
others ...” (51013, M - 32 Years)
From the interview’s transcripts above, information can be

obtained that they want to get recovered by their own willingness
in order to make their parents happy, and for their future, also they
want to be useful for others, etc.
4.8. Quality of Life
4.8.1 EQ 5D-5L results of narcotics users compared to EQ 5D-5L data in

general population of The Indonesian EQ-5D-5L (2017) 15
The well-being condition is seen from several dimensions, namely

mobility, self-care, ordinary activities, pain/discomfort, and anxiety/
depression. Each dimension is assessed according to the level of
problems that arise from no problems to extreme problems.
15
Data Self-reported health using the EQ-5D-5L descriptive system and the EQ VAS. Sumber Purba et al, The Indonesian
EQ-5D-5L Value Set. July 2017.

Respondent’s self-assessment of Narcotics-use who have had or are
undergoing rehabilitation compared to general population respondents
(Table 21), there are an increase of respondents who experienced problems
in self-care dimension of narcotics users by 2.3%, while ordinary activities
dimension is 7.28%, then anxiety / depression dimension 8.15%.
Table 21: Domain-based Welfare Score (n = 602)
Prob- Descriptive System of EQ-5D-5L by score (%)

lems Mobility Self treatment Common pain Anxiety/de-
Level activity pression
DATA Refer- Re- Refer- Re- Refer- Re- Refer- Re- Refer- Re-
SOURCE ence search ence search ence search ence search ence search
Having 7.96 7.1 1.89 4.20 10.82 18.1 39.66 36.0 34.25 42.4
Problems
Light 6.74 6.1 1.71 3.00 9.68 14.1 36.53 24.40 28.18 30.4
Moderate 1.04 0.8 0.09 0.50 1.14 3.30 2.56 8.80 5.50 8.10
Heavy 0.19 0.2 0.09 0.70 0.00 0.50 0.57 1.50 0.38 2.70
Extreme 0.00 0.00 0.00 0.00 0.00 0.20 0.00 1.30 0.19 1.20
From the information in Table 21 above, research respondents have

worse scores, especially when examined the severity, namely in the severe
and extreme categories.
Table 22: Level of Problems experienced by Narcotic Consumers from

5D-5L Results Based on Age
Age Group (Years)

Dimension 5D 5 L
< 20 20 - 29 30 – 39 40+
Walking ability 8% 2% 10% 0%
Self care 4% 5% 5% 0%
Daily activities 19% 15% 15% 50%
Comfort / pain 38% 30% 40% 0%
Anxiety / depression 45% 36% 45% 50%
Total 100% 100% 100% 100%

Based on the age characteristics, the comfort and anxiety problems
tend to be owned by more than 35% of narcotics users from various age.
4.8.2 Personal Health Assessment Score (EQ-VAS)
The score of self-health assessment in general and narcotics users

population who participated in the rehabilitation showed the higher
evaluation in the narcotics users of the rehabilitation participants.
Narcotics users of rehabilitation participants generally rated their

health to be an average of 85.This is a self-expression of how rehabilitation
users feel the quality of their health is now better than before by taking
part in rehabilitation and being under the influence of narcotics abuse.
Table 23: Comparison between EQ-VAS scores in the General Population

and Narcotic Consumers Participating in Rehabilitation
EQ-VAS Value Reference Data Research Data

Mean 79,38 85,07
Standar deviasi 14,01 13,705
25th Precentil 70 80,00
Median 80 90,00
75th Precentil 90 95,00
Total 100% 100%
4.8.3. Comparison of Welfare Score Between Gender and Age Groups
Figure 09 below shows the average of EQ VAS score between men

and women has the similar type of tendency, where in the age group 20-29
years have the highest self-quality assessment score compared to other
age. It means that, the older respondent, the more decreased of condition .

Figure 09: The EQ-VAS Average Score of Respondents as Drugs
Consumers based on Gender and Age Group
100.00
90.00
VAS Score
80.00
70.00
60.00
50.00
<20 20-29 30-39 40+
Male 81.03 86.84 85.47 83.36
Female 82.50 87.94 85.00 70.00
Total 81.15 86.78 85.45 82.47
The decline in health and well-being conditions in line with increasing

age is no different from the general population. The decrease in the group
of women who were research respondents needs to be observed because
it was lower than male. Related to the decline in the relationship between
the burden of stigma and more serious illness, it can not be answered in
this research because the less number of female respondents.
4.9. Post Rehabilitation Support Needs
The important thing that need to be considered is that addicts need

support when they have finished rehabilitation program so they can apart
from narcotics use. Many of the temptations they will encounter when they
go back to their environment, especially if they return to the community of
negative friends. Although it was not asked in the questionnaire, it was
asked in a qualitative interview.
Support from family and loved ones is needed to fortify them so

they do not go back to use drugs. As stated by the following rehabilitation
officers.

“When there are abuser and the only one who got rehabilitated was
the client, i could emphasized that what needs to be rehabilitated
is all, even if necessary, the community environment must know
that people with substance abuse must be helped, especially
about Mbak Kris’s stigma which is still a problem, because the
biggest stigma comes from the family.....…” (52004 – F)
The stigma that is always attached to the addicts will continue to

overshadow them even when they are declared to recover after following
a rehabilitation program. The existence of this stigma causes them to
return to drugs abuse. This is as stated by the client when asked what his
hopes when returning to the following community:
“... Yes, it does not stigmatize even though I feel so hard to get
through this to be able to change...” (51012 – M)
“The community environment must know that people with

substance abuse must be assisted, especially related to stigma,
because the biggest stigma comes from the family... besides that,
the clients is stigmatizing themself ...” (52004-Psychologist
F- 33 Years)
But there were also respondents who stated that they would keep
trying not to consume drugs even though they received stigma from the
public. As stated by the following respondents:
“... Thinking about it now. Surely people think put a negative thought
on me huh. but certainly I have to do the best for the family. Let
that stigma ... surely it is my own deed, it’s clear. People also don’t
believe. Most people don’t know what I did in rehab. Maybe they
think it’s like in prison. There are those who know and don’t know
what it seems to be like. IMaybe stigma might still exist. Because
I went home yesterday, to celebrate Eid, i just been there for two
days ... Yes, so why should I go back to the village again, surely

