An article to be published in medical journal the Lancet next month concludes that compulsory drug detention centres, such as those used by the Cambodian government, don’t work and recommends for their closure.
The study, made available online this week, compares relapse rates for users of opioid substances (ie, heroin) at voluntary treatment centres and compulsory treatment centres in Malaysia, where, much like Cambodia, they exist in tandem.
It found that users going through voluntary treatment were at seven times less “risk of relapse to opioids and any-illicit-drug after release” compared to those in compulsory treatment.
What’s more, the study finds that those who do relapse do so much sooner if they came from compulsory treatment, with a median relapse time of 33 days versus 355 days.
The study also concludes that compulsory centres “are ineffective in preventing relapse to use of amphetamine-type substances, and should be closed even in regions where amphetamine use disorders are common”.
Methamphetamine use constitutes some 85 per cent of all drug use in the Kingdom, according to the National Authority for Combating Drugs.
For observers in Cambodia, these findings come as no surprise. “Cambodia should also learn the bitter story [of the] war on drug[s] in Thailand, and [that] they admitted it failed,” Sou Sochenda, a policy specialist for the NGO KHANA, wrote via email yesterday, adding that Cambodia should look to alternative models.
“We request the government consider[s] to invest in community based treatment which is cheaper than building new rehab centres and compulsory treatment which is proved [to be] ineffective and costly.”
Civil society consultant David Harding, who has spent years working with drug addicts in Cambodia, yesterday said that compulsory centres “have no place in the prevention of relapse of any form of substance addiction or dependence . . . They should be closed.”
The Health Ministry is implementing a strategy that revolves around community-based treatment through health centres, having equipped some 100 locations so far, according to Chhum Vannarith, undersecretary of state at the ministry who is the focal point for their treatment policy. Vannarith said these have proved highly effective compared to compulsory centres. Nonetheless, “the new strategy of the government is to use both ways”.
Meas Vyrith, of the National Authority for Combating Drugs, said the government plans to phase out compulsory centres (of which there are seven government-run and 10 privately run) but only once new voluntary drug centres are built. No such state-run voluntary centres currently exist.
ADDITIONAL REPORTING BY VANDY MUONG