Minister of Health Anwar Husnoo seems to have finally acceded to the plea of NGOs demanding the reinstatement of the distribution of methadone at health and community centres rather than at police stations, as had been the case since 2015 following a decision by Husnoo’s predecessor, Anil Gayan.

The NGOs’ request lay on the claim that distributing the opioid substitute methadone at police stations gave methadone patients the impression that their addiction amounted to a criminal offence, hence the need for them to call at a police station. Psychologically, such a thought is devastating. Moreover, methadone patients ran the risk of being spotted outside a police station by a friend, a relative or even their boss who would then find out about their addiction. Logic would also want patients, especially addiction ones, to be treated at health institutions rather than... at police stations – although Ministry of Health employees’ and nurses’ unions have unsurprisingly but distastefully expressed their support in leaving the hot potato in the hands (or yard) of the police. The decision to move the methadone substitution programme away from police stations is thus laudable, as it follows in the footsteps of the global campaign ‘Support, don’t punish’.

Yet, distributing methadone at health centres is not an end in itself. Patients who want to get out of the drugs inferno would definitely find it a boost to their rehabilitation and reintegration. Conversely, the local residents’ issue relates not so much to where the methadone is distributed, but how. Various press reports regarding the issues arising from methadone distribution mention patients roaming around in groups after the distribution is over and others partaking in methadone trafficking by regurgitating their dose despite police presence (see l’express of 4 May and l’express dimanche of 12 August for instance). The feeling of insecurity induced by the minority of rowdy patients who stay after distribution hours unfortunately paints a bleak picture of the whole methadone patient community.

This state of affairs stems from the lax handling of the methadone distribution whereby only a couple of poor and scared functionaries are tasked with handling a whole distribution point. Let’s face it, even if they wanted to ensure patients gulp down their dose, would they really be able to? Residents would thus still face the same issues if similar distribution procedures are applied at health centres.

NGOs and the Health Ministry have a leading role to play in accompanying patients psychosocially during their therapy. Trained and devoted staff should be out in numbers to ensure that doses are properly taken; patients should be spoken to; social relationships set up. Addiction treatment requires a holistic approach which goes beyond mere withdrawal (see the Commission of Inquiry on Drug Trafficking). Community-based programmes and social empowerment go in concert with medical treatment. Only then will distributing methadone at health centres rather than at police station fully make sense.

When it comes to drugs, we’ve come a long way since the introduction of injection drugs in Mauritius in the early 1980s and the first case of HIV in 1987. Yet, the history of treatment care has been marred by relapses which we are only now redressing, one step at a time.

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