At a conference on international human rights in Hanoi, Anand Grover, the UN Special Rapporteur on the Right to Health, called for the decriminalisation of drug use and an end to compulsory drug rehabilitation camps in Asia. He said compulsory treatment amounted to "keeping sick people jailed" and that criminalising drug use "hinders the right to health of all persons."
Compulsory drug treament is practiced by several Asian states, including China, India, Malaysia and Vietnam and the Open Society Institute estimates that there are over 50,000 inmates of mandatory drug treatment camps in Vietnam, and up to 350,000 in China.
Heroin users who detoxify in rehabilitation camps have relapse rates exceeding 90 per cent. Most scientific experts now advocate oral substitution therapy with drugs such as methadone and buprenorphine, which eliminate the craving for heroin.
But many countries are reluctant to embrace such therapy, which they consider substituting one drug dependency for another. In Vietnam, heroin addicts are sent to mandatory rehabilitation centers for up to four years.
Several Vietnamese experts at the conference said their country was gradually moving away from the treatment center approach and embracing substitution therapy. The country's 2007 law on AIDS adopted a so-called "harm reduction" approach to drug addiction, rather than focusing solely on detoxification.
A pilot program of Vietnamese methadone clinics began operating in April 2008. Six methadone clinics now serve 1600 former heroin addicts in Haiphong and Ho Chi Minh City, funded with grants from the US PEPFAR anti-AIDS program.
About 95 per cent of those receiving methadone have stuck with the program, said Dr Nguyen To Nhu, Vietnam program director of Family Health International, which helps run the clinics.
Dr Le Giang, a Vietnamese researcher who has studied the clinics, said the failure of detoxification at treatment camps often led to a fatalistic belief that quitting heroin was impossible.
"Many families, and even drug users themselves, completely lost their faith in treatment," Giang said. He said many users had been inspired by the ability of methadone to restore their "ownership of their own bodies and lives."
Giang said there was "much more openness, from the top level to the community level, to talk about [methadone treatment], but there's still a long way to go."