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Global: Torture in Drug Treatment Detention

Reports by Campaign to Stop Torture in Health Care Describe Abuse

(New York) - People identified as drug users in many countries are confined to abusive locked detention centers for months - or even years, say two reports released today by The Campaign to Stop Torture in Health Care. Such detention centers are supposedly mandated to treat and "rehabilitate" drug users, but the "treatment" they receive in some cases amounts to torture or other cruel, inhuman, or degrading treatment or punishment, said the campaign, an Open Society Foundations initiative that Human Rights Watch, the Canadian HIV/AIDS Legal Network, and Harm Reduction International have joined.

People detained in these centers are denied medical care that has been proven
effective and subjected to physical and sexual violence, forced labor, and
involuntary or experimental medical procedures, the campaign said.  A 36-page report, "Treated with Cruelty: Abuses in the Name of Drug Rehabilitation," compiles personal testimony by detainees in Russia, China, Cambodia, and Mexico. A 64-page publication, "Treatment or Torture?: Applying International Human Rights Standards to Drug Detention Centers," reviews the multiple forms of abuse common in drug detention centers and shows how these practices in many cases constitute torture, or at least cruel, inhuman, or degrading treatment - in violation of basic human rights treaties widely ratified by most nations worldwide.

"There are proven ways to address drug dependence while protecting human rights," said Rebecca Schleifer, health and human rights advocacy director at Human Rights Watch and a co-author of "Treatment or Torture?" "But beatings, forced labor, and humiliation are not among them. These centers need to be closed, and voluntary, effective drug treatment provided in their place."

The reports were issued on June 24, 2011, in advance of June 26, which is both he United Nations' annual International Day against Drug Abuse and Illicit Trafficking, and the International Day in Support of Victims of Torture.

International health and drug-control agencies - including the UN Office on Drugs and Crime, UNAIDS, and the World Health Organization - all endorse comprehensive, evidence-based drug dependence treatment services. These include medication-assisted therapy - for example, with methadone or buprenorphine in the case of opioid dependence - as essential to protect the health and human rights of people who use drugs.

Yet drug detention centers rarely provide treatment that meets these standards. Depending on the country, so-called rehabilitation consists of a regime of military drills, forced labor, psychological and moral re-education, and shackling, caning, and beating. Even people who voluntarily seek treatment are exposed to these forms of punishment, as are people who are - legally or otherwise - committed there by their parents or relatives.

In China, for example, as many as 500,000 people are incarcerated in mandatory drug detention centers, where they can be held without due process for up to six years. Treatment consists of unpaid, forced labor and psychological and moral re education - marching in formation, repetitive drills, and rote repetition of slogans (such as "Drug use is bad, I am bad"). The UN Special Rapporteur on Torture has said that that China's system of "re-education through labor" in prisons and other institutions can also be considered a form of inhuman or degrading treatment or punishment, if not mental torture.

"Forcing people into sub-standard, ineffective treatment - or even worse, administering physical and mental abuse and calling it treatment - violates a whole slew of international human rights that governments have legal commitments to respect," said Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network. "Torturing people in the name of care is a mark of shame for governments that permit or actively support such practices."

Forced drug treatment remains popular, even in the face of evidence of abuse, the campaign said. Governments outside of Asia have begun to embrace such centers for drug users, notwithstanding the lack of evidence that they work to treat drug dependence.

"Many people are detained in these centers without clinical assessment, because of one positive urine test, or because the government wants to ‘clean the streets' of homeless and poor people," said Roxanne Saucier of the Open Society Foundations, who edited the two reports. "Detaining people in holding pens and labor camps isn't a worthwhile way to address either poverty or addiction."

Currently in Russia, addiction treatment is often left in the hands of unaccountable private companies. For example, at the privately-run City Without Drugs Foundation facilities located throughout Russia, up to 50 people at a time are crammed to a room, handcuffed to their beds, and fed a diet of bread and water. The centers receive broad public and government support, notwithstanding evidence of abusive practices, including illegal detention.

"Governments should support national drug policies that ensure access to evidence-based treatment," said Rick Lines, director of Harm Reduction International. "At the same time, they should protect everyone - including drug users - from torture and cruel, inhuman, and degrading treatment. This means ending torture and other abuses committed in the name of treatment."        

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