Current status of substance abuse and HIV in Taiwan

Methamphetamine abuse, which surged in the early 1990s, remains a major social and health issue in recent years in Taiwan. The danger of the spread of HIV among heroin injecting drug users (IDUs) gradually increased because of needle/syringe sharing in the early 2000s. The percentage of IDUs among all addiction treatment admissions increased from 34.7% in 2000 to 63.9% in 2004, and the percentage of IDUs sharing needles increased from 4.0% in 2000 to 15% in 2004. Alerted by the escalating IDU-associated HIV situation, the Department of Health launched the national pilot harm reduction program (PHRP) in four of 25 cities/counties in 2005. In 2006, the Taiwan Centers for Disease Control reported a 10% decrease in all new HIV seropositive cases and a nationwide harm reduction program was implemented. Besides the implementation of PHRP, HIV testing executed in 2004 and the HIV education program were essential for the effective control of HIV. Abuse of club drugs, such as MDMA, ketamine, flunitrazepam, and zolpidem have also been a new phenomenon since the early 2000s. It is noteworthy that the ketamine-positive cases in urine samples increased sharply from 47 in 2002 to 11,616 in 2011. Although ketamine has not been scheduled by the United Nations, the epidemic level of its use and harms may have been underestimated. In summary, heroin, methamphetamine, and certain club drugs are the current major drugs of abuse in Taiwan. The risk factors of drug abuse-associated infectious diseases, such as needle/syringe sharing among heroin IDUs and unprotected sex among club drug users, deserve further scrutiny.