Categorized | Asia, Drugs, UN, World

Compulsory Drug Treatment in Southeast Asia – Neither Ethical Nor Effective.

Image by riekhavoc

Image by riekhavoc

ASEAN foreign ministers signed the Joint Declaration for a Drug-Free ASEAN on the 25th of July 1998, committing association members to eradicate illicit drug production, trafficking and abuse by 2015. The strategy, founded on the specious belief that taking a sufficiently ‘tough’ stance on the drug trade would result in its demise, has been shown to be as nonsensical as it was empirically dubious. ASEAN will not be drug free by 2015, nor will it be by the new extended deadline of 2020.

According to the latest regional studies by the UNODC and the Transnational Institute, the use of Amphetamine-type stimulants (ATS) such as Methamphetamine has both increased and diversified in recent years. Heroin use has reached ‘epidemic’ levels in several parts of northern Myanmar, while the continued implementation of repressive drug control policies has resulted in increasingly harmful patterns of consumption.

Supply from the infamous ‘Golden Triangle’ region of Thailand, Myanmar and Laos, has duly risen to meet the burgeoning demand. Opium production almost tripled between 2006-13 from an estimated 340 tonnes to almost 900 tonnes per year. Over a similar period, the UNODC reported a 90% rise in the number of ATS laboratories dismantled in the region, clearly indicating a substantial expansion in production despite the continued imposition of punitive drug policies.

A core facet of ASEAN’s strategy has been an increasing reliance on compulsory drug detention centres (CDDCs) to forcibly detain drug users, or those suspected of using drugs, for the ostensible purpose of treatment and rehabilitation. According to the latest available figures, over 236,000 people are currently being held against their will in over 1,000 CDDCs throughout the region, without due process, legal safeguards, or judicial review.

They may have failed a single urine test, been captured in police sweeps, or even been turned over by family or community members. No distinction is made between casual and dependent drug users, or even if the person is a drug user at all. In some cases, centres facilitate a form of social cleansing by holding perceived undesirables such as street children, sex workers, and people with psychosocial disabilities.

Once inside, periods of detention can last up to five years, with multiple sentences potentially resulting in decades spent confined in the most lamentable conditions. Human Rights Watch documented the abuse in 2012, reporting that patients were routinely beaten, whipped, and electrocuted for violating centre rules. In some cases, beatings are administered for no discernible reason at all.

Those attempting to escape are treated especially harshly. There is evidence of patients being beaten unconscious, before being shackled outside in the sun for hours without access to food or water. They may subsequently spend months confined in solitary ‘punishment cells’, with little to no access to health care or basic amenities.

Reports of rape and the sexual abuse of women and children in Cambodian and Laotian CDDCs are not uncommon. Combined with a distinct lack of any effective HIV prevention measures, the result is an unacceptably high transference rate of infectious diseases, helping maintain high HIV and Hepatitis C rates among injecting drugs users in the region of up to 36% and 90% respectively. Although HIV testing is widespread throughout the centres, detainees are rarely informed of the results, and seldom provided with antiretroviral therapy (ART).

Not only are CDDCs guilty of an array of human rights abuses, they are also extremely ineffective conduits for reducing drug use. Relapse rates range from 70% in Thailand to more than 95% in Cambodia, due predominantly to the imposition of non-evidence based and experimental treatments, administered often by military or law-enforcement personnel lacking any formal medical training.

‘Treatment’ often constitutes the completion of military-style drills and the adherence to strict standards of discipline. Generally, a component of manual labour is included with inmates forced to work long hours for little or no wages in extremely harsh conditions. Work is often carried out on behalf of private companies, resulting in ethically tainted products as diverse as sportswear and cashew nuts entering the global supply chain, in direct violation of the ILO Convention 29, the International Covenant on Civil and Political Rights (ICCPR) and the Universal Declaration of Human Rights.

In response to the plethora of abuses, twelve United Nations entities released a joint statement in March 2012 demanding that all states, “close compulsory drug detention and rehabilitation centres and implement voluntary, evidence-informed and rights-based health and social services in the community”.

Yet despite this wholly unambiguous declaration, international donors including the United States, and even the United Nations, continue to provide funding and support to many centres, despite the risk of complicity in torture and other human rights abuses.

There are however promising signs of reform. The Global Fund reiterated the call to close CDDCs in November 2014, explicitly prohibiting funding to any programmes that enforce compulsory treatment. At the national level, Cambodia has committed to expand community-based treatment to 350 communes by 2016, while Vietnam aims to reduce the number of drug users detained in compulsory centres from 63% in 2013 to 6% by 2020. Malaysia has continued to move away from compulsory detention, and plans to convert 18 of 28 CDDCs into voluntary Cure and Care Centres by the end of the year.

Despite these notable positive steps, progress is glacial and hampered by significant impediments to reform. Significantly, states continue to favour punitive drug control methods, despite a widespread rhetorical acceptance of the utility of evidence-based policies. Even though harm reduction programmes are being increasingly piloted and developed throughout the region, they remain extremely limited, underfunded, and wholly inadequate.

Similarly, progress that has been carefully won can easily be lost again. Vietnam recently reversed a decision that prohibited the compulsory detention of drug users, unless they had relapsed following the completion of a voluntary community-based rehabilitation programme. Aimed at improving the country’s human rights record, it was deemed inefficient, and altered so that drug users could now once again be held against their will in ‘Transitional Centres’ until district courts decide whether or not to commit them to a CDDC.

Three years after the United Nations called for the immediate closure of CDDCs, the majority remain functioning and wholly unreformed. ASEAN members continue to pay lip service to reforms, while simultaneously dedicating the majority of their resources to pursuing the same failed abstinence-based drug policies.

Unless ASEAN and the wider international community prioritises the closure or conversion of compulsory centres to voluntary institutions, providing evidence-based harm reduction initiatives, infectious diseases will continue to spread, addicts will repeatedly relapse, and human rights will continue to be abused. A ‘drug free ASEAN’ is a chimera; it’s time to embrace a scientific, humane and pragmatic approach to drug control, free of stigma, ideology and moral judgements. Only then will Southeast Asia begin to ethically and effectively tackle the harms associated with the drug trade.

Image courtesy of riekhavoc

Nick Watts

About Nick Watts

Nick is a security analyst for a world-renowned risk management and crisis avoidance firm. He holds a BSc in Politics and an MSc in International Security with a focus on Asian geopolitics and human security. Follow him on Twitter: @NickWatts1988

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