We arrive at Tham Krabok, Thailand’s monastic answer to the Betty Ford clinic; the door of our minibus is slammed back to reveal a 6ft 2in tall Buddhist monk, a Vietnam vet. ”OK,” he rasps. ”Who’s fucked up?” When the clearly intimidated Stuart Brindley, a methadone addict from Dundee, admits that he is indeed in a bit of a mess, Monk Gordon stares intensely into his eyes. ”Well, Braveheart, this is the last stop. Everything in the past is gone. You either live or you die, brother.”
An hour later, Brindley is experiencing another aspect of Tham Krabok’s unique welcome. His body is racked with grim convulsions after drinking a shot of the monks’ home-brewed herbal medicine. Alongside him are 11 other addicts, retching and spewing like a line of wells striking oil. They’re all trying to be rid of drug habits that have taken an unforgiving grip on their lives. Whether it’s heroin, crack or methadone, all are desperate to be clean. What sets Brindley aside is that he’s the first British addict to receive treatment at the monastery since it was given the green light by the NHS to be part of clinical trials alongside chemical detoxes in the UK.
It is mainstream recognition for what is, perhaps, the most radical treatment for addiction in the world. When Brindley and other addicts enter the monastery, they leave behind most of the trappings and comforts of 21st-century life. They take sacred vows, live in a spartan compound, wear basic cotton pyjamas and line up for strictly timed daily rituals. If they’re a danger to themselves or others, they may be chained to a pillar in a locked cell. They place their welfare in the hands of brown-robed monks, 40% of whom were junkies who themselves detoxed at Tham Krabok — and they place their dreams of a drug-free life in the hands of a higher spiritual force.
For five days the patients rise at the first light of dawn to swallow a secret potion. Its formula of 108 herbs and barks not only eases withdrawal symptoms, but also contains a brutal emetic to help expel the physical debris of addiction. After the forced sickness, there’s a week, sometimes longer, of odd jobs, relaxation, meditation and contemplation under towering statues of Buddha.
It’s 9 600 kilometres and a world away from residential treatments in Britain. There, rather than monks, it is doctors and nurses who supervise the physical detox, either in dedicated NHS beds, hospital psychiatric wards or contracted units in the independent sector. Individual regimes differ, but addicts will usually be stabilised on methadone, before being weaned off with gradually reduced dosages over the next five to 10 days, while taking a chemical such as Lofexidine to lessen the agony of withdrawal. Typically, they’ll then receive around 10 to 14 days of psychological support and counselling before leaving. Some may also take Naltrexone, which works on the brain’s receptors to block the heroin’s ”high” and accompanying cravings. Ideally, the ex-addicts will then get funded through continuing rehabilitation. (The 12-Steps recovery programme, with its belief in a higher force, that is pursued in Narcotics and Alcoholics Anonymous, would be the closest parallel to the spirituality of the monastery’s regime.)
Depending on the trial results, the two approaches — British and Thai — might one day be related: non-identical twins both funded by the NHS. Having visited Tham Krabok five years ago, the very idea of the monastery taking part in clinical trials — questionnaires, statistical analysis, computer print-outs — seems extraordinary. I’ve always wanted to go back. Several foreign patients have told me that it transformed their lives, often after they’d relapsed on detoxes at home. But I always spoke to them after the event; I wanted to see someone actually going through the mystical Buddhist treatment. I also hoped to taste the medicine myself, to take part in the hypnotic ceremony that left addicts purged and wonderfully serene. Brindley’s visit gave me the chance to do both.
His journey to Thailand began 25 years ago. He first took amphetamines when he was 13 — ” back street blues, three for one pound” — to keep him going at northern soul all-nighters, mixing them with barbiturates. Four years later, like many teenagers in Dundee, he moved on to the seductive buzz of ”dfs”, the prescription painkiller dihydrocodeine (df118).
”I can still remember the first time. I took three and lay in the park. Nothing. I took three more. Nothing. By midnight I’d taken 15. When they finally kicked in, it took all week to come down. There were six of us that night, all schoolmates; first lassies together, first bevvies together. Now there’s only two of us left alive.”
