The highs and lows of Thailand’s new holistic approach to drug rehabilitation

A young monk has been happily attending a drug-rehabilitation programme at Songkhla’s Saba Yoi Hospital every week for the past month.

Instead of relying on medication, this programme manages withdrawal symptoms and cravings with holistic methods such as empowerment, encouragement and counselling.

“We prescribe no medicines. We offer guidance and moral support,” said Dr Supat Hasuwannakit, the hospital’s director.

The 23-year-old monk registered voluntarily for this rehab system, known as the “Matrix” programme, determined to give up his addiction to methamphetamine.

“I felt sorry for my mother, so I decided to quit,” he said.

He joined the monkhood to escape the lure of the drug and pull away from his old gang of friends. He said that if he lived outside the monastery, his friends would likely talk him into taking drugs again.

He decided to go one step further and enrol in the Matrix programme to kick his habit once and for all. “Most participants in our programme are methamphetamine abusers,” Supat said.

Each participant is prescribed 20 one-hour sessions. Staff give participants feedback on their progress and the dangers of taking drugs, plus advice and motivation on resisting the temptation to lapse back into their habit.

Occasionally, participants all sit down together to share their experiences and acquire new insights on how to battle their cravings.

“Before joining the programme, each participant has to sign an agreement. They need to understand the rehabilitation process and be truly willing and determined to give up narcotics,” Supat said.

The family of the participant must also agree to offer them much-needed support. However, only around 20% of participants manage to quit drugs permanently.

“Most do not complete the programme,” Supat explained.

“As soon as they return to their old community and surroundings, they start abusing drugs again. The successful ones are those who join the programme voluntarily, instead of being forced into it by their community or authorities.”

Power of community

Naiyana Yoljoho, president of the Wat Sawatwareesimaram Community in Bangkok’s Dusit district, admitted to feeling overwhelmed when she joined the community board in 2006 and was told her mission was to fight the local drugs problem.

“My community was once a red zone. It was full of drug traffickers, addicts and organised criminals,” she said.

Undeterred, she fought back by making allies and joining groups such as the Women and Men Progressive Movement, the Child, Youth and Family, and local agencies.

The first step was to crack down on traffickers and arrest addicts.

However, this approach resulted in a trickle-down effect that sparked a surge in criminal activities within the community. In response, the community decided to change its approach to befriending drug addicts instead of treating them like criminals.

Over the past year, her neighbourhood received extra support thanks to the Srettha Thavisin government’s emphasis on “community based treatment” (CBTx). Under this approach, the community plays a bigger role in getting people to quit drugs and also rehabilitating residents who go astray.

The CBTx system engages help from the military, police, local subdistrict administrative organisations, district chiefs and public health offices.

Drug abusers who are not heavily addicted are rehabilitated via CBTx activities, including the Matrix program. Those with more serious addictions are sent to medical facilities for treatment with medicines and counselling.

This multidisciplinary approach features a support network of social workers and district office staff tasked with ensuring that former addicts resist temptation and don’t fall prey to dealers. It includes job opportunities for those who successfully kick the habit with support from the network.

“Today, our community is a white [drugs-free] zone,” Naiyana said.

Her Wat Sawatwareesimaram Community is home to around 123 households totalling over 600 people.

The number of drug addicts in Thailand stood at 1.9 million last year, according to the Public Health Ministry. Of these, 38,000 were heavily addicted. Some 24% of these people have been taking drugs frequently, while others indulge occasionally.

A total of 83,689 drug addicts joined the community rehabilitation programme in the first five months of this year. More than half (54%) joined voluntarily or at the request of their families or communities.

The CBTx programme has treated a total of 9,291 drug addicts so far.

Challenges remain

A kamnan in Udon Thani’s Phen district warned CBTx cannot achieve success unless strong community leaders step in when police are not available.

“More often than not, community members are afraid to identify drug addicts or traffickers out of concern for their own safety. They know that police cannot be there for them at all times,” the kamnan said.

While he appreciates the principles behind CBTx, he said its success in battling hardcore addiction is limited. Only drug abusers who are determined to get out of the cycle of narcotics complete the programme.

“Some 50 drug addicts have joined our rehabilitation programme, but not many have completed it,” he said.

Golf (not his real name), a young detainee at the Ban Kanchanapisek Juvenile Protection and Observation Centre, said his family disintegrated due to his father’s addiction to gambling. After his parents went their separate ways, one of his maternal aunts took him in.

However, as she worked hard to earn a living, he was left pretty much on his own. Overcome with a need for belonging, he spent much of his time in a gaming café, where customers had easy access to alcohol, gambling and drugs.

“I was so happy to be accepted by my older peers that I agreed to carry narcotics for them. I was caught and charged,” the young inmate said.

But under the guidance of rehab staff at Ban Kanchanapisek, Golf said he has rediscovered his individual dignity and integrity.

Recommendations

Rangsan Chuenprasert, leader of the Wat Amphawa Community and member of the Risk Reduction Community Network, said anti-narcotics efforts will only bear fruit if the government engages consistently with communities and provides support. He also urged authorities to establish closed-system drug rehabilitation centres.

“Meanwhile, campaigns should be waged to promote job opportunities for former drug abusers in both the government and private sectors,” he said. The Labour Ministry should also establish a fund to help former prisoners and drug addicts start small businesses like food stalls to get back on their feet, he added.

Currently, 220,000 out of 301,533 prisoners are serving their drug-related jail.