Rehab as Punishment

Why Cambodians, Chinese, and Vietnamese shun treatment—if they can.

The term “drug rehab” usually means one of two things to Americans: Either a genuine, if not always effective, clinic for drug withdrawal, counseling, and follow-up; or else a touchy-feely form of group therapy and 12-step religiosity. What we don’t expect drug rehab to mean is beatings, forced labor, detention without appropriate treatment, or electric batons.

Start with China. A New York Times report by Andrew Jacobs documented the fate of as many as 500,000 Chinese citizens held at government-run drug rehabilitation centers. “Detentions are meted out by the police without trials, judges or appeals,” Jacobs wrote. “Created in 2008 as part of a reform effort to grapple with the country’s growing narcotics problem, the centers, lawyers and drug experts say, have become de facto penal colonies where inmates are sent to factories and farms, fed substandard food and denied basic medical care.”

It has been a long-standing tradition in China and Russia to send addicts to labor camps, along with political dissidents. Change has been promised in China, but thus far there is no evidence of the new community-based rehabilitation the government has proposed. “In China,” said one addict, “to be a drug addict is to be an enemy of the government.”

In Cambodia, according to a report in The Nation by Joseph Amon, the director of health and human rights for Human Rights Watch, police have rounded up men, women, and children in “street sweeps” and placed them in detention facilities without legal consultation. As in China, writes Amon, treatment in Cambodian rehab facilities “consists of military drills, hard labor and forced exercise. Detainees are forced to work and exercise to the point of collapse, even when they are sick and malnourished. These centers offer no medically appropriate treatment such as cognitive behavioral therapy, psycho-social support (counseling, for example) or opiate substitution therapy. As one former detainee explained, his centre was ‘not a rehab centre but a torture centre.’”

The government of Cambodia routinely denies the charges. As Amon argues, “Individuals who use drugs do not forfeit their human rights, and the Cambodian government should not create detention centers that are exempt from the protections afforded to all. “

In Vietnam, 600 addicts broke out of a state-run rehabilitation center in Haiphong and made a run for it. According to Foreign Policy magazine, they were fleeing a similar collection of “treatment” options such as beatings and years of illegal detention in the government’s 100 drug facilities. Along with Malaysia and Thailand, and Laos, Vietnam has opted for “get-tough” policies over evidence-based treatment. Even worse, the policies themselves resemble the practices inflicted on southern chain gangs in early 20th Century American prison farms.

The irony of the great Vietnamese rehab escape is that the patients may have much better luck on the outside. Amon of Human Rights Watch reports that Haiphong “is one of three [cities] in Vietnam that is piloting the use of methadone to manage opiate addiction, the preferred approach in most developed countries.”

Photo Credit: http://www.hrw.org/

Drug Addicts Punished in New York Prisons

Drug offenders get “the box” instead of treatment.

The common practice of placing drug addicts in “disciplinary segregation” for drug use violations in New York state prisons has drawn fire from Human Rights Watch. The international human rights group issued a report condemning the practice of placing addicts in “the box” and denying them treatment for their drug dependence, calling it “cruel, inhuman, and degrading treatment.”

In the report, entitled “Barred from Treatment: Punishment of Drug Users in New York State Prisons,” Human Rights Watch notes that even addicts who are allowed to seek treatment face major delays “because treatment programs are filled to capacity.” New York State Assemblyman Jeff Aubry, chair of the State Committee on Corrections, told the investigators: “Denying treatment to inmates who suffer from a drug dependency is illogical and counterproductive to the goal of rehabilitation.”

Some of the findings in the report are shocking: “Despite overwhelming evidence that medication-assisted therapy is the most effective treatment for opiate addiction, the majority of New York State prisoners dependent on heroin or other opiates have no access to methadone or buprenorphine.” Furthermore, the state’s Department of Correctional Services “has conducted few evaluations of its own treatment programs.” Prison officials have estimated that as many as eight out of ten inmates have substance abuse problems. A National Institute of Drug Abuse (NIDA) study earlier this year, covered in a previous post, estimated that only one-fifth of the nation’s inmates needing formal treatment are able to get it.

The report comes just as New York legislators have agreed to revamp the so-called Rockefeller drug laws, which are among the strictest in the nation. “Reforming the Rockefeller drug laws to prevent drug users from being sentenced to long prison sentences is critically important, said Megan McLemore, a researcher with Human Rights Watch. “But timely and effective programs must be available to serve the inmates still in prison.” McLemore said in a press release that “discipline should be proportionate to the offense, and should never prevent prisoners from getting the treatment they need.”

As a prisoner at Attica told Human Rights Watch, “Here is a notice telling me ‘it could be a long time’ until I get into treatment again. There’s plenty of room for me in the box, but not in a program.”

Photo Credit: ACS blog

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