people are suspicious again. I just think so. In this place we also
learn to deal with the people there. Here we also learn how to do
good things so that trust will come naturally, at least starting from
the family first ... “(51016 –F, 31 Years)
In addition to the stigma that exists in the community, another

problem faced by an addicts after being rehabilitated is when they returns
to the environment that once introduced them to narcotics. An addicts
who has completed the rehabilitation program must be able to protect
themself from the negative environmental influences so they don’t return
to using narcotics.
In addition, the most appropriate solution to overcome this problem

is that former addicts do not return to to their previous environment,
they should move to an environment that is safer from narcotics. They
needs support from the family to be able to move from their previous
environment.

V
CONCLUSION
Rehabilitation Centre of National Narcotics Board

Deli Serdang, North Sumatra
Nias Batik, North Sumatra
V
CONCLUSION
1. Indonesia has a drugs problem which is characterized POLYDRUG

USE by a young population, experimenting with various psychoactive
substances, using it in a risky way, and tending to use it long term.
Most of them use substances before they are 20 years old. They are
candidates for a serious and expensive burden of disease in Indonesia.
2. Long-term drugs abuse, especially ATS, cannabis, heroin,

hallucinogens, NPS and various over-the-counter psychoactive drugs
have a serious impact on physical and mental-emotional health
aspects. In addition, the negative impact of drugs abuse and other
substances also affects well-being and quality of life aspects that
involve social relations with family and close relatives, friends and
work colleagues, as well as the neighborhood.
3. The effects of substance abuse in the spiritual life also needs to be

considered carefully, because the abusers often feel isolated and do
not get help in this realm.
4. Schools have an important role in prevention and post rehabilitation

programs. This institution has a performance measure that can be
used to guide observations when individuals begin to have problems
with drugs. In addition this institution has a very crucial role for

individuals who want to return to the community after undergoing a
rehabilitation program
5. Family, spouse and close relatives are important supporting of

emotional factors and resources in recovery efforts. Interviews with
clients show that they feel very grateful when families are still willing
to pay attention and support their recovery. In the post rehabilitation
stage, the role of the family not to exclude ex-addicts who return home
is a crucial factor in preventing relapse.
6. Female respondents have specific needs. Further research is needed

to understand their complexity and special needs, especially the
factors that cause them tend to not reach professional rehabilitation
services.
7. Self-assessment of drugs-use respondents who have or are

undergoing rehabilitation compared to respondents in the general
population has a higher level of problems in the dimensions of self-
care ability, doing daily activities and anxiety /depression.
8. Drugs users participating in the rehabilitation assess their health

quality so that an average score of 85 and a median value of 90 is
obtained. This value is a self-expression to illustrate that drugs users
who have or are currently rehabilitating their health quality are better
than before undergoing rehabilitation and are under the influence
drugs abuse.
9. There is a serious need to develop a post-rehabilitation support

program. Especially when families cannot provide full support
and the community still discriminates and tends to give a negative
stigma. Facilities owned by National Narcotics Board to support post-
rehabilitation needs to be sought to provide relevant services.

VI
FUTURE IMPLICATION OF
NARCOTICS POLICY
Rehabilitation Center of National Narcotics Board

Kalianda, Lampung
Siger Batik, Lampung
VI
II
FUTURE IMPLICATION
OF NARCOTICS POLICY
1. Indonesia has long faced on the adverse effects of drugs abuse.

Global efforts with other countries have been carried out since the
beginning of the new order and to this day the problem is still very
serious. Therefore, various policy analysis need to be carried out.
The health impact places a significant burden on the Draft State
Budget, but a detailed study of health costs for narcotics abuse has
not been conducted. It is time for the government, in this case the
National Narcotics Board (BNN) to seek a variety of strategic research
in connection with the economic costs of health, social, and other
benefits and determine a more comprehensive response strategy.

2. In addition to the trend of substance abuse, it should be noted that
National Narcotics Board survey since 2013 showed that the
drugs abuse in Indonesia is characterized by young people and
polydrug users. This fact is a challenge itself because polydrug users
are vulnerable to the influence of substances while at the same
time vulnerable to the effects of interactions between substances
(Vanderplasschen, De Maeyer,Colpaert, Cogel, Rea, Dom, Sabbe &
Broekaert, http://www.belspo.be/belspo/organisation/publ/pub_
ostc/Drug/rDR55_en.pdf ) which is very dangerous for the health
and lives of its users. erefore, polydrug-users will be a very expensive
health burden if not taken seriously.

3. One topic of discussion in public policy handling and narcotics
countermeasures is sectoral authority. National Narcotics Board was
established under the mandate of Law No. 35 of 2009 concerning
Narcotics so that the authority is to supervise and control substances
contained in the list of the Act. In addition to the categories listed
above, especially the misuse of drugs that can be purchased freely
or through prescription must be monitored and controlled by the
health sector namely BPOM and the Ministry of Health. This sectoral
debate can lead to an adverse decision if it does not look at the reality
above, namely that users or those who abuse Narcotics also abuse
other substances including over-the-counter drugs and substances
that circulate in the community or so-called polydrug users. Sectoral
oversight will require very difficult coordination which has not been
going well so far. Therefore, it is necessary to conceive and create
a special cross-sectoral criminal unit, which so far may already
exist within the National Narcotics Board or Police institutions with
expanded mandates or more flexible functions so that they can
respond to various dynamic changes in the demand-supply chain and
its market.
4. The next issue that needs to be discussed is substance abuse as part of

