By Dariush Farahani
April 02, 2020
Back in 2010, the Iranian Expediency Council amended Iran’s anti-narcotics law in a manner that drastically altered the status of drug users. The law now identified and discerned between two types of “addict”: those who would voluntarily join a treatment program, and those described under Article 16 of the new law, who would not.
Members of the first group, as long as they were enrolled in a program and did not continue to use drugs, would theoretically be given a certificate exempting them from criminal prosecution. At the same time the government reserved the right to send members of the second group to compulsory drug treatment centers for a period of one to three months, which could be extended by officials at the judiciary’s discretion.
These treatment centers are known locally as “kamp,” derived from the English word “camp”: or in Persian, kamp-e darman-e ejbari, or kamp-e tark-e e‘tiyad. These camps existed before 2010 but were formalized by the legislative change, meaning they should be regulated and overseen by the State Welfare Organization in collaboration with the Iranian judiciary.
Since then, the camps have rapidly expanded across Iran. In 2013 there were 18 such camps for individuals who fell under Article 16, with 50,000 such individuals “treated” between 2011 and 2013. In these settings, clients are ostensibly supported in their journey toward abstinence, and trained in various skills to prevent them from relapsing into drug use. The camps run a 12-step abstinence-based program modeled on those run by Narcotics Anonymous (NA) and Alcoholics Anonymous (AA), although NA does not have a formal relationship with them.
The abstinence rule within these camps is incredibly strict. Even drugs prescribed for mental health problems are forcibly discontinued on entry. According to several sources, this has led to many clients having psychotic episodes during treatment and suffering from severe downturns in their mental health. Recent studies have shown that individuals held in the camps under Article 16 face a detrimental impact to their health and wellbeing — not least indicated by the high mortality rates. Other research has shed light on a flawed admissions process, a lack of judicial oversight and severe restrictions on the roles of social workers.
Internationally, the camps have attracted widespread condemnation. They are fundamentally ineffective in bringing about sustainable health improvements. Instead, the camps have become hotspots for human rights violations, through the degrading treatment of the people living there and non-evidence based “health” interventions, including forms of institutionalized punishment and torture. In 2012, some 12 separate United Nations agencies released a joint statement calling on member states to immediately close these centers.
In Iran, concerns also abound regarding the way the camps are run, the alleged corruption impacting budgetary commitments toward them, and the abysmal conditions inside. Medical practitioners and scholars, speaking in confidence, have raised the issue of hunger in the camps. The overarching impression is that these camps have become a holding pen for the most marginalized and vulnerable drug users, homeless people, and those suffering from mental health disorders in Iran.
Elsewhere, one police chief has stated that officers in some areas frequently “mop up” urban spaces, removing those who look like addicts from the streets — and from time to time, “selling” them on to the camps. Drug treatment camps are paid per capita by the state for those apprehended and treated under Article 16. As such, there is a perverse financial incentive for wardens to fill their camps to bursting point. It is understood that some bribe local police officers to bring users to their camps rather than to others. This circumvents the official process, whereby an “addict” as defined by Article 16 is first supposed to see a physician to undergo a drug test, and a judge, who hands out a time-limited detention order.
Drug Recovery Camps as Profit-Making Enterprises
Some Iranian camps are managed by compassionate individuals who genuinely want to provide a safe space for those who voluntarily attend. Within these settings, individuals are free to leave at any time and are treated with dignity and respect. Unfortunately, they appear to be far from the norm. Most camps are run as profit-making enterprises, extracting money from the state or the families of drug users to hold them for months on end in cramped settings, with no judicial or medical oversight. These settings have become a useful way to hide the most disadvantaged drug users, homeless people and other social “deviants” from the public eye to maintain the illusion that the government is succeeding in its drug policy.
Along with a delegation of local Narcotics Anonymous (NA) members, I attended an evening session at one of the camps. Some of the NA members have a close personal relationship with this particular site, having been forcibly detained there themselves in the past. Our NA host Bagher’s brother has been held there for 12 months.
