U.S.-Style Rehabs Take Root in China As Addiction Grows

Patients take a cigarette break at the Yunnan facility, where the focus is on accountability and peer interaction  --  an atypical approach for drug treatment facilities in China.
Patients take a cigarette break at the Yunnan facility, where the focus is on accountability and peer interaction -- an atypical approach for drug treatment facilities in China. (Maureen Fan - Twp)
By Maureen Fan
Washington Post Foreign Service
Friday, January 19, 2007

KUNMING, China -- Half an hour outside this capital city in southwest China's Yunnan province, amid 100 acres of fruit trees and vineyards, three dozen recovering drug addicts stand every morning in a loose circle, their arms around each other's shoulders.

The voices that ring out do not recite the forced slogans and denouncements often heard in China's state facilities for drug users. Instead, the group reads aloud a mission statement that has been adopted from a New York-based drug treatment center:

"I am here because there is no refuge," the participants said in unison on a recent Saturday morning. ". . . Until I confront myself in the eyes and hearts of others, I am running."

That focus on individual responsibility and peer interaction is atypical for a drug treatment facility in China. Much more common are techniques used at the nearly 600 compulsory detoxification centers run by the police, or the even tougher techniques used by the Justice Department at reeducation campuses for repeat offenders. Both are military-like institutions that emphasize manual labor as part of their regimen.

Here outside Kunming, at the Yunnan Daytop Drug Abuse Treatment and Rehabilitation Center, a "therapeutic community" approach involves group counseling in a family setting. It is an approach, currently practiced by only a handful of centers in China, that could attract more adherents as this country struggles to curb a burgeoning drug problem, experts say.

The use of drugs in China has been fueled in recent years by unprecedented social change. Experts estimate there are at least 2 million to 3 million drug users in the country. Meanwhile, authorities have reported staggering increases in seizures of drugs.

Yang Maobin, the director of Yunnan Daytop, has seen the changes firsthand.

"Every year, farmers who lose their land come to the city for jobs, but they can't cope with the changes," Yang, 45, said as he watched over the morning meeting. "People all over China want a better life, but they feel lost. They cannot hold their families together, and in frustration they turn to drugs. And white-collar workers like to go to discos and use ecstasy. They like to use new drugs and follow the latest fashion."

Across China, there are more than 200 voluntary drug rehab centers. And while they treat withdrawal symptoms, experts say they fail to address the root causes of addiction. Many addicts enroll at rehab centers to evade police, fool parents or rest their veins before taking drugs again. The compulsory treatment programs run by the government have been criticized for shortcomings of their own.

"Compulsory centers haven't done enough to treat addicts psychologically, because the government is short of professional psychiatrists in centers that take care of thousands of addicts," said Guan Yongsheng, a drug treatment doctor based in the western Xinjiang region, a pathway for drugs from Afghanistan to China's coastal cities.

When the Communist Party assumed power in 1949, it cracked down on what it said were 20 million drug users, who had been helped along in their addiction by foreign drug traders, especially British opium sellers. But in the 1980s, the opening and reform of China's economic policies and the relaxation of border controls allowed drug trafficking to resume, much of it coming in from Southeast Asia.

"It just boomed," Yang said, recalling the flood of drugs at the time into Yunnan, which borders Laos, Burma and Vietnam. "Yesterday, no drugs. This morning, all over the place. Heroin was very cheap in those days."

Today, Yang oversees a program in which recovering addicts live together and work toward recovery. After the morning meeting adjourned on a recent day, a participant, Zheng Guoha, moved outside to a sunny spot for a cigarette. He was relaxed recalling the pain and ease of his addiction.

Zheng, 29, said he started smoking heroin in 1993, when he was 15. "My family is well educated. My parents gave me everything I wanted," he said. "At that time, drugs had started to appear in society, and we didn't know how addictive they were. We were just curious. We inhaled heroin and stayed at bars late at night."

Now, his former friends relax in nightclubs with their favorite drug, ecstasy. "Society is so utilitarian now. People only get along with others if they can give them something," Zheng said. "It's such a cold society, and people feel abandoned. People give up at night. They want to forget."

Just before noon, the smell of fried rice and vegetable soup began to waft through the center. Director Yang stood in the front office explaining to visitors the origins of his program, patterned on what he learned during an eight-month visit to a center run by Daytop Inc., a New York-based treatment program.

A pilot project he operated here in 1995 lasted only nine months, he said. Staff complaints, office politics, a lack of support from Chinese officials and the taint of its American origins led to the project's end.

But Yang said he was persuaded to restart the program in 1998 by recovering addicts who begged for the return of the treatment. One addict was from a wealthy family, which gave the center enough money to get started. Since then, individual programs at Yunnan Daytop have received funding from the British Department for International Development, the Catholic relief group Caritas Internationalis and Daytop Inc. itself, among other groups.

Government leaders now understand that drug addiction is a mental illness, Yang said. And while they continue to focus more on disciplining users instead of rehabilitating them, officials "are now coming to us and saying they want to learn. They call us and ask us to help them in their compulsory centers. We are about to sign a contract to help run a compulsory center in Kunming. That's a big change."

A director of the Beijing Compulsory Drug Treatment Center affirmed that the government sees merit in Daytop's methods.

"Now government agrees that therapeutic drug treatment is effective, and is going to promote it," he said on condition of anonymity, because he said he was not authorized to comment. "But since therapeutic treatment needs more money and, especially, more professional staff, the government is not capable to develop in large scale right now."

Yang said he, too, has learned to change over the years. In 1989, he was a doctor assigned to the Yunnan Mental Hospital, the first center in China for the treatment of drug addiction. "At the time, I treated the addict like a doctor to a patient," he said, recalling his work. "Now I know that's wrong because the addict just passes all responsibility to the doctor: 'I'm ill. You should cure me.' Now we know it's a behavioral problem. It's a whole disorder of a person."

Researcher Li Jie contributed to this report.

© 2007 The Washington Post Company