a lifestyle. The theoretical approach uses a bio-psycho-social-spiritual
model framework, providing opportunities to see substance abuse as
part of a lifestyle that is aspirated by its users (Davies, Ellison, Ward,
& Laudet, 2015; Rahman, Gupta, Suklecha, & Khunte, 2010 ). thus,
finding out the reason for substance abuse becomes crucial because
it will determine what lifestyle a user imagines and this relates to what
substance is chosen and with whom the substance is used. National
Narcotics Board in its epidemiological research in 2015 has warned
of the increasing abuse of ATS, specifically crystal meth and ecstasy
in addition to the abuse of cannabis which has always been the most
selected substances. Misuse of heroin or putaw that is rife in previous
years has decreased dramatically. The improved level of per capita
economic income in line with the rise of entertainment centers and
clubbing, which matches the stimulant characteristics such as ATS, a
community that is more open and involves more people than culture
that reflects a generation of confusion and frustration that underlies
depressant abuse including heroin. However, authorities that oversee

substance abuse need to be aware that there is no sedentary lifestyle.
The increase in opium production in the world (65% from 2016 to
2017) reported by The World Drug Report (UNODC, 2018) in the
Afghanistan region signals that opiates will return again. Maybe in a
new and cheaper form.
5. The role of the community, especially schools and workplaces, to

work with families and National Narcotics Board, namely:
a. Early detected cases of drug abuse and narcotics. Observations
at school and at work are far more likely to find problems in
the behavior of individuals who abuse Narcotics. In addition,
educational institutions need to create an atmosphere of teaching
and learning that supports positive self-concept, a sense of courage
and ability (self-efficacy), and the ability of students to choose
positive alternative activities. These things are often the reasons
for substance abuse because they want to be brave, unable, and
sometimes want to be more creative. At home, individuals can
isolate themselves in the room or outside the house so that other
people’s supervision become limited. Reports on early indications
can help parents, the apparatus or the abusers to get or receive
assistance. Early detection balanced with early intervention will
help manage the client’s risky behavior, especially preventing
more substances from being used and in the long run. In addition,
clients can also be helped not to use substances in an intoxication
state. For this reason, it is necessary to develop supportive and
educative school and workplace policies that reduce the fear of
reporting and seeking professional help.
b. Preventive efforts must be done early and must be more aggressive
and comprehensive because adolescence (10 years and over) is an
age at risk for gateway drugs. Besides that, cigarette and alcohol
monitoring is also very crucial. In this case we tend to under-
estimate existing data and facts because these two substances
play a role in social functions that are accepted by society.
c. Support post-rehabilitation recovery and reintegration.
Schools and workplaces are secondary environments that are
urgently needed by survivors of rehabilitation. Many addicts
are arrested and lose school opportunities because of carrying,
experimenting, or recreational users. The opportunity to continue

school and work is the hope of most addicts who complete their
rehabilitation program. Building a school culture and work culture
that does not discriminate against former addicts and individuals
who have been in conflict with the law will be an enabling
environment for long-term sustainable recovery.
6. Indonesia has long invested in rehabilitation, especially when the

Indonesian Supreme Court issued SEMA No. 3 of 2011 which prioritizes
the treatment of narcotics abusers in the Rehabilitation Institution and
encourages the issuance of Government Regulation No. 25 of 2011
concerning Implementation of Report Obligations. Various parties
stated that this new policy did not work well due to the lack of capacity
of the Reporting Obligatory Institution in providing professionals who
manage medical treatment programs (doctors, psychiatrists) which
sometimes have an impact on the availability of essential medicines,
and who manage psychosocial programs (social workers, addiction
counselors psychologist, spiritual handler). This need was voiced both
by respondents / research informants, and by professional workers in
rehabilitation institutions who felt overwhelmed because they were
few and did not receive serious professional support. In addition, it
should also be noted that qualitative data shows that clients and their
families have difficulty accessing rehabilitation services because they
are only in certain regions/cities. Strategic and community-based
expansion is needed so that in terms of financing does not burden the
client and his family.
7. In connection with the above problem, mental health problems have

not been given much attention such as depression, paranoia, anxiety,
etc. this is due to lack of professional resources, so there is a tendency
to respond to these symptoms when they are disturbing. Increasing
staff capacity through task and skill shifting programs in dealing
with psychosocial and mental health issues will greatly assist client
recovery without serious dependence on medical and psychological
professionals.
8. Judging from the needs based on gender, qualitative data shows

that the needs of female respondents are more complex than men’s.

One reason is the problem of dependence on couples, families both
nuclear families and extended families, on their own children when
they have offspring and double stigma they experience. Reaching
out and helping families and clients to have the courage to have
information about available services is an important program in every
rehabilitation institution, both inpatient and outpatient.
9. Self-assessment of narcotic-use respondents who have or are

undergoing rehabilitation compared to respondents in the general
population has a higher level of problems in the dimensions of self-
care ability, doing daily activities and anxiety / depression. This factor
is one source of bias in this study but also shows the importance of
rehabilitation care.

dr. Linda Octariana, M.Si
17.
APPENDIX
National Narcotics Board

Headquarters,Health
Jakarta
Research Of Drugs Abuse Effects 2019 97
Gurdo (Garuda) Batik
Appendix
Appendix 1 Effects of Types of Narcotics

Types Substances Effects
Cannabis Marijuana WHO states that Cannabis is a generic terminology
used to denote several concoctions of the Cannabis
sativa plant. The main psychoactive substance in
cannabis is (Delta) ∆-9 tetrahydrocannabinol (THC).
Its compounds are structurally similar to THC referred
to as cannabinoids. There are several compounds
which have different structures but similar to
pharmacological properties. Marijuana from Mexico,
for instance, has exactly cannabis plants, called
“marijuana” (unpollinated female plants are called
“hashish”) Produced as hashish oil is cannabinoid
oil which is processed from its resin or crude plant
material.
The effect of a cannabinoid substance called delta-9

Tetrahydrocarbo cannabinol or THC works on certain
brain cell receptors which will normally react to natural
substances similar to THC in the brain. The substances
have a role in the development and function of the
brain. Marijuana will push the function of the part of
the brain which contains the highest amount on the
receptors. This will cause the users to feel “high” and
experience several other effects, such as:
• Change in time consciousness
• Mood swings
• Body movement disorder
• Thinking and problem solving difficulties
• Impairment of long-term memory
Long-term effects :
• Impairment of thinking ability, memory processing,
and learning functions which also affect brain
performance.
• Respiratory problems. Marijuana smoke can cause
irritation on lungs which triggers coughing with
phlegm, lung disease to lung infections.
• Heart rate increase. Marijuana can increase heart
rate after 3 hours of smoking. This can cause heart
attack.
• Impairment on infancy. The use of marijuana during
pregnancy may affect infant’s brain and behavior.

