By Patrick Tibke Sep 15, 2014 11:21AM UTC
Authorities round up ‘addicts’ and place them in compulsory treatment centres
Last week, in the early hours of Tuesday morning, a joint task force of 250 army and police personnel descended on 18 neighbourhoods throughout Bangkok, as part of a door-to-door operation designed to round up the Thai capital’s drug users.
At 5am uniformed officers armed with M-16 rifles and urine testing kits blitzed residential areas, identifying potential ‘suspects’ purely on the basis of their age and appearance. Those unfortunate enough to be selected were goaded by police to confess to using recreational drugs, or else face a mandatory, on-the-spot pee test.
“Hundreds” of startled Thais were then made to decant their urine into little plastic capsules provided by the police: If the test was negative, then the urine would stay its natural colour and the ‘suspect’ would go free. But if the test was positive, then the urine would turn a dreaded purple, and the ‘suspect’ would be detained at a nearby police station.
By the end of the two-hour operation, 83 “drug addicts” and 22 “small-time dealers” had been arrested, according to a statement made by Police Major General Itipon Piriyapinyo. Itipon did not reveal the total number of people summoned for testing, but he lauded the search and arrest tactic as an efficient, humane and exemplary way of tackling Bangkok’s drug problem.
Speaking to the press later that day, Itipon described the operation as a “targeted” raid focussed on “places where there are teenagers gathering;” places where one might find “people suspected of taking drugs.” As quoted by Thai Rath, Itipon explained that the apprehended users will be dispatched separately to compulsory treatment centres in Central Thailand, where they are expected to spend at least one month in detention “reforming their minds and bodies,” after which they may “return to society as good people.” This, he believes, is both a medical and a humanitarian intervention from which all Thais can benefit. “If they don’t go to rehab,” he said of Tuesday’s detainees, “[then] they might be sent to court… but if they go voluntarily, they will be considered as patients.”
Itipon also revealed that Tuesday’s raid was merely a “test mission” for a wider anti-drugs crackdown, endorsed by the ruling junta, which will aim to put at least 900 Bangkok “drug addicts” into compulsory treatment centres. All this, presumably, in service of General Prayuth’s relentless efforts to restore “moral soundness” and “return happiness to Thai people.”
“Treated as patients, not criminals”
Last week’s raid, and Itipon’s subsequent comments, are symptomatic of the limbo stage in Thailand’s drug war, in which drug abuse is widely accepted to be a medical problem -rather than a criminal one -yet the persecution and stigmatisation of drug users continues unabated. In recent years Thailand has diverted hundreds of thousands of drug users away from criminal penitentiaries and into compulsory treatment centres, yet the growing perception of drug users as “patients” remains fundamentally at odds with existing laws that continue to criminalise drug consumption or possessing drugs for personal use.
Since 2002, when Thai lawmakers passed the Narcotics Rehabilitation Act, compulsory rehabilitation of all drug users has been a central aim of Thailand’s drug policy. Based on the principle that drug users should be “treated as patients, not criminals,” the Act established a new legal framework through which low-level drug offences could be spared prosecution in favour of rehab. In theory, this of course sounds rather progressive. But in practice, however, the Act has enabled drug users to be abused on two fronts: Firstly by law enforcement – who continue to harass and persecute; and secondly by the treatment centres – where drug users are effectively detained without criminal conviction, and denied professional medical care.
One of the greatest pitfalls of the Act itself, is that it makes no attempt to differentiate between varying degrees of drug use, (occasional, non-problematic, dependent etc.), meaning that every single drug offender unlucky enough to be brought before court – from a once-monthly cannabis smoker to a daily heroin injector – is liable to receive a compulsory treatment order. Inevitably, a great number of non-dependent drug users get needlessly caught up in the system, being forced to partake in pointless therapy at the taxpayers’ expense.
Neither the wording nor the implementation of the Narcotics Rehabilitation Act admits the possibility that a drug user might not be dependent, and might not – therefore – be in urgent need of rehabilitation. This is a convenient default position for anti-drugs crusaders like Itipon, who needn’t hesitate before summarily labelling 83 people as “drug addicts,” purely on the basis of a purple pee test. (A purple pee test – if anyone cares – does not even establish which illicit substance the ‘suspect’ has taken, to say nothing of dosage, frequency of use, or associated risk behaviours, etc.)
The reflexive pronouncement of all apprehended drug users as “addicts” clearly undermines concurrent efforts to treat drug users as “patients.” For medical professionals, international best practice dictates that one or more validated measures of drug dependence – such as the WHO Addiction Severity Index – should be applied to each individual patient before a diagnosis can be made. Addiction therapy, if required, should then be conducted in a way that is flexible and tailor-made to suit the needs of the individual, causing the least possible harm and suffering during treatment. For dependent opiate users, for example, this would include methadone maintenance therapy to alleviate painful withdrawal symptoms, en route to a total cessation of opiate use.
In contrast to international best practice, Thailand’s current anti-drugs regime allows for urine tests and law enforcement figures to do much of the diagnostic work, whilst a blanket form of ‘rehabilitation’ is performed at treatment centres en masse, with no regard to an individual patient’s needs. Worse still, centres are often run by religious organisations, charities or the armed forces – rather than qualified medical professionals – and genuinely dependent drug users are denied medication to counteract withdrawal symptoms. Most rehabilitation programs consist of daily group therapy exercises and military-style, boot camp activities, in which vulnerable “patients” are made to endure a rigorous physical exercise regime. Many detainees also report physical and sexual abuse at the hands of their treatment leaders, such as corporal punishment for breaking centre rules, or public shaming for resisting therapy.
Around 150,000 drug users are currently being ‘treated’ in Thailand’s compulsory rehab centres, yet despite the enormous scale of the project, its efficacy remains impossible to quantify. And this is largely due to the continued criminalisation of drug use. Successful patients who “return to society as good people,” to borrow Itipon’s phrasing, are expected to attend follow-up urine tests to prove their abstinence, but many former detainees disappear upon their release. Somewhat predictably, perhaps, those who continue to use drugs after their ‘rehabilitation’ program simply don’t bother to turn up to their scheduled pee test appointments, or, alternatively, they work around the pee tests so as to avoid getting caught twice.
It is little wonder, then, that the United Nations has called for an immediate end to the use of compulsory treatment centres, and a shift towards voluntary addiction therapy. I quote here form the Joint Statement of 2012, endorsed by the UN Office on Drugs and Crime among others:
United Nations entities call on States to close compulsory drug detention centres and implement voluntary, evidence-informed and rights-based health and social services in the community… The deprivation of liberty without due process is an unacceptable violation of internationally recognised human rights standards. Furthermore, detention in these centres has been reported to involve physical and sexual violence, forced labour, sub-standard conditions, denial of health care, and other measures that violate human rights.
Ironically, under the rubric of the seemingly progressive Narcotics Rehabilitation Act, Thailand’s drug users are neither guaranteed the same rights as patients, nor subject to the same due process as criminals. They remain, precariously as ever, trapped in limbo somewhere in between.
Thai police continue to hunt down and apprehend drug users on criminal charges, only to have those charges summarily waived as soon as the offender comes face-to-face with a prosecutor. Then, having been spared the trauma of a criminal imprisonment, the offender is finally handed over to a treatment centre run by people with no expertise in medical care – “as patients, not criminals.”
The absurdity of this arrangement should elude no one.
If Thailand’s drug users are indeed patients, not criminals, then why not simply decriminalise all drugs and allow dependents to seek treatment on their own terms? It’s the next logical step…
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