Human Rights Watch: Hundreds of Thousands Still Tortured in Name of Drug Treatment

If we want to end human-rights abuses in drug-detention centers in Asia, we should start by addressing the abusive "treatment" practices being used in our own backyard

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Correction Appended: Aug. 6, 2012

More than 350,000 people are held in filthy, overcrowded “drug treatment” centers — actually forced-labor camps — in Asia, where they are beaten and compelled to engage in harsh work for little or no pay, according to a new report from Human Rights Watch (HRW). They are detained without due process, some tortured with electric shock, starved and deprived of food and water.

Although 12 U.N. agencies, including the World Health Organization and the U.N. Office on Drugs and Crime, called for the closure of these detention centers in March, little action has been taken, according to the report. The centers are located mainly in China, Cambodia, Vietnam, Malaysia, Thailand and Laos. Even countries that are against human-rights abuses appear to be funding them inadvertently, according to the medical journal the Lancet: in June, the U.S. government pledged $400,000 toward the upkeep of one such abusive program, targeted in a previous HRW report, though the State Department denies that human-rights abuses take place there.

Drug users and other people who are considered nuisances, like the homeless, are often rounded up by police and taken to these programs, where they may be held for years without trial or the right to appeal their confinement. Children as young as 7 are often detained in these programs with adults, and sexual and physical abuse is common. There is little financial incentive to close the centers or release the prisoners, however, because their labor is free or extremely cheap and the goods they toil to produce can bring big profits to local companies.

As TIME reported last year, some centers in Vietnam produce what have come to be known as “blood cashews” that are sold on the international market. Vietnam is the world’s largest exporter of processed cashews and the U.S.’s top supplier of the nut. But most consumers have no idea that the nuts are processed by what is essentially slave labor, in abysmal conditions that are advertised as treatment for addiction:

[Vietnam's drug detainees] spend six to 10 hours a day husking and skinning nuts. It is drab and unhealthy work: cashew oil is caustic and burns the skin. “I would sometimes inhale the dust from the skins, and that would make me cough,” one man told HRW. “If the fluid from the hard outer husk got on your hands, it made a burn.” For their labor, detainees are paid nothing or a few dollars a month. Even this pittance is whittled away, says HRW, since some centers charge detainees for food, lodging and what they term “managerial fees.”

(MORE: From Vietnam’s Forced-Labor Camps: ‘Blood Cashews’)

The forced labor is believed to treat the detainees’ drug addictions, but it fails miserably. HRW reported on the case of Que Phong, a Vietnamese man who voluntarily sought treatment for heroin addiction in 2004, when he was in his late 20s. Asked why he and others agreed to perform cashew-husking work for little to no pay, even though it did not help their addictions, Que Phong explained, “If you refused to work, they slapped you. If you still refused to work, then they sent you to the punishment room. Everyone worked.” In the punishment room, inmates were held for weeks at a time in a small, crowded space with no beds and were allowed to shower only once a week.

None of this, of course, is effective in treating addiction. When released from their stints in abusive detention centers, most people return to drugs. Research shows, in fact, that such traumatic experiences increase the risk of relapse and the severity of addictions.

Yet the misguided idea that harsh treatment helps solve drug problems is widespread, stretching far beyond Asia. The tactics used in U.S. treatment centers — including boot camps, rehab centers, emotional-growth boarding schools and wilderness programs — tend to be less extreme, but they have included beatings, forced labor, excessive exercise and deprivation of sleep and food to try to break participants.

Just this week, California legislators moved to regulate private boot camps for teens in response to a widely circulated video of youths in one such program, who were made to drink water until they vomited and forced to engage in endurance exercise beyond their capacities while instructors yelled at and taunted them. Earlier this year, an instructor at that boot camp was charged with five counts of sexually assaulting and raping two 14-year-old girls in 2004; it’s not clear whether those charges were connected to the boot camp, but the instructor is also charged with kidnapping and extortion in relation to incidents at the camp in 2011. He has pleaded not guilty to both sets of charges, which are pending.

Over the years, dozens of teens have died in such programs, which are unregulated at the federal level and continue to be permitted to operate despite data showing that they are ineffective. Several states — including Florida, Maryland and South Dakota — have endured scandals involving widespread abuse or deaths of children in state-run or state-funded programs.

As in Asia, the U.S. uses its courts to sentence addicted people and youth to tough boot-camp programs — again, despite evidence showing that they don’t work. If we want to urge Asia to end its abusive practices in addiction treatment, we can’t ignore similar problems in our own backyard.

MORE: Viewpoint: Why Tough-Love Rehab Won’t Die

The original version of this post misstated the criminal charges filed against the boot-camp instructor in California and did not include the defendant’s plea status.

Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.