Drug Rehabilitation and De-Stigmatisation

Parliamentary Speech, 15 Jan 2019.

  1. Mr Deputy Speaker, it is clear that this bill, among other things, seeks to introduce new offences to deter the promotion of certain drug-related activities. This is evident through the introduction of the new sections 11B, 11C and 11D.
  2. I am in general support of these amendments to the Misuse of Drugs Act. They are in line with the current framework of statutory prohibition against drug misuse. I would like to take this opportunity to express my support in particular for the new section 11B which, to my mind, tackles the undesirable but unfortunately rampant phenomenon of intergenerational drug use.
  3. We are beginning to see a more nuanced and calibrated approach to drug rehabilitation led by the Ministry of Home Affairs.
  4. MHA’s intention is clear. There is a continued focus on helping drug abusers break the cycle of addiction more effectively and reintegrate into society sooner. I commend this intent especially given that we all agree neither criminalization nor imprisonment is viewed as the miracle solution. However, our drug rehabilitation regime still tacitly acknowledges the stigma associated with drug use and addiction. Even without the World Health Organisation declaring that addiction to illicit drugs is the most stigmatized, it is not hard to surmise that social isolation and marginalization hampers the effectiveness of even the most effective rehabilitation efforts.
  5. Mr Deputy Speaker, with the current amendments, I believe we now have an excellent opportunity to reinforce the statutory framework on the prohibition of drug misuse with concerted, government-led efforts to de-stigmatise drug addiction. Public education and policy realignment in the direction of de-stigmatising drug addiction can and should complement institutionalised drug rehabilitation. Allow me to elaborate. [Source: Singapore Anti-Narcotics Association 2018]
  6. At the moment, it would not be a misstatement to say that illicit drug use and addiction is met with great social disapproval. Commonly held perceptions of persons with drug addictions are that they are weak in resolve, irresponsible and out to have a good time at society’s expense. In short, addiction is viewed as a moral failing, and t the associated harms of addiction considered wholly self-inflicted.
  7. I believe that it is time we challenge the common wisdom that shame, a fundamental element of stigmatisation, is the best way to respond to undesired social behaviours and habits. Especially in light of advances in neurobiology research which validate the characterisation of addiction as a brain disease tied to changes in brain structure and function.
  8. Advances in the field of neurobiology show that addiction causes deficits to the functioning of the prefrontal cortex. While I have been informed that these studies have not been researched in our local context, some have been co-published by researchers hailing from, amongst others, our very own Department of Pharmacology at the Yong Loo Lin School of Medicine, Yale University, Imperial College London and the National Institute on Drug Abuse in the US. In lay terms, addiction impairs the brain in ways which weaken brain regions involved in executive functions such as decision making, inhibitory control and self-regulation.
  9. It is easy to surmise, given this impairment, that stigma or externally-imposed shame would only provide very minimal, if at all, effective support or incentive for individuals who are seeking to quit their drug addictions. Additionally, according to a study published by the US National Institute on Drug Abuse, stigma towards addiction also externalises in practical ways for example lower priority in healthcare policies such as insurance.
  10. Conversely, I believe that if we are able to align (a) the public’s understanding of drug use, (b) our public health policies on drug misuse, as well as © our institutionalised drug rehabilitation programmes with the brain disease model of addiction, we could start creating the right conditions for decreasing, or even preventing, drug misuse and addiction. Similar recommendations have been made in studies published by researchers on drug abuse. [Sources: (1), (2), (3)]
  11. For clarity, Mr Deputy Speaker, I am not saying that Singapore must soften its stance on the statutory prohibition of drugs. Rather, I am very encouraged by the widespread success of our whole of government effort on War on Diabetes. That effort addresses the misconceptions and stigma, and has also begun to make headway in structural changes within business and community to influence social behaviours and habits. Learning from this, I urge the Government to consider commissioning an inter-ministerial task force for our “War on Drugs” to undertake the following: (A) Conduct a large-scale public education campaign to (1) educate the general public on the newly-introduced provisions, their underlying rationales and the increased severity of drug offences to ensure the deterrent intent of the amendments is well understood, and at the same time, (2) encourage de-stigmatisation of drug addiction to complement our calibrated rehabilitative approach, AND (B) Commission research based in Singapore which can be used to guide, strengthen and reinforce, our national policies on drug misuse, ensuring they are aligned and remain up to date with neuro-biological advancements and upstream prevention through public health education on substance abuse and mental health conditions. This would also support our public education programmes as shared earlier.
