The Opium Treatment Centre, Singapore

Abstract

Before war broke out in Malaya in 1941, the use and sale of opium was controlled as a government monopoly. An addict, having been examined by a medical officer and duly certified, was registered and then permitted to purchase an allowance of opium from a government shop. It was the policy of the monopoly to bring about a gradual reduction in the consumption of opium by addicts in accordance with the provisions of The Hague Convention, of 1912, and of the Geneva Opium Agreement of 11 February 1925, the recommendations of the League of Nations Commission to the Straits Settlements in 1929,*and the Bangkok Agreement of 1931. The registers were finally closed, except for medical cases, on 31 December 1934. In 1927, sales of opium through the monopoly totalled 30,000 lb. By 1935, they were reduced to 19,000 lb., and by 1938 to 15,000 lb. At the time of the Japanese invasion in 1942, there were 16,552 addicts on the Singapore registers, while in the Federation of Malaya the figure was probably quadrupled. During the Japanese occupation of this country from 1942 to 1945, the registers were ignored, and anyone who could pay for it was allowed to smoke. The campaign since 1925 to promote gradual reduction of opium consumption was thus largely nullified, and as opium addiction was openly encouraged, the number of smokers alive today can only be conjectured.

Details

Pages: 13 to 17
Creation Date: 1957/01/01

The Opium Treatment Centre, Singapore

By the Director of the Central Nareoties Intelligence Bureau, Singapore.

Before war broke out in Malaya in 1941, the use and sale of opium was controlled as a government monopoly. An addict, having been examined by a medical officer and duly certified, was registered and then permitted to purchase an allowance of opium from a government shop. It was the policy of the monopoly to bring about a gradual reduction in the consumption of opium by addicts in accordance with the provisions of The Hague Convention, of 1912, and of the Geneva Opium Agreement of 11 February 1925, the recommendations of the League of Nations Commission to the Straits Settlements in 1929,*and the Bangkok Agreement of 1931. The registers were finally closed, except for medical cases, on 31 December 1934. In 1927, sales of opium through the monopoly totalled 30,000 lb. By 1935, they were reduced to 19,000 lb., and by 1938 to 15,000 lb. At the time of the Japanese invasion in 1942, there were 16,552 addicts on the Singapore registers, while in the Federation of Malaya the figure was probably quadrupled. During the Japanese occupation of this country from 1942 to 1945, the registers were ignored, and anyone who could pay for it was allowed to smoke. The campaign since 1925 to promote gradual reduction of opium consumption was thus largely nullified, and as opium addiction was openly encouraged, the number of smokers alive today can only be conjectured.

From the liberation of Singapore in September 1945, no opium was purchased or sold by the Government of Singapore, and all shops were closed. In February 1946, an Opium and Chandu Proclamation declared a total prohibition of the sale and use of opium except for medicinal purposes. In 1951, this proclamation was superseded by the Dangerous Drugs

Commission of Enquiry into the control of opium smoking. See its Report to the Council, League of Nations publication No. 1930.XI.10.

Full size image: 73 kB

Ordinance, prohibiting the import, export, possession, manufacture or sale of opium. Any person contravening these provisions was liable to a fine not exceeding 10,000 Malayan dollars or imprisonment for a period not exceeding five years, or both. The use of premises, the possession of utensils for the administration of opium, and the consumption of prepared opium, were also punishable under the law. The customs and police departments were responsible for the enforcement of these provisions, the former being organized the better to prevent the import of opium by sea, air or land, while the police dealt with internal peddling, and endeavoured to suppress the opium divans. The customs department also operated - on behalf of enforcement authorities in the Malayan area - a Central Narcotics Intelligence Bureau for the dissemination and exchange of information on the traffic.

It was noted that many addicts, imprisoned for opium or other offences, showed a marked improvement in health as a result of prison routine, diet and treatment for their physical ailments, and it was decided that as an experiment a special penal institution for the treatment of addicts should be opened. Part of the quarantine station on St. John's Island was selected for the purpose, because it offered a complete change of surroundings and living conditions and, as traffic to and from the island is controlled, a reasonable prospect of denying opium to the inmates.

