Measures to prevent and reduce drug abuse among young people in Burma
Current drug-abuse situation
Measures for the prevention and reduction of drug abuse
Informational and educational programmes
Lectures and discussious
Other school activities
In-service training programmes for teachers
Alternatives to drug use
Compulsory treatment and rehabilitation programmes
Author: U. KHANT
Pages: 81 to 89
Creation Date: 1985/01/01
Part two: Promotion of measures to prevent and reduce drug abuse among youth
Consultant Psychiatrist in Charge of the Drug Dependency Treatment and Research Unit, Rangoon Psychiatric Hospital, Rangoon, Burma
Opium and to a certain extent canna bis were the only drugs of abuse in Burma until the early 1970s when heroin addiction spread rapidly among young people, reaching epidemic proportions. Heroin addiction has caused serious social and health problems that prompted the authorities to adopt new legislation in 1974, the Narcotic and Dangerous Drugs Law, which provided for compulsory treatment and severe penalties for drug-related infractions, including the death sentence for certain categories of d rug trafficking. The authorities in Burma consider that legislation , drug-law enforcement, prevention, treatment and rehabilitation, and community measures are important and interrelated strategies in combating drug abuse among young people.
Various forms of drug-abuse preventive programmes are carried out for such groups as youths, parents, community leaders and professionals dealing with the problems of the young. Preventive school programmes include lectures and discussions; exhibitions; essay writing and other forms of competition for students ; in-service training for teachers ; healthy alternatives to drug use ; a scheme for talented students ; and participation in a national mass movement for literacy. Young people are also encouraged to take active part in various community programmes such as the "Red Cross" and voluntary fire brigades as well as in specially designed programmes that are carried out at the local level to prevent and reduce drug abuse. As the extended family still prevails in Burma, with parents and elders being respected by the young, this important resource is utilized in coping with drug abuse among young people. Compulsory registration as well as treatment and rehabilitation of d rug-addicted persons is carried out in specially assigned town hospitals. Community measures support after-care and social reintegration of young d rug addicts who have undergone treatment. Recent hospital statistics indicate that there is a slowing down in the rates of increase of new cases of heroin addiction , but concurrently the rates of abuse of psychotropic substances, such as benzodiazepines, methaqualone and barbiturates, as well as multiple drug abuse, are increasing.
There is no available evidence to indicate exactly when opium was first grown and used in Burma. The earliest existing record refers to a Venetian trader who visited Burma in 1581 and sold opium to people in Pegu. Records of the Dutch East India Company reveal that in the early part of the sixteenth century, the Company made a profitable business of selling opium to Burma, Malaccas and Siam. Christian missionaries going from Assam to Ava in 1837 noted in their travel records that poppy cultivation in the Hukawng and Mogaung areas was widespread. From those areas poppy cultivation spread to the northern and eastern parts of the country [ 1] .
Under the Burmese kings, the use of opium was not encouraged. King Mindon objected to the smoking of opium and King Thibaw, the last Burmese king, prohibited it. The prohibition, however, was not wholly effective. After the British occupation of areas of Burma, opium was sold under licence and raw opium was easily available from Yunan. Opium became an integral part of the social, cultural and economic life of the population in the hilly and frontier areas of Burma.
After Burma gained independence, the Government introduced many social and economic reforms to raise the living standard, but was unable to Control the cultivation, production , sale and use of opium by the population in the hilly and frontier areas. Decisive steps to eradicate opium problems were taken by the Revolutionary Council in 1962. The Opium Enquiry Commission was formed in 1964 with the following objectives : to estimate the prevalence of opium addiction and to study its causes ; to study the feasibility of introducing crop substitution in areas cultivating opium and to provide detoxification services for opium addicts ; and to revise the laws in order to provide for effective control and suppression of illicit drugs.
The sale of opium was prohibited in Burma in October 1965. A t the invitation of the Government a United Nations team assisted in studying opium problems and introduced the Kokang Development Project to improve the economic and social conditions of people in the areas producing opium.
In the early 1970s, reports from hospitals revealed that heroin was being increasingly abused by young people. There was no conclusive evidence to indicate why heroin abuse, which had not previously.existed in Burma, had spread to an epidemic proportion. The following two events should be mentioned as possible precipitating factors in the occurrence of such an epidemic : one was the scarcity of opium resulting from the 1965 prohibition of its sale and the other was the influx of heroin into Burma as a result of increased preventive activities in South-East Asia [ 2] .
Over the last decade, young addicts have mostly abused either heroin , opium or codeine (in the form of cough preparations). Cannabis, which is locally known as "Sai - chauk", was once a popular drug abused by t he young. It was either smoked or cooked in curry at parties. There were a number of regular and heavy cannabis abusers, but most of them during the heroin epidemic switched over to become chronic heroin addicts.
Since the beginning of 1980, the statistical reports from drug dependency treatment centres indicate a gradual decline in the incidence and prevalence rates of heroin addicts. Unfortunately, the same reports reveal that concurrently with this decline, psychotropic substances, such as benzodiazepines (mainly diazepam), methaqualone and barbiturates, have been increasingly abused by heroin addicts, who are turning to multiple drug abuse that involves these substances. Psychotropic substances are legal, inexpensive and easy to obtain. They are also abused by young drug experimenters. This changing trend in drug abuse has probably been influenced by the increased drug-law enforcement activities resulting in the decreased availability and higher price of heroin.
