In recent years, Cambodia has experienced a surge in the use of methamphetamines, known here and in Thailand as "crazy medicine." Apart from the 11 government-run centers, drug users in Cambodia have few places to turn for help with their addictions.Photo: Justin Mott for The New York Times - More photos

PHNOM PENH, Cambodia — Nguyen Minh Tam said he got used to the routine during three months in a government drug detention center, although he sometimes lost consciousness: three punches to the chest when he woke up in the morning and three more before he went to bed.

Another heroin addict said he was whipped until he passed out with a twisted metal wire as thick as his thumb. “They used a blanket to cover me, and they beat me,” said the detainee, who insisted that only his first name, Chandara, be used. “There were 10 of them beating me.”

Ban Sophea, on the other hand, an emaciated man who supports his heroin habit by collecting used cans and bottles, said things were quite different for him during a carefully monitored 10-day detention.

“They gave us medicine three times a day from a bottle that looked like a whiskey bottle,” he said. “The rest of the time we just wasted time and ate. They let us dance and eat cake. We were eating all the time.”

These treatments — both the physical abuse and the involuntary administration of an experimental drug — have stirred concern in Cambodia since they were documented recently by the New York-based monitoring group Human Rights Watch.

In a report last month, Human Rights Watch described in detail abuses in 11 government-run centers that included electric shocks, beatings, rapes, forced labor and forced donations of blood.

“Sadistic violence, experienced as spontaneous and capricious, is integral to the way in which these centers operate,” the report said. “Human Rights Watch found the practice of torture and inhuman treatment to be widely practiced throughout Cambodia’s drug detention centers.”

This description echoes a separate Human Rights Watch report, also issued in January, about compulsory drug detention centers in China that it said denied inmates treatment for drug dependence and “put them at risk of physical abuse and unpaid forced labor.”

In Cambodia, the government dismissed the report as being “without any valid grounds” but did not address most of its allegations.

“The centers are not detention or torture centers,” said Meas Virith, deputy secretary of the National Authority for Combating Drugs, at a news conference this month. “They are open to the public and are not secret centers.”

In December, the government tried another approach that also drew criticism from rights groups and health professionals: administration of an experimental herbal drug imported from Vietnam but not registered for use in Cambodia.

Twenty-one drug users were taken to one of the drug treatment centers and administered a potion called “bong sen” for 10 days before being released to their homes or to the streets. No systematic follow-up was done, and the national drug authority conceded that at least some of those treated returned to drug use.

“No information is known to exist as to the efficacy of this claimed medicine for the detoxification of opiate dependent people, nor to its side effects or interactions with other drugs,” said Graham Shaw, an expert on drug dependence and harm reduction with the World Health Organization in Phnom Penh, in a briefing note in early December.

Like its neighbors, Cambodia has experienced a surge in recent years in the use of methamphetamines, known here and in Thailand as “crazy medicine.” A smaller number of people are heroin users.

Vietnam has a network of drug treatment centers and is reported to be widely using the herbal drug in detoxification treatments. In 2003, Thailand embarked on a “war on drugs” in which an estimated 2,800 people suspected of being dealers were summarily shot and killed.

Apart from the 11 government-run centers, drug users in Cambodia have few places to turn for help with addictions. In some cases, desperate families commit their relatives to the centers, but most former detainees interviewed by Human Rights Watch said they had been locked up there against their will.

The centers appear to be used not only for drug users but also as a means to clear the streets of vagrants, beggars, prostitutes and the mentally ill, according to Human Rights Watch and the reports of other former detainees.

Government figures for drug use in Cambodia are unreliable and range from about 6,000 to 20,000. The United Nations has estimated that as many as half a million people in Cambodia may be drug users.

In 2008, the National Authority for Combating Drugs reported that 2,382 people were detained in government drug detention centers, almost all of them involuntarily. Some families, with no other recourse, pay the centers to take in relatives for what they hope will be a cold-turkey cure.

“If Cambodian authorities think they are reducing drug dependency through the policy of compulsory detention at these centers, they are wrong,” said the report by Human Rights Watch. “There is no evidence that forced physical exercise, forced labor and forced military drills have any therapeutic benefit whatsoever.”

Like other former detainees, Mr. Tam, 25, an ethnic Vietnamese, said he was committed involuntarily along with other drug users and street people. He confirmed allegations in the report that a number of the detainees were children.

He described what he called the “eight punishments” — painful and humiliating exercises that included rolling shirtless on the ground, running into walls and a series of physical contortions with names like leopard crawl, hopping like a frog, vampire jumping and shooting Rambo.

“I think this is not treatment,” he said. “This is torture.”

As soon as he was released, he said, he resumed his heroin habit.

“Inside, you are thinking of drugs all the time,” he said. “When you come out, you are free to use again.”

Labels: drug, Phnom Penh