Rehabilitation centers rudderless for lack of monitoring

Published On: July 25, 2016 12:50 AM NPT By: Kamal Pariyar

KATHMANDU, July 25: Drug addiction treatment and rehabilitation centers that are mushrooming along  with the increase in the number of drug users have remained rudderless for lack of effective guidelines and monitoring, putting lives at risk.

According to the Central Bureau of Statistics, the annual growth rate of illicit drug users is 11.36 percent.

The number of drug users being rehabilitated at such centers runs into the thousands, with over 50,000 drug users apparently having already received rehabilitation treatment, including for harmful use of psychoactive and addictive drugs, and the sharing of injection needles.

According to a survey carried out in 2015 by the Federation of Drug Demand Reduction (FDDR), an umbrella organization of such centers, approximately 10,000 patients were treated at 20 different treatment and rehabilitation centers in Kathmandu. About 30 percent of these were people who injected drugs and a few others were alcoholics. Problems, however, abound.

“The drug treatment and rehabilitation centers, which are meant for the care and cure of illicit drug users to reduce their use and dependence, have remained rudderless for lack of proper government policies,” Karma Sherpa, president of  FDDR, said.

Last year, the Narcotics Control Branch under the Ministry of Home Affairs began monitoring such centers in Kathmandu Valley, but the campaign was limited to just five centers.

The monitoring team found that the centers were not operating as per the Drug Treatment and Rehabilitation Centers Operation Directives, 2068.

The layout and physical infrastructure, security measures, human resources and the caring modality were found to be inadequate, creating additional problems for the patients.

“During surprise inspections at some centers in the Valley, we were astonished to see male and female drug addicts rehabilitated under the same roof,” said Under-Secretary Phadindra Mani Pokharel, who heads the Narcotics Control Branch at the ministry.

They could not continue inspections at other centers in lack of adequate manpower, budgets, location information and other related information; Pokharel said.

At present, there are more than 160 drug treatment and rehabilitation centers in Nepal, including 75 to 80 in the Valley, according to FDDR, which brings together over 103 centers across the country. But the number of centers in government records is only 61.

Bishnu Sharma, an experienced campaigner against drug abuse who is now associated with Recovering Nepal, a national network of drugs services organizations, expressed serious dissatisfaction over the government's long neglect of the vulnerable situation in Nepal.

“The government does not seem to have any long-term plan to regulate those centers for more effective treatment of drug users,” Sharma said. A small branch under the ministry cannot by itrself tackle the growing challenges related to the management of rehabilitation centers, counseling and treatment of drug users, said experts. They spoke of the need of a special department comprising senior officials and professionals .

Pokharel, the Home Ministry official, said, “It is not possible to regularly monitor or regulate all those centers unless there are amendments in policies and a reshuffle in the departments concerned.

Over 90 percent of the operators are former drug users and they are unaware of the legal parameters and the human rights issues, he added

The Drug Treatment and Rehabilitation Centers Operation Directives, 2068 comprises clear guidelines but very few of the centers have followed them, Pokharel said.

The directives state that such centers should have at least one ropani of land with a compound wall, a peaceful environment and security round the clock, and they should be able to accommodate 30-35 people each. . Similarly, the directives require the hiring of medical doctors, psychiatrists, TU-affiliated counsellors, and provisions  for compensation in case of casualties due to negligence and for other reasons.

Because of the lack of proper government policies, some care and treatment centers have been charging huge amounts to the victims' families, some of them even misusing government manpower and influence, the experts alleged.

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