Facilitating a transition from compulsory detention of people who use drugs towards voluntary community-based drug dependence treatment and support services in Asia

Harm Reduction Journal

Anand Chabungbam¹  Gloria Lai⁵  Gino Vumbaca²  Robert Ali⁹  Nicholas Thomson⁸  Alex Wodak³  Apinun Aramrattana⁴  Adeeba Kamarulzaman⁶  Pascal Tanguay⁷ 

[1] Asian Network of People who Use Drugs, Bangkok, Thailand;Australian National Council on Drugs (ANCD), Canberra, Australia;Alcohol and Drug Service, St Vincent’s Hospital, Sydney, Australia;Department of Family Medicine, Chiang Mai University, Chiang Mai, Thailand;International Drug Policy Consortium, Bangkok, Thailand;University of Malaya, Kuala Lumpur, Malaysia;Ozone Foundation, Bangkok, Thailand;John Hopkins Bloomberg School of Public Health, Baltimore, United States;Australian National Advisory Council on Alcohol & Drugs (ANACAD), Adelaide, Australia

关键词: People who use drugs;    Resource mobilization;    Principles;    Health systems;    Drug policy reform;    Planning;    Community-based treatment;    Compulsory treatment;    Drug dependence;   

Others  :  1230042
DOI  :  10.1186/s12954-015-0071-0

 received in 2015-05-27, accepted in 2015-09-15,  发布年份 2015

【 摘 要 】

Evidence indicates that detention of people who use drugs in compulsory centers in the name of treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based drug dependence treatment and support services.

In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, drug policy reform to eliminate barriers to community-based drug dependence treatment and support services, and the integration of community-based drug dependence treatment in existing national health and social service systems.

In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results.

The need to accelerate national-level transitions to voluntary community-based drug dependence treatment and support services is compelling—on economic, medical, sustainable community development, and ethical grounds—as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based drug dependence treatment and support services across the region, as well as the steady scale-down of compulsory centers for drug users.

Components of voluntary community-based drug dependence treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use drugs in Asia.

