Instead Provide Medically Appropriate, Voluntary Treatment Options for People Who Use Drugs
(New York) - The Cambodian government should immediately halt the forced participation of drug users in the trial of an experimental herbal formula to "cure" their drug dependence, Human Rights Watch said today.
Since December 11, 2009, police have arrested at least 17 people and detained them in the government-run Orgkas Khnom drug detention center on the outskirts of Phnom Penh. With no indication of voluntary consent, they were administered a seven-day course of an herbal formula called "Bong Sen." Such a trial violates the rights of the forced participants and does not meet minimum scientific standards, Human Rights Watch said.
"The perverse experiment at Orgkas Khnom was only made possible by arbitrary detention and compelled participation," said Rebecca Schleifer, the health and human rights advocacy director at Human Rights Watch. "Any supposed ‘results' would be scientifically unreliable, and the whole thing is ethically outrageous."
People forced to participate in the trial did so after being arrested by police from Phnom Penh streets. Unlike ordinary arrests - when people who use drugs are processed by Ministry of Social Affairs center staff - the police took them directly to the Orgkas Khnom center.
Cambodia has not always been so open to the idea of drug trials. In 2004, Prime Minister Hun Sen called for an end to trials of the antiretroviral drug tenofovir carried out in Cambodia by Family Health International, stating: "Cambodia is not a trash bin country, they should not conduct experiments with Cambodians. They should do it with animals."
The use of coercive tactics to put drug users on a wholly unknown and unproven ‘cure' for drug dependency violates the most fundamental principles of medical ethics and human rights, Human Rights Watch said.
"Bong Sen" has not been registered for use in Cambodia. The trial bypassed the Ministry of Health's ethical review committee.
The head of Cambodia's National Authority for Combating Drugs was recently quoted in the media saying the formula will be more widely used to treat people dependent on drugs in Cambodia "if the trial is successful." The trial is reportedly a collaborative effort between that agency and a private Vietnamese company, Ben Tre Fataco General Import-Export and Trading Services. The company is reported to claim that the substance provides a "gentle detox" over seven to ten days.
"This is a poor imitation of a scientific experiment," Schleifer said. "It's impossible to assess the ‘success' of a treatment for drug dependence immediately, without measuring how many people relapse to drug use over time - not to mention the possible harm the treatment could cause."
Both the World Health Organization (WHO) and the United Nations Office on Drugs and Crime recommend opioid substitution therapy as the standard means to manage opioid dependence. WHO includes methadone and buprenorphine on its Model List of Essential Medicines. Cambodia's anticipated trial of methadone treatment has been repeatedly delayed over the last few years.
Human Rights Watch said that if the Cambodian government is genuinely interested in treating opiod dependence, it should immediately make available medications with proven track records of effectively treating those addicted to heroin and other opiates, such as methadone and buprenorphine. Such medications are prohibited in Cambodia.
The trial of Bong Sen is part of increasing collaboration between Cambodia and Vietnam in anti-drug efforts. The 2008 annual report on drugs issued by the Secretariat General of the National Authority on Combating Drugs anticipates that the agency "is prepared to receive Vietnamese delegates to Cambodia in order to discuss the feasibility of [Vietnam] giving Cambodia youth drug detention centers for drug users." No timeline for this assistance is presented in the report.
"Instead of arbitrary detention or an unknown cocktail of herbs, Cambodia should be promoting voluntary, medically appropriate treatment options for those who are dependent on drugs," said Schleifer.