Expert Seminar on ATS and Harm Reduction

Experiences from China, Myanmar and Thailand
Transnational Institute (TNI) / Western Australian Substance Users Association (WASUA)
Kunming (Yunnan, China),
November 26-27, 2010

This report captures the main outcomes from an informal expert seminar on harm reduction in relation to the rising problems with the use of Amphetamine Type Stimu­lants (ATS)[1] in Southeast and East Asia, organized by the Transnational Institute, with the sup­port of the Western Australian Substance Users Association (WASUA). The aim of the meeting was to have an open-minded exchange of opinions and experiences about the situation in Myanmar, Thailand, and Yunnan Province (China).

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Problematic use of ATS has become a significant health and social problem in the region. The repressive response of national governments, consisting of arresting and incarcerating ATS users, has further aggravated the situation and put a burden on the criminal justice system. At the same time little is known about the methamphetamine market in the region, and treat­ment as well as harm reduction[2] strategies are in its initial phases. The situation seems to deteriorate: the substances are getting stronger (from yaba pills to crystal meth­ampheta­mine or ‘ice’) and methods of use are getting more harmful (from swallowing pills to injecting), and the number of ATS users – especially among youth – keeps increasing.

The seminar in Kunming, the capital of Yunnan Province, and was held under Chatham House Rule to ensure confidentiality and to allow participants a free exchange of ideas. When a meeting is held under the Chatham House Rule, participants are free to use the information received, but neither the identity nor the affiliation of the speaker(s), nor that of any other participant, may be revealed. A total of 21 people attended from Burma, Thailand and Yunnan as well as five international experts. Participants comprised a mixture of outreach workers and representatives from self-help user groups, health and harm reduction associations, and academics. The ideas expressed were those of individuals in their capacity as experts and should not be interpreted as reflecting consensus among the group, or endorsement by the organizers. In preparation, background papers[3] which clarified technical matters were sent to all participants. Each session started with an introduction by key participants in order to stimulate reflection and dialogue, followed by a frank debate.

The agenda on the first day focused on two main items: (1) Overview of ATS market and latest trends; and (2) Experiences with harm reduction measures and self-help strategies among meth­amphetamine users. On the morning of the second day the participants visited a Drop-In Centre (DIC) in Jincheng, a small town located just outside Kun­ming. In the afternoon the agenda focused on The way forward: possible harm reduction strategies for ATS. Participants broke up in working groups according to country and into an international working group. The seminar ended with Reports from the working groups & conclusions and recommendations on the way forward.

The information in the report is based on the informal presentations and discussions during the seminar. While the participants are all well-informed on the issue, a word of caution is necessary on the facts presented, due to the lack of substantiated data in general.

[1]. The World Health Organisation (WHO) defines Amphetamine-type stimulants (ATS) as a group of drugs whose principal members include amphetamine and methamphetamine. However, a range of other substances also fall into this group, such as methcathinone, fenetylline, ephedrine, pseudo­ephe­drine, methylphenidate and MDMA or ‘Ecstasy’ – an amphetamine-type derivative with hallucinogenic properties.

[2]. Harm reduction refers to policies and practices aimed to reduce adverse health and social consequences for drug users, their families and society as a whole, without necessarily ending drug consumption.

[3]. Suggested reading: The ATS Boom in Southeast Asia (chapter from Withdrawal Symptoms in the Golden Triangle: A Drugs Market in Disarray); Speeding up the response: A global review of the harm reduction response to amphetamines, by Sophie Pinkham, in the Global State of Harm Reduction 2010, International Harm Reduction Association, 2010; The fast and furious – cocaine, amphetamines and harm reduction, in Harm reduction: evidence, impacts and challenges, EMCDDA, Lisbon, April 2010.