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The World's Toughest Rehab Is a Monastery in Thailand

Tham Krabok, Thailand's monastic equivalent to the Betty Ford Clinic, helps people overcome their addictions by living like monks and drinking a "cleansing" brown liquid that makes them vomit excessively each day.
All photos by Maruetea Cult

Alesha flinched as a monk uncorked a dusty bottle and lifted it to a shot glass. He poured out a 25-centiliter measure of tarry brown liquid. Sweating in the early-afternoon sun, Alesha—a detoxing heroin addict—gulped hard before swallowing the evil-looking mixture. He washed it down with warm water from a stainless steel bucket. A minute or two later, he was hunched on all fours, violently heaving the contents of his stomach into an open drain.


This harrowing ritual takes place on a daily basis at Tham Krabok, Thailand's monastic equivalent of the Betty Ford Clinic. Located 150 kilometers north of Bangkok in the province of Saraburi, the facility has been treating addicts for over 50 years and is widely regarded as the toughest rehabilitation clinic in the world.

Two Tham Krabok patients take part in the daily afternoon purging.

There is little indulgence at the monastery. The lodgings and detoxification are free, but life there is Spartan. The daily rituals kick off with early-morning floor sweeping at 4:30 AM. Only one meal per day is served, at 7 AM each morning. Monks lead ritual chanting every evening at 6:30 PM. Everyone wears the same plain uniforms, provided by the monks, and relinquish their personal belongings for the duration of their stay. The minimum stay is seven days, but some stay for up to a month.

The monastery's main claim to fame, meanwhile, is its signature brown potion—the ingredients of which are an intensely guarded secret—which is fed to patients each day after lunch to induce massive "cleansing" fits of vomiting.

Overseeing the administration of the herbal emetic is Katrisha, a senior foreign nun at Tham Krabok who hails from London. A heroin addict for over 20 years, Katrisha was once a beneficiary of the brown substance herself. If the cocooning sensation of a heroin high is heaven, then her early days at the rehab in Thailand were a living hell.

A monk fills a bottle with the monastery's homemade herbal medicine. This is not the herbal emetic, but an other foul-tasting concoction given to the patients

"You have to really face yourself here, there's no pussyfooting around like in the West," she said. "I had been hooked on heroin for a long time so it was never going to be an easy process. I'd never been interested in Western-style withdrawal, with methadone or other meds. I didn't want to swap one drug for another or make it easy for myself."


If she was going to quit, she said, she wanted to quit for good. "Puking my guts out every day into an open drain while withdrawing from heroin was horrible. Absolutely awful. It was real, though, so I pushed through."

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Katrisha inside her quarters at the monastery

Tham Krabok's unorthodox methods and spiritual atmosphere has earned it worldwide fame, in part because it seems to be effective. According to one report, which looked at the recovery rates of 65 long-term substance users who checked into the monastery, 90 percent of those who come to Tham Krabok complete the program and 60 percent remain drug-free one year later. Those are compelling statistics compared to the recovery rates in Western rehab centers, which are closer to 30 or 40 percent. The recovery rate for Alcoholics Anonymous programs, which dominate Western rehab facilities, is a mere 5 to 10 percent.

The rehabilitation program was conceived in the late 1950s during the iron-fisted rule of Field Marshal Sarit Thanarat. The dictator was a hardliner on drugs and thousands of addicts were executed under his regime. In response, monks at Tham Krabok developed the drug detoxification program and successfully lobbied for it to be introduced as a means of rehabilitating heroin and opium addicts. The monastery also treats alcoholism and methamphetamine addiction, a growing problem in Thailand due to the prevalence of yaba, a methamphetamine derivative, which translates literally as "madness drug."


Since 1959, over 100,000 addicts have passed through the gates of the monastery to detox amidst its golden stupas and collection of giant beatific Buddhas. Walking around the expansive monastery campus in the late afternoon, the tranquil surroundings belied the fearsome reputation of the facility. Stray dogs dozed lazily in the shade and red-robed monks chattered among themselves, on their way to meditation sessions. In the residential section, patients played table tennis or bashed out melodies on battered acoustic guitars. The scene was relaxed and playful—but there are no illusions about the mental fortitude required to get the best out of the Tham Krabok experience.

Monks relax after taking breakfast at the monastery's common dining hall

"The physical detoxification is only a tiny fraction of the process here," said Mitrakhovich Evgenii, a chef from Minsk in Belarus who came to the monastery to treat his heroin addiction. "You must do the remaining work in your mind and through your actions."

While Evgenii acknowledged that the rehabilitation process is immensely difficult, "most of the monks here were former patients themselves, so there's a feeling of empathy and understanding. Nobody is treated with kid gloves. Far from it. But I think it is true that the atmosphere here instils a kind of determination that makes it possible to succeed."

Two patients take the sajja (vow) before starting their rehabilitation at Tham Krabok

Central to the psychology is the sajja (vow), which is undertaken before treatment commences. Led by a senior monk, patients solemnly promise to forgo intoxicating substances. A sacred act that is performed—according to Buddhist belief—"in clear view of the universe," the sajja is taken extremely serious. In fact, patients are only allowed one shot at rehabilitating at Tham Krabok, with the breaking of the vow precluding a return visit.


"You have to be committed to the sajja," said Vijit Akarajitto, the monastery's deputy abbot. "You are asking the elements to believe in your vow, so it is absolutely vital that you also believe in it fully. If you have faith, the sajja can connect you to your own willpower as well as a powerful spiritual force. It can be like a lifeboat that ferries you through turbulent waters."

Vijit Akarajitto, the monastery's deputy abbot

Back at her home at the edge of the monastery grounds, Katrisha, the senior nun, was taking in the last rays of the sun. A resident chicken pecked around her feet as the soft strains of reggae pulsed out into the still Thai evening. It had been a long day attending to often-distressed patients, but she spoke with obvious satisfaction about what she had been able to achieve at Tham Krabok.

"I've come a long way, and I'm proud of that. I got my sense of self back here," she reflected. "There is no miracle cure. You need to really fully want to quit and be prepared to give everything to achieve that goal. If you don't, you will fail. We often see people who treat the monastery like an item on a drug rehab bucket list. They regard it as exotic to detox in Thailand. The treatment only works if the patient is serious. You can't be a tourist. You can't be a victim. You have to be a warrior."

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