Illicit Drug use in the Asia Pacific Region - Burnet Institute

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Situational analysis of illicit drug issues and responses in the Asia–Pacific region 250 A10 .7 References Amadora-Nolasco, F ., Alburo, R .E ., Aguilar, E .J .T . and Trevathan, W .R . (2002) . Knowledge and perception of risk for HIV and condom use among male injecting drug users in Ceru City, Philippines . Drug and Alcohol Review 21: 137–143 . AusAID (2004a) . Country programs: Burma program details . Retrieved 16 December 2004, from http://www .ausaid .gov .au/ country/cbrief .cfm?CountryID=31&Region =EastAsia&CFID=1385568&CFTOKEN= 13987823 . AusAID (2004b) . Philippines country program . Retrieved from http://www .ausaid .gov .au . Dangerous Drugs Board (2005) . Drug Issues and Responses in the Philippines. Manila: Dangerous Drugs Board . Dangerous Drugs Board (no date) . National Anti-Drug Program of Action . Manila: Dangerous Drugs Board . Dangerous Drugs Board (no date) . National Anti-Drug Strategy . Manila: Dangerous Drugs Board . Mateo Jr, R ., Sarol Jr, J .N . and Polblete, R . (2004) . HIV/AIDS in the Philippines . AIDS Education and Prevention 16(Supplement A): 43–52 . Reid, G . and Costigan, G . (2002) . Revisiting the ‘Hidden Epidemic’: a situation assessment of drug use in Asia in the context of HIV/AIDS . Melbourne: Burnet Institute, Centre for Harm Reduction . Republic Act No . 9165 (2002) . United Nations Office on Drugs and Crime (2003a) . Country report by Philippines. Paper presented at the Twenty-seventh Meeting of Heads of National Drug Law Enforcement Agencies, Asia and the Pacific, Bangkok, 8–12 December 2003 . United Nations Office on Drugs and Crime (2003b) . Primary Prevention of ATS Abuse among Youth in the Philippines (No . AD/ RAS/01/G07) . Bangkok: UNODC, Regional Centre for East Asia and the Pacific . United Nations Office on Drugs and Crime (2004a) . Integrated Drug Abuse Data and Information Network (IDADIN) Workgroup Evaluation Meeting: First Report . Bangkok: UNODC, Regional Centre for East Asia and the Pacific . United Nations Office on Drugs and Crime (2004b) . World Drug Report . Volume 2: Statistics . Vienna: United Nations . United States Department of State, Bureau for International Narcotics and Law Enforcement Affairs (2003) . International narcotics control strategy report . Retrieved 30 November 2004 from http://www .state .gov/g/inl/rls/nrcrpt/ . World Health Organization (2005) . Philippines country health information profile . Retrieved from http://www .wpro .who .int . A11 . Thailand Geography Thailand is located in south-eastern Asia, bordering the Andaman Sea and the Gulf of Thailand, south-east of Burma . Its terrain consists of central plain; Khorat Plateau in the east; mountains elsewhere . Arable land: 29 .36% Permanent crops: 6 .46% Other: 64 .18% (2001) Government Constitutional monarchy Chief of state: King Phumiphon Adunyadet (since 9 June 1946) . Head of government: Prime Minister Thaksin Chinnawat (since 9 February 2001) and Deputy Prime Ministers Chaturon Chaisaeng, Gen . Chawalit Yongchaiyut (Ret .), Purachai Piamsombun, Vishanu Krua-ngam (since 8 November 2003); Liptapanlop Suwat (since 1 July 2004); Somsak Thepsuthin, Phinit Charusombat (since 6 October 2004) Elections: None; the monarch is hereditary; Prime Minister is designated from among the members of the House of Representatives; following national elections for the House of Representatives, the leader of the party that can organise a majority coalition usually is appointed Prime Minister by the King . Population 64,865,523 Note: Estimates for this country explicitly take into account the effects of excess mortality due to AIDS; this can result in lower life expectancy, higher infant mortality and death rates, lower population and growth rates, and changes in the distribution of population by age and sex than would otherwise be expected (July 2004 est .) . Median age: 30 .5 years Male: 29 .7 years Female: 31 .2 years (2004 est .) Human development index HDI rank 76 (177 countries) Unemployment rate 2 .2% (2003 est .) Language Thai, English (secondary language of the elite), ethnic and regional dialects 251 Country profiles: Thailand
