In September 2011, the government of Thailand moved to try and decrease the number of drug-users by 80 percent by adopting a more “softly, softly” approach, rather than sending people straight to jail. Progress on drug addiction is being made, say experts, but challenges remain.
Under the new approach, groups of drug-users are offered voluntary treatment, without prosecution, for a specific period of time, typically 15-90 days, with follow-up as needed.
According to the treatment division at the Thai government's Office of Narcotics Control Board (ONCB), nearly half a million drug-users voluntarily registered for rehabilitation in the past year. Some 100,000 overcame their addiction problems.
Previously only 40,000-60,000 drug-users received free treatment in government-run hospitals per year, with many more filling up the prisons.
“The government’s intention to help the drug-users to quit drugs is good. However, as the success of drug treatment is mainly due to the readiness and willingness of drug-users, the approach of the treatment in large groups within a certain period of time is not appropriate and has little chance of succeeding,” Petsri Siriniran, director of the National AIDS Management Centre in the Public Health Ministry’s Department of Disease Control, told IRIN.
Over the past year the government has set up nearly 1,000 newly modified community health centres and rehabilitation facilities across the kingdom. They provide largely free services.
The Ministry of Public Health estimates there was a three-fold increase in the number of drug addicts from nearly half a million in 2007 to 1.4 million in 2011.
The sharp increase is partly due to the ready availability of drugs: neighbouring Myanmar’s opium output has risen for the sixth consecutive year, according to the UN Office of Drugs and Crime (UNODC).
Civil society groups and health activists, meanwhile, have expressed concern over the quality of treatment on offer, saying that Thailand’s initiative on drug-users could seriously hamper large-scale efforts to reduce drug-related problems.
“The [existing] treatment system is not the answer. Harm reduction should be [the] government’s priority,” said Lavan Sarovat, the coordinator at 12D, a network of 12 civil society groups working on harm reduction in Thailand.
HIV prevalence among injecting drug-users (IDUs) dropped to 22 percent in 2010 from over 40 percent in 2008 and 2009. However, this rate is still among the highest in the region, according to the Global AIDS response progress reports submitted by governments to the Joint UN Programme on HIV/AIDS (UNAIDS).
“IDUs are a driver of HIV infection in Thailand. Any comprehensive health response to drugs must include a comprehensive package to prevent HIV transmission,” said Gary Lewis, the regional representative at UNODC.
The World Health Organization estimates there are nearly 40,000 IDUs in Thailand.
“We haven’t been able to clean the country. Drugs are still everywhere. The government should realize it’s time and spend budget to develop [its drug treatment programme] with the involvement of drug-users and community networks to design how it should look like,” Sarovat said.
Lewis stressed the importance of voluntary, evidence- and community-based treatment, and care for people with drug dependence.
“We stand ready to support the Royal Government of Thailand to develop a cost-effective, evidence- and rights-based system that addresses the separate issues of drug use and drug dependence,” he said.
According to the 2012 UNODC World Drug Report, apart from cannabis, the use of opioids (especially heroin) and amphetamine-type stimulants (mainly methamphetamine), are the primary concerns in Southeast Asia.