Against the backdrop of increasing substance abuse cases especially among the youth, the nation today faces a shortage of rehabilitation centres.
According to an official with the Bhutan Narcotics Control Authority (BNCA), the rehabilitation centres in Serbithang in Thimphu and Samzang in Paro are able to take only two to three clients each every three months.
However the number of clients that have to undergo compulsory treatment and rehabilitation for not less than three months in an approved treatment centre are twice the number of what the centres could take in.
BNCA’s programme officer with the Demand Reduction Division, Karma Tenzin, said that the two rehabilitation centres combined could take in less than 50 clients in three months including voluntary clients.
Police stations across the country referred 330 clients to the Treatment Assessment Panel (TAP) since the enactment of the Narcotic Drugs, Psychoactive Substance and Substance Abuse (NDPSSA) Act in July 2015.
The Act requires the suspects apprehended for substance abuse to be referred to the TAP for assessment.
The TAP, consisting of a medical doctor, legal officer, addiction professional and counsellors will assess the severity of a person’s substance use and provide appropriate intervention. A board member of the Narcotics Control Board chairs the panel.
Karma Tenzin said that not all suspects apprehended for the offence of substance abuse and referred to the TAP require treatment in a rehabilitation centre.
The clients are referred to a rehabilitation centre only if he or she is found dependent on controlled substances otherwise they are referred to drop-in centres for counselling.
“In a month, we have about six clients that needs to be sent to rehabilitation centres,” he said.
Minors and school students who are caught abusing but are not dependent on controlled substances are referred to counsellors in schools and institutions.
“We have to compulsorily treat clients that the RBP refers to the TAP committee,” Karma Tenzin said. “Some clients on the waiting list to join a rehabilitation centre relapse before they are enrolled in the centres.”
Considering the need for more rehabilitation centres in the country, BNCA is planning to open a compulsory treatment centre by mid this year. The centre is likely to be located in Thimphu. The authority will operate the centre.
He pointed out that some clients referred by the RBP are from economically disadvantaged families and without any means of earning because of which they are not able to afford the rehabilitation fees.
The rehabilitation fees to enroll in Serbithang and Samzang rehabilitation centres are Nu 5,000 and Nu 3,000 per month respectively.
Last month alone, the RBP referred 44 people apprehended for abusing controlled substances to the TAP.
Of the total aged between 15 and 25, some 12 are unemployed while 18 are students.
Meanwhile 17 clients were assessed during the 13th TAP meeting on March 10, where five were referred to schools for counselling, eight to drop-in centres for counselling ranging from one to three months, and three were referred for rehabilitation in the two centres.
A client who had a mental disorder was sent for psychiatric help at the national referral hospital in Thimphu.
Karma Tenzin said that the clients are given educative sessions on basics of drugs, science of addiction, ill effects as well as laws related to substance abuse and trafficking. “Individual counselling as well as group and family counselling are also conducted for the clients,” he added.
Further, relapse prevention and coping skills are also imparted to the clients.
A total of 29 individuals were assessed by TAP in January and February this year. Nine of them are students and 12 are unemployed that include class 12 and university graduates.
Karma Tenzin said that clients are referred from all across the country and the limited numbers of drop-in centres and school counsellors are other challenges the TAP and BNCA face today.
Drop-in centres are established only in major towns such as Paro, Thimphu, Phuentsholing, Gelephu, Mongar, Bumthang and Samdrupjongkhar.
Karma Tenzin said that clients living in the dzongkhags that don’t have a drop-in centre have to travel to the nearest dzongkhags that have one while some private schools don’t have counselors. “This leads to difficulties in providing counselling services to the clients.”
Section 153 of the NDPSSA Act states that the offence of substance abuse for the first time is to undergo compulsory treatment and rehabilitation for not less than three months in an approved centre if addicted as assessed by TAP or a month’s counselling if he or she does not require treatment or rehabilitation, or both.
If a person is caught abusing controlled substances for the second time, he or she has to undergo compulsory treatment and rehabilitation for not less than six months in an approved treatment centre and not less than a year if caught for the third time.
If caught for the fourth time then he or she is liable for a misdemeanour with compulsory treatment and rehabilitation, and community service for not less than a year.
Meanwhile, section 154 of the Act states that a minor committing an offence of substance abuse for the first time shall be referred for institutional-based counselling.
A non-school going minor shall be referred to an approved treatment centre for minors or a drop-in centre for a period of not less than two weeks.
The second timer shall be liable to undergo compulsory treatment and rehabilitation for not less than a month in an approved treatment centre for a minor as assessed by the TAP or community service as specified under rules and regulations.
If a minor is caught abusing controlled substances for the third time then he or she has to undergo compulsory treatment and rehabilitation for not less than three months. If a minor is caught for the fourth time, he or she is liable to undergo compulsory treatment for a year or less at a juvenile correctional centre and early release on good conduct and early recovery as recommended by the TAP.
Dechen Tshomo