Teenagers are increasingly using a new concoction derived from a prescription drug for a cheap high, according to the police.

"Taxi" is the casual name for tramadol, a prescription opioid pain medication, mixed with cough syrup. Although its abuse is on the rise, tramadol itself is not illicit. The drug comes in green and yellow capsules and is sold at affordable prices.

This widespread misuse of tramadol recently captured public attention and led to a police crackdown beginning August 17 when 20 spots in Bangkok and the surrounding provinces were raided. The operation is a joint initiative between the Royal Thai Police and the Food and Drug Administration (FDA).

In one raid that day, five suspects were detained. A large amount of powdered tramadol, a capsule-filling machine, filled capsules and bottles of cough syrup were seized at a commercial premises in tambon Suan Luang, Krathum Baen district, Samut Sakhon.

Pol Col Thiradet Thamsuthi, deputy chief of the Narcotics Suppression Bureau, who is leading the crackdown in Samut Sakhon, said the Technology Crime Suppression Division had received complaints from parents of high school and university students about drastic changes in their behaviour which they suspected were caused by drug use. 

Their children had regularly been missing school and appeared to be isolating themselves from both friends and family. A drug suppression team was sent to get acquainted with the students. After several days, the police gained their trust and they began to open up about the drugs they had been taking, according to Pol Col Thiradet.

"At first, the officers were puzzled when they were told by one of the teenagers that he was hooked on taxi. The police searched the teenager's room and found some green and yellow capsules," he said.

The police brought them to the FDA where lab tests were conducted to determine what was in the capsules. The FDA confirmed that they were tramadol, which doctors normally prescribe to patients who are suffering from extreme pain for which a normal painkiller is ineffective. The sale of tramadol to people under 17 is forbidden and a prescription is required before the drug can be dispensed. Even then, it is only allowed to be sold in quantities not exceeding 20 capsules.

Some teenagers interviewed said that they mixed 20 capsules-worth of tramadol with cough syrup and would then sip the concoction to experience what they called a pleasant "drifting" sensation, said Pol Col Thiradet. The mixture is highly addictive and can cause withdrawal symptoms such as nausea, vomiting, seizures and even coma among heavy users. 

"If they continue using the drug, they end up looking and behaving like zombies," Pol Col Thiradet said. Parents are advised to keep a close eye out for any changes in their children's behaviour.

Investigators managed to locate several pharmacies suspected of selling to underage users. However, since tramadol is not illegal, the task of dealing with the pharmacies is far from easy. The police and FDA have tried to trace the origin of the tramadol sold at these pharmacies. If the production was not approved by the FDA, the police might have a case.

Unauthorised producers of tramadol are regarded as makers of fake medicine. But police are required to find and seize the containers, labels and medicine first, Pol Col Thiradet said. The offence carries a maximum prison term of five years and fine of up to 10,000 baht. 

"The [producers] know well what they must do to avoid getting into trouble with the law. So they separate their production, packaging and labelling bases," he said.

Narcotics Suppression Bureau deputy chief Thiradet Thamsuthi shows tramadol capsules in a packet.

Each container of tramadol contains 1,000 capsules and is sold for 1,700 baht, while the average retail price of the drug is 3.50 baht per capsule, which makes it affordable to most teens, he said.

Deputy Tourist Police chief Surachate "Big Joke" Hakparn, who is supervising operations to halt the rising abuse of tramadol and the illegal trade of the drug, has warned that more crackdowns are on the way.

Contact Crime Track: crimetrack@bangkokpost.co.th