The Long Trip Down the Mountain:
Social and Economic Impacts of Illicit Drugs in Thailand
November 2003
United Nations Office on Drugs and Crime
Regional Centre for East Asia and the Pacific
Third Draft
Daniel Ray Lewis
Report Title
We are approaching the peak in methamphetamine abuse in Thailand, with millions of
Thais directly affected by drug abuse. Although new drug use will likely decline in the
years to come, the jobs remaining to us are bringing society back to normal especially by
rehabilitating current drug users, and bringing down the prison population to a reasonable
level. Recent efforts by the government to suppress drugs have helped to reduce the
number of casual users of Yaa Baa, but the problem continues for the rest. We are on
top of a mountain of abuse, and we must make our way back down again.
Yaa Baa Seizures in Millions of Pills
120
100
80
60
40
20
0
1997
1998
1999
2000
2001
2002
Source: ONCB Annual Reports
Disclaimer
The views expressed in this report remain those of the author. They do not represent the
official position of the United Nations Office on Drugs and Crime. The responsibility for
any errors also remains with the author. Our apologies for any misinterpretations arising
from the many interviews conducted for this study.
ii
The Long Trip Down the Mountain:
Social and Economic Impacts of Illicit Drugs in
Thailand
Third Draft
Please address comments to:
Daniel.L@chula.ac.th
iii
Preface
Thailand has a long history as a drug transit country due to the presence of opium/heroin
in neighboring countries, but until recently did not have a serious drug epidemic of its
own. Drug use within Thailand was well known, but either limited to less dangerous
drugs such as marijuana or kratom, or limited in scope in the case of heroin and opium.
Drug use was not causing serious social or economic effects at that time. All that
changed with the methamphetamine epidemic which began in about 1996.
Around 1996, heroin producers began producing methamphetamines and many small
methamphetamines labs began to crop up. Methamphetamines (known as Yaa Baa in
Thailand) was popular, and drug abuse spread very quickly. The use of
methamphetamines in Thailand rose rapidly during the 1990s, and by the early 21st
century had reached epidemic proportions. By the time of the peak in usage in late 2002,
per capita usage of methamphetamines was the highest in the world.
The social disruption from Yaa Baa was of great consequence. Families were broken
asunder, the prison population began to grow out of control, children were left without
parental support. The far flung distribution network for drugs had an economic effect on
buyers and sellers. Watching this rapid rise in drug use with great concern, and in
awareness that these drugs would have a strong averse affect on the Thai social and
economic situation, the United Nations Office on Drugs and Crime became aware of the
lack of publicly available information on the drug crisis, and commissioned this study.
Early in 2002, the UNODC decided that a study of the social and economic effects of
drug use in Thailand was urgently needed. By building awareness of social and
economic problems arising from drug use it would be possible to forestall some of those
problems before they had more serious consequences. In addition, understanding the
Thai case better would help other countries facing similar style epidemics.
It was at that time that Sanong Chinanon of the UNODC contacted the Faculty of
Economics, Chulalongkorn University about the possibility of writing such a report. A
team of researchers, including Associate Professor Nualnoi Treerat, Assistant Professor
Noppanun Wannathepsakul, and myself had written an earlier study for the UNODC
about the economic consequences of drug use in Bangkok. Although other members of
the team were not available, it was with pleasure that I accepted the invitation of the
UNODC to write the study you have before you.
In consultation with the UNODC it was decided that the study should be in a form that
would appeal to a general audience. While giving an outline of the main attributes of
drug use in Thailand for professional observers, it would also be desirable to appeal to a
wider audience inside of Thailand, so that facts about the drug situation could be
discussed and recognized, and appropriate solutions considered. In recognition that a
number of drugs, including heroin, marijuana, kratom and party drugs all play a role in
iv
Thailand, it was decided to keep the study broad including the social and economic
effects of all drugs.
The majority of the study was conducted in the later part of 2002, and during the early
part of 2003, although updates continued throughout 2003, particularly in reference to
Thaksin Shinawatra, and the Thai government's successful efforts at fighting drugs
through an aggressive anti-drug campaign from February to April 2003 and thereafter.
Although it remains to be seen if the effects of the campaign will last, first indications are
that the campaign were very successful at reducing drug use in Thailand.
Sanong Chinanon and Wayne Bazant, of the UNODC were immensely helpful in the
process of writing this report, and responded to successive versions of the research with
truthful and sometimes blunt comments. The paper would not be what it is without them.
I would like to thank Sandro Calvini, director of the UNODC, for his comments and
suggestions, and for writing the forward for the report. I had the aid of an excellent
research assistant, Nopparit Ananapibut, who helped both in researching and in writing
the first draft of the report. Many of the personal stories gleaned from popular
newspapers can be attributed to him. Most of all, I would like the thank all of the people
I interviewed formally, or informally, for sharing their views on this serious problem
which affects us all.
Daniel Ray Lewis
Faculty of Economics
Chulalongkorn University.
v
The Long Trip Down the Mountain:
Social and Economic Impacts of Illicit Drugs in Thailand
Abstract
Methamphetamine abuse in Thailand has been a huge problem with an estimated 2.6
million users at the peak of the epidemic, out of a population of 63 million. How did a
peaceful and generally law abiding country like Thailand come to face such a threat?
How was the drug problem able to spread so quickly and easily? It wasn't always like
this - only a few years earlier in 1996 the use of methamphetamine was known but rare,
and was confined to truck drivers or fishermen who had to work grueling hours or at
night. Dosage was low. In those days, methamphetamine in the form of tablets were
eaten or mixed with energy drinks at a rate of about 1 pill per day, to help maintain
alertness. Within five years the methamphetamine problem was worse than anywhere
else in the world, with the highest per capita use (almost double anywhere else) and the
highest number of seizures in 2001. Drug use was listed among the most serious
problems in the country, with some addicts using 30 or more tablets a day.
The use of methamphetamine swept over Thailand like an epidemic. The rate of growth
of drug abuse was extremely high. Drug seizures grew at more than 50 percent a year in
the late 1990s and were nearly 100 million tablets by 2001. Although other countries
have faced methamphetamine epidemics, this was a homegrown problem. Neighboring
countries did not have problems with methamphetamines at the time, and more distant
but trend setting countries such as the USA, Japan and European countries used an
entirely different form of methamphetamine.
Several events happened in 1996 that may have contributed to the onset of the crisis. The
price of heroin skyrocketed due to the arrest of Khun Sa, the Burmese kingpin who until
then controlled much of the heroin trade. Heroin was used more widely in those days,
and it is hypothesized that many heroin users switched to methamphetamines due to the
high price of heroin. Of more significance, as Khun Sa's networks were halted, heroin
producers in Burma and Thailand switched to producing easy-to-make
methamphetamines for which the technology was already widely known, and discovered
it was more profitable than heroin.
Although growth in the supply side was a big push to amphetamine use, the epidemic
could not have occurred without a concurrent jump in demand. The change on the
demand side was a shift in the method of ingestion, from eating to smoking. Eating
methamphetamines results in strength and endurance and a feeling of well-being, but
smoking allows the drug to go straight to the brain, and creates a form of euphoria similar
to that produced by cocaine. With smoking, the typical dosage increased dramatically.
One pill was enough to keep the user awake, but the feeling of euphoria was something
you could enjoy over and over again.
vi
The Asian economic crisis in 1997 may have also played a role as people switched to
selling drugs to support their families, after losing their jobs in legitimate business.
As the use of amphetamines rose at truly alarming rates, the government began an
extensive anti-drug campaign, changing the name of the drug to Yaa Baa (crazy drug)
which emphasizes the established but not so common link between the use of
methamphetamines and psychosis. This anti-drug campaign probably backfired, as the
use of the drug in high schools and technical schools became an accepted counter-culture
outlet. Suddenly everyone was hearing about Yaa Baa and wanted to try it.
Methamphetamines in Thailand have three main user groups - the school-age student
population, the technical school / common laborer population who are in their early
twenties, and an unemployed group who may be involved in selling Yaa Baa for
economic reasons.
Usage among the student group could be modeled as if
methamphetamine use were a fad. As the novelty fades, a new generation will likely try
something new. In fact, Yaa Baa use among school-age children may have peaked as
early as 2000. It is also likely that the recent government hard-line suppression campaign
will have the greatest effect on this group. Unfortunately there is some evidence that
student groups in Laos and Cambodia may be following in Thailand's footsteps.
The older groups may be more intransigent. They are already decision-making adults.
They realize the physical risk of using methamphetamines is not great, and in fact both
employers and workers realize drugs can enhance performance. They may depend on
Yaa Baa for some income. Finally, they are at a socio-economic level that receives less
attention than middle class students.
Throughout the epidemic the government has taken a strong-arm approach to dealing
with the drug problem. At first this took the form of large numbers of drug arrests, and
tough sentences for drug addicts. Of the 140 large countries in the world, Thailand is
number 9 in terms of number of incarcerated persons relative to the size of its population.
This is true, despite the widespread acceptance that Thailand is a very safe country, with
little crime or violence. There are 100s of thousands of Thais incarcerated who do not
pose any threat to the society.
Recently, the government decided to fight a limited war on drugs by attacking drug
sellers directly, with rumored extra-judicial killings, and capture quotas for law
enforcement personnel. This approach (3 month intensive campaign from February to
April 2003) had a significant effect, as drug addicts were fearful of being captured or
shot, and because the price of drugs was kept high enough to make them unaffordable to
the average Thai person.
It is still early to know the full effects of the recent suppression campaign, but evidence
from other countries suggests that it will be most effective against casual users, who have
little to lose from giving up drugs. Suppression tends to make sellers and serious abusers
more clever in hiding their activities, and more willing to be violent to defend
vii
themselves. Credibility about the government's long term stance will play a deciding role
in determining the long term effectiveness of the campaign.
Even without the recent "war on drugs", seizure, arrest and treatment data show slowing
trends that suggest that use of Yaa Baa may have peaked, or would have done so soon. In
addition, many forces: the government, cultural forces, and religious authorities have
rallied to halt the spread of Yaa Baa. It is likely that the use of Yaa Baa will fall over the
coming years. Nevertheless much work needs to be done to rehabilitate users, and to
reverse the pernicious effects that drugs may have had on Thai society.
Use of Yaa Baa is probably reached its peak in early 2003 after about 6 years of rapidly
increasing demand. The suppression and prevention campaigns are in full force, new
users are still appearing, but there is beginning to be hope that this battle can be won.
Besides the important work of fighting the war on drugs, it is time to start thinking about
what will need to be done to bring Thai society back to normal after the crisis. There
were more than 1/2 a million serious abusers of Yaa Baa most of whom will continue to
take the drug if it is available, and who need to be reached somehow, and rehabilitated.
Some of them will be hard to reach, especially if they feel that Yaa Baa helps them with
their work, or if it provides them with income.
Thai prisons are in an abominable state. UN statistics show them to have the worst
crowding in the entire world, with prisoners literally sleeping all over each other. This is
a shameful state of affairs. Seventy percent of prisoners are in jail for drug crimes, and
prison officials argue that most of them pose little direct threat to society. If the war on
drugs is won, it would be hoped that some of these prisoners could be released.
Despite the enormous amount of information that has come out about Yaa Baa in the last
five years there are clear and persistent misperceptions in the public about the drug.
There is a common misperception that Yaa Baa has gotten stronger over time, which is
what has made it dangerous. That is not true. Instead what has changed is the route of
administration from oral to smoking.
Few people realize that smoking Yaa Baa makes it much more addictive.
They also do not know that there is a feeling of euphoria and extreme happiness from
smoking Yaa Baa, which is why people like it.
The vast majority of people who use Yaa Baa DO NOT primarily need it for its stimulant
qualities. There is a general feeling that the reason people use Yaa Baa is for work,
which is probably only partly true. Amphetamines have a long history of being abused
under the guise of self-medication. Amphetamines have some desirable qualities such as
providing endurance, warding off sleepiness, weight loss, and anti-depressants. What
makes them unsuitable for any of those functions is their extreme addictiveness which
leads users to take them in unreasonable quantities, and to focus on them to the point of
viii
neglect of other important parts of their lives, such as their education or supporting their
family. That is almost certainly what is happening in Thailand.
Yaa Baa for work purposes is simply not economical. With a daily wage of 200 baht (5
USD) or less, and a price per tablet of 80 baht, it is hard to see how common laborers
could get enough benefit from the drug to make it worth buying. Furthermore, doses over
a pill a day are excessive and possibly counterproductive for work, yet addicts often take
3-4 pills a day.
People do not understand that it is Yaa Baa's addictiveness, and the corresponding
irrational, unproductive, and harmful activities to procure it that make Yaa Baa
dangerous. The medical danger from Yaa Baa at doses of a pill or less a day is low, but
plenty of risk of becoming addicted, then taking it in doses that are harmful to the body.
Several interesting results came out of our study.
Treatment data suggest that student use of Yaa Baa has been declining for some time,
possibly for a number of years, while other groups were increasing.
The amount of money spent in Thailand on drugs was estimated at about 1 % of
Thai GDP, or 48 billion baht or 1.2 billion US dollars. Of this, about 80 percent is
for Yaa Baa.
The amount of money laundered in Thailand is on the order of 46 billion baht a year
(1.1 billion USD).
The social cost to Thai society was estimated at 16 billion baht (380 million US
dollars), but does not include the cost of drugs, medical costs, or any costs due to
loss of life.
The study suggests four groups of Yaa Baa users, with the number of pills they
personally use.
Casual users
Beginner/Light Abusers
Regular Abusers
Retailers
10 pills a year
1/2-1 pill a day
2-4 pills a day
5-30 pills a day (average of 10.1)
Retailers consume more than 40% of all pills, but make up only 2.5% of all users
For most of the past 6-7 years the average purchase price of Yaa Baa hovered at about 65
baht, even though the retail price was closer to 80 baht. This is so, because many of the
pills are used by retailers who pay wholesale prices.
The study used 2002 estimates of the Ministry of Public Health .
Yaa Baa - 2,024,000 users, 544,000 addicts
ix
Heroin use continues to decline, as per treatment statistics.
The Thai society has been profoundly affected by the epidemic use of Yaa Baa. The use
of drugs ruined lives and ruined families. Schools lost their reputation as a safe place for
learning. Children became more distant from their parents. Money was spent by addicts
that was needed for other things, and those receiving the money for drugs often spent it in
ways that made the society more corrupt. Many people who would otherwise have been
law abiding have spent time in prison, and have perhaps learned things there they ought
not to have.
All of these unfortunate effects came from Yaa Baa. We did not ask for a Yaa Baa
epidemic, but now that it has occurred we must work at bringing Thai society back to
health.
The main areas of concern are
1) There are far too many prisoners for a peaceable society like Thailand.
2) There is need of a strong rehabilitation push to help the remaining drug abusers, who
are still addicts in spite of all of the efforts of the government.
3) We have a moral responsibility to help our neighbors who are at an earlier stage in the
epidemic.
While working on this study we elicited comments from many ordinary individuals, some
who had used drugs and others who had not. These people mainly felt that those who use
Yaa Baa are sick, but they are not criminals. On the other hand, those who sell Yaa Baa
are criminals who hurt others and must be punished. As the government works at
punishing the drug sellers, so society must work at helping those who are drug users.
Most drug users do not have strong families to support them. They do not have friends
who encourage them to quit. They do not have supportive drug-free environments in
which to live, should they try to quit. It is up to us as a society to build that sort of
environment. We need to take responsibility for others, to encourage those we know to
quit, to treat them with respect, but with firmness. We need to be tolerant of drug users,
but not tolerant of drugs. If drugs are being sold, it should be reported. Even where
authorities are corrupt they will feel pressure if there is concern from the community.
x
The Long Trip Down the Mountain
Table of Contents
DISCLAIMER ............................................................................................................................................... II
PREFACE .................................................................................................................................................... III
ABSTRACT .................................................................................................................................................. V
TABLE OF CONTENTS .................................................................................................................................. X
CHAPTER 1. INTRODUCTION ..................................................................................................................13
CHAPTER 2. OVERVIEW OF ILLICIT DRUG PROBLEMS IN THAILAND .........................................18
BRIEF HISTORY .........................................................................................................................................18
DRUG PRODUCTION ...................................................................................................................................19
TRAFFICKING.............................................................................................................................................20
CHAPTER 3. IMPORTANT ISSUES ..........................................................................................................23
FAR TOO MANY PRISONERS ......................................................................................................................23
Crowding in Thai Prisons ....................................................................................................................23
Prison Population Higher than Most Other Countries ........................................................................26
Jail Time – What is it Like? .................................................................................................................28
Why Did It End Up Like This? .............................................................................................................32
How Can We Reduce the Overcrowding Problem? .............................................................................35
Abuse versus Trafficking ......................................................................................................................36
INSUFFICIENT TREATMENT ........................................................................................................................38
Shortage of Treatment Centers ............................................................................................................38
Other Challenges Faced by Thai Rehabilitation Centers ....................................................................40
Treatment – What Works and What Doesn’t. .......................................................................................42
Different Target Groups.......................................................................................................................42
CHAPTER 4. SOCIAL IMPACT OF ILLEGAL DRUGS ...........................................................................44
INTRODUCTION ..........................................................................................................................................44
DRUGS AND CHILDREN ..............................................................................................................................45
Why Kids Don't Use Drugs ..................................................................................................................45
Why Kids Do Use Drugs ......................................................................................................................46
The Kinds of Drugs Kids Use ...............................................................................................................48
Children Who Sell Drugs .....................................................................................................................49
Information ..........................................................................................................................................50
EDUCATION ...............................................................................................................................................52
Drug Abuse in Schools .........................................................................................................................52
Slowdown in Teen Use of Drugs ..........................................................................................................53
School Performance .............................................................................................................................53
School Dropouts...................................................................................................................................54
Long Term Effects / Effect on Educational Attainment of Drug Abusers .............................................56
EMPLOYMENT............................................................................................................................................57
Drugs Reduce Efficiency ......................................................................................................................57
Large Share of Yaa Baa Abusers are Unemployed .............................................................................57
Quality of Work Suffers ........................................................................................................................58
WOMEN .....................................................................................................................................................60
Violence Against Women .....................................................................................................................60
Women Who Use Drugs .......................................................................................................................61
Access to Treatment .............................................................................................................................62
Prostitution ..........................................................................................................................................63
Pregnancy ............................................................................................................................................63
xi
Women Selling Drugs...........................................................................................................................64
DRUGS AND HIV/AIDS ............................................................................................................................65
Brief History ........................................................................................................................................65
Access to Needles .................................................................................................................................66
HIV/AIDS in Prison .............................................................................................................................67
HIV Transmission through Drugs in Thailand ....................................................................................68
Sexual Behavior and Drugs .................................................................................................................70
THE FAMILY ..............................................................................................................................................71
Family Cohesion ..................................................................................................................................71
Drug Use Can Spread Through the Family .........................................................................................72
Family and Rehabilitation ...................................................................................................................73
Community Responsibility for Drug Rehabilitation .............................................................................74
Effects on Family Life ..........................................................................................................................74
DRUGS AND CORRUPTION .........................................................................................................................75
Not all Police are Corrupt… ................................................................................................................75
But Some Are........................................................................................................................................75
Corruption behind Bars .......................................................................................................................76
Corruption by Police............................................................................................................................77
Corruption in Courts ............................................................................................................................78
CRIME AND VIOLENCE ..............................................................................................................................79
Links Between Drugs and Crime… ......................................................................................................79
Are Weaker than Usual in Thailand.....................................................................................................79
Drugs and Violence..............................................................................................................................79
Drugs and Crime..................................................................................................................................80
Psychosis and Violence ........................................................................................................................81
CHAPTER 5. ECONOMIC IMPACT OF ILLICIT DRUGS .......................................................................83
INTRODUCTION TO ECONOMIC IMPACT......................................................................................................83
ESTIMATION OF DIRECT COSTS OF CONTROLLING DRUGS ........................................................................83
Government Expenditure on Preventing and Suppressing Drug Problems .........................................83
OVERVIEW OF DRUG PRICES AND DETERMINANTS ..................................................................................87
Retail Price of Illegal Drugs in Bangkok, in Baht ...............................................................................87
Supply...................................................................................................................................................88
Demand ................................................................................................................................................89
ESTIMATION OF EXPENDITURE ON YAA BAA CONSUMPTION ...................................................................90
Classification Scheme for Yaa Baa Users ............................................................................................90
How Common Are Each Class Of User? .............................................................................................91
Possible Objections to the Approach used in this Paper .....................................................................93
MONEY LAUNDERING ................................................................................................................................96
Scale of Money Laundering Due to Drugs ...........................................................................................96
Thai Anti-Money Laundering Office ....................................................................................................97
Money Laundering – What to Look For ...............................................................................................99
ESTIMATION OF EXPENDITURE ON ALL DRUGS .......................................................................................100
Methamphetamines ............................................................................................................................100
Marijuana ..........................................................................................................................................100
Kratom ...............................................................................................................................................100
Heroin ................................................................................................................................................101
ANALYSIS OF ILLEGAL DRUG MONEY IN THE SOCIETY ..........................................................................102
Drug Supply Chain ............................................................................................................................102
Characteristics of Participants in the Supply Chain ..........................................................................103
LOSS OF PRODUCTIVITY ..........................................................................................................................106
Does Using Illegal Drugs Reduce Productivity? ...............................................................................106
Productivity Effects of Individual Drugs ............................................................................................108
LOSS OF MAN POWER AND LABOR COSTS ..............................................................................................110
Average Wage of Those Incarcerated ................................................................................................110
Education Level of Prisoners .............................................................................................................110
xii
Average Lost Income to Family .........................................................................................................116
Other Costs to Families of Incarcerated Members ............................................................................117
SOCIAL COSTS OF ILLEGAL DRUGS..........................................................................................................117
Size Of Market for Illegal Drugs ........................................................................................................117
Social Costs of Illegal Drugs .............................................................................................................117
CHAPTER 6. CONCLUSION AND RECOMMENDATIONS .................................................................119
RECOMMENDATIONS ...............................................................................................................................121
INTRODUCTION ........................................................................................................................................123
ROUTES OF ADMINISTRATION .................................................................................................................124
Solubility and Drug Testing ...............................................................................................................125
BRAIN BASICS .........................................................................................................................................126
PHYSICAL AND PSYCHOLOGICAL EFFECTS OF INDIVIDUAL DRUGS .........................................................127
Yaa Baa ..............................................................................................................................................128
Drug-Induced Psychosis ....................................................................................................................131
Heroin ................................................................................................................................................133
Ganja (Cannabis, Marijuana)............................................................................................................135
Yaa E (Ecstasy) ..................................................................................................................................136
Inhalants (glue, gasoline, paint thinner) ............................................................................................137
Common Health Problems among Thai Drug Users .........................................................................138
APPENDIX B
TREATMENT OPTIONS FOR THAILAND .................................................................140
What Does a Drug Treatment Program Require? .............................................................................140
Common Treatment Options in Thailand ...........................................................................................142
Therapeutic Communities (TC) ..........................................................................................................142
Matrix Program .................................................................................................................................143
Twelve-Step Programs .......................................................................................................................144
Harm Reduction .................................................................................................................................145
Drug Treatment Programs for Young People ....................................................................................146
Monks and Soldiers ............................................................................................................................146
APPENDIX C
DRUG SUPPRESSION AND LAW ENFORCEMENT ................................................150
ENFORCEMENT ........................................................................................................................................150
Intelligence Gathering .......................................................................................................................150
Police have good sources of information… .......................................................................................150
…but suffer from a lack of evidence. ..................................................................................................152
Threat of Arrest and Prison as a Deterrent Prior to Crackdown ......................................................153
APPENDIX D
HANDLING PSYCHOSIS .............................................................................................156
APPENDIX E
DRUG PRICES IN THAILAND ....................................................................................158
INTERVIEWS.............................................................................................................................................160
REFERENCES ............................................................................................................................................161
13
Chapter 1. Introduction
The rise in methamphetamine abuse during the late 1990s and early this century was
swift and epidemic. Out of a population of 63 million, the government estimates the drug
abusing population at five percent, with one percent addicted. Most of these are Yaa Baa
users. Since drug abuse is most prevalent in a narrow age and sex range of 15-30 year
old boys and men, drug use by that special cohort is and was very high.
2002 Estimates
Users
Yaa Baa
2,024,487
Heroin
20,397
Marijuana
96,835
Others
124,410
Total
2,266,129
Source: Ministry of Public Health
Addicts
543,934
58,038
77,316
84,350
763,638
Total
2,568,421
78,435
174,151
208,760
3,029,767
The government has risen to the challenge, and has spent an ever increasing amount of its
budget on the struggle against drugs, now nearly 1% if drug-related costs of affected
agencies are included.
There are nearly 60 different government bodies and
organizations playing a role in the fight against drugs. They also mounted a reasonably
successful "war on drugs", which although criticized by human rights groups, slowed the
use of drugs significantly. Thai people widely supported the war on drugs even with its
dark overtones - after six years they had lost patience with Yaa Baa users.
Community and NGO groups have also been active in the fight against drug abuse. There
have been many, many community efforts to reduce Yaa Baa abuse, especially among
student-aged users.
Despite the war on drugs and proclamations that the country will be drug free by the end
of 2003, the Yaa Baa epidemic is far from over. Following the war on drugs, the
epidemic lost steam, but it is likely that many of the problems will spring back without
(or even with) sustained efforts to resolve them. Almost daily reports of seizures in the
newspaper make it clear that drugs are still widely available in Thailand.
However, if the campaign manages to reduce the number of drug users by a half, it
should be judged a success. The future will likely see much reduced levels of drugs in
schools, but continued drug use by workers and the unemployed. Casual and light users
may stop using drugs, but there remain many Yaa Baa addicts in Thai society, and while
some of them may have temporarily foregone drugs, they will begin again as the price of
drugs falls.
It is also unlikely that the government will be able to keep the price of drugs high in the
long run. The ease and low cost of production, high profits, 1,000s of kilometers of
lightly guarded frontiers not to mention existing factories and supply networks will all
continue to put enormous pressure on drug suppression units. A second war on drugs
14
would be much less effective, as drug supply chains will have adjusted to the possibility,
and it is likely they will begin to be better armed as well.
Drug use in Thailand is beginning to be well studied. When we conducted our previous
study three years ago, there was very little available to the public on the effects of illegal
drugs. Since that time, a number of books have been written in Thai. Mostly they have
been written by doctors who are caring for patients who are addicted to Yaa Baa. Since
their background was medical, the books emphasize the physical effects of illegal drugs.
Sanchai (2001) has a well written book in Thai outlining the physical effects of the
different drugs.1
How Common are the Different Kinds of Drugs in Thailand?
The following table gives a feel of the relative frequency of drug use by looking at the
number of people arrested in drug seizures.
Number of Persons Arrested for Drug Possesion in 2001
180,000
160,993
160,000
140,000
120,000
100,000
80,000
60,000
40,000
18,780
20,000
10,719
3,340
2,332
1,079
413
623
Heroin
Opium
Kratom
Ecstasy
Other
0
Yaa Baa
Marijauna
Volatile
Solvents
Source: ONCB
Clearly Methamphetamine (Yaa Baa) dominates the illegal drug market in Thailand. The
second most important drug for drug enforcement agencies is heroin. This is due to the
proximity to two big opium growing countries (Burma and Laos), and to the seriousness
of heroin addiction. Thailand is also used as a main gateway for heroin from its
neighbors to the rest of the world, and has a tradition of growing poppies itself.
1
Sanchai Watsuntra, (2001) Drugs….You can quit by yourself
15
Although methamphetamine is addictive, it is not as addictive as heroin.
Yaa Baa
Heroin
Addicts
21%
Users
26%
543,934
20,397
2,024,487
58,038
Addicts
74%
Users
79%
Source: Ministry of Public Health Estimates for 2002
These two circle graphs show the number and relative percent of addicts and users of Yaa
Baa and heroin in Thailand in 2002.
Yaa Baa New Cases Rising Over Time While Heroin
New Cases Are Falling
25,000
20,000
15,000
10,000
5,000
0
Yaa Baa
Heroin
1997
1998
1999
2000
2001
Source: Drug Dependence Information System
Although there are still many older heroin addicts in Thailand, the number of new heroin addicts as
per treatment data is dropping rapidly. On the other hand, effects of the Yaa Baa epidemic are
clearly visible in treatment data.
Treatment data is fairly comprehensive in Thailand2. Here treatment data shows that new
cases of methamphetamine are continuing to rise, while heroin use is falling off.
2
Unfortunately the Thai government decided to halt the collection of treatment data in 2003. Treatment
data is excellent in that it gives lots of detailed information about a population who has little incentive to
16
Route of Administration of Yaa Baa Switched From
Oral to Inhalation Just Prior to Epidemic
120
100
Percent
80
60
IV
Oral
Inhale
40
20
20
01
20
00
19
99
19
98
19
97
19
96
19
95
19
94
19
93
19
92
19
91
19
90
0
Source: Drug Dependence Information System, Department of Mental Health
This chart shows the rapid transformation in route of administration which led up to the
Yaa Baa epidemic. This data is from Thai treatment centers.
Methodology
This study relies heavily on interviews with drug addicts, law enforcement personnel,
prisoners, government officers and those involved in the drug suppression effort.
Secondary data sources include publications in academic journals, articles in the popular
press, publications of the drug suppression community, published works about individual
drugs, rehabilitation, addiction, etc, and government documents and statistics from a
broad range of Thai ministries and departments and international sources.
The initial drug study took place over a six month period from October 2002 to April
2003, with some extensive revisions in the six months thereafter.
The organization of the study is as follows: Chapter 2 presents a quick overview of the
illegal drug problem in Thailand, Chapter 3 looks at some problems that need to be
resolved to bring Thailand back to normal, particularly in reducing the number of
prisoners, and treating Yaa Baa addicts. Chapter 4 takes a look at the social effects of
Yaa Baa, and how it affects different members of society as well as society as a whole.
