Illegal rehabs cash in on inadequate drug treatment facilities

After getting admitted to college six years back, Manik (not his real name) began experimenting with yaba with some of his friends in Mugda area in the city. His friends were all classmates from the same college.

Within a year of using yaba, he found it hard to survive without the stimulation produced by the drug. He spent more time in Mugda area instead of going to college. And this pattern continued.

One day, four months back, after taking yaba with friends, Manik came home to Badda late at night. His mother suddenly told him they would need to go out as his elder brother had had an accident. He and his mother arrived at an area close to Badda Thana. Then, in the blink of an eye, a microbus appeared from nowhere and Manik was whisked off by some people.

He would discover later that the vehicle belonged to a drug rehabilitation centre named the Aradhana Madakashakti Chikisha O Paramarsha Kendra in the Tejgaon area.

On a five-storey building in Tejgaon, Aradhana is a 30-bed facility. Manik has been residing in a room on the third floor for the last one month along with seven to eight other recovering addicts in a 20 by 20 feet room.

When this correspondent approached Manik, he appeared nervous.

"I am not allowed to speak to you. If I say anything, they will beat me up."

Although given his condition Manik can barely be described as a reliable narrator, allegations of physical abuse against drug rehab facilities like Aradhana is nothing new.

Aradhana is among at least 200 such facilities in Dhaka city alone who are not registered with the narcotics control department and yet continue to provide so-called treatment to drug abusers.  Their name is not on the list of rehabs approved by the government.

And yet Manik's parents spend Tk 10 thousand per month for his treatment in the rehabilitation centre.

The owner of the rehab, Syed Mizanur Rahman Sumon, admitted that their licence has been revoked by the authorities two years back.

"We operated out of a tin-shed facility which is why our license was revoked. We have since upgraded but the government is yet to certify our facility," he added.

According to narcotics department officials, however, the licence revocation had more to do with their failure to maintain the specified standards for running a rehab facility.

This correspondent did not find any doctor or nurse at the rehab centre. By law, for every 30 patients there has to be one physician present at all times, one psychiatrist and two nurses.

Seeking anonymity one patient's relative claimed that some time the rehab staff physically abuse patients to bring them under control.

The main reason behind the growing number of unauthorised rehabs is the lack of such facilities both at government and private levels. There are no official statistics on the number of addicts in the country. Officials of the narcotics control department said the number is estimated to be no less than 70 lakh.

Dr Arup Ratan Chowdhury, founding president of Manas, the association for the prevention of drug abuse, told The Business Standard that many people are finding ways to come back to normal life as the government has begun cracking down on drug abuse.

"As there are insufficient rehabs across the country, people are getting admitted to the illegal ones too," he said, adding that entrepreneurs are now being encouraged to set up private facilities across the country.

Insufficient government facilities

One-third of the districts in the country do not have any rehabilitation facilities, be it government or private. There are no rehabs in 23 districts, including Meherpur, Panchagarh and Kurigram – the districts bordering India.
 
The county has four rehabs in four divisional headquarters. The largest of those is the Central Treatment Centre, which is based in Dhaka and has 124 beds. Of those, 90 are for men, 24 for women and 10 for children. Chattogram, Rajshahi and Khulna each has a 25-bed rehab.

Altogether, there are 199 beds in government-run rehabs. The admission fee is Tk10 and a deposit of Tk500 needs to be made. The monthly expense is Tk350.

Syed Emamul Hossain, chief consultant of the narcotics control department, told The Business Standard that the existing facilities are insufficient. "The government has taken initiatives to set up a 200-bed rehab in all divisional headquarters."

Seeking anonymity, a high official of the department, said the government centres grapple with a bed crisis most of the time, and this is one of the reasons why patients go to private facilities.

"Another reason is that they think people will come to know all their private information if they go to a government centre. So, they go to private centres to hide their information," he said.

In general, government-run rehabs provide treatment for a patient for 28 days. It is extended by another 28 days if doctors find that the patient still has the tendency to take drugs.

Private facilities making profits

According to the narcotics control department, there are 319 private rehabilitation centres across the country with a capacity of 4,035 beds. Dhaka has 119 clinics, the highest among all areas.
 
Treatment time and cost in these facilities vary. The monthly expense is between Tk40,000 and Tk1 lakh. Also, it is hard to know the condition of patients and treatment methods as relatives have little access to rooms patients live in.   

In most cases, private rehabs do not want to maintain the rules set by the narcotics control department. Some of those admit more patients than the approved limit.

SM Zakir Hossain, director (treatment and rehabilitation) of the department, told The Business Standard that the agency is trying to compel rehab owners to comply with the rules and regulations.

Psychotherapist Dr Mohit Kamal said many private rehabs are run by former addicts and they do not have formal training to provide treatment.

"It is not an easy job to treat addicts without formal training," he said.

When asked about illegal rehabs in the city, Home Minister Asaduzzaman Khan Kamal said action would be taken against them.