Realizing that drug abuse presents the worst possible danger to young people, a national campaign has been waged against drug abuse. Anti-drug exhibitions and mass rallies to denounce drug abuse have been held to generate awareness of the dangers of drug abuse and to encourage involvement of young people in drug-abuse prevention programmes [ 3] .
To combat effectively d rug abuse and its related problems the Government has established the Central Committee for Drug Abuse Control (CCDAC) and subsidiary committees to support its activities. The Government and CCDAC have adopted and are implementing a number of measures in the following areas :
Legislation to Control the cultivation , production , sale, supply and use of drugs ; *
Law enforcement against drug traffickers as well as users who do not voluntarily submit themselves for treatment and rehabilitation ;
In formation and educational programmes for primary prevention of drug abuse ;
Compulsory treatment and rehabilitation programmes for drug addicts ;
* lncluding narcotic and other dangerous drugs.
In 1974, at the peak of the heroin epidemic, the Narcotic and Dangerous Drugs Law was adopted to provide severe penalties for drug trafficking. The Law also provides for punishment of abusers of narcotic and dangerous drugs who fail to take proper treatment and rehabilitation. It is believed that with strong and effective legislation , the country will be in a better position to control and reduce the availability of illicit drugs.
The Law of 1974 imposes the death penalty for the following drug-related in fractions : illegal manufacturing of drugs ; illegal import and export of drugs ; and illegal selling of drugs.
The Law provides for compulsory registration of drug addicts, who must register themselves at a hospital in the nearest town and undergo Compulsory treatment and rehabilitation.
The Army of Burma "Tatmadaw", the People's Police Force and the people themselves have been united in a campaign against drug abuse. This includes destroying poppy plantations and intercepting drug traffickers and seizing their refineries. The Army of Burma is in the vanguard of these activities. The success achieved by such campaigns has had a significant impact on the illegal supply of d rugs.
In 1983/84, 11 ,078 acres of opium poppy crop were destroyed. In 1983 , 3,l67 kilograms of opium, 48 kilograms of heroin, 48 kilograms of brown heroin and 916 kilograms of cannabis were seized.
Steps are also being taken to identify heroin abusers in the population. Persons suspected of being heroin abusers are arrested and, if found to be addicted to heroin but not registered at the treatment centre, they are prosecuted under the 1974 Law. These activities are primarily intended to identify drug abusers as early as possible and to reduce the illicit demand for drugs.
Various informational and educational programmes are carried out to meet the needs of specific population groups, such as youths, parents, community leaders and professional personnel dealing with the problems of young people. .
The family structure in Burma is usually in the form of an extended family and the relationship of its members is close. Parents and elders are respected highly by the young. The teachers of the schools have full command over their students. These resources in the family and school are fully utilized for the prevention and reduction of drug abuse. Particular attention, in the informational and educational programmes, is given to persons who have the greatest personal contact with young people. Educational programmes are, thus, primarily intended to reach family members, teachers, members and leaders of youth organizations and students [ 4] .
The Ministry of Education is responsible for the drug education of students in schools. It has designed and implemented various measures to prevent and reduce drug abuse among students, which are described briefly below.
The lectures and discussions on drug abuse and associated problems are usually conducted by teachers and students in schools. Sometimes experts from treatment centres and drug-law enforcement agencies are invited. Such lectures and discussions usually cover all dependence-producing substances, including tobacco and alcohol, and provide information on the following subjects : history of drug abuse ; types of dependence-producing substances and their effects ; indications for medical use ; the 1974 Narcotic and Dangerous Drugs Law and its enforcement ; physical and mental effects of drug abuse ; medical and social complications of drug abuse ; and treatment and rehabilitation of drug abusers.
Exhibitions on drug-abuse problems are organized by schools at least once a year to help educate the young and students against drug abuse. The displays are prepared by students and teachers, but the voluntary organizations concerned and the community also participate. Although there is not as yet research evidence on the effectiveness of these exhibitions, they are believed to be effective in helping the students and young people to understand and realize the dangers of drug abuse.
Schools organize other drug-abuse prevention activities for their students that include : essay competitions on d rug-abuse problems ; cartoon contests ; poem contests ; and poster and slogan contests.
Both the Ministry of In formation and the Ministry of Education publish and circulate leaflets, newsletters and magazines to keep young people informed of the activities in the field of preventive education , treatment and rehabilitation, and law enforcement. These publications are disseminated free of charge to schools and youth organizations.
In-service drug-abuse prevention training for teachers and school administrators is designed and carried out by the Ministry of Education. Such training programmes are organized for the whole country or at the regional level. Those teachers and administrators who are trained at the national level serve in turn as organizers of in-service training for teachers in their respective regions.
In-service training is usually carried out in the form of a conference or seminar. These training programmes help to increase knowledge on drug abuse problems and teaching skills to convey effectively drug in formation to their students.