Brindley was soon lying to his GP that he was a heroin addict, a condition allowing him to get ”dfs” on prescription. He was rattling on 100 df118s and 60 temazepam (tranquillisers) each week. Living on benefits, he now hid his habit from friends and family. There were odd run-ins with the law, but close relatives bore the brunt of any crime. ”I’d take money and bank cards from my brothers’ wallets, jewellery from my ma. I did a lot of bad shite to them.”
Four years later, in 1990, the year his son Nathan was born, Brindley’s relationship and drug habit came to an abrupt halt. His doctor cut the supply stone dead, sending him to the Dundee Drug Problem Centre, which transferred him to a daily dose of methadone — usually given as a synthetic replacement for heroin. Around 60 000 people in the UK receive it on prescription, either stabilised on a regular daily dose, or being weaned off on reduction programmes supervised by pharmacists. Not Brindley. His use spiralled. He was soon ”topping up” through the black market, doubling his prescribed dose to 200ml a day. Around half a coffee mug, it’s roughly four times the average stabilisation volume.
With methadone came cravings for sweets — up to 57 bars of chocolate and 19 litres of Coke a week — bad teeth and huge weight gain. He tried to get clean. An eight-month detox in 1995, costing around 15 500 pounds, saw him switch immediately to alcohol and then, weeks after finishing, back to methadone. By 2000 he’d relapsed to 200ml a day. ”I went for a long weekend in Blackpool with Nathan, my sister and brother-in-law. They’d be larking about, enjoying themselves, while I’d sneak away for my fix. You couldn’t call it a life. I think methadone kills the soul.”
By March 2001, he’d had enough. ”Enough of lying, hurting people I care about, enough of being a dirty junkie.” He hired a room every Wednesday and set up a support group, drawing the strength to detox from three or four other methadone users. Under a supervised programme, he started to cut down. His father’s death last September gave him more incentive. ”I want to do this for his memory.”
It was a huge struggle to kick the final dregs of methadone. Experts wouldn’t be surprised. Some believe the synthetic opiate has a longer half-life in the brain, making it tougher to withdraw from than heroin. Others point to the physical habituation — the lifestyle of taking a daily dose over many years. What all agree, however, is that it’s a hard habit to break.
And then fate intervened. At a meeting of the Scottish Drugs Forum, where he did voluntary work, Brindley met Mike Sarson, a passionate advocate of Tham Krabok’s regime. The Berkshire-based drugs counsellor had first heard about it in the early 1990s, visiting several times and striking up a rapport with the then abbot, Phra Chamroon Parnchand. Sarson’s enthusiasm met only scepticism back home, so he funded British patients out of his own pocket, bringing them over during his holidays and rehabilitating them in his own home for months afterwards.
Time after time he watched addicts get and stay clean (more than 100 000 mainly Thai addicts have now taken the treatment). After setting up East-West Detox in 1996, Sarson courted local businesses for funds and collected money in pubs. He brought a GP, psychiatric nurse and a police representative out to Thailand to witness the treatment. ”I’ve put my personal integrity on the line over this,” he says. ”All the patients I’ve taken over had been through chemical detoxes that hadn’t worked. I’m not saying it’s better, but this can definitely be another option.”
In fact, what evidence there is suggests Tham Krabok’s results compare favourably. Nine of the 12 patients East-West has taken there have remained drug-free. An Australian organisation, the Tham Krabok Foundation, claims that more than 70% of the 400 addicts it has taken are free of their former addiction, ”with the vast majority clear of substance abuse”. Surprisingly, the monks, who have followed 65 foreign patients over the past two years, claim total abstinence is more like 30% — and 70% for Thais who return to families and a familiar environment.
By contrast, figures for some of England’s 94 residential rehab units suggest total abstinence rates of between 15 and 20% after five years. There are notable exceptions: Clouds, a charity offering treatment for both NHS and private patients, claims that 61% remain clean after 30 months. Doctors also point to other measures of success, including reductions in injecting, crime rates and use of harder drugs.
That wouldn’t represent success to Brindley, however. His only target is to be free of all addiction. Having convinced East-West of his determination to succeed by further cutting down his methadone intake to 18ml a day, he became their first methadone patient to travel to Thailand. All the others were on heroin or crack.
