Laos’ forgotten opium addicts

Roughly 15,000 people are hooked on the drug, but treatment options are few and rates of relapse are high.

Muang Sing, Laos – Sitting high on the steps of his wooden hut in northern Laos, So Te surveys his village with a glassy stare. Children wearing dirty clothes chase chickens among litter and rubble.

Te does not have much, but inside his home is an opium pipe and a family who bear the burden of his addiction.

“The father should take care of his children, not the children taking care of the father,” said 50-year-old Te, who suffers from occasional tremors as he collects his thoughts. “I want to give up but I am in pain.”

Te is a member of a growing population of opium addicts in Laos, a community that receives little attention in the country. After nearly a decade of decline in opium production and use, from a peak in 1998, recent years have seen a resurgence.

According to the United Nations Office on Drugs and Crime (UNODC), Laos was home to about 15,000 opium users in 2013, three times the number recorded in 2009. It is likely that many more remain unaccounted for in Laos’ remote areas.

But treatment options remain woefully inadequate, and – in a culture once ambivalent towards the use of opium – attitudes are changing among the hill tribes, leaving users increasingly marginalised. In addition, intense poppy eradication programmes mean that the cost to fuel one’s addiction has grown, placing stress on the addict’s family to become the main provider.

Few treatment options

There is only one rehabilitation provider for opium users in the country – the UN Office on Drugs and Crime (UNODC) – and it said a lack of funding limits its ability to do the job properly. “The problem is huge,” said Wai Maung Hia, a technical adviser at the UNODC in Laos. “In general, the delivery capacity is not sufficient according to the needs of the issue or the job that has to be done.”  



an older man who has a chronic disease that cannot be cured with modern medicines and often relapses after detox.”]

With US government funding, the UNODC’s alternative development programme aims to increase household income and support health treatment after the removal of a highlander’s traditional opium cash crop. But the programme currently operates in just 78 villages.

Opium, which was traditionally used for pain relief in the absence of modern medicine and at social gatherings, has long been a part of many ethnic minorities’ cultures in Laos, and breaking the habit is difficult.

Addicts who do receive treatment have a 40 percent chance of relapse, according to the 2011 International Narcotics Control Strategy Report issued by the US State Department.

Minavanh Pholsena is the Laos country programme manager for Norwegian Church Aid, an NGO that has more than 20 years of experience working with opium addicts in the country. She described the typical profile of its clients: “An older man who has a chronic disease that cannot be cured with modern medicines and often relapses after detox.”

The group provides community education programmes to 27 villages in Muang Long district, but ended its detoxification programme in 2005.

Addicts require years of post-detoxification support, including counselling and health checks in order to remain clean, she added.

Addiction: Not a priority?

The Laotian government issued a strategy document that called for $72m in funding from 2009-2013 to cover a range of narcotics reduction activities, with $16m allocated to treatment and education.

But as of October 2013, just $20m had been raised from international donors and the UNODC, according to the US State Department’s 2014 International Narcotics Control Strategy Report.

Laos has enjoyed strong economic growth recently, with gross domestic product growing by more than 7.5 percent annually for the past five years. But an opaque government makes it difficult to see where the benefits have gone, though it appears opium addiction is not a priority.

The Lao National Commission for Drug Control and Supervision – the government body responsible for tackling drug trafficking and abuse – declined to comment for this article. 

Like many highland villagers over the past few decades, Te and his family were drawn to the lowlands by the government’s lures of farmland, hospitals and schools. But living in a developed area also means increased enforcement of opium prohibition. 

After the government stepped up its efforts to enforce prohibition, opium cultivation fell dramatically from 26,800 hectares in 1998 to 1,800 hectares in 2005. Supply became sparse, which caused prices to spike. But with so few treatment options, addicts’ demands remained.

No longer able to grow their own opium, smokers like Te turned to their families for support. Wives and children were made to take on greater responsibility for the household income.

Encouraged by village elders to use opium to treat a head injury when he was young, Te no longer works. He is a prisoner in his own home, where he lies down three times a day to smoke his tar-like opium. Te smokes one saleung – about 3.75 grams of opium – every two days.

His wife, Me Pak, pays 60,000 Laotian kip ($7.45) for her husband’s saleung, an amount that takes her a day’s work on a nearby farm to earn. Little is left over to feed their family of four. “It is very hard when the children are still young,” said the 46-year-old.

Meanwhile, some hill tribes have changed their attitudes towards opium. The drug has polarised communities into opium and non-opium villages.

Paul Cohen, a senior research fellow in the department of anthropology at Macquarie University in Australia, said the denunciation of addicts dates back to the US’ war on drugs in the 1970s, and intensified in the 1990s, when Laos’ government, through a UN-backed programme, sought to demonise opium as a cause of hardship rather than a symptom.

“The Laos government discourse and the UNODC discourse was that you had to get rid of opium because it was causing poverty, both at a macro level and an individual level, by debilitating addicts. But this is grossly exaggerated,” said Cohen, whose research in Laos dates back to the 1990s. “Opium addicts have been stigmatised and in many cases exiled from villages.”

‘No one smokes opium here’

Just kilometres away from Te’s village, the village of Nam Deatsomboun shows the divisive nature of opium. 

If there is no opium, I will die. I am addicted.

- So Te, opium addict

“No one smokes opium here,” says 34-year-old farmer A Sol, sitting proudly by his neatly placed ploughing tools. “People grow rice, sugar cane and rubber, and the Chinese come and buy it.”

In Sol’s village, many of the houses have farm machinery parked below. There’s no machinery under Te’s house – just piles of firewood – a situation that is not likely to change anytime soon.

Two years ago, Te volunteered for a Chinese-sponsored rehabilitation programme, the only detox service that has been run in his district for the past eight years. He shared his small room with three other addicts. They slept on beds made from bamboo and were fed three meals of boiled rice and vegetables a day.

“I could not sleep. I was in too much pain: I tried to walk but I had no energy,” Te said, recalling his cold-turkey attempt.

Te lasted barely a week. Unable to walk, he was carried home. He lay paralysed in bed for days until he was strong enough to move and – more importantly – return to his opium pipe.

“If there is no opium, I will die,” Te said. “I am addicted.”

Source: Al Jazeera

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