The "Lanzin Youth Committee" has been established at the national level to organize and mobilize young people for active participation in the construction work of the country. As part of the measures for the healthy development of the young, the Committee has organized numerous training courses to help young people to improve their qualifications, and to develop social consciousness and a sense of responsibility. The young are encouraged to participate in sports, music and other recreational activities as well as in community welfare programmes. These activities are intended to promote healthy personality development and psycho-social maturation of the young. Those young people who derive satisfaction from such alternative activities or who develop an interest and participate in community welfare programmes are less likely to become regular users of illicit drugs. Providing meaningful opportunities for the active involvement of young people and helping them to keep engaged in and contribute to recreational, social and cultural activities in a community will, it is hoped, reduce the influence of social and environmental factors that are conducive to the initiation of illicit drug use [ 5] .
Other more important projects that the Government has organized and implemented for the development of young people are summarized below.
The "Luyechun" scheme is for outstanding young men and women in studies. It was introduced to attract talented students to be trained for healthy competition among the youth of the nation and to serve as a source of inspiration for other young people. The "Luyechuns" are selected annually from students of secondary schools, universities, colleges, institutes and vocational training institutions. It is hoped that this scheme will promote the identification of young talents and encourage the acquisition of knowledge and skills among students.
The literacy movement commenced on a small scale in 1964 and since 1969 has taken the characteristics of a national mass movement. The movement is intended to mobilize all available resources, in which the young play the major role. Thousands of students and out-of-school youth from the whole country have taken an active part in this movement by teaching villagers to read and write.
In most of the towns of the country , local youth are organized to take part in the activities of the Red Cross and voluntary fire brigades. Both the students and young people out of school are encouraged to get involved in these activities. Training courses with discussions and practical demonstrations are held throughout the year for the members of these organizations to increase their knowledge and skills in such activities.
It is considered that drug addiction is both a medical and behavioural problem that may lead an individual to criminal activity, and that such addiction may be the source of a further spread of the use of illicit drugs. Therefore, medical, social and legislative measures are needed to deal with drug addicts in order to help them to achieve full recovery. For these reasons the 1974 Law has provided for compulsory treatment and rehabilitation of drug addicts. The Ministry of Health has set up many treatment centres for detoxification and medical rehabilitation of young drug abusers. In addition, two large comprehensive centres were established in August 1982 by CCDAC to provide in-patient treatment for addicts who are between 16 and 40 years of age [ 6] .
The main objectives of treatment and rehabilitation programmes are to help addicts to restore their physical health , to achieve psycho-social adjustment and, through training, to acquire necessary occupational and vocational knowledge and skills for employment.
The increase in drug abuse and associated problems in the country and the need to cope with such problems have prompted the Government to recognize that co-operated and co-ordinated efforts on a broad scale in the community should be organized to combat such a scourge. With active participation of the community, it is believed that early detection of drug abusers can be achieved. Community efforts can make the detection of drug traffickers much easier too. Following detoxification of addicts, their aftercare, rehabilitation and social reintegration are much more effective with organized community support.
For these reasons, the Government has mobilized the mass media to alert communities to both the problems of drug abuse and the possibilities of their effective involvement in combating drug abuse and related problems.
In those communities where there are many drug addicts, detoxification services are provided at the local level. In communities with young drug experimenters emphasis is placed on developing alternative programmes to drug use such as recreational activities, leadership-training programmes and voluntary labour contribution schemes. These programmes are organized and carried out under the guidance of local authorities. Mass rallies are also organized for young people to denounce drug abuse.
The Ministry of Social Welfare has developed the voluntary social worker scheme. The main aim of this scheme is to involve the community in the rehabilitation of drug addicts. The Directorate of Social Welfare has provided a number of full-time residential care institutions, such as trade training centres, social support centres and social rehabilitation centres, in areas with a large number of young drug abusers.
It is considered that legislation, drug-law enforcement, prevention, treatment and rehabilitation, and community measures are all interrelated strategies and valuable means of combating drug abuse among young people in Burma. In spite of the fact that the country has still to fight a long battle against drug abuse and related problems, it is clear that the efforts of the fight against drug abuse and its associated problems have shown certain positive results.
l. U. Khant and Win, Drug Abuse in the Socialist Republic ofthe Union of Burma , National Institute on Drug Abuse, Research Monograph Series No. 19 (Washington, D. C., Government Printing Office, 1978).02
U. Khant, "Use and abuse of minor tranquillizers", Mooyit Magazine, No. l , 1983 , p. 10.03
World Health Organization, "Services for the prevention and treatment of dependence on alcohol and other drugs", Fourteenth Report of the WHO Expert Committee on Mental Health, Technical Report Series No. 363 (Geneva, 1967).04
Report of the Workshop on Drug Abuse Prevention Education (Pattaya, Thailand, Colombo Plan Publication, 1979).05
World Health Organization, Youth and Drugs - A Report by a Study Group, Technical Report Series No. 516, Geneva, 1973.06
U. Khant and Win, Acute Drug Abuse Emergencies - Diagnosis and Treatment (Rangoon, Bharti Publishers, 1980).