The accounts call to mind 18th century insane asylums: patients confined against their will in dismal conditions, abused and subjected to experiments and unscientific treatments. Today’s inmates ― at least 350,000 ― are locked up, in China and Southeast Asia, just for using illegal drugs, or being suspected of it.

Human Rights Watch recently released a paper detailing the practice of warehousing alleged drug users in China, Cambodia, Vietnam and Laos, adding to a stack of damning reports about these centers, which also exist in Thailand and Malaysia. In March, the U.N. Office on Drugs and Crime and 12 other U.N. agencies called for closing all such institutions. It was a noteworthy statement, given that the UNODC, as well as the U.S. and other donor countries, has given many of them financial support.

Dumped there by police or well-meaning but uninformed families, detainees are sometimes held for years. Authorities consider detention and grueling exercise to be treatment, though there’s no evidence this is effective. Opiate addicts, whose numbers are waning in Asia, get no opiate-substitution therapy. No equivalent treatment exists for addiction to methamphetamine, the use of which exploded in Asia in the late 1990s, prompting a boom in detention camps. But existing, proven interventions, such as individualized counseling, would help and aren’t made available.

Former detainees have told human rights investigators about being beaten with bricks and truncheons, subjected to medical experiments, forced to crawl through excrement and swallow foul water. A center staff member in China said female inmates were HIV-tested so guards could identify whom they could rape without a condom.

Forced labor is a feature in some countries. Sometimes it is pointless, such as being made to repeatedly dig and fill holes. Some centers in China and Vietnam amount to slave camps because they produce goods ― notably processed cashews in Vietnam ― using the labor of inmates, including children.

The U.S., Japan, Sweden and the UNODC have actually helped Laos build its centers. Countries including the U.S., Australia, Canada, Luxembourg, Netherlands, Sweden and the U.K. have funded programs within facilities throughout Southeast Asia to improve, for instance, health care, vocational training or sports facilities. They argue that at least they can make life better for detainees.

This support just sustains a corrupt system. Even if these institutions treated people well, they would still be based on unlawful detention. And they utterly fail at their purpose. The U.S. government estimates that 95 percent of released detainees in Vietnam return to drug use. By contrast, in Australia, a study found close to half the drug users who participated in a two- or four-session program of motivational interviewing and cognitive-behavioral therapy remained abstinent after six months.

The call by U.N. agencies to close the Asian centers was a good sign, though it would have been more reassuring had the UNODC not co-sponsored a fashion show that same month to raise funds for one such facility in Vientiane, the Laotian capital.

The UNODC, the U.S. and other donors would do well to withhold relevant funding until the centers are closed, detainees are released and local authorities agree to respect international norms for treating drug abuse. These include patient consent. Exceptions to that principle can be made only rarely, for a short period, with judicial oversight, for the purpose of restoring a patient’s ability to make decisions autonomously. Treatment and rehabilitation services should be offered within communities ― through health clinics or welfare offices, for example ― so patients can access them easily and without being stigmatized.

As a half-measure, some donors already support community- based programs alongside the detention centers. Asking patients to enter voluntary programs is risky, however, when their identification as drug users might land them in a far worse place. The drug-treatment system in China and Southeast Asia can’t be reformed. It requires a do-over.

(Bloomberg)