Less than a week before departure, we speak on the phone. Brindley knows that Tham Krabok will be gruelling, but is worried I’ll portray it as ”junkies in deckchairs”, a sort of Thai holiday camp. He changes his mind three times before agreeing that I can follow him. I plan to spend a week observing his physical detox, then head off, leaving him in peace for further rehabilitation.
I’m not expecting a wasted heroin addict, but when we meet at Heathrow I’m shocked to see that Brindley is far stockier than Vince Cullen, the IT specialist who has given up his holidays to buddy the Scotsman through the detox. Although they’ve met just once before, he seems relaxed in the company of the East-West volunteer. It’s only when we walk out into Bangkok’s stifling 92% humidity that there’s a surreal reminder of why we’ve come. ”It’s just like Dundee,” Brindley says matter-of-factly. ”On 200ml, the sweat would roll down my back, even in the winter snow.”
As we drive 80 miles north to the monastery, he tells me, ”This is my last hope. Any faith I have left I’ve put into this detox. I’m not scared of the treatment, I’m scared of failing, of being on methadone for the rest of my life, like a diabetic on insulin.” Yet he also talks about future plans: studying social work and coaching football to local youngsters. ”I’m really excited.”
But as we arrive at Tham Krabok, the confidence fades. Whether it’s the brooding mountains, the statues looming above the dense foliage, the monk breaking rocks or the packs of stray dogs in the clammy heat, Brindley seems to wither. The strapping 38-year-old reminds me of a small boy on his first day at school.
After signing in, he’s weighed, measured and given the addict’s pink and orange pyjamas. ”Bit severe,” he whispers. ”I feel like Steve McQueen in Papillon.” He hands over his last supply of methadone – it’s now more than 24 hours since he took a pre-flight stabilising dose — which a monk pours unceremoniously into a water cooler tray. He then heads to the open-sided shrine to take the Sajta, the sacred vow of abstinence. He is not alone. There’s a tiny, shaking Thai alcoholic and a family of five, the mother and father here for treatment, accompanied by their three children. Babysitters are a luxury in Thailand.
When the Scotsman says that he has been on methadone for 12 years, the senior monk studies him with wide eyes. What does he know? The Scotsman vows he’ll be drug-free for the rest of his life. In a week’s time, he’ll receive a kahtah, a sacred word that he’ll memorise, before swallowing the paper it’s written on, and repeat if he’s ever tempted to relapse.
Almost immediately, the shrine’s serenity is replaced by the cacophony of the medicine ceremony. After entering the addicts’ compound, past a giant portrait of the king, the new patients kneel by the side of an open drain. I join Brindley to experience a first purge. It’s not a private affair. There are 11 other addicts — 10 hooked on yabba, the amphetamine-based tablets now sweeping Thailand, the other on heroin — all of them sporting the chequered sarong worn for vomiting. Across the drain, those in post-treatment rehab strike up a mesmerising chant, backed up by drums and cymbals. Their rhythm picks up with the arrival of the herbalist, an elderly monk with neck sinews like tree roots. He whispers a holy word over the medicine and pours each of us a liquor glass shot.
The recipe appeared in a vision to the abbot’s sister, Luang Poh Yai, in 1959. The mix, looking like a thick, evil form of Coca-Cola, was honed over the next two years as the monastery became one of five treating addicts in the country’s offensive against widespread opium addiction. But while the others’ brews — only one still offers a detox — induced immediate semi-consciousness, Tham Krabok’s made you violently sick. Unsurprisingly, it tastes shocking. Absolutely shocking. Like a liquid ashtray, as if someone has stuck 50 cigarette butts in a blender. We hold it down, letting the herbs cleanse, until, at the signal, we start greedily spooning water out of buckets. Litres go down. My stomach distends like a famine victim’s. I push my fingers down my throat, but nothing happens. Next to me, a tattooed monk — many take the medicine for a regular purge — hurls like a fire hydrant. The hypnotic background chants rise, subside and rise again. I realise people are actually co-ordinating their ejections with surges in the rhythm.