The necessary legislation for the Opium Treatment Centre was enacted under the Dangerous Drugs (Temporary Provisions) Ordinance, 1954, which, inter alia, provides for the establishment of opium treatment centres, the appointment of officers, and the setting up of an advisory committee. The main centre on St. John's Island was opened for the treatment of male addicts in February 1955. At the same time "C" Hall, the female prison and the hospital in the local prison on Singapore Island were gazetted as opium treatment centres, since addicts were kept there.

Full size image: 52 kBFull size image: 75 kB

The Advisory Committee is an important link in this whole experiment. The offender, while on remand, is checked with a view to finding out the possibilities of rehabilitation. The reports of the medical and rehabilitation officers are laid before the Advisory Committee, consisting of the superintendent and medical officer of the Opium Treatment Centre and a rehabilitation officer. If it is found necessary that the offenders would benefit by admission to the centre, the Committee makes a recommendation accordingly to the magistrate, who, if he concurs, orders the addict's detention in the centre for an undetermined period not exceeding twelve months. Otherwise, the offender is sentenced to three months' imprisonment. Sentences under the existing legislation are mandatory, but there is an amendment being considered to provide for sentences to be discretionary.

Full size image: 43 kBFull size image: 46 kB

The Advisory Committee considers a person's suitability for treatment from the following aspects:

  1. Age limit : 50 years, in general, but many cases are accepted up to the age of 55.

  2. Disease : Active cases of organic disease, etc., are not accepted.

  3. General physical condition : Chronic debility and extreme emaciation may be causes of rejection.

  4. Length of addiction : Preference is given to more recent addicts.

  5. Environment : If the addict is socially or thoroughly an undesirable character, he may be rejected for treatment.

The Opium Treatment Centre at St. John's Island consists of twelve huts. They are used as follows: carpenters' workshop, tailors’ workshop and laundry, rattan workshop, hospital, office and store, and attendants’ barracks. The remaining six huts have accommodation for inmates. (The maximum capacity of each hut is forty beds.)

Full size image: 68 kBFull size image: 60 kB

On admission after withdrawal treatment, which is usually completed within three weeks in the remand prison on Singapore Island, the addict is interviewed by the superintendent, and provided with clothing, bedding, etc., all his personal belongings being taken from him. He is seen by a medical officer, either on admission or on the following morning. He is admitted to the sick bay, where he is detained for a minimum period of a week, and given extra food, including milk and eggs. At the end of the week, he is again seen by the medical officer, and if found fit for light duty is given a choice of acquiring knowledge and skill in several different trades, including carpentry, tailoring, rattan work, cooking, gardening and laundering.

While in the centre, the addicts are given the usual prison diet plus an extra 4 oz. of rice or wheat. If it is considered that any inmate should have additional nourishment such as eggs or milk - he is re-admitted to the sick bay. It is interesting to note that in only one case has there been a failure to gain weight during the period of detention. The average weight gained has been 13 lb.

It has been found that the inmates in the centre are very happy to be employed, and there have been few, if any, breaches of discipline. The rehabilitation officers visit the centre regularly, and keep in touch with each individual's progress.

Though the addict is sentenced, as a rule, to be detained for a period of twelve months, it has been found that most of the inmates are fit to be released after a period of from six to seven months; and it has been noted that at the end of this period most of them realize that the addiction has gone. The rehabilitation officer ensures that they have employment waiting for them on release. Subsequent follow-up has shown that, in the case of skilled labourers, the majority stay in the employment which has been secured for them, and though the general trend is for unskilled labour to remain in employment, many change their jobs. However, the limited statistics so far available do not permit any firm conclusions. All business firms and branches of the services have been most sympathetic in taking the former addict employees back on the recommendation of the rehabilitation officers. There has been no instance of a firm's refusing to re-employ such persons on discharge.

Full size image: 83 kB

At the outset, it was considered that probably fifty per cent of the addicts appearing before the Advisory Committee might be found suitable for admission to the centre. Following are details regarding addicts remanded for investigation:

 

Male

Female

Total number interviewed
1,756 76
Total rejected
1,111 51
Rejected on account of age and general condition
529 7
Rejected on account of disease
501 21
Rejected on account of character and past history
81 23
Total selected
658 22

These figures are from February 1955 to December 1956. In 1955,28% of those interviewed by the Advisory Committee meeting were selected. In 1956,47% of those interviewed by the Advisory Committee meeting were selected.

