Vietnam: Proving compulsory rehab doesn’t work
In May 2015, the first community-based, voluntary treatment centre for people with drug addiction in Vietnam opened in the Bac Giang province.
Nguyen Thi Huong, 32, she recalls how she started using heroin 11 years ago, when she was 21. “Myself and my family were very ashamed because of this. There was no help, only the compulsory centre and the fear of being arrested and sent there. I felt hopeless.”
Compulsory rehab has been the norm in Vietnam and the rehab centres are more like prisons or labour camps than health facilities. They are widely acknowledged to not only be ineffective at treating drug dependency, but also to violate human rights and create HIV vulnerability. They need to close.
Nguyen’s struggle to quit drug use was a long one: “It took me 15 rounds of detox to finally quit. It was a very painful time. And even after I quit, the shame of being a drug user continued haunting me.”
Even after I quit, the shame of being a drug user continued haunting me.
The new ‘Cao Thuong’ centre marks a new era. “Myself and many people who use drugs in Bac Giang have been very much looking forward to the launch. Health workers here are very committed and friendly. [It’s a place where] people who use drugs can be very open and frank to ask for help.”
Nguyen also observed that as a result of community-based work that “people in the local community now also have friendlier attitude towards people who use drugs.”
Support don’t Punish
The centre is supported by Alliance Linking Organisation SCDI, as part of the Asia Action programme, which is tackling HIV rates among people who use drugs with a harm reduction approach. People who inject drugs are 28 times more likely to contract HIV than others in the general population, with the sharing of injecting equipment being a major driver. Countries with a repressive approach to drug use have escalating HIV epidemics, and countries that adopt a harm reduction approach have seen the rates of HIV among people who use drugs dramatically decline.
Safer injecting equipment, voluntary HIV and counselling and testing and methadone programmes are some of the harm reduction services on offer at Cao Thuong.
A peer-led model is also vital in creating a stigma-free, accessible environment; Nguyen is one of the outreach workers.
“My experience of drug use is useful to others. Now I help people who use drugs to prevent HIV, hepatitis C and overdose by sharing with them my knowledge and experience…I visit the families. They trust me.”
The staff are enrolled in training which also involves community members and people with influence. A Chief Judge took part in a recent workshop.
For every 10 people we sent to compulsory centres, 11 came back and started to use drugs again
“I remember he said – ‘for 18 years I have been member of a committee that sends people who use drugs to compulsory centres. I can say for every 10 people we sent, 11 came back and started to use drugs again. We can't continue like that. We have to change and develop a more effective treatment system’. He got a big applause from participants of the training. I could not believe my ears. I used to be so afraid of people like him.”
With testimonies like this it seems the team are well on their way to achieving their mission, which is not only to provide high quality services for people who use drugs, but also to demonstrate to the government that community-based harm reduction services are an effective alternative to compulsory detention centres.
“[It’s been] hard to imagine that one day people suffering from drug addiction, like myself, can come openly to the health centre and get help. They feel more optimistic about the future. It is like a dream come true.”