That takes practice. I’m suddenly racked by uncontrollable waves of dry retching. I push most of two whole fingers down my throat, gagging horribly. And then it starts. Small dribbles at first, building up to several staccato jets into a tin bowl. Sweet relief. My last emissions, minutes later, are dark spurts that splatter the photographer a couple of yards away. My body feels strangely tight. Brindley, however, is still struggling. A monk clamps him around his middle, helping him bring up the liquid. He finishes five minutes after everyone else.
I rejoin him at 5.45am next day. He’s back by the drain. ”Fuck, it’s awful,” he groans. ”I cannae go through with this. I’ve nothing left.” He’s wrong. Another ghastly brown arc of liquid raises a cheer from watching Thais. Although he hasn’t slept, he’s still joking: ”I heard the birds singing this morning – they went, ‘Uuuhhhhgggg’.” He’s also reflective, saying that he felt cleansed by last night’s medicine. ”Colours were brighter. I’m sure that Buddha statue was smiling at me.” Around 10am, he realises that he hasn’t even thought about collecting his prescription from the chemist, the ritual that has dominated virtually every day of his adult life. ”Who’s fucked up? I’m fucked up. All I did for 12 years was think about getting methadone. It’s an obsession.”
Occasionally, a bell rings to summon the addicts to daily rituals: the singing of the Thai national anthem, the hand-out of Tham Krabok money (good for food and sweets, but unusable outside the compound), herbal tea and tablets, a regular sauna to help the muscles, breathing and skin, and afternoon meditation.
Brindley’s room is clean and bright. Graffiti tells of foreigners slowly enduring detoxes: days are crossed off one by one, ”Fuck the Pain” is scrawled on the back of the door. Brindley will live there for all 15 days, but after five he can be accompanied outside the compound for work tasks.
Next morning, despite zero sleep, he’s still fine. He wears his patterned sarong jauntily like a kilt – ”Royal Stuart tartan.” He stands up, putting his full body into the vomit. ”It’s years on the drink,” he explains. ”I always made sure I missed my shoes.”
The first faint signs of trouble arrive at lunchtime. The herbal tea is ”disgusting”, he suddenly sneers; it’s ”de-motivating”. An hour later, almost exactly 72 hours after the last dose of methadone, the ugly withdrawal symptoms kick in: aching muscles, the soles of his feet ”burning up”. He lies on his bed, sheet over his head, moaning. ”I miss my wee lad, I want to leave.”
Cullen tries to calm him, bringing him bananas to replace potassium lost through vomiting. But Brindley is furious. He hasn’t been told enough, he claims, decrying the conditions — which to me seem no worse than a backpack hostel — as disgusting. He’s bored, isolated and claims that a Thai addict has tried to charge him for translating a simple request. ”They’re taking the piss. What happens if I’m violent?” That night is awful. He drags his bed around the room and smashes his head against the wall. His body, he tells me next morning, is screaming. ”I’m on fire from my toes to my waist, from my fingers up my arms.” A nun, Sue Pin, brings boiled rice soup to ease the stomach pain, but he seems little better. He begs me to get help from the British embassy in Bangkok and demands a loan of 1 000 pounds. ”I’m drug-free now. I need counselling and support. You can’t make me stay.”
He snaps angrily at Cullen’s reassurances. ”This is the last resort,” he groans. ”I’m at a drug rehab in Thailand. I don’t fucking believe it.” Worries about ”junkies in deckchairs” stories seem a long way away.
A masseur is called. Brindley lies there, hand over his eyes, growling at the agony, maniacally laughing at the ecstasy. He sits in the compound’s narrow bathing pool. It brings a brief moment of relief and lucidity. ”I could talk myself out of this, I really could.” It doesn’t last. His mood swings violently. ”Spirituality? Don’t give me that crap. I’m through with it.”
That afternoon, he tries to check out. Cullen can’t prevent him from going, but uses the first of many delaying tactics. Flights may not be available, he says, it could cost around 1 000 pounds to change. The intellectual Monk Hans takes over, gently urging him to stay and giving him more fruit.
Brindley sits there sourly. ”This place is freaky,” he growls. ”I’ll stay at your hotel tonight, Ian, and fly home tomorrow.” He’s drawing me in. It’s an uncomfortable feeling – are we about to witness the first East-West patient not to complete the detox?