This camp currently houses a total of 112 patients. Of these, 50 have been referred by the government at a cost of 400,000 tomans per month each for treatment, and 62 are private clients whose families pay 670,000 tomans per month. The camp is attended by a doctor twice a week. Anyone who tests positive for HIV/AIDS, hepatitis or other infectious diseases on arrival is sent elsewhere.
Camp director Bijan, who has been in post for the past eight years, took me on a tour of the site. As we walked through the camp, people were at pains to tell us how good the camp is, and that they are well taken care of. Everyone stood up and greeted us as we walked past. Their behavior seemed forced rather than sincere, particularly in the presence of the director and wardens.
“When people leave the camp,” Bijan explained, “the State Welfare Organization gives them help in terms of vocational training, which is free. Some of the addicts don’t have families, others do.
“They have to read books, then they have lunch. Twice a week they have to write thoughts and feelings on paper, and then throw them away.”
In the rudimentary sleeping quarters, up to 150 people were packed into bunkbeds in one large room at night. They share a bathroom and are locked behind a reinforced steel door.
Most of the daytime is spent in a courtyard, surrounded on all sides by a high wall and containing some rudimentary exercise equipment. All the clients are enlisted to help keep the camp clean, cook food and carry out other day-to-day chores to pass the time.
No Government Scrutiny
Bagher introduced me to his brother — who, it transpires, is not a drug user. He suffers from mental health difficulties and is now well into his second year in the camp.
We enter the space in which “addicts” are held to detox for seven days on arrival. This is also the point at which the majority of those held under Article 16 die, due to withdrawal symptoms and a lack of access to health professionals. The camp director introduced me to “clients” who stood upright in a semi-circle around us.
Bijan told me: “The addicts are all clever, smart people. Here, for example, we have an aeroplane engineer.
“For the first few days they cannot eat as they are going through detoxification. After a week or so, they eat several times the amount of a normal person.
“Our internment runs for 28 days to three months. Some camps keep people for up to 11 months, or for as little as 15 days. This is under the control of a psychiatrist.
“Many camps beat people, but not this one. Everything is by the book in this camp.”
In contrast with the rosy vision of the camp the director tried to paint for me, I recalled an earlier conversation with Amin, one of the younger NA members, on his six or seven periods of internment at his family’s behest, all of which proved ineffective in the long run.
“The routine in the camp goes like this,” he had told me. “At 7am you wake up. At 7.30am you have breakfast, and after that two hours of work. Between 10 and 11am there is an NA meeting. At 12pm you have lunch, and then until 4pm you relax. After that, you work until the evening NA session. At 10pm you go to bed and sleep. Twice a week you get access to the shower.
“The environment in there is not very good. You are among 100 to 150 people constantly talking about drugs and pleasure. I fled twice and was beaten when I was found by the wardens, who brought me back.”
Back at the camp, the director Bijan revealed that he himself was formerly a drug user. He was sent to a camp, he said, and eight years ago decided to set up his own.
“Everyone in the camp is medically insured, for free,” he said. “We need to free the brain of the addict. You can do more with speaking than with medicine. Diazepam, for example, you can’t eat in here. It was given to me when I was in the hospital and it took me a year to get my brain back in order.”
The NA’s function is to improve clients’ experiences of the camp and support them in remaining abstinent. “We do what we can,” an NA member, Ehsan, said, “and hopefully they remain clean.”
This particular drug treatment camp is known as one of the better ones in Iran. It begs the question as to what those at the allegedly worse end of the spectrum may be like. Several clients including Bagher’s brother have been here for far longer than three months, and from my conversations with drug users here, few who were forcibly detained under Article 16 had seen a judge, let alone a doctor.
In a sense, serving time here may be worse than serving time in Iranian jails as the camps operate without any scrutiny, while similarly stripping occupants of their rights. There is no regular oversight of these spaces either by the State Welfare Organization or the judiciary, and money that goes into the camp is not necessarily spent on meeting clients’ needs. Many of those detained here may not have a support network, meaning no one knows where or for how long they might have been gone. They could, in principle, be held in perpetuity in the name of “drug treatment” in order to extract profits from the state and the families of drug users and people suffering from mental ill-health.