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 266 Incarceration has long been known to be a significant risk factor for HIV in Thailand . Choopanya et al . (2002) found that incarceration is related to the incidence of HIV infection through multiple pathways: injecting while incarcerated, recent incarceration without injecting and previous incarceration . Many studies have also highlighted the association of HIV, IDU and incarceration . Choopanya et al . (1991) found that IDUs in Bangkok were twice as likely to be HIV-positive if they had been incarcerated . HIV prevention services within Thai prisons are limited to basic HIV education . Despite evidence of drug use within prisons (Choopanya et al ., 2003), prisoners do not have access to clean needles and syringes or bleach . Other harm reduction tools such as drug treatment or condoms are also not available . Health and treatment responses As discussed above, Thailand’s response to drug issues changed dramatically with the introduction of the Drug User Rehabilitation Act in 2002 and the subsequent Fight to Overcome Drugs which commenced in late 2002 . The Office of the Narcotics Control Board lists 12 official treatment centres on its website (Office of the Narcotics Control Board, 2005a) . However, many other programs are run by both public and private hospitals, as well as private clinics and NGO programs . Some monasteries also conduct detoxification programs which combine spirituality and meditation to help drug users stop using drugs (Lewis, 2003; United Nations Office on Drugs and Crime, 2004a) . While all policies point toward increased access to a variety of drug treatment services, whether or not these policies have been implemented effectively is difficult to ascertain . According to Pol . Gen . Pracha Promnok, the Deputy Minister for Public Health, Thailand would be prepared to treat 600,000 drug users in 2003, 50,000 of whom would be treated as in-patients in hospitals and military camps and the rest in the community setting (Lewis, 2003) . As stated above, treatment data are not available from the year 2002 onwards . While anecdotal reports suggest a large number of drug users entered treatment in 2003, there are no data available about the type of treatment patients received or about treatment outcomes . Limited methadone treatment has been available in Thailand for 12 years . Methadone treatment is based on providing the drug user with a decreasing dose of methadone over a set period of either 21, 90 or 180 days . However, according to Sivalee (K . Sivalee, personal communication, April 2005), who is a former treatment provider in Thailand, doctors have some flexibility in tailoring methadone treatment for patients, including increasing doses over time . She further stated that once a patient has completed a program, they can apply to start another . According to Sivalee, buprenorphine-facilitated detoxification treatment is available at the Parmonkout Military Hospital . The majority of drug treatment for ATS offered in Thailand is based around a combination detoxification and the Matrix model of treatment, which is an outpatient treatment experience that combines behavioural, educational and 12-step counselling techniques . A report on the situation of drug treatment in Thailand is currently being prepared by Professor Vichai Poshyachinda, Head of the Drug Dependence Research Centre, Chulalongkorn University, but was not available for this report . Other responses Since the early 1990s Thailand has placed a strong emphasis on disseminating health information through media campaigns . The Ministry of Public Health in Thailand has orchestrated various drug education campaigns emphasising the negative aspects of drugs . They have also focused on awareness building around needle sharing as a major mode of HIV transmission among IDUs (Perngmark et al ., 2003) . The most recent prevention education campaign is the ‘Kingdom Unity for Victory over Drugs’ campaign . In addition to mass media advertising, the strategy plans to recruit three million community-based volunteers who will provide education about the dangers of drugs and encourage drug users to register and to seek treatment . Considerable attention is still being directed toward primary prevention of drug use . In association with Chulalongkorn University and the ONCB, the United Nations Office on Drugs and Crime has recently funded and published a research study looking at improving primary prevention of ATS abuse among Thai youth (Sthapitanonda, 2004) . Education campaigns are focusing drug education messages to school children and through sporting clubs and at community events . School-based education targets four subgroups of students: those who have never used drugs, those who have tried drugs, those who have become addicted and those who have become sellers . Drug education is conducted through the Ministry of Education with the assistance from the ONCB (United Nations Office of Drugs and Crime, 2002) . Drug user organisations and advocacy groups (a) Thai AIDS Treatment Action Group (TTAG) Established December 2002 To promote equal access to AIDS treatment for all through policy advocacy, coalition building, and strengthening the capacity of people living with or highly vulnerable to HIV/AIDS to advocate for their human rights . (b) Thai Drug Users Network (TDN) Established December 2002 To promote the basic human rights of people who use drugs, in order to be able to live equally and with dignity in society . 267 Country profiles: Thailand
