Study Examines Consequences of Thailand’s “War On Drugs”

Researchers from the Johns Hopkins Bloomberg School of Public Health, the Chiang Mai University Research Institute for Health Sciences and the Northern Drug Treatment Centre in Thailand conducted the first study on the effect of Thailand’s aggressive war on illicit drugs and the war’s impact on injection drug users. According to their study, 70 percent of injection drug users surveyed said they stopped using heroin after the campaign began. However, nearly a third of those who quit heroin said they switched to using methamphetamine and other drugs. The researchers also found the war on drugs had a greater impact in the rural countryside than in to the more densely populated cities. The study is published in the March 2005 edition of the International Journal of Drug Policy.

“The war on drugs in Thailand had a significant impact on injection drug use. However, policy makers must be aware of the unintended consequences of their actions,” said David Celentano, ScD, co-author of the study and professor in the Department of Epidemiology at the Bloomberg School of Public Health. “Our findings indicate that many of the injection drug users switched to taking methamphetamine and other drugs when heroin became more expensive and harder to obtain.”

Thailand’s war on drugs began in February 2003 and has been criticized by a number of human rights groups. The initiative was intended to reduce the supply and demand for illicit drugs, particularly the growing use of methamphetamine, known there as “ya baa.” All drug users are required to submit to drug treatment or face arrest. Treatment options include enlistment in newly established drug treatment camps. For the study, the researchers followed 165 injection drug users who took part in another study conducted in 2002.

The study found that the war on drugs had a greater impact in rural communities, where drug users are easier to identify, than their counterparts in urban centers. Seventy-eight percent of rural drug users said they quit injecting drugs compared to 55 percent of urban users. Despite the strictness of the policy, 85 percent of study participants said they believed the initiative was “good,” ostensibly because it might keep others from initiating drug use.

“Some participants in the study may not have fully reported their injection drug practices out of fear of the government’s war on drugs. This could lead to increased risky syringe behaviors, which contribute to the spread of HIV. More research is needed to monitor the effects of Thailand’s drug policy,” said Susan Sherman, co-author of the study and assistant professor in the Department of Epidemiology at the Bloomberg School of Public Health.

“The influence of Thailand’s 2003 ‘war on drugs’ policy on self-reported drug use among injection drug users in Chiang Mai, Thailand” was written by Tassanai Vongchak, Surinda Kawichai, Susan Sherman, David D. Celentano, Thira Sirisanthana, Carl Latkin, Kanokporn Wiboonnatakul, Namtip Srirak, Jaroon Jittiwutikarn and Apinin Aramrattana.

The study was funded by the Division of AIDS of the National Institute on Allergy and Infectious Diseases, NIH.