Twenty years since the foundation of the Rehabilitation Association of Drug Addicts of Macau (ARTM), founder and president Augusto Nogueira, himself a former drug addict, discusses his life experience and how he managed to free himself from addiction, and the work and success that the association has achieved in the past two decades
How is the situation in Macau currently, in regards to drug use and addiction?
If you break it down by type of drug use, there has been a huge decrease in the use of traditional drugs like heroin. This trend has been happening all over the world, not only in Macau. On one hand it is good, but on the other hand it brings about other kinds of challenges because the population that uses or used heroin is quite old now, with big health problems and quite limited life goals, which forces us to be more intensive in motivating and finding ways to help these people. On the other hand, there has been an increase in methamphetamine, commonly known as ice, which is a synthetic stimulant drug. In Southeast Asia there has been a significant increase in consumption, and Macau is no exception. In fact, almost weekly there are cases of methamphetamine trafficking caught by the police. I am concerned about the latest cases that have come to light related to the trafficking of methamphetamine and cocaine, as it seems to me that there may be an increase in the consumption of both.
Why do you think heroin use is in a decline? And what has led to this possible increase in the consumption of synthetic drugs?
I think it is fad. Heroin has been catalogued as a degenerate drug. It had its golden age, when heroin was considered ‘fashionable’, but today this doesn’t make sense. Notice that heroin, accompanied with the advent of HIV, made, at some point, the image of the users a bit degenerate. The consequences of its use and the ‘look’ of the people who used it, and use it, is what made the drug degenerate. People lost their teeth, many started sleeping on the streets, with bad skin, etc. This image, from one moment to the next, started to get into the heads of young people who don’t want to go through that. Then, the change in lifestyle can also explain these changes. Ecstasy, the love drug, ketamine, etc. started to appear and didn’t bring this decadent ‘look’ to the users. But those who are dependent on heroin, hardly ever quit. You can try other things, but you always come back to heroin. The new generations are the ones who ended up leaving heroin behind. Heroin also causes a greater physical dependence than these synthetic drugs. Normally, these drugs have a lower price than heroin or cocaine, although now, with the pandemic, any drug in Macau has a high price.
Given all the many restrictions at the borders due to the Covid-19 pandemic, how do the drugs get in to Macau?
Good question. Well, there are people who control the market, and they are not the Vietnamese who were arrested recently, because they, being foreigners, can neither leave nor enter. However, there are people who, due to their nationality, are already able to enter and leave Macau, as you know. And, therefore, these are the people who, naturally, bring drugs into the territory. And then there are the express couriers or Taobao, who can facilitate some trafficking, when they are not intercepted at the border, because there is not, let’s be honest, a 100 percent capacity to check all the packages that leave and enter Macau. It is humanly impossible to see everything in detail, besides the fact that there are many ways to disguise the drugs in packages. It is a bit like a game of cat and mouse.
Has the economic crisis due to the pandemic affected ARTM in any way?
There was a cut of about 50 percent in the extra activities, which is a separate subsidy. But in regards to essential funding, there has been no cut on the part of the government. However, it’s not because of this cut that we stopped doing the activities. We continue with basketball, gymnastics, pilates, among other activities. The casinos have also helped, other benefactors as well. We haven’t had any problems with the needle distribution programs, nor have we stopped distributing meals. Everything is normal.
Apart from the government, who are ARTM’s major patrons?
Clearly the casinos, but I must also highlight the help from the Banco Nacional Ultramarino (BNU). Notice that we are not begging either. We have our support channels open. Whoever wants to support, we are very grateful. Many individuals support us, but we are so busy with our projects that it is very difficult to concentrate on fundraising. We have our annual dinner precisely so that civil society and companies can help us.
Do you have any idea how many people ARTM has rehabilitated?
Through ARTM there have been more than 700 people. Many have already been rehabilitated, maybe around 50 percent. There are people who have come and gone over the years. Some relapse. Others die. A few dozen have died, unfortunately, mostly from overdoses, but also from drug-related health problems like AIDS, accidents, or suicides. ARTM is currently in charge of 20 men and seven women in the rehabilitation program. Most are Chinese, but there are some Portuguese, too, and other nationalities, like Indians and Filipinos.
Have you ever felt helpless because you couldn’t save a person?
If we were to think like that, we would be constantly depressed. Of course we feel sorry that some people can’t quit drugs, but we try not to take things personally. We can’t internalize these things, otherwise every failure would be a pool of tears around here, not to mention the loss of self-confidence in the work we are doing here at ARTM. It’s important to be aware that we do our best to help people, but for some reasons, in some cases, it doesn’t work out. The most important thing is to welcome the successful cases. We don’t have a magic wand to change people’s lives. With our help, they have to find their way, fighting against their own inner self. One I was in Zhuhai and stopped at a convenience store to buy a bottle of water. When I went to pay for it, it was already paid for. It was a boy, recovered, who had passed through ARTM and wanted to thank me. This example is, in fact, a bit of our personal satisfaction.
Are your employees mostly former drug addicts?
Not anymore, but we still have some former drug addicts. It is very important for the therapeutic community to have recovered people working here, because a psychologist, as good as he or she may be, always lacks the life experience of having gone through things, of having been a drug user. It’s a very specific language that we always have to keep in mind. Civil society and, in particular, the government has to look very carefully at what parameters are sewn into the labor market for people recovered from drug use who deserve a second chance. Some don’t have enough studies. Anyway, for us, as a therapeutic entity it is important to have recovered people working with us. I always tell this to the Social Welfare Bureau.
Can a former drug ever escape stigma associated with their past?