【 授权许可】

   
2015 Tanguay et al.

【 参考文献 】

• [1]Baldwin S, Thomson N, Dorabjee J, Kumar S. Compulsory detention of people who use drugs in Asia—looking for alternatives. 2012
• [2]Between 2010 and 2015, UNODC has collected data from national governments in regards to CCDU, including the number of people detained in such institutions. Responses to the self-administered questionnaires were submitted voluntarily and no data triangulation or validation process was applied.
• [3]World Health Organization. Assessment of compulsory treatment of people who use drugs in Cambodia, China, Malaysia and Viet Nam: an application of selected human rights principles 2015. www. wpro.who.int/publications/docs/FINALforWeb_Mar17_Compulsory_Treatment.pdf webcite
• [4]Hayashi K, Milloy M-J, Fairbairn N, Kaplan K, Suwannawong P, Lai C, Wood E, Kerr T. Incarceration experiences among a community-recruited sample of injection drug users in Bangkok, Thailand. BMC Public Health. 2009; 9:492. BioMed Central Full Text
• [5]Chen HT, Tuner N, Chen CJ, Lin HY, Liang S, Wang S. Correlations between compulsory drug abstinence treatments and HIV risk behaviors among injection drug users in a border city of South China. AIDS Educ Prev. 2013; 25(4):336-48.
• [6]Amon JJ, Pearshouse R, Cohen JE, Schlieffer R. Compulsory drug detention centres in China, Cambodia, Vietnam, and Laos: health and human rights abuses. Health Hum Rights. 2013; 15:2.
• [7]Pearshouse R. Compulsory drug treatment in Thailand: observations on the Narcotic Addict Rehabilitation Act B.E. 2545 (2002) 2009. www. aidslaw.ca/site/compulsory-drug-treatment-in-thailand-observations-on-the-narcotic-addict-rehabilitation-act-b-e-2545-2002 webcite
• [8]Davis SLM, Triwahyuono A, Alexander R. Survey of abuses against injecting drug users in Indonesia. Harm Reduction J. 2009; 6:28. BioMed Central Full Text
• [9]Human Rights Watch. An unbreakable cycle drug dependency treatment, mandatory confinement, and HIV/AIDS in China’s Guangxi Province. 2008. http://www. hrw.org/sites/default/files/reports/china1208web.pdf webcite
• [10]Human Rights Watch. The rehab archipelago forced labor and other abuses in drug detention centres in Southern Vietnam. 2011. www. hrw.org/report/2011/09/07/rehab-archipelago/forced-labor-and-other-abuses-drug-detention-centers-southern webcite
• [11]Human Rights Watch. “Skin on the cable”—the illegal arrest, arbitrary detention and torture of people who use drugs in Cambodia. 2010. www. hrw.org/sites/default/files/reports/cambodia0110webwcover.pdf webcite
• [12]Human Rights Watch. Public insecurity: deaths in custody and police brutality in Vietnam. 2014. www. hrw.org/report/2014/09/16/public-insecurity/deaths-custody-and-police-brutality-vietnam webcite
• [13]Open Society Institute. At what cost? HIV and human rights consequences of the global “War on Drugs”. 2009. www. opensocietyfoundations.org/reports/what-cost-hiv-and-human-rights-consequences-global-war-drugs webcite
• [14]Open Society Institute. Detention as treatment: detention of methamphetamine users in Cambodia, Laos, and Thailand. 2010. www. jhsph.edu/research/centers-and-institutes/center-for-public-health-and-human-rights/_pdf/Thomson_OSI_DetentionAsTreatment_2010.pdf webcite
• [15]PSI Thailand. Rapid PEER study to strengthen the injecting drug users quality of life programme. 2011. www. scribd.com/doc/265730746/Rapid-PEER-study-to-strengthen-the-injecting-drug-users-quality-of-life-programme webcite
• [16]Amon JJ, Pearshouse R, Cohen JE, Schlieffer R. Compulsory drug detention in East and Southeast Asia: evolving government, UN and donor responses. Int J Drug Policy. 2014; 25:13-20.
• [17]Asian Network of People who Use Drugs. Position paper: compulsory detention of people who use drugs. 2013. http://anpud. org/anpud-position-paper-compulsory-detention-people-use-drugs webcite
• [18]Pearshouse R. Compulsory drug treatment in Thailand: observations on the Narcotic Addict Rehabilitation Act B.E. 2545 (2002) 2009. www. aidslaw.ca/site/compulsory-drug-treatment-in-thailand-observations-on-the-narcotic-addict-rehabilitation-act-b-e-2545-2002 webcite
• [19]Csete J, Kaplan K, Hayashi K, Fairbairn N, Suwannawong P, Zhang R, Wood E, Kerr T. Compulsory drug detention centre experiences among a community-based sample of injection drug users in Bangkok, Thailand. BMC Int Health Human Rights. 2001; 11:12.
• [20]Open Society Foundations. Human rights abuses in the name of drug treatment: reports from the field. 2009. www. opensocietyfoundations.org/publications/human-rights-abuses-name-drug-treatment-reports-field webcite
• [21]United Nations Office on Drugs and Crime. World drug report. 2014. www. unodc.org/documents/wdr2014/World_Drug_Report_2014_web.pdf webcite
• [22]Cook C, Bridge J, Susie McLean S, Phelan M, Barrett D. The funding crisis for harm reduction: donor retreat, government neglect and the way forward. 2014. www. ihra.net/files/2014/09/22/Funding_report_2014.pdf webcite
• [23]Chua-nam S, Jantip S, Yasuwan S, Aramrattana A. Community-owned comprehensive program for methamphetamine users in Northern Thailand. Abstract Presented at the 15th ISAM Annual Meeting, Kuala Lumpur, Malaysia, 21–23 November 2013.
• [24]Anthony JC. Epidemiology of drug dependence. In: Davis KL, Charney D. Coyle JT, Philadelphia NC, editors. Neuropsychopharmacology, The Fifth Generation of Progress, Philadelphia; 2002: p.1557-1574.
• [25]Tiezzi S. China's Growing Drug Problem. The Diplomat. 28 May 2015. http://thediplomat. com/2015/05/chinas-growing-drug-problem webcite
• [26]Soeriaatmadja W. Indonesia faces growing drug problem. The Straits Times. 22-02-2015. www. asianewsnet.net/Indonesia-faces-growing-drug-problem-71966.html webcite
• [27]Kentung, Mongla. Getting higher. The Economist. 12 April 2014. www. economist.com/news/asia/21600748-opium-growing-rise-again-drug-consumption-getting-higher webcite
• [28]Teehan S. Ecstasy use rising: UN. The Phnom Penh Post. 6 July 2015. www. phnompenhpost.com/national/ecstasy-use-rising-un webcite
• [29]Wright L. Asia’s meth habit: synthetic drug trade has 'exploded'. DW. 20 August 2014. http://www. dw.com/en/asias-meth-habit-synthetic-drug-trade-has-exploded/a-17868210 webcite
• [30]Reid G, Sharma M, Higgs P. The long winding road of opioid substitution therapy implementation in South-East Asia: challenges to scale up. Journal of Public Health Research. 2014 3:204. doi:. . www. [10.4081/jphr.2014.204] webciteresearchgate.net/publication/265213252_The_Long_Winding_Road_of_Opioid_Substitution_Therapy_Implementation_in_South-East_Asia_Challenges_to_Scale_Up webcite
• [31]WHO. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. 2014.
• [32]UNAIDS. The GAP Report. 2014.
• [33]Ghani MA, Brown S-E, Khan F, Wickersham JA, Lim SH, Dhaliwal SK, Kamarulzaman A, Altice FL. An exploratory qualitative assessment of self-reported treatment outcomes and satisfaction among patients accessing an innovative voluntary drug treatment centre in Malaysia. Int J Drug Policy. 2015; 26(2):175-82.
• [34]Tanguay P, Aramrattana A, Wodak A, Kamarulzaman A, Ali R, Thomson N, Lai G, Chabungbam A, Vumbaca G. In press. Discussion paper: Transition from compulsory centers for drug users to voluntary community-based treatment and services. 2015.
• [35]UNODC. Supporting access for drug users to health and social care in Cambodia—case studies of community-based services in Banteay Meanchey, Battambang and Stung Treng provinces. 2015.
• [36]Kamarulzaman A. Transformation from Compulsory Drug Detention Centers to Ambulatory Care Programs, Presentation delivered on 11 February 2015 at the Informal Partner Consultation on the Compulsory Centers for Drug Users in East and Southeast Asia in Bangkok, Thailand.