Appendix

• Hallucinations, paranoia and unclear thinking.
• The use of marijuana can affect a person’s mental
state.
Psyche- Several There are natural or synthetic substances which

delic or natural and if consumed can cause sensory hallucinations,
hallucino- synthetic especially auditory and visual. In general, the effects
genic substances on the human body are: increased heart rate,
nausea, dry mouth, trouble sleeping, change in
body temperature, excessive sweating, panic attack,
strange behavior, paranoia and up to psychosis.
Long-term effects: continuous symptoms of

psychosis (visual impairment, chaotic thoughts,
paranoia, mood swings). Consumption in high
doses may cause seizures, paralysis, memory loss
(amnesia) and limited difficulties.
LSD (acid) It is the most powerful psychoative substance in

changing a person’s feelings and perceptions. The
substance is made from lysergic acid (lysergic acid)
which comes from the ergot fungi that grows on
wheat and other grains.
The substance is presented in crystals and

distributed in liquid form. However, LSD is widely
marketed in the form of capsules or small pills and
gelatin sheets which will melt when touching saliva.
The effect of LSD (Lysergic Acid Diethylamide) is

unpredictable, but depends on how much it is
used, on a person’s mood, personality, and on the
situation at the time it is being consumed.
Like a roll of a dice — a race, pseudo high feeling or

severe paranoia. Usually, the first effect of LSD works
30 to 90 minutes after the drug is taken. The pupils
often enlarge. Body temperature may be higher
or lower, while blood pressure and heart rate may
increase or decrease. Sweating or cold is common.
LSD users frequently experience loss of appetite,
sleeplessness, dry mouth and tremors.

Appendix

Ketamine Drug which is used as animal anesthesia, where
or Special K, animals are put to sleep during surgical procedures.
Valium Therefore, Ketamine is often available on the free
Kucing, market and is widely used by veterinarians. This
KitKat, drug is abused due to its recreational effect like a
horse calming, dissociative, and hallucinogenic effect. Its
anesthes ia, chemical structure is almost the same as the one in
etc. Phencyclidine or PCP and results in an unconnected
feeling with the environment. Long-term use causes
tolerance and psychological addiction.
The effects of long-term

• Often feel sleepy
• Changes in perception of color and sound
• Hallucinations, delirium, confusion
• Learning and thinking difficulties
• Agitation
• Numb
• Uncontrolled muscle movements, seizures
• Speech disorder
• Increased pressure in the brain and eyes which
causes brain swelling, Brain nervous system
fatigue, tumors and glaucoma
• Easily forget
• Difficulty in controlling eye movements
Psilocybin Psilocybin (4-phosphoryloxy-N, N-dimethyltryptamine,

or Mush- DHT) is a natural ingredient in the shape of mushrooms
room (Blue which grow a lot in cow dung. Its use is recreational
Omelette, to cause hallucinations or imaginations which may
magic endanger one’s self or others.
mushroom,
little smoke, Short-term effects of magic mushroom on mind and
shroom) consciousness:
• Overemotional feeling. It could be overly happy,
overly sad, or overly angry
• Unable to tell the difference between fantasy and
reality
• Anxiety
• Panic attacks
• Disorientation or daze
• Fear or paranoia
• Find things either hilarious or depressing

Appendix

Short-term effects of magic mushroom on the body
(biologically):
• Numbness, especially on the face
• Increased blood pressure and heart rate
• Dry mouth, even nausea, and vomiting
• Weak muscles, twitching, or spasms
• High fever to shivering and sweating
• Uncontrollable urination
Long-term effects on mind and awareness:

• Changes in mindset (becoming more chaotic and
disorderly)
• Decreased cognitive function
• Delusions and hallucinations
• Impulsive behavior (risky and reckless)
• Drastic and unexpected mood swings
• Death due to careless and dangerous actions, such
as suicide
Peyote Peyote is a type of cactus that contains mescaline

substances that give hallucinatory effects to the
user. It is called ‘buttons’ because what is taken to
be consumed is the part near the root of the plant,
which looks like a button. Mescaline is psychotic
and functions as a stimulant. This substance has an
effect that can last for 10-12 hours. It is often used for
contacting ancestral spirits by the Native Americans.
It is also used to treat asthma, toothache, fever,
childbirth pain, breast pain, rheumatism, diabetes,
etc. The use of Peyote if used with other stimulants,
will potentially increase blood pressure and heart
rate. The use during pregnancy may cause congenital
disabilities to the baby.
One of the effects of peyote is a damaged mechanism

of serotonin release, which affects perception,
hunger, mood, body temperature, muscle control,
behavior, and sensory aspects of sex.

