Innovative community based drug treatment pilot makes inroads in Cambodia

Banteay Meanchey (Cambodia), 8 February 2012
- In a northern Cambodian province, eight small communes are making Cambodian history as the first to trial a community-based approach to drug treatment. With the assistance of the United Nations Office on Drugs and Crime (UNODC), WHO, UNAIDS, the National Authority for Combating Drugs (NACD) and other partners, the Banteay Meanchay communities are piloting an evidence-based drug-treatment system that places the individual - and their community - at the centre of treatment. It's also getting noticed.

"Before this programme, my community suffered greatly from drugs. The selling of drugs was as common as selling candy in my district," said one commune member who wished to remain anonymous.

Since the program's inception however, illicit drugs have greatly diminished in the community. Community stakeholders such as parents of drug-users, local authorities and drug-users are more united. Police attitudes towards drug users in the community have also changed -- because of clear community instructions that drug-users should be encouraged to receive treatment instead of being punished.

Launched in 2011, UNODC's Community-Based Drug-Treatment (CBTx) program is a vastly different alternative to the Compulsory Centres for Drug Users (CCDUs) currently in place throughout Cambodia. Studies from around the world show that community-based models of treatment for drug addiction are far more effective than compulsory treatment largely because they create long-term supportive environments for users that include family and the community.

With assistance from the local community, the Cambodia Community-Based Drug Treatment program provides drug users with voluntary, cost-effective and sustainable drug treatment, rehabilitation and reintegration services. Community stakeholders include public hospitals, health centres, HIV/STI services, non-government organizations, families, community leaders and the police. At any stage of their drug use and dependence, drug-users can freely and continuously access services that include counseling, self-help and harm-minimization education.

Local support available is extensive. This encourages more people to access drug treatment and creates a virtuous cycle that benefits the community. The Commune Chief visits drug users at home while local non-government organizations provide transport for drug users to service providers. Community based treatment project participants now have greater job opportunities, while the community has benefited from improved security and safety within the commune.

There is a pressing need for community-based drug treatment services in Cambodia. Illicit drug use, particularly of amphetamines, is increasing throughout the country. Government estimates of the number of people who use illicit drugs range from 23,108 to 75,000 people. The majority of these are young people. This is of particular concern as around 50% of Cambodia's population is aged below 20 years.

Given the risks that drug use thereby poses to Cambodia's growing workforce, the Royal Government of Cambodia specifically requested that the UN pilot community-based treatment in the Country. UNODC worked with the Government, WHO, UNAIDS and UNICEF to develop a 5-year Community Based Treatment Project, which is designed to expand to cover 350 communities.

This initiative has received support from the senior-most political levels in Cambodia. It also has the potential to provide a model for other Greater Mekong Sub-region countries who wish to move away from their current heavy reliance on compulsory centres for drug users towards more evidence-based, community level, voluntary drug treatment services.

"Community based drug treatment is an alternative for drug users which has been found to be effective in Banteay Meanchey, so there is a requirement to expand such a services," said His Excellency General Ke Kim Yan Deputy Prime Minister, Chairman of the National Authority for Combating Drugs at the CBTx pilot phase concluding evaluation.

Within the United Nations, UNODC is the leading agency for combating drug and crime-related issues. To deliver this programme, UNODC Cambodia has partnered with Cambodian government authorities including the National Authority for Combating Drugs (NACD), the Ministry of Health (MoH) and the Ministry of Social Affairs, Veterans and Youth Rehabilitation (MoSAVY). UNODC has also partnered with other UN agencies including WHO, UNAIDS and UNICEF, as well as with other non-government organizations to deliver this programme. Supported with funds provided by Sweden and the United States, the Global TREATNET programme and the Global Joint UNODC-WHO Programme on Drug Dependence Treatment, the community based treatment program is expected to expand nationwide in Cambodia by 2016.