deceive. This makes it the most complete and accurate information available. Given the continued
importance of drug problems it is hoped that the government will reconsider its decision which seems to
have been a result of the reorganization of the ministries in 2002 rather than anything else.
17
Chapter 5 is an analysis of the economic costs of drugs, including effects from Yaa Baa
and other illegal drugs, and concentrating on lost income due to incarceration, and
Chapter 6 is a summary of the paper, and suggestions resulting from analysis.
18
Chapter 2. Overview Of Illicit Drug Problems In Thailand
Brief History
The history of illegal drugs in Thailand is long and convoluted, and begins with the
production of opium and eventually heroin in the northern mountains, and in the area
known as the Golden Triangle. Although opium use by ethnic minorities was known for
centuries, increased production in this area arose from two main causes – the gradual
closing of the Turkey – Marseilles route of Heroin transfer to the USA and the war fought
first by France and then the USA in Vietnam which tended to spill over into other parts of
Indo-China. During the 1950s and after, Thailand and other countries in the region
became a primary production and shipping route for heroin.
Going back even further, the use of especially Opium, a precursor to heroin, was
enormous in China in the last century. Some of this was blamed on the British with their
opium war which forced China to open up its domestic market to imported opium in
exchange for tea. The methods of growing opium became well-known during that time.
Use of opium was mostly limited to the high-lands until the 1960s. Because of
crackdowns in transportation, heroin became more popular, as it was smaller and easier to
smuggle.
Use of amphetamines started in the 1960’s with long distance transport. The drug was
used for many years by long distance truck drivers. At that time it was called Yaa
Khayan, “Diligent Drug,” or Yaa Maa, which means “Horse Drug” implying you could
work like a horse. The pills were scored in two directions, so that the driver could eat
one of the horses “legs” every few hours. In this way, he would eat one tablet over a
period of a day. This was thought to be sufficient to keep the driver awake all day, and in
fact in retrospect drivers talk of how well it worked compared to the high caffeine drinks
available today. Yaa Baa was also available at gas stations dissolved in high caffeine
energy drinks. Drivers could either buy energy drinks unopened for 5 baht, or opened for
50 baht. (Opened means containing Yaa Baa.)
Heroin began to be a serious problem during the Vietnam war. There were a lot of covert
operations, rebels in the hills, armies in needs of guns. There has always been a strong
link between rebel forces and illegal drugs. Weapons are generally very expensive, and
transient rebel groups living in the hills have very few ways to pay for them. Necessity
leads to invention, and poppies, which grow quickly and well in rough mountainous
terrain are a natural for funding armies. It is not unusual therefore to find an area of
conflict, such as first Laos and Cambodia, then the Burmese border becoming a center for
illegal drugs. What is unusual is that in the Burmese case, the drug program seems to
have become institutionalized, with fixed factories, and growing infrastructure. It is
perhaps unusual in the long history of the world that those who do harm to a neighboring
state feel safe hiding over an undefended border. Certainly the concept of a nation-state
is strong protection for the Burmese drug lords in this case.
19
Conflict died down in Indochina after the 1970’s only to increase on the Burmese border
regions due to fighting between the Burmese government and ethnic minorities.
Warlords ruled and still rule significant areas in the northern part of Burma. They were
first funded by heroin, and likely later by both heroin and Yaa Baa. Now, however, the
level of conflict is much less. The production of heroin and Yaa Baa production has
transformed itself into simply being a very profitable business venture.
On the demand side, Yaa Baa began to become popular in the mid 1990’s. This ties in
with the capture of Khun Saa, the then controller of the Heroin trade, and with a very
steep jump in the price of heroin. It is speculated that this jump in price led to a switch
from heroin to amphetamines. This is less strange than it appears at first, when it is
realized that it was at about this time that smoking amphetamines became common
practice. When smoked, methamphetamines give a feeling of euphoria which is different
from the happy calm of heroin, but that has some of the same features.
Is Yaa Baa use driven by Supply-Push or Demand-Pull?
Both factors were very important.
The supply-push factors that are important are
High drug prices - for producers, middle men, corrupt officials, retailers
Recession - which put many folks out of work, and led them to sell drugs
Addicts Need Money - which leads addicts to push drugs to their friends
The demand-pull factors that are important are
Addictive - Addicts have no choice about demanding more
Acceptance - Especially among young people, who want to feel cool and belong
Productive - Yaa Baa useful for many things like work, stay awake, lose weight
Whether or not there was a switch from heroin to methamphetamine, it is likely that the
advent of smoking methamphetamine was key to the epidemic. If methamphetamine is
eaten, the drug must pass through the digestive system and the liver, before reaching the
brain. Absorption is slow and incomplete. Much of the rush of euphoria is lost along the
way, leaving only a feeling of well being and the ability to stay awake and work hard left.
This is mainly because the uptake is so slow. When methamphetamine is smoked the
drug goes from the lungs straight to the brain, where it gives a rush of happiness and
euphoria, which lasts a half-an-hour to an hour. It is this rush that is addictive and leads
to repeated use day to day, and many times in the same day.
Drug Production
The production of methamphetamine is simple and straightforward, which explains why
there have traditionally been so many kitchen laboratories in different parts of the world.
The author bought a detailed lab manual for making methamphetamine from
Amazon.com on the internet. The key requirements are ephedrine – a key ingredient in
20
legal medications for allergies and also the active ingredient in the ancient Chinese
medicine mahuang, caffeine which enhances the effects of the methamphetamine but
which is present in much lower levels than are found in a cup of coffee, and some
industrial solvents and bases. Unlike some anti-drug material would have you believe,
these solvents and bases (such as lye) are not present in the final product. They are only
used during the processing of the chemicals.
Although ecstasy is closely related to methamphetamine, and producing ecstasy is only a
few steps beyond producing methamphetamine, in practice they are difficult steps to
accomplish. For that reason, sufficient quality of ecstasy is still not available from the
golden triangle area. In fact, most ecstasy used in the world is still coming from the
Netherlands. The price in Thailand is not very different from in Europe, at 500-800 baht
a tablet, but that is a very high price for the average Thai worker to pay. Unless Burmese
factories find a way to make high grade ecstasy cheaply, it is not likely to become very
popular. Adding to that is the fact that ecstasy use is beginning to die down in the rest of
the world.
There are a number of routes that can be used to produce methamphetamines. The
compound is not particularly complicated and can be made in a number of different ways.
The compound is similar to ephredine or pseudo-ephredine, a common cold remedy, and
a number of recipes for methamphetamine starting with these cold remedies are floating
around the internet. This has led to frequent changes in the formulations of these cold
remedies around the world, as authorities have tried in vain to keep kitchen chemists from
producing their own stocks of methamphetamine. For larger commercial production,
illegal ephredine is often used as the raw material. One of the earliest known processes
for producing methamphetamines involved using phenylacetone and n-methylformamide.
Production using these chemicals results in a pungent odor similar to concentrated cat
urine. Stories still float around about how labs cannot be situated near civilization
because of the strong smell.
Trafficking
Trafficking, especially of heroin, continues to be a serious problem in Thailand. Bangkok
is ideal for traffickers because of the enormous flow of trade and tourists, which makes it
very hard to find drugs as they pass through. Intelligence operations and chance play the
biggest role in stopping drug traffickers.
Asaad was sitting in a lounge in the Bangkok International Airport. He had
not intended to come to Bangkok. In fact, he had been trying to go to Hong
Kong. On arrival in Hong Kong he had had trouble with his visa, and
eventually had had to buy a return ticket to Pakistan. The only ticket
available had a stopover in Bangkok. Now, worse luck, he was stuck in the
transit lounge in Bangkok, as his connection was delayed by five hours.
Asaad was not feeling well. He was sweating and felt very sick to his
stomach. Not only that, but he was feeling very nervous and anxious to get
back to Pakistan. He was especially nervous about what he had eaten
21
earlier. He was worried that it was having a bad effect on him. Eventually
his shaking and pallor caught the attention of a policeman on patrol. He
asked what was the problem, but Asaad was moving beyond the ability to be
rational.
At the hospital nurses removed a condom filled with heroin from Asaad’s
stomach. He had swallowed it to smuggle it into Hong Kong from Pakistan.
Even though he had not intended to come to Bangkok at all, he was charged
under Thai law with 1) being under the influence of a controlled substance, 2)
importing an illegal drug into Thailand, and 3) intent to export an illegal
drug out of Thailand. His stay was extended indefinitely under the invitation
of the Thai Police Department.
Besides being a true story of an unlucky guy, this story also shows how much chance and
hunches play a role when undertaking the difficult job of apprehending traffickers.
Much of the Yaa Baa consumed in Thailand is smuggled from Burma, but not much of it
is sent on to the rest of the world. The exception is Yaa Baa sent to Laos and Cambodia,
both with rapidly growing Yaa Baa problems of their own. The existing organization for
trading in Yaa Baa is probably used for expanding into these neighboring markets.
Thailand also faces a serious heroin problem, although unlike Yaa Baa, the greater part of
the heroin smuggled into Thailand is transshipped to the other parts of the world. Again,
most of the heroin comes from Burma, often from the same producers as the Yaa Baa.
Burma is one of the two big heroin producers in the world. (The other being
Afghanistan.) Proximity has brought the problem to Thailand. It is interesting that
heroin addiction is not very prevalent in Thailand even though there is a lot of trafficking,
while Pakistan, with a parallel role for traffickers from Afghanistan, has an enormous
heroin addict population, estimated to be near 500,000 persons3. This warrants further
research.
Because of its compact size, heroin is often smuggled by air. The focus of much
trafficking effort is on the Bangkok International Airport which handles more than 30
million passengers a year.4
Catching drug users in such a busy place is difficult. Drugs are not easy to spot in
luggage, at least if the trafficker is half-way clever. The police rely heavily on profiles
and tips. Often the customs officials are looking at the person more than the luggage.
Bangkok International Airport is not a particularly safe place, with open access to most
parts of the terminal, and fairly light security. It is rare to see guards in many parts of the
terminal, especially places far from check-in and departure areas.
3
UNODC estimate, population of Pakistan about 130 million persons.
Bangkok International Airport continues to grow rapidly. It is now ranked in the world top twenty in
terms of both passengers and cargo, and ranks third in Asia.
4
22
While interviewing one anonymous customs official, we were told that he does not allow
his family to come to the airport ever, because of the threat of bombs in luggage or
garbage cans. Guards are told to dispose of unattended luggage, but in practice they
might be slow to do so. The author left a bag unattended in a conspicuous spot for an
hour to test this hypothesis. The bright red bag was unnoticed and untouched.
Bag left unattended
in a conspicuous
spot at Bangkok
International
Airport. After an
hour the bag was
unnoticed and
untouched.
Catching drug suspects upcountry can be just as challenging. Manually searching
vehicles is a slow and arduous job. The government suggests that police will simply xray everything until all drugs are found, but in truth the government does not own even a
single x-ray machine capable of scanning a truck or a shipping container. The customs
department is in the process of buying a couple of these expensive units for the Bangkok
port, but it would be inefficient to station such units on the many roads through the
Northern provinces. Because of lack of x-ray facilities, vast amounts of time can be
spent tracking down leads. Police must pay for produce or other goods that are ruined
during the search.
Police in the countryside also use
dogs to sniff for drugs. Unfortunately
the dogs can work only very short
hours – perhaps a half an hour at a
time – due to Thailand’s hot weather.
The same dogs doing the same job in
America can work for two or three
hours at a shift.
Dog worn out by the hot Thai sun.
23
Chapter 3. Important Issues
As mentioned above, it is the feeling of the author that use of Yaa Baa has reached or
passed it's peak and that steps must be taken to counteract the strong negative effects Yaa
Baa has had on the country.
There are two key issues that are addressed in this section. Thailand has a very high
prison population relative to most countries in the world, and the facilities to deal with
prisoners are abominable both in terms of physical capacity and personnel. Although the
prisons have installed some interesting and progressive programs, the fact remains that
due to extreme crowding prisoners are treated in a cruel and unusual way. The majority
of these prisoners are incarcerated for drug crimes. As the drug situation improves, ways
must be found to improve the crowding situation, hopefully by reducing the number of
people incarcerated.
The second issue concerns the lack of drug treatment facilities and the lack of follow-up
for those who are treated. The number of Yaa Baa addicts in Thailand has been estimated
at about 540,000, while the facilities to treat them can handle only 40,000-60,000 of
them. What is to become of the other 500,000 addicts who need treatment? The
government has suggested that communities must rally to help the remaining addicts, but
there is currently only minimal signs of this occurring. Although the government is
following a sensible course on this one, a lot more needs to be done both in terms of
quantity and in terms of quality.
This chapter will develop these two issues, while the following chapter looks at some
social effects of drug use, and the chapter following looks at the economic effects of
illegal drugs.
Far Too Many Prisoners
Crowding in Thai Prisons
Crowding in Thai prisons is the worst, or near the worst in the world. The following
charts show conditions for the 60 or so countries for which the United Nations keeps
prison statistics. In two different measures, prisoners per rated capacity, and prisoners
per prison employee, Thailand ranks the worst in the world 5. Thai prisons are thus both
crowded and severely understaffed. Although not available in statistics, a final factor is
that the prison budget per prisoner is extremely low.
Why is Thailand, a low-crime country, having so many troubles with its prisons?
Crowding occurs because of the drug epidemic, and strict laws that kept drug users
5
In the case of overcrowding, Khazakstan was originally thought to be higher, but at 42.5 persons per
place, there was a problem with physical impossibility. Other sources show that the Khazakstan figure is a
misprint. There is also good data at International Centre for Prison Studies listed in the web resources.
24
locked up for a long time. This is one problem that needs immediate attention if Thai
society is to return to normal.
0
Korea
Ireland
Denmark
Finland
Canada
Slovakia
Italy
Netherlands
Slovenia
Bulgaria
United Kingdom
Germany
Czech Republic
Switzerland
Portugal
Spain
Hungary
Hong Kong
Estonia
Malaysia
Papua New Guinea
Turkey
Lithuania
Sri Lanka
Macedonia
Japan
Latvia
Moldova
Georgia
Azerbaijan
Chile
Zimbabwe
Ukraine
USA
Romania
Ireland
Finland
Macedonia
Estonia
Georgia
Latvia
Slovakia
Mauritius
United Kingdom
Denmark
New Zealand
Bulgaria
Lithuania
Norway
Canada
Switzerland
Japan
Papua New Guinea
Germany
Azerbaijan
Australia
Malaysia
Moldova
Spain
Czech Republic
Netherlands
Slovenia
Portugal
Hong Kong
Mexico
Ukraine
Italy
Zimbabwe
Romania
Kyrgyzstan
Venezuela
Korea
Hungary
Jamaica
Belarus
Colombia
Dominican Rebuplic
South Africa
Zambia
USA
Botswana
Sri Lanka
THAILAND
Persons per "place"
Should not be over 1.0
3.0
Botswana
Prisoners per
Corrections Officer
Mexico
Colombia
Zambia
Kyrgyzstan
Belarus
India
Venezuela
0.0
THAILAND
25
Crowding in Thai Prisons perhaps Worst in World
2.5
2.0
1.5
1.0
0.5
In UN statistics, Thailand is the worst in both overcrowding and in being understaffed.
Thai Prisons may be the most Understaffed in World
24
20
16
12
8
4
Source: United Nations Prison Statistics
26
Prison Population Higher than Most Other Countries
In the author's opinion, by far the greatest harms stemming from the Yaa Baa
epidemic are the direct and indirect effects of putting a large group of fairly ordinary
people into crowded prisons, where they can 1) learn how to be worse criminals, 2)
represent lost productivity to the society, and 3) leave their families without
breadwinners leading to further hardship, and further desperate activities such as more
drug selling, prostitution, child labor and an increase in debt.
Thailand is a safe country with a low crime rate. Why do we need to
have so many people locked up in prison?
Top 15 Countries in Terms of Incarceration Rates (out of 140 countries)
800
Prisoners per 100,000
700
600
500
400
300
200
100
us
si
a
B
el
ar
K
us
az
ak
hs
Tu
ta
rk
n
m
en
is
ta
n
U
kr
ai
K
ne
yr
gy
zs
So
ta
n
ut
h
A
fr
ic
TH
a
A
IL
A
N
D
B
ot
sw
an
Si
a
ng
ap
or
Tr
e
in
id
La
ad
tv
ia
&
To
ba
go
Es
to
ni
A
a
ze
rb
ai
ja
n
R
U
SA
0
Source: World Prison Population List, Thai Dept of Corrections (2001)
Includes countries with populations of at least 1 million.
Thailand had a prison population of 250,903 as of the 30th of September 2001, and that
population has undoubtedly grown since. That represents an incarceration rate of about
400 persons per 100,000, 9th highest in the world, and the highest rate in Asia. With the
current “war on drugs” this number is sure to continue to rise.
Thai prisons are already incredibly crowded, and prison officials speculate that 70 percent
of those incarcerated do not need to be there.
27
Several countries have exceptionally high levels of prisoners. Of the largest countries,
the USA, Russia and Thailand stand out.
Incarceration Rates in 20 Largest Countries
800
Prisoners per 100,000
700
600
500
400
300
200
100
C
hi
na
In
di
a
In US
do A
ne
si
a
B
ra
Pa zi
ki l
st
a
B Ru n
an s
gl sia
ad
es
Ja h
p
N an
ig
er
M ia
ex
G ic
er o
m
a
Vi ny
Ph etn
ili am
pp
in
es
Ira
Tu n
rk
ey
E
TH g
A ypt
IL
A
N
Fr D
an
U
ni
ce
te
d
I
K t al
in
gd y
om
0
Source: World Prison Population List, Thai Dept of Corrections (2001)
Although the incarceration rate in Thailand is less than the rates in the US and Russia, it
is nearly four times higher than most of the rest of the world. (The overall average for the
world is about 115 persons per 100,000.)
Thailand has the highest incarceration rate in East and South East Asia, with
Singapore a close second.
Prison Population as Share of Total Population Asian Countries
450
350
300
250
200
150
100
50
K
on
g
an
w
on
g
Ta
i
H
n
or
ea
K
Ja
pa
C
hi
na
0
B
ru
ne
C
i
am
bo
di
a
In
do
ne
si
a
M
al
ay
si
a
M
ya
nm
Ph
ar
ili
pp
in
es
Si
ng
ap
or
TH
e
A
IL
A
N
D
Vi
et
na
m
Prisoners per 100,000
400
Source: World Prison Population List, Thai Dept of Corrections (2001)
28
Jail Time – What is it Like?
We were able to visit some prisoners at a Thai prison, but they were reluctant to talk
about what happens in the prison for fear of being reprimanded. We did get the sense
that they were quite unhappy about conditions, and that the attending wardens did not
want them to talk about it.
Ex-prisoners were much more willing to talk about their experiences since they were no
longer under any threat of reprisals. Here are some of the things we were told.
Food
The food looked so bad that the first day I could not eat anything at all. The second
day I had to eat a little because my body needed it. We are served rice with sauce,
but any meat is like nothing you have ever seen. It is worse than I would feed a
dog.
The food is worse than a dog would eat, and there is not enough.
Health
Lots of people get sick in prison. They make us wash in water from the river, and
people get lots of skin diseases. There is a lot of hepatitis, TB, and other diseases.
I went to the prison doctor, but it was useless. I had a bad infection and they just
gave me Tylenol.
Sleeping
We slept in the most incredibly crowded conditions. If I wanted to roll over I had to
wait for everyone else to roll over at the same time. If you get up to go to the
bathroom you lose your spot.
If you have money you can pay the warden for a little bit better sleeping spot.
Bribes
Most things available outside are available inside as well if you have enough
money. Drugs are available, but are very expensive.
You can pay the warden not to go to work.
29
Source: Department of Corrections
The cozy sleeping arrangements in a Thai jail.
Source: Department of Corrections
How’s the food? Daily budget 29 baht per person (69 US cents) divided into three
meals.
30
No space for activities
On the positive side, the atmosphere in the prison is not frightening. There is little
violence or abuse, and generally prisoners are as likely to be friends with each other as
not. Were it not for the crowding and lack of budget it would probably compare
favorably to many other prisons around the world. Prison officials are fairly open about
the problems the prison has, but the general population has little idea of what is going on.
Daily routine of a Thai prisoner
5 AM Wake up, wash up and stand in line to be checked and counted
7 AM Eat breakfast
8 AM Go to work, e.g. making stickers, sewing, making artificial flowers
12 AM Lunch
3 PM Stand in line for checking and counting
4 PM Go to bedroom and prepare for bed
6 PM Pray
10 PM Turn off TV (most people go to sleep at this time)
31
Sleeping Tight in a Thai Prison
Male Sleeping Space
201,570
Female Sleeping Space
28,517
Total Official Sleeping Space
230,087
Actual Sleeping Space - includes extra space
239,256
such as pathways, canteen used for sleeping
Prisoner population on September 30, 2001
250,903
Space per person
0.95
square meters
square meters
square meters
square meters
persons
square meters
Source: Department of Corrections’ documents compiled by author
As we have seen, Thai prisons are incredibly crowded. By using pathways and canteens,
prisons are able to provide nearly a square meter of sleeping space per prisoner.
Compare that to the international standard of 7.5 meters per person, or the Thai standard
of 2.25 meters per person. There is even a "maximum capacity" standard for Thailand of
1.2 meters for men, and 1.1 meters for women. You guessed it - Thai prisons don't meet
the maximum capacity standard either!
Capacity of Thai Prisons
Standard
International Standard 7.5 square meters
Thai Standard
2.25 square meters
Thai Maximum
1.2 men, 1.1 women square meters
Actual Prisoners
Capacity
30,678
102,261
201,973
250,903
Source: Department of Corrections’ documents compiled by author
Why are there so many prisoners? More than 70 percent of prisoners are in for drugs.
Those imprisoned for things other than drugs have not changed significantly. Once the
drug crisis is over, are we going to keep those drug sellers locked up for another 30
years?
Prices of some common goods while in prison
Goods and Services
Price in Prison
Price Outside
Mor Mee snuff (Thai herb – contains ephredine?) 350 Baht ($8.30)
7 Baht ($0.17)
Not going to work for a month
2,000 Baht ($48)
------Heroin (one Q-tip contains about 1/8 straw)
500 Baht ($12)
13 Baht ($0.31)
Slightly better place to sleep
depends on warden
32
Guard Station at a Prison – There is always a chance to advertise, isn’t there?
Why Did It End Up Like This?
Thai prisons haven't always been so crowded. Crowding occurred because of the drug
epidemic, and strict laws that kept drug offenders locked up for a long time. The truth is,
the threat of prison is not a very effective way to get the attention of young and
disenchanted drug users. The Thai prison population more than doubled in just a few
years, with those arrested for drug crimes reaching about 70 percent of the prison
population.
Thai Prison Population
120,000
100,000
80,000
60,000
40,000
20,000
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Drugs Other Crimes
Includes only convicted prisoners
Source: Department of Corrections 2001
33
As the prison population rose, the facilities to house them, and the budget to feed them
could not keep up. There are four new prisons under construction, but they will add only
a little to the current capacity when they open in June 2003, too little and too late.
The department of corrections budget also did not keep up with the number of prisoners,
putting more and more pressure on prisons to make due with what they had.
300
Index, 1996=100
250
Number of
Prisoners
200
150
Department of
Corrections Budget
100
50
0
1996
1997
1998
1999
2000
2001
2002
So urce: Department o f Co rrectio ns
As the drug epidemic slows, hopefully the prison population will shrink too, but what to
do about drug smugglers serving life sentences when there is no longer any demand for
their wares were they to be let out? Is it really best to keep them locked up indefinitely?
So, Why Do Punishments For Drug Offenders Tend To Be So Severe?
In a 2001 article6 comparing incarceration rates in various US states, the magazine
Scientific American reports that the most important factor in determining incarceration
rates is the emphasis of the political leadership on “law and order”. If you want to find
people to catch, they will be there. If you want to punish them severely, there is no one
to argue with you. In other words, incarceration rates depend more on the number of
policemen than on the number of crooks.
In determining the punishment for drug use, it is useful to look at the problem from the
perspective of the main players involved. Each group is principally interested in making
its own jobs easier, not in the final effect on drug laws.
Police
Fighting crime is difficult work, made more difficult by the privacy protections society
affords each of us. Police are very interested in the powers they are allowed to use while
on the job. If they are allowed to enter buildings without warrants, to tap phones, to open
trunks of cars, it makes their job much easier. They are generally in favor of strict
sentencing, since they went to great trouble to catch the drug addicts in the first place,
and they prefer laws which put the burden of proof on the defendant, since it is difficult
for them to find proof themselves.
6
Scientific American, December 2001. "Why do Prisons Grow?"
34
For corrupt policemen, active drug addicts can be an enormous money earner. Money
may be made at every stage of the drug supply chain. The ingenuity in seeking out
money from drug addicts stretches the mind.
Judicial System
This group is the primary lobby for strict and narrow interpretations of drug laws,
including long minimum sentences. Their job is much easier if the laws are clear, if
sentences are strong and will hold up, and if they have a strong position from which to
negotiate trades for information.
As they are the experts in law, this group also is the one which takes primary
responsibility for writing the drug laws. This is one reason for the strict sentences that
often accompany drug crimes.
As in the US, and other law and order countries, the failure of drug sentences to stop drug
use leads naturally to pressure to make sentences longer and even more strict.
Prison Administrators
Prison administrators tend to feel that far too many people are incarcerated. More
prisoners mean more work. Prison budgets are already stretched and spending money on
new prisons is not a popular item. They also have to face the waste of human potential
every day on a much more personal level. In our visits we were told that 70% of Thai
prisoners should not be in prison.
In addition, prison administrators and others are clearly aware of the effects exposing
young people to a prison environment can have on their future. Not only might future
employers look askance at a prison record, but prisoners are surrounded by other
criminals, and experts in every conceivable vice. With so much time on their hands, it
can act as a training camp for vice. Even without this influence, in the crowded
conditions of a Thai jail, inmates become very close to each other, and often work
together, or support each other after prison. Sometimes this can work well, as they
support each other in efforts not to return, but it is also an ideal place to put together a
drug selling team for after they are released.
Probation Department
The probation department is responsible for overseeing all those who are given
suspended sentences, and those who have just left the prison system. In general they see
the human side of drug addicts more than the police and judiciary, and are integrally
involved in the suspended sentence process which involves interviews with counselors
and psychologists. On the other hand, they are already overworked with many cases, and
may prefer to depend on the prisons to cope with new cases.
Money Laundering Commission
As with the police, this group is interested in having strong powers, especially when it
comes to intelligence work, and the right to confiscate property. They don't like to see
people get away, so they would favor laws that put the onus of proof on the defendant.
35
They are mostly concerned with big players, so may not care so much about sentences for
average drug users.
Drug Users
Discredited, and with almost no voice, this group cannot argue against the penalties that
may be far out of line with the potential harm they might be doing to society.
Budget Woes
Almost every stage of the legal system has budget troubles. The use of drugs has grown
so rapidly that it has put enormous strains on many public services. One single exception
is the anti-money laundering office, which has a fine budget, and is seen as a profit
center, since confiscated property reverts to the government.
Credibility of Justice and Law Enforcement
Popularly, there is little faith in the integrity of the judicial system, with the expectation
that judges and prosecutors could easily be bribed and expected bribes. However, among
the mid-level government officers we interviewed we found a certain degree of faith in
the integrity of the judicial system. There was much less faith in the police, at least as far
as bribes were concerned. The stories from the man and woman on the street, and
accounts of drug addicts, astound one with the variety of ways the police have found to
extract money from the illegal drug trade. No one thinks all police are corrupt, but
certainly some of them are. Of course judges have less need to be corrupt, as they
typically earn 100,000 baht a month, many times greater than the 6,300 baht which is the
salary of a starting police officer.
How Can We Reduce the Overcrowding Problem?
Certainly a better sleeping situation, better food, and normal tap water for washing rather
than river water are priorities. If the drug epidemic fades relatively quickly, then the
overcrowding problem in prisons will fade quickly too. The danger is that strong
suppression and a strong law and order approach to drugs will exacerbate the problem.
We feel that a softer, gentler approach to drug addiction is needed to help bring drug
addicts back into the general population, while strict suppression is being practiced with
the drug dealers. To some extend this is already being done, as there is a new law that
sends those captured with 5 pills or less to rehabilitation rather than to prison. Without
community support for follow up through it is unlikely that this sort of mandatory
rehabilitation will be effective at curing addicts.
Contradictions in the Thai Perceptions of Drug Users
Of those we spoke to in the government, in the private sector, and on the street, the
overwhelming response we got was that those who use drugs were sick, that they were
not bad, and that society should take care of them. On the other hand, it was generally
felt that those who sell drugs are bad, and deserve what they get. This, together with an
enormous pent-up frustration with the drug problems and worrying about their own
children and relatives, have made the general population sympathetic to the government's
new get tough on drug sellers campaign, which by some accounts is pretty brutal.
36
Abuse versus Trafficking
Drug related crime includes crimes for trafficking as well as crimes for abuse. In practice
this comes down to the amount of the drug found in the possession of the accused. For
Yaa Baa, possession of more than 15 pills is considered trafficking. What a lay person
might understood as a trafficker – someone who transports large quantities of drugs, or
transports drugs between countries - make up only a very small percentage of those in
prison.
Generally those arrested for abuse will be given shorter sentences, and often may be able
to avoid being sentenced to jail time (especially minors). They may be given suspended
sentences or probation. Since early in 2003, those arrested for 5 pills or less will be sent
to the drug treatment system rather than prison.
Share of Prisoners Arrested for Drug Crimes by Category
Possesion
for the
Purpose of
Selling
38%
Exporting,
Importing,
Production
1%
Use
5%
Abuse
Use and
Possesion
16%
Posession
7%
Trafficking
Selling
33%
Source: Department of
Corrections, 2002
Nonetheless, abusers still make up a surprisingly large share of those imprisoned. The
associated chart shows the share of convicted drug-crime prisoners by type. This chart
likely underestimates the true share of abusers in prison, and also misrepresents the share
of abusers who are given jail time.
37
When a person is arrested for a drug crime he or she is placed in prison. The person may
then be prosecuted (93%), convicted in court (83%) and sentenced to jail time. Part of
that jail time will already have been served as the prisoner awaits trial. In many cases the
process of getting through the court system may take up to a year, so the actual jail time
may even exceed the sentenced jail time for small offenses. None of those awaiting trial
are included in the statistics shown above since prisoners cannot be classified until they
are convicted. That means that many abusers are awaiting trial, after which they are
released. They do not show up in prison statistics, but they have in fact been spending
time in jail for drug abuse.
In addition, since drug abuse sentences are generally shorter than drug trafficking
sentences, a large number of drug abusers going through prison will only appear as a
small share of total prisoners. For instance, suppose 6 drug abusers are each sentenced to
two months in prison. Annual statistics will count only one of these as being imprisoned
since the others will have passed through at a different time of year. In essence prison
statistics are a snapshot of the situation on one day of each year.
Drug-related crime is difference from other criminal offences in that there is generally no
victim. Indeed, the criminal and affected person is one and the same. The crime is
against oneself, or in the case of traffickers, against society as a whole. Because of this,
most prisoners accused of drug crimes are not considered dangerous to society. They are
in prison as a warning to others and to themselves, not to protect society from anti-social
behavior. The distinction may be important. If it is found that incarcerating drug abusers
is not effective at slowing drug abuse, there is no longer any reason for locking up drug
abusers, unless they are thought to be dangerous. (Drug traffickers are a different case,
because selling drugs makes drug more available, and may lead to more drug addicts in
society. )
Final Note on Prisoners
It is our impression that youngsters sent to detention centers may be in even a worse
situation than adults if that is possible. The budget and facilities for these detention
centers are very limited, and there is not nearly enough staff for rehabilitation work with
the children. Often the kids are sent to the big prisons with adult convicts first. It is likely
that in many cases these detention centers are making kids worse off rather than helping
them.
38
Insufficient Treatment
Shortage of Treatment Centers
Offical Drug Treatment Population in Thailand
(if include unofficial programs number will be slightly higher)
50,000
45,000
40,000
35,000
Re-Entries
30,000
25,000
20,000
15,000
10,000
5,000
0
1997
New Cases
1998
1999
2000
2001
Source: Drug Dependence Information System
The number of patients entering treatment programs is growing and is likely to
mushroom as Thailand starts to move beyond its Yaa Baa epidemic. Besides the many
patients who will be trying to quit on their own, there will also be a big jump in
mandatory treatment cases. In 2002, the Thai government passed the “Narcotic Addict
Rehabilitation Act 2002” which says that anyone caught in possession of 5 Yaa Baa pills
or less will have to enter mandatory treatment. This law was implemented last spring
(Spring 2003). In addition, the government’s tough war on drugs has made Yaa Baa and
other drugs more scarce and more expensive. The price of a pill of Yaa Baa jumped from
80 to 300 baht from February to April 2003, which drove many people to quit Yaa Baa
for economic reasons. Since then Yaa Baa prices have fallen but are still high at 150 baht
per pill. Thanyarak hospital estimates that treatment admissions rose 40 percent during
the suppression period (March and April 2003) because of increased enforcement and
higher drug prices.
In 2001, official Thai treatment programs7 handled about 73,000 cases This probably
represents about 90 percent of all treatment cases in the country. Of this 73,000, about
42,000 were re-entry cases, and 31,000 new cases. Many of the re-entry cases are heroin
addicts. There are an estimated 540,000 Yaa Baa addicts in the country. This leaves a
shortage in treatment capacity of more than 500,000 places. How will all of these addicts
be treated?
7
Those licensed by the Department of Public Health
39
Treatment centers are accepting rapidly increasing numbers of Yaa Baa patients.
Presently Yaa Baa patients make up 37% of the treatment population.
Almost all organizations in treatment and rehabilitation have expressed concern over the
lack of facilities and materials to deal with the present number of Yaa Baa addicts.
Drug rehabilitation programs are somewhat decentralized in Thailand, with a large
number of both public and private hospitals running treatment programs, as well as a few
private clinics, and NGO programs.
Percentage of people seeking treatment for each type of drug
Drug
Number of Persons Share of Total
Heroin
34689
48%
Yaa Baa
26601
37%
Opium
3481
5%
Alcohol
2148
3%
Cigarettes
1851
3%
Inhalants
768
1%
Marijuana
665
1%
Others
2468
3%
Total
72671
100%
Source: Department of Public Health 2001
Of those entering treatment, the clients most likely to be returning are heroin users.
Share of Re-Entry Clients out of Total Clients, by Type of Drug
Alcohol
29%
Opium
Marijuana
Inhalants
51%
27%
25%
Heroin
Methamphetamines
87%
22%
Heroin Users Come Back to Treatment Programs Over and Over Again
In 2001 they made up about half of all rehabilitation clients
Source: Department of Public Health
40
To try to counter this problem, over the last few years, the government has significantly
increased the budget available for treatment and rehabilitation, but it is likely to be far
from enough.
Thai Government Budget Spent on Drugs, by Objective, 1992-2003
Million Baht
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
200
0
Suppression
1992
1993
Prevention
1994
1995
Treatment and
Rehabilitation
1996
1997
Mixed
1998
1999
General
Services
2000
Narcotic Crop
Control
2001
2002
2003
Source: Putthamilinprateep (n.d.) and ONCB
The cost of rehabilitation as a share of government expenditure will continue to rise very
rapidly. Again this puts pressure back on communities and the society as a whole to help
take responsibility for those around them.
Since Thailand does not have enough drug rehabilitation places for all the people who
need help, a big proportion of treatment will have to depend on communities. Pol. Gen.
Pracha Promnok, Deputy Minister of Public Health, said that the Minister of Public
Health had set a target of 600,000 persons in 2003 to attend drug treatment and
rehabilitation programs. Of them, 50,000 persons would be treated as in-patients at
hospitals and military camps, whereas the rest would be treated in their communities all
over the country.8
Other Challenges Faced by Thai Rehabilitation Centers
Besides a general lack of availability, Thailand faces a number of critical problems in its
rehabilitation programs.
1) Lack of Follow Up - In interviews, the number one problem mentioned was a
lack of follow-up in just about every type of rehabilitation in Thailand. Prisons
did not know what had happened to their inmates after releasing them,
rehabilitation centers did not know if their patients had returned to drugs, youth
8
I.N.N. 2-3-2003. “Ministry of Public Health Set Target to Treat 600,000 Drug Addicts”
41
detention centers did not know what had happened to their detainees. The fear in
every case, was that once the person left the protective environment of the centers,
they would have no support, and would return to their old ways. In many cases,
this fear was justified by high recidivism in prisons, detention centers and
treatment centers. The transition from a protective and controlled environment to
life back on the street is probably the one of the hardest a drug abuser is likely to
face, and in Thailand it is handled poorly. What little is done is handled by a very
stretched probation department, but halfway facilities, or at least counseling is
sorely needed. Another big problem with the lack of follow-up, is that it is very
difficult to know which programs work when there is no way to measure program
success rates
2) Lack of Community Involvement - More community involvement is needed in
drug rehabilitation efforts. Although Thais seem to feel that drug abuse is a
disease, not a crime, there is little sense of responsibility in getting people into
treatment, and helping them stay better. Attitudes range from indifference, to tacit
encouragement by employees in labor intensive occupations. Drug abuse is a
symptom of an unhealthy environment - physically unhealthy, emotionally
unhealthy, socially unhealthy. It is the job of the community to work towards a
more healthy environment, not only for drug addicts, but for everyone.
3) Top Down Design of Treatment Programs - Treatment programs are mandated
from the top rather than designed to fit clients needs. Because of this, they are
inherently inflexible, and there is no mechanism to adjust the programs based on
what has been successful or to be more responsive to client needs. There is a
fundamental problem with trying to fit all users into one program.
4) Lack of Research on Yaa Baa - There is a need for research into what kinds of
treatment works best for Yaa Baa addicts. Adopting internationally accepted best
practices and standards would be a start, but research on the local situation is also
needed.
5) Insufficient User Profiling - Related to #4, there is a need for better profiling of
drug abusers to better understand the groups who are abusing, and what could be
done to make drugs less interesting to them.
6) Lack of Joint Drug Abuse Mental Illness Programs - One of the key risk
factors for drug abuse is mental illness. Some programs need to be designed that
address persons with both drug abuse and mental illness.
7) Lack of Training for Treatment Personnel - There is a lack of training of
treatment personnel. Many treatment programs are run through hospitals where
specialist knowledge about drug addiction is in short supply. Counselors in the
newly formed Matrix program are given only 6 weeks of training before assigned
to a rather difficult counseling assignment.
42
Treatment – What Works and What Doesn’t.9
The available research worldwide is quite clear on the following:

Education about drugs is not enough to stop drug abuse – some people will use
drugs irregardless.

Consequences of drug use (loss of job, arrest, divorce) are important motivators
leading to entry into drug abuse treatment and should not be mitigated.

Jailing drug addicts does not cure many of them, relapse rates are over 70 percent.
Rehabilitation is needed to cure addiction.

Addiction is more than just getting drugs out of the body – relapse rates after
detox are about the same as after jail. Again, rehabilitation is needed.

The clearest predictor for success in rehabilitation is the length of time in
treatment, no matter what the type of treatment.

Drug abuse is best treated by a mixture of programs, all of which include followup with continuing outpatient therapy, medications as needed, and monitoring the
addict with the goal of reinforcing and maintaining the full benefits of the
treatment.
Different Target Groups
The ONCB (Office of Narcotics Control Board) list three main user groups of Yaa Baa in
Thailand. These are workers, students and the unemployed/disfranchised. It is likely that
the actual situation is more complicated than this, but not enough work has been done on
profiling of drug abusers to be more complete.
According to this simple framework, students are thought to use drugs for fun and as a
fad, workers are thought to use it to enhance performance, and the unemployed are
thought to use it to make money. Of these, the worker group is thought to be the largest,
followed by students, and the unemployed.
9
Material under this heading is mostly from Investing in Drug Abuse Treatment, UNODC 2003b, p.iv.
43
a
a
Students
B
a
Workers
a
a
B
a
a
Ya
Y
Ya
aB
Unemployed
aa
Selling, work benefits, and pleasure are all positive attributes in the eyes of a Yaa Baa
addict, which makes eradication difficult.
44
Chapter 4. Social Impact of Illegal Drugs
Introduction to Social Impact
Those living in Thailand are confronted everyday with the visual signs of the war against
drugs. Everywhere there are posters, banners, and advertisements placed by the
government that threaten, cajole and discourage the use of illegal drugs.
These are but the superficial signs of an underlying malaise affecting the culture. Illegal
drugs have adverse effects on many parts of the Thai culture, and especially for young
people, poor people and the working class.
These social effects of narcotic drugs can be seen at all levels of society, be it the
individual level as a person cannot work because of drugs, family level as a couple
divorces because of one partner’s drug addiction problem, community level as
communities must commit resources to solve drug problems, institutional level, as
schools and hospitals cope with a growing addict population, or national level as law
enforcement officers fight drug smuggling on the border, temples host rehabilitation
efforts, and taxes go to solving a non-productive problem.
This chapter outlines some of the social impacts of illegal drugs on individuals and
communities, addressed from a variety of different perspectives. Issues such as the effect
of drugs on families, women, children, education, employment, health, crime and
corruption are all part of the broader picture of how drugs affect the society. Of all of
these, we will start with how drugs affect children as one of the biggest concerns in
Thailand, and we will also include what factors put children at risk of becoming drug
addicts as this is of primary concern to all Thai parents.
Drug use should not be seen in isolation from other social problems of young people. It
is a symptom and goes together with a number of other social problems which may
reflect a poor environment for the drug abuser, or underlying problems in their emotional
makeup.
45
Drugs and Children
Children have an irrepressible curiosity, an undeveloped ability to cope with the world’s
problems, and a strong need to be loved and to belong. Most of the drug use in the world
is by children and young adults due to this volatile mix of attributes. Generation after
generation experiment along the same lines, with similar effects. Some children will be
harmed by drugs, others will become addicted to drugs and will continue to use drugs
throughout their adult lives, others will use drugs as a passing phase and move on, and
most children will pass through childhood with no experience of drugs at all.
Although it is not known which children will become addicted to drugs, it is a sure bet
that if drugs are available some kids will become addicted. Addiction often leads to a
miserable life for the addict, as well as those around him who are affected by his
behavior. For this reason (among others) society tries extremely hard to keep drugs out
of the hands of children. Parents, schools, law enforcement, and other institutions all
cooperate to suppress drug use by children. The battleground for control of drugs is often
any place that kids congregate - schools, clubs, street corners - and the children are
usually there on the front lines.
Drug use affects children adversely in many, many ways. Drug use in high schools and
vocational schools affects the educational environment and the quality of education
children receive. Drug use in families results in family breakups, financial troubles that
may take kids out of school, the possibility of having one or both parents in prison and
may involve pressure from the family to sell drugs. Craving for drugs may drive children
to take up selling drugs themselves, may lead to prostitution, dangerous activities, or lead
to a life of crime. All of these issues will be taken up in the sections below.
The drug epidemic is no longer in its infancy and many government initiatives are under
way. Many of the community and government efforts at reaching drug users are aimed at
children. Children are easier to reach since they are all together in the school. They are
often more impressionable and easier to persuade. If we reach them we can change the
whole course of their lives. Finally, older users may be thought to be more responsible
for their own actions, so the community bears less responsibility for them.
These efforts at helping young people may be paying off. The median age of those
seeking treatment for Yaa Baa is only 21 years of age, but as recently as 1998 the median
age was 18, suggesting some success at reaching student abusers. Young people between
the ages of 15-19 remain the largest group in treatment centers, but older age groups are
growing rapidly while the size of the younger age cohorts are remaining stable.
Why Kids Don't Use Drugs
Before talking about what leads a child to use drugs, we should say what factors make a
child safe from drug use.
46
A child who is in a warm, supportive environment, with parents who love and pay
attention to him or her, who can do at least reasonably well at school, who has friends,
but is happy to spend time alone as well, who does not face abusive or drug abusing
parents, is at a very low risk of being addicted to drugs. This lucky and well adjusted
child is also safer and can handle most of what the world throws at her. Her parents
should be congratulated.
In addition to personal factors, the environment plays an important role in whether a child
will use drugs. A child who lives in a place where drugs are not readily available, where
only a few people are talking about drugs, where drug use is not seen as cool, where there
is active supervision, and where there are other interesting activities also stands an
excellent chance of never trying drugs.
So what can go wrong? Actually it can be many things, and is generally a result of
several of them. Suppose the child has a problem – perhaps difficulty in finding good
friends – one of the common reasons to start using drugs. That child has a great number
of tools to work with in meeting temptation. Besides support from her surroundings, she
has a reasonable amount of self-confidence built up from success or contentment about
many other things. This confidence and support will likely see her through her problem.
But what if the problems start to mount up? How about if there are two problems. Her
parents are facing a divorce plus she doesn’t have friends. The risks are building. Now
in addition suppose the child is failing out of school as well. Now it is beginning to
sound like a child who is likely to use drugs. If you add to this, someone who has been
abused, whose parents do not love him/her, who is afflicted with a mental illness. Then
you begin asking - Why isn’t that child abusing drugs?
If you want your child to be safe from drugs, don’t start by searching her room, start by
ensuring that she has the tools she needs to deal with the world’s problems.
Why Kids Do Use Drugs
In an interview with Nicom Charumanee at the Student Patrol Center, we asked what
made kids use drugs.
Question: What makes kids use drugs?
Answer: The biggest determinant of whether kids will get addicted to Yaa Baa depends
on how much time the parents spend with them. If parents spend time with their children
and understand them there will be no problem. Parents, be they rich or poor, think the
only way they can give their kids happiness is with possessions, so they spend too much
time at work, and not enough with their children.
The absolutely most important thing Thailand needs to do is to teach parents how to be
good parents. This includes teaching them to give love, pay attention to kids and to hide
the pain and anger from their own lives, so that grown up problems like messy divorces
do not affect children.
47
The children who became addicted to drugs are mostly trying to escape their problems.
Broken families and a bad family environment lead to drug abuse, as do mental health
problems.
Question: Is it mainly bad students who use drugs?
Answer: No, drug users are a mix of good and bad students.
Question: Is it outgoing kids or shy kids who use drugs?
Answer: Both, but in different ways. Outgoing, and especially brave kids were more
likely to try Yaa Baa, since they are often in groups and are willing to try anything.
Shy kids want to use drugs because it made them feel strong, confident, less shy, and
makes them feel like part of the group. They want to be brave. It is as if there are two
people living in the same body - the shy one, and (while on drugs) the brave one. Shy
children are more likely to become addicts of Yaa Baa and heroin than outgoing kids.
Question: What kinds of behavior are predictors of drug use?
Answer: The most common pattern is for youngsters to start by using cigarettes and
alcohol. This is true in 80 percent of the cases. Another big warning sign is teenage sex.
People who engage in sex when they are very young often do it because they want to feel
close to someone - they are very lonely.
"High school students have a lot of daydreams. When you are young it is
time to dream about what you can do in your life. But for many kids who
grow up poor, all they can see around them are walls and barriers in their
real life. While they are using drugs, it at least allows them a chance to
dream."10
The table below comes from a total of 72,000 drug treatment patients who entered
treatment in Thailand in 2001. Curiosity was the most often cited reason for using
drugs, which suggests self-motivation is as much a factor in drug use as is peer pressure.
10
Nicom Charumanee, Student Patrol Center, previously of the Ministry of Education
48
Reasons Given for Becoming Addicted to Drugs
Enhance Others
3%
Relieve Work
Pressure 4%
6%
Physical
Illness
2%
Persuaded
by Friends
25%
Recreation
8%
Curiousity
52%
Source: Drug Dependence Info System
The percentages change slightly when only Yaa Baa patients (21,000 persons) are
considered. 'Persuaded by friends' becomes 32%, 'curiosity' becomes 46% and 'enhance
work' becomes 10%.
Predisposing Factors for Drug and Alcohol Abuse
Behavioral Correlates
1) Antisocial behavior
2) Hyperactivity
3) Poor school performance
4) Peers who abuse substances
5) Expectations of positive effects
6) Low self-esteem
7) Psychiatric disturbances
8) Suicidal behavior
Individual Risk Factors
1) Genetics/family history
2) Poor parent-child relations
3) Sexual and physical abuse
- Review article from Manual of Adolescent Substance Abuse Treatment, Ch. 2 Patricia Harrison
The Kinds of Drugs Kids Use
The most common drugs for Thai children are Yaa Baa and inhalants, followed by ganja.
This is a change from an earlier generation who would use ganja as the first illegal drug.
Before any of these will often be cigarettes and alcohol.
The pathway from cigarettes to smoked drugs to injection, is a path from the familiar to
the frightening. We can envision the thought process of a child, who feels brave and
grown up and rebellious by smoking cigarettes at ten, then feels brave and grown up and
rebellious by smoking Yaa Baa at 12, then feels the same thing again when trying sex at
49
14-15 years old, and then being brave by injecting drugs when they are in their late teens
or early twenties.
Three factors likely to affect which drugs are used first are:
 How available is each drug.
 How dangerous each drug is perceived to be.
 The route of administration.
In Thailand, the adoption of a route of admission that was not too frightening, probably
played a significant role in the age group of the users and correspondingly the extent of
the epidemic. In addition, Yaa Baa has been very available and perceived as safe.
Median Age of those in Treatment for each Kind of Drug
Drug
Median Age of
(as per
Treatment
2001 Data)
Population
Inhalants
21
Yaa Baa
21
Marijuana
27
Heroin
29
Opium
39
Alcohol
40
Cigarettes
41
Source: Department of Medical Services11
Yaa Baa New Cases
2001
2000
1999
1998
Median Age of
Treatment
Population
21
19/20
19
18
Source: Department of Medical Services
In the first of the two tables above, Inhalant and Yaa Baa groups are the youngest in
treatment populations with a median age of 21. Drug abusers probably use drugs for a
number of years, so median onset would be some years earlier. In the second table, the
median age of those in treatment for Yaa Baa is increasing rapidly, as the problem among
school children has peaked, while older abuser groups continued to increase.
Children Who Sell Drugs
Children are often used to sell drugs because penalties for children are much lighter than
for adults and they can travel about without suspicion. Young girls are often used to
carry drugs because police are reluctant to search them for drugs. Children of all ages are
used for drugs and cash.
11
The Department of Medical Services keeps statistical records for all registered treatment centers in
Thailand, about 90 percent of the total treatment capacity in the country. This data was very useful to this
study and is used on a number of occasions. The data is helpful in that it contains a large sample (70,000
plus per year) of known drug users, in an environment that allows them to answer questions honestly and
completely. As with all treatment data, the sample will be strongly biased towards more serious abusers.
During the period of this study there was no court required treatment in effect, so the sample is of those
voluntarily seeking treatment.
50
Most often a child will become involved in selling or transporting drugs because of prior
family involvement, but it is not the only reason. The child may be living on the street
and looking for a way to make easy money, or the family of the child is so poor that they
allow the child to be used in this way. The child may even carry drugs to seek approval
from an older child or adult. Poverty is the most likely cause of involvement since a very
young child will not be using drugs yet.
“Nok is a bright young girl - quick, vivacious and curious; under the right
circumstances she should be a model student with an equally bright and
lively future ahead of her. But Nok is the daughter of a beggar. Her mother
begs on the streets of Bang Lampoo for a subsistence wage with hope to get
enough money to pay for the price of her daughter's right to schooling or
any chance to escape a vicious cycle of poverty. And Nok uses her energy
and quick wits to learn the art of selling chewing gum. Due to poverty, the
filthy school uniform she wears to encourage tourists to pass with their
money is the closest she's ever going to get to an education.”12
Although the Nok of this story is not involved in drugs, she is an example of a youngster
who might easily be drawn into selling drugs. We might imagine that Nok is a prime
target for being sold into prostitution, being drawn into the drug trade, or other illegal
activities, and that her future is nearly non-existent. There is upward mobility in
Thailand, but not for illiterate folks who live on the street.
Information
Children are especially prone to fads and fashions. Advertisers know that the way to get
kids to buy products is to create '‘buzz'’ about it. If kids are talking about something,
there are likely to be sales. Drug use in children often follows a similar “fad” pattern.
Children do not know much. If they have not heard about drugs, they will not be likely to
try them. On the other hand, if everywhere they turn they hear about drugs, they will
become curious. Campaigns to fight drugs in schools often backfire, as they act to
advertise the very behavior they seek to stop. Pop stars, fashion and fun venues are also
ways in which kids learn about drugs. Many movies glamorize the use of drugs even in
cases where the drug abuser ends up poorly. Kids who smoke cigarettes sit and share
information about other drugs. Harm reduction campaigns sometimes have unintended
negative consequences as they draw attention to drugs.
If kids are already aware of drugs, then they need some information to help them decide
not to use drugs. Institutions trying to halt drug abuse try to associate drug use with
negative or frightening images. They emphasis that drug use is “wrong” and
“dangerous.” They emphasize the risk of going to prison – which probably doesn’t have
much meaning to most teenagers, or the risk of death, which probably is more
understandable. One problem with this approach is that kids become cynical and do not
12
Bangkok Post. 19-11-2000. “Fresh hope for child laborers”
51
believe the sometimes exaggerated claims of drug propaganda. This may lead them to
stop listening, or to seek more sympathetic “credible” sources, which may be just as
biased in the opposite direction.
Special Risks from Heroin
Many youngsters are tempted to try drugs when they are in high school and college. For
many drugs and many youngsters this is just a passing faze, and they may grow up to be
law abiding adults. For those who have the misfortune of having tried and become
addicted to heroin it is different. Heroin takes over their lives. It is heart-wrenching to
interview heroin addicts who have been trying extremely hard for twenty years to quit,
and yet still cannot. Most of those we interviewed had been in treatment centers five to
ten times already, and had been to prison a few times as well. They are usually estranged
from their families, generally cannot be in relationships, and often cannot have a normal
job. Without heroin, they could have been normal members of society.
52
Education
Part of the problem of keeping children off of drugs is providing them with a drug free
environment. No place is more important for this than the schools. Yaa Baa use among
students in Thailand is a very serious problem. The prevalence of drug use is highest in
vocational schools, followed by secondary schools, and includes elementary schools.
Most Yaa Baa addicts are students and young people under 25, with the biggest group
ranging in age between 15 and 19. According to the Ministry of Education, some 3 to 5%
of students are either addicts or small-time dealers.13 ONCB figures show more than
320,000 students involved in drugs14which would be close to five percent of all students
nationwide, and a much higher percentage of secondary school students.
With so many students using drugs it is no wonder that the school system is adversely
affected by drugs. Some of the problems include less discipline, more absenteeism,
poorer performance in the classroom, probably higher dropout rates, and a less secure and
comfortable learning environment.
Drug Abuse in Schools
Most dealers in schools are students and former students. Because the dealers are
students it is very hard to isolate them from their customers. Drug buyers and sellers also
function as a network of friends, so they are unlikely to betray each other. School
administrators have a tough job monitoring all students at all times. The Thai school
system operates with a large number of students for each teacher, usually ranging from 40
to 60. It is extremely difficult for these teachers to keep tabs on all their students all of
the time. Drug abuse and trading can occur anywhere, though certainly there are
locations that are particularly troublesome. Students use drugs in bathrooms, behind
school buildings, outside gates, or at each others homes while listening to music or
hanging out.
A 17-year-old 11th grade student said he started using Yaa Baa when his
friend provided it when they hung out at his house. Then one day, using the
excuse that he had no money to repay a debt, the friend asked if he could
repay it in the form of Yaa Baa. “He suggested I use some and sell the rest to
other students. I did, and made good money. I found that by hiding the pills
inside my underwear and arriving very early at the school, I could easily get
them in,” said the student. Since the drug costs approximately 70 baht for
each pill, on some days, he sold 7 pills, at 100 to 200 baht each, and made a
profit of 300 to 400 baht. On better days, he might sell as many as 30 pills.15
13
Ministry of Education. N.D. Manual for Drug Prevention and Suppression in Schools
Daily News. 22-9-2002 “Yaa Baa Breaks into School”
15
Bangkok Post. 13-9-2000. “A Picture of Abuse”
14
53
Slowdown in Teen Use of Drugs
Although drug use in schools is a critical concern, there is evidence that the student drugusing population is beginning to respond to drug fighting efforts, and that the number of
drug using students may be beginning to fall. Many students are probably still at the
experimental stage of drug use, both because they are young, and because they do not
have the money to buy drugs in large quantities. This group may find it easier to quit
than those who have been long term addicts. Certainly the share of students in treatment
is beginning to fall.
Methamphetamine Users are Aging
9,000
Number of Patients
8,000
7,000
6,000
5,000
4,000
3,000
2,000
1,000
0
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
Age
1998
1999
2000
2001
Source: Drug Dependence Information System
School age addicts are much less dominant in treatment populations than just a few
years ago, and unlike other age groups their numbers are falling. In the above graph,
the number of 10-14 year olds in Thai treatment populations are falling, the 15-19 age
group is steady, and other groups are rising rapidly.
School Performance
It is common to find a negative correlation between drug use and school performance.
What is harder to measure is what comes first, bad grades or drug abuse. After all, poor
school performance is one of the key risk factors for using drugs as adolescents search for
identity and escape from their troubles. However, even if it is poor performance that led
them to drugs, their performance is likely to continue to slide after beginning drug use.
After becoming addicted, students may become distracted and lose interest in studying.
Although Yaa Baa has little direct effect on their behavior at school (although it might
cause drowsiness if used the night before), it provides another focus to their lives – one
54
which is antagonistic to the school and counter culture as well. The student may take
different values to heart.
Students who use drugs often suffer from preoccupation with acquiring drugs, adverse
emotional and social development and generally impaired classroom performance.
Reduced cognitive efficiency leads to poor academic performance and a resulting
decrease in self-esteem.16 This contributes to instability in an individual’s sense of
identity which, in turn, is likely to contribute to further drug consumption, thus creating a
vicious circle.
Chitsawang (2001) found that for a drug addict respondent group in prison, 18.5%
experienced a decline in academic performance sufficient to require them to quit school.17
A research project conducted by the Student Patrol Division18 found most Yaa Baa using
students had a GPA between 1.01-3.00, while Suwannachote (1999)19 found most drug
abusers to have a GPA in the 1.00-2.00 range.
At Wat Chu there is a technical school student who is now in his 6th year of a
3 year technical school program. Professors can’t figure out why he can’t
pass the exams. Actually, if he finishes and gets his certificate he will only
make 1,000 baht ($24) a week. If he stays in school he can make 7,000 baht
($170) net profit a week selling drugs. Actually he claims that he makes
12,000 ($290) a week selling drugs at 3 different schools. Of that 12,000 he
gives 5,000 ($120) to the police to leave him alone.
School Dropouts
Petchsingha (1987) studied the relationship between drugs and quitting school and found
that, of those who dropped out, 16.7% had been addicted to illicit drugs, and 2.7% still
used drugs habitually.20 A more recent study by Pattanakamjorn (1998) on drug use by
students showed that as dosage and frequency of drug use increased, absenteeism, loss of
interest failure rates increased among Yaa Baa abusers.21
However, Ministry of Education data about dropout rates did not support the theory that
large numbers of students are dropping out because of drug use. In fact, it is the situation
in the economy which determines the majority of school dropouts.
16
Pattarakorn, A. n.d. Amphetamines. Disseminated Leaflet. Thanyarak Hospital.
Chitsawang. 2001, "Life Careers of Drug Offense Inmates"
18
Student Patrol Division 2000
19
Suwannachote, K. 1999
20
Petchsingha, P. 1987
21
Pattanakamjorn, W. 1998
17
55
Annual Dropout Rates for 7th to 9th Graders
3.0%
1997 Asian
Economic Crisis
2.63%
2.48%
2.5%
2.35%
2.35%
2.19%
2.0%
1.52%
1.51%
1995
1996
1.5%
1.21%
1.0%
0.72%
0.5%
0.0%
1993
1994
1997
1998
1999
2000
2001
Source: Office of the National Primary Education Commission, Thai Ministry of Education
Dropout data do NOT show an effect from the Yaa Baa epidemic. The jump in
dropouts in 1997 and years thereafter is a result of the 1997 economic crisis. As the
economic situation gradually improved in the late 1990s, the dropout rate fell, in spite
of increased use of Yaa Baa in schools. If the Yaa Baa epidemic caused more students
to dropout, it is masked by the stronger effects of economics on dropout rates.
Students do not seem to be a big user group for heroin although use (particularly
smoking) is observed in older teens. Treatment data supports the contention that heroin is
a drug taken up later, perhaps as the last link of the chain from cigarettes to Yaa
Baa/ganja to heroin.
The following chart shows the age distribution of Yaa Baa and heroin users in treatment.
Very few school age heroin addicts are found in treatment, while school age Yaa Baa
addicts are the largest cohort.
56
Yaa Baa vs. Heroin Treatment Populations
12,000
Number of Patients
10,000
8,000
6,000
4,000
2,000
0
10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69
Age
Methamphetamines
Heroin
Long Term Effects / Effect on Educational Attainment of Drug Abusers
Drug use in schools is likely to lead to worse grades or dropping out, and a lower socioeconomic status later in life. Selling drugs can lead to expectations of easy income,
dependence on crime and a general style of living that will make student’s lives much
worse.
Drug addicts are also more inclined toward youth prostitution to raise money for drugs.
The ABAC Poll Research Center, Assumption University, surveyed youth in Bangkok
and surrounding areas in 2002, and estimated the number of youth in prostitution at
41,083 persons. Leading factors thought to lead to prostitution included abusing illicit
substances, such as cocaine, Yaa Love, Yaa E, ganja, Yaa K, Yaa Baa, and barbiturate.22
22
Econnews 13-5-2002. “Record / Consumption”
57
Employment
Drugs Reduce Efficiency
Due to the fact that some illicit drugs reduce efficiency, those who are addicted to illicit
drugs tend to be fired or unemployed. They also lose opportunities in career advancement
and must seek new jobs more often. In fact, in Thailand, drug addicts are restricted by
law from seeking some positions such as applying to be a politician or a government
official. They eventually may be unable to find a job, and therefore crime may be the
only source of income.
Using illicit drugs can also impair efficiency in the workplace. There is concern about the
potential effects of illicit drug use on behavior in the workplace and its implications in
terms of safety, productivity and costs. Although an individual may never take drugs
during working hours, the acute or chronic effects of psychoactive drugs are such that
they can impair working efficiency, resulting in absenteeism, accidents or health care
costs, all of which have effects on employers and colleagues as well as the user.
Large Share of Yaa Baa Abusers are Unemployed
Employment Status of Those Entering Treatment at Thanyarak Hospital
%
50
45
40
35
30
25
20
15
10
5
0
Unemployed
Student
1997
Permanent Job
1998
1999
2000
Temporary Job
Other
2001
Source: Drug Dependence Information System Treatment Population, Department of Medical Services,
Ministry of Public Health and the Institute of Health Research, Chulalongkorn University, FY 1997-2001.
Data from Thanyarak hospital indicate that the share of unemployed in treatment
populations has been increasing, rising from 27% to 35 % from 1997 to 2001. The
58
"Unemployed" in this case may refer only to legal employment, so that some of the
unemployed are actually employed selling drugs. The share of those admitted who have
only a temporary job has also been rising.
Although these figures show that there are many unemployed addicts, at the lower end of
the labor market there does NOT seem to be a bias against hiring workers who use or
have used Yaa Baa, at least in small amounts. Yaa Baa is thought of as increasing
productivity. In fact there are even stories of employers putting Yaa Baa into the water
their workers drink to get more effort out of them, or encouraging employees to use Yaa
Baa.
If a Yaa Baa addict begins to take very high doses of drugs, such as ten plus pills a day,
they are much more likely to be unemployed. For one thing, they tend to become more
asocial and the risk of frightening psychotic behavior increases. For another thing, to be
able to take that much drug they are almost certainly selling drugs as well, so they don't
have any need for legal income.
Heroin use is more incapacitating, and it is more likely to find people out of work, as they
may steal, or be irresponsible during times when they need drugs.
Quality of Work Suffers
Depressant drugs such as heroin, at low doses, may leads to mood changes, lower activity
and impair psychomotor skills related to driving and related tasks. Heroin impairs the
function of all of the highly integrated response mechanisms in the nervous system which
control coordinated acts such as skilled work and the operation of motor vehicles. Heroin
by impairing higher brain functions and distorting or rendering inactive sensory input, or
by rendering the user inattentive to these controlling signals, may make those who are
addicted completely incapable of performing complex voluntary actions.
Currently, many users of Yaa Baa have a positive attitude towards the drug, as they do
not believe it is addictive and find it enhances both work performance and enjoyment.
One study on diffusion of Yaa Baa among hill tribe communities in Mae Hong Sorn
province found that since ethnic minorities had very little knowledge about Yaa Baa –
they knew only the beneficial aspects which give them more endurance, but did not know
of negative effects – contributed to both addicts and non-addicts having positive attitudes
toward Yaa Baa. In in-depth interviewing they pointed out that “Using Yaa Baa is good,
we can work more and get more money. In driving, if we did not use Yaa Baa, more
accidents would occur.”23
Another report24, with similar result as above, found that, among truck drivers, 89%
believed if they do not use Yaa Baa, it will lead to more accidents because of drowsiness.
70% of them knew the negative effects of Yaa Baa, however 91% said they could quit
Yaa Baa only if they quit driving.
23
24
Sila, S.; et al. 1991
Manunpichu, K. 1991
59
Some other drugs, such as ganja, may disrupt cognitive processes, increase response time
and decrease psychomotor accuracy. This may impact a person's ability to operate a
motor vehicle.
The UNODC25 concluded in a report that illicit drugs have an adverse effect on such
employment indicators as absenteeism, turnover, medical claims, safety risk and lost
productivity. Drugs can alter psychomotor function, thereby affecting man's capacity to
respond appropriately to his environment.
25
UNDCP. 1995
60
Women
Although in Thailand, most drug abusers are boys and men, some women do use drugs
and face special problems. In addition, women face problems from a drug abusing
partner. Women are often the mothers, wives or daughters of drug-abusing men and help
to shield them from the consequences of their abuse. In trying to cope they may
themselves be drawn into drug abuse. Sometimes a woman living with a drug addict
spouse will be the sole supporter of a family. The drug abuse problems of male partners
may affect women in the form of difficulties in interpersonal relationships, instability,
child abuse, economic insecurity, deprivation of schooling and risk of sexually
transmitted disease, HIV infection, and violence.
Women who use drugs are easily drawn into prostitution to finance their drug habit.
Women face more social approbation from using drugs. Drug abusing women risk losing
rights over their children, have to face issues of fetal health during pregnancy. Women,
in practice, have much less access to treatment than do men.
Although women face special problems associated with drug use, it is also likely that they
play a disproportionate large role in distributing drugs.
Violence Against Women
The nightmarish image of Yaa Baa in the Thai popular press has a man holding a
women/child hostage after taking too much of Yaa Baa. The behavior is crazed and
without reason, and the demands of the kidnapper do not make any sense. Although this
sort of psychotic behavior may occasionally occur, more often drugs are only one factor
in an already unhealthy family situation, which may include alcohol, infidelity, unbridled
jealousy, work troubles and money troubles. Nevertheless, illicit drugs often play a role
in family violence even if they are not the root cause. For instance,
A drug-addicted man in Muang district of Chiang Mai was known to quarrel often with
his wife. One night he returned home very drunk. His suspicions that his wife would run
off with another lover led to another quarrel in which he shot her dead and also injured
their son. Investigating police said the drug-addicted man's frustration with his situation
and all his problems led to the tragic incident.26
Women and children can also be subject to abuse by drug addicted husbands and fathers.
Mistreatment of women and children is still a significant problem in Thailand. Police
statistics for the northern part of Thailand show that the number of domestic family
violence cases has increased since 1999. There were 278 reported violations of children's
rights. These included cases of child abandonment, physical abuse, and a majority for
sexual assault. Of these, there were 157 cases where the child recognized the assailant,
either as a friend of the family, stepfather, or a family member. Approximately 20 percent
26
Bangkok Post. 26-5-2002. “Breaking the Code of Silence”
61
of the victims identified their own father as the assailant. These are only reported cases
while actual cases may be more widespread.
According to a Mahidol University study, as many as 44% of Thai women have been
assaulted in some manner by their husbands or lovers. Some 28% of women have been
hurt physically, 29% have been subjected to forced sex, and 22% have been subjected to
various forms of humiliation, which may or may not be considered as actual abuse.27
Women Who Use Drugs
Overall, the 2001 household study shows that women make up 7.3 percent of all drug
abusers in Thailand. Women use drugs in different ways and different situations than
men. They tend to learn of drugs through their husbands or boyfriends rather than other
women, and are more likely to abuse drugs alone rather than in groups. Klee (1997)
found that many women who use methamphetamine in England, used it at home while
alone doing housework. Although statistics show that men are the majority users for
every type of drug, Thai women clearly use some drugs more often than others. The two
drugs most commonly being reported as being used by women are Yaa E (Ecstasy) which
is used in party settings and tends to make a person feel more empathetic to those around,
and opium which is used heavily by women in some ethnic minority communities.
Although the household survey endeavors to be as complete as possible, the social
approbation against women using drugs may have induced more women than men to
deny involvement with drugs. The table below summarizes results from the household
study showing women as a percentage of drug abusers for each drug.
What drugs do women use?
What drugs do women use most?
Yaa E
Kratom
Inhalants
Marijuana
Opium
Heroin
Yaa Baa
0%
10%
20%
30%
Percentage of Users who are Women
40%
50%
Source: ONCB
Source: This table comes from information in a report by the ONCB on women and drugs. Data is based
on the first National Household Study (ONCB 2001), use of drugs within the last 30 days.
27
Ibid.
62
Access to Treatment
Women have less access to treatment than do men. First of all, women are less willing to
seek help through treatment themselves. Because of greater social stigma for women
drug abusers, women are unwilling to come forward and admit that they have a problem.
Women often cannot attend inpatient rehabilitation programs because they have
immediate family obligations such as taking care of children, infants, and other
household chores.
Treatment programs are usually designed with men in mind, and the style may not appeal
to women. Interaction styles may be more aggressive in a program designed for males.
For example, therapeutic communities traditionally include a certain amount of mental
bullying and shaming to help break down entrenched behavior or to punish those who
break community rules.
Socially, women and men are more separated in Thailand than in many western cultures.
Women mostly share their troubles with other women and men with other men. That
makes mixed rehabilitation programs awkward and ineffective. Women should mostly
be treated in single sex programs.
Women as Share of Those in Treatment
Inhalants
Marijuana
Opium
Heroin
Yaa Baa
Alcohol
Cigarettes
0%
2%
4%
6%
8%
10%
12%
Source: Drug Dependence Information System, Department of Public Health
One indicator of the extent to which women are excluded in treatment programs are
statistics showing the share of women in treatment populations for each type of drug. By
comparing the table above based on treatment statistics with the earlier one showing
usage patterns from the household study we can see a similar pattern emerging. If
women make up a big share of abusers of a certain drug, they also make up a big share of
patients in treatment for that drug. The relative patterns between drugs are there, but
women make up a much smaller share of those in treatment than their share in usage. For
63
example, the household survey showed that women made up 39 percent of users of
opium, while they are only 12 percent of those in treatment for opium. If women had
equal access to treatment, we would expect that the percentage would be the same, at
39%.
Prostitution
Prostitution and drug abuse often go hand in hand. Prostitutes often work in environments
where drugs are sold, and benefit from using Yaa Baa since they work late at night and
are supposed to be animated for their customers. Prostitution is also an easy way for a
women to make money to buy drugs. The money may be used to support either their own
or their partner’s drug habit. This puts both partners at risk from sexually transmitted
diseases. Despite all of this, drug use by prostitutes is thought to have declined
significantly, mostly due to careful enforcement by the police.
One taxi driver told us how he had been offered sex one night by a woman drug
addict over on Silom road who was desperate for drugs. At first she wanted 200
baht, but eventually she went down to 60 baht, the price needed for one Yaa Baa
tablet. He says he did not go with her.
Independent research conducted in 1994 found that almost 20 percent of women working
in brothels started between the ages of 13 and 15.28 Child prostitution has become much
less prevalent since due to strict law enforcement, but it probably still exists in some
places. Much child prostitution has migrated to neighboring countries.
Pregnancy
A pregnant woman who consumes drugs may unwittingly cause harm to her unborn
child. She may use fewer drugs on becoming aware of her condition, but in many cases it
will be hard for her to stop completely. A study by the US National Institute of Drug
Abuse (NIDA 1992) found that 35% of women continued to use drugs to some extent
throughout their pregnancies29. If she cannot or will not give up drugs, it is likely that the
consequences of drug abuse will result in problems during and after the birth. Drug
abuse leads to unhealthy babies, which generally means low birth weight and weak
infants. (Using alcohol or cigarettes during pregnancy has the same effect.) This
situation could be exacerbated by sleeping and eating difficulties in the newborn which
have been associated with maternal drug use, and it could also inhibit the intimate
bonding process which contributes to a stable future for a child. Moreover, the gradual
disappearance in Thailand of the extended family involving several generations living
under one roof may make the children of drug abusing parents even more vulnerable to
traumatic disruption.
28
29
Bangkok Post. 19-11-2000. “Fresh hope for child laborers”
NIDA 1992 National Pregnancy and Health Survey
64
Women Selling Drugs
Although women are often victims of drug abusing males, they also play an
unexpectedly large and perhaps unrecognized role in selling and distributing drugs.
Although women make up a small share of drug abusers (7.3%) and a still smaller share
of those in drug treatment (6.6%), they make up a surprisingly large share of those in
