Addicts Speak of Benefits From Criticized Detox Trial

As human rights groups and government anti-narcotics officials trade barbs over whether 21 Phnom Penh drug users were forcibly used as guinea pigs in a herbal drug trial to cure addiction, six men who participated in the program said that they had benefited from the medicine.

The six said in interviews on Monday and yesterday that despite some skepticism early on about the treatment, which they also claimed was not forced on them, taking the Vietnamese-made “Bong Sen” medicine lessened their withdrawal symptoms from heroin and methamphetamine.

“I think it’s good,” said Meas Mony, 28, one drug-treatment participant who was interviewed yesterday in Chamkar Mon district’s Boeng Trabek commune outside the drug-treatment NGO Korsang, which was not involved in the Bong Sen treatment.

Mr Mony was released from the Orkas Khnhom government-run drug rehabilitation center on Monday after being kept there for 10 days of treatment with the medicine.

“I never thought they were trying to get me to do an experiment, but I thought that if they use it in Vietnam, I should try it,” he said, adding that he had not yet returned to drug use.

Mr Mony said that he was ap­proached on the streets of Boeng Trabek, which is an area where addicts are known to congregate, earlier this month by two police officers who asked him if he was interested in taking the medicine. After he agreed, Mr Mony said that he was taken to the district police station where he was given a urine test and asked questions about his drug habit.

“They gave me a chance for the new treatment so I volunteered to go there because I want to get a job to feed my wife and kids,” he said.

However, Mr Mony said that not all the 21 participants went voluntarily – at least initially, he said, claiming that two addicts at the district police office told him they were forced to sign up for the treatment.

“They said they did not want to come, but police still brought them anyway,” Mr Mony said, adding however that the two men were later persuaded that it was in their interests to try the treatment before they were taken to Orkas Khnhom rehabilitation center.

“After the detox made progress, they [the two men] said it was good,” Mr Mony said.

Still, he said, the treatment was not a success for everyone.

“I know about four or five guys who used Bong Sen and now use heroin,” he said of the group of 21 who were released on Monday.

Seventeen heroin addicts and four amphetamine addicts received doses of the Vietnamese-made herbal medicine for 10 days starting Dec 11 at Orkas Khnhom. The facility, an isolated compound in Sen Sok district with recently-built dormitories, gardens, a basketball court and football pitch, which rights groups claim is as detention center for forced detoxification treatment.

“They said this was a kind of drug used in Vietnam for detox with success. And I volunteered to get it,” said 35-year-old Pat Mien, a participant who said he had used heroin for 20 years.

Mr Mien, who was interviewed inside Orkas Khnhom on Monday before his release and then later after his release in Boeng Trabek commune outside Korsang, said he had tried quitting heroin before several times but withdrawal symptoms became too intense and he relapsed.

“After getting Bong Sen my symptoms are better but I don’t know what will happen in the future,” he said.

Mr Mien said he hadn’t yet experienced adverse affects from the medicine.

“I have to wait and see, but after 10 days I have had no problems,” he said.

Another participant, Mon Sokha, 26, said police “invited” him earlier this month to join the program, but he claimed that the officers hadn’t pressured him unduly.

“They did not use strong words, they just discussed it,” he said. “The police just spoke to us in a normal tone and asked if we wanted help detoxing.”

“If you compare heroin to Bong Sen, with heroin I was in a very bad condition. But with Bong Sen I feel 70 to 80 percent relief,” he said.

Vann Sophea, 30, who was also put on the Bong Sen treatment, said he was approached by a Vietnamese doctor and her translator in Chamkar Mon district who explained the benefits of the drug and that he agreed voluntarily.

“I did not feel pressure at all. I don’t think they used us as an experiment because we are not animals. They did not force me, it was up us to detox or not,” he said, also speaking outside Korsang, adding the medicine eased his withdrawal symptoms, whereas previous attempts at quitting had failed.

Though authorities never told him so, Mr Sophea said that he felt he could leave the treatment center if he had wanted to.

“I think if I had asked that [to leave] they would not allow me, because we had a deal,” he said, adding, though no money changed hands.