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 252 Literacy % Age 15 and over can read and write: Total population: 92 .6% Male: 94 .9% Female: 90 .5% (2002) Religion Buddhism 95%, Muslim 3 .8%, Christianity 0 .5%, Hinduism 0 .1%, other 0 .6% (1991) Health Life expectancy: 71 .41 years Male: 69 .23 years Female: 73 .71 years (2004 est .) Under 5 mortality rate: 21 .14 deaths/1000 live births Male: 22 .49 deaths/1000 live births Female: 19 .73 deaths/1000 live births (2004 est .) HIV prevalence: 1 .5% (2003 est .) Economics GDP: purchasing power parity — $477 .5 billion (2003 est .) Percentage of population living below the poverty line: 10 .4% (2002 est .) A11 .1 Narrative summary of drug vulnerabilities A number of factors contribute to increase Thailand’s vulnerabilities to drugs and their negative effects . Thailand has witnessed a shift away from opium and heroin use to a dramatic increase and expanding use of amphetamine-type substances (ATS) . It is now estimated that up to 5 per cent of the population use ATS . The public health ramifications associated with this level of use within a population are not entirely clear . Reports have raised concerns about the effects ATS use has on mental and physical heath of heavy users . Other studies have suggested the ATS use is associated with increased sexual health risks including HIV and STI . An additional risk of increasing drug use within the population is the number of people facing criminal charges associated with drugs . Despite a policy shift toward treating drug use as a medical issue, many people are still imprisoned for drug-related offences . Other factors that could predispose Thailand to increased problematic drug use result from the effect of the rapidly urbanising community . Increased use of cocaine, ecstasy and ketamine have been reported among the urban wealthy . Another, perhaps more worrying, effect of urbanisation is the inequality of access to drug-specific treatment and services . As Thailand shifts to a more private sector model of medical care, access for the most marginal (and most needy) to drug treatment and mental heath services could become more difficult (Siriwanarangsan et al ., 2004) . Ethnic minorities also face increased vulnerabilities to drug use due to the geographical location of many of these people along drug trafficking routes, lack of access to health services, education and the economy . While the government has made efforts to reduce the barriers, they still exist, as evidenced by the poorer health and education status of these populations (Lyttleton & Cohen, 2003) . An additional vulnerability to the negative effect of drug use is the lack of services to prevent the spread of HIV provided to drug users in Thailand . Thailand’s response to the HIV/AIDS epidemic has often been cited as a model of success in HIV prevention . However, a number of authors have pointed to clear limitations, especially with regard to IDU . Although HIV infection rates among sentinel groups in Thailand have shown significant decreases since 1996, rates among IDUs have remained high and have increased in some places (Beyrer et al ., 2003) . Thailand still does not provide maintenance therapy for dependent opiate users, needle and syringe programs are extremely limited, and drug treatment is based on abstinence models that do not suit the needs of all drug users (Sungkawan, 2004) . Historical and cultural interactions with drugs Thailand has a long and complex history with drug use, production and trafficking . Opium use and cultivation remained relatively confined to isolated hill tribe villages in the north of Thailand until the British–China opium wars of the 19th century . During this time ethnic minority groups (primarily the Yao and Hmong) fleeing conflicts in southern China began to expand cultivation in Thailand, Laos and Myanmar (Lyttleton, unpublished) . The economic value of opium was quickly realised by these new opium producers as China began to seek domestic markets to import opium in exchange for tea (Lewis, 2003) . Opium production continued to increase in Thailand with government support until late 1959, when Prime Minister Sarit banned the production, sale and use of opium with the Harmful Habit Forming Drugs Act (Renard, 2001) . While this policy was slow to affect the production of opium in the region, three decades of intense sustained national and international pressure have seen a huge reduction in opium cultivation in Thailand . In fact, the United States Department of State’s Bureau for International Narcotics and Law Enforcement Affairs (2004) notes that Thailand has had one of the most effective crop eradication programs in the world . Since the 1990s Thailand’s opium production has accounted for less than 10 per cent of that produced by Laos and Myanmar, the other two countries that make up the Golden Triangle region where the three countries share borders with the Mekong River (Treerat et al ., 2000) . 253 Country profiles: Thailand
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