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Last month, drug users staged two major breakouts from rehabilitation centers in southern Vietnam that occurred less than a week apart.
On the morning of November 6, a group 166 addicts pelted guards with rocks before smashing a brick wall and escaping from a drug detention center in Dong Nai Province.
Four days later, 200 inmates broke through the walls of another center in Ba Ria - Vung Tau Province.
“There’s no single reason to explain these escapes; they should be considered case by case,” said Nguyen To Nhu, deputy country director of FHI360, an NGO that works on drug addiction and HIV prevention.
A VnExpress investigation found that Vietnam's transition toward harm-reduction programs has hit a snag on old ideas and methodologies, creating a crowded, poorly-monitored population of detainees.
Authorities continue to remand drug users to two-year stints in compulsory drug detention centers, where they face a program of detoxification and labor that has drawn international criticism for years. In 2012, United Nations organizations issued a joint-statement calling for the closure of drug detention centers on the grounds they “raise human rights issues.”
Vietnam developed its approach to addiction based on the presumption that it represents a "social evil" that can be cured with abstinence and re-education.
The international community agrees that’s simply not the case.
“Addiction cannot be treated by force,” Nhu told VnExpress International. “It’s a disease that requires lifetime treatment so the patient’s cooperation is key.”
The government of Vietnam agreed and in 2013 established a timeframe to gradually replace compulsory detention centers with community-based, voluntary treatment regimens.
The transition, however, has proven tricky. Inconsistencies in how the legal system treats drug addicts and the widely-held belief that drug addiction stems from moral failure persist. The country also lacks competent doctors, therapists and equipment to carry out its ambitious new laws on treatment.
“The system just can’t keep up with the policy changes,” Nhu said.
Doomed to relapse
Current legislation recognizes drug addiction as a disease that manifests itself in chronic relapses. As such, medical professionals and organizations have campaigned, for years, to close compulsory drug detention facilities -- otherwise known as 06 Centers.
“Addiction requires long-term community-based treatment,” Nhu said. “A proven method for heroin users involves methadone, a replacement drug, just like insulin for diabetes.”
The data confirms as much.
Studies conducted by the Vietnamese government indicate that up to 95 percent of addicts discharged from compulsory drug detention centers relapse within two years. Meanwhile, a study published in the Harm Reduction Journal of drug users enrolled in a methadone maintenance treatment program in Vietnam found only 20 percent tested positive for illicit drugs after two years.
The job of managing these centers primarily falls to the Ministry of Labor, Invalids and Social Affairs (MOLISA).
On November 10, MOLISA’s Deputy Minister Nguyen Trong Dam admitted that most drug users don't want to go to compulsory detention centers and agreed that the state should do a better job of classifying addicts.
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Drug addicts that led the breakout at the Dong Nai center were quarantined from the general population. Photo by VnExpress/Phuoc Tuan |
Nhu argues that compulsory detention centers should only be a last resort for drug addicts who have committed a crime so they can serve their prison sentences while receiving necessary treatment. Serious cases characterized by psychosis should be referred to mental hospitals.
But drug addiction is still considered an administrative violation under the law, which means homeless addicts, repeat drug offenders and those who drop out of community-based treatment programs can be remanded to two years of compulsory drug detoxification and labor at an 06 Center by local authorities.
District courts have the final say on who ends up in detention following a consultation from a physician.
Housing homeless drug addicts awaiting doctors appointments and court hearings is a problem in itself. Cong An Nghe An newspaper reported that such candidates end up in social centers that sometimes aren’t equipped to care for addicts suffering from withdrawal.
Last year, a MOLISA report found local authorities could not comply with intake procedures drafted by the Ministry of Health.
The procedures required qualified doctors to interview potential detainees and determine whether or not they met three out of six criteria for addiction.
“Most patients are not cooperative; they can’t describe their addiction level,” the report found.
Local newspapers put it more bluntly: there aren’t enough doctors to actually diagnose the country’s addicts.
>> Part 2: Doctors remain rare in Vietnam's drug detention centers
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> Over 500 drug addicts escape from rehabilitation center in southern Vietnam