And then, at the very last minute, a large figure looms in the doorway: Monk Gordon, the only person, according to Brindley, who talks his language. Like Samuel L Jackson’s hit man in Pulp Fiction, the monk launches into a preacher’s tirade. ”Go ahead and die brother, but die somewhere nice because other addicts gonna step over you and spit on your body. Tell me now, I’ll issue the last rites.
”Tell the drug you ain’t no monkey. Hell no. He’s chasing you but you ain’t gonna climb no tree. C’mon brother, you cuss him, you call him a motherfucker. You ain’t no quitter.”
It’s pure theatre. I see the Scotsman’s eyes filling up. ”Ain’t no shame, brother,” says Gordon. ”Let the tears flow right down to your dick.”
Brindley composes himself. ”OK, I’ll see you tomorrow.”
The incident sparks off days of wildly erratic behaviour. He talks of escaping to score drugs, of deliberately breaking his arm to get home on emergency insurance. Several times he mentions suicide — a ploy, believes Cullen, to get back to Scotland for methadone. Despite being physically threatened, the volunteer buddy spends several ”long dark nights of the soul”, talking Brindley out of leaving again and again. At other times, it’s Monk Hans or Sue Pin. Finally, when all else fails, it’s the abbot himself.
I’m consistently struck by people’s kindness. Cullen, an alcoholic for 25 years, says, ”I know every tactic, every excuse”, while Monk Hans arrived at Tham Krabok ”shaking, sweating, spaced out” after ”horrible” shamanic experiences in the Amazon.
It’s clear that the addicts are deliberately allowed to experience withdrawal pain. Overcoming the darkest moments and building up willpower are one ingredient in a pot pourri of spirituality — the intangible element of the treatment that the monks credit with 95% of its success. ”You have to pay your karmic debt,” explains Monk Hans. ”It’s the whole encounter with what you have done to yourself with drugs. That’s why we don’t give anything to relieve pain.” Tham Krabok is a sacred site — you couldn’t administer the medicine elsewhere to the same effect. ”The abbot calls the monastery an airport to Nirvana,” says Monk Hans. It’s telling that many monks are ex-junkies and that several are former criminals — one is said to be a former mafia Mr Big.
Just getting to Tham Krabok is part of the cure. Cullen constantly refers to the ”Journey of the Hero”: the ritualistic passage to manhood now lost in the west. It involves visiting an alien place, accepting the help of strangers and returning home changed for ever. And one thing’s obvious: the monastery really is an alien place. The fruits of the abbot’s visions are everywhere: a 100-ton water wheel dreamed up to clean Bangkok’s canals, huge, half-finished statues, bodies embalmed in home-made fluid, reams of music composed by setting note patterns in rocks, and thousands of bottles of coloured acid for the abbot’s experiments.
On night five there is a subtle but undeniable change. As usual, Brindley is awake, pacing the room, uttering primeval groans, battering the window bars. Around midnight, Cullen takes him to the shrine. ”I asked Buddha for 10 minutes’ sleep,” Brindley tells me next morning. ”I got 35. I think I’ll ask for the full eight tonight and a lie-in on Sunday.” Perhaps it’s macho pride, but at this moment he can only joke about it. Later, he admits trying to close his mind and open his heart: ”I have to grab whatever’s offered.”
That morning’s vomit is a joyous occasion. He sends large, frothing fountains across the drain, raising his arms to whip up a cheering crowd. On the morning of my departure, a bleary Cullen is revising the charity’s approach to treating methadone addicts, including longer stays and a mandatory 24-hour notice period for checking out. But I leave Brindley in the most positive mood of the week. ”I’ve looked inside myself and found strength. I’ll cope with problems at home rather than running to the chemist. I’ve got my life back.”
For the next week, before returning to Dundee, he’ll live in the compound while working – perhaps on new buildings, perhaps on the giant speedboat the abbot has dreamed up — and, hopefully, relaxing. The trip, including his and Cullen’s flights, food, accommodation and treatment, has cost 2 500 pounds, paid for by East-West Detox, the Hope Trust, an Edinburgh-based charity, and the Dundee Drug and Aids project. In an age of closely scrutinised NHS expenditure, with domestic detoxes and rehabs starting at around 6 000 pounds, it could represent serious value for money.
