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Rehabilitation 'boot camps' take aim at rising meth use

Rehabilitation 'boot camps' take aim at rising meth use

Patients participate in daily exercises at a DARAC drug rehabilitation centre in Phnom Penh.

A new brand of middle-class meth users are winding up in private detox clinics, described by some as effective and by others as inherently abusive of patients.

Video By Rick Valenzuela

DURING the three years that he used methamphetamine, Khem Samnang grew to hate his parents and others around him who criticised the changes in his demeanor. They said drug use had transformed him from a likeable boy to one who was increasingly sullen, dishonest and isolated.

Shortly after he first began using the drug, he turned to selling presents that had been given to him by his parents - a watch, other pieces of jewellery, a motorbike - to fund his habit. He said he spent about US$5,000.

"I wanted to know how the drug tasted. That's why I agreed with my friends to use it," said Khem Samnang, now 19, in a recent interview.

Like a growing number of young people trying to find their place among Cambodia's new urban elite, Khem Samnang developed an addiction to meth, officially labelled Cambodia's "most used" drug by the UN Office on Drugs and Crime in June.

For the past month, he has been residing in the Drug Addict Relief Association of Cambodia (DARAC), one of Cambodia's private,
boot-camp-style rehabilitation centres, where he was taken by his parents so he could break his habit. Living in a compound with 29 other addicts, he now adheres to a rigorous schedule of exercise and study designed to take his mind off drugs.

"They have to stay in the centre for three months and are not allowed to go outside," said Meas Sovann, the director of the centre. "I am afraid that their friends will come and meet them and ask them to use drugs again."

Rehab centres like DARAC, which is located in Phnom Penh Thmey district and treats mostly meth users, began to sprout up around Cambodia in 2004, when the use of meth tablets and crystal meth began to increase as the drugs were transported with greater frequency via the Mekong River.

The centres, many of which strive to marry traditional counseling with military-style discipline, have been criticised by rights groups and other civil society actors for their treatment methods.

"None of these existing centres come up to even the minimal requirements of treatment or rehab," said Graham Shaw, a technical officer with the World Health Organisation (WHO).

"We have no idea what the relapse rate is, and so no idea about whether the centre is working."

None of these existing centres come up to even the minimal requirements of treatment or rehab.

Meth drug of choice
According to the 2009 annual report from the UN Office on Drugs and Crime, 1,719 drug users were admitted to government-operated centres in 2007, marking a 58-percent increase over 2006. The report, which did not include 2008 data, stated that most of those admitted had been using meth.

Shaw expressed concern that those becoming more prone to addiction are part of a new group of middle-class users, about which little is known.
"Barely any research has been done on this group. We're not sure what their risk factors are, or to what extent they are moving from smoking to injecting, which poses an HIV risk," he said.

The UN report did not include the total number of rehabilitation centres, though the National Authority for Combating Drugs recently reported that there were 14 in the Kingdom.

Since its founding in 2005, DARAC has treated nearly 1,000 people, Meas Sovann said. He added that patients also receive language and computer lessons and can learn other skills such as "motor repairs and make-up".

DARAC charges a $100 fee from its patients, though Meas Sovann said many don't pay anything because they are unable to.

"Some parents give me $100 for taking care of their child, and some do not give me anything, but I get some donations from the government and other people to support them," he said.

Involuntary detention
Though centre directors and some former patients said in recent interviews that the centres get results, they also acknowledged that patients are in many cases involuntarily detained.

Hang Choeun, president of the Drug Addict Relief Treatment-Education-Training Association (DTA), also located in Phnom Penh Thmey district, said this was the case for many of the 55 addicts currently staying there.

"People who stay here were arrested or forced by my centre or by their parents," said Hang Choeun, who also works as a police officer.

Shaw said the issue of involuntary detention was particularly important because the number of meth users is likely to rise in the near future.

"As the global economic downturn affects more and more families and the stress of daily life increases, young people will turn to different escape mechanisms to feel good and energetic," he said, adding that arbitrary imprisonment had led to many of the centres becoming "dumping grounds for undesirable people".

But Chea Chanserey Buth, 17, a drug addict staying at DTA, said he did not feel like a prisoner.

"It does not feel like a jail even though I have to stay in a room with many people. We are not prisoners," he said.

Like Khem Samnang, Chea Chanserey Buth was sent to the centre by his parents after he started to sell gifts they gave him - including a necklace and watch - to buy crystal meth.

"I spent the money that my parents gave me for studying and sometimes sold things they bought me," he said. "I spent more than $1,000 in the two months I used the drug."

Government responses
Phnom Penh Municipal Police Chief Touch Naruth said Thursday that municipal police were under orders to take drug users found on the streets or elsewhere to government-operated rehabilitation centres.

"We always get criticised or accused by NGOs of child rights violations, but actually we just want to take them and train them to become good people," he said.

Prime Minister Hun Sen last month was praised for a speech in which he referred to drug users as victims, suggesting a more progressive government stance towards addiction. He also announced plans for a new rehabilitation centre in Kampong Speu province.

Shaw said he believed the centre's success would depend on whether it could get away from the current boot-camp model and become more "community-based" by adopting a "health response rather than a law-enforcement approach".

Speaking generally of the Kingdom's drug rehabilitation centres, he said, "We still have a long way to go."