Appendix

Amethyst Datura Stramonium or Amethyst in Indonesia is
known as ‘Trumpet’ Flower. It contains various
types of alkaloids, such as atropine, hyoscyamine,
and scopolamine. The roots, leaves, flowers, fruits,
seeds, and stems are useful. There are nine types
of amethyst, but the one with white flowers are
the most poisonous. Amethyst has many benefits
for health, including overcoming seizures, asthma,
gout, and various skin diseases. However, if it
is being abused, especially by smoking it, the
following effects will occur:
• Hallucinations and temporary joy
• Prolonged dizziness to vomiting.
• Although due to health benefits from the
amethyst, it is called the ‘Angel’s Trumpet’, it
may turn to be the ‘Devil’s Trumpet’ which has
the potential to kill the users if being abused.
PCP (Angel’s It is also known as Angel’s Dust. At first, in 1926,

dust) it was made for anesthesia to reduce pain, but
later in 1950, it got banned due to its side effects.
Other effects of PCP or Phencyclidine other than
anesthetics include:
• Hallucinations and dissociative (difficult to tell the
difference between what is real and what is not)
• Increased energy and loss of sleepiness
• Euphoria and peacefulness
• Amnesia
• Confused thoughts and feelings between
dreams and reality
• Changes in perception of time
• Heart rate and breathing become fast, and body
temperature rises which results in a lot of sweating
If taken in higher doses, it causes:

• Delirium (Unable to tell the difference between
what is real and what is not)
• Drastic mental changes such as panic attacks
and paranoia
• Become delirious

Appendix

• Total loss of motor nerve control/whole body
muscle control
• Slow heartbeat and breathing
• Epileptic seizures
• Causes coma and even death. Long-term use of
PCP causes damage to brain tissue and causes a
mental illness that resembles schizophrenia.
Effects on the Brain:

Abuse of PCP distorts the perception of vision
and sound. It results in feelings of being lost and
isolated from the surrounding and even from
themselves. This effect is affected by the disruption
of interactions between nerve cells and the
neurotransmitter serotonin.
Effects on users :
If someone tries to abuse a drug once, and it
becomes a habit, it will tend to be difficult for the
abuser. This abuse can also lead to addiction and
compulsive PCP seeking behavior despite severe
adverse consequences. During this process, there
are long and short term effects depending on the
quantity and the use of the drug.
Long term effect:

Some of the long term effects caused by PCP
abuse in a long time include negative effects on
the respiratory system and the cessation of the
respiratory system within a few minutes, which
results in sudden death, vomiting, blurred vision,
eye twitching, etc. Around 90% of PCP drug abusers
are taken to the emergency room with severe
psychological effects. Abuse of high doses of drugs
will affect the central nervous system, and abusers
may experience a coma.

Appendix

Short-term effects:
The least dangerous effect is a mood disorder for
48 hours with symptoms such as anxiety, the
respiratory rate will increase slightly, and there is an
increase in blood pressure along with an increase
in pulse rate. Short breath, redness with excessive
sweating, and loss of muscle coordination may
also occur. This drug can impair thinking and
communication ability due to the abuse.
Synthetic N, It is shaped in white crystalline powder and

N-Di- administered by snorting or smoking. It is available
methyl- in liquid form as well so that it can be injected.
tryptamine Even in small amounts, it will have a psychedelic
(DMT or N, effect because they affect the neurotransmitter
N-DMT) serotonin. This substance is popular among
people who want to have strange experiences in
perception changes in visual and auditory it can
cause. The effect is similar to the effect of using
LSD and Psilocybin, which are:
• Perceptions change of space and time
• Awareness of a changing body
• Visual and auditory hallucinations
Natural Cocaine Cocaine is a powerful, addictive substance which

Stimulants is stimulant. It is produced from the leaves of the
coca plant (Erythroxylon coca), which grows in
South America. Dried-up substances from Coca
leaves were found medically beneficial by the
German chemist Albert Neiman in the 1960s and
in the same year by French chemist Angelo Mariani
who claimed that these substances could be used
as a beverage ingredient capable of “restoring
health and vitality”. It turns out to be used by Coca-
cola in 1899 and in 1903 this substance no longer
used because of the negative effects it causes and
due to racial politics at that time.

Appendix

Due to its form, cocaine is used by snorting (sucking
with the nose), but it can also be rubbed on chewing
gums. Moreover, today there has been liquid cocaine,
which is injected to obtain a quick drug effect that
lasts for a more extended period.
Cocaine increases the availability of a neurotransmitter

called dopamine, which connects to the movement
control and reward system in the brain. Dopamine on
the brain is naturally rotating back to the cells. Cocaine
inhibits the rotating process, which results in the
sufficient dopamine between cells that secrete and
receive it. It triggers the development of tolerance
and the tendency to use even more. Because of its
pleasing effects, users tend to use it in large quantities
or many times. Therefore, addiction develops
quickly, and the results of withdrawal symptoms are
harrowing.
Crack- The next process also made in the form of crystals

cocaine called Crack which is shaped like rock candy. The
price is lower, but the effect is more powerful. It
is taken by burning and smoking it. The sound of
crystal fragments is what causes to get called Crack.
It is considered the most addictive substance in the
world.
Short-term effects:
• Extreme happiness and vitality
• High mental alertness
• Hypersensitivity to light, sound, and touch
• Very easily offended
• Paranoia - extreme mistrust of others
• Large amounts of cocaine consumption will trigger
unusual, unexpected, and aggressive behavior
Other effects:
• Vasoconstriction
• Nausea
• Increased body temperature and blood pressure
• Fast and irregular heartbeat
• Tremors and twitching muscles
• Extreme anxiety

Appendix

Long-term effects
• Depending on how it is used, if it is inhaled, the
user loses the ability to smell, get a runny nose,
swallowing difficulty
• If smoked, it may cause cough, asthma, nosebleeds,
vulnerability to pneumonia
• If chewed and swallowed, it may cause
decomposition on rectal areas due to lack of blood
flow
• If injected, it may cause a risk of bloodborne
diseases such as HIV/AIDS, skin infections, etc.
Synthetic Ampheta- Amphetamine is a synthetic substance that is

mine usually taken to treat AD-HD (attention-deficit
hyperactivity disorder) and narcolepsy. This
substance is also usually used for programs to
reduce appetite and body weight and not allowed
to be used for children.
Amphetamine is known as a habit-forming

substance; hence it is often misused. The use of
amphetamine can trigger or worsen episodes of
psychosis if the user has a history of depression,
mental illness, or bipolar disorder.
Short-term effects of amphetamine:

