Following is a question by Dr the Hon Junius Ho and a reply by the Secretary for Security, Mr Tang Ping-keung, in the Legislative Council today (October 18):
Question:
The Out-patient Methadone Treatment Programme (Programme) of the Department of Health provides methadone maintenance treatment and detoxification treatment services. There are views that the Programme mainly provides drug substitutes to patients only, and is not effective in assisting them to get rid of drug addiction and get back on the right track. In this connection, will the Government inform this Council:
(1) of the expenditure and staffing establishment of the Programme in each of the past five years, and whether it has assessed the actual effectiveness of the Programme in assisting patients to get rid of drug addiction;
(2) whether the Government reviewed the situation of the patients under the Programme in the past five years, including the number of patients, the number of years of receiving treatment, the number of persons who developed side effects or complications after receiving treatment and their mortality rate, etc.; if so, of the details; and
(3) whether it has formulated long-term plans and performance indicators for the Programme, so as to achieve the long-term objectives of assisting in the rehabilitation of patients and reducing the number of drug addicts; if so, of the details?
Reply:
President,
The Government has all along been combatting drugs with a multi-pronged strategy encompassing preventive education and publicity, drug treatment and rehabilitation (T&R), legislation and law enforcement, external co-operation, and research. T&R is an integral part of this strategy. Our policy is that we should help drug abusers to stay away from drugs, and T&R services should be provided to suit persons with different backgrounds and needs through the adoption of a multi-modality approach.
According to international medical knowledge and standards, abusers of opiate drugs should receive sustained treatment and support, so as to reduce the cost arising from their drug addiction problems that individuals, families and society have to bear. Using methadone as a maintenance agent in the treatment for abusers of opiate drugs is currently recognised as one of the most effective treatments by the international medical community and is endorsed by organisations such as the United Nations Office on Drugs and Crime (UNODC) and the World Health Organization. At present, this treatment is widely used worldwide, including the Mainland, Macao and other regions such as the United Kingdom and the United States.
Launched in 1972, the voluntary Out-patient Methadone Treatment Programme (Programme) in Hong Kong adopts an open-door policy, where people in need may attend any methadone clinic voluntarily to receive services. The Programme has been implemented for over 50 years. Currently, the Department of Health (DH) manages a total of 18 clinics in various districts across the territory. The Programme adopts an integrated treatment approach, offering professional counselling and social welfare support to provide holistic care alongside the provision of methadone as a maintenance agent. Methadone helps reduce the discomfort of abusers of opiate drugs when they go through detoxification, and prevent them from falling prey to temptation of taking drugs again and even committing crimes. Apart from helping drug abusers stay away from drugs, the Programme provides a legal, effective, affordable and readily accessible alternative to illegal opiate drugs to people who are unable to attain total abstinence; reduces crime and anti-social behaviour arising from drug abuse; enables drug abusers to lead a normal productive life and continue their work; and prevents the spread of diseases , in particular blood-borne diseases such as AIDS, hepatitis B and tetanus, through reduction of intravenous drug taking and needle-sharing.
My reply to the three parts of the question raised by the Member is as follows:
(1) and (2) Regarding the expenditure of the Programme, according to DH, the actual annual expenditure in the past five financial years (i.e. between 2018-19 and 2022-23) was $55.4 million, $57 million, $57.1 million, $60.1 million and $54.2 million respectively.
As regards manpower, there are a total of 13 civil servant posts in the establishment. In addition, DH has arranged part-time staff and entrusted the Auxiliary Medical Service to serve the methadone clinics.
As to patient statistics, in the past five years, the Programme recorded an average of over 3 800 daily attendance, and these patients have been receiving treatment for about six years on average. Medically, there is no time limit for using methadone as a maintenance agent. In general, the longer the treatment period, the less public order and personal health problems arising from drug relapse occurs.
The Government does not maintain statistics on the number of cases involving side effects, complications or deaths arising from participation in the Programme. That said, methadone has been used for decades both internationally and locally and is generally regarded as a safe and effective medication.
As regards effectiveness of the Programme, according to the "UNODC-WHO Joint Programme on drug dependence treatment and care" published in 2009, investing in treatment for drug dependence can bring many benefits to society, such as lowering healthcare-related costs, improving security and contributing to social cohesion and development. It was estimated that for an average of every one US dollar spent on methadone treatment or other similar evidence-based addiction treatment, six US dollars were saved in terms of costs for security, health and welfare for the society. In the same year, the UNODC and the Joint United Nations Programme on HIV/AIDS also shared with their members the success of the Programme in Hong Kong.
Over the years, both the Government and the Action Committee Against Narcotics (ACAN) have reviewed and provided advice on the Programme. In 2012, DH commissioned independent international consultants to review the Programme. Apart from reaffirming its effectiveness, the review recommended continued implementation of the Programme in Hong Kong. DH conducted in-house studies again in 2017 and 2022. Study findings revealed that when compared with drug abusers who did not participate in the Programme in the previous year, the rates of illicit opiate drug administration, abusing more than one type of drugs, being arrested for committing crimes in the previous year and unemployment of those receiving sustained methadone treatment were lower, and they also had more harmonious relationships with their family members.
(3) Over the past 10 years, the overall number of reported drug abusers in Hong Kong has dropped by more than half. According to the statistics of the Government's Central Registry of Drug Abuse, while heroin (commonly known by its Chinese street name as "white powder") is still the most commonly abused drug, accounting for about 40 per cent of the total number of reported drug abusers in Hong Kong, the number of reported abusers of narcotics analgesics which includes opiate drugs (mainly heroin) has dropped significantly over the past decade, from 5 847 in 2012 to 2 145 in 2022, representing a decrease of 63 per cent. This shows that the anti-drug efforts against opiate drug abuse, including the Programme as mentioned in the question, have also been effective.
Regarding performance indicators, the Controlling Officer's Report of DH has adopted an average attendance rate of more than 70 per cent of patients registered with methadone clinics as the performance measure, and the target has been met in recent years.
As the Programme has proved to be effective, the Government will continue to implement it so as to fulfil its function by providing services to those who need it. Besides, the Government will make adjustments to the anti-drug strategies and measures from time to time by taking into account the latest drug situation, observations from frontline professionals and views of ACAN and stakeholders. We will work with different sectors of the community with a view to keeping the overall drug problem in Hong Kong continuously under control.
Thank you, President.
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