Compulsory and voluntary drug treatment models in China: A need for improved evidence-based policy and practice to reduce the loaded burden of substance use disorders

Abstract

In China, the majority of people who use drugs (PWUD) identified by authorities are admitted to compulsory isolated detoxification centers in which their treatment is administered by administrative and judicial systems that restrict their freedom. China's compulsory isolated detoxification centers have been criticized as an abuse of human rights. The two other primary models of drug treatment in China include community-based treatment and medically-oriented voluntary treatment. This article presents an overview of the three primary treatment models for PWUD currently practiced in China. The existing compulsory and voluntary treatment models predominantly operate separately from each other, and lack evidence-based guidelines. A drug treatment system that embraces social support, psychosocial interventions and well-qualified health-based workforce is currently lacking. We propose that China needs to employ a localized model that is composed of well-facilitated and evidence-based treatment methods for both compulsory and voluntary treatment for PWUD to reduce the burden of illicit drug use. The implementation of these models of care, however, need to be tailored to the country's historical background, large population of PWUD and cultural settings in order to succeed. Urgent changes in drug treatment policies and practices are needed by the Chinese governments at different levels, organizations and front-line practitioners if we are to see a reduction in the incidence and impact of harms related to substance use in China.