• Increases body temperature
• Damage to the cardiovascular system
• Paranoia
• Increases heart rate
• Increases blood pressure
• Hyperactive
• Reduces drowsiness
• Decreases appetite
• Euphoria
• Dry mouth
• Dilated pupils
• Nausea
• Headache
• Changes in sexual behavior
• Tremor

Appendix

Long-term effects:
• Psychosis (unreal thoughts, away from reality)
• Psychological disorders and behavior
• Headaches
• Mood swings or mental changes
• Trouble breathing
• Nutritional deficiencies
• Mental disorders
Effects on the central nervous system:

In the case of acute poisoning, amphetamine users
generally feel euphoria, anxiety, agitation, and
excessive anxiety
ATS Amphetamine Type Stimulants (ATS) refer to

a group of substances/drugs made based on
amphetamine or methamphetamine. However,
some of the following substances are also
classified as ATS: methcathinone, fenethylline,
ephedrine, pseudoephedrine, methylphenidate,
and MDMA or ‘ecstasy’ - ATS substances which may
give hallucinogenic effects.
Crystal- Crystal meth or Crystal-Methamphetamine is one

Metham- of the most abused substances in Indonesia. This
phetamine substance is a synthetic stimulant that triggers
(Crystal the release of dopamine with the same effect
Meth) as cocaine. Dopamine has an important role in
motoric functions, motivation, and how humans
define pleasure.
The use of methamphetamine causes dopamine to

overflow in the brain and the human body, which
may damage the important functions, and even affect
verbal and motor learning skills.
It widely used for recreation, especially for parties and

sex. The euphoria effect can last up to 12 hours, making
methamphetamine one of the favorite substances,
but may give the most serious effects to the brain.

Appendix

Short-term effects
• Loss of appetite
• Increased heart rate, blood pressure, and body
temperature
• Enlarged pupils
• Disrupted sleep patterns
• Nausea
• Strange, unpredictable, sometimes act violently or
cruel actions
• Hallucinations, excessive happiness, irritability
• Panic and psychosis
Long term effects

• Permanent damage to blood vessels in heart
and brain, high blood pressure resulting in heart
attacks, strokes, and death
• Damage to the liver, kidneys, and lungs
• Damage to nasal tissues if inhaled
• Respiratory problems if smoked like a cigarette
• Infectious diseases and inflammation, if injected
• Malnutrition, weight loss
• Severe dental caries
• Disorientation, apathy, confusion, and fatigue
• Great psychological dependence
• Psychosis
• Depression
• Brain damage similar to Alzheimer’s disease,
stroke, and epilepsy
Ecstasy The history of ecstasy production was developed

(Inex, CTC, by a German pharmaceutical factory in 1912. It
Cece) was called “Methylsafrylaminc”, which had been
the main compound for synthesizing various
medications to control bleeding – not to control
hunger as it is known today. It was quite popular
in the 1970-1980s without formal permission from
the US food and drug agency. In 1985 the US Drug
Enforcement Administration (DEA) banned the
use of MDMA and placed it as a substance under
supervision.

Appendix

Short-term ecstasy effects
• Decreased appetite
• Insomnia
• Dizziness and fever
• Muscle cramps
• Tremors
• Cold sweating
• Blurred vision
• Increased heart rate
• Increase in blood pressure
• Facial tension on mouth, face, and chin
Long-term effects of ecstasy

Researchers believe that ecstasy can cause leakage
on serotonin in the brain during its use. Without the
neurotransmitter functioning, conditions such as
depression, anxiety, insomnia, and memory loss will
be more likely to occur. This condition may appear
for a long time, even after it is no longer used.
The long-term effects of ecstasy on psychology

and physical:
• Increased addiction
• Panic attack
• Insomnia
• Confusion
• Unable to tell the difference between reality and
fantasy
• Paranoid delusions
• Depression
Inhalant Glues The effects are euphoria and hallucinations, which

which con- can affect brain nerve damage depending on how
tain Ethyl, much it is taken or used. In long-term use can
Ketones, result in pneumonia, heart attacks, hypoxia (lack of
and others oxygen and brain damage).

Appendix

Opioid Tramadol This drug is used to reduce pain for adults. It is
considered to have something in common with
opiate in terms of its ability to reduce pain. It is not
recommended for anyone who already consumes
antidepressant pills.
Effects that may appear due to the use of

tramadol:
• Dizziness, fatigue, and drowsiness
• Nausea and flatulence
• Constipation
• Dry mouth
Long term effect:

• Heart rate becomes slower and irregular
• Respiration becomes slower and irregular
• Seizures
• Thought disorder leading to slow thinking
If tramadol has been taken in the long-term then

gets stopped abruptly, withdrawal symptoms
may occur, such as abdominal pain, diarrhea,
hallucinations, ringing in the ears, and so on.
Fentanyl is a form of pain treatment coming from synthetic

opiates which are usually prescribed to people
who experience severe pain after surgery or pain
due to injury, or other causes. This drug is much
stronger than heroin and 100 times more potent
than morphine.
Paul Janssen Pharmaceutical first produced it in

1960. The effect of pain reduction does not last
very long, so people often use it many times,
especially patients experiencing a feeling of
euphoria. When abused, it is often combined with
cocaine or heroin. This combination is hazardous.
It is presented in the form of a lollipop, a pill that
quickly dissolves in the buccal area, and small
strips or film put under the tongue. Some of the
consequences of abuse are as follows:

Appendix

• Confusion
• Depression
• Walking difficulty
• Stiff muscles
• Breathing difficulty
• Don’t keep sleepy
• Dizziness and light-headedness
• Slurred speech
• Visual hallucinations
• Itching
• Constricted pupils
• Weight loss
Sedative / Xanex Cam- Are medicines that are used to reduce brain
sleeping let/ Calmlet activity so that individuals feel more relaxed. These
pills (Alpra- medicines are usually prescribed to people who are
zolam) always anxious and have trouble sleeping.
The common side effects are:

