Korea's biggest drug addiction treatment ward has gone dark

An unsettling silence filled the country’s largest inpatient psychiatric ward — not because patients were asleep, but because there were no doctors to take care of them.

Bugok National Hospital's psychiatric ward has 90 designated beds, the largest capacity among the 33 narcotics addiction treatment institutions designated by the Ministry of Health and Welfare.

However, not a single patient occupied a bed in the ward of the South Gyeongsang hospital when the JoongAng Ilbo visited the facility on July 6. The lights were off, and there were no doctors in sight.

The hospital treated 529 drug addiction patients between 2020 and 2024, either through voluntary admission or as part of a court order, according to the hospital's annual reports and the Supreme Prosecutors' Office’s white paper on narcotics crime, with 329 receiving inpatient treatment.

Patients aren't the only thing missing from the ward. So are doctors.

"We closed the inpatient ward in April because of a physician shortage," Chung Young-in, the hospital's acting chief, said.

Chung, who turned 70 this year and described himself as "old enough to retire," is now the hospital's only board-certified psychiatrist.

Chung's predecessor, also a psychiatrist, stepped down when his tenure ended late last year. The leadership position has since remained vacant. Another psychiatrist left in March before their contract expired.

The hospital no longer meets the minimum staffing requirement of three psychiatrists to train medical residents. As a result, its four psychiatry residents are due to leave in August.

"We don't have enough doctors to keep the ward staffed overnight," a hospital representative said.

Medical experts warn that the staffing crisis has effectively halted inpatient treatment for severe addiction cases across Korea outside the greater Seoul area.

Doctors warn that any delay in care could prove fatal. Bugok National Hospital and Incheon Chamsarang Hospital serve as Korea's two leading institutions for drug addiction treatment.

In 2024, the two facilities treated 650 patients — 509 at Incheon Chamsarang and 141 at Bugok National, according to the prosecutorial white paper. Together, they handled 74.3 percent of all patients registered in the state-run treatment scheme.

While Incheon Chamsarang primarily covers the greater Seoul area, Bugok National has long been the main referral center for the rest of the country.

"Patients came not only from the Gyeongsang region but also from Chungcheong, Jeolla and even Jeju Island,” a Bugok National representative said.

The hospital has failed to attract a single psychiatrist despite multiple recruitment openings this year.

It first posted openings for three psychiatrists on Feb. 23 and reissued the notice seven more times through June 17. Separately, it has maintained an ongoing recruitment notice for five additional psychiatrists.

"We didn't even receive inquiries," a hospital spokesperson said.

The hospital also launched an open recruitment process for its chief position in March but failed to find a suitable candidate.

The staffing shortage is not new. Although the hospital can employ up to 11 psychiatrists, it has operated with only one to three in recent years, according to hospital administrators.

The hospital's addiction treatment center, which specializes in diagnosing, treating and researching substance abuse disorders, has been without a single full-time specialist since its director resigned in February 2024.

Staff attribute the recruitment failure to the hospital's remote location, limited transportation infrastructure and lower compensation compared to private hospitals.

The psychiatrist positions are classified as senior civil service posts equivalent to Grade 4, with a minimum annual salary of 70.49 million won ($47,300).

The 2024 revisions to the Public Officials Remuneration Regulations removed the salary cap to attract physicians and other professionals from the private sector. It now technically allows experienced specialists to earn as much as 200 million to 300 million won annually.

"Even with those salaries, we believe the pay is only about 50 to 60 percent of what private hospitals offer," a hospital source said. "Many doctors are also reluctant to work here because the hospital is in a remote area about an hour from the nearest major city."

The complexity of treating drug addiction has also made it harder to recruit psychiatrists.

Compared with patients with other psychiatric disorders, those with severe drug addiction are more likely to become violent or injure themselves while experiencing delirium or hallucinations. They are also less likely to follow treatment plans and face a higher risk of relapse, often requiring prolonged care.

"Doctors experienced in addiction treatment often say that treating 10 drug addiction patients requires as much effort as treating 60 patients with other psychiatric conditions,” Jang Ok-jin, a psychiatrist at Inje University Haeundae Paik Hospital, said.

Jang previously worked at the Bugok National from 2016 to 2022.

"There are established treatment protocols for alcohol addiction, but drug addiction is different because new synthetic drugs keep emerging," he said. "There is effectively no standard protocol. Physicians have to respond continuously to patients whose conditions can change from moment to moment."

For patients with severe addiction, there are few alternatives to the Bugok National.

“Patients with severe addiction have mainly been treated at the Bugok hospital because its facilities are larger and better equipped than those at private hospitals," Lee Jeong-soo, the head of the South Gyeongsang branch of the Korea Association Against Drug Abuse, said. "I'm concerned that one of the region's leading state-run drug treatment centers could lose its ability to serve patients if the ward remains closed for an extended period."

A Ministry of Health and Welfare official said the government is working to normalize ward operations at Bugok National.

"Patients in need of treatment are being referred to other designated treatment centers as we work to restore normal operations at Bugok National Hospital,” the official said. “We are also looking at ways to expand addiction treatment infrastructure in response to the growing number of drug addiction patients.”

BY KIM MIN-JU [[email protected]]