Forced Rehab More Likely to Lead to Relapse Among Southeast Asia's Opioid Users

By Keri Blakinger 12/13/16

Around 600,000 people are detained every year in compulsory drug treatment centers across the region.

Forced Rehab More Likely to Lead to Relapse Among Southeast Asia's Opioid Users

Compulsory drug treatment doesn’t work as well as voluntary alternatives, according to a new study.

State-mandated substance abuse treatment and detention facilities have proliferated in Southeast Asia, but research published this month in the Lancet Global Health shows that those controversial compulsory centers have a higher relapse rate than their voluntary counterparts, according to Science Daily.

“Our findings strongly support international calls to eliminate compulsory drug detention centers by showing that they are ineffective in treating drug dependence, especially for those who use opioids,” said one of the study’s authors, Professor Frederick Altice of the Yale University School of Medicine.

The new study relied on drug tests and repeated interviews with just under 200 patients – about half of whom went to compulsory centers and half of whom finished treatment at a voluntary facility offering methadone.

A month after their release, nearly half of the mandated patients had relapsed, while only 10% of the voluntary center graduates had fallen back into drug use. On average, those who finished at compulsory centers relapsed within 31 days, while half of those who went to a voluntary center made it an average of 352 days before returning to opioid use.

“In recent years, compulsory drug detention centers in Malaysia and across Asia have come under scrutiny and question over their lack of effectiveness in treating addiction and their human rights transgressions,” said another of the study’s authors, Professor Adeeba Kamarulzaman of the University of Malaysia.

“This study is the first to show the stark difference in the rate of relapse amongst people detained in these centers compared to those who received methadone – an evidence-based treatment. Not only does this study have major drug policy implications for Malaysia, but for much of Asia where compulsory drug detention centers and the number of people detained in them are expanding.”

The study did not distinguish between the different types of treatment available at each center, but researchers suggested that the use of methadone may have impacted the relapse rate.

Around 600,000 people are detained every year in compulsory drug treatment centers across Southeast Asia, despite troubling reports of human rights abuses and a lack of due process. The centers have no legal oversight and may accelerate risks of overdose and disease. In 2012, the United Nations called for the closure of the controversial centers.

This isn’t the first time scientists have questioned the efficacy of that sort of brutal, mandated drug treatment. In early 2016, research by the International Centre for Science in Drug Policy found that compulsory treatment doesn’t reduce post-treatment drug use, arrests, or incarceration, as The Fix reported in February. Published in the International Journal of Drug Policy, the study examined existing literature and found that the practice could be detrimental.

“Evidence does not, on the whole, suggest improved outcomes related to compulsory treatment approaches, with some studies suggesting potential harms,” the researchers concluded.

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Keri Blakinger is a former drug user and current reporter living in Texas. She covers breaking news for the Houston Chronicle and previously worked for the New York Daily News and the Ithaca Times. She has written about drugs and criminal justice for the Washington Post, Salon, Quartz and more. She loves dogs and is not impressed by rodeo food. Find Keri on LinkedIn and Twitter.