Forced treatment and the UN Human Rights Council

Municipal police argue with a presumed drug addict found sleeping on the street during an anti-narcotics operation in Rio.

At the beginning of February, the UN Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez, published a report highlighting abuses within the healthcare environment that amount to torture and ill-treatment.

The report gives particular attention to the mistreatment of those who take drugs. Specifically, it says that

“Detention and forced labour programmes violate international human rights law and are illegitimate substitutes for evidence-based measures, such as substitution therapy, psychological interventions and other forms of treatment given with full, informed consent… A particular form of ill-treatment of drug users is the denial of opiate substitution treatment.”

This report clearly defines medically unsubstantiated forced treatment as well as the denial of opiate substitution treatment as ill-treatment. When the state is involved in these activities, it amounts to torture.

The report has particular relevance to South East Asia, where Human Rights Watch have reported shocking abuses involving forced labour in involuntary drug treatment centres in The Rehab Archipelago. Such treatment programmes, although they receive funding from the international community, have been identified as abusive, and the UNODC claim to be working to stop them.

However, two weeks after the UN report, the Government Commission on Legislation in Moscow approved a bill sponsored by the Russian Federal Drug Control Service on the forced treatment of drug users upon a court order.

"The bill will give the courts the power to order drug users and individuals who abuse psychotropic medication to undergo a course of treatment and a medical and social rehabilitation program, or preventative treatment," the government's press release reads. The legislation will be considered by the government later this month.

This is a move in the wrong direction that has parallels across the world. As part of its clean-up before its upcoming major international sports events, Brazil is also considering legislation that would mandate forced treatment for crack addicts across the country. In the favelas of Sao Paulo and Rio, armed police have already detained both traffickers and users of drugs, and have forced users into treatment programmes.

Most countries, including the UK and even Portugal, where drug use is decriminalised, have some provision for coercing people into drug treatment. If this is to happen though, it is absolutely necessary that such treatment is evidence-based, humane, and recognizes the place of opiate substitution treatment. 

In Russia, access to methadone is already severely limited, and it seems clear that the country is not providing evidence-based and rights-based treatment for its large population of opiate users. In Brazil, where the main problem is with crack cocaine the situation is more complicated.  There is no internationally accepted humane treatment for addiction to stimulants, so the legality of their forced treatment programme is less clear.

In Brazil, Russia and across the world, though, there is much to be improved about the provision of treatment for drug users. Juan E. Méndez calls on all states to “Adopt a human rights-based approach to drug control as a matter of priority to prevent the continuing violations of rights stemming from the current approaches to curtailing supply and demand”.