prison for drug use (26.5%). Most of these women are incarcerated for selling drugs.
Women as a Percentage of Drug Populations
30
25
20
15
10
5
0
Drug
Drug
Drug
Prisoners Treatment
Abusers
Sources: Medical Services, ONCB, Corrections
Women may sell drugs on the street, or they may sell drugs out of their own homes.
Women are less likely to be suspected of selling drugs than men since most drug abusers
are male. They are also perceived to be more trustworthy than men. Some women may
find it a convenient way to raise money while also caring for children.
65
Drugs And HIV/AIDS
Brief History
The first case of acquired immune-deficiency syndrome (AIDS) in Thailand was
identified in September 1984; and the first epidemic outbreak of the human immunedeficiency virus (HIV) infection was found among intravenous injecting heroin addicts in
treatment in 1988.30 This initial epidemic ended in the infection of virtually all the
injecting population who shared needles. The problem then moved to sex workers, and
assumed enormous proportions, before widespread use of condoms, and a general
awareness of the problem brought the epidemic under control.
The HIV Situation in Thailand, Baseline Scenario
Cumulative Total HIV/AIDS
Cases in Thailand
Still Living with
HIV/AIDS
New HIV/AIDS
Cases in Thailand
Source: Projections for HIV/AIDS in Thailand:2000-2020, March 2001, Division of AIDS, Ministry
of Public Health
Thailand has generally been seen as a success story in the control of HIV/AIDS despite
the fact that the HIV population is still very high, at around 700,000 persons living with
HIV and about 300,000 having died from AIDS to date. That represents a current
infection rate of 1.2 percent of a current population of 63 million persons, with males
having an infection rate roughly double that of females.
Thailand is seen as a successful model since it was able to halt a very serious epidemic by
government and NGOs promotion of condom use. Strong promotion of condom use in
30
Vanichseni, S.; et al. 1989; Poshyachinda, V. 1990
66
the early 1990s rapidly reduced new infections spread through the sex worker industry.
However the legacy of that sex worker epidemic continued through the 1990s and is still
very much in evidence today. The sadness and tragedy of deaths from those infected
with the virus ten to fifteen years ago is taking a big toll now, with loss of family
members and often parents affecting many people, especially children. In addition the
end of the crisis in the sex worker population did not stop the virus from spreading. The
virus has continued to thrive and spread through avenues that are harder to protect
against, mostly inside the home. Men who had visited sex workers during the epidemic
came home and infected their wives. Women who had worked in the sex industry
returned to their villages, married, and passed the disease to their husbands. Those same
women became pregnant, and many of them passed the disease to their children.
Since HIV/AIDS is most likely to affect both parents because of sexual transmission, the
virus has left many orphans, some infected themselves, others not. Although many of the
orphans have been adopted into their broader family group, others have been left to a
poorly funded social welfare network, or even left to fend for themselves.
As the prevalence of sexually transmitted HIV has diminished in recent years, attention is
again turning to injecting drug users as a source of new HIV cases. Of the roughly
30,000 new cases expected this year, nearly 10,000 of them may be due to the sharing of
needles.
Access to Needles
In many countries, lack of access to needles for injection is a major cause of HIV
infection, as the shortage leads to sharing of needles and the spreading of blood borne
diseases. Needle exchange programs operate to supply users with clean needles, often
without the official permission of the government. They are also used to identify drug
addicts so they can be offered treatment.
In Thailand, it is easy to obtain needles for injecting drugs. Needles are available in any
drugstore without a prescription, and are cheap at 5 or 6 baht (12 US cents) a piece
compared to the cost of drugs at 120 baht a hit (3 US dollars) for heroin. Nevertheless
even more needs to be done. In small communities a lack of anonymity is an important
factor in drug addicts' reluctance to visit pharmacies. Pharmacies also are not open late
when drugs are likely to be consumed. If needles were available through minimarts such
as 7-11 it would enhance distribution significantly, by allowing needles to be available at
more of the times and places where drugs are consumed.
None of the Thai heroin addicts we talked to admitted to sharing needles. Some of them
used a single needle each day, others changed needles every time they injected drugs.
They were certainly aware of the dangers posed by AIDS and other blood borne disease.
67
Why Would an Addict Share a Needle, Even if Needles are Easily
Available?
An addict in Argentina gave the following reasons for why addicts share needles even
when needles are easily available.
Drugs Come First - It's easier and quicker to share than to go out to buy needles.
Don't want to lose time when the drug is available.
Fear of Pharmacist - Addicts fear refusal or the attitude of pharmacists who might
look down on them, inform the police, or simply know they are addicts. This is
especially a problem in a small town, where there may only be a single pharmacist.
Pleasure of Sharing - It makes the experience closer to use the same needle. For
instance, for couples or friends who use drugs together.
Don't want to Anger Peers / Trust - Other drug users may look down on them if
they refuse to share a needle. Friends say they don't have any diseases, and the addicts
believes it.
Situation doesn't Allow - For instance, a user might be out eating with friends who
are not addicts and not be able to leave the restaurant to go look for needles.
Source: Internet Discussion Group
HIV/AIDS in Prison
Any place where there are needle shortages may be a problem because heroin addicts
need the drug so desperately. Although a heroin addict may act rationally about needle
sharing for years, a time may come when a clean needle is not available, and he or she
may HAVE to share a needle with others. Ironically, in Thailand, this situation is most
likely to occur in prison. With enough money heroin can be obtained in prisons and
holding cells, despite all efforts to suppress it. When an addict first enters prison he or
she begins to go into withdrawal. At this point the addict may go to any lengths to obtain
heroin. Although heroin may be available, clean needles may not be available, since they
are much harder to smuggle in.
One woman heroin addict we interviewed described this exact situation about while she
had been in prison. A group of heroin users in prison had gotten hold of a little heroin
and were passing it around with a shared needle. She managed to avoid using it out of
her fear of HIV, but many others did use it because they could not resist.
A recent study by Buavirat et al.31 points to this problem, and shows that HIV infection
rates of drug addicts who have been recently incarcerated are much increased. The HIV
infection rate was 35% per 100 observation years among IV injectors who recently had
been incarcerated and who had injected drugs while in prison, while it was only 11% per
31
Buavirat, et. al. 2003
68
100 observation years for IV injectors who had recently been incarcerated, but did not
inject drugs in prison.
Heroin is very popular in prison since it numbs both the body and the mind, and prison is
a place where both the body and the mind are under great stress. We were told that some
people who had never tried heroin, tried it in prison and became addicted. Yaa Baa is not
as helpful in prison as it gives energy and alertness, but there is very little to do there.
HIV Transmission through Drugs in Thailand
Since users inject drugs directly into their bloodstream, anyone who shares the needle
also shares the blood. As a result, sharing or using contaminated needle is the most
efficient way to pass HIV into bloodstream.32 Moreover, there is a serious risk of
transmission of the HIV and other blood-borne viruses to partners and children of
injecting drug users. In early 1994, it was estimated that of all drug users, around 100,000
to 250,000 were injecting heroin33. Current figures are probably much lower as Yaa Baa
has supplanted heroin as the drug of choice.
Those who share mixing bowls or spoons for heroin may also be in danger. Some blood
can get into the needle of one user, and then end up in the mixing spoon. The spoon can
then be used again by another addict, who can become infected.
Several licit and illicit drugs can be administered by injecting, not just heroin, Yaa Baa
and sedatives are sometimes injected. For Yaa Baa, users inject the drug by putting the
pill onto a spoon, crushing it and heating it until it is dissolved, then mixing it with water,
putting it into a needle and injecting. These Yaa Baa users believed that injecting makes
the drug more potent and last longer than other methods, so it is usually found among
chronic addicts.
Injecting Yaa Baa is much more dangerous than smoking it, especially with ground up
pills which can cause trouble in the bloodstream, and because of risks from blood borne
diseases, especially AIDS and hepatitis. In addition, it probably is NOT more potent
taken in this form. There is no evidence that the drug is more potent injected (unlike
heroin), injecting actually delivers the drug to the brain slower than smoking, and finally,
since the drug is so cheap, even if it were more potent, why would you want to risk your
health for a couple of baht anyway?
As shown in the table below, the most preferred method of administering heroin
according to treatment data is injecting, accounting for around 60% of all heroin users.
The prevalence of injecting heroin has decreased during the last five years from 68.6% of
all heroin users in 1997 to 60% in 2001. The figure is less than 1% for Yaa Baa abusers
and 0% for ganja abusers. Heroin users typically start by smoking heroin mixed with
tobacco, and mainly switch to injecting for economic reasons. Heroin is expensive, and
32
33
Riley, D. and Smits T. 2001
UNAIDS and UNODCCP. 2000
69
is much more effective when injected. If smoked it may require twice as much to have
the same effect. They simply cannot afford to maintain their habit while smoking.
As very few Yaa Baa users are currently injecting their drug, the risk of acquiring HIV or
other blood-borne virus is dramatically reduced. Yaa Baa injectors are also less likely to
get HIV from shared needles, because the drug is not as physically addictive. If there is
not a clean needle available, the Yaa Baa addict will likely be able to forbear using the
drug for a little while. For a heroin user this is much more difficult.
New Cases of Drug Users who Administer by Injecting
Type of Drugs
1997
1998
1999
2000
Heroin
68.6
64.5
59.5
61.6
Yaa Baa
0.7
0.4
0.3
0.3
Ganja
0.4
0.0
0.0
0.0
Unit: percent
2001
60.0
0.3
0.0
Source: Statistical Report, Drug Dependence Information System Treatment Population,
Department of Medical Services, Ministry of Public Health and the Institute of Health Research,
Chulalongkorn University, FY 1997-2001.
Many studies have shown that the incidence of HIV infection among Thai injecting drug
users is very high. UNAIDS and UNODC estimate approximately 30-40% of drug
injecting users in Thailand are HIV positive.34 Chucherd (2001) gives an estimate of
50% for the same group.35 Peak (2001) finds that 1995 HIV prevalence nationally among
injecting drug users was 32%, increasing to 51% in 1999. In 2000, the national sentinel
surveillance found the HIV positive rate to be 54%. Peak also estimated that 5-10% of
drug users becomes HIV infected each year.36
Researchers from Johns Hopkins University conducted a longitudinal study of AIDS in
Thailand. They studied army conscripts during the 1990s and found that cases of sexually
transmitted HIV fell from 11% of conscripts in the period 1991-93 to 2% in 1998.
Furthermore, drug users had eight times more HIV infections in 1997, and 13 times more
in 1998. One quarter of all HIV/AIDS victims were users of injection drugs, generally
meaning heroin.37
HIV can lead to drug use, just as drug use can lead to HIV.
“A server in a boiled rice shop whose husband died because of HIV
infection had gone with her 5-year-old son for a blood test and was found to
be HIV positive. When this news was spread around, she was fired. Then
she made decision to be a Yaa Baa dealer, and sold to the students and
youngsters in her village, in order to support her life and to afford V.1
34
Ibid.
Chucherd, K. 2001
36
Peak, A. 2001. Drug use and HIV/AIDS in Thailand in the year 2000
37
Bangkok Post. 26-2-2002 “New Front Opens in The AIDS Fight”
35
70
medicine which is used to treat HIV. Eventually, she was arrested by the
police on allegations of Yaa Baa possession for distribution.38
Sexual Behavior and Drugs
Drugs can increase the risk of acquiring AIDS though sex by either increasing the
likelihood of sex, or by increasing the risk of unsafe sex. Although some people use
drugs as an aphrodisiac, more often it is the lack of control and the lifestyles of drug
abusers which lead to a greater risk of AIDS.
The Yaa Baa epidemic has had a negative effect on HIV transmission among drug users,
in that it facilitates increased sexual risk taking and thus increases the risk of HIV
infection. Yaa Baa is a social drug, used at parties that include drinking alcohol and then
moving on to recreational activities, including having sexual intercourse without
condoms. It increases sexual risk taking which eventually induces to the HIV infection.
Poshyachinda studied the reported effects on sexual behavior of taking Yaa Baa and
heroin. An increase in the desire for sex and actual intercourse were reported after taking
the drug by 54% and 35% of Yaa Baa addicts. Figures for heroin addicts were 5% and
11% respectively.39 A survey conducted in Chiengrai province pointed out that the
majority of HIV infected groups are 15-40 years old students. Those students, who like to
go out at night and take many kinds of drugs mixed with beverages, are likely to have
sexual affair without condoms afterwards.40 Yaa Baa has also been associated with
rougher sex, which would increase the chance of HIV transmission.
Kom Chad Luk. 3-10-2002 “HIV Infected Lady Turns to Yaa Baa Trafficking”
Poshyachinda, V.; et al. 1999 (citing previous study by same author)
40
Naernar. 5-9-2001. “AIDS Epidemic in Chiengrai Is Still Virulent, Students Go to Entertainment Place
before Having Sex”
38
39
71
The Family
If someone in the family is using drugs it can put great strain on family relations. At its
worst, the strain can pull the family apart at the seams, or the drug addict may simply be
thrown out from the house. At its best, the power the family holds over an addict is
much stronger and persistent than the power of the state. In many cases it is the only
force strong enough to get an addict to give up drugs and to keep him off drugs. Not all
families are healthy, and it may also be that the family will drive someone to use drugs
through physical abuse, emotional abuse or simply neglect.
Family Cohesion
“A minor drug dealer worked as a motorcycle taxi driver and used Yaa Baa
to stay alert since he had to work at night. He then turned into a Yaa Baa
dealer because almost all motorcycle taxi drivers use Yaa Baa and his wife
was unemployed. Thereafter he decided to jump into the Yaa Baa trafficking
network. However, when his wife found out and asked him to quit his illegal
behavior, they fought about it and eventually divorced each other.”41
Normally drug abusers and dealers face rejection by their family. Often they do not let
their family know that they abuse or sell drugs because the disclosure will lead to
arguments and rejection42. Although in some cases family members recognize drug
trafficking as a necessary way to increase family income, it is seldom seen as a desirable
career move. Often the family will suspect drug use, but will learn definitely of drug use
only when the abuser is arrested.
If it is suspected that a child abuses drugs, the parents are likely to try to intervene to
persuade the child to stop. Whether this intervention is successful will depend largely on
the previous relationship between the child and the parent. Family pressure to quit drugs
can be effective. On the other hand, sometimes pressure can simply drive the child away.
A child, new to independence, and also caught up in drug culture is much more at risk of
endangering his own life than an adult would be, and home is probably the safest option.
Unfortunately it seems that some birds must learn to fly on their own, despite the best
endeavors of the parents.
Parents must be cautious about enabling drug use. It is commonly felt that anything that
is done to shelter a drug addict from the negative effects of his addiction will enable him
to continue using drugs. It is the negative consequences of drugs which will eventually
drive an addict to quit on his own. On the other hand, the natural reaction of the parent is
to cushion the child from any sort of harm. If the parent does decide to cushion the child
by paying off debts, bailing the child out of jail, intervening at school, etc, these efforts
should be limited in scale and duration to allow the child to learn43.
41
Chitsawang. 2001
Ibid.
43
Jay and Jay 2000
42
72
Adult relationships may also suffer from drug abuse by one or both partners Besides
physical and emotional strife in the home this may create many problems for the family
including increased health costs, employment problems, emotional trauma, and the loss
of common financial resources. One partner may be pushed into providing for the whole
family if the drug abuser abandons his/her responsibilities. The family may end up being
less well fed, clothed and housed.
Families break-ups for problems unrelated to drug use may put extra stress on children. In
fact, a dysfunctional family life, rather than poverty, is the most significant factor in
predisposing an individual to take drugs in Thailand. Dhurakitpundit University
Research Center conducted a survey of those who lived in Bangkok in 2002. Survey
results show that 60% of respondents believed that if families stayed together, the
children would not be addicted to drugs.44
The director of Thanyarak Institute Dr. Boonrueng Triruengwarrawat pointed out that of
those in drug rehabilitation, only 37% came from poor families, while the remaining 63%
came from middle class or rich families. He believed that economic status is not the
cause of drug addiction, but rather a lack of love and nourishment in the family.45
Drug Use Can Spread Through the Family
Drug use and drug trade can spread easily through families. Brothers and sisters can
learn to use drugs from each other, children can watch their parents and learn about
drugs. Cousins and the extended family can also be a source of knowledge about drugs.
The drug trade is also quite likely to move through families. If the finances of the family
are tied to drug sales by one of its members, it is likely others will start to help out.
Young children will be employed as couriers, other family members will pass on
information, and store or transport drugs. It is very likely if the drug seller is thrown in
prison that another family member will take over the business to support the family.
Family services called one home to talk to the parents of a 9 year old girl who was
not doing well at school. When asked to speak to the mother, the girl said she was
not home. Likewise her father and older brothers were not home. After asking
when they would return, it eventually came out that all adult members of her family
were in prison for drug sales and she was living alone.
One of the cardinal rules for putting together a team to sell drugs is to include only people
who can be fully trusted, especially people you have known for many years, and have
little incentive to betray you46. Because of this, family members are ideal partners, as
exhibited in the drug cartels in Colombia, and of course the Mafia.
I.N.N. 7-10-2002. “Bangkok Residents do not believe that All of Seized Drugs were Destroyed”
Thairath. 28-9-2002. Page 1
46
Gross (1992) Drug Smuggling: The Forbidden Book
44
45
73
Family and Rehabilitation
Since the 1st National Economic and Social Development Plan was launched in 1961,
social and economic conditions in Thailand have changed dramatically. Particularly
since the 6th plan (1987-1991), Thailand has succeeded in substantially increasing its
economic growth. While the changes have been mostly beneficial in terms of material
wealth, they have also changed and weakened the way society addresses problems. As
the importance of extended family, community and religion weakens, a vacuum is left
which must eventually be filled by more political or institutional ways to solve problems.
The following are some of the major changes that have taken place in Thai society in the
last 30 years.
Change in Mode of Production: from an agricultural system to industry and services;
Change in Social Structure: from rural society to urban society;
Change in Family Structure: from an extended family with many generations who live
together to single families that are smaller in size – with less attention to young people
and a concordant increase risk of drug use.
The family can be important in getting someone who uses drugs to seek treatment. In
fact, after self motivation, it is the most commonly given reason for seeking treatment.
Share who said Family Coercion was the primary
reason for entering treatment
25%
20%
15%
10%
5%
0%
Yaa Baa
Heroin
Opium
Marijauna
Inhalants
Alcohol
Cigarettes
Source: Ministry of Public Health (Data refer to all Thai Treatment Centers)
Family coercion is most likely to be effective when the addict is young. That is borne out
in these statistics which show higher rates of family influence for drugs associated with
young people, such as inhalants, Yaa Baa, and marijuana.
As families become smaller the number of adults who can counsel, encourage and
support young people decreases. The ties and responsibilities between generations
diminish. In a modern family, with both parents working outside the home, even the
power of the immediate family is diminished. In addition, when the parents have
abdicated their traditional supervisory roles, peers have a greater degree of influence.
Parents who exercise traditional family roles may not be able to limit the influence of
74
peer groups on children’s attitudes towards drug use and therefore have a crucial
influence on children’s behavior.
Community Responsibility for Drug Rehabilitation
As the family becomes smaller and less effective, it increasingly falls on the wider
community to help with drug problems. Ways in which the community can help take
responsibility include trying to get help for those known to be addicted to drugs, to be
INTOLERANT of drugs in the community, and support those who are trying to recover
from drugs. In fact, a number of community based initiatives have been successfully
undertaken in Thailand, but more needs to be done as community support compensates
for smaller extended families.
Effects on Family Life
The impacts of drug abuse tend to fall first on the family of the drug addict. The family is
likely to experience times of emotional or physical distress. They will likely be turned to
for financial assistance and for child support. The extended family may have to take
responsibility for financial problems of the addict, bankruptcy, children quitting school,
prostitution, and so on.
According to Chupikulchai (1980) after becoming addicted to drugs, 79% of drug abusers
did not have enough revenue to support themselves, 64% were in debt, and 69% had to
pawn some possessions.47 This led to assault to obtain money to buy drugs, and stealing
property to trade or exchange for drugs. Families must also bear the cost of supporting
the drug addict in terms of room and board, since they may not provide for themselves.
In addition, the drug addict’s family might have to face the effects of crime in the life of
the addict, which might include robbery, assault, suicide, accidents and fraud. The
family or individual members can also be affected by attempts to apprehend the drug
addict, and may be held responsible themselves if drugs are found in the house.
In poor families money spent on drugs may exceed that on food and therefore, though it
cannot be said that poverty causes drug abuse, there can be no doubt that the
consequences of drug abuse can be infinitely more wretched for families in precarious or
poverty-stricken circumstances. A study by the Thailand Development Research Institute
points out that most drug addicts are family heads or breadwinners. The research was
based on data from clients in treatment centers, truck drivers, detained offenders in police
stations, and wage laborers. Their income was spent to buy drugs instead of raising the
quality of life of their families.48
47
48
Chupikulchai, S.; et al. 1980. This older study refers primarily to heroin addicts.
TDRI 1995
75
Drugs and Corruption
Not all Police are Corrupt…
We want to preface this section by saying that there are many good government officers
and many good police officers who are honest, and who risk their lives every day to
protect us all from drugs and drug related problems. Police are paid little money and they
have a difficult job. Low pay and little recognition can make a police person turn to
corruption, but many do not do so. These honest police deserve our thanks.
Individual police do not act in a vacuum, and often the environment may force them to
corruption. A person at a police academy told us of two young idealistic police cadets who just after graduation from police academy, were assigned together to a certain police
station. In corrupt police stations bribes are accepted by those at the lowest levels, and
then some of the money is passed on to their superiors, who in send money up to the next
level. This may be in the form a fixed amount each month.
Supported by each other, these two idealistic officers refused to take bribes and came
under intense pressure by everyone at the police station. Social outcasts, their careers
blocked, and frustrated in their own beliefs they together took their own lives.
This story points out how important the higher levels are in setting the tone towards
corruption. Police chiefs should be moved around every two years, the same way judges
and forestry officers are moved to minimize corruption.
But Some Are
Because drug trafficking involves large sums of money, and must be done surreptitiously,
it is inevitable that it attracts corruption. Corruption involves all levels of the supply
chain and is probably most rampant at the lowest levels. Many if not most drug retailers
report paying off some policeman. Police regularly shake down addicts for money, and
bribes are accepted when drugs are found on a person, either to let them go free or to
reduce the number of pills found. Sometimes police have pills with them and demand a
bribe or they will claim the pills come from the victim.
At higher levels, corruption may involve information about government operations,
protection from prosecution, and regular payoffs to permit illegal operations, often
including valuables such as cars or houses.
Comments by Drug Abusers
If I am found with heroin or needles they charge me 700 baht, if I don't have
either they still charge me 100 baht if I have needle scars.
(A different interview) Once I had to pay 700 baht, even though I didn't have
any heroin with me that day.
76
A policeman knew the son of a wealthy man was a drug addict. The police
regularly came to the house of the parents demanding money so as not to
arrest the son. The police took enough money that the man was not wealthy
anymore.
(Drug addict) I had to pay 500 each day I went to school so the policeman
would leave me alone.
Comments by Drug Retailers
While selling drugs I had to pay 5,000 baht a week to the police in charge of
my Soi.
A big retailer had to pay 5,000 of the 12,000 baht he made each day to a
police officer.
Several addicts said they bought drugs in the Khlong Toey area, not just
because they are cheap, but also because it is perceived to be a safe place to
buy. "In Khlong Toey, you know all the police are paid off", one addict said.
Corruption behind Bars
“Sithichai Sukhathip had a very special mobile phone number for those who
knew it. One call settled prices, delivery schedules, terms of payment and the
amount of heroin or Yaa Baa the caller wanted. At the age of 32, Sithichai
was a rich man. Even while he was serving a life imprisonment term in his
detention cell his mobile phone kept him busy dealing drugs. No one knows
how long Sithichai ran his drug trading operation from his prison cell before
authorities found out about it in November 2002. Before his arrest and
imprisonment, Sithichai turned up frequently on police records as a major
drug distributor for Wei Hsueh Kang, a long-wanted narcotics kingpin of the
United Wa State Army. Before that, Sithichai worked for Khun Sa, the drug
warlord who surrendered to the Burmese authorities in 1996.”49
Following the discovery of Sithichai's drug dealing business within the penal institution,
drug suppression agents dismissed and charged several prison officials, including the
prison commander, Somsak Saraphol. A narcotics suppression agent said “These corrupt
officials provided Sithichai with everything he wanted and turned a blind eye to what he
was doing in the cell.”50 Sithichai's men working outside the prison gave the corrupt
officials money in return for their ignorance. The prison commander received a new
Mercedes sedan. The Anti-Money Laundering Office (AMLO) then seized 20 million
baht worth of Sithichai's assets, including the former prison commander's new car.
49
50
Bangkok Post. 9-2-2003. “Return of a Dangerous Powder”
Ibid.
77
A prisoner who escaped from Loei provincial prison some years ago confessed after
being re-arrested that he had paid 1.5 million baht to four prison officials who arranged
his escape.51 Without help from prison officials, how could he pass through four locked
doors that were manned by guards 24 hours? Corruption and bribery are part and parcel
of life behind prison walls. Well-to-do prisoners can live a comfortable life behind bars if
they have the money to bribe prison officials.
Corruption by Police
Corruption by police has been recognized as a problem by the public for a long time. A
survey conducted in 199952 found that 67% of those questioned felt that the police’s
position on the drug problem does not help solve the drug problem and even makes it
worse. Police officers sometimes arrest and release the accused, or they inform the sellers
in advance when police from the central unit will arrive.
Police use strong enforcement only to buyers and small sellers, but relax enforcement for
big dealers. The big dealers realize that they have a partnership with the enforcement
officers so that they react fearlessly in spite of strong legal penalties.
If drug offenders are captured they can often reduce their sentence. The police have to
use some drugs as bait for the arrest of drug dealers. By making a deal with drug
offenders to report only a small amount of the drug seized to lessen the penalty for drug
use, the enforcement officers can have some drugs to be used as bait. Both can benefit
through this arrangement. The alleviation of the charge from seller to drug user is very
common. Usually a money payment is made as well.
An interview with the public prosecutor revealed a similar pattern. He said that when
police seize offenders, they may offer to reduce the number of pills they find on the
offender for a price. He had clients who claimed to have paid 50,000-100,000 baht to
have the number of pills lessened. Another possibility he said, is that the police will find
only 10 pills on an offender who they know to be a dealer, then demand the dealer pay
them not to discover an additional (planted) 5 pills on him – in recognition of Yaa Baa
narcotic laws which classify anyone who possess 15 pills or more as possessing pills with
the intent to sell. The prosecutor had done his own analysis and found that virtually all
cases were either 15 pills of less or more than 100. All the middle ground just didn’t
exist, suggesting they were all buying reductions.
In another publicly reported case, eight Phra Khanong police were charged with
demanding a bribe from a man who was caught with 2,000 Yaa Baa pills. They detained
Mr. Chan Pungkong, the drug suspect, at a safe house and then demanded 100,000 baht
money from him in exchange for his freedom. Then his wife, Mrs. Aree, offered the
police gold necklaces and rings worth around 60,000 baht instead.53
Bangkok Post. 2-12-2000. “Dateline Bangkok”
Chitradub, S. 1999
53
Bangkok Post. 8-3-2001 “Police Nabbed in Bribe Case”
51
52
78
In 2003, a police officer working for the Narcotic Drug Suppression Bureau was arrested
for alleged drug trafficking in a campaign to “clean house” before the national "war on
drugs." While allegedly delivering Yaa Baa pills to his nephew in Lopburi province, 115
kilometers (71 miles) north of Bangkok, Pol. Maj. Thawee Samrerng was arrested, and
confessed to having given Yaa Baa tablets to his nephew on seven occasions. Separately
on the same day, Bangkok police arrested another officer, Pol. Sgt. Maj. Nat Chitsanguan, for suspected drug trafficking after they found two ecstasy pills and other drugs in
his car.54 According to the law, police officers face a maximum penalty of death if they
are found guilty.
Corruption in Courts
Corruption by police is much easier than corruption at higher levels since it is at the point
of arrest, and no one else knows about the crime yet, while by the time it comes to court it
is much more visible. Nevertheless, there is still corruption. Informal inquires found that
about 30% of those going to trial had been asked for some sort of money along the way.
Another factor which helps to keep corruption down in the court system is that judges are
moved every two years to reduce the chance for corruption. This policy which is also
used in the forest service, has not been instituted in the police force.
54
Associated Press 26-1-2003. “Thai Police Arrested for Drug Trafficking Ahead of Crackdown”
79
Crime And Violence
Drug abuse in and of itself is a crime, so the level of crime is certain to rise with abuse of
drugs. Besides this direct role, drugs can lead to many other types of crime, such as
property crimes to raise money for drug habits, violent crimes as suppliers fight over
lucrative trading territory, or as psychotic drug users act irrationally to harm others,
corruption as drug traffickers and or police act to increase benefits to themselves from
drug trade, and a multitude of other crimes including human trafficking, fraud, robbery,
etc.
Links Between Drugs and Crime…
In most countries there is a very strong link between drugs and crimes, and prisons are
filled with joint drug addicts/criminals. In the USA, violence by different levels of the
supply chain, and property crimes to pay for drugs are very serious problems. Those
arrested for many types of crime are found to be high on drugs, or engaged in crime to
pay for drugs.
At times it has been found that criminal behavior led to drugs rather than the other way
around. The amphetamines epidemic in Japan in the 1980's started with use by those in
organized crime, and more than half of those in rehabilitation centers in the early days
were from organized crime.55
Are Weaker than Usual in Thailand
Interestingly, the drug - crime link is less central in Thailand than in many other
countries. Drugs are relatively cheap, and unemployment relatively low, so that property
crime is probably not as much of a necessity to support a drug habit as in other countries.
In an earlier study, the author found that Yaa Baa users can generally support their own
drug habits without resorting to crime. Heroin users were found to be unable to obtain
enough money legally to support their drug habits.56.
However, minor crime may be rising. If an addict in Thailand is going to steal, he or she
is most likely to start with his or her own family and relatives, as shown in a study by
Pattanakamjorn (1998) 57. These crimes are seldom reported. Other forms of minor
crime such as shoplifting, and fraud are not common, but pick pocketing, purse-snatching
and theft of unattended articles may be on the rise.
Drugs and Violence
Violence related to drugs has been concentrated around two different poles. The zone
around the border can resemble a war zone with regular casualties by both police and
55
Japan Chapter in Klee 1997
Treerat et. al. 1999, The same results have been found in England, where cheap amphetamines are
associated with lower levels of crime. Klee 1997
57
Pattanakamjorn, W. 1998
56
80
smugglers. There was also violence associated with the anti-drug suppression campaign
in February-April 2003.
Perhaps because of the speed at which the market grew, there has not been a lot of
violence along the supply chain. Violence in the supply chain can result as competitors
vie for power, or may be a result of broken agreements between higher and lower levels
of the supply chain. Both cases seem to have been rare, with news in the press generally
referring to crimes against foreign gangs on Thai soil.
An exception to this is the high level of homicides that occurred during the government
crackdown on drugs in the spring of 2003. Over 2,000 people were killed58. The police
claim that most of these people were killed by others in the supply chain who were afraid
of being betrayed to the police. This argument doesn't make a lot of sense. Most often
police are aware of those who are involved in drug trafficking (the so-called black lists),
but do not have enough evidence to prosecute these people. The crackdown allowed the
police to arrest the suspicious black-listed people without proof, so the need of a third
party, or "rat" was unnecessary.
Violence along the border takes the form of raids on stashes of drugs stored in border
villages or standoffs with smuggling groups near the borders. Both sides are well armed,
and both know the consequences of not being prepared. There is a great deal of money
involved, so the flow of smugglers is continuous, in spite of strong suppression efforts.
Many of those who are killed are ethnic minorities hired by drug lords to transport drugs
across the mountains.
Drugs and Crime
Yodmanee (1991)59 studied the correlation between drug addicts and crime. By surveying
criminal defendants who were detained in police stations throughout the country, the
author found a Cramer’s V coefficient of 0.68 relating crime to drugs. This was
interpreted as saying that the greater the number of drugs addicts, the more criminal
behavior occurred. This study was long before the Yaa Baa epidemic, but points at a
relationship between heroin and crime.
However, more recent prison statistics do not show an increase in non-drug crime levels
associated with the recent Yaa Baa epidemic. Crimes did increase about 20% after the
1997 economic crisis, but fell again just as the Yaa Baa crisis became a significant factor.
58
59
A mid-April police report put the number at 2,275 persons.
Yodmanee 1991
81
Drugs vs. Other Crimes in
Thai Prison Population
120,000
100,000
But do NOT
increase as drug
arrests increase
Other crimes
increase after the
economic crisis
80,000
60,000
Crisis
40,000
20,000
0
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Drugs Other Crimes
Includes only convicted prisoners
Source: Department of Corrections 2001
Psychosis and Violence
Thai people agree that the most severe and frightening problem stemming from drug use
in recent years is the drug induced psychosis resulting from Yaa Baa. The last five years
have seen a parade of frightening images in the popular press, and gruesome stories to
accompany them. A typical image shows a Yaa Baa maniac using a knife to hold a child
or lady as hostage. Although the press has probably exaggerated the crazy aspects of the
drug because of the name (these were not big parts of campaigns in other amphetamine
using countries), some psychotic events clearly occurred. There is little evidence the
problem is very widespread, and violent crimes in Thailand are on a declining trend.
A Yaa Baa maniac called his brother and told him that he was going to be
killed. This paranoia led him to shoot his wife and she died on the spot
(Banmueng, 2002).
A man killed his mother and grandmother by using a meat cleaver to hit them
on their necks then saw them up to separate their heads from their bodies.
Later, he confessed that he needed Yaa Baa and asked his mother for money
to pay for it, but she wouldn't give him any. Due to his fury and need for Yaa
Baa, he committed these terrible crimes (Daily News, 2002).
An adopted son who stayed addicted to Yaa Baa until he became psychotic
poured gasoline onto himself and his parents’ bodies. Then he lighted the
fire. Subsequently, he died at the hospital. (Daily News, 2002).
Dr. Jaroon Jittiwuthikarn, Psychiatrist Director of the Northern Drug Dependence
Treatment Center in Chiengmai, pointed out that Yaa Baa can cause paranoia or
82
aggressiveness leading to more aggressive behavior. With long term use, users become
psychotic and can be a danger to themselves and others. They might commit suicide or
homicide (Jittiwuthikarn, 2000). They may engage in other dangerous activities such as
climbing high on things, or feeling that they are immortal.
Dr. Apichai Mongkol, Deputy Director-General of Department of Mental Health, stated
that Yaa Baa addicts tend to be suicidal and full of tension because of their misconception
that they are going to be attacked by unknown persons. They choose to escape by
committing suicide.
Drug related psychosis is indistinguishable from schizophrenic psychosis, in which those
with violent temperaments may tend to act out their aggression more often. Stimulants,
even without psychosis tend to make people more aggressive.
83
Chapter 5. Economic Impact Of Illicit Drugs
Introduction to Economic Impact
Illegal drugs can have a number of economic effects. The costs may be to the society as a
whole, including the direct cost of suppression, costs from corruption, and inefficiencies
as capital is used unwisely through money laundering. Individuals and families can also
feel effects directly due to the incarceration of a family member, the inability for a drug
addict to hold a job, or money spent on drugs. When all of these effects are taken into
account, drugs can have a considerable economic effect on the country.
In this chapter, the author attempt to estimate direct costs of controlling drugs,
expenditure on drugs, average lost income and other costs to families of incarcerated
