By Renaud Cachia and Thura Myint Lwin

Southeast Asia is well known as a major market for both the production and consumption of amphetamine type stimulants (ATS). Myanmar, in particular, has arguably become one of the world’s major suppliers, as highlighted by the record seizures of methamphetamine regularly making the headlines. The topic is ever more frequently debated in the media and is overall perceived as a major concern; yet too little is actually known about these products and the people who use them.

Amphetamine type stimulants include a range of substances, which can vary significantly in their composition, form, potency and the way they are administered. For example, methamphetamine tablets – known as “Ya Ba” in Thailand and “Ya Ma” in Myanmar, crystal methamphetamine (also commonly named “ice” or “Shabu” in the Philippines), and ephedrine tablets (a legally produced medication that is particularly popular in China) all fall within the broad category of ATS.

The illicit nature of the production, distribution and consumption of these substances makes it difficult to study them and to conduct research. People who use them are often reluctant to engage on the topic, due to the fear of arrest. Clinical research, when it is available, largely focuses on the impact of methamphetamine on the health of people using them and the potential cognitive deficits they can cause. The clinical significance of these findings has, however, been questioned by specialists who highlighted flaws in the methodology and raised concerns about the interpretations of their results.

The prevailing view in Southeast Asia, both among the public and policymakers, is that repression is the best solution to tackle drug related problems (see box for a more detailed description of drug laws in the region). The justification offered for imposing harsh penalties on people involved in drug production, trafficking or even use is that exemplary punishment is necessary to deter and discourage future potential offenders. Forcing people who use drugs into compulsory treatment has also been extensively used in the region. There are, however, a growing number of people, including officials, who acknowledge that other approaches, more respectful of people’s health and dignity, are necessary.

This study’s primary objective is to improve our understanding of methamphetamine use in Myanmar, and to a lesser extent in China and Thailand, by shedding light on specific aspects that can help to better comprehend this complex phenomenon. It aims to answer a few basic, yet fundamental questions:

• What types of stimulant drugs are used in the region, and how are these used?

• Who are the people who use these substances, and in what context do they use them?

• What problems might methamphetamine cause to people who use them, but also, what benefits do they experience?

• Does methamphetamine use necessarily lead to problematic or dependent use, and are there ways to reduce harms and exert better control over one’s use?

Finding “solutions” to ATS related problems requires, first of all, a better understanding of the experiences of people who use these drugs, in their own terms and from their own perspectives. In fact, there can be no sound policies or effective interventions without learning first from those who know these substances best – the people who use them.

We hope that this report will contribute to a better understanding of this topic by the public and policy makers alike, and ultimately, support the adoption of a more rational and effective approach to drug control, based on evidence, public health and human rights.