So far, 396 males and 16 females have been released on licence, and the rehabilitation officers visit them regularly. There have been six known cases of relapse among the males, but the period is as yet too short for any conclusion to be drawn.

The follow-up of the released addict provides a problem. After a period of about three months or so all the addicts are referred to the medical officer for a check-up. It is not easy to diagnose a relapse. In most cases, however, addicts were able to keep away from the drug for a varying period of time; relapses if they do occur, generally come after a period of a few months, by which time the licence has expired, and past addicts are no longer obliged to attend for check-up. However, a number of patients do present themselves, long before their turn is due, seeking medical advice on minor complaints, and in some cases for help in the matter of finding work. A few have brought their personal and family problems to the doctor, and there have been a few who brought their addict companions for help or for admission as volunteers to the centre.

From the inception of this rehabilitative centre up to the end of 1956, a total of 425 patients have undergone rehabilitation and have been discharged. Out of all these, six persons were arrested a second time on a charge of possession of prepared opium or of possession of opium-smoking utensils. This does not mean that only 6 out of the 425 had relapsed into opium addiction. At the present time, it is not possible to make any exact estimate of the number who, having undergone treatment, have completely freed themselves from addiction. There is, however, ample evidence to suggest that the present procedure is well worth while.

It has now been decided under section 1 (2) of the Dangerous Drugs (Temporary Provisions) Ordinance (cap. 138) to extend the operation of the ordinance until 8 February 1958. This will mean that the centre will run for at least another year. During 1956, the centre continued to prove its value. The following figures clearly illustrate its importance in the treatment and rehabilitation of opium addicts :

Number of releases since the camp opened on 2 February 1955
425
Number of known failures
6
Number of volunteers
12

Many tributes have been paid to the establishment, including one from the World Health Organization.

The question of whether the centre should be made permanent and be expanded to provide for all opium addicts is being examined in some detail, and it is hoped that it will be possible to reach a decision within six months. The representations made by the Chinese Advisory Committee will be borne in mind while the review is being made.

The approximate cost of an accommodation hut for forty persons is 25,000 Malayan dollars, and as there are at present twelve such huts at the centre; the estimated cost of accommodation blocks is 300,000 Malayan dollars.

Details of annual recurrent expenditure in 1956 are shown in appendix A, and figures of admission from February 1955 to December 1956 in Appendix B.

APPENDIX A

OPIUM TREATMENT CENTRE, ST. JOHN'S ISLAND, SINGAPORE

Annual recurrent expenditure for 1956

(Malayan dollars)

Note : The figures quoted above are in Malayan dollars. (One U. S. dollar is approximately equal to three Malayan dollars.)

 
Total amount spent, 1956
Amount per day
Average daily muster (inmates)
Average expenses per inmate per day
Average per month (30 days)
Administration (staff pay, etc.)
102,802.50 282.00 165 1.70 51.00
Ration (inmates)
35,559.00 97.00 165
- .59
18.00
Maintenance, clothing, etc
61,707.00 169.00 165 1.03 22.78
Total
200,068.50 548.00 165 3.32 91.78
Full size image: 97 kB

APPENDIX B

OPIUM TREATMENT CENTRE, ST. JOHN'S ISLAND, SINGAPORE

Patients admitted and patients interviewed from Februar 1955 to December 1956

 

Males

Females

1. Total admissions from 1 February 1955 to December 1956
658 22
Age groups
   
20-25
8 1
26-30
31 3
31-35
64 3
36-40
124 3
41-45
150 9
46-50
154 1
51-55
94 2
56-60
20
-
61 and over
6
-
Number of volunteers
12 2
Highest number held on any one day
229
-
Daily average at:
 
-
Opium Treatment Centre
165
-
Opium Treatment Centre hospital
13
-
Released on licence at Opium Treatment Centre
396
-
Released on licence (females)
-
16
Number of volunteers completed rehabilitation term
12 1
Died at Opium Treatment Centre
1
-
Died at General Hospital
1
-
2. Cases interviewed by the Advisory Committee from 1 February 1955 to December 1956
   
Total number cases interviewed (including volunteers)
1,756 76
Total cases rejected
1,111 51
Rejected on account of:
   
Age and general condition
529 7
Disease
501 21
Character and past history
81 23
3. Weights
   
Total average gain at end of first month
6 lb.
5 lb.
Total average gain on release
13 lb.
-