persons, based on treatment data and some basic assumptions. The social costs of illegal
drugs, which refers to the welfare losses of the society due to the existence of illegal
drugs are also estimated. Other topics in this chapter include the overview of drug prices
and determinants, money laundering, analysis of illegal money in the society, and the
effects of drugs on productivity.
Estimation of Direct Costs of Controlling Drugs
Government Expenditure on Preventing and Suppressing Drug Problems
The Thai government has had to spend an increasing amount of its budget on drug
treatment and suppression. When looking at the classification of the Thai budget, by
program, the budget for drugs falls in the Drug Prevention and Suppression Program,
under the Maintenance of Internal Peace and Order Section. The drug program is then
further divided into 5 main measures as follows: drug prevention, drug addict treatment
and rehabilitation, drug suppression, mixed measures and narcotic crop control. To
accomplish these tasks, the agencies involved are spread across several ministries and
involved police, army and government bureaus.
As shown in the table below, the Thai government has had to spend a substantial amount
of money fighting with drug problems. In 1992, the amount was only 270 million baht
(US$ 6.5 million) while in recent year the amount has been increasing quickly (except for
1998 and 1999 in the aftermath of the Asian crisis), to more than 4 billion baht (US$ 95
million) in 2003. Since the Thai government has limited resources, and severe budget
constraints, the overwhelming budget spent on drugs means that the government has to
cut the budget spent on other necessary programs such as education and public health.
Therefore, the drug problem has not only engendered catastrophe to the society in the
past and present, but also significantly deteriorated the developmental potential of
Thailand in the future.
The previous government focused more on suppression more than on prevention. During
1992-2001, the budget allocated for suppression measures is constantly greater than the
84
budget for prevention measures. During the early period, there were only 2 agencies,
ONCB and the Royal Thai Police, who were committed directly to fighting drug
suppression, but their job was very clearly related to drugs. For drug use prevention on
the other hand, there were 27 agencies involved, each with more peripheral roles, which
used their budgets to advertise, launch media, train, and hold seminars, etc. Since those
who abuse drugs are comprised of many groups of people, differing in careers and age,
many agencies needed to be involved in order to assist in prevention. These agencies
included, for instance, General Education Department, Ministry of University Affairs,
Skill Development Department, Public Welfare Department, etc. However, because they
had their own main tasks to do, drug prevention task was recognized as indirect task, and
not always given priority.
After the Thaksin government assumed power in 2001, its policies increased the priority
on prevention, treatment and rehabilitation, and looking at drug users as “patients,”
instead of “criminals,” so that these budgets have been increased substantially. The
prevention measure budget, for instance, increased nearly 5 times, from 200 million baht
(US$ 4.8 million) in 2000 to more than 1 billion baht (US$ 24 Million) in 2001.
Meanwhile, the treatment and rehabilitation measures budget also has been increasing
around 400 million baht (US$ 9.6 Million) each year since 1999.
The category called "mixed measures" includes overlapping tasks from the other
measures, including prevention, suppression, treatment and rehabilitation. In practice, the
Thai government has used this budget to implement activities such as promoting
community participation for defending themselves from drugs. Since each community
knows its own community better than anyone else, it is felt that the best way to fight
drugs is to let the communities independently take care of their members, allowing those
communities to choose their drug reduction plans themselves.
Therefore, the budget allocated to mixed measure is flexible and sometimes the
government has to determine only the amount of the budget and let the specific plan and
program pursued later. This measure first occurred in 1993 with around 56 million baht
(US$ 1.3 million); later it has gradually been increasing to 200 million baht (US$ 4.8
million) in 2002 and 2003.
The general services measures budget was the budget which could not be classified into
any particular measure; it lasted only 6 years, from 1996-2001. As for narcotic crop
control measure, there were 3 agencies involved in its budget, ONCB, the Office of the
Permanent Secretary for Interior, and the Third Division of the Royal Thai Army.
Although this measure’s budget seems very little compared to other measures, in
addiction it received grant support from foreign governments totaling around 2 billion
baht (US$ 48 million) during 1973-1998. The Thai government recently dismissed this
measure in 2002.
85
Governmental Drug-Related Budget Classified by Objective, FY 1992-2003
Measures
Treatment and
Suppression Prevention
Mixed
Rehabilitation
Year
1992
61
71
212
236
307
462
408
481
610
472
894
949
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
28
35
54
61
83
193
147
74
110
215
1,042
1,065
158
225
268
263
312
293
360
248
590
976
1,392
1,806
Total
General
Services
Narcotic Crop
Control
(Million
Baht)
58
70
612
136
139
139
25
29
30
30
18
20
19
13
12
6
272
417
623
652
807
1,084
1,067
1,021
1,629
2,006
3,528
4,020
57
58
61
28
47
71
68
168
198
200
200
Source: Putthamilinprateep (n.d.) and ONCB
Thai Government Budget Spent on Drugs, by Objective, 1992-2003
Million Baht
2,000
1,800
1,600
1,400
1,200
1,000
800
600
400
200
0
Suppression
1992
1993
Prevention
1994
1995
Treatment and
Rehabilitation
1996
Source: Putthamilinprateep (n.d.) and ONCB
1997
Mixed
1998
1999
General
Services
2000
2001
Narcotic Crop
Control
2002
2003
86
Drug-related Budget Classified by Government Agency in FY 2003
Agencies
Office of the Narcotics Control
Board (ONCB)
Internal Security Operations Office
Suppression
346
Measures
Treatment and
Prevention
Rehabilitation
826
100
Office of the Permanent Secretary
for Public Health
Department of Medical Services
Department of Medical Science
Department of Mental Health
35
64
Office of the Permanent Secretary
for Justice
Department of Probation
Department of Corrections
Office of the Permanent Secretary
for Defense
Supreme Command Headquarters
11
1
Total
Mixed
(Million Baht)
200
1,386
100
173
173
275
5
275
35
69
15
15
173
1,005
173
1,005
1
9
10
25
43
64
15
81
160
Royal Thai Navy
26
11
18
55
Royal Thai Air Force
2
3
24
28
Royal Thai Police
499
499
Total
949
1,065
1,806
200
4,020
Note: The Department of Corrections has in previous years, never received any drug-related budget. This
year it is receiving drug control money because of the new Drugs Addicts Rehabilitation Act, and is using
the money to construct four new prisons for approximately 7,000 new prisoners, and is rehabilitating some
others Source: ONCB
Royal Thai Army
Many government agencies are involved in the budget for coping with drugs. There are 6
main agencies in suppression measures, 9 agencies in prevention measures, 11 agencies
in treatment and rehabilitation measures, and 1 agency in mixed measures. The three
agencies receiving the greatest drug budget are the Office of the Narcotics Control Board
(ONCB), Department of Corrections, and Royal Thai Police, respectively.
87
The proportion of the drug-related budget to the total budget was stable from 1994-1999.
As the drug epidemic has taken hold, the share of the government budget spent on drugs
has increased continually reaching 0.4% in 2003.
Share of Total Government Budget used for Drug-Related Activities Unit: Mil Baht
Fiscal Year Drug-related Budget Total Government Budget
(1)
(2)
1997
1,084
925,000
1998
1999
2000
2001
2002
2003
1,067
1,021
1,629
2,006
3,528
4,020
830,000
825,000
860,000
910,000
1,023,000
999,000
Percent
[(1) : (2)] x 100
0.12
0.13
0.12
0.19
0.22
0.34
0.40
Source: ONCB and Thailand’s Budget in Brief FY 1994-2003
In summary, the Thai budget directed specifically at drugs in 2003 was about 4 billion
Thai baht (100 million dollars). In addition there are a number of other departments of
the government whose expenses are closely tied to drugs, but are not included in the drug
budget, since fighting drugs is part of their normal area of concern. Trying to get an
estimate for how much these agencies spend on drugs is very difficult. For instance, the
judicial system has had to face a great increase in the number of court cases, the
corrections department has had a three fold jump in the number of prisoners they are
guarding, and the regular Thai police force must deal with many more responsibilities
due to drug suppression campaigns and drug arrests. The Thai Royal Army dedicates
enormous manpower and budget to the eradication of drugs for 2-3 months each year, but
its budget is part of the normal military budget. Between 1997 and 2003, the departments
of corrections budget went from 4.3 billion baht to 6.3 billion baht, an increase of 2
billion baht. Much of this increase is probably due to increased incarceration of drug
prisoners. Overall, the extra direct expense on drugs by the Thai government is probably
on the order of twice what is stated in the official budget, or about 8 billion Thai baht
(200 million US dollars.)
Overview Of Drug Prices And Determinants
Retail Price of Illegal Drugs in Bangkok, in Baht
Methamphetamine,
One tablet (.07 gram)
Heroin, #4,
1 straw (.05 gram)
Marijuana, One
small bag, (.5 gram)
Ecstasy,
One tablet
1997
70-100150
50-120
1998
80-100120-150
100-120
2000
45-80-100
2001
50-80-100
2002
60-80-100
100-300
100-120
100-120
50-100
1999
60-80-100150
100- 120300
50-80-100
40-50-100
50-80
40-50
30-40
800-1200
8001200
500-8001000-1500
500-1000
500-1000
500-800
88
Sources: Compiled by the author from various sources. These prices are mostly for one pill, not for 2-5 pills
at a time. (Prices in US dollars and wholesale prices can be seen in Appendix II of this paper.)
The price of drugs depends on both supply and demand conditions. Supply will be
affected by costs - cost of production (very small), the cost of transportation (larger), the
cost of selling (very high), and the risk premium (depends on enforcement). One clear
message from the above table is that drug prices have been very stable over time. This
stability suggests that factors other than suppression are determining price.
Supply
Most of the cost of drugs sold in Bangkok is from selling cost. Drugs must be sold on a
small scale using direct marketing, which makes selling expensive. Transportation costs
of drugs due to the accompanying risk are also quite high, so that the wholesale price in
Bangkok cannot go much lower than 35 baht, even though the border price is only 12-20
baht. The border price also reflects the high cost of transportation both in terms of risk in
getting the drugs across the border, and direct costs to middlemen. Cost of production is
likely only 1-2 baht, with high profits at the factory level. However, those profits are
probably much smaller (5-10 baht per pill) then profit levels between the border and
Bangkok (10-20 baht per pill). In both cases, profits reflect high risks. If the risks to
drug smugglers were reduced these prices would come down somewhat.
Increasing the price of drugs by spending more on enforcement at the border or en-route
to Bangkok is relatively difficult. For one thing, the risk is already perceived to be quite
high. For another, more enforcement would only slightly increase the risk of capture, and
likely lead to only small price markups.
The markup from 35 baht wholesale to 80 baht retail reflects the cost of maintaining a
large sales force, and the risk to the seller. Calculating profit margins to sellers is
difficult because there are so many different levels of involvement, but using data from
Yaa Baa retailers (calculated below in the expenditure on Yaa Baa section) we can
estimate a profit of about 500-800 a day for a retailer selling 30 pills. That would be 2-3
times the normal salary for someone in the working class, and probably amply rewards
the seller for the risks involved.
This margin cannot come down much unless the method of distribution were to change
dramatically, or if there were a significant change in enforcement. Given that the prisons
are already full of drug offenders, stronger normal enforcement is difficult. Again, the
government's recent changing of the rules of engagement are allowing the police to have
a much greater effect for the same amount of money. There is widespread fear among
those selling drugs. For a small retailer, this fear is mostly ungrounded, since the police
are not very interested in them, but nonetheless it is fear, and raises the price of drugs
substantially.
89
Demand
Demand is a function of price, income, substitutes, and tastes. In Bangkok, income
probably plays the biggest role in keeping the price of drugs down. An average worker in
Bangkok probably makes between 150 - 300 baht a day. That represents the maximum a
person could spend without selling drugs themselves, but for many, the discretionary
income available for drugs will be much less. Students typically would only have enough
money to buy one or less pills of Yaa Baa a day, at a price of 60-80 baht. Workers
If drugs are expensive, or if family income is low, it can persuade an addict to seek
treatment. About 6 percent of those seeking treatment gave this as the main reason.
Share who said No Money to Buy was the primary
reason for entering treatment
16%
14%
12%
10%
8%
6%
4%
2%
0%
Yaa Baa
Heroin
Opium
Marijauna Inhalants
Alcohol
Cigarettes
Source: Ministry of Public Health 2001 (Data refer to all Thai Treatment Centers)
Generally Yaa Baa is cheap enough that it does not convince addicts to seek treatment.
Only one percent of Yaa Baa users said they entered treatment because of the cost.
Heroin is the most expensive of the drugs listed here, and opium is used heavily by ethnic
minorities and rural users who do not have much income.
typically have to feed themselves and their families, which limits what they can spend.
Although there are thought to be about 540,000 Yaa Baa addicts in 2002, only about
200,000 of those are thought to use 200-300 baht a day on drugs without selling.
Everyone else is using discretionary income.
Substitutes - note that the price of a movie ticket is about 100 baht.
Suppose the price of Yaa Baa were fixed by the extra work effort that a pill could offer a
worker. If the extra energy or effort from taking a tablet of Yaa Baa is worth 80 baht,
than it would be rational to take one. If the extra work effort were worth 200-300 baht, it
would be worth taking 3-4 tablets. Given that a whole day's work effort is only worth
200 baht, it is generally irrational for workers to take drugs for work. This is another
argument against the idea that people are using Yaa Baa primarily for work.
Prices respond to local demand conditions as well as city-wide ones. In schools, the
competition is fierce for customers, while the income of the buyers is limited. This keeps
90
prices in schools quite low. Another frequently mentioned factor is that drugs are
cheapest in slum areas, particularly Khlong Toey, and that the price of drugs rises with
distance from Khlong Toey. This can give us some feel for the income elasticity of drug
use. Average income in slum = 5000, cost of drug is 60 baht. Average income out of
slum is 10,000, drug price is 80 baht.
Interestingly, the price of drugs in Thailand has been quite stable over time. This
suggests that variables that can be adjusted (enforcement, production) are not playing a
major role in price determination, while structural factors such as selling costs and
income are important.
Update: Since the government started the recent crackdown (Feb-April 2003), drugs have
become harder to get. We spoke to one Heroin addict who said, "I went to Khlong Toey
and there wasn't any heroin, then I went to Saphan Mai, then Saphan Puun, and there still
wasn't any heroin. Then I came here." [To the treatment center.] Those entering
treatment have increased about 40% since the crackdown started.
Estimation Of Expenditure On Yaa Baa Consumption
Measuring the number of drug addicts and drug users is a very difficult task, and the
numbers that have emerged from the survey process have varied enormously. Two
frequently quoted data sources are data from the Ministry of Public Health, and the
National Household Study commissioned by the ONCB and carried out by a coalition of
different universities in 2001.
There is excellent data from the treatment centers in Thailand which is a great help to
researchers in this field. Starting with data on frequency of use and data on money spent
on drugs, it was possible to put together a picture of several classes of user of Yaa Baa.
Based on interviews with both users and professionals it was decided to use the following
groupings, which depend on treatment data, but do not mirror them exactly.
Classification Scheme for Yaa Baa Users
Classification
Pills Used per Day Baht Spent per Day Treatment Statistic Equivalent
Casual Users
1 per month
Very low
-----Beginner Addicts
1/2 to 1
0-100
habitual and "1 pill per day"
Regular Addicts
2 to 4
120-300
2-3 pills & <=300 baht per day
Retailers
5 to 30
More than 300
>300 baht per day
Source: Classification suggested by author, treatment data from Drug Dependence Information System,
Ministry of Public Health
(Casual) Users
Casual Users are not included in the treatment data as they would not seek treatment.
They are those who might use drugs socially, but are not addicted to them. Alternately
they might be workers/students who occasionally use drugs for their stimulant properties.
They probably use a pill per month or less on average. Casual users are the biggest
group, and probably make up about 80 percent of those who have ever tried Yaa Baa.
91
Addicts
Addicts are those who feel some psychological dependence on Yaa Baa.
Beginner Addicts (or light addicts?) are either just starting on their Yaa Baa habit, are
limited by income (such as students or unemployed) or feel content with a lower level of
the drug. They include those listed in treatment data as "habitual" and "1 per day" users.
Regular Addicts are those who use Yaa Baa on a regular basis, but who pay for their
habit through a normal job. This group does not earn most of their income from selling
Yaa Baa, though they may sell a little on the side. They may wish to consume more than
2-4 pills per day, but are limited by their income which is 200 to 300 baht per day. They
may depend on their families for other forms of support, such as food and shelter. In
treatment data, they include all of the "2 to 3 pills per day" grouping and those who spend
300 baht or less on Yaa Baa a day.
Retailers are those who make most of their income selling drugs. They generally spend
more than 300 and up to 1500 baht or more a day on drugs. Generally they sell
substantial amounts of Yaa Baa and keep some of the drug for themselves. With easy
access to the drugs and high profits, they use Yaa Baa in great quantities and without
much thought to cost. In treatment data, they include those who spend more than 300
baht on Yaa Baa a day.
How Common Are Each Class Of User?
The treatment data contains two useful tables for our purposes. One tables separates
users into whether they are habitual users (less than 1 pill a day), 1 pill a day, 2-3 pills a
day, or more than 3 pills a day. The other table separates users by how much they spend
on their principal drug each day, e.g. 0-20 baht, 21-40 baht.
It was possible to work backward from these two tables to try to determine how much
each class of user was spending on buying drugs each day. The two tables provide a
check for each other. For example, someone spending 80 baht a day, was most likely
buying 1 pill, but someone spending 140 was likely buying two. The number of habitual
users more or less matched the number of users who paid 60 baht or less a day, while the
number of 1 pill a day users matched the number of users spending 60-100 baht a day.
We decided to use a somewhat different classification system than that used in the
statistical tables based on many interviews.60
Then by using expenditure and usage data we were able to generate the following table.
The following statistics are generated from 2001 treatment data for Yaa Baa addicts.
60
The drug treatment data classification system was originally designed for heroin users, and drug usage
levels make more sense for them.
92
Share of Average Pills Average Price Share of Avg Expend
Share of
Classification
Addicts
per Day
per Pill
Pills Bought
per Day
Expenditure
Beginner Addicts
44%
0.9
81
13%
72
17%
Addicts
44%
3.0
71
44%
212
48%
Retailers
12%
10.1
54
42%
548
35%
Avg - All Addicts
100%
2.9
65
100%
191
100%
Source: Drug Dependence Information System, Author's Analysis
In the treatment population, beginner and regular addicts make up the same share of the
population (44% each), while retailers make up a smaller group (12%). In spite of this,
retailers consume a large share of the pills (42%) and spend a significant share of the
money spent on drugs (35%). Beginner users consumed an average of 0.9 pills per day,
regular addicts consumed an average of 3 pills a day, and retailers consumed an average
of 10.1 pills a day. Numbers for average expenditure for day were beginner users - 72
baht, regular users - 212 baht, and retailers - 548 baht.
Using this data along with much data from interviews of different types of users and
prices paid we came up with estimates for the prices addicts were paying for Yaa Baa. It
was estimated that beginner addicts paid an average of 81 baht per tablet, regular addicts
spent an average of 71 baht per tablet, and retailers spent an average of 54 baht per tablet.
A more complete breakdown based on usage rates follows.
The following prices reflect the actual prices addicts were paying for the drugs they were
using, which is not necessarily the same as the market price for that quantity of pills. For
instance, the addict buying 21-30 pills was probably buying 100 or 200 pills at a time,
and consuming 20 to 30 pills themselves.
Quantity
1 pill or less
2-5 pills
6-10 pills
11-20 pills
21-30 pills
Price
81 baht
71 baht
61 baht
50 baht
40 pills
Several interesting results came out of this exercise. First, 42% of the pills were
consumed by a small group of retailers who also spent 35% of the money which addicts
spent on drugs. Retailers spent from 300 baht to more than 1,500 baht a dayon their own
personal drug habit, averaging 548 baht.
Starting from the assumption that about 700-800 million pills were smuggled into
Thailand last year, we first tried to see whether either of the two surveys commonly in
use made sense.
If you work with drug data, sooner or later you have to make a great leap of faith. Our
leap of faith was that the distribution of addicts in the general population is similar to the
addicts in the treatment population. So if retailers make up 12 percent of the treatment
93
population we assumed they also made up 12% of the 544,000 addicts estimated by the
Ministry of Public Health.
Using this assumption, along with the average number of pills per user times the total
number of users from each class gave us the following estimates.
Ministry of Public Health Data - a total consumption of 603 million pills a year.
ONCB commissioned study - a total consumption of 120 million pills.
Clearly our data suggest that the Ministry of Public Health Data is more realistic, and
when given a choice we used it in preference to the ONCB data in our analysis below.
Several comments are in order. It is our impression that the number of pills claimed to be
entering the country is a little too high. Our consumption estimates, built up from
treatment data, is likely to be too high since we would expect addicts in treatment to use
more pills on average than those who are not in treatment. Therefore our data is
consistent with at most 700 million pills entering the country for domestic consumption,
with 100 million of them being seized.
In summary, Yaa Baa consumers spend different amounts, depending on what class of
addict they are.
Avg Expend
Expenditure Expenditure
Number of
per Day in
per Year in per Year in
Users
Baht
Million Baht Million US$
Casual User
2.2
2,024,487
1,626
39
Beginner Addicts
72
240,414
6,318
150
Addicts
212
236,961
18,336
437
Retailers
548
66,625
13,326
317
All Users/All Addicts
15 / 191
2,568,487
39,606
943
Source: Drug Dependence Information System, Author's Analysis
Classification
Estimations for other types of drugs are in the section that follows.
Possible Objections to the Approach used in this Paper
Binge Behavior - Addicts use varying amounts of drugs, and in particular tend to go on
binges using great quantities of drugs, then not using any for a while. Money spent or
pills used may refer to when addicts are on binges. Answer: Impossible to judge
accuracy of data since self-reported, but assume here reported amounts are averages. If
survey asked for money spent per month rather than per day, results could be better.
Bias towards Serious Addicts in Treatment Data - Certainly more serious addicts will
enter treatment than less serious users. Our study uses treatment data to estimate the
share of serious users. Answer: Since we don't know about the overall population, we
can not say how serious this effect will be. In this paper we have chosen to assume the
treatment 'sample' mirrors the user population and then informally acknowledged the
problem and bias, resulting in some overestimates of the number of serious users.
94
Estimate of Total Yaa Baa Pills are Too High - Estimates of the number of Yaa Bill
tablets entering the country are based primarily on drug captures. It is thought that drug
suppression units can capture about one in seven pills that enters the country. Therefore
if captures are 100 million, it is estimated that the total pills are 700 million. This number
may be far, far off. Answer: Although we argue in this paper that government estimates
are a little high, it is unlikely, for example, that half of all pills are captured. We use
government estimates as a starting point, and work down from that.
Non-Addict Drug Use Estimates too High. - The two million "users" include all people
who have every tried Yaa Baa. To think that each of these casual users uses ten pills a
year is almost certainly an overestimate. Answer: Even if each of them uses ten pills a
year, the total number of pills and share of total pills is very small, so it will not affect
overall estimates of drug use.
95
For those with a logical bent, here is one argument that provides a check on our data.
Suppose we assume that retailers must sell at least 30 pills a day to be able to afford their
own habit. Now suppose that 700 million pills enter the country each year, or roughly
two million pills a day. 2 million pills/30 pills per retailer, allows for at most 67,000
retailers. The same approach can lead us to make the following estimates:
730 million pills/year implies 2 million/pills a day which implies
Number of Frequency
Transport
pills
per day
Car carrying 40,000 pills
40,000
50
Single individual crossing frontier
10,000
200
Number of Number of
Supply
pills/day
persons
Drug lords
200,000
10
Large retailers
20,000
100
Medium retailers
1,000
2,000
Small retailers
30
66,667
Consumption Number of Number of
Consumption
Share
pills/day
persons
Retailers (more than 4 pills/day)
41%
10.1
81,000
Regular Addicts (2-4 pills/day)
43%
3.0
286,000
Light Addicts (1/2-1 pill/day)
13%
0.9
287,000
Casual Users (10 pills/year)
3.4%
0.027
2,482,000
Source: Deductive reasoning based on 730 million pills a day.
600 million pills/year implies 1.64 million/pills a day which implies
Number of Frequency
Transport
pills
per day
Car carrying 40,000 pills
40,000
41
Single individual crossing frontier
10,000
164
Number of Number of
Supply
pills/day
persons
Drug lords
200,000
8
Large retailers
20,000
82
Medium retailers
1,000
1,640
Small retailers
30
54,667
Consumption Number of Number of
Consumption
Share
pills/day
persons
Retailers (more than 4 pills/day)
41%
10.1
66,000
Regular Addicts (2-4 pills/day)
43%
3.0
235,000
Light Addicts (1/2-1 pill/day)
13%
0.9
235,000
Casual Users (10 pills/year)
3.4%
0.027
2,035,000
Source: Deductive reasoning based on 600 million pills a day. 61
Of course this is all just an exercise, but it helps give some general parameters for what
values are reasonable estimates.
61
The fact that small retailers are always fewer in the supply side just tells us that more serious drug addicts
as well as retailers are more likely to enter drug treatment than less serious addicts.
96
Money Laundering
Scale of Money Laundering Due to Drugs
It is reasonably easy to get a rough estimate of the amount of money likely to be
laundered due to the methamphetamines trade. Suppose we estimate that 700 million
pills will enter the country in 2003. Pills are first sold on the Thai side of the border for
about 15 baht. They are then resold in Bangkok for about 50 baht. These are the only
stages of the drug supply chain in which large amounts of money are generated that must
be laundered, leading to a very rough estimate of 15*0.7 billion plus 50*0.7 billion equals
46 billion baht (1.1 billion dollars) of laundered cash a year.
It is estimated that about 46 billion baht (1.1 billion US dollars) of
money from illegal Yaa Baa is laundered in Thailand each year.
Reviewing the different stages of the drug supply chain shows this value is reasonable.
The methamphetamine tablets probably cost 1-2 baht to produce. That 1-2 billion baht is
spent on precursors and salaries, so it is not laundered. The drugs are then transported
across the border. In the old days this was done in large posses of perhaps 10 people with
guards, porters, etc. Nowadays a single person with a backpack is just as likely since
enforcement has made the large group approach more dangerous. In either case, we can
estimate a wage to the carriers of about 1 baht a pill, which adds up to about another 1
billion baht. Although wages to individual people are small enough that they could be
used up in the normal economy, one billion baht going into poor hill tribe towns on the
border should be pretty easy to spot. Start with the nice looking houses…. The carriers
would generally be working for someone else and mostly would not own the pills
themselves.
Then there might be some other employees up in the northern communities who arrange
trades, coordinate logistics, locate carriers who must be paid. Their salaries would be
harder to track since they live in towns, and would be easily absorbed in the general
economy.
Now we come to the first major transaction where the pills are sold (15/baht pill) in the
north. Here the track becomes a bit less certain. The sellers of the drugs at this point
may be Burmese, which means the money could be laundered in Burma. On the other
hand, payment is most likely in Thai baht, which means that the money would need to be
laundered on this side of the border.
A further complication is that the buyers could belong to two different groups. One type
of dealer buys drugs, then arranges transport for them for sale in Bangkok. Alternately,
the buyer might be a dealer in Bangkok who arranges for transportation himself. In this
case, one of the two points of sale where money would need to be laundered would be
eliminated.
97
A carrier is then employed to transport the pills to Bangkok, or to other places. Often the
carrier will not be told directly that they will be carrying drugs. “Hey, if I paid you
20,000 baht, would you drive my car down to Bangkok and leave it at such and such a
place?” Generally anyone met with such a proposition involving a large sum of money
would be suspicious, but would most likely know enough not to ask more. On the other
hand, some carriers (e.g. a normal bus or truck driver) might have no idea at all of the
illicit part of their cargo. In general we can figure on a wage of 1-2 baht per pill, or 1-2
billion baht. This much money, in twenty thousand baht amounts, would disappear in
Bangkok without a trace.
The wholesale price of drugs in Bangkok is 35-50 baht a pill. We feel that it is
appropriate to use the higher end of this range for an estimate of laundered money since
drugs sold at the lower price are probably sold in large quantities. They are probably then
resold again in quantities that would require money to be laundered.
In summary, there are only two steps along the supply chain which involve selling Yaa
Baa at sufficient prices and quantities to require money laundering once at the wholesale
level in the North, and once in Bangkok or other cities.
Heroin remains a very serious problem in Thailand mostly because of the close proximity
to Burma. Because of this, and because Thailand has good air transport to the rest of the
world, a good deal of heroin passes through Thailand. The trend in this sense is perhaps
steady to a slight increase. For the most part, the sellers, buyers and traffickers are not
Thai, and payments may be made in dollars. Therefore Heroin will likely not lead to as
much money laundering in Thailand as Yaa Baa.
Thai Anti-Money Laundering Office
The Thai anti-money laundering program is still in its infancy, but already they have had
some success at tracking laundered drug money. Unlike in more established institutions
the Thai Anti-Money Laundering Office (AMLO) does not try to find drug users through
money laundering laws. Instead they are purely reactive, trying to tract assets of drug
suspects who are already captured. This is actually a critical job, since most suspects at a
high level in the drug supply chain cannot be arrested on normal drug charges. They
would never be caught in possession of any amount of drug, and they try to make the
chain of command as obscure and as trust worthy as possible. Besides helping to make
the cases against drug suspects more solid, AMLO also has the useful job of identifying
assets bought with drug money, and returning them to the government. The money
laundering laws that are in place, therefore, are not laws that ring alarm bells, but rather
laws that allow agents to reconstruct money and asset transfers that occurred in the past.
In most Asian countries including Thailand, a significant share of transactions occur in
cash. This makes tracking money laundering a difficult proposition. If you walked into
most western banks with a big bag of cash, they would be suspicious. Not so here, where
the absence of checks and the slow adoption of credit cards upcountry have made this a
98
common occurrence. You can deposit a million baht in cash (25,000 dollars) in a Thai
bank without anyone paying the slightest attention.
As the law stands now, banks must report to the office any cash transaction over 2 million
baht in a given day for a given individual. Since most Thai people have a number of
different bank accounts with different banks due to strange automatic deposit rules, it is
still possible to move a significant amount of money around. Banks must keep records of
these transactions, as well as most other transactions, for five years.
When paying for large items such as property or houses, the method of payment which
could still be cash. With houses the deed or bill of sale must state if payment was in cash.
It is not reported to the government, but the government can go back and look at the deed
if need be. There is no such law for cars, jewelry, or other big ticket items that are
frequently used to launder money. In theory, you could walk in and pay cash for a
Masarati with no record of any kind being kept. The large casinos across the border in
Cambodia also provide an easy outlet for laundering money. Many of them are Thai
owned.
Drug laws state that only assets owned by the drug suspect may be confiscated, not those
of his or her relatives. Therefore many assets are kept in the names of spouses or other
relatives. The laws in this area are under revision, and currently the spouse has some
responsibility of proving that the money used for purchases came from a legal source.
The burden of proof is always on the owner of the possessions, which makes AMLO's job
a lot easier.
The assets of drug suspects may not be seized until the suspect has exhausted all legal
recourse. The long life of most drug cases, including all the appeals and retrials means
that most of the assets seized by AMLO are frozen, and may not be available to anyone
for years.
99
AMLO Seized Assets
Jewelry,
Other
Cars
4%
7%
Banknotes
22%
Land
16%
Total =
1,250 Million Baht
Bank
Accounts
51%
Source: Anti-Money Laundering Organization
Of the 1,250 million baht (3 million dollars) of seized assets shown in the diagram above,
only 28 million (66,000 dollars) has already cleared the court system. The rest must wait
for further trials before the government can use the money!
AMLO officials feel that their office is a dangerous place to work. Most of the drug
suspects they investigate are wealthy people with great influence and power.
When asked about corruption and bribery at their office, they felt it was not a problem.
However one suspects that if someone were paid NOT to discover a particular asset, it
would be extremely hard to trace, and well worth the trouble for the drug suspect.
Money Laundering – What to Look For
Money laundering refers to taking money that does not have a history, and giving it a nice
clean one. If the drug dealer is caught, any money that has already been laundered may
be impossible for the government to seize, so the dealer has a strong motivation to
launder any drug profits as quickly as possible. In addition, spending clean money does
not rouse suspicion, while spending unexplained money often does.
Anti-money laundering experts track several things
1) The purchase or sale of large ticket items, especially those which leave no paper trail.
These include property, vehicles, jewelry, casino earnings, etc.
2) Movements of large quantities of cash. Most drug trade relies on cash transactions.
As money laundering laws become more severe, this becomes more true. There are
only certain ways that large amounts of cash can move through society.
100
3) Experts watch things that drug dealers like to buy. These may include surveillance
equipment, drug making equipment, weapons, and chemicals.
Estimation of Expenditure on All Drugs
It is estimated that the equivalent of about 1% of the Thai GDP is spent
on illegal drugs each year.
Methamphetamines
The retail price of methamphetamines is about 80 baht per tablet, but with a very wide
range of prices and venues. Our calculations in the expense on Yaa Baa section suggest
that the final average price for a Yaa Baa pill is more likely to be about 65 baht since so
many are bought in quantity. If there were 600 million Yaa Baa pills bought last year that
would be 65 * 600 million or 39 billion baht, or about 900 million dollars. This is
equivalent to about 0.8% of the Thai GDP, although all of these transactions would be in
the underground economy and would not show up in GDP figures. Once we add in other
drugs, we estimate that about 1% of Thai GDP is spent on illegal drugs each year.
Marijuana
The second most common drug used in Thailand is marijuana. The majority of users of
marijuana live in the Northeast although there are certainly still many users in Bangkok
and other parts of the country. The market for marijuana is likely to be fairly limited in
the northeast for the reasons explained under kratom. Most production would be in the
form of rural residents growing a few plants. The price of a bag of marijuana in Bangkok
is about 40 baht for half an ounce. The Ministry of Public Health estimates the total
number of users and addicts at 174,151 the average dose likely not more than three bags a
week. That means we could add about 2.5 billion baht, or 60 million dollars to our total.
Kratom
The third most commonly used illegal drug in Thailand is kratom. Kratom is a tree that
grows wild in the south of Thailand, as well as other parts of South East Asia. Sale of
kratom is illegal, but access for farmers is easy. Kratom is not used in other parts of the
country as an easily transported and more effective substitute for endurance (Yaa Baa) is
available. Therefore it is unlikely that much of a formal market exists for this drug
outside of the south. In the south, leaves of kratom cost 5-10 baht each. They are widely
used by the same hired labor that uses Yaa Baa in the rest of the country. Those who use
kratom usually use it every day. The National Household Survey of the ONCB estimates
that 85,000 people use Kratom daily. At 5 baht a leaf, total expenditure would be 155
million baht, or 3.7 million dollars. A serious abuser might chew 5-10 leaves a day.
101
Heroin
Heroin is the other major focus of attention for the drug control community. It is a very
serious drug due to 1) its being addictive, 2) its risk of overdose, and 3) the increased risk
of blood-borne diseases, especially AIDS.
There remains a number of hard core users of Heroin, and another group of opium users.
The typical profile of the heroin user is a person in his thirties or forties, who has been in
and out of jail for years. The Ministry of Public Health estimates the number of heroin
addicts to be 58,038 in 2002, with an additional 20,397 users. Heroin addicts must use
the drug everyday. The amount they use usually depends on the money they have
available to them, but it is generally a minimum of twice a day, and often three times.
Heroin is often sold in straws containing about .05 milligrams of fairly pure (60-80%)
heroin. The cost of a straw is 100-120 baht. On average we can estimate a cost of 300
baht per day per user. That would lead to a cost to the end users of 6.4 billion baht,
(assuming that users use very little compared to addicts) so we could suppose figures of
about 150 million dollars
Ecstasy, Ketamine, etc. have approximately 10,000 estimated users, though many of
these are likely to be occasional. A tablet of ecstasy goes for 500-800 baht in Bangkok,
which is not far from what it costs retail in Europe. Because of its great expense, only
well-off kids would be using it, and then most likely just on the weekends. Suppose the
average usage was one pill per week per user. That would add only about 300 million
baht (7 million dollars) to our total. Since most of the drugs are smuggled directly from
Europe for use by friends, there are not likely to be many other stages in the supply chain
that affect Thailand.
102
Analysis Of Illegal Drug Money In The Society
The following table shows the supply chain for illegal drugs with all those who play a
role in it. The main players are then evaluated in the analysis section.
Drug Supply Chain
Place
China
(transit)
Burmese Factory
(transit)
Border Town
(transit)
Drug Location
Physical Control
Ownership
Producers of Precursors
Producer


