Thai drug user study calls for greater investment in evidence-based healthcare

Latest research from BC-CfE’s international program highlights failure of “war on drugs”

A new study from researchers at the BC Centre for Excellence in HIV/AIDS (BC-CfE) adds to the growing mountain of evidence pointing to the international war on drugs as a failed policy.

The latest study, co-authored with researchers from the Thai AIDS Treatment Action Group and Thailand’s Mitsampan Community Research Project (MSCRP), found the Thai government’s longstanding war on drugs, involving the mass incarceration of drug users, has failed to suppress the availability and use of illegal drugs in the country. In fact, the availability of illicit drugs has actually increased in Bangkok despite these aggressive drug policies.

The study, soon to be published in the peer-reviewed journal Drug and Alcohol Dependence, calls for greater investment in evidence-based healthcare and harm-reduction initiatives for injection drug users (IDU) in Thailand, both to save lives and prevent HIV infections.

“Drug addiction is a chronic, relapsing health condition and research shows that it is best addressed through evidence-based drug treatment,” said Dr. Thomas Kerr, senior author of the study and co-director of the Urban Health Research Initiative, a program of the BC-CfE. “The findings of this study and various prior reports provide significant evidence that simply incarcerating people who use drugs will not help achieve the objective of reducing the demand and supply of illegal drugs.

“In fact, this approach has led to unintended negative consequences such as strengthening the link between users and drug dealers, and health risks such as HIV/HCV transmission.”

The study is the latest research to come MSCRP. For decades, Thailand had experienced high rates of illicit drug use and HIV/AIDS among IDU. However, as highlighted in the study, the Thai government’s response has been to rely on criminal justice approaches such as policing, incarceration and compulsory drug detention centres.

MSCRP was launched in 2008 under the leadership of Dr. Kerr with the goal of reducing these drug-related harms. MSCRP is a collaboration among the BC-CfE, the Thai AIDS Treatment Action Group, the Mitsampan Harm Reduction Center and Chulalongkorn University in Bangkok.

The project has since published 18 peer-reviewed studies that have provided insight on previously undocumented social and structural vulnerabilities to HIV/AIDS and other drug-related harm among IDUs in Bangkok.

The work has also garnered broad media attention in Thailand, including stories in some of the country’s highest circulation daily newspapers. The new study was covered in publications across Thailand.

However, the outreach goes beyond media coverage. The project has been successful in developing important relationships with community groups, local politicians and public health officials.

“Our project has been favourably received by local IDU communities, as well as other civil society organizations engaged in harm reduction programs in Thailand,” said Kanna Hayashi, research coordinator for MSCRP.

In September 2011, MSCRP published a research summary report that included a series of recommendations for the Royal Thai Government and United Nations (UN). Following its publication, they assembled a panel of high-level officials from various Thai authorities and UN agencies to present the recommendations, which included exploring models for the decriminalization of illicit drug use, providing evidence-based harm reduction services and phasing out compulsory drug detention centres.

The message has been received.

“For far too long, we have focused on compulsory drug detention as a way to address the rampant issue of illicit drug use, but this study and reports before it have showed that this approach has failed,” said former Thai senator Jon Ungphakorn following the publication of the MSCRP’s recent research.

“The time has come to move away from incarcerating people who use drugs and instead invest in proven addiction treatment and harm reduction programs to meaningfully address their treatment and care needs.”

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