Compulsory drug detention center experiences among a community-based sample of injection drug users in Bangkok, Thailand
1 Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, 50 Haven Avenue, New York, NY 10032 USA
2 Thai AIDS Treatment Action Group, 18/89 Vipawadee Road, soi 40 Chatuchak, Bangkok 10900 Thailand
3 Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, British Columbia V5Z 1M9, Canada
4 British Columbia Centre for Excellence in HIV/AIDS, 608 - 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada
5 Provincial Health Services Authority, 700 - 1380 Burrard Street, Vancouver, British Columbia V6Z 2H3, Canada
BMC International Health and Human Rights 2011, 11:12 doi:10.1186/1472-698X-11-12Published: 20 October 2011
Despite Thailand's official reclassification of drug users as "patients" deserving care and not "criminals," the Thai government has continued to rely heavily on punitive responses to drug use such as "boot camp"-style compulsory "treatment" centers. There is very little research on experiences with compulsory treatment centers among people who use drugs. The work reported here is a first step toward filling that gap.
We examined experiences of compulsory drug treatment among 252 Thai people who inject drugs (IDU) participating in the Mitsampan Community Research Project in Bangkok. Multivariate logistic regression was used to identify factors independently associated with a history of compulsory treatment experience.
In total, 80 (31.7%) participants reported a history of compulsory treatment. In multivariate analyses, compulsory drug detention experience was positively associated with current spending on drugs per day (adjusted odds ratio [AOR] = 1.86; 95%CI: 1.07 - 3.22) and reporting drug planting by police (AOR = 1.81; 95%CI: 1.04 - 3.15). Among those with compulsory treatment experience, 77 (96.3%) reported injecting in the past week, and no difference in intensity of drug use was observed between those with and without a history of compulsory detention.
These findings raise concerns about the current approach to compulsory drug detention in Thailand. Exposure to compulsory drug detention was associated with police abuse and high rates of relapse into drug use, although additional research is needed to determine the precise impact of exposure to this form of detention on future drug use. More broadly, compulsory "treatment" based on a penal approach is not consistent with scientific evidence on addressing drug addiction and should be phased out in favor of evidence-based interventions.