• Sleepy
• Coordination difficulties
• Fatigue
• Muscle weakness
• Ataxia, and
• Light-headedness
• If consumed in breastfeeding mothers result
in lethargy on their babies and weight loss.
Less common side effects, for example:
• Headache
• Vertigo
• Changes in salivation, gastrointestinal disorder,
• Skin rashes and
• Vision problems
More serious side effects which occur relatively rarely:

• Respiratory depression
• Addiction
• Mental disorder
• Amnesia Confusion
• Blood disorders and jaundice
• Urinary retention
• Hypotension

Appendix

Paradoxical side effects may occur, including:
• Anxiety
• Irritable
• Seizures
• Insomnia
• Muscle cramp
• Changes in libido
• In some cases, anger and even violence.
Barbitu- The word “barbiturate” is the barbituric compound

rates acid. This substance is also used as a sedative or
hypnotic drug which makes people feel calm.
It is widely used for the treatment of anxiety,
insomnia, and seizures in the 1960s-1970s. Today,
it has been replaced with benzodiazepines, which
are considered safer. This drug carries the risk of
addiction and is prone to overdose with symptoms
such as coordination disorder, lethargy, slow
speech, and speeking difficulty, agonal breathing,
coma, and death.
Benzodi- Valium Benzodiazepines are also sedatives used to treat

azepine Rohypnol, anxiety, panic disorders, muscle spasms, and
/ Tran- Magadon seizures, the effects of alcohol withdrawal, and
quilizer Koplo Pills, pain before menstruation.
BK, Mboat,
Mboti, Side Effects of Benzodiazepines
Roda Drug reactions in every person are different.
Nipam Possible side effects after using benzodiazepine
drugs:
• Sleepiness
• Dizziness
• Confusion
• Limp
• Memory disorders
• Impaired body balance
• Akathisia (a body movement disorder)
• Seizures
• Nausea
• Vomiting
• Constipation
• Dry mouth
• Weight gain

Appendix

• Difficulty in controlling appetite
• Decreased sexual desire
• Respiratory depression
• Drastic fall in blood pressure
• Desire to commit suicide
Analgesic, Dex- Dextromethorphan is an opioid analgesics used

Antitussive trometho- to relieve cough (antitussive). It is an over-the-
rphan counter drug and is abused a lot. It should not be
(Dextro) used for cough with phlegm and is not for long-
term use. Overuse may result in death to pediatric
patients. It should not be given to children aged
four years and under and is not recommended
for pregnant women. Do not take this drug
while taking alcohol, diet pills, caffeine pills, and
stimulants because it will increase the risk of drug
side effects.
Side effects of this drug are:

• Itches
• Facial swelling
• Breathing difficulty
• Seizures
• Hallucinations
• Orientation disorder
Others Trihexy- Is a drug used to treat Parkinson’s disease
phenidyl/ and is often misused. This drug is classified as
Trihex antimuscarinic. It is available in liquid form.
Side effects:
• Dry mouth
• Bulging eyes or blurred vision
• Tired or dizzy
• Difficulty urinating or constipation
• Nervous or anxious
• Stomach disease
• Reduced sweating
• Irritated/agitation

Appendix

Zenith (Car- Is an anti-depressant but is also used to relax
nophen) muscles or overcome muscle spasms. Many are
from the Philippines. Misuse of this substance
results as follows:
• Heart rate increases dramatically
• Indigestion
• Hallucinations and unconsciousness
• Confusion
• Seizures
• Numbness
• Nausea and vomiting
• Easily offended
• Floating sensation
• Fainted
• Headache
• Stomach ache
References :
Drugabuse.com: https://drugabuse.com
NIH National Institute on Drug Abuse: https://www.drugabuse.gov/
Narconon : https://www.narconon.org

Appendix
Appendix 2 Drugs Effects
Type and
Effects Class of Sub- Description
stances
Constipa- Anti- psy- General constipation (25% of the frequency
tion chotic: of bowel movements) occurs in psychotic
Clozapine patients who take antipsychotic drugs,
especially clozapine. This drug can cause
gastrointestinal complications, which may
(rarely) cause death. It is estimated that 30-
60% of patients taking clozapine experience
constipation.
Neuro- All psychoac- Its effects go through the central nervous

logical tive sub- system and affect the management of
disorders stances neurotransmitters - i.e., the fluid released
and brain by the brain to affect feelings and body
damage muscles. Therefore, abuse of psychoactive
substance in the long term will disrupt the
neurotransmitter’s normal utilization pattern.
Not to mention if it is mixed with harmful
substances such as ethyl ether, acetone,
gasoline, and others.
Respiratory Zenith Is an anti-depressant but is also used to relax

tract (Carnophen) muscles or overcome muscle spasms. Many are
from the Philippines. Misuse of this substance
results as follows:
• Heart rate increases dramatically
• Indigestion
• Hallucinations and unconsciousness
• Confusion
• Seizures
• Numbness
• Nausea and vomiting
• Easily offended
• Floating sensation
• Fainted
• Headache
• Stomachache

Appendix
Type and
stances
Gastroin- Alcohol Alcohol affects the acidity of the digestive system,
testinal which may cause peptic ulcers and a condition
Disorders called Mallory-Weiss Syndrome, i.e., bleeding
that occurs due to tearing of the mucosal lining
between the stomach and esophagus.
Opiates and The use of opiate-based substances will

their derivatives cause narcotic bowel syndrome, i.e., digestive
such as function is weakened, which results in bloating,
morphine, constipation, nausea, and vomiting.
oxycontin, and
vicodin
Cocaine The use of Cocaine is associated with the risk of

blood clots, causing a lack of blood supply to the
liver and result in necrosis in liver and gangrene.
Prenatal Alcohol Consumption of alcohol in large amounts

effects on during pregnancy will cause FAS (Fetal
baby during Alcoholic Syndrome) to the baby, which is
pregnancy serious brain damage.
Stimulants, May result in still-birth or death to the baby in

marijuana, the womb.
and tobacco
MDMA Placental disorders, fetal growth restriction,
abnormalities on the brain and heart, the risk of
premature birth.
Inhalant Unplanned abortion, the abnormal physical

shape of the fetus.
Cocaine, Cause Neonatal Abstinence Syndrome,

heroin symptoms of withdrawal of drugs in the fetus,
which results in eating difficulty, frequent
seizures, colic, and the slow development of
motor skills after they are born.

