Withdrawal Symptoms in the Golden Triangle

A Drugs Market in Disarray
Transnational Institute (TNI)
January 2009

Witdrawal symptomsDrug control agencies have called the significant decline in opium production in Southeast Asia over the past decade a 'success story'. The latest report of the Transnational Institute (TNI). based on in-depth research in the region, casts serious doubts on this claim noting that Southeast Asia suffers from a variety of 'withdrawal symptoms' that leave little reason for optimism.

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application-pdfThe ATS Boom in Southeast Asia (PDF)
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Opium production in Southeast Asia has decreased significantly in the past decade and the international community is trumpeting success. There is little reason for optimism, however. The supply of opium and heroin on the global market has not been reduced and there are serious questions about the decline’s sustainability.

The abrupt decline in production has caused untold misery for opium farmers in the region because they do not yet have sufficient alternative livelihoods in place. The situation is further complicated by acute land shortages that are exacerbated by Chinese investment in commercial plantations. Meanwhile, current levels of development assistance for Burma and Laos remain low.

The fall in opium production has led users to shift from smoking opium to injecting heroin, significantly contributing to the HIV/AIDS epidemic in the region. Now signs are that the quality of heroin is also declining while the price is increasing causing drug users to experiment with pharmaceutical cocktails. The new health risks are not yet known.

Meanwhile, the market of amphetamine-type stimulants (ATS) has increased rapidly in the region. East and Southeast Asia have become major producers of methamphetamine and almost two thirds of the world’s methamphetamine users live there. Users are increasingly switching from swallowing pills to smoking and, more recently, to injecting methamphetamine. Use of the even more addictive and damaging crystalline form of methamphetamine is also on the rise. The ATS boom is thus also fuelling the HIV/AIDS epidemic in the region.

There is an urgent need to harmonize drug policies with HIV policies. Long-term support for harm reduction and health care programmes for drug users must be prioritised. Only a small proportion of intravenous drug users harm reduction programmes have access to these services. Sentences for minor drug offences are disproportionately high and need to be reviewed. Repressive legislation that criminalizes drug users further hampers access to treatment and prevention services.

The international community should not abandon (former) opium growing communities and drug users at this critical stage of market changes in the Golden Triangle. National and local authorities in the region need to acknowledge that these are complicated issues and there can be no quick fixes or one-size-fits-all solutions.

This TNI report aims to contribute to a better understanding of current market dynamics in Southeast Asia, which is essential for designing more effective and sustainable policy responses that are consistent with human rights and harm reduction principles.

A hardcopy of the report is availabe for purchase in our online bookstore.

In the press: Drug report in Southeast Asia, The Nation (Thailand), 16 January 2009

TNI's report shows that the rapid decline in production has caused major suffering among former poppy-growing communities in Burma and Laos, and poses serious questions about the sustainability of the opium bans in those countries. The report also notes that the decline in opium has been accompanied by a rise in the use of other drugs with an increase in health risks among consumers, including rising HIV/AIDS rates.

"The Southeast Asian drug market is going through a process of profound transformation," says Tom Kramer, TNI's Southeast Asia expert. "The enforcement of opium bans in the Golden Triangle has driven hundreds of thousands of families deeper into poverty." Early warning signs show that opium cultivation in Burma and Laos is again on the increase and is spreading to previously unaffected areas in Burma.

Meanwhile, production and consumption of Amphetamine Type Stimulants (ATS) - methamphetamine in particular - have increased even more rapidly than opium has gone down. "The traditional opium growing and consuming region has now evolved into a complex and dynamic market of opiates, ATS and pharmaceutical replacements," Kramer concludes.

Stronger drugs and more harmful patterns of use

A pattern is emerging across the region in response to the repressive drug control policies and the criminalisation of drug users that shows an increased use of stronger drugs and more harmful patterns of use.

Higher prices and lower quality heroin are leading to shifts in consumer behaviour which create serious problems. While total numbers of opium and heroin users may be going down, more people have started to inject (the most cost-effective means of administration) and many have turned to a cocktail of pharmaceutical replacements with largely unknown health risks. Users move from orally ingesting methamphetamine pills to smoking and injecting dissolved pills. There are also strong indications that smoking and injecting the even more addictive crystal methamphetamine ('ice') is gaining ground.

"Optimistic drug control officials presumed that reducing opium production would automatically lead to a reduction of drug consumption and drug-related problems," says Martin Jelsma, TNI's drugs programme coordinator. "The reality in Southeast Asia proves them wrong. In the region, an HIV/AIDS epidemic is spreading. Inadequate - even counterproductive - drug policies contribute significantly to increased HIV/AIDS rates."

Understanding the market

The report 'Withdrawal Symptoms in the Golden Triangle: A Drugs Market in Disarray' is the first effort to analyse the Southeast Asian drugs market as a whole. Previous studies have focused on particular aspects rather than the full panorama of the drugs situation. "Understanding how the market responds to policy interventions is necessary to avoid the displacement of drug-related problems from one area or substance to another - the so-called 'balloon effect'," says Jelsma.

"Understanding the dynamics of drug markets - why people produce or use drugs - is essential to making rational and effective policies."

New research and analysis presented in the report allows for a series of conclusions and recommendations that take into account all aspects of the drugs market in the region. The report shows that policy responses to both supply and demand need to be integrated as they are strongly interconnected.

"Authorities in the region should realise that these are complicated problems and that there are no quick fixes or one-size-fits-all solutions," Kramer says.

Conclusions and recommendations

The lessons that can be drawn underline the need for a longer-term vision and commitment. Drug control policies should be accompanied by more humane and better sequenced development-oriented policies and programmes, which actively involve from the outset those people who are targeted to guarantee the sustainability of policy interventions. Current drug control policies and targets in Southeast Asia, such as making ASEAN drug-free by 2015, are focused on reducing supply and demand by applying repressive measures. Poorly-designed policies have severe unintended negative or even counterproductive effects, and tend to ignore the adverse consequences for drug users, their families and society as a whole.

Alternative livelihoods

The mounting problems with drug control need a careful re-assessment of the current approach. To maintain the sustainability of opium reduction and prevent exacerbating the hardships of rural communities it would be wise not to enforce the 2015 deadline. It would be far better to take a longer-term perspective.

A key guiding principle is to ensure the right sequencing: eradication of opium poppy fields or implementing opium bans should not occur unless farmers have viable and sustainable livelihoods in place.

Development assistance should not be made conditional on a reduction in opium cultivation. Drug control objectives need to be mainstreamed into all development interventions and, conversely, all drug control programmes should have a development oriented approach.

Harm reduction and drug law reform

Only a very small proportion of injecting drug users in need of effective harm reduction programmes actually has access to services. Harm reduction measures such as needle and syringe exchange need to be increased to tackle the HIV/AIDS epidemic. Drug laws across the region are excessively harsh and penalties, including for minor offences, are disproportionately high. The main victims of these repressive drug control policies are the most vulnerable at both ends of the trade: the opium farmers and drug users. A comprehensive review of drug laws with a view to "humanising" them is necessary. Human rights and proportionality of sentences should be high on the regional and national policy agendas.

Regional and international aid

Countries in the region and the international community should not abandon former and current opium growing communities and drugs users in this delicate phase of transformation of the Golden Triangle. Current levels of humanitarian aid to affected populations and support for alternative livelihoods, harm reduction and HIV prevention programmes are woefully insufficient. Donors need to increase their involvement in the region.