In the context of the International Day Against Drug Abuse and Illicit Trafficking (yesterday) can we hope for improvement in guiding desperate, vulnerable people towards true recovery from addiction?
To put the scale of addiction into context, consider the following facts. There are around 10,000 problem drug users of heroin alone. Alcohol, being socially accepted is causing significant problem everywhere. All villages of this small island are affected by alcohol abuse. Addiction devastates our local communities, particularly our poorest areas. It is estimated that the harms arising from substance abuse, including health and social costs, amount to billion yearly. The National Agency for the Treatment and Rehabilitation of Substance Abusers (Natresa) was established in December 1996 to co-ordinate and facilitate efforts at National level towards the implementation of programme for the prevention of substance abuse and the treatment, and rehabilitation of substance abusers. It is heartbreaking to find out that after so many years of existence, Natresa has failed in meeting its primary objectives as thousands of children are living in homes where a parent has a serious drug or alcohol problem.
CURRENT TARGETS ARE FOR PROCESS, NOT LIFE CHANGE
There has been an obsession with getting addicts into ‘treatment’ alone, rather than recovery. Success is measured as completion of so many weeks ‘in treatment’. It seems there has been no strategy or incentive to reduce the numbers on maintenance treatment, or move people from dependence to independence. Again the body in charge to monitor these has failed considerably.
A FATALISTIC ADDICTIONS STRATEGY
We don’t have any information on the number of those seeking help/treatment and those who have been in structured treatment, despite an increase in the number of addicts seeking treatment. Since the number of heroin users who are on prescribed methadone is on the increase, it is hailed as a success, because a record number of addicts are described as “in treatment”. This obsession with numbers in treatment alone, alongside a fatalistic and undignified strategy of maintenance not recovery, fuels such ongoing failure.
ALCOHOL IS NEGLECTED
Increasing levels of alcohol harm have hit society and a growing culture of drinking has emerged, especially among young people. Alcohol consumption by Mauritian children has significantly increased in the past 15 years.
As alcohol harms have increased in recent years, the gulf between need and access to treatment has widened dramatically. Expenditure on alcohol treatment is very little compared to the overall drugs budget.
REPLACE THE NATIONAL TREATMENT AGENCY WITH AN ADDICTION RECOVERY BOARD.
This will shift culture from maintenance and harm reduction as an end-goal to full recovery. The new board must be chaired by a minister and led by an individual committed to full recovery and evidence-based treatment.
The Addiction Recovery Board (ARB) should bring alcohol treatment on the same level with drug treatment and provide an integrated strategy.
Treatment of dependency on prescribed drugs and over the counter drugs is negligible. This should also be targeted by the ARB as well as tobacco and other forms of addiction.
Protecting communities by the setting up of a new Advisory Council on addiction in different regions of the island
A regional Advisory council which will include social workers, psychologist, business persons, and experienced recovery-based treatment practitioners and representatives of the police should be set up to coordinate drug prevention, treatment and rehabilitation.
A strategy for drug and alcohol reforms in prison will complement those undertaken in communities. It will include robust enforcement, a review of detection and testing regimes – including the introduction of innovative voluntary drug testing regimes, rebalanced treatment, and provision to move from harm reduction to recovery and new approaches to sensible measures to assist in a stable resettlement.
Families and children must be actively prioritized for treatment in order to break the cycle of addictions. Social workers, drugs counsellors and child-protection services must work together to identify and help families where children are at risk from parental substance abuse, and would otherwise be likely to enter the system.
The regional ARB teams must develop close contact with local groups and direct clients to them, to take advantage of the sponsorship, mentoring, counselling and peer support.   
The approach of tackling drugs and addressing alcohol dependence, both of which are key causes of societal harm, includes crime, family breakdown and poverty. Together, they cause misery and pain to individuals, destroy families and undermine communities. Such suffering cannot be allowed to go unchecked.
The causes and drivers of drug and alcohol dependence are complex and personal. The solutions need to be holistic and centred around each individual, with the expectation that full recovery is possible and desirable.