Appendix
Type and
stances
Hormonal Types Serotonin (pleasure hormone)
effect of brain Dopamine (reward hormone)
hormones Epinephrine - adrenaline hormone to fight
Opiate Can cause gonadal and adrenal dysfunction in

both men and women which increases the risk
of infertility and triggers mental disorders.
Steroids Reduce sperm productivity, testicles shrink,

and triggers testicular cancer
Alcohol Can damage the gland function which releases

hormones (because it disrupts blood sugar
production and calcium metabolism) which
can result in serious consequences, especially
on reproductive ability, the strength of bone
mass, and affect growth and development. Also,
alcohol use also has the potential to disrupt the
function of thyroid hormone receptors.
Cocaine Being influential to the menstrual cycle. Cocaine

causes an increase in the Prolactin hormone,
which inhibits the release of a mature egg
(ovulation), and leads to Polycystic Overy
Syndrome - infertility due to lack of ovulation.
Heroin Women who use heroin will stop menstruating

after experiencing heroin addiction because
their production of the estrogen and
testosterone hormones is disrupted.
Baldness Steroids Causing male pattern baldness to women.
Alcohol Causing malnutrition and hair loss.

Malnutrition can also lead to a lack of thiamine
which causes brain damage and hair loss.

Bibliography
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chapter/10.1007/978-94-017-2570-5_10

HEALTH
2019
Research of Drugs Abuse Eﬀects
H ealth Research of Drug Abuse Effects 2019 is conducted based on

cooperation between National Narcotics Board (BNN) and Atma
Jaya Catholic University and National Institute of Health Research and
Development, Ministry of Health, Republic of Indonesia. This research is
conducted in six provinces, which provides places for rehabilitation for
drug abusers, such as West Java, Riau Islands, North Sumatra, Lampung,
South Sulawesi , and East Kalimantan. The target of this research is
clients/participants who undergo services in places implementing
narcotics prevention programs by National Narcotics Board such as
Rehabilitation Center, Post Rehabilitation Program, Primary (Pratama)
Clinic of Provincial Narcotics Board, and Community Partners of Provincial
Narcotics Board.
The main research objective is to obtain a systematic picture of narcotics

use effects on an individual and elements of socio-cultural relations,
which influence personal life. This research is one of the National Priority
Programs which are used as a reference in implementing the national
policy
RESEARCH, DATA AND INFORMATION CENTER

NATIONAL NARCOTICS BOARD
REPUBLIC OF INDONESIA
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HEALTH

RESEARCH, DATA, AND INFORMATION CENTER

Health Research Of Drugs Abuse Effects 2019

All rights reserved.

Health Research Of Drugs Abuse Effects 2019

Assalamu’alaikum Warahmatullahi Wabarakatuh.

All praises and thanks be to God Almighty,

Health Research of Drugs Abuse Effects

The main research objective is to obtain a systematic picture

One of the obvious impacts of sustainable narcotics use in the

Health Research Of Drugs Abuse Effects 2019 i

Finally, as the Head of the National Narcotics Board, we would like

That is all, and thank you.

Jakarta, December 2019

Drs. Heru Winarko, S.H

ii Health Research Of Drugs Abuse Effects 2019

The main research objective is to obtain a systematic picture of

We thank Research and Development Centre- Ministry of Health, the

Jakarta, December 2019

Health Research Of Drugs Abuse Effects 2019 iii

Health Research of Drugs Abuse Effects 2019 is the mandate of the

This research is a survey research/self-report involving 602 randomly-

This research finds several problems as follows:

respondents have experienced being drunk while driving and 15%

Health Research Of Drugs Abuse Effects 2019 v

the duration of the consumption may worsen the family situation.

Narcotics Board rehabilitation centers for supporting rehabilitation

IMPLICATION OF THE FUTURE OF NARCOTICS POLICY

Health Research Of Drugs Abuse Effects 2019 vii

require complicated, coordination which has not been going well

and students’ sense of courage and ability to choose positive

Health Research Of Drugs Abuse Effects 2019 ix

counselor, psychologist, spiritual experts). This need was voiced

x Health Research Of Drugs Abuse Effects 2019

CHAPTER II – LITERATURE REVIEW 15

CHAPTER III – METHODOLOGY 25

CHAPTER IV - RESEARCH FINDINGS 43

Health Research Of Drugs Abuse Effects 2019 xi

4.3. Relations with Mental and Social Health 60

CHAPTER VI - IMPLICATION OF THE FUTURE OF NARCOTICS

Table 01: Narcotics and Penitentiary Residents Case Data

Health Research Of Drugs Abuse Effects 2019 xiii

Figure 01: Ecological Systemic Theoretic Model 24

Rehabilitation Center of National Narcotics Board

The United Nations Office on Drugs and Crime (UNODC) has

Health Research Of Drugs Abuse Effects 2019 3

Along with various global efforts, Indonesia has also strived to

4 Health Research Of Drugs Abuse Effects 2019

Estimation data of narcotics users from National Narcotics Board

Another troubling thing is the rise of new psychoactive substances

We are also quite understand that in many newspaper articles, there

LIPI-BNN data 2018 also presents worrying statistics to every

Health Research Of Drugs Abuse Effects 2019 5

6 Health Research Of Drugs Abuse Effects 2019

Educational Ever Used Last Year to Use

c. Basic Health Research Data in 2018 (RISKESDAS, 2018)

There are following data on the use of several types of Narcotics

c.1. Tobacco and Cigarettes

In terms of the first time using alcohol, 3.8% of children and