Will Brazil Support Compulsory Drug Treatment?

How best to treat people who use drugs? By prison and forced treatment in evangelical “rehabilitation” facilities, or by government-funded voluntary treatment based on evidence? This is the subject of fierce debate in Brazil, given form most recently in a bill put forward by Congress member Osmar Terra. Julita Lemgruber, coordinator of the Center for Studies on Public Security and Citizenship (an Open Society grantee), offers her thoughts.

If compulsory treatment of those with drug dependence in facilities that offer religious discipline in place of evidence-based treatment has been condemned by jurists as unconstitutional and by health care professionals as a complete absurdity—why then would the Brazilian government support such an approach?

As coverage in the April 29 issue of O Globo has made clear, the so-called “therapeutic communities” to be funded through the government’s “social society initiatives” are being politically used by congressmen who stand to receive large sums of money from the proposition. For example, Bill 7633/10, also known by the name of its sponsor, Osmar Terra, proposes forced treatment for those with drug dependence despite the fact that international authorities ranging from the UN Office on Drugs and Crime and the UN Special Rapporteur on Torture have condemned the practice. Alarmingly, the rapporteur for the Osmar Terra bill is Congressman Gerival Carimbao, is himself responsible for the “therapeutic community” known as Fazenda Vila Nova that is already registered to receive federal government funding for work with drug users.

Some may argue that forced treatment is better than no treament. However, a robust report by the Federal Council of Psychology, which organized inspections of therapeutic communities and other places of internment in 68 localities, clarified exactly what kind of “treatment” is on offer. The Council found that programs in many of these facilities were not regulated by the government, “rely on principles that are contrary to those that should orient public policy,” and disrespect fundamental rights. Those who enter for treatment are forced to participate in religious activities. Evidence-based medical or psychological support, however, is often absent.

It is unbelievable and unacceptable that the government of President Dilma Roussef, a woman who herself was victim of the abominable practice of torture during the military dictatorship, would not oppose the Osmar Terra bill that will legitimize torture in the name of health. President Dilma should not allow her administration to appear paralyzed or supportive of an approach that will further victimize the poor and the dispossessed.

Better approaches are in view. At the International Congress on Drugs, which took place in Brasilia from May 3 to May 5, more than 700 participants including respected international neuroscientists, psychiatrists, social scientists, law professors, and human rights activists articulated a call to the government to support voluntary treatment and decriminalization on the path to smarter drug policy in Brazil. Their letter, “Brasilia Letter in the Defense of Reasoning and Life,” calls on the government and the population to reflect on the very serious harm caused by drug policies that “go against fundamental guarantees of the Brazilian Constitution, spread corruption in all spheres of society, block research, prevent the debate, and stupify collective thought.”

For all of these reasons, it is time now for the government and for society in Brazil to move beyond bad proposals like the Osmar Terra bill to a more considered drug policy. And it is well past time for President Dilma Roussef to speak out, lest her biography be stained by a bill that elevates force and criminalization at the expense of law and health.

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