--Couriers


Factory
Employees at Factory


On Foot or Car
Drug Runners
Military Escorts
Robbers


In Ground
Sales Representative
Warehouse
Drug Storage


Car or Pickup
Hired Transporter/
Independent
--
Burmese Drug Lords

Burmese Drug Lords

Burmese Drug Lords

Local Wholesaler/
Bangkok Wholesaler

Large Wholesaler/
Bangkok Wholesaler/
Independent


Underlings
Large Wholesaler


Underlings
Medium Wholesaler

Medium Wholesaler
Medium Wholesaler

Rented House

Drop Location

Rented Apartment
(transit)
Drop Location
Small Wholesaler
Small Wholesaler
In Home, or Hidden
Small Wholesaler
(transit)
Handoff
Retailer
Retailer
Hidden, or On person
Retailer
(transit)
Handoff
User
Large Wholesaler
(transit)
User
On person
User
Source: Global Study on Illegal Drugs: The Case of Bangkok, Nualnoi Treerat, Noppanun
Wannathepsakul and Daniel Lewis, UNDCP 2000
103
Characteristics of Participants in the Supply Chain
Border Runners
Evidence from the border suggests that many of those transporting drugs belong
to a variety of ethnic minorities, indigenous to the area. Although many different ethnic
minorities are involved in the transportation of drugs, it is thought that the Hmong may
play a particularly significant role in organizing the trade because of their superior
organizational ability. Amphetamines and Heroin are transported by foot and sometimes
by car along the mountainous terrain on the Thai-Burmese border. Some drugs are
transported in specially engineered cars. Groups on foot are usually escorted or consist of
heavily armed militants. One disturbing fact is that attacks on border patrols and armed
confrontations have tended to be well organized and thought out, suggesting a
sophisticated army network consistent with hired mercenaries or members of the United
Wa State Army. It does not fit well with the concept of unorganized hill tribe runners.
As is true for all links in the supply chain, drugs usually change hands by being hidden by
one party, and picked up by another. Drugs are stored in many hill tribe villages, often in
the ground.62
Border Towns
Drugs in border towns are owned either by drug lords from Burma, or by local
wholesalers who buy from them. The drugs are hidden, often in the ground, but
sometimes in warehouses, until an agent of the drug lord or the local wholesaler makes a
sale. They are then transferred to the buyer through a drop location. Members of ethnic
minorities are often involved as runners, custodians of hidden drugs, and go-betweens in
this trade.
It is not clear that all drugs change ownership in border towns. In particular it has
been noted that many Burmese have been arrested in the process of transporting drugs
south, suggesting that some drugs may not change ownership until they reach the
wholesaler in Bangkok (or in many other cities in Thailand).
Drug towns are alive with the drug trade. In a small town are found couriers,
wholesalers, visiting buyers, and police trying to suppress the trade.
Transporters
It is fairly easy to buy drugs in large quantities in the north of the country.
Evidence suggests that drugs are transported by many different individuals acting either
independently on their own behalf, or as hired agents on the behalf of different agents in
Bangkok, or even in Burma. The distance from the border to Bangkok is about 700
kilometers.
Evidence for drugs being transported directly by Burmese drug lords includes one
story in which a pair of drug transporters claimed that they were hired to pick up drugs at
a factory in Burma and deliver them directly to Bangkok, in exchange for about 3 baht a
tablet.
62
Bangkok Post 12-1-2000 “Illicit drug consumption doubles,”; Nation, 22-12-1998
104
In other cases drugs may be bought by Thai wholesalers who hire transporters to
get the drugs to Bangkok. These are probably the bigger, better organized wholesalers in
Bangkok.
Then there are many independent operators who buy drugs in border towns and
sell them again in Bangkok. This sort of trade requires agents to have sufficient capital or
credit, but is probably fairly profitable and quite risky.
Finally there are traffickers from other countries who buy drugs in border towns,
transport them to Bangkok, then take them to another country via the airport. Besides the
central location of Thailand and the good international connections, traffickers are
thought to like Thailand because Thai authorities tend to be more lenient in punishment,
as opposed to Malaysia and Singapore where drug dealers face death automatically.63
In all there are probably many separate routes and transporters to Bangkok,
employing many different methods of concealing drugs. Therefore this step of the supply
chain is quite competitive, with prices mostly reflecting the risks to safety and capital
inherent in moving drugs. Thai police estimate that there are about 5,000 drug laden
trucks on the roads in Thailand each day.
Large Wholesalers
It is thought that there are several large drug wholesalers in Bangkok, with
turnovers from 100,000 tablets a week to perhaps as many as 100,000 tablets a day.
Large wholesalers might typically sell drugs in units of 5-10,000 tablets to medium
wholesalers. They probably have a sophisticated supply network from the north with
shipments at least weekly or bi-weekly. These large scale operators are well established
with powerful connections in the police and politics, and are very difficult to capture.
Evidence suggests that large wholesalers are geographically separated from each
other , so are not involved in direct competition. There are also many independent
operators bringing drugs from the north, so that a medium wholesaler will potentially
have a number of sources of supply. (In spite of having many choices, the wholesaler
will likely be loyal to a single supplier, unless the price of the outsider is quite different).
This competition acts as a force to keep price down. At this time, the distribution of
amphetamines and heroin is quite decentralized, and competition from independent
operators from the north keep the prices for large wholesalers in check.
64
At present there are no reports of violence between the operations of large
wholesalers, or on the part of large wholesalers against independents. It is thought that
the low level of conflict is partly the result of a rapidly expanding market, in which it is
better to expand to new customers, then fight over existing ones. If this trend changes it
will be quite unfortunate for Bangkok.
63
64
Nation, 10-9-1998 “Gov’t beefs up ONCB to curb drug abuse”
In particular, in Nontaburi, Khlong Toei, and Samut Prakhan
105
Medium Wholesalers
Medium wholesalers might have a weekly turnover of 10,000 tablets. They will
typically sell drugs in units of 200 tablets to a variety of small wholesalers, and will
probably not do much, if any, retail trade. They will probably buy a weekly supply from
either a large wholesaler, or from an independent operator bringing drugs from the north.
They will do much of their own business, including handling drugs themselves, but will
make wide use of drop locations, will likely have several helpers to at least deliver drugs,
and will have places to store drugs outside of their home, perhaps in a rented apartment.
They probably have some connections to the police on a local level, and may pay them
off to look the other way.
Drug lords thrive on legal gaps.65 Adult drug traffickers often avoid risking the
death penalty by hiring children to deliver or sell drugs. The number of children arrested
on drug-related charges has skyrocketed since the government imposed the death penalty
for amphetamine users and traders in 1996. Children as young as five are hired to sell or
distribute the drug for 50-100 baht ($1.33-2.67 ) a job. Children under seven are not
subject to penalty for any crime in Thailand.
Small Wholesalers
Small wholesalers might have a weekly turnover of 1,000 tablets or more. They
sell tablets to retailers in units of less than a pack (200 tablets) as per the need of the
retailer. Selling amphetamines in units of 10 tablets is common. Small wholesalers also
are involved directly in the retail trade. A serious drug user (not a seller) will likely buy
directly from the small wholesaler in units of ten or twenty because the price will be
better. Small wholesalers will also sell individual tablets, but at a higher price.
Retailers
Retailers are often drug addicts who sell drugs to support their habit. They might
typically sell 50 tablets a day, but this will vary quite a bit. Certainly new kids selling
drugs might just sell 10-20 a day, while those who are well established could sell quite a
lot more.
65
Nation, 31-8-1998 “Drug lords thrive on legal gaps”
106
Who are the big guys?
It is a popular game to speculate who among the rich and famous could be involved in
selling drugs. Most likely drug enforcement has a pretty good idea of who some of these
individuals are, but no proof. Another group which may know, but won't tell are
bankers, especially in the northern provinces. The rest of us just like to speculate.
Several things are valuable on the resume of a potential drug lord.
Connections - A successful drug lord will have many connections, including with the
police, business people, bankers, those across the border, and a host of underlings.
Money laundering facilities - The drug lord must be able to launder money through
some sort of connections with property developers, jeweler dealers, banking or finance
experts, or cross-border trade.
Local Knowledge - contacts with people on both sides of the border for arranging drug
trades and transportation. Again, pre-existing cross border trade is useful.
Intelligence and Circumspection - Knowing how to get things done in a quiet and
inconspicuous way takes intelligence and circumspection.
Money - This is a large investment, high risk, high return sort of a business.
Loss Of Productivity
There are adverse effects on performance from using drugs, but there are also positive
effects. It is difficult to discover whether the net effect is positive or negative.
Does Using Illegal Drugs Reduce Productivity?
Overview
Another load of fish came over the bow. Boon is so tired he can’t think He
has been working out in the gulf of Thailand for 30 hours straight. He takes
another pill of Yaa Baa and hopes it will all be over soon. Catching fresh fish
in a hot, tropical country means there is no time to waste in getting the fish
processed and on ice. Yaa Baa helps keep him going on the incredibly long
shifts.
Somchai drives a truck from Chiangmai to Songkla, a 20 hour trip. In order
to stay awake and to keep his concentration, he uses Yaa Baa to stay alert.
He feels the risk of an accident would be higher without drugs.
Chart drives a taxi on the evening shift. Most days he wouldn’t use any
drugs, but over New Years or during Songkran when there are many
customers he might take one Yaa Baa pill so he could work up to three shifts
in a row. The extra money is a big help to his family.
107
Ask these people if Yaa Baa reduces their productivity and their answer is a definite NO!
This being said, the vast majority of people who use Yaa Baa DO NOT need it for its
stimulant qualities – its ability to keep people awake and alert. In fact, many people who
smoke Yaa Baa sit around afterwards, while many others use many pills a day when a
single pill would be enough.
Several factors help show that Yaa Baa is not needed primarily for its stimulant
properties. One it is almost universally smoked rather than eaten. When Yaa Baa is
smoked it first gives the user a feeling of euphoria or happiness that follows the same
chemical pathways to pleasure as we get from food or sex. After that feeling passes, the
user is able to stay awake and alert for at least 4-8 hours. If the pill is swallowed instead,
the result is the drug must pass through the digestive system and is absorbed more slowly,
and without the strong euphoria. The stimulant effects are the same with the user being
able to stay awake for at least 4-8 hours. When the pill is smoked it suggests that it is the
euphoria that is sought rather than the ability to stay awake.
Another factor is the high dosage commonly used. Those who use Yaa Baa regularly
may use 3 or 4 pills each day, or more. One pill should be more than enough to keep
them awake and alert, and to keep them performing effectively, as the many stories of the
efficacy of Yaa Baa from the old days can attest.
There are many stories of employers adding Yaa Baa to drinking water to keep their
employees working hard, or requiring employees to take Yaa Baa so they will be at their
best all day long. These stories are most likely false, but show the feeling people have
about the relationship between Yaa Baa and productivity. The most pernicious effect is
that employers would seldom discourage their workers from using Yaa Baa, and would
not encourage them to quit. This is important since employers often have more
knowledge about their employees than anyone else, and also have a great deal of power
over them. It would be worthwhile to design a program to encourage employers to help
their workers to quit.
In some ways Yaa Baa also reduces productivity in that it does not result in any
productivity itself, while time and effort must be spent in obtaining the drug, time is used
in smoking the drug, etc. If the person becomes sick, time is lost, and if the person uses
too much of the drug, performance is likely to be reduced.
At the societal level, it is our feeling that the net effect on productivity of Yaa Baa and
Thai illegal drugs in general is neutral. Some drugs are used to enhance performance,
others might detract, while still others are used during time that would normally be used
for recreation. For a particular individual the effect on productivity could be anywhere
from strongly positive to strongly negative, or neutral depending on their job, the drug,
and the method of administration.
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Productivity Effects of Individual Drugs
Yaa Baa
Yaa Baa was first used by long distance truck drivers to stay awake. It is still used by
those who work long, long hours who need to stay awake and alert.
It does not give the user energy, but it does allow access to emergency energy reserves
inside the body. For someone who has unusual energy needs that might be important.
Once those reserves are used up, the body must replenish them, which leads to the typical
binge and crash pattern found in the most serious addicts.
Marijuana
Marijuana is used widely in the Northeast. Young guys sit around and smoke it in the
evening. In the countryside there is not a lot to do in the evenings. One person we
interviewed cynically suggested that the government could completely solve the
marijuana problem by buying TVs for rural Thai villages.
The effects on productivity are minimal since it is almost never used during working
hours. Health effects are minimal so there would be little or no lost work time.
Heroin
The majority of people who use heroin have used it for a long while. They have spent
much of their life in and out of the prison system, with some prison inmates back for their
sixth or seventh tour. They are more likely to be out of work than users of other drugs.
The physical addiction also makes it more likely that they may engage in illegal activities
since they are willing to engage in desperate measures to have access to the drug.
Certainly their presence in the prison system is much greater than their estimated
numbers in the general population would suggest, which may be a result of their turning
to desperate measures.
Not all users of heroin are incapacitated, though many do not have regular jobs. Heroin
may also be favored by artists and artisans who value it for the insights it gives them.
The effects of heroin are likely to be a significant drain on productivity. Effects on
aggregate productivity are limited by the small number of users.
Kratom
Kratom is a mild analgesic which has stimulant qualities at low doses. It grows wild in
the south of Thailand. The kratom is a tree, and farmers have for centuries chewed on the
leaves to give themselves energy and endurance when working in the fields. Kratom is
an interesting drug which has characteristics of most classes of drugs –hallucinogenic,
analgesic and stimulant. Not much study has been done on the species and it is almost
unknown outside of Thailand. Fortunately, there is currently no way to convert kratom
into something stronger.
Kratom is probably mildly productivity enhancing.
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Dance Drugs
Dance drugs such as Ecstasy (Yaa E) and Ketamine (K, Special K, or Yaa K) are used
mostly at entertainment venues. The drugs are very expensive, at 500-800 baht for one
tablet of Ecstasy, relative to perhaps 70-80 baht for Yaa Baa. The drugs are used almost
exclusively for recreation, mostly on the weekends, and usually at an entertainment venue
or private party.
Dance drugs are unlikely to have much effect on productivity since the users would not
otherwise be working.
If drugs can enhance productivity, should they be legal?
The issue of legalizing drugs is a very sensitive and political issue. Governments
must not be seen to support drugs in any way. This is true even for marijuana,
the drug for which the legalization case is the strongest. The case for legalizing
Yaa Baa is much, much weaker as it is clearly addictive. Once people start to use
methamphetamines they cannot get themselves to quit. Users also are not able to
self-control the amounts of the drugs they take, so that they create health risks to
themselves and others, by taking levels that lead to psychosis, use up family
income, and may lead to eventual health problems.
Another argument for legalization claims that drugs should be legal to reduce the
high profits made by drug lords. It suggests that drug use is mostly supply
driven, so that if there were not high profits in producing drugs, little would be
produced. It also suggests that most of the harm that comes from drugs is from
the money, and the power that go with it – in short the violent distribution
network. This argument is weak as there are clearly dangers to users from the
drug itself, while at the same time demand is not rational due to addictive
properties. Some groups would almost certainly increase use of Yaa Baa were it
to be legal, such as drivers, and night workers.
Other arguments for legalization claim that the government could benefit from
drugs by taxing them as it does with liquor and cigarettes, and that the
government could have more control over harmful additives if production were
legal. Both arguments hang on whether the drug is actually harmful in itself. If
it is harmful in itself the government should not profit from it, and controlling the
additives would not resolve the health risks.
Generally there is little thought worldwide that Yaa Baa should be legal.
Source: compiled by author from various sources
110
Loss Of Man Power And Labor Costs
The biggest cause of loss of manpower is the time lost while drug users spend time in jail.
Macroeconomic Effects
If there were no drug-related prisoners in Thailand it could theoretically lead to a greater
labor supply and lower wages. However prisoners represent only 0.72%, or less than 1%
of the Thai labor force. If they were released they would add to demand as well as to
supply.
In addition, although the unemployment rate in Thailand is low, at around 2.9%, there is a
vast pool of agricultural labor which can be drawn into the labor market if there is any
shortage, and return to the farm when there is a surplus. This was evident after the Asian
economic crisis in 1997 when many Thais returned to the farm. In addition, many
foreign workers from Burma, Cambodia and Laos function in much the same way,
coming when there are jobs to be done, and being sent home when there are not. These
foreign workers mostly do unskilled or low paid work that Thais do not prefer.
Finally, over the last five years the average Thai wage in baht terms has hardly budged.
All of these arguments point to an elastic labor supply curve for which wage rates would
not change due to small changes in labor supply. In sum, incarceration is unlikely to
have an effect on macroeconomic measures of labor such as wage rate, the
unemployment rate, and aggregate labor supply.
Average Wage of Those Incarcerated
Although the effect of incarceration on macroeconomic variables is likely to be small, the
lost income from incarcerated persons is still a substantial amount.
Methodology: To be able to calculate lost income from incarcerating prisoners, it is
necessary to know the education level of the prisoners, the region the prisoners come
from - since regional income differs so greatly in Thailand, their sex, and the
unemployment rate. These will be combined with information from the Thai Labor
Force Survey to come up with a value for lost earnings.
Education Level of Prisoners
Three separate studies support each other in showing that the average level of education
in prison is lower than the population as a whole, in the range of 1-6 years of schooling.
In a study of 365 prisoners from a variety of prisons, incarcerated for Yaa Baa and
Heroin, and published by the department of corrections66 it was found that the median
level of education depended on position in the supply chain for drugs. For addicts and
66
Nathee Chitsawang and Sumonthip Jaihlek. 2000
111
small retailers, the median education was 1-6 years, but for large retailers the median
education was 7-12 years. Overall the median education level was 1-6 years.
In another study of 505 prisoners at a prison in Pitsanulok (northern region) 67, the
median level of education was 1-6 years, with 12% having no education, 55% having 1-6
years of schooling, 19% having 7-9 years of education, 9% having 9-12 years, and of the
remaining 5%, all but one person had studied in technical school. That one person had a
B.A.
A third study of 200 prisoners at Bangkok Metropolitan Special Prison68 found that again
the median level of education was 1-6 years, with 61% having studied 1-6 years, 26%
having studied 7-9 years, 11% having studied 10-12 grade, and the remaining 2% having
studied either at a technical school or for a B.A.
In comparison, the estimated average education level for treatment populations by
drug was as follows:
Median Education Level of Treatment Populations for Different Drugs
Illegal Drug Median Years
of Schooling The typical drug user in treatment centers also has a
typical level of education for the country. Two
Yaa Baa
07-09
exceptions are opium and alcohol abusers. Many opium
Heroin
07-09
users are hill tribe persons who had no access to formal
Inhalants
07-09
education. Alcohol abusers likely have less education
Opium
Never
since they are older, and older persons in Thailand
Alcohol
01-06
typically had less access to education.
Cigarettes
07-09
Control
07-09
The median education level for Thailand is 07-09 years
Group
Source: Statistical Report FY 2001, Department of Medical Services
Comparing these data sources, the suggestion is that those who are in prison are less well
educated than the average person in either treatment programs, or the general population.
So, to summarize,
Median Education Level
Prison Population
Treatment Population
General Thai Education Level
1-6 Years
7-9 Years
7-9 Years
Our interest in this section is the average potential income level for these prisoners, but it
is worth pointing out at this point that any policy or training for prisoners should take
these low levels of education into account.
67
68
Tadtapong, A. 2001
Ponthong, A. 2000
112
Very nicely done publication of the Thai Probation Department which explains the legal process
from arrest through to probation, while taking into account the average education level of prisoners.
Do uneducated people commit more crimes, or do uneducated people
just get caught more often?
There is no fully satisfying answer to this question, since we can't know about
those who are NOT caught. Low I.Q. is clearly associated with delinquency in
schools for which we have a 100% sample, and is a clear risk factor for a criminal
record. It is also a risk factor for drug use. A U.S. Department of Education
study69 found that the average I.Q. of the prison population in the U.S. was about
15 points lower than the average population (85 versus 100). Crime also has a
genetic component, as identical twins of criminals were much more likely to be
criminals themselves than were fraternal twins. The most likely answer is that
both statements are true.
One thing that is clear is that intelligence in prisons is clearly associated with
different kinds of crimes. Those with low I.Q. are much more likely to engage in
impulsive, or aggressive crimes. High level drug sellers and distributors are likely
to be intelligent since it takes skills to be successful at almost any business. High
I.Q is also associated with property crimes and fraud.
- Edwin H. Sutherland Criminology Home Page
It is important to know what regions prisoners come from since regional wage rates vary
significantly, and to know whether they are men or women. Generally, although
prisoners are first placed in jail near where they are arrested, they are eventually moved
to be near their homes, so we can use location of incarceration to predict wage rates.
69
U.S Department of Education 1992
113
The distribution of prisoners by region is as follows:
Region
Population
in Millions
Workforce
in Millions
Rate of
Unemployment (%)
Prison
Population in
Thousands
Incarceration
Rate per
100,000
Bangkok
7.9
4.4
3.2
52.5
665
Central
14.4
8.0
1.9
77.1
536
North
11.3
6.2
2
49.4
436
Northeast
21.3
11.0
4.1
41.2
193
South
8.5
4.4
2.4
21.5
253
Total
63.4
34.0
2.9
241.7
381
Source: Compiled by the author using several documents of the department of corrections, and the labor
force survey. Note that the total incarceration rate is slightly different from that used earlier.
As in most countries, the majority of prisoners are men. Women make up only 18.5
percent of the prison population, but women make up 26.5 percent of those in prison for
drug crimes.
The distribution of prisoners by sex is as follows:
Sex of Thai Prisoners
Female
19%
87% are
for drug
crimes
60% are
for drug
crimes
Source: Dept of
Corrections 2001
Male
81%
Taking this data on sex, region, unemployment rates, and education level to the tables of
the Thai Labor force survey, it is possible to estimate the lost wages of those incarcerated.
The most difficult to calculate is the relationship of education to wage, as labor force
statistics do not include data on wages per education level.
The method used was to work with a basket of professions that matched the education
profile of those incarcerated. In this case, five types of workers were chosen, Service
Workers, Agricultural & Fisheries Workers, Crafts & Related Trades, Plant & Machine
Operators, and Unskilled Labor. A median monthly wage rate was calculated based on
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the median wage rate for an average of these five categories for each of the five regions
and for both sexes. Results for monthly income in baht are in the table below.
Median Wage Rates by Region and Sex
Baht
per Month
US Dollars
per Month
for common laborers and unskilled or low skilled workers
6,000
144
5,000
120
4,000
96
3,000
72
2,000
48
1,000
24
5,500
4,300
4,500
3,500
4,500
3,000
3,500
2,700
3,000
2,500
0
0
Bangkok
Central
South
Men
Women
North
Northeast
Source: Compiled by author from
Thai Labor Force Survey Q2 2002
Finally we would like to know the share prisoners serving time for drug crimes, so that
we can know how much of lost income is directly attributed to drugs.
115
Reason for incarceration of Thai and Foreign prisoners.
Thai Prisoners
Narcortics
2
Foreign Prisoners
1
0%
.
10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Firearms
Property
Life
Bodily Harm
Immigration
False Documents
Sex Offense
Forestry Laws
Social Security
Other
Source: Dept of Corrections 2001
This table shows us that overall, about 65 percent of all Thai prisoners were in prison for
drug crimes. Although there is a stereotype that most foreign prisoners are serving time
for drug trafficking, actually the share is less than for Thai prisoners, at about 53 percent.
Foreigners are jailed for possessing firearms, murder/manslaughter and false documents
more often than Thais. A greater share of Thais than foreigners are jailed for sex crimes.
Given regional wage rates by sex, unemployment rates, the share of prisoners who are
women and the share of drug crime populations who are women, and share of drug crime
among all prisoners, the following estimates of lost income were calculated.
Lost income due to Incarceration, in Baht
Millions of
Baht
Bangkok
Central
North
Northeast
South
Total
Lost
Income
Male
2,839
3,456
1,719
1,204
958
10,176
Lost
Income
Female
504
610
301
228
145
1,788
Lost
Lost
Income All Income All
Prisoners
Drugs
3,343
2,143
4,066
2,606
2,020
1,294
1,431
921
1,103
701
11,964
7,664
Lost
Income
Yaa Baa
1,847
2,246
1,115
793
604
6,606
So in summary, the total lost income for locking up all drug related prisoners was 7,664
million baht (182 million dollars), while the lost income for locking up only those
arrested for Yaa Baa was 6,606 million baht (157 million dollars). The same table is
reproduced in terms of US dollars for the reader's convenience.
116
Lost income due to Incarceration, in US Dollars
Millions of
Dollars
Bangkok
Central
North
Northeast
South
Total
Lost
Income
Male
68
82
41
29
23
242
Lost
Income
Female
12
15
7
5
3
43
Lost
Lost
Income All Income All
Prisoners
Drugs
80
51
97
62
48
31
34
22
26
17
285
182
Lost
Income
Yaa Baa
44
53
27
19
14
157
Several interesting demographic results emerged as well. Nearly 90 percent of sentenced
women prisoners are serving time for drug crimes, while just over 60 percent of men
were serving time for drug crimes. Also, counter to common wisdom, only about half of
foreign prisoners are serving time for drug crimes, with the rest spread out over a wide
variety of offenses.
A less precise but simpler way of calculating lost income from incarceration based on
Macroeconomic data is also an option. The number of persons in Thai prisons is
currently around 250,000. Out of a population of 63 million this represents about 0.4
percent of the population. The Thai labor force is about 34 million persons. Those
incarcerated represent about 0.72 percent of the labor force. Almost all of the prison
inmates could be considered to be part of the labor force. Prison figures do not include
children (sent to detention centers) and include very few retirement age people (greater
than 60 years in Thailand). With low current unemployment rates of 2.9 percent, almost
every person incarcerated could be working.
The Thai GDP is about 120 billion US dollars a year. 120 billion represents the sum of
the salaries of all of the Thai labor force. Therefore we can use 0.72% * 120 billion =
865 million dollars as an upper bounds on the amount that might be earned if no prisoners
were incarcerated.
Of those incarcerated, only 73% are for drug crimes – 59% related to Yaa Baa, and 14%
for other kinds of drugs. An upper bound of income lost due to incarceration due to
crimes involving Yaa Baa would be 510 million, or for all drugs 630 million dollars.
We use these figures as upper bounds since the average Thai prisoner would likely earn
much less than an average member of Thai society. In the analysis presented in the main
paper, lost income based on microeconomic analysis for the prison system as a whole was
only 300 million dollars, with 200 million due to drug cases. In other words, the
opportunity cost of the typical prisoner was only 1/3 the average for the country.
Average Lost Income to Family
If there is only one family member involved in drugs, the cost in lost income from
incarceration, or from not being able to hold a job, is roughly equal to the wage rate for a
person of that sex, region and education level as specified in the lost income due to
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incarceration section above. Of course, it is not uncommon for several members of the
same family to be involved in drugs, especially if selling drugs is an economic necessity.
There are a group of people who use drugs, but are involved in drugs first and foremost
for economic reasons. In such a family, as one drug seller goes to prison, another might
take over the business to support the family. Families in which the only income is
coming from the incarcerated person may try smuggling drugs into the prison to be sold.
Other Costs to Families of Incarcerated Members
The family often takes some responsibility for the costs of the imprisoned person while
he or she is in jail, including clothing, some food, and other minor expenses. It is
sometimes possible for prisoners to buy basic necessities in prison using an account paid
for by those outside. Prisoners are not allowed to have money inside the prison.
Those who cannot work because of drug use, must also be supported financially. The
average expenditure per person per day depends on family income, but could be
estimated at about 100 baht per day.
Social Costs of Illegal Drugs
Size Of Market for Illegal Drugs
The final cost of consumption on illegal drugs in Thailand was estimated at 48 billion
baht, or about 1.2 billion dollars. However, this cost is NOT part of social costs. It does
represents the value of the market for illegal drugs. However, one of the central tenets of
cost of illness studies is that the cost of consumption is not a cost to society, since no one
would buy pills unless they received that amount of money in utility. So, for example, if
I spend 80 baht on a methamphetamine pill, I would get at least 80 baht worth of pleasure
from it, or I wouldn’t have bought it.
Social Costs of Illegal Drugs
Social cost refers to the amount of welfare that society loses due to the presence of illegal
drugs. It does not include the cost of the drug itself, but does include the reduction in
welfare that drugs cause due to the costs of controlling/suppressing/rehabilitating drug
abusers, the suffering drugs cause in terms of health and loss of life, and the loss of
production due to health problems, mental problems, and incarceration. With that in
mind, the cost of illegal drugs to Thai society includes,
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Social Costs
Direct Cost in Thai Budget
Opportunity Cost - Incarceration
(All Drug Crimes)
Opportunity Cost - Mental
Hospital Psychosis
Opportunity Cost - Physical
Problems
Productivity Effects
Total Social Costs
Thai baht
8 billion baht
7.66 billion baht
US dollars
190 million dollars
182 million dollars
0.2 billion baht
5 million dollars
Uncalculated - could be
large if there is loss of life
None
15.86 billion baht
None
377 million dollars
The social cost of drugs is then about 16 billion baht (377 million dollars) but does not
include medical costs (thought to be low), or costs due to loss of life.
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Chapter 6. Conclusion and Recommendations
The Yaa Baa epidemic is not yet over, and only time will tell if this is really the peak of
mountain. Certainly, at this time the situation is looking more hopeful, but it is not yet
known if government interventions can remain successful.
The drug epidemic can be seen almost as a disease, which attacks the body. At first it
grows quickly before the body has mounted a defense. Then the body begins to fight
back, struggling harder and harder until the forces are tied. And finally the defense start
to win the battle, and the body is left weak, and in need of support.
There is still an enormous amount of work that needs to be done. The situation in the
prisons is among the worst in the world. There are a vast number of addicts that need to
be reached in some fashion, and coaxed through treatment programs. Some of those who
need treatment are at risk of being ignored, perhaps resulting in a festering problem
among the working poor for decades to come. The risk is that those high profile cases
such as the student population will be cured quickly, after which the anti-drug fervor will
die down and leave the working poor untreated.
There is also a risk of concluding that the problem is solved too quickly, cutting off
support to many thousands of addicts who still need help, and weakening the forces
currently mustered to fight the use of drugs. If we claim victory too quickly, just like a
disease the drug problem will come back again, stronger and more virulent than at first.
In brief, this paper found the following.
Thai prisons are crowded and the number of prison population is high relative to the rest
of the world. Conditions in Thai prisons are abominable. There are also a lack of drug
treatment facilities and the lack of follow-up for those who are treated.
The social impact of illegal drugs is widespread among different social groups. Children
are the most vulnerable and drug use affects children in many ways: the educational
environment, the quality of education, and, at the worst, prostitution and crimes.
A drug free environment is important in keeping children away from drugs, and schools
play a very important role. The prevalence of drug use is highest in vocational schools,
followed by secondary schools and elementary schools. Although drug use in schools is
still a critical concern, there is evidence that the use of drugs by students is slowing.
Effect of drugs on educational attainment is negative.
Women are affected by drug abusers who are their spouses or other family members.
Difficulty in interpersonal relations, instability, economic insecurity, risk of sexually
transmitted diseases, and violence are often cited as effects of the drug abuse problems of
male partners. A small percentage of Thai women abuse drugs. They have less access to
treatment relative to men, due to greater social stigma for female drug users, immediate
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family obligations, and male-oriented treatment programs. Women also face issues
related to prostitution, and drug use during pregnancy.
Injecting drug users make up an increasing share of HIV/AIDS patients, partly because of
success in promoting safe sex. Although needles are readily available, more needs to be
done to make them available at places and times when they might save lives. Drug
abusers in prisons are vulnerable to HIV/AIDS since there is a lack of access to needles
for injection. Infection rates for those recently released from prisons are much higher
than for others. Stopping drug use in prisons entirely is probably not possible.
Drug use can put great strain on families, and can damage family relations as well as
cause financial problems. The drug addict's family might have to face the effects of
crime, including robbery, assault, suicide, accidents and fraud. Parents' attitudes toward
drugs and their own drug-using behavior can constitute strong influences on their
children, both for good and bad.
Another social effect of drugs is crime. Drug-related crime includes crimes for
trafficking as well as crimes for abuse. In the case of traffickers, the crime is against
society as a whole, and the punishment should be strong. In the case of drug abusers, the
crime is against oneself, and they are not considered dangerous to the society.
Incarceration might not be effective at slowing drug abuse and more effective
rehabilitation might be a more appropriate method to reduce drug abuse.
In general, Thailand has faced less problems with drug-related crimes than other
countries. Low drug prices and low unemployment rates reduce the need for property
crime often found in other countries.
The presence of large scale, profitable and illegal drug trafficking is an open invitation to
practice corruption. Corruption is ubiquitous all along the supply chain, and the ways
that those with power have found to extract money from drug abusers is astonishing.
Illicit drugs affect the Thai economy in various ways. To prevent and suppress drug
problems, the government has spent a steadily increasing amount of its budget on drugs.
Without the drug epidemic, the public resources could be used in more productive
activities. Government expenditures due to drug abuse were estimated. Budget priorities
have properly moved away from suppression and towards rehabilitation.
The equivalent of about 1% of Thai GDP is spent on illegal drugs each year.
Money laundering is widespread and easy in Thailand because so many transactions take
place in cash. The Thai Anti-money laundering agency is still in its infancy, but has done
a good job of tracking down the assets of convicted drug lords.
Illegal drugs can exert both positive and negative effects on productivity, but the net
effect cannot be determined easily on the individual level. However, at the societal level,
the net effect on productivity of illegal drugs in general is expected to be neutral.
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Illegal drugs are a drain on a society's resources. Part of the loss is the funds the
government uses to fight drugs or repair damage done by drugs. In addition, society loses
productivity as previously productive workers are locked up in prisons or mental
