China's Drug Treatment Slammed

China orders better care for detained drug users after a blistering report.

2010.01.06
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drug_305 Women drug addicts at a rehabilitation center in Kunming, 1999 file photo.
AFP

WASHINGTON—Chinese authorities have ordered better care for detained drug users after a damning report by a leading human rights organization accused government-run facilities of using them for forced labor and denying them appropriate medical care.

State-run Xinhua news agency on Wednesday announced Beijing's order that detention houses, prisons, drug rehabilitation centers, and hospitals should improve medical care for detainees and convicts.

Detention facility staff should have "in-house nurses and doctors, and practitioner pharmacists if possible," it said.

Detention facilities with insufficient in-house doctors should seek assistance from hospitals, it said, and they will be required to establish medical profiles for those in custody and must hold consultations on major medical cases.

Joseph Amon, health and human rights director at New York-based Human Rights Watch, said that while the announcement shows Beijing is aware of issues facing detained drug users in China, the country's system of drug abuse treatment requires an overhaul.

Human Rights Watch reported Wednesday that even in Yunnan province, hailed for rapidly scaling up methadone and needle-exchange treatment programs, drug detention centers are operating outside of judicial restraints.

The report, titled "Where Darkness Knows No Limits," accused the centers of using detainees for forced labor and subjecting them to mandatory HIV screening without disclosing test results or providing any health care or drug dependency treatment.

"With a minimum sentence of two years, incarceration in a drug detention center goes far beyond the period of what is necessary for physical detoxification and serves as punishment only," the report said.

"Mandatory drug detention centers effectively serve as incubators for infectious diseases, actively contribute to the poor health of detainees, and violate both Chinese and international law."

Following a new drug law in June 2008, promoted as a major reform to treat drug users as "patients, not criminals," conditions at drug detention centers have worsened, it said.

'Flawed' model

"While it's very good to see this announcement and emphasis being put on improvement of access to healthcare in detention centers, the problem with drug detention centers is that they are intended [for] treatment [but] they are being run by Public Security forces and the basic model is flawed," Amon said.

"We're not looking to improve conditions within drug detention centers—we're looking to shut them down because what's effective at treating drug dependency is voluntary, community-based, out-patient treatment," he said.

The new directive left several issues unaddressed, including the detention terms handed down to drug users in China—notably southwestern Yunnan province, where many people fall prey to heroin from Thailand, Laos, and Burma, he said.

That area comprises the notoriously lawless Golden Triangle, where Southeast Asia's drug trade flourishes.

"Even if healthcare is improved within drug detention centers, people are being sentenced for two, three—up to seven—years. You don't need to treat drug dependency for three years and you don't treat it with forced labor and physical abuse, whether or not there is better access to healthcare," Amon said.

Some 1.16 million people are registered drug users in China, the report said, adding that recent estimates suggest there are as many as 5 million illicit drug users in the country, of whom nearly 9 in 10 are believed to inject heroin.

Amon said that the country's existing drug laws are not well-defined and allow for a broad interpretation at the local level.

"A lot more needs to be done to set out a clear directive of interpreting and explaining the law so that abuses aren't continuing to take place," Amon said in an interview.

No enforcement

One article in the existing law says staff in drug detention centers cannot inflict corporal punishment, maltreatment, or humiliation on individuals receiving treatment for drug addiction, he said.

And yet no mechanisms exist to ensure the law is implemented.

"There is no oversight of drug detention centers, there are no opportunities for individuals to file an appeal or a complaint for their treatment—and so what needs to happen…is both stronger interpretation of the law and also a putting in place of a mechanism and a framework for accountability," Amon said.

"The forced labor definitely means that these centers can be very profitable. Building these centers—like building prisons everywhere—it follows that you want to fill them up. There's a momentum and an incentive to detaining drug users once you've created these centers."

Amon said that even with an increased access to medical care within the drug detention centers, rehabilitation rates would likely remain low.

"In China, where those voluntary treatment facilities are nonexistent, people who want to get off drugs have very, very few choices. No one is going to sign up for three years of forced labor and detention as a strategy for reducing their drug use."

Original reporting by Joshua Lipes. Edited by Sarah Jackson-Han.

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