In a statement Saturday, Human Rights Watch called the treatment a “perverse experiment’ and “ethically outrageous.” Human Rights Watch continues to say the 21 patients were lied to, detained, and subjected to a treatment that has not been used in clinical trials.

There is some anecdotal evidence to support those claims.

Several drug users in Boeng Trabek commune said yesterday in interviews that the day the drug trial began, they saw police on motorcycles apprehending drug users in the area.

“They did not use any sweet words. They used their arms and legs and batons,” said Veasna, who declined to give his family name.

Chea Long, 34, a resident in the commune, said on Monday that he spoke to several drug users who said they were rounded up in the police sweep, but didn’t complain about their 10-day stint in rehab.

“They said they were treated well out there, and I saw them when they came back they started using heroin again,” he said.

“I think the medicine worked well for detox, but cravings are the problem.

Christophe Peschoux, representative for the UN High Commissioner of Human Rights in Phnom Penh, said that UNOHCHR has drafted a formal request to the Phnom Penh municipality to “establish the facts and for that purpose we have sought access to the centers.”

“There are questions whether these drugs are harmful or not or helpful. That’s the first question. And whether they were administered on a voluntary basis,” he said, adding they will also investigate whether NGOs were pressured to assist the program.

Rebecca Schleifer, the health and human right advocacy director at Human Rights Watch, said by telephone that she stood by HRW’s earlier statement on the issue.

“As far as what the patients say it is hard for Human Rights Watch to understand how they gave free and informed consent in this context,” she said. She also suggested that patients might have felt unsafe speaking freely to reporters about the treatment because of the government’s involvement.

Licadho consultant Mathieu Pellerin said that the government has a history of detaining drug addicts against their will, which casts suspicion on the Bong Sen trials.

“This is something we have documented for years, and so we think the same thing has happened this time,” he said.

He said Licadho became concerned after a man reported to them that he had been taken against his will, but was later released and was not a participant in the trials.

David Harding, a technical advisor to the drug program at Friends International, said that his NGO was asked by the NACD to participate in the Bong Sen but declined because of the lack of information on the product and commitments to donors.

“An international funding agency would be within its right to ask if the product is safe, and non-toxic in everyway,” Mr Harding said. “We don’t know what this product is we simply don’t know,” he said.

According to Vietnamese state-run media, the firm Ben Tre Fataco General Import-Export and Trading Service Co began production of Bong Sen, which is Vietnamese for lotus, in 2007 for use in drug detoxification.

Bong Sen’s two main ingredients, according to the label on the bottle, are angelicae sinensis root, also known as female ginseng, and ginseng root. A pamphlet that accompanies the bottled liquid warns women against using Bong Sen during pregnancy, menstruation and when breastfeeding as well as warning against operating heavy machinery. The directions recommend four doses a day to relieve drug cravings.

Neak Yuthea, director of the prevention and education department at the National Authority for Combating Drugs, said NACD Chairman Ke Kim Yan visited Vietnam earlier this year and learned about the effectiveness of Bong Sen.

Vietnam officials then sent over both doctors and crates of the potion so Cambodian authorities could try the medicine in their national drug centers.

There were not enough patients at Orkas Khnhom going through detoxification to participate in the trial, so NACD officials searched neighborhoods in capital known for drug users and asked them to participate, Mr Yuthea said.

“We explained to them if you are still going to use heroin, you are going to face risks. If you stop, your life will be better,” Mr Yuthea said. “We told them that in Vietnam this treatment is used and it’s successful, and if you want, you can get this service.”

He said the drug has been approved by the ministries of Health and Commerce in Vietnam, and the results of just-completed 10-day treatment of the 21 at Orkas Khnhom will be submitted to an inter-ministerial board, which includes the ministries of the Interior, Health and Social Affairs. That body will decide whether or not the treatment will be officially released in Cambodia, Mr Yuthea said.

Graham Shaw, a technical officer with the World Health Organization, said there’s not enough information available to say whether the drug is safe or even if the treatment of the 21 addicts was ethical. So far the WHO has not discovered independent research on Boeng Sen, only studies conducted by the company. However, Mr Shaw added, more support needs to be given to addicts after the drugs are out of their system.

“Detoxification is just the first in a long and difficult road to being drug free,” he said. “Detox is the easy part.”

 

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