The forced administration of drugs, usually by injection, may accompany physical torture. In the extrajudicial environment in which torture occurs, documentation of the types of drugs used is difficult. In violation of all codes of professional ethics, physician participation appears to be ubiquitous. In the Soviet Union, human rights abuses have become institutionalized within the mental health care system. Therapeutic drugs are used, often at toxic levels, to punish political and/or religious dissidents.