Opium re-emerges to create new drug problems

Opium re-emerges to create new drug problems

Medical personnel are fighting the revival of an old addiction with methadone, but need more money and help

Health officials provide consultations to people seeking advice on opium addiction at a village clinic in Tak. (Photos by Onnucha Hutasingh)
Health officials provide consultations to people seeking advice on opium addiction at a village clinic in Tak. (Photos by Onnucha Hutasingh)

Speed pills and crystal meth have dominated media and public attention for years with almost daily reports of the drugs being smuggled over the border or traded in bulk on the streets.

With public attention focused on these narcotics, the more traditional illicit drug, opium, which was on the verge of being wiped out in recent years, is quietly making a comeback.

Evidence shows that addiction to speed and crystal methamphetamine, or ya ice, among drug abusers is on the rise. But statistics are also showing that the number of opium addicts has surged in recent years.

A special method has been adopted to medically combat opium addiction.

High up in the mountains in the northern province of Tak, a carpet of brightly-hued flowers of the poppy plants extends across remote valleys.

Poppy produces the pods from which a milky latex is gathered to produce highly addictive opium. The dried opium latex can also be processed chemically into heroin.

The size of poppy-growing areas in the remote North has grown to almost 900 rai from 258 rai last year, according to the Office of the Narcotics Control Board (ONCB).

The increase in supply has led to a rise in demand and in the number of opium addicts, and that prompted the government in 2013 to launch a rehabilitation programme using methadone treatment in five villages in tambon Mae Tuen of Mae Ramat district which house a large number of addicts.

The methadone treatment is conducted under a "harm reduction" concept which aims to encourage opium victims to beat drug addiction by minimising the serious side-effects that addicts experience during the course of treatment and rehabilitation.

Methadone is a synthetic analgesic drug used in the treatment of morphine and heroin addiction as it possesses properties similar to morphine. It can also help reduce cravings for opium without having the usual opium withdrawal symptoms such as arthritis, dizziness and drowsiness, which leave many addicts too weak to work, according to sources in the ONCB.

At Mae Ramat Hospital, over 100 villagers who voluntarily attend the opium addiction rehab programme are provided with methadone every Wednesday.

The harm-reduction methadone treatment is explained to opium addicts. RIGHT  An addict shows needle marks on his arm from drug abuse.

During the early stage of rehab, they are given a dosage of methadone that is enough to last a week. The drug is mixed with water for drinking. After that, the dosage is adjusted based on the condition of each patient.

Patients must carry the hospital's rehab card with them in order to present to authorities in case of inspection as methadone is classified as a narcotic substance that requires official permission to possess it.

Distribution of the rehab drug is done under the state-owned hospitals' opiate rehab project registered with the Thanyarak Institute, a drug abuse treatment centre in Pathum Thani.

With the methadone medication, patients can gradually recover from opium addiction. Their living conditions improve as they are able to carry out their duties during treatment.

The addicts are also spared legal action which they would otherwise face if they did not consent to join the rehab programme, the ONCB sources said.

The legal-exemption approach also encourages more villagers hooked on opium to participate in rehab.

Tambon Mae Tuen is also under the Mae Tuen Forest Conservation Royal Project which introduces alternative crops to villagers, such as coffee and avocado, to wean them off poppy growing.

A 50-year-old father of three, who works in a maize farm in the district, said his life had been devoted to prolonged opium use for over a decade. He spent roughly 1,000 baht a day on opium, which nearly killed him.

He tried to quit many times but the willpower just wasn't there. He was unable to overcome the craving for the addictive drug or bear the severe pain of withdrawal.

"I suffered from severe arthritis. I coughed up blood and there was also blood in my excretion. It dawned on me that if I didn't quit opium, it would finish me off eventually," he said.

But after seeing his friends beat opium addiction with methadone, he applied for a place in the rehab programme at the hospital a year ago. He is now completely cured.

"After quitting opium for a year, I have managed to build up some savings. My family is very happy with my decision to go to rehab because they suffered from seeing me fall ill because of opium," he said.

A 33-year-old Karen highlander, who is also treated with methadone, said before rehab he went through a full medical check-up to determine if he had contracted various diseases such as HIV/Aids and Hepatitis B as many drug addicts have a history of sharing needles.

An official at the Thanyarak Institute said most of the 400 residents in the five villages in tambon Mae Tuen are ethnic Karen highlanders. Of them, 270 are being treated with methadone.

She voiced concern over the opium rehab situation, saying hilly landscapes and rugged terrain hinder villagers from accessing the treatment, which requires a long and sometimes treacherous trek. The treatment and the rehab facilities are only offered at select hospitals and clinics in Muang district and some outlying tambons.

In the past, opium use was ubiquitous among people aged 50 and over. However, the latest statistics reveal the addicts are getting younger, with 16-year-olds among them.

Also, several patients have relapsed into opium use as they live in an environment where they are exposed to poppy cultivation and socialise with other opium addicts.

Therefore, it is necessary for hospitals and clinics to step up their efforts to deploy more medical personnel and open more rehab programmes to remote areas, she said.

The officials, however, said that even though opium farming and addiction problems are still prevalent in the province, more and more addicts apply to the rehab programme each year, which is a good sign.

Of the 700 to 800 opium addicts in the province, about 50 to 100 annually go to the rehab centre of their own free will in the hope that they will completely recover from the addiction, she added.

Dr Jeerapong Uthaisil, top, director of Mae Ramat Hospital, at the hospital where villagers attend the opium addiction rehab programme and are given methadone. Health officials, centre, visit remote villages to help families seeking treatment. An elderly woman uses a basic system of community tap water to do her laundry.

Mae Ramat Hospital director Dr Jeerapong Uthaisil said despite an increase in opium users in several rehab centres, mountainous terrain makes it difficult for medical personnel to reach drug victims due to inconvenient transport.

Currently, there are only two mobile rehab units at the Tambon Ban Kham Wan Health Promotion Hospital and the Ban Huai Pong Health Centre. The hospital wants to expand its service in a bid to access opium addicts in distant places.

"If we can train villagers as public health volunteers to help us with the distribution of methadone, we will be able to reach more opium addicts," Dr Jeerapong added.

Aside from veteran personnel, the hospital director said funding is a crucial factor in addressing the long-standing issue.

"If we want more opium users to attend our rehab programme, there must be a bigger budget to finance the cause. Currently, the methadone treatment, sponsored by the government, costs around 35 baht per person per year," he said.

A participant in the opium addiction rehab programme shows his medication and registration book. A clinic is set up to offer psychological counselling to those wanting to beat drug addiction.

National Health Security Office assistant secretary-general Dr Chuchai Sornchamni said methadone treatment for drug abusers was being actively encouraged. It reduces the harmful effects of treatment and rehabilitation, which presents an incentive for more people to join the programme.

Tambon Mae Tuen Administration Organisation chairman Weerapol Buchakhunnatham said after the rehab project was launched, the number of opium addicts fell steadily. He said getting the addicts treated successfully breaks a vicious cycle.

"Most opium addicts turn to peddling the drugs and eventually to poppy farming," he said. If there are fewer addicts, there will be fewer drug peddlers and poppy farmers as well."

Mr Weerapol raised concern over the future of children in his hometown. Some parents cannot afford to send their children to school because they spend most of their household money on opium. A few hilltribe families he knows spend as much as 1,000 baht, an excessively large amount of money by the outlying communities' living standards, on opium a day.

He insisted poppy farming can be eradicated for good if locals are given alternative careers as well as improved transport networks so that authorities can access remote areas quickly and easily.

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