hospitals. Lost income from incarcerating drug-related and psychotic prisoners was
estimated. Finally, total social costs of illegal drugs were calculated, which mainly
consisted of 3 estimable components: i) direct cost in Thai budget, ii) opportunity cost
related to incarceration, and iii) opportunity cost related to mental hospital psychosis.
Other costs such as health costs and loss of life could not be calculated.
Recommendations
Due to lack of funds, and severe overcrowding from the government's strong arm
approach to drugs, prisons are unbelievably crowded and unhygienic. Locking up drug
abusers and small retailers probably does little to slow the flow of drugs, and creates
incredible hardships for both the abusers and their families, far out of line with the harm
they do to society. More attention needs to be given to how to improve the prisons and
preferably to lock up fewer low level drug chain participants.
There is a need for Thai society as a whole to take more of an active role in the
rehabilitation of drug users. Everyone feels like it is only his or her family that needs to
be watched, but we all have to look out for each other. If you know someone who is
addicted to Yaa Baa, how can you help encourage them to quit? Thai people need to see
drugs as a disease rather than an evil, and help cure it.
We need to take some responsibility for the problems that are spilling over to our
neighbors, and help them to avoid the problems that we have faced. We need to at least
share our experiences and knowledge with them.
Finally, now it is not the time to give up the fight. Although it is attractive to think that
drug problems can be solved easily, it is not so, and never has been in the history of the
world. Our great, great grandchildren will still be in danger from drugs. At this moment
people and resources are organized around stopping drugs. Once that structure is gone, it
will be hard to replicate. Let's make sure this battle is won.
In time, and with effort, we will be able to find our way down off the mountain.
122
The Following Appendices are not
included in the forthcoming United
Nations Publication.
They are included to supply further general information
about drugs that is not directly related to social and
economic effects.
123
Appendix A
Commonly Used Illegal Drugs and their Physical and Mental Effects
Introduction
Understanding a few rudimentary concepts about how the brain and body works can go a
long way towards understanding why drugs have the effects they do, and why they are so
popular and commonly abused. Many drugs work by short circuiting the body's centers
of happiness or pain in ways that cause pleasure, peace, energy, relaxation, dreams and
empathy. They do so in ways that can be dangerous, expensive, disruptive, hurtful to
others, and harmful to health.
Usually worse than any of the other harmful effects, is the sacrifice of the drug abuser's
ability to control his or her own actions / decision making / life. It is this concept of loss
of self control that is imperfectly captured in the term "addiction". Addiction can be
defined narrowly or physiologically as abuse of a drug for which there are physical
withdrawal symptoms. More often in the drug and alcohol literature it is defined in ways
that grasp at a lack of self -control. Does the abuser continue to use the drug even when
it is having an adverse effect on his or her life? Does the abuser crave the drug all the
time? Is the abuser willing to invent unlimited lies and rationalizations to be able to use
the drug, even in the face of people he or she loves? This is closer to the idea of
addiction.
Drugs are not bad for everyone. Many people use drugs, even illegal drugs, and do not
become addicted and do not have adverse health effects. Those who use drugs and do
NOT become addicted or harmed DO get positive benefits from the drugs. As mentioned
above, drugs bring pleasure, peace, energy, relaxation, a dreamlike state and empathy,
among other things, to those who use them. In fact, almost all illegal drugs currently
abused were created because of some physical benefit (heroin as a pain-killer, cocaine to
give stamina, amphetamines – diet pills, stamina, anti-depressant, barbiturates – sleeping
AIDS, marijuana - relaxant).This creates much conflict over what should be legal and
what should not.
Although society does not have perfect judgement, the drugs that have been made illegal
are the ones that have proven themselves over many years to have an adverse or addictive
effect on many people. When writing laws about drugs, the government must take into
account both the risk of addiction / harm and the benefits derived from the drug. If only a
small share of the users become addicted, and many others receive benefits from the
drug, it may be left legal. That is the case with alcohol. There is clear evidence that
alcohol can be addictive for many people, and that it causes many health problems, yet it
remains legal. It is still legal because so many people use it and get benefit from it,
without adverse effects. If society says that a drug is too dangerous to have around, those
who used to benefit from the drug will lose the benefits of using it. This often leads to
acrimony.
Those who continue to use illegal drugs need to be aware that their use may end up
harming others unintentionally. Their continued use of a drug helps maintain drug
124
networks, access to the drug and interest in the drug, that may lead to addiction and harm
to someone else, even if they will not become addicted themselves.
Most illegal drugs have physical effects as well as mental effects. This is no accident.
Most drug research is focused on solving problems of the body, and almost none on
trying to change the way people think. Most illegal drugs were invented to solve a
physical ailment and their effects on the mind were discovered later. It is not unusual for
people to take illegal drugs for the purpose for which they were originally invented. That
does not keep them from becoming addicted or harmed by the drugs.
More worrisome is when the dose that gives positive mental effects is stronger than the
dose needed for physical effects. Heroin stops pain and calms the mind, but at a dose that
might be attractive to the addict, it might slow the body enough that it stops breathing.
Often the physical harm described from illegal drugs is a dosage problem - the adverse
effects of taking far too much of what was designed to be a helpful drug.
Routes of Administration
Drugs can enter the body in a number of different ways, and the way of taking them can
have a significant effect on the experience of the user, and the risk he or she faces. All
common illegal drugs are psychoactive (they have an effect on the brain), and the
objective of the user is to get the drug into the blood stream where it will be transported
to the brain. Some methods of ingestion are much quicker at delivering drugs to the brain
than others. If the drug reaches the brain quickly it generally will have very different and
stronger effects than if it arrives slowly.
Eating - The slowest way to get drugs to the brain, and also one of the least certain ways.
Generally drugs that are eaten pass through the digestive system including the liver and
kidneys before entering the blood stream and passing to the brain. Along the way, some
or all of the drug may be metabolized (digested) or may be removed by the liver or
kidney as a contaminant. Whether this happens depends on the type of drug. Yaa Baa
generally passes through the liver, and is not metabolized, but uptake is slow. Heroin
cannot be eaten in this way nor can Yaa Baa's sister stimulant, cocaine. Dance drugs,
Kratom, sometimes Yaa Baa, and Marijuana can be ingested in this way.
Smoking - Smoking is one of the fastest way to get drugs to the brain, since the lungs
pass oxygen and other gases directly to the bloodstream where they are given one final
push by the heart and sent to the brain. Only eight seconds after smoking a drug it
reaches the brain. Compare this to injection, where the drug takes 14 seconds to reach the
brain. Smoking may send other unwanted chemicals along as well, and many
carcinogens are found in smoke. Heating some drugs can also destroy them. Yaa Baa,
Marijuana, and crack cocaine (normal cocaine burns up) are drugs that are generally
smoked.
Snorting - The mucous membranes in the nose are quite thin (the reason for nosebleeds)
and present another method of introducing drugs into the bloodstream. Only small
125
molecules can pass across the mucous barrier, excluding a number of drugs. Some forms
of cocaine are snorted, and occasionally a number of other drugs in powder form. Uptake
is again very fast, and reasonably safe since the mucous membranes keep many
contaminants out, though the drug can irritate the mucus membranes. Uptake rate and
amount will depend on molecule size. There are other mucous membranes in the body,
and although some might consider them a disgusting method to take drugs, they are
sometimes used as detection is made more difficult.
Injection - One of the fastest and most direct approaches, but also the most dangerous.
The body has mounted all sorts of defenses to keep things out of the bloodstream such as
skin, mucous membranes, the lungs, and clotting factors to seal wounds quickly. Any
direct injection into the bloodstream is dangerous since it allows biological contaminants
and impurities to enter freely. Drug overdoses are much more likely since a high level of
drugs can be delivered into the blood all at once. The risks are well recognized, and
usually drugs are not injected if there is an alternative. Heroin is usually injected, Yaa
Baa can be injected, though the final effect should be about the same as smoking with
much greater risk. In order to be injected, a drug must be easily soluble in water. Heroin
is used by mixing with water and heating, then injecting.
Inhalation - Similar to smoking, the drug is either heated or not depending on its vapor
point, and then inhaled. This approach is commonly used with solvents such as gasoline,
paint thinner or glue. The solvent may be sprayed on the inside of a bag to increase
surface area, then inhaled. Uptake is again through the lungs and is very rapid, just as
with smoking. Solvents were never meant as medicines and are very harmful to the body.
Common Modes of Ingestion
Oral
Methamphetamine
Heroin
Ecstasy
Marijuana
Inhalants
Kratom
Cocaine
Ketamine
Compiled by author
X
X
X
Smoking/ Inhaling
Snorting
X
X
Injection
X
X
X
X
X
X
X
X
X
These routes of administration are the same ones available for legal drugs, though
whenever possible drug companies prefer the oral route as it is widely accepted.
Solubility and Drug Testing
Entering the body - Drugs must generally be water soluble to cross the mucus membrane
or to enter the bloodstream. In addition all psychoactive drugs must be at least somewhat
fat soluble in order to pass through the blood-brain barrier. Fat soluble substances tend
126
to be taken up by body fat as well, explaining why former abusers may test positive for
drugs well after they have stopped taking them. The problem is particularly acute with
marijuana, which is extremely fat soluble. The body generally cycles though its body fat
in three or four months. People who are losing weight are the most likely to test positive
for drugs at a later date.
In interviews, we found that there were many ways to fool common drug testing
measures. Adding a little Yakult (yogurt drink) to one's urine was one example used.
Apparently many similar substances will work as well. There is a joke that claims that
one drug suspect submitted a urine sample with a tiny live fish in it!
Brain Basics70
1) The brain not only tells us who we are, what we are doing, and what we have done, but
it also controls some very basic and critical body functions.
2) The brain is extremely complex, with thousands of kinds of nerve cells. Drugs can act
differently on each of these.
3) The brain has an amazing ability to adjust itself temporarily or permanently to
whatever it experiences, be it chemical, memories, or sensations. This is the explanation
for most tolerance and withdrawal symptoms.
Brain Neurons operate by either firing or not firing. Both firing and not firing can cause
things to happen. Drugs often change the way we act by speeding up, or delaying the
firing of neurons.
To keep the firing of neurons at the appropriate level, the brain delicately keeps one foot
on the gas pedal, and one foot on the brakes. Moving either “foot” can change that
delicate balance.
The brain adjusts itself to keep this delicate balance. For instance, if a drug causes an
excess of happiness by exciting pleasure neurons, the brain adjusts itself to expect more
stimulus of pleasure neurons, bringing the mood down to normal. This is what explains
the build up of tolerance. It also explains depression or other withdrawal symptoms
(absence of increased stimulus) when a patient is recovering from a lack of the drug.
Physical tolerance and withdrawal operates in the same way, as the brain adjusts itself to
the presence of a drug, then suffers when it is absent.
Different parts of the brain may adjust at different speeds, so tolerance for some things
may take only a few days, and intolerance with abstinence occurring just as rapidly. In
other cases tolerance may occur more slowly.
70
Most of this section is based on a chapter of the same name in Buzzed (Khun et. al. 1998.) This is a very
valuable reference book about drugs written by 3 doctors from Duke Medical Center.
127
Many dangers from drugs occur as the drug slows several types of neurons at the same
time, e.g. slowing neurons that control heartbeat at the same time as slowing neurons that
control pain. When a person takes a drug it goes to just about every part of the body with
different effects in different places.
One of the most complex things a brain can do is to construct memories. Mostly drugs
do not interfere with existing memories, but a number of drugs including marijuana and
alcohol inhibit the laying down of new memories. That explains the black outs alcoholics
experience when they can’t remember things they did while drinking the night before.
Physical and Psychological Effects of Individual Drugs
Drugs have both positive and negative effects. In the following sections those effects are
outlined for the individual drugs. In general drugs can be divided into stimulants –which
speed up the body giving energy and happiness, sedatives – which slow down the body
and give peace and sleep, and hallucinogens – which change the way the mind interprets
the senses or how it experiences the world.
The effects of drugs depend on the interaction of three sets of variables - the
characteristics of the drug and the characteristics of the user.
Characteristics of the Drug
 pharmacological properties;
 route of administration, i.e. oral, smoking, snorting, injection (subcutaneous,
intravenous or intro-muscular);
 whether it is taken alone or together with other drugs or alcohol;
 level of purity and presence of adulterants;
 dosage level.
Characteristics of the User
 personality of the user;
 intensity or frequency of previous use;
 user’s pre-existing state of health;
 social and economic circumstances of the user;
 the user’s expectations of the drug’s effects.
 genetic composition
Structural Determinants
 social environment
 emotional environment
 physical environment
128
The existence of so many variables means that the effects of drugs can differ widely from
one individual to another. Some people may suffer no serious side effects from multiple
experiences or heavy dosages of drugs, while for others a single experience can lead to a
serious complications. People also differ in their innate tendency to become addicted.
Some abusers may become addicted after multiple experiences with a drug, others may
become addicted after a single experience. Anyone with the any of the significant risk
factors for drug abuse listed above should be extremely cautious about experimentation.
When drugs start to affect an addict's health, he or she may become worried and seek
treatment. Length of use is also a significant factor, as health effects are cumulative and
related to age.
Share who said Poor Health was the primary
reason for entering treatment
40%
35%
30%
25%
20%
15%
10%
5%
0%
Yaa Baa
Heroin
Opium
Marijauna
Inhalants
Alcohol
Cigarettes
Source: Drug Dependence Treatment Statistics, Ministry of Public Health
Smokers and drinkers were the most likely to seek treatment because of poor health. They
were also older than other groups. Inhalant users also sought help for medical reasons.
Inhalants are particularly dangerous for the body. Yaa Baa addicts showed the least
interest in seeking treatment for health reasons. This was the third most important reason
for seeking treatment overall.
Yaa Baa
Yaa Baa or methamphetamine is a stimulant, similar to cocaine, amphetamines,
ephredine and a number of others. Stimulants speed up the body, inspiring a fight or
flight response designed to help animals survive in the wild. When an animal faces a
predator in the wild, it either must fight with the predator, or it must run away. In either
case it needs to tap into its body’s emergency energy reserves. (Soldiers during wartime
often carry amphetamines in their packs for this very reason.) While giving the body
energy from emergency reserves, and the endurance to get away from trouble, the drug
also tells the body to put off normal functions like eating and sleeping. The physical
effects of Yaa Baa are valuable to workers, and occasional to dieters or those who fall
asleep too easily. Effects are likely to last 4-8 hours.
129
When Yaa Baa is smoked71 or injected it also gives the user a feeling of intense happiness
or euphoria. That feeling of intense happiness is extremely addictive. The body is
designed to pursue activities that are pleasurable to it, and often that is healthy. Food and
sex are several of the things that give us pleasure in this way. Stimulants provide a
shortcut to the chemical pathways to happiness. Once discovered it is a hard pathway to
ignore, no matter how much harm it does to the user.
Yaa Baa, if eaten, gives the user a general feeling of well being and confidence, as well
as physical strength and endurance, but it does not generally give a feeling of euphoria.
Many people abuse methamphetamines regularly for this generally feeling of well being,
but usually at much lower dosages than smokers or injectors.
Is Yaa Baa Addictive?
Yes and no. To answer the question, suppose we start with the similar question,
"Is sex addictive?" Certainly it is pleasurable to the extent that there is an
overwhelming and unstoppable desire to pair up with the opposite sex. However,
there are no withdrawal symptoms, and abstinence does not make you sick. It is
therefore psychologically addictive, but not physically addictive.
Yaa Baa is the same. Is it addictive? -See how many people use it everyday
around the world, in spite of its expense, social stigma and often strong negative
effects on their lives - That is evidence of addiction, whether they confess to being
addicts or not.
Because of potential disagreements about the definition of addiction and addicts,
the terms "drug abuse" or "drug abuser" or “substance abuse” and “substance
abuser” are often preferred to describe any person who uses illegal drugs.
The physical dangers of Yaa Baa are minimal at low dosages.
Although
methamphetamines are stimulants and therefore increase heart rate, and blood pressure,
and put stress on the liver and kidneys, all of these effects are minor unless the person
already has a weak heart, weak kidney, etc. Given that most drug abusers are young, and
therefore strong and healthy, it is not surprising that very few cases of drug related health
problems are reported, unless usage is high. With prolonged use, the damage to the body
could be greater.
Dr. Vichai Poshyachinda, Director of the Drug Dependence Research Institute,
Chulalongkorn University says that the greatest portion of users in Thailand, take 1-2
pills a few times a week. This figure is lower than those shown in Statistical Reports, but
71
In Thailand, Yaa Baa is usually smoked. Yaa Baa is used in a process called "Chasing" or sometimes
"Chasing the Dragon" The abuser starts by taking the foil off a gum wrapper, folding it lengthwise, adding
the a crushed Yaa Baa tablet, putting a lighter underneath and inhaling the smoke though a tube. Sometimes
Yaa Baa tablets may be crushed and smoked in a cigarette as well.
130
it was affirmed by Dr. Narong Sillapasakran, drug expert at Thanyarak Institute. At this
dosage, it has no bad health effects on the body at all.72
Is Addiction Permanent?
Most addiction professionals would say that addiction is permanent. Although a
person can become free from the craving for drugs or alcohol, and can be drug
free for many years, he or she is always at an increased risk of going back to
drugs. Former addicts should be aware of this and must avoid drugs at all costs.
-The Recovery Book (1992)
Effects at high doses
With higher doses - perhaps 10 plus pills a day, the stress on the body, and particularly
the kidneys, is much greater, and the risks are greater. The physical effects are also much
more pronounced, with shaking and eyeshot common. Drug addicts tend to become
nervous and keep to themselves when high. A number of people paint the picture of a
drug addict as a silent, nervous type. They agreed you should stay away from people like
that. At these doses, a behavior called "tweaking" becomes common. The addict
becomes increasingly engrossed in small repetitive, non-essential tasks. They may take
apart and put together small objects repetitively, or spend hours trying to get something
just right. They also tend to pick at their skin, which may lead to open sores.
In addition, the impression of speed will continue as they, in fact, become slower and
slower. If you ask them, they will say they are getting so much done, but actually they
are slow and ineffectual. Yaa Baa does not actually give a person physical strength, it
simply allows the person to borrow from emergency reserves. As those reserves are
depleted, the person starts to grind to a halt.
%
120
Route Of Administration Of New Cases Of Yaa Baa
97.3
100
1997
1998
1999
2000
2001
80
60
40
20
2.1
0.3
0
Injection
Oral
Smoke
Source: Drug Dependence Info System, Department of Medical Services, M. of Public Health
72
Ibid.
131
Tolerance of Yaa Baa is possible, with reports of some addicts using thirty pills a day or
more. In fact it is difficult to maintain such a large dosage for a long time, since the body
cannot tolerate it. Those who use very high levels of the drug tend to go through
repetitive binge episodes - using pills in great quantities for 2 -4 days, then sleeping for
several days.
One young girl who used to be a dealer told us that she used 30 pills a day
regularly “until she collapsed” At some point the need for sleep is so intense
that the person crashes for a couple of days. She said that the longest she
ever stayed awake at one stretch was for 6 days in a row.
Another problem is that methamphetamines inhibits appetite, meaning that addicts (who
are typically thin) may go for days eating little or nothing. Again this is something that
the body cannot tolerate, and will eventually rebel against. Drug addicts are almost
always thin, but their bodies will not allow them to use drugs until they starve.
Is Addiction Progressive (Does it Continual Get Worse?)
Addiction is thought to be a progressive illness with regular stages of
deterioration. An addict, who at first can lead a normal life, often learns to crave
the drug more and more until he or she becomes completely dysfunctional. The
only way to stop the disease is complete abstinence.
One group lists the stages of addiction as follows:
1) Introductory - Enjoying drugs, but not thinking about it much.
2) Maintenance - Beginning to adapt behavior to places and people where
drugs are available.
3) Disenchantment - Focus of life beginning to be based around drugs. Other
things take second place.
4) Disaster - Focus on drugs so complete that normal life has fallen apart.
- Based on www.eiconline.org web site material
Drug-Induced Psychosis
Although physical diseases stemming from Yaa Baa use are possible with high doses,
long periods of use, or with those who are weak, the most common and worrisome risk of
taking methamphetamine is drug-induced psychosis - a condition that is indistinguishable
from schizophrenic psychosis. It is this condition that gives the drug its Thai name of
“Yaa Baa” or crazy drug. Although there is not a clear relation between drug dosage and
psychosis, it is generally found in users who use significant amounts of the drug, such as
ten plus pills a day, or those who have used Yaa Baa for long periods of time. Psychosis
is a state of extreme confusion and paranoia. The person feels that everyone is out to get
him (or her). He will do irrational acts such as grabbing a hostage to reassert control
132
against an unknown enemy. Those who are psychotic feel that they are immortal and can
do anything. They may sometimes climb up high on buildings or undertake other
dangerous stunts. They may also be more inclined to be suicidal. Drug-induced
psychosis is a disease that is curable. Typically 3-6 months after quitting drug use, the
psychosis will go away.
Many news stories in Thailand deal with this frightening aspect of Yaa Baa. There are a
number of pictures or stories circulating around in newspapers and on the internet of Yaa
Baa addicts acting crazy, taking children or women to be hostages, or killing themselves
or their families. Actually, Yaa Baa related to violent cases are relatively rare, and are
most common in people who are angry or violent by nature. Yaa Baa related psychosis is
less rare, but does not strike the majority of Yaa Baa users.
The Thai Department of Mental Health have issued several conflicting reports about the
frequency of Yaa Baa related psychosis cases. The graph below comes from their annual
report.
According to this report, Yaa Baa related psychosis cases reached about 3,000 in 2002.
For a user population of almost 3 million, and an addict population of 540 thousand, this
would be an incidence of about 1 in 1000 for users, and 1 in 200 for addicts. Cases that
result in violence are much more rare.
Yaa Baa
Psychosis
3.0%
Total Thai
Psychiatric Patients
Other
Psychiatric
Problems
97.0%
in 2002 = 98,698
Thai Dept. of Mental Health Annual Report
Another publication of the Department of Mental Health, Mental Illness in Thailand,
2000-2001 suggests that the problem of Yaa Baa psychosis is growing rapidly and gives
figures that suggest an incidence of psychosis for addicts closer to 1 in 100 persons.
Suggestions for what you should do if you encounter a psychotic person can be found in
Appendix D.
133
Dr. Prach Boonyawongvirot, Director-General of the Mental Health Department, said that
mental illness may result from drug use, but conversely it may also follow mental illness
as patients try to cope with pre-existing mental health problems by using drugs. There
are a lot of mental health problems in Thailand right now, especially anxiety, depression,
and personality disorders, and these sick persons tend to use drugs as a solution. Drug use
can also cause mental health problems other than psychosis, as individuals experience
anxiety from striving to conceal their drug use, and alienation from their family.
Heroin
“Several senior students died while intravenously injecting heroin. Two dead
students were founded in the same apartment. One was a senior student at the
faculty of Economics, Dhurakitpundit University and held the position of
president of the rural development volunteer camp. He died on his bed with a
needle still stuck in his left arm. The other student was also in the same
faculty. This student was found in a squatting position with his head bent
towards the floor. There was also a needle in his left arm.”73
Heroin, Opium, Morphine, Codeine, all belong to a class called opiates which act to slow
the body and also act as anesthesias. This class is noted for its ability to reduce pain, thus
heroin numbs the body to any pain, and indeed to any outside stimulus. Heroin was an
invention of the Bayer company, which was trying at the time to make morphine more
effective by making it more fat soluble so it could cross the blood-brain barrier
effectively. They were far too successful. The active ingredient in heroin is actually just
morphine, delivered in very high doses.
All of these drugs are dangerous in that they slow down the body, and if taken in too
great a dosage, can slow the heart so much that it simply stops. Since heroin is a powder,
and very expensive, it can be cut (mixed) with other powders to increase profits. These
other powders can be dangerous to the body, since they are injected into the bloodstream.
The greatest danger of overdose occurs when the addict is exposed to heroin which is
uncut after using the adulterated kind. The great jump in dosage can kill them. The body
can build up a tolerance to almost any level of heroin, but the buildup must occur
gradually. Most heroin addicts buy until they run out of money.
The heroin addict is a normal person most of the time. He or she must use the drug
generally at least twice a day. After injecting the drug, the first reaction is sleepiness, so
he might nod off right away, which explains the frequent pictures of heroin addicts
slumped over with needles still in their veins. Then the addict will feel a feeling of calm,
lack of pain and dimming of most sensations. Physically, their breathing slows, and their
skin may flush. Pinprick pupils are also a mark of a heroin addict. For long-time addicts
these feelings will pass in about an hour. They then act completely normal for ten to
twelve hours when an intense craving drives them to inject again.
73
Siamrat. 16-2-1999. “2 University Students Die while Injecting Heroin”
134
Heroin users are usually very careful about changing needles and can be mostly law
abiding citizens except for narcotics laws. The problems arise on those occasions when
they cannot get heroin. Perhaps there is a shortage, perhaps they have no money, perhaps
they have heroin, but no needles. At this point they will do ANYTHING to get access to
heroin. They steal from their family and boyfriends or girlfriends, which is why they
cannot maintain relationships. They can steal, rob, and pester everyone around for
money, and if they cannot find a clean needle they will also risk their own health as well.
A Yaa Baa addict is also addicted, but if Yaa Baa is not available for 2 or 3 days, he will
not take it. For heroin users that is not an option.
Because of its very high physiological addictive effect, abusing heroin only a few times
is enough to become addicted. Some people feel that smoking heroin will not make them
addicted. That is not true, especially if the heroin is of high quality. Usually the addict
will smoke heroin at first, become addicted, then switch to injecting because they get
more for their money. That is, it takes less heroin for the same effect if it is injected.
Normally, it is 4-8 times and 30-80 times more potent than morphine and opium
respectively. Heroin depresses the central nervous system and is used as a euphoriant and
as a means of reducing anxiety, boredom, physical or emotional pain. It reduces outside
stimulus from the body. Thus abusers would be relieved from any pain, feel comfortable,
be in a rapture, drowsy, and do not care about anything around them.
It is often preferred by consumers because it is potent, easily dissolved in water for
injecting and penetrates the blood-brain barrier very quickly. Abusers mix a small amount
of heroin with water on a spoon, heating it slightly, then injected. Effects may last from
4-6 hours for new users. As shown in the accompanying table, the trend of administration
has been slowly moving away from injection. Thus the proportion of heroin-injecting
abusers has declined from 69% in 1997 to 60% in 2001, whereas the smoking abusers
proportion has increased from 31% in 1997 to 39.4% in 2001.
Some of the most severe effects of heroin abuse stem less from the drug itself than from
unhygienic injecting practices which cause hepatitis, HIV and AIDS and the wider
diffusion of these disease by sexual contact. It is generally believed that injecting heroin
users are more severely dependent than smoking users because injecting is the least safe
but most cost-effective way of using illicit drugs. It is also possible to take more of the
drugs by injecting since smoking users tend to fall asleep before they reach the point of
overdose.
135
%
80
Route Of Administration Of New Cases Of Heroin
70
60
60
50
1997
1998
39.4
40
1999
30
2000
2001
20
10
0.6
0
Inject
Smoke
Inject/smoke
Source: Drug Dependence Info System, Department of Medical Services, M. of Public Health
Heroin users may have bad health, with decreased weight and may suffer from a variety
of blood borne, and other ailments. Heroin overdoses result in suddenly death, and are
difficult to control because purity cannot be assured. On the whole, heroin is the most
common substance associated with drug-related deaths.
For heroin users, the prison uses a "cold turkey" approach in which the heroin addict
stops using drugs as soon as entering. Thanyarak and other treatment centers often use a
methadone treatment instead, so occasionally drug addicts are shipped between the two
types of programs if, say, the cold turkey approach will not work for one prisoner.
Ganja (Cannabis, Marijuana)
Ganja is generally smoked, but can also be eaten. Besides being smoked as a joint or
cigarette, abusers may also use a bong, which allows the smoke to be bubbled through
water. Nowadays youngsters may also smoke ganja by mixing it with tobacco in a
cigarette – which is called “Yad Sai” or “Pan Lum.” All of those in treatment for ganja
used it by smoking.
136
%
120
Route Of Administration Of New Cases Of Marijauna
100
100
1997
1998
80
60
1999
2000
2001
40
20
0
0
0
Inject
Oral
Smoke
Source: Drug Dependence Info System, Department of Medical Services, M. of Public Health
Ganja contains THC, a substance that gradually affects the nervous system. It can be
classified as a sedative, but it also has hallucinogenic effects which may last up to several
hours. When smoked, the drug is absorbed quickly into the bloodstream and reaches the
brain within seconds. Since ganja has a relaxing and mood enhancing effect, at first,
abusers feel many emotions, such as feeling joyful, excited, depressed, or talkative, and
some may feel like they can drift, or that time slows down. Patterns become intriguing
and absorbing. It often makes people feel like laughing. Later users will feel hungry (it
is sometimes used as a food additive for this purpose in Cambodia) and may have
hallucinations. Sometimes a feeling of paranoia results. Some people use ganja to relax,
or to sleep after using Yaa Baa.
THC, the active ingredient in ganja, is also found in chocolate. However
THC is a lot less concentrated in chocolate. A hopeful druggy would have to
eat 25 pounds of chocolate to get the same buzz as from a single ganja
cigarette. The sugar buzz from 25 pounds of chocolate must be amazing
though.
One may conclude that, in Thailand, the impact of Ganja use on physical and mental
health is low compare to other drugs.
Yaa E (Ecstasy)74
Yaa E gives the user a warm, empathetic feeling, that makes people feel at home with
strangers. It is a derivative of Yaa Baa, so it also has stimulant qualities. It leads people
to be interested in sex, but unable to act on that interest. It fits in well with the nonalcohol, non-violent rave parties, best exemplified by the full moon parties held by
foreigners in the southern islands of Thailand. Some people in Thailand think of Ecstasy
as a "women's drug", although there are still more male users than female users.
74
Saunders (1995) provided background for this section.
137
Yaa E is not very popular in Thailand because it is too expensive. The effects are popular
among users, but at 500-800 baht a pill it is outside the price range of most Thai people.
Worldwide, concern about health effects has mostly focused on long term damage to the
brain - very controversial since it involves animal studies with extremely high dosages,
and about those who have taken it for dancing, then danced themselves to death because
of weak hearts, or interesting because of drinking too much water. Apparently the drug
makes you thirsty, and it is possible to drink enough to kill yourself. Mixing ecstasy with
methamphetamines increases the risk of overheating.
In Thailand, Yaa E and Ketamine are both drugs of the well-to-do, and are often found at
parties with groups of stars, foreign-educated students, and high society people. The
drugs are probably often brought in by one in the group who has been travelling abroad.
They have a cachet about them which is attractive to those who want to appear worldly
and well off. It is a social drug, and is almost never taken alone.
Yaa E is usually taken orally by swallowing, but can also be injected or smoked. It takes
effect within 30-60 minutes and has a half-life of about 6 hours. Although usually taken
orally, some youngsters do so by putting it in a beverage75, which could just be water. As
the drug is metabolized some of it is converted into MDA, a different illegal drug.
The recent emergence of Yaa E injection has added a new and much more harmful
dimension to the drug which was previously considered a clean drug because it was taken
orally. The normal dosage is around 1-2 milligrams for each kilogram of body weight.
Since the average weight of Thai people is around 50-70 kilograms, they could tolerate
only 1 or 2 pills (50-100 milligrams) each time.
In Europe, where the drug has been most popular, many people take it only during the
weekend to go dancing, then do not use it during the week. It is thought to be much less
addictive than Yaa Baa, although this weekly pattern can persist for years.
Inhalants (glue, gasoline, paint thinner)
Almost every drug in this report was first used medically, then discovered to be addictive.
Inhalants are the exception, and in fact are poisons. The range of toxins in inhalants are
impressive. Physically, inhalants give the user a warm and fuzzy feeling. Inhalants are
used by putting the drug in a bag and inhaling them. Inhalant use has been increasing
since the recent police suppression of Yaa Baa.
Inhalants are commonly used by young people because they are the only drug that can be
obtained legally. Even where cigarettes and alcohol are age-restricted, gasoline and glue
is still available to kids.
75
This is a traditional way to take many kinds of drugs in Thailand. Beverages can include water, soft
drinks, or energy drinks. I have not heard of mixing with alcohol yet.
138
Drugs and Sex
Late nights and irresponsible behavior have led drug use to be associated closely with
sex, and particularly risky sex. Different drugs are thought to have different effects on
sex lives. By far the most prevalent drug in this arena is alcohol, which reduces
inhibitions and is responsible for increased sex and less safe sex. Other illegal drugs are
also associated with sex.
Ganja/ Marijuana - Marijuana has long been associated with sex. It is thought by
many to enhance the sexual experience or add new dimensions to sex but may not
actually increase interest in sex.76
Heroin - Heroin numbs and calms the body so it is not associated with sex except for
increased prostitution to raise cash for drugs.77 That may in itself a frequent way for HIV
to spread.
Ecstasy (Yaa E) - Ecstasy, the "hug drug", enhances pleasure from touching and
intimacy and makes people feel closer to one another. In spite of this, it lessens the
desire for sex, the ability to perform sex acts, and enjoyment from orgasm.
Yaa Baa (Methamphetamines) - Yaa Baa78 is thought by some to be an aphrodisiac,
but is best known for giving endurance during the sex act, and for allowing for long
periods of love making that may go on for days. It may be associated with rougher sex.
Large and frequent doses reduce the ability to perform sexually.
Ketamine - Ketamine has a reputation for having a "cold" feel about it that makes sex
almost impossible. It is also used to medicate against unwanted erections during
operations. However some people feel that coming down off the drug makes them very
interested in sex. 79
Common Health Problems among Thai Drug Users
What kinds of physical and psychological ailments are found most often in Thai drug
users? The following study comes from Thanyarak Hospital, one of the premiere
rehabilitation centers in the country. Of a total of 5,874 inpatients admitted in 2002,
51.5% of them had some sort of physical or psychological problem. Although results are
not broken down by drug, overall 78 percent of Thanyarak's patients are seeking
treatment for Yaa Baa addiction. By far the most common problems were psychological
problems, such as dysfunction or imbalance in thinking, mood, or behavior which led to
alienation from the society.
Disease among Inpatients at Thanyarak Institute in FY 2002
Disease
Persons