An addict will always have a cross to bear. It is indeed a stigma that stays there for the rest of your life. Some are also left with physical after-effects. Anyway, it’s more of a social issue, which still persists. Labels are created for people. I, for example, am an ex-drug addict and I have no problem admitting it and talking about it. Obviously, an ex-drug addict or an ex-drug user has to have, all his or her life, a different focus. It is like an ex-alcoholic. You have to be vigilant, knowing that there are certain lines that cannot be crossed again. A relapse or a less than correct thought can be the death of the you. A mere joint can be a great illusion. No matter how much you like it, you can’t touch it anymore.
As a former drug addict, when did you reach the point that you said ‘enough, I don’t want this for me anymore’?
I used heroin, cocaine and hashish. In 1993, I was eventually forced by my parents. Either I entered a treatment center to recover – my cousin was even already there – or I had the door of my house open to leave. A little against my will, I gave in and went to see how things worked in the center. I entered Castro Verde, in Alentejo. After a week, week and a half, I almost ran away, but I gave up. I asked for a transfer to another center that was in Salir, in Algarve. Things went well from there.
What do you think about the decriminalization of drugs?
I don’t hide my support for the decriminalization of drugs, however, I am still opposed to the legalization of drugs because it is a very complex issue. First of all, decriminalization will decrease the black market. But the main reason is that nobody should go to prison for using drugs. Trafficking is the big problem. Putting people in prison because of drug use, something they put in their own body, doesn’t make sense. Alcohol also has the same effect and nobody goes to jail for getting drunk. If a person uses drugs and then goes on a rampage, the person has to pay for the bad things he does. That has nothing to do with the consumption of drugs or alcohol. But a person going to jail for doing drugs, no, I don’t agree with that. Let the authorities spend their energy pursuing those who deal drugs.
How do you see the growing importance of cannabis in the world, with the plant being used for therapeutic and medicinal purposes?
You have to be very careful with cannabis, which is getting stronger and stronger. The levels of THC (tetrahydrocannabinol the main psychoactive substance found in plants of the Cannabis genus) have been increasing and the drug is stronger than compared to a few years ago. Usually, those who use cannabis are young people whose brains are still developing and this will cause problems. Smoking a joint is not the same as smoking a cigarette. Cannabis alters the nervous system. However, there is a current trend that believes that cannabis has several medicinal properties, but for this there are medicines prepared with the ideal amounts of THC and other cannabis ingredients that do not cause harm to the body. There is, in fact, therapeutic use of cannabis in HIV and cancer treatments. And there are those who just want to legalize cannabis for recreational purposes, to smoke a few joints with friends. Legalization of cannabis would require, in my opinion, a great deal of control, otherwise public health would be greatly harmed.
What are ARTM’s projects for the short, medium and long term?
Right now it’s complicated to make plans. But our big goal is to continue helping people. We really want to improve our therapeutic program and, at the same time, show in Asia that Macau has been very successful in combating drug addiction and, in particular, HIV-related issues. For the fifth year in a row we have no HIV infections among people who inject drugs. This is something that has even been highlighted by the United Nations, because there is no region or country with these numbers. Thanks to our syringe and methadone distribution programs, the results have been acheived. We are already starting to be seen as an example, a reference, in this matter.
ARTM has been active in recent months, especially with the opening of the new Be Cool center in Taipa and the new space reserved for culture and a café in Ka-Hó.
Yes, since 2008 we have been improving our conditions. In 2008, with the opening of the syringe distribution program, then, in 2011, with the opening of the women’s center. Then Be Cool, then the methadone program. In 2016, we concentrated all of ARTM in Ka-Hó. At the end of last year the new Be Cool space in Taipa, and now this new project here in the old leprosarium. Sooner or later, if all goes well, we will be responsible for the whole methadone program in the territory. We are working on this with the Social Welfare Bureau. Currently, the program is split between us and them, but ideally ARTM should be the one to administer the entire program in Areia Preta. We are concerned about some non-residents like Filipinos or Vietnamese. These are communities that have been affected in recent years by the scourge of drugs. There has been an increase in consumption and these people have a precarious situation in Macau.
What are your expectations for this new project in the old leprosarium of Ka-Hó?
For the little yellow houses, I hope that they will be a launching pad for the recovered people who work there to have some kind of opportunity in the future in the casinos, namely in the hotel and restaurant sectors. We have already had training with Wynn Academy, and soon we will also have training with Melco. Two houses are currently being used, one dedicated to coffee and the other dedicated to art, with a small exhibition space. We also want to be able to exhibit the works of our patients and have several partnerships and art collectives. We recently inaugurated an exhibition of work done here at the center with Professor Raul Martins, also a former drug addict. They are works of sculpture and painting that deserve to be seen. The good thing about this is that, even though we are far away from everything in Macau, many people come to visit us every day, especially during the weekends.
Is art therapy a good way out for those who want to quit narcotics for good?
Yes, of course. It’s a way for people to have their mind occupied with other things, and then at the end, to see their work exhibited. I really believe it’s a very important complement for people to develop their inner selves. There are people here who have never had any contact with art and today they make works of great quality. We also have good equipment that allows patients to make their works. I would like to thank not only the Social Welfare Bureau but also the International Ladies Club of Macau (ILCM) for their support.
With your life experience and with all that you have seen in these 20 years of ARTM, what advice do you have for people?
The biggest advice is to resist drugs. Even in the worst moments, even if someone comes along and offers you drugs, avoid using them. From the moment you try drugs it is an unknown and you don’t know what can happen for the rest of your life. Some people do drugs and don’t become addicted, but some people do drugs and become completely dependent, in a spiral of consumption and other things. One small experience can radically change your life 180 degrees. There are many ways to have fun and feel pleasure in life, but drugs are certainly not one of them. Take my word for it.
