Individuals who are dependent on opioids are more likely to relapse after treatment in a compulsory drug detention center versus a voluntary drug treatment center that provides methadone therapy, say the Yale authors of a new global study.
Published in The Lancet Global Health, the study is the first to compare the outcome of both approaches and confirms the ineffectiveness of compulsory drug detention centers.
An estimated 600,000 people who use opioids are detained in compulsory drug detention centers in East and South East Asia each year. The centers result in high rates of drug relapse and disruption to people's social networks after release, accelerating the risk of negative consequences, such as infection, overdose, and death, said the researchers.
The research team compared treatment approaches in Malaysia where both types of treatment centers exist. They studied 89 people from compulsory centers and 95 from voluntary centers. The patients took drug tests and were interviewed when they joined the study, and repeatedly after release (at one, three, six, nine or 12 months post-release).
The researchers found that people held in compulsory centers were 84% more likely to relapse to opioid use, and did so 10 times sooner—within 31 days—compared with 352 days for those in voluntary centers.
"Our findings strongly support international calls to eliminate compulsory drug detention centers by showing that they are ineffective in treating drug dependence, especially for those who use opioids," said Yale professor of medicine and study author Frederick Altice, M.D. "Countries using these measures should instead increase the availability of proven opioid agonist therapies, such as methadone, assure adequate access to voluntary treatment programs in community settings, and make it easier for people with opioid addiction to seek treatment."
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