76
Stafford 1992, Psychedelics Encyclopedia
Fernandez 1998, Heroin
78
Klee, ed. 1997, Amphetamine Misuse
79
Jansen 2001, Ketamine: Dreams and Realities
77
% of Total
139
Psychiatric System
Respiratory System
Digestive System
Skin System
Muscle and Bone System
Nerve System
Blood Circular System
Urogenital System
Others
Total (5,874 inpatients all year round)
Source: Thanyarak Institute80
1,173
500
340
305
291
108
103
22
181
3,023
20.0
8.5
5.8
5.2
4.9
1.8
1.8
0.4
3.1
51.5
Another study, carried out in 2001, emphasized only physical problems, and showed that
31% of drug addicts had been coping with some form of physical deterioration, such as
weakness, emaciation, or facial ticks (facial ticks are a sign of high doses of Yaa Baa).81
80
81
Thanyarak Institute. 2003. Interesting Statistics: Fiscal Year 2002. Disseminated Leaflet.
Nathee Chitsawang et. al. 2001.
140
Appendix B
Treatment Options for Thailand
What Does a Drug Treatment Program Require?
A treatment program consist of three components: detox, rehabilitation and follow-up.
All three components are important, and have different methods and objectives. Even
with all three components, a large number of drug addicts may relapse, but a reasonable
effort on each of these elements will increase the success rate enormously.
Detox
Objectives: Freedom from chemical dependence and from the immediate emotional
instability of quitting drug use.
Timeframe: varies from a few days to months
Methods: Heroin – admission to detox clinic. Yaa Baa – outpatient treatment is possible.
The objectives of the detox (detoxification) stage of treatment are to get the drug out of
the patient’s system, and to deal with the immediate withdrawal symptoms of doing
without the drug. For heroin or other opiate users, this may involve serious physiological
changes which result in “muscle and bone pain, insomnia, diarrhea and vomiting, cold
flashes with goose bumps ("cold turkey"), kicking movements ("kicking the habit"), and
other symptoms.82” Withdrawal symptoms for Yaa Baa are psychological and include
depression and disorientation. Heroin detox takes about one week for the physical
symptoms to subside, probably longer for the psychological effects which also include
depression, Yaa Baa detox may last as long as two weeks83.
Measures of success: Significant reduction in physiological and emotional instability,
and integration into a rehabilitation program
Rehabilitation
Objectives: Behavioral change to regain control over the urge to use drugs.
Timeframe: the longer the better – from 6 weeks to a year or more
Methods: Inpatient care in a rehabilitation clinic or hospital, outpatient care in the same.
The objectives of the rehabilitation stage of treatment are to help the addict to regain
control over the desire to use drugs, to keep the user from using drugs which would
require a jump back to detox, and to help the user build healthier ways of living and
82
83
http://www.heroinaddiction.com/heroin_addiction.html
UNODC 2003b
141
coping with problems which will be necessary for long term health and freedom from
drugs.
Successful programs will make use of a combination of self-help – where the client
admits to drug addiction and works on a program to be free of it, mutual support - where
he works with a group in which members help each other to remain drug free, and better
living strategies – where he develops ways to live drug free and solve problems without
using drugs. It is far better if the counselors were once drug addicts themselves, and have
had experience with the problems that arise, or if they have had professional training.
One element of most successful training programs is a twelve step program as outlined
below which incorporates self help and mutual support.
Sometimes programs need to address issues of physical needs for food and shelter for
former addicts, and some programs need to be available for those with mental illnesses as
well. Separate groups for women are a necessity in Thailand.
Families and the community should be involved as much as possible in helping the drug
addict through the program, as the factors which led the user to become addicted are
probably still present. Friends and family still addicted to drugs should be avoided during
treatment.
Measures of success: Keeping the addict drug free during rehabilitation, emotional
stability and ability to cope with problems without using drugs, and the ability to live
drug free.
Follow-up
Objectives: Integration into society in a healthy and drug-free state.
Timeframe: varies, with biggest effort soon after rehabilitation, but can go on for years.
Methods: Counseling including about jobs, half-way houses for those in danger of
relapse, mutual support groups.
The follow up stage has two main goals – to get the addict reintegrated into society in a
healthy and stable way, and to keep the addict healthy in the long run. The first goal is
accomplished by helping and/or monitoring the addict in the search for jobs and housing.
The second part is best accomplished through a mutual support group where participants
can listen and help each other through problems and encourage each other to remain drug
free. The risk that the addict will return to drugs will always be present. The family and
community need to help the addict in his efforts to stay drug free. That includes the
family creating a caring environment in which drugs are not needed, friends not to tempt
the addict to use again, the boss to be clear on a position that is supportive, but against
drugs, and the community as a whole to maintain an environment where drugs are not
always available as a temptation, and drug use is not tacitly condoned.
Measures of Success: Relapse Rates, Healthy Integration
142
Common Treatment Options in Thailand
Therapeutic Communities (TC)84
Therapeutic communities have been used for drug rehabilitation for forty years and have
proven themselves through the test of time to be one of the most successful treatment
methods available. A therapeutic community is an intensive inpatient program which
makes use of mutual support and group interaction and analysis to teach addicts to
understand their addiction. The TC operates in a tightly controlled environment in which
participants have to follow house rules, earn privileges, go through intense self-analysis,
and participate in many group activities. The TC community provides a “new family.”
To promote a sense of family, participants conduct group discussions as if they were
relatives. Many other activities are designed to build community.85
Several aspects of the program help to make it a success. . The focus is also on coming to
understand and deal with the underlying causes of their drug use so abusers won't need to
return to drugs. The tight schedule leaves participants with little or no time to think about
drugs. Some aspects of TCs can be harsh, such as when residents break rules and are
subjected to the recriminations of the community. Another problem with TCs is that the
environment is so far from what is generally experienced outside that leaving the
community can be a shock in itself. However, with proper follow-up, TC success rates
are quite high. Because of its cost and intensive nature, TCs are usually used with the
worst addicts who need a lot of change in the way they deal with the world. Many of
these are heroin addicts.
The best known TC in Thailand is that run by the prison system, and in operation
continuously since 1993. Since the government has to lock up drug addicts anyway, it is
a natural time to put them into a treatment program. The prison program is well-run, and
well-thought-out, but cannot hope to cope with the hundreds of thousands of drug
prisoners who come through the system. Instead entry into the program must be strictly
limited, with the greatest focus on heroin users. In 2002 the program treated about 7,000
prisoners. That left more than 100,000 drug crime prisoners untreated.
Running successful TCs is difficult and requires well-trained staff. It is also a very
expensive treatment option. Probably the biggest problem with establishing TCs in
Thailand is the lack of funding. TCs would only be accessible to a very few people, and
would take up a lot of a scarce drug treatment budget.
84
Parts of this heading were taken from Therapeutic Community, NIDA 2002, and from Hooked,
Shavelson 2001
85
Department of Corrections. n.d. The Solution to Problem on Drug-Addicted Prisoners and
Therapeutic Community.
143
Inpatient versus Outpatient Drug Treatment Programs
Inpatient programs are generally less intensive, less intrusive on normal routines,
less expensive to administer, require less trained staff, and are probably less
effective at treatment. Are they a “lesser” option?
It’s the money first and foremost. - The biggest issue for the Thai
government is money since most Thai addicts cannot pay much, if anything, for
their treatment. The idea is that it is better to treat a large number of addicts as
outpatients rather than a small number as inpatients. It was estimated that the
Matrix program in Thailand will cost only a tenth of an inpatient program.86
Yaa Baa addicts may need less intensive programs - It is also thought
that Yaa Baa addicts may not need the same intensive treatment that heroin
addicts receive, and many organizations, including the UNODC are
recommending the Matrix program (an outpatient program) for stimulant
addiction. Heroin addiction often pulls addicts further away from leading a
normal life than does Yaa Baa addiction in terms of crime, loss of work, and loss
of relationships, so Yaa Baa addicts often need less intensive programs.
Advantages of outpatient programs - There are also some clear advantages
to outpatient programs as addicts can continue their jobs and their role in the
family, they are not as removed from everyday life so the transition after
treatment is much less serious, and the effect on family income is minimized.
Whichever program is chosen, it is important that it goes on as long as possible,
and that some follow-up be included to make sure addicts get the benefits
intended. Currently, about 75 percent of those undergoing treatment for drug
abuse in Thailand are in outpatient programs.
Matrix Program87
The Public Health Ministry has proposed using the outpatient Matrix Program as the
principal method for treating Yaa Baa dependence. The program, first introduced in the
United States in 1984, was designed explicitly to help those addicted to stimulants such
as speed and cocaine who were sent to the program by court order. Introduced in
Thailand in 2001, the matrix program has the following objectives: Stimulant addicts
should be able to achieve the following a) cease drug use, b) stay in treatment, c) learn
about issues critical to addiction and relapse, d) receive direction and support from a
trained therapist, e) receive education for family members affected by addiction, f)
become familiar with self-help programs, and g) receive monitoring by urine testing.88
86
BMA AIDS web site in Bangkok
UNODC 2003a has a useful summary of this topic
88
NIDA web site
87
144
In Thailand the program is designed to last for 4 months (16 weeks), although the
UNODC recommends a 12 month program. Addicts meet for three two-hour sessions
each week, The follow-up component is a mutual support group such as a 12 step
program.
The training program tries to win over addicts using a positive approach. Without
criticizing or blaming the patients or families, it explains how drug abuse is a disease that
must be fought against. The program teaches family members along with addicts and
covers topics such as how to keep drug users from relapse, how to build social support
networks, how to learn to solve problems without drugs, etc. By involving family
members it is hoped that the addicts will continue to have the support they need to
continue without relapse. In comparison to Matrix programs used in the west, the
emphasis in Thailand is more on family involvement and traditional social support
networks, and less on psychiatric counseling and written treatment manuals.
Twelve-Step Programs89
Alcoholics Anonymous instituted its twelve-step program in 1935, and the same program
has been adapted to fight addiction in almost every form imaginable. Narcotics
Anonymous, Cocaine Anonymous, and Pills Anonymous are some of the programs
important in fighting drug addiction in the states, and almost every drug treatment
program including therapeutic communities and the Matrix program incorporate some
form of a twelve step program. The core of a twelve step program is a mutual support
self help group. These groups meet very often (addicts must attend every day for the first
three months) and participants are supposed to share their life stories and problems.
Since all the participants are former drug users, the group is very supportive of efforts to
quit, and has a lot of collective expertise of how to do so. A mentoring program is a
significant piece of the program so that some individual has primary responsibility for
helping every addict, but the desire for help must come from the addict himself.
The twelve steps themselves refer to twelve progressive steps that each addict must go
through on the road to recovery, which are primarily concerned with admitting that a
problem exists, self analysis, and helping others. There is also a strong spiritual element
to the 12 steps, which explicitly refer to the existence of a ‘higher power’ and appeal to
that higher power for help in fighting drugs/alcohol. This has made 12 step programs a
subject of controversy as some perceive them as promoting religion, or a particular
religion. In practice the definition of higher power is left completely up to the addict,
which allows for interpretations including the group itself as the higher power, which
neatly sidesteps the issue of religion. The proof of the twelve step program is the
enormous success it has had at curing alcoholics worldwide.
Although pure 12 step programs are rare in Thailand, the content of a 12 step program is
an integral part of both the Matrix program and the Therapeutic Community, and most
other modern treatment options.
89
One good reference for this topic is The Recovery Book, Mooney et. al. 1992
145
God and the Twelve Steps
The twelve steps of alcoholics anonymous have a strong spiritual side. In fact six
of the twelve steps refer explicitly to God, or to a "Higher Power." This has
complicated the adoption of twelve step programs in countries with religions
other than Christianity. The problem is particularly acute in Buddhist countries
as Buddhism does not make reference to any God or higher power. Liberation is
supposed to come from within, by freeing the mind from the body. The Buddha
acts as a guide or teacher in this respect, but is not standing by watching over us,
in the way the Christian God does.
A number of attempts have been made in the US to create alternate twelve step
programs that do not depend on god or spirituality. They attract a much smaller
membership than does AA, but may be appropriate for those development in
Thailand if the above approach is not successful.
Quoting from the 12 steps of Alcoholics Anonymous…
Step Three: Made a decision to turn our will and lives over to the will of God
as we understood him.
Step Seven: Humbly asked Him [God] to remove our shortcomings.
Step Eleven: Sought through prayer and meditation to improve our conscious
contact with God as we understood him, praying only for knowledge of His will
for us and the power to carry that out.
Recovery Book (1992)
Harm Reduction
The treatment programs described above emphasize that the only way to stop using drugs
is to stop using them absolutely – never taking another pill in your life. Harm reduction
takes a different tack. Assuming that some addicts cannot quit, or at least cannot quit at
this time, harm reduction concentrates on reducing the harm resulting from drug use. The
biggest push has been with heroin addicts, and other drugs that are injected, but harm
reduction can refer to any activity used to minimize the harm from any drug. In reference
to heroin, the biggest effort is to reduce the likelihood of contracting or spreading AIDS
through the sharing of needles. Some activities used to reduce risks are distributing or
trading clean needles for old needles, lobbying for easier access to buying needles,
promoting the use of safe sex by drug users, educational materials on the harmful effects
of drugs and risks of overdose, and many other activities. Methadone clinics are often
associated with this movement as well although methadone is used as a way to break
heroin users of heroin use. This movement is particularly strong in Europe and Australia,
though it has a significant voice in many countries of the world including Thailand,
especially among NGOs. Since it accepts the presence of drug addicts as an ongoing
reality it is difficult for governments to accept a harm reduction platform.
146
Drug Treatment Programs for Young People
Most drug treatment programs are designed for adults, and may not work well for young
people. For instance, therapeutic communities, the matrix program, and twelve-step
programs all depend on a fairly high level of maturity of the participants since they are
required to understand themselves and their situation well enough to be able to make
difficult adjustments in their life decisions. Since many of the persons addicted to drugs
in Thailand are quite young, it is helpful to consider the kinds of programs that have been
more successful with youth and children.
In general, children have a weaker idea of what they will face in life, what kind of person
they are, what societal values expect of them (particularly if they grew up with little
supervision) Programs for children require less introspection, and depend more on
interpersonal skills, teaching societal values, and teaching occupational skills and indeed
treating the patients as children. In Sweden, training programs for youths emphasized
"training in social norms, education and training of new patterns of behavior" while
training programs for adults emphasized "equality within the staff and between staff and
clients, voluntary treatment, open communication and shared responsibilities."90 A child
oriented program in Thailand is described below.
Monks and Soldiers
Success at recruiting addicts into treatment.
In many western countries, attracting addicts to enter treatment programs is difficult.
Addicts are naturally shy of authority or any place where they feel they may be identified.
One of the primary benefits of needle exchange programs is to establish contact with
some of the users the program is trying to help so they can be drawn into treatment
programs.
One model run jointly by monks and soldiers has had some success at recruiting young
drug abusers in Thailand. To enlist young people to the rehabilitation program monks
and soldiers bring the process of recruiting rehabilitation patients directly to schools.
Teams of soldiers and monks hold camps either at schools around the country, or at
temple events designed for the purpose. During a three day program students are taught
about the importance of love for six themes central to Thai culture – family, school,
temple, country, king and self. They are shown how using drugs hurts all six of these
"loves".
The monks and soldiers explain that those who use drugs are in trouble and need help,
and that they have come to help rather than to judge or blame anyone. Anyone who
confesses to drug use will not be prosecuted – instead the monks and soldiers will help to
cure them. The presence of both monks and soldiers lends credibility to the claims. The
students do not want to lie in front of the monks. They also trust the soldiers not to arrest
them with the monks present to hold them to their word. The response to being treated
90
Kall 1997 in Klee, ed. Amphetamine Misuse, p. 223
147
seriously and warmly is amazing, and many students give themselves up and enter
treatment. Although this particular program is run by soldiers and monks, a number of
community based programs in Thailand make use of this same basic technique.
Students crying as they give themselves up, confessing to their prior use or selling of
Yaa Baa.
Students at a three day event at which many of them will confess to drug use and give
themselves up for drug treatment and rehabilitation. Note the monks in the
background.
148
Rehabilitation – Thai Style
The Six Loves - All are Hurt by Drug Use
Love of …
Self
Religion
King
Family
Country
School
As explained by Phra Acharn Veerapan of Wat Chuchitthammaram - If the student gives him/herself
up for treatment, he or she will 1) not be prosecuted, 2) agree to give up drugs for good, 3) agree to
go to one of the special treatment camps.
Special Treatment Camps
A drug rehabilitation center for youths and students run by monks in Wang Noi district,
Ayutthaya, has been in operation for four years. The center can take up to 1,000 young
people at a time, initially for a three-day rehabilitation course. Those found to have used
drugs but not yet addicted undergo another 15 days of treatment, while addicts are treated
for another 45 days.
The treatment at the camp is based on building self-esteem and judgment, as well as
knowledge about drugs.
Students are engaged in practical activities and training.
Although living conditions are Spartan, with students observed eating less than
appetizing food, and sleeping on the floor, students seemed content. This author's feeling
was that virtually all young people, with or without drugs, would benefit from this sort of
esteem building exercise.
149
Rehabilitating Student Drug Users
Students planting and harvesting rice.
Source: Wat Chujitthammaram
Another activity involves building an entire house with only three tools – an axe, a
hoe, and a knife. Teams of students are given only 15 days to complete the activity.
Success in staying off drugs after the camps may not be great, however. The treatment
period is short, and little or no effort is made at follow-up. Some of the worst abusers
stay on at the camp as counselors, which is probably the best place for them.
150
Appendix C
Drug Suppression and Law Enforcement
Enforcement
Law enforcement is not an easy job. It can be difficult, boring, dangerous, and frustrating
all at the same time. The skills required depend on the assignment, but for those
involving drugs the most important skill is often intelligence gathering.
Intelligence Gathering
Some crimes require intelligence gathering after the crime, and others before the crime.
With crimes of passion there is rarely any way to know who will commit a crime, or
when or where. If a bar fight breaks out and results in a homicide, although certain
locations may have a bad reputation, the night and time of the fight is hard to predict.
Intelligence needs to be gathered afterwards to convict the perpetrator of the crime.
On the other hand, repeated crimes are usually solved by catching the criminal in the act
of committing the crime, so the intelligence needs to be gathered beforehand. This is the
case with repeated crimes such as selling illicit drugs or burglary. Intelligence gathering
involves discovering who is actively committing crimes, then finding out when and
where the crimes will be committed through intelligence. Once a person has been
convicted once in association with a particular crime, it becomes much more difficult for
him to break the law, but even if the suspect has no prior record, the police often have
good evidence due to reports by others who are involved in the case.
Crimes also differ in how easy they are to identify. A car accident is inherently
transparent, as are many property crimes as the victim will report them. Physical injury
will also be reported in most cases. (Rape may be an exception.) Other crimes may fall
into a category which are hard to detect. Neither the buyer nor the seller wants the crime
to be reported. Therefore police need to spend a great deal of time simply discovering
what crimes are being committed. On the other hand, the repeated nature of the crimes,
makes it worthwhile to try to find out about drug crimes whenever possible. Much of the
effort police exert when suppressing drugs is through intelligence work..
Police have good sources of information…
One of the key sources of intelligence for the police are reports by those already arrested
or convicted. Those arrested are usually required to complete two documents which
assist the police in drug suppression efforts. The first is the drug network diagram which
gives information about everyone the arrested person knows in the drug supply chain.
This chart will includes information about the supplier the arrested person buys from, and
may include information about higher levels of the supply chain. A drug addict may
know full contact information for his supplier, but only sketchy information above that
level, such as that the drugs come from Chiang Mai, or a phone number. All useful
contact information is recorded. In addition the drug network diagram includes
151
information about anyone who buys drugs from the arrested person. A fictitious example
as seen by a fictitious arrested person "Apichai Lertwinit" is shown below:
The drug network chart helps to keep track of important numbers, addresses, and is
used to build a picture of the supply chain.
Drug Network as seen by Apichai Lertwinit
Drugs from Chiang
Mai
01-565-5656
Bom
09-234-5432
21 Villa Apartments
Back Door, Red
Students at Udom Pratom
Daeng
Top
Supika L.
Apichai Lertwinit
01-090-2323
7 Villa Apartments
Anonymous Source
This diagram is probably one of the key sources for the government's black lists of those
involved in drug trafficking. If a name or a phone number shows up often on the drug
network diagrams it is likely tat the person is important in the drug supply chain.
The other document is a map of the physical location of drug transactions in which the
arrested person has taken part. This map helps track the location of central drug
marketing areas and areas with severe problems with drug use. If a school or location
appears on drug transaction maps for many persons, it becomes a location of concern for
law enforcement. Although access to this information is restricted, a causal look at where
the city of Bangkok posts anti-drug posters may give a rough sense of which areas are
considered problematic. The map drawn below is a fictitious example of a drug
transactions map, again drawn by the fictitious Apichai Lertwinit..
152
The map shows the physical location of drug transactions, and highlights areas with
significant drug problems, and 'drug markets'.
Map as drawn by Apichai Lertwinit
Anonymous Artiste
In addition to these documents, the police depend on the usual mix of informants,
infiltrators, surveillance, and anonymous tips.
…but suffer from a lack of evidence.
The police force is not permitted to run around and arrest people simply because they
don't like the look of them, they are suspicious of them, or even if they have extensive
evidence such as that available from the documents above. Rather the police need to
have evidence of a crime to make an actual arrest. In the case of drugs, they are actively
looking for intelligence about drug suppliers and sellers, and usually will have varying
degrees of evidence against many individuals. They then have to decide how to use their
scare resources in terms of time and money in who to track further. Sometimes the
intelligence against a particular person can be very strong, yet there are not resources to
track that person. This leads to the Most Wanted lists that help police focus their efforts
on certain cases, either because they are particularly onerous, particularly expeditious
politically (suppose a campaign is announced against kidnappers - that is not the time to
look for car thieves), or for a variety of reasons, many, but not all of them, good ones.
Resources are often a critical concern for drug fighting divisions. The drug business is
very profitable, and many drug sellers are able to live and travel in luxury. This presents
a particular problem when a detective is assigned to follow a wealthy drug seller.
Suppose the drug seller goes to eat in a fancy hotel. The detective must wait outside
because he cannot afford the price of even a coffee in the hotel dining room. Or suppose
the drug seller flies to Chiang Mai, but the detective has to follow on the bus. Money is
153
necessary to set up sting operations in which police officers pretend to buy drugs from
drug sellers.
Time is of equal concern, as the number of leads will far outpace the number of people
available to follow up on them.
It is rumored that the government's drug campaign was designed to ease up on these
serious constraints on the police, by temporarily lightening the burden of proof so that
some of the well known drug agents could be apprehended.
It is also rumored that the purpose of the campaign was to target medium level
wholesalers in order to break the drug chain, but also enough small retailers to scare
others away from the trade.
Drug Lord
Wholesaler
Wholesaler
Targeted
Retailer
Retailer Retailer
Retailer
Threat of Arrest and Prison as a Deterrent Prior to Crackdown
In spite of all efforts, the popular perception before the government crackdown was that
the risk of detection was small. Of the reasons given for seeking treatment, both the
threat of law enforcement and the difficulty of purchasing drugs were minor reasons for
seeking treatment, suggesting that, at least prior to the drug crackdown drug abusers were
not seriously worried about being arrested (despite very high incarceration rates) and that
drug enforcement was not able to keep drugs unavailable for most drug users. The long
term stability in the price of illegal drugs cited in the report also supports the contention
that drug availability was not being affected by law enforcement prior to the crackdown.
154
If drugs are difficult to get, addicts may seek treatment to free themselves from their
addiction. This is especially true for more addictive drugs.
Share who said
Difficult to Purchase
was the primary
reason for entering treatment
6.0%
5.0%
4.0%
3.0%
2.0%
1.0%
0.0%
Yaa Baa
Heroin
Opium
Marijauna Inhalants
Alcohol
Cigarettes
Source: Ministry of Public Health 2001 (Data refer to all Thai Treatment Centers)
This picture suggests that with the exception of opium, addicts have little trouble in getting
whatever drugs they need. This was the least cited reason for seeking treatment, with
less than 1% of rehabilitation seekers..
If law enforcement is strict and severe, it may cause addicts to seek treatment out of fear.
Share who said
Law Enforcement Threat was the primary
reason for entering treatment
4.0%
3.5%
3.0%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%
Yaa Baa
Heroin
Opium
Marijauna Inhalants
Alcohol
Cigarettes
Source: Ministry of Public Health 2001 (Data refer to all Thai Treatment Centers)
The enforcement threat is perceived to be highest for opium and marijuana while the
government is focusing on Yaa Baa and heroin. Possibly police are more of a threat in
rural areas. Marijuana and opium are both drugs which are used more heavily in the
countryside. As a reason for seeking treatment, law enforcement was cited by less than
2% of those seeking treatment
155
To help avoid detection, communication between buyers and sellers of drugs is often by
hand signals. Below are some samples of the signals used:
Research Assistant Demonstrates Some Common Drug Signs
Fifty Baht
Pills / Yaa Baa
Police are Coming
156
Appendix D
Handling Psychosis
What should you do if you are confronted by a psychotic person?
1) Keep the situation calm and people away. It is easy for the situation to escalate
through noise and confusion.
2) Say that you are not there to hurt him. Tell the person you can help. Remember this
individual feels that the world is against him, so you want to distance yourself from that.
3) Set rules. E.g. “You will talk to me, I will talk to you, but we won’t do anything
violent.” Although a person in a psychotic episode may not be rational, he will often
respond to suggestions of this sort. He or she often feels a lack of control, and is looking for
someone outside to suggest it.
4) Stay away. Respect his space and your space. No Heroics.
5) Dialog is the only safe way out. Keep him talking if possible.
6) Do not deny what he or she says no matter how fantastic– he or she believes it.
Instead direct the conversation to tasks – Suggest what he will do, and tell him what
you will do.
7) Ask what he thinks would help him. Try to understand what he thinks is going on, and
use it. For instance, if he thinks his family hates him, get the family to show their love. If
there is someone he trusts, get them. If he fears something irrational, show that it isn’t
happening.
8) Remember psychosis is temporary. If you can get through this, you can help this
person get back to being normal again. He or she is sick, not bad by nature.
Source: Developed from information in a publication of the Connecticut Police Force, USA
157
Anecdotal evidence from Thailand suggests that in many cases, those who suffer at the
hands of psychotic persons are those closest to him or her, such as family members, a
girlfriend or boyfriend, or others who know the person well. In anticipation of that
situation, the following advice is also offered for handling a family member who is
psychotic.
What to do if someone in your family is psychotic.
Know when to look for help. You know this person better than anyone, which is both good
and bad. You will not have your guard up and you will not believe that things can go out of
control. On the other hand, you will know when this person is not acting normally. If the person
is irrational, or if you are scared, it is time to get help.
Know when to back down. Relationships often have longstanding issues that are sensitive.
Relationships are not always fair, and one of the persons may behave wrongly. This is NOT the
time to address these issues. If the person is acting strangely, stay away from any kind of
argument or conflict.
Who to ask for help The ideal helper is someone who knows both you and the psychotic
person, is big enough to handle the situation physically, and will stay calm. They also would have
to be able to get to your house quickly. The police are best if the situation is already very serious,
but they will tend to make things worse if you are just uneasy.
How to ask for help In most cases a psychotic episode will not happen suddenly. Over a few
weeks or months the person will act stranger and stranger. If this is happening to you, look
around you for someone to call in an emergency. Tell that person (or perhaps that person's wife if
you are a woman) that your spouse is acting strangely, and ask if you could call on them if you get
scared. If the situation remains out of control, or if you don't have an appropriate neighbor, call
the police.
Express positive feelings about the psychotic person. This may be difficult to do if you
are feeling scared or threatened. However, it is important to be aware that sometimes people hurt
themselves and their family because they feel extremely bad about themselves, and they can't
tolerate the situation any longer. Tell them it will be better later, and that you love them.
Afterwards If you get through a psychotic encounter get professional help for the
person. He or she will not get better on their own. The Thai government provides free
detoxification help at Thanyarak hospital among other places, or call the drug hotline at
Thanyarak, phone #: 1165 or the equivalent in your region or country. Drug related psychosis
generally goes away about six months after the person stops using drugs.
158
Appendix E
Drug Prices in Thailand
Retail Price of Illegal Drugs in Bangkok, in Baht
Drug
Methamphetamine,
One tablet (.07 gram)
1997
70-100150
1998
80-100120150
100120
50-100
1999
60-80100-150
2000
45-80100
2001
50-80100
2002
60-80-100
100100-300
100-120* 100-120*
120-300
40-5050-8050-80
40-50
30-40
100
100
800-1200 800500-800- 500-1000 500-1000 500-800
1200
10001500
Sources: Compiled by the author from various sources. These prices mostly for one pill, not for 2-5 pills at
a time. * This data from ONCB, treatment data suggests addicts almost always buy at 100 baht.
Heroin, #4,
1 straw (.05 gram)
Marijuana, One
small bag, (.5 gram)
Ecstasy,
One tablet
50-120
The variation in prices at any given time is much greater than the variation in prices over
time, so it is quite difficult to get an accurate measure.
Retail Price of Illegal Drugs in Bangkok, in Dollars
Drug
1997
1998
1999
2000
2001
2002
Methamphetamine,
2.26-3.23 1.95-2.44 1.58-2.11- 1.32-2.111.251.43One tablet (.07 gram)
4.83
2.93-3.66 2.63-3.95
2.63
2.00-2.50 1.90-2.38
Heroin, #4,
1.61-3.87 2.44-2.93 2.63-3.16
2.63-7.89
2.50-3.00 2.38-2.86
1 straw (.05 gram)
7.89
Marijuana,
One 1.29-1.61 1.22-2.44 1.32-2.11- 1.32-2.11
1.00-1.25 0.71-0.95
small bag, (.5 gram)
3.23
2.63
13.20-21.00 13.1611.90Ecstasy,
25.8019.5012.5026.30-39.50
19.05
One tablet
38.70
29.30
26.32
25.00
Source: ONCB, Exchange rates 1997 1:31, 1998 1:41, 1999 1:38, 2000 1:38, 2001 1:40, 2002 1:42
Chart of Wholesale Prices Over Time
Wholesale prices show a similar pattern to retail prices, suggesting that there is
not much market power at the retail level. If the retail level had market power they
would try to maintain price when the wholesale price dropped. With many suppliers we
did not expect much market power at the retail level. There is some evidence that the
price margins have been falling from the wholesale to the retail level in the last year due
to increased competition.
Wholesale Price of Illegal Drugs in Bangkok, in Baht
Drug
Methamphetamines
Pack of 200 tablets
Heroin, #4,
700 grams
Marijuana,
One kg.
1997
13,00015,000
300,000350,000
3,0005,000
Source: Mostly ONCB
1998
12,00016,000
250,000270,000
3,0005,500
1999
8,00010,000
300,000350,000
2,5005,000
2000
9,00015,000
250,000450,000
2,0004,000
2001
9,00015,000
300,000320,000
3,0007,000
2002
9,00015,000
370,000
2,0003,000
159
Wholesale Price of Illegal Drugs in Bangkok, in Dollars
Drug
1997
1998
1999
2000
2001
2002
Methamphetamines 419293211237-395
225-375
214-357
Pack of 200 tablets 484
390
263
Heroin, #4,
9,7006,1007,9006,6007,5008,800
700 grams
11,200
6,700
9,200
11,800
8,000
Marijuana,
97736653-105
75-175
48-71
One kg.
161
133
132
Source: ONCB, Exchange rates 1997 1:31, 1998 1:41, 1999 1:38, 2000 1:38, 2001 1:40, 2002 1:42
Price of Illegal Drugs Along the Supply Chain, in Baht
Border
Price
1-3
Runner’s
Commission
1-2
12
1-2
Drug
Precursors
Methamphetamines
1 tablet
Heroin, #4,
.05 gram
Ecstasy
1 tablet
Bangkok,
Medium
Wholesaler
30-40
Bangkok,
Small
Wholesaler
40-70
Bangkok,
Retail
12-20
Transport
to
Bangkok
2-3
14-18
2-3
22-50
50-100
100-120150
500-800
90
70-100
Source: Various sources, compiled by the author.
Dosage and Purity of Drugs
Drug
Weight
Purity
Net Weight of
Drug
Unit Price
(2002)
Methamphetamine,
One tablet
Heroin, #4,
One Straw
Marijuana,
One small packet
.07 gram
30 %
.02 gram
80 Baht
Price per gram
of pure drug in
US Dollars
$95
.05 gram
80 %
.04 gram
120 Baht
$71
.5 gram
100 %
.5 gram
35 Baht
$1.67
Source: Based on an exchange rate of 42 Baht:1 dollar, prices as of 2002
Weight of Seized Drugs each Year
Drug Seizures
Methamphetamines - Kg
(Tablets in millions)
Heroin, #4
(Kg)
Opium
(Kg)
Marijuana
(Tons)
Ecstasy
(Tablets)
Source: ONCB
1997
1,573
313
9.11
1998
3,012
(33.5)
541
1999
4,518
(50.2)
404
2000
7,554
(83.9)
384
2001
8,450
(93.9)
475
1,739
2,046
1,595
2,319
5.89
14.68
10.32
11.31
5,919
21,794
72,182
67,326
160
Interviews
Name
Mr. Aekajit Chaiyawong
Mr. Apichai Kulcha
Mr. Charnchai Pongpassorn
Mr. Charoen Tanchatchaval
Ms. Chaunpit Chumvattana
Dr. Jaroon Jittiwuthikarn
Dr. Narong Sillapasararn
Nikom Charumanee, Ph.D.
Miss Ornsri Srivana
Ms. Pornprapa Klaewkla
Phraajarn Veerapan
Dr. Vichai Poshyachinda
Ms. Vipacharee Putthamilinprateep
Mr. Sopon Thitithammapruk
Ms. Sumonthip Jailek
Mr. Thavatchai Thaikeaw
Mrs. Vachira Svetanant
Vithavas Knongkakul, Ph.D.
Pol. Maj. Gen. Watcharapol
Prasarnrajkit, Ph.D.
Mr. David McDonald
Mr. David Feldman
Mr. Allan Beesey
Workplace
Office of the Narcotics Control Board
Special Affairs Division, Ministry of Education
Anti-Money Laundering Office
Office of the Attorney General
Office of the Narcotics Control Board
Department of Medical Services
Thanyarak Institute
Student Patrol Division, Ministry of Education
Department of Juvenile Observation and
Protection, Ministry of Justice
Department of Probation
Chuchitthammaram Temple
Drug Dependence Research Center,
Chulalongkorn University
Budget Bureau
Department of Corrections
Department of Corrections
Department of Juvenile Observation and
Protection, Ministry of Justice
Department of Corrections
Duang Prateep Foundation
Narcotics Suppression Bureau, Royal Thai Police
United States Drug Enforcement Agency
UNESCO
Consultant on Harm Reduction and Human
Trafficking
Anonymous Interviews
Twelve anonymous drug addicts at Thanyarak Hospital
Several prison inmates at a Thai prison
At least 50 taxi drivers, as well as ice coffee sellers, general vendors and guards, some of
whom were experts, others who were not, but all of whom had an opinion!
161
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