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 268 A11 .7 References Aceijas, C ., Stimson, G ., Hickman, M . and Rhodes, T . (2004) . Global overview of injecting drug use and HIV infection among injecting drug users . AIDS 18: 2295–2303 . Amnesty International (2003) . Thailand: grave developments — killings and other abuses . (No . AI Index: ASA 39/008/03) . Retrieved from Amnesty International website: http://web .amnesty .org/ report2003/tha-summary-eng . Apinum, A . (2004) . Ice. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Assanangkornchi, S . (2004) . Tranquillizers and hypnotics: anti-anxiety medication with addictive effects. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Barrett, M .E . (2003) . Correlates of illicit drug use in Karen villages in northern Thailand . Substance Abuse and Misuse 38(11–13): 1615–1649 . Beyrer, C ., Jittiwutikarn, J ., Teokul, W ., Razak, M .H ., Suriyanon, V ., Srirak, N . et al . (2003) . Drug use, increasing incarceration rates, and prison-associated HIV risks in Thailand . AIDS and Behavior 7(2): 153–161 . Choopanya, K ., Des Jarlais, D .C ., Vanichseni, S ., Kitaporn, D ., Mock, P .A ., Raktham, S . et al . (2002) . Incarceration and risk for HIV infection among injection drug users in Bangkok . Journal of Acquired Immune Deficiency Syndromes 29: 86–94 . Choopanya, K ., Des Jarlais, D .C ., Vanichseni, S ., Mock, P .A ., Kitayaporn, D ., Sangkhum, U . et al . (2003) . HIV risk reduction in a cohort of injecting drug users in Bangkok, Thailand . Journal of Acquired Immune Deficiency Syndromes 33(1): 88–95 . Choopanya, K ., Vanichseni, S ., Des Jarlais, D .C ., Plangsringarm, K ., Sonchai, W ., Carballo, M . et al . (1991) . Risk factors and HIV seropositivity among injecting drug users in Bangkok . AIDS 5(12): 1509–1513 . CNN .com (2003) . 2,274 dead in Thai drugs crackdown . Retrieved 7 May 2003 . Danthamrongkul, V . (2004) . Treatment. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Danthamrongkul, V ., Sukcheep, P . and Zapuang, K . (2004) . An epidemic of cough medicine abuse in the southern region of Thailand: a threat for long term illicit diversion and addictive use of essential medicine. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Department of Corrections (2002) . Statistics, prisons and correctional institutions . Retrieved 17 May 2005 from http://www .correct .go .th/statis .htm . Gray, J . (1995) . Operating needle exchange programmes in the hills of Thailand . AIDS Care 7(4): 489–499 . Human Rights Watch (2004) . Thailand: drug war darkens AIDS success . 8 July 2004 . Retrieved 11 January 2005 from http://www .hrw .org/english/ docs/2004/07/08/thaila9012_txt .htm . Kanato, M . (2004) . Drug users registration and monitoring process. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Kitayaporn, D ., Vanichseni, S ., Mastro, T .D ., Raktham, S ., Vaniyapongs, T ., Des Jarlais, D .C . et al . (1998) . Infection with HIV-1 subtypes B and E in injecting drug users screened for enrolment into a prospective cohort in Bangkok, Thailand . Journal of Acquired Immune Deficiency Syndrome Human Retroviral 19(3): 289–295 . Klongyut, P . (2004) . Estimated substance user population. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Lewis, D .R . (2003) . The Long Trip down the Mountain: social and economic impacts of illicit drugs in Thailand (UNODC Publication No . 12/2004) . Bangkok: United Nations Office on Drugs and Crime, Regional Centre for East Asia and the Pacific . Lyttleton, C . (unpublished) . Relative pleasures: drugs, development and enduring dependencies in the Golden Triangle (draft report) . Sydney: Macquarie University . Lyttleton, C . and Cohen, P .T . (2003) . Harm reduction and alternative development in the Golden Triangle . Drug and Alcohol Review 22(1): 83–91 . Nation (2003) . Drug war killings . The Nation, 19 February 2003 . National Household Survey (2003) . Status of Substance Abuse: National Household Survey . Bangkok: Academic Committee on Substance Abuse . New York Times (2003) . Drug wars. The New York Times, 8 April 2003 . Office of the Narcotics Control Board (2003a) . Thailand Narcotics Annual Report 2003 . (No . 1-04-2546) . Bangkok: Ministry of Justice . Office of the Narcotics Control Board (2003b) . ‘War on Drugs’ Concept and Strategy . Bangkok: Ministry of Justice . Office of the Narcotics Control Board (2005a) . Narcotics treatment and rehabilitation centers . Retrieved 12 May 2005 from http://www .oncb .go .th/ e1-frame05 .htm . Office of the Narcotics Control Board (2005b) . Office of the Narcotics Control Board website: http://www .oncb .go .th/ Emain .htm Retrieved 15 April 2005 . Perngmark, P ., Celenano, D ., & Kawichai, S . (2003) . Needle sharing among southern thai drug injectors . Addiction 98: 1153–1161 . Phaileeklee, S . and Kanato, M . (2004) . Cannabis use: from past to future. Paper presented at 2nd National Conference on Substance Abuse, Khon Kaen Province, Thailand, 31 August – 2 September 2004 . Phongpaichit, P . (2004) . Drug policy in Thailand . In Global Drug Policies: national policies facing multiple challenges . Paris: The Senlis Group . Phongpaichit, P ., Piriyarangsan, S . and Treerat, N . (1998) . Guns, Girls, Gambling, Ganja: Thailand’s illegal economy and public policy . Chiang Mai: Silkworm Books . Punpanich, W ., Ungchusak, K . and Detels, R . (2004) . Thailand’s response to the HIV epidemic: yesterday, today, tomorrow . AIDS Education and Prevention 16(Supplement A): 119–136 . 269 Country profiles: Thailand
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