Drug Policy

Advocacy Group
Myanmar

Addressing
drug problems in Myanmar:
5 key interventions that can make a difference

February 2017
 About this paper

This policy briefing was drafted by a group of local and international organisations1 with in-
depth knowledge and extensive experience of drug-related issues in Myanmar. It is structured
around a set of five strategic interventions, each of which comes with concrete recommenda-
tions that are adapted to the Myanmar context. It contains reliable, up-to-date information
and examples of evidence-based practices from Myanmar and around the world.

Acknowledgements
This publication is the result of a collaborative effort by all member organisations of Drug Policy
Advocacy Group - Myanmar: HIV/AIDS Alliance, Myanmar Anti-Narcotics Association (MANA),
Transnational Institute (TNI), Mdecins du Monde (MdM), Myanmar Opium Farmers Forum (MOFF),
Save the Children, Population Services International (PSI) and National Drug Users Network
Myanmar (NDNM).

It was compiled by Renaud Cachia (TNI).

Special thanks to the following individuals for providing inputs and guidance and for reviewing the
briefing: Nang Pann Ei Kham (DPAG), Dr. Mi Mi Khine Zin (MANA), Kyaw Thu (NDNM), Phone Kyaw
(NDNM), Kiira Gustafson (PSI), Ernestien Jensema (TNI), Tom Kramer (TNI), Dr. Hla Htay (Burnet
Institute), Matt Grace.

Cover Photo

Sterile syringe for injection and aluminium capsule containing heroin.

Credit: Transnational Institute (TNI)

Layout Design

Shadan Seng Raw

Printing

Thiri Khaing Printing Media

Contact

DPAG Coordinator: Nang Pann Ei Kham

Ph: +95 (0) 9 799 852 080
Email: [email protected]
Drug Policy Advocacy Group-Myanmar
Contents

Executive Summary ......................................................................................................................... 1

Introduction ....................................................................................................................................... 2
Key strategic interventions .......................................................................................................... 3
1. Increase access to health, harm reduction and .............................................................................. 3

voluntary drug treatment for people using drugs

2. End the criminalisation of drug users and small-scale farmers .............................................. 6

3. Refocus law enforcement efforts on violent organised crime ................................................. 9

and large-scale drug production and trafficking

4. Promote development projects in opium growing areas ........................................................... 11

5. Include civil society and affected communities in policy reform ........................................... 14

Conclusion ........................................................................................................................................... 14
Endnotes .............................................................................................................................................. 15

I believe that drugs have destroyed many

lives, but wrong government policies have
destroyed many more.

Kofi Annan,
former Secretary General of the United Nations
EXECUTIVE SUMMARY

Myanmars drug policies are out-dated and programmes voluntarily abandoned opium
inadequate to respond to the great challenges cultivation and successfully transitioned
posed by problematic drug use and production towards licit livelihoods strategies.
in the country. The 1993 Narcotic Drugs and
Psychotropic Substances Law has failed to These domestic experiences add up to a growing
eliminate - or even reduce - drug use, trafficking body of evidence from all around the world,
and production. Worse, the implementation which indicate that policies grounded in public
of harsh policies and penalties has caused health, human rights and development, can
immense additional harm to Myanmar people yield an impressively wide range of benefits.
and communities. Indeed, such policies not only improve peoples
health and support livelihoods, they also lower
Thousands of people have been unnecessarily levels of drug related crime and corruption,
exposed to the risk of infectious diseases and reduce violence, conflict, and pressure on the
premature death as a direct result of those criminal justice system, and ultimately result in
policies. Myanmar prisons are filled with drug greater social cohesion.
users serving long-term sentences for mostly
non-violent small drug offenses, while major Existing good practices are no doubt positive
traffickers are left undisturbed. Entire villages steps but are yet to be implemented at scale.
of impoverished poppy farmers have been Overall, the lack of adequate response by previous
targeted by forced eradication campaigns and Governments has led to great frustration among
pushed further into poverty, without any viable affected communities and the Myanmar population
livelihoods alternatives to survive and pay for at large, as drug related problems have continued
healthcare and education of their children. to mount and have become a key national
concern.
Fortunately, successful interventions have also
been conducted in the country. HIV prevalence Time has come to learn from such failures,
among people who inject drugs started to embrace a different approach and adopt policies
decline following the implementation of health that are based on public health, community
and harm reduction services for drug users. safety, human rights and development. Only
The lives of thousands of drug users and their such policies will deliver on the promise to
families have hugely improved, thanks to the improve peoples lives; only such policies will
benefits of methadone programmes initiated by truly allow Myanmar to reduce the harm
Myanmar Ministry of Health and Sports. Several caused by problematic drug use, trafficking and
isolated communities from Eastern Shan State production.
that were included in alternative development

