Karen has been working in public health for over 15 years, starting with a community-based organisation on HIV prevention in South Africa. She is currently the Southeast Asia regional focal point for the United Nations Office on Drugs and Crime covering their mandates on Drugs and Health

Compulsory drug detention is a form of custodial confinement where perceived or known people who use drugs undergo forced drug abstinence for a pre-determined time period. Given these facilities’ lack evidence-based drug treatment, harm reduction or after care services and evidence of human rights violations, their ongoing use has been widely condemned by United Nations entities and civil society organizations. This study highlights the latest available data on the number of compulsory facilities and people detained therein and assesses progress toward phasing out compulsory treatment in favour of voluntary community, evidence- and rights-based alternatives in Asia.
Cross-sectional data were collected using a questionnaire distributed to government health and drug authorities and a literature review of published governmental records in nine countries: Cambodia, China, Indonesia, Lao People’s Democratic Republic, Malaysia, Myanmar, the Philippines, Thailand and Vietnam. A validation process was conducted with national authorities. Descriptive analyses were computed for available data from seven countries.
The total number of people detained in compulsory facilities remained the same or increased in most countries between 2012 and 2018. In 2018, there were 886 compulsory facilities for people who use drugs in seven countries. Since 2012, 440,000 - 500,000 people were detained annually in compulsory facilities. Compulsory facilities reported capacity levels ranging from 73% in Malaysia to 478% in Thailand. Overall, financial support for compulsory treatment remained substantial. Voluntary community-based drug treatment services remained insufficiently available.
Despite commitments to phase out such facilities, political and financial support for compulsory treatment in Asia continues, evidenced by the high numbers of facilities and people detained therein. Renewed advocacy efforts and policy reforms, such as the decriminalization of drug possession for personal use, are needed to allow for the permanent discontinuation of compulsory treatment modalities and transition to an integrated continuum of voluntary, evidence-based services in the community.