Addictions/Substance Abuse

Addictions are one of the most common forms of human suffering. Because helping people with addictions is challenging, in our home countries we have developed elaborate systems of care and coordination. People in successful recovery often participate in numerous healing activities, including individual and group psychotherapy, support groups, psychiatric care, spiritual guidance, complementary/alternative treatments and social work support.  Many healing activities are organized by empowered consumers.  The professionals involved may coordinate with each other so as to best support the client.  Nothing even remotely similar to this exists here.

In my opinion, Bangkok is an difficult place to attempt a recovery from any form of addiction, even under the best circumstances (e.g. mild addiction, good life structure, cohesive and understanding support network).  In Bangkok, the "ordinary" challenges and obstacles of successful recovery are greatly compounded by (1) a permissive, unstructured environment that encourages and rewards addictive behavior (and where negative consequences for most addictive behaviors are absent), and (2) the near total absence of effective treatment/support systems that are so common and plentiful in our home countries. If you lack a cohesive and engaged support system here in Bangkok, Bangkok is probably not a good place for you as someone in recovery, particularly for people in early recovery.

A sustained recovery from addiction requires commitment, and in particular, a commitment to lifestyle change. This means a commitment to living a healthier, more balanced, and more engaged life than you were living when you were actively pursuing addictive behaviors.  The services available for you in Bangkok will be: private individual counseling, psychiatric care (mostly mediocre), and 12-step recovery groups.  While individual counseling can be incredibly valuable in your journey into and through recovery, by itself it is rarely sufficient to sustain recovery from moderate or severe addictive behaviors. Most counselors in the Bangkok area offer therapy for people wanting to change addictive behavior.  Ancillary and supportive healing services are not available or at best inconsistently available (as the expatriate nomads who offer them arrive and leave Bangkok).

Please note: what is true in Bangkok is triply true in the rest of Thailand.  The challenges are multiplied and the resources are nonexistent.  For example, outside of Bangkok it is basically impossible to find a Thai psychiatrist who can support your recovery by treating addiction competently.

Recently, a number of rehabilitation centers have opened around Thailand, staffed by expatriate professionals. The 28-day, inpatient rehabilitation has traditionally been regarded as the strongest way to start recovery from moderate-severe addiction.  In my personal and professional opinion, Thailand in general and Bangkok in particular are not environments that help foreigners succeed in breaking the cycle of addiction.  Thailand is not a healthy environment for foreign men who have difficulty regulating their own behaviors. 

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12-Step Groups (self help groups are an important part of recovery)
Alcoholics Anonymous Meetings (including meetings in english)
Narcotics Anonymous Meetings

Bangkok Recovery Club (Ekamai; numerous support groups)
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Rehabilitation Centers
This is an unstable and rapidly changing area.  In recent years, a number of western-style rehabilitation centers have opened in Thailand.  Unfortunately, these programs tend to open and close in quick succession.  There have been issues around qualified management and staffing, and very high staff turnover.  Staff turnover degrades program quality and is indicative of management problems.  When evaluating the quality of a rehab in Asia, look for a program managed and run by qualified, credentialed expatriate professionals, which also has smooth, working links with local medical professionals and hospitals.

Caveat Emptor-- please evaluate each program carefully and speak with intake directors at length.  Ask each person you speak with, how long have they been working for that program?  Where did they work before and for how long?   
The programs below are, to the best of my knowledge, staffed by competent professionals and aspire to run at international standards.
[As of May 2016, we're down to two that I would recommend.  If you have suggestions, please let me know]
Log Cabin (Chiang Mai; in  place for many years; I have received good reports about this program)
Lanna Rehab (Recently opened in Chiang Mai- well staffed but quality as yet unclear; I welcome your reports)