Reaching out and reaching up - developing a low cost drug treatment system in Cambodia

Cambodia, confronted by the spread of drug misuse among young people, requested support

from international agencies to develop a drug treatment programme in 2000. The initial plan

developed by the United Nations Office on Drugs and Crime was to set up a number of

conventional drug treatment centres in urban areas. During the planning phase, however, the

project was redesigned as a community based outreach programme. Ten Community

Counselling Teams have been formed and trained in pilot areas, and within the first year of

operation 462 drug and alcohol users contacted. Comprising former drug users, family

members affected by drug use and health care staff, they have drug scene credibility, local

knowledge and connectivity, and a rudimentary level of medical competence. Crucially, they

enjoy the support of village elders, who are involved in the planning and reporting stages.

While the Community Counselling Teams with their basic training in addiction counselling

are in no position as yet to either provide or refer clients to treatment, they can provide brief

interventions, organise self help groups, and most importantly provide an alternative to law

enforcement. By taking a development centred approach, with emphasis on community,

empowerment and inclusion, it provides a constructive and inclusive alternative to medical

approaches and the compulsory drug treatment centres. The paper is based on an evaluation

involving interviews with a range of stakeholders and a review of project documents.