  12. Mr. Deputy Speaker, I now move on to more technical queries and proposals addressing specific clauses in the Bill.
  13. First, the offences set out in section 11B apply to persons of or above 21 years of age in relation to exposing or permitting a child to drug use. The section also defines “child” to mean any person below 16 years of age. I would like to ask the Minister if this provision was intentionally drafted in such a way as to omit any legal effect on of persons between the ages 16 and 20 years old. If this was the case, why? If this omission was unintentional, may I then ask the Miinister what effects this drafting might nonetheless gives rise to.
  14. Second, Clause 16 both (i) introduces minimum sentences for some offences where there was previously none, and (ii) enhances punishment of an offender convicted of certain offences. Further, Clause 17 introduces enhanced penalties for a person who is convicted of certain offences under the Act and has certain antecedents. Aside from a clear and continued emphasis on the severity of drug-related offences, I wish to ask the Minister what specific goals these amendments are intended to achieve and how they do so. Further, I wish to ask the Minister if and how these amendments strike an appropriate balance between criminal penalty and rehabilitation.
  15. Third, with regards to clause 18(a), I wish to ask the Minister how the number of 7 years was arrived at for determining the period not exceeding which any person reasonably suspected to be a drug addict may be committed for the purposes of medical examination or observation. Further, I would like to ask the Minister if it would be more appropriate and prudent for the broad phrasing of the proposed section 34(1) which states “to any place specified by the Director for the purpose of any medical examination or observation” to be amended to (i) reflect a schedule or pre-determined list of places, and (ii) reflect that the medical examination or observation be for the purposes of determining whether traces of drug remain in a person’s body?
  16. Fourth, Clause 19 requires a parent/guardian to attend any counselling session with a supervisee who is below 21 years of age. I wish to ask the Minister what type of counselling this section envisions. Further, in what ways does this provision ensure that the psychosocial support programmes, if any, put in place with a view to include parents and guardians are able to serve their intended purpose?
  17. Mr Speaker, the challenge of drug use is a complex one because it’s a human one. Studies have found that illicit drug users and persons with drug addiction are unable, due to social stigma, shame and guilt, to connect in healthy ways with fellow human beings thereby impeding their recovery and social integration. Perhaps this is why it has been said that the opposite of addiction is not sobriety, it’s human connection.
  18. I commend the Ministry for taking the first steps in the right direction with a more human-centred approach with these new amendments. Yet beyond taking the legal, medical and institutionalised approach, we must have a concerted community response to this adaptive challenge of drug misuse and addiction. Social integration without de-stigmatisation is a job half done! We must remain open to evolving strategies as well as new social and scientific research that continue to put the human in the centre of our laws and their implementation on drug misuse and rehabilitation efforts.
  19. Mr Deputy Speaker, I support the Bill.

Anthea Ong is a Nominated Member of Parliament. (A Nominated Member of Parliament (NMP) is a Member of the Parliament of Singapore who is appointed by the President. They are not affiliated to any political party and do not represent any constituency. There are currently nine NMPs in Parliament.)

The multi-sector perspective that comes from her ground immersion of 12 years in different capacities helps her translate single-sector issues and ideas across boundaries without alienating any particular community/group. As an entrepreneur and with many years in business leadership, it is innate in her to discuss social issues with the intent of finding solutions, or at least of exploring possibilities.

She champions mental health, diversity and inclusion - and volunteerism in Parliament.