”Tham Krabok is an enticing prospect,” says Dr David Best, senior lecturer at the Institute of Psychiatry. ”It could be particularly good for long-term addicts maturing out of drug use who are really committed to getting clean, or those referred through the criminal justice system.” Best is especially interested in the monastery’s potential for rehab. As an NHS expert on the treatment of addiction, he believes that our ”very sophisticated and effective” chemical detoxes are often sabotaged by the lack of effective follow-up support. ”It beggars belief that, with such a strong commitment to treatment on behalf of the NHS, there’s often no adequate cooperation with social services to ensure funding for aftercare. Effectively, a person gets clean, but then returns home, often to the same inner-city problem area, with no support system in place. They’re vulnerable. It’s a recipe for disaster. Half to two-thirds will relapse within about three weeks of finishing treatment.”
Tham Krabok could offer a viable alternative in two ways, he says. First, it takes addicts to the other end of the earth from the streets that spawned their problem. Second, it offers the possibility of extended rehab at very low cost. Should Brindley wish to stay longer in other monastical buildings — by private arrangement with the abbot — it will cost just £10 a week.
”It offers such a radical departure from a drug user’s normal lifestyle, along with a post-detox period to continue psychological recovery,” says Best. ”The cost is negligible. Sending people for several months is cheaper than three weeks’ detox in the UK.”
East-West Detox hopes to establish a house within the monastery’s grounds for people to extend their rehab in Thailand. Its present treatment package ensures telephone counselling and advice for returning patients, including, if needed, help to arrange residential rehabs away from old drug haunts. However, a small organisation has its limits and the charity does n’t anticipate taking more than 90 people a year from the UK and Europe — a tiny dent in Britain’s 281 000 problem drug users. It also fears that greater numbers of westerners would dilute the unique experience.
And Best sees some difficulties ahead: medical cover and safety issues will be a major concern, he says. At present, only one NHS regional board has approved the trials (comparing the success rate of the Tham Krabok treatment with that of chemical detox treatments and methadone programmes in Britain) — and some won’t send patients without analysing the medicine. And that’s never going to be allowed.
So, could we really see it on the NHS? Last year, the government set up the National Treatment Agency specifically to increase the availability of effective treatment for drug addiction both inside and outside the NHS. Successful trials couldn’t help but provoke interest. ”The drive for us is whatever works,” says Paul Hayes, head of the NTA. ”If sending people to Thailand works, then we’re happy to send them to Thailand; if sending them to the Isle of Man works, then we’re happy to send them there.”
Most of the ex-patients — I’ve spoken to men and women from Britain, Australia, Denmark, Austria and Switzerland – give glowing testimonies. Thirty-year-old Terrence Jones travelled out from Reading in 2000, after spending more than 100 000 pounds on crack in the 12 years. Two years later, he speaks to me on the phone. He has relapsed once, but is now clean, living in Peterborough. ”You have to get down to the bare essentials,” he says. ”I’ll never forget that place.”
Nor will Brindley. I next see him at Heathrow on his way home. His second week has included heat stroke, diarrhoea and virtually no sleep. He’s still grizzly — ”It was fucking horrendous” — but I’ve seen it before. It’s the same black cloud of sleep deprivation. His muscle pain is virtually gone, and he’s immensely proud of being drug-free for 17 days. ”What an achievement, eh? I feel very emotional.”
Ten days later, we speak again. He’s finally sleeping – seven hours in the previous two nights. He’s sick of people asking if he had a nice holiday in China, but says, ”I now realise Tham Krabok was what I needed. I’ve just gone past the chemist where I used to collect my prescription and I could hear Monk Gordon’s voice. ‘When your friends get their methadone,’ he was saying, ‘go get a Pepsi, brother.’ ”
Two months on, and we catch up again. Brindley is now almost evangelical. Not only is he fundraising to take out a friend who’s recently relapsed on methadone, but he’s hooked up with Terrence to return to the monastery this Christmas. ”The other day, the wind was rustling the leaves,” he tells me. ”They were giving off a scent of the medicine. It’s in the wind. It’s weird. It’s just fucking weird.” – Guardian Unlimited (c) Guardian Newspapers Limited 2001