Withdrawal Symptoms in the Golden Triangle
A Drugs Market in Disarray
Tom Kramer, Martin Jelsma and Tom Blickman
Published by the Transnational Institute

ISBN 978-90-71007-22-4
96 pp, 210 x 297 mm
Baht 495

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 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.