ONDCP and NIDA Voice Concerns over Vietnam's Approach to Drug Treatment

A recent Human Rights Watch report asserts that there may be over one hundred facilities in Vietnam subjecting thousands of addicted individuals to inhumane labor conditions under the pretense of providing drug treatment.  Furthermore, there are indications that the Government of Vietnam may erroneously believe that these practices comply with NIDA’s Principles of Effective Treatment

In a letter forwarded to Human Rights Watch earlier today, the Director of National Drug Control Policy and the Director of the National Institute on Drug Abuse (NIDA) reiterated the United States’ strong support for safe, effective, evidence-based, drug addiction treatment that is consistent with NIDA’s Principles of Effective Treatment and internationally recognized human rights.  This joint letter from NIDA and ONDCP sets the record straight.

The United States does not in any way condone the forced labor or inhumane conditions described in Human Rights Watch’s report on drug rehabilitation facilities in Vietnam.  While NIDA’s Principles of Effective Treatment include a principle stating that “treatment does not have to be voluntary to be effective,” it is not intended to provide a justification for violent or punitive coercion without access to due process or internationally recognized human rights.  This principle is based on evidence that treatment entered as a result of a criminal justice mandate to avoid imprisonment, or even within a criminal justice setting, can be successful.  It also applies to other addicted individuals who would not have entered treatment were it not for a doctor, nurse, relative or friend who took the time to present to them the serious health consequences of avoiding needed drug treatment. 

ONDCP wholeheartedly supports all of NIDA’sresearch-based Principles of Effective Treatment, which also include:

  • Addiction is a complex but treatable disease that affects brain function and behavior;
  • No single treatment is appropriate for everyone;
  • Treatment needs to be readily available;
  • Effective treatment attends to multiple needs of the individual, not just his or her drug abuse;
  • Remaining in treatment for an adequate period of time is critical;
  • Counseling – individual and/or group – and other behavioral therapies are the most commonly used forms of drug abuse treatment;
  • Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies;
  • An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs;
  • Many drug-addicted individuals also have other mental disorders;
  • Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse;
  • Drug use during treatment must be monitored continuously, as lapses during treatment do occur; and
  • Treatment programs should assess patients for the presence of HIV/ AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases.

NIDA and ONDCP believe that regardless of the manner in which an intervention is initiated, effective drug addiction treatment ultimately must be:  a) evidence-based; b) take advantage of the various treatment modalities available; and, c) address the multiple needs of the individual. 

The United States will continue to work to ensure that Vietnam and other countries worldwide receive this important drug treatment message loud and clear.  For more information, read the full letter.

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