More S’pore residents going overseas to kick the drug habit

More S’pore residents going overseas to kick the drug habit

Search online for "private drug rehabilitation" and "Singapore", and at least six centres specialising in helping drug addicts kick the habit pop up - none of which is located here.

Instead, one is in Sabah, Malaysia, and several are in Thailand - in Chang Mai, Ko Chang and Bangkok. There are also centres in Bali, Indonesia, and the Philippines' Baguio.

They charge up to US$15,000 (S$21,200) a month.

Most of their websites have a dedicated page for prospective Singaporean clients. Their key selling point is anonymity.

They warn of how doctors in Singapore are obliged to report suspected drug use to the authorities, and highlight the strict anti-drug laws and stiff penalties here.

"A client can fly directly from Changi Airport to Chiang Mai and return following rehab without anyone in Singapore ever knowing," according to The Cabin Chiang Mai, which charges US$14,000 a month.

Operators said the number of drug rehab patients from Singapore is increasing, and they stay for an average of two months.

The Cabin Chiang Mai had 46 clients from Singapore in the first 10 months this year, and 52 in 2014. It had 23 patients from Singapore five years ago when it first opened.

Solace Sabah has a toll-free hotline for calls from Singapore. It had 18 Singapore clients this year, and they made up a quarter of its clients. Hope Rehab Centre in Bangkok opened in 2013 and sees 20 to 30 people from Singapore a year.

Dr Munisada Winslow, senior consultant psychiatrist at Promises Healthcare, Novena Medical Centre, said he refers two to three patients for overseas drug or alcohol rehab each month.

Given the high fees these centres charge, their clients tend to be from the upper and middle classes.

Most are in their 30s and 40s, and in professional and managerial jobs. According to The Cabin Chiang Mai, nearly nine in 10 of its Singapore clients are in professional, managerial, executive and technical jobs.

Topping the list of addictions they seek treatment for are the abuse of methamphetamine, prescription drugs and heroin, along with alcohol.

But increasingly, Singapore clients are also getting younger.

"We are seeing a shift to a younger demographic of professionals and semi-professionals, often from good families, well-educated and upwardly mobile," said The Cabin Singapore's head counsellor Suresh Joseph.

The Cabin Singapore, at Novena Medical Centre, conducts outpatient addiction treatment and does follow-up care for clients of its facility in Chiang Mai, once they are discharged and return to Singapore.

Mr Joseph's observations reflect a key worry among the authorities - that more young people from middle-class families and who do well in their studies are using drugs.

Last year, of the 1,093 new drug abusers arrested, two-thirds were aged below 30. This is a 24 per cent increase from just five years ago.

"I've had calls with Singaporean parents seeking help for their children's addiction. They wouldn't give me their last name or any details," said Mr Alastair Mordey, programme director at The Cabin Addiction Services Group.

Fear of being identified and ending up with a criminal record is another big reason why the number of Singapore residents at these regional rehab centres is on the rise.

"There is a huge amount of fear and they feel safer going overseas," said Mr Mordey.

He recalled a phone call from a Singaporean who had "meth mouth", which is the severe tooth decay associated with methamphetamine abuse. He needed dental care but was afraid of being reported to the authorities by the dentist.

Dr Prem Shanmugam, the chief executive of rehab centre Solace Sabah, said he often receives phone calls from family members of addicts looking for help. One in particular stuck in his mind.

"I had a woman from Singapore call about her husband, and her first question was: Would you report him to the police?" said Dr Prem, who is also president of the Association of Psychotherapists and Counsellors (Singapore).

Singapore law requires doctors to inform the Central Narcotics Bureau (CNB) if they are treating any person for drug addiction.

"CNB may act on the information, to ensure that the person has stayed off drugs, and provide additional intervention if necessary," said a joint reply to The Sunday Times by the CNB, Singapore Prison Service and Singapore Corporation of Rehabilitative Enterprises.

Addiction professionals, however, question this policy.

Said Dr Winslow: "People need to be encouraged to seek help, and the reporting system tends to make people hide their addictions."

Mr Joseph described the reporting system as a double-edged sword. "While it deters people from wanting to try drugs, it also deters those who succumb from seeking treatment."

Tampines GRC MP Desmond Choo, who is on the Government Parliamentary Committee for Home Affairs and Law, stressed that deterrence is a major arm of Singapore's anti-drug efforts.

"The best way to care for our people is still to discourage them from trying illegal drugs in the first instance," he told The Sunday Times.

But when it comes to addicts, the focus is on helping them and there is a wide range of rehab programmes, the authorities said.

"Rehabilitation is a key plank of our fight against drugs," the joint statement stressed.

First-time abusers under the age of 21 are placed on the Youth Enhanced Supervision Scheme or at the Community Rehabilitation Centre. Family members are roped in and voluntary welfare groups help support the rehab process.

First- and second-time drug abusers aged 21 and above undergo compulsory rehabilitation at the Drug Rehabilitation Centre, which includes schemes to strengthen ties between them and their families.

The Sunday Times understands that such offenders are usually not charged and so do not end up with a criminal record. "So there is reduced stigma," said Mr Choo.

"If you come forward and seek treatment yourself, you will not be convicted," said Pasir Ris-Punggol GRC MP Zainal Sapari, who was part of the steering committee for a government taskforce on drugs.

He added that the drug abuse problem here is not of such a magnitude that "we need to make changes to our law to encourage more people to come forward".

Dr Prem suggested that the authorities make clearer the rationale for the reporting system and what they do with the information, so people will not fear seeking help.

And Dr Winslow said overseas rehab clinics may not be the best solution. It is tougher to ensure proper follow-up care with the client here and the centre overseas. Without proper coordination, the risk of relapse is pretty high.

He added: "Also, regional rehab centres tend to be unregulated, with variable standards of care and effectiveness."

This article was first published on November 29, 2015.
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