Treatment, not torture

Photo by: PHOTO SUPPLIED
Women and children locked up in Koh Ker, a Ministry of Social Affairs-run rehabilitation center, last year

Written by Rebecca Schleifer
Friday, 26 June 2009

Across Asia, too many countries continue to use torture as a weapon in their war against drug abuse

Even in the UN's crowded calendar, June 26 is a big day. Many governments burn confiscated narcotics in bonfires to celebrate the "International Day Against Drug Abuse and Illicit Trafficking". Meanwhile, across town, members of nongovernmental groups might organise a candlelight vigil or a film screening to mark "International Day in Support of Victims of Torture".

It would be nice to think that there's time enough in the 24 hours of June 26 to fight both drug abuse and torture. Truth be told, many countries use torture, pure and simple, in their war against drugs. This claim isn't entirely a rhetorical flourish: In the "treatment and rehabilitation" centers of many countries, physical and mental abuses - which in some cases amount to torture - are inflicted on drug users in break-them-down, boot camp-style discipline, to which the difficulty of withdrawal itself pales in comparison.

International health and drug-control agencies - including the UN Office on Drugs and Crime, UNAIDS and the World Health Organisation - all endorse comprehensive, evidence-based drug dependence treatment services, including medication-assisted therapy (for example, with methadone or buprenorphine), both inside and outside prisons to protect the health and human rights of people who use drugs.

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Truth be told, many countries use torture, pure and simple, in their war against drugs.
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In many places, though, people who use drugs are forced into "treatment and rehabilitation" centres without any form of due process or trial, sometimes for months or even years. Often run by military or public security officers and staffed by people with no medical training, these centres rarely provide treatment based on scientific evidence. Depending on the country, "treatment" consists of a regime of military drills, forced labour, psychological and moral re-education, shackling, caning and beating. People who voluntarily seek treatment in such centers are exposed to these forms of punishment, as are people who are (legally or otherwise) sent there by their parents or relatives.

A number of Asian countries have such programs. In Singapore, according to a government report distributed in March, people who use drugs can be arbitrarily detained for extended periods of time and caned if they relapse - even though relapse is a common symptom of recovery. (The scenario is cruelly ironic, given that Singapore has also banned buprenorphine, one of the most effective treatments for opioid dependency, and is now jailing people for using it.)

In Malaysia, detainees in compulsory drug treatment centers report that treatment involves extended periods of military-style discipline and abuse. Detainees are made to crawl through animal excrement or to "act like a whale" by drinking and spitting out dirty water, and are caned. In Cambodia, juvenile detainees in a government-run "Youth Rehabilitation Center" have told of being shocked with electric batons.

In China, as many as 350,000 people are interned in mandatory drug-detoxification and "re-education through labour" centers, where they can be held without due process for up to three years. Treatment consists of unpaid, forced labour and psychological and moral re-education - marching in formation, repetitive drills and rote repetition of slogans (such as "drug use is bad, I am bad"). The UN special rapporteur on torture has stated that this system "can also be considered as a form of inhuman or degrading treatment or punishment, if not mental torture".

Such torture and cruel, inhuman or degrading treatment is not restricted to drug rehabilitation centers. As UN human rights monitors have observed, it is a fundamental part of many countries' "war against drugs". According to a recent study from Indonesia, which involved interviews with more than 1,000 drug users, 62 percent of participants reported physical abuse at the hands of the police. These incidents ranged from beatings by officers with hands, fists or boots, to cigarette burns to electric shock. Those interviewed said the abuse was usually to coerce confessions or to extort bribes. The UN special rapporteur on torture described as routine the torture and ill-treatment of people who use drugs by Indonesian police.

So which is it, a day against drug abuse or a day against torture? Governments should create national drug policies that ensure access to evidence-based drug treatment. At the same time, they should protect everyone - including drug users - from torture and cruel, inhuman and degrading treatment. It is difficult to see how people who use drugs can get evidence-based drug treatment if they face torture from military or public security forces in drug "treatment and rehabilitation" centers. Unless countries take positive measures to end the use of boot camp-style discipline in the name of the fight against drug abuse, the celebration of June 26 will continue to be two-faced.

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Rebecca Schleifer is advocacy director for the Health and Human Rights Division of Human Rights Watch.