Illicit Drug use in the Asia Pacific Region - Burnet Institute

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