Experiences with compulsory drug detention among people who inject drugs in Bangkok, Thailand: A qualitative study

Abstract

Abstract Background Thailand has employed a system of compulsory drug detention centres (CDDCs) where drug users are confined following arrest. Although concerns regarding CDDCs persist, research focused on CDDCs in Thailand is limited. We undertook this study to explore experiences with CDDCs among people who inject drugs (PWID) in Thailand. Methods Data were derived from the Mitsampan Community Research Project, a mixed- methods study involving PWID in Bangkok. Between July 2011 and June 2012, semi-structured, in-depth interviews were conducted with PWID who had been exposed to CDDCs. Interviews explored experiences with CDDCs, including conditions and program structure within CDDCs, and the impacts of CDDCs on on-going patterns of drug use. Audio-recorded interviews were transcribed verbatim, and a thematic analysis was conducted. Results Participants included 27 individuals, including 12 women. Participants indicated that CDDCs varied in their design and structure, although most described the conditions as being poor and unsanitary, with overcrowding and limited access to clean water and adequate nutrition. Most participants were placed in military-operated CDDCs and subjected to long hours of physical exercise and forced labour as punishment, which staff perceived as being essential to attaining a drug-free lifestyle. Many participants also experienced severe verbal abuse and violence by staff. Access to healthcare was limited and often denied, and individuals living with HIV/AIDS were typically unable to access antiretroviral therapy. None of the participants described being exposed to evidence-based addiction treatment, and most participants reported returning to drug use immediately upon release. Conclusion This study raises concerns regarding CDDCs in Thailand, including poor conditions and human rights violations within CDDCs, as well as a lack of access to appropriate healthcare and addiction treatment. CDDCs appear to be contributing to the stigmatization of drug users, while also perpetuating drug use rather meeting the intended objective of facilitating “rehabilitation”.