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Drug lords will run our government, warns Tonga’s psychiatrist

Nuku'alofa, Tonga

Psychiatric unit at Vaiola Hospital, Tofoa. 21 May 2019.

By Eleanor Gee

Tonga's drugs problem is on the rise, “like a cancer in the community,” says Psychiatric Specialist, Dr Mapa Puloka, who warns that government is too slow in tackling the epidemic and needs to urgently prioritize more funding before it gets out of hand.

He issues a stark prognosis: “If they can’t stop it, we will end up like some of those countries in South America. What will happen is drug dealers or drug lords will run our government and end up being their puppets because of the power of money.”

“The fastest way to stop it is to enforce capital punishment,” this embattled medical professional told Matangi Tonga this week.

Dr Puloka and the little 18-bed psychiatric unit at Vaiola Hospital in Nuku'alofa are on the frontline, dealing with the ugly consequences of drug abuse and addictions.

The number of patients suffering from mental illness caused by drug addictions are on the rise. He said in 2017 and 2018 a total of 93 new patients were admitted to the psychosis unit.

"Methamphetamine and marijuana addiction could trigger mental illnesses or psychosis," he said.

Dr Puloka said, while patients with mental illness triggered by marijuana use had been occurring for a while in Tonga in the 1990’s and early 2000’s, methamphetamine was a more recent arrival.

"With meth, cases started to emerge in 2015. Meth has been around for a while, but meth-related cases started to appear in our unit back then, and in 2016, and it’s getting worse right up to today.”

Since 2016, the psychosis unit statistics show between 20% and 70% of monthly admissions are marijuana or meth-related and most of them are involuntary admissions (admitted by police), including criminals.

They are usually aged from their early 20’s to early 30’s, although there have been about 16 patients under the age of 18 over the last three years, he said.

He said the patients show symptoms of psychosis such as having hallucinations and hearing voices. They use profanity and become dangerous.

Dr Mapa Puloka, Psychiatric Specialist in charge of the Psychiatric Unit at Vaiola Hospital, Tofoa. 21 May 2019.

Treatment

Dr Puloka said, when patients arrive at the psychosis unit, they are given the “cold turkey” treatment, where there are no drugs accessible to them, resulting in withdrawals.

“If we see that the withdrawals are too severe, they give them valium to lessen the severity of the symptoms. It takes, probably, three or four days for them to get over withdrawals and then we start psychosis treatment,” he said.

This takes around three weeks for patients to get much better. They are then referred to the Salvation Army to provide rehabilitation to stop their drug addiction, while patients who are criminals are sent back to jail.

A new psychiatric unit has been built just outside the Hu’atolitoli Prison for the violent mentally-ill patients.

Dr Puloka said they used to stay at the psychiatric unit at hospital but it became too dangerous to keep them there.

The new prison psychiatric unit was completed earlier this year and four criminals were admitted there in March this year.

There is also an old psychiatric unit inside the prison, with eight criminal patients.

“They are all mentally ill because of their addiction to marijuana and meth,” he said.

Getting worse

But a weary Dr Puloka believes the battle lies “upstream with the supply of drugs, not downstream where people end up mentally ill.”

“In my opinion, the situation is getting worse. But this [Police Drug] Taskforce that was established last year, is doing good work,” he said.

He believes the government needs to prioritize funding and do more, before things get out of hand.

“I believe the government is insensitive.”

While he agrees with some of government's projects, he thinks funding was wasted on the Popua Park project. “Like when the problem of the drugs emerged that should have taken a backseat and focus on this [drug problem] but work is slow.”

Death penalty

On Tonga’s meth frontline the prescription is dire.

“In my view, this drug is like a cancer in the community. The fastest way to stop it is to enforce capital punishment, like countries such as Singapore, Malaysia, and Indonesia. I don’t think what we are doing now will quickly stop the problem,” he said.

Amphetamines

Methamphetamine (meth) belongs to the amphetamine class of drugs and is a chemically synthesized central nervous system stimulant. 

Other well known amphetamines are Benzedrine, Dexedrine, and Desoxyn. When meth is prepared illegally, the drug ranges from a fine to coarse powder, crystals or chunks and the colour ranges from white to yellow. It is highly addictive.

More information on meth can be found here: https://drug.addictionblog.org/tag/meth/

This interview was conducted in Tongan and English on May 21, with parts translated into English.