The war on drugs has been an utter failure.

Barack Obama

1
INTRODUCTION to be high, in particular in Kachin and Northern
Shan States.9 The main health consequences
of problematic drug use include high rates
Situated within the Golden Triangle,2 Myanmar of HIV and Hepatitis B and C transmission, as
is the worlds second largest producer of illicit well as lethal overdoses, due to unsafe injection
opium after Afghanistan.3 Poppy cultivation is practices.10
primarily concentrated in the mountainous
areas of Shan and Kachin States, where an Beyond the questions of production and use,
estimated 300,000 households are growing
drug-related problems in Myanmar appear to
opium,4 mostly as a result of poverty.5 Part of
be complex and deeply interconnected with
the opium produced is consumed locally for
traditional and medicinal purposes;6 however, numerous other issues such as conflict, poverty,
a large share of the production is refined into food insecurity, lack of development, limited
heroin for the domestic and international access to land and weak governance or rule of
markets.7 Myanmar has also become a major law. Overly simplistic solutions are regularly
producer of amphetamine-type stimulants, proposed, the most common of all being to wage
more commonly known as Yaba or Yama.8 another war on drugs. However, evidence
shows that such strategies have failed and have
actually caused problems much greater than
those they intended to address.11

We must recognise the global

drug problem as a set of
interlinked health and social
challenges to be managed,
rather than a war to be won.
The Global Commission on Drug
Policy12
The suffering of individuals and families
affected by drug-related problems are real,
and as a result deserve drug policies that are
pragmatic, effective and grounded in evidence.
Myanmars drug policies must be based on
available scientific and empirical evidence and
Blooming opium poppies in Shan State no longer under the influence of emotions and
Photo credit: Transnational Institute (TNI) ideology. Addressing problems linked to drug
use, trafficking and production will require
Although there is no reliable data on the overall long-term, multidimensional approaches that
number of drug users in the country, the focus on public health, community safety,
prevalence of problematic drug use is thought human rights and development.

2
KEY STRATEGIC protect health, Myanmar has prioritised drug
INTERVENTIONS demand and supply reduction strategies based
on repression for decades, while little effort has
1. Increase access to health, harm been made, and even fewer domestic resources
reduction and voluntary drug allocated, to establish evidence-based health
treatment for people using drugs and social interventions.13

Protecting peoples health is the main aim of the Devastating HIV and Hepatitis C epidemics
international drug control system: it is precisely continue to rage among drug users.14 The
because of the health problems potentially Myanmar Ministry of Health and Sports has long
caused by drug use that Member States have acknowledged that this situation represents
attempted to reduce drugs availability and the biggest challenge the country is facing to
consumption. The 1961 UN Single Convention reduce and prevent a further spread of HIV, and
on Narcotic Drugs states that its ultimate has again included harm reduction services
objective is to improve the health and welfare for people who inject drugs as a key priority of
of mankind. But despite the imperative to its new national strategic plan for HIV / AIDS
(2016 2020).

Did you know? To respond to this major public health crisis,

the Myanmar Ministry of Health and Sports
Nearly 1 in every 3 injecting drug users
has supported the provision of specific health
in Myanmar is living with HIV. This is 48 services for drug users in regions most affected
times higher than the prevalence in the by injecting drug use Kachin and Shan States,
general population.15 and Mandalay, Sagaing and Yangon divisions.
In some parts of Kachin State, nearly 1 Known as harm reduction, these programmes
in every 2 injecting drug users is living aim at reducing the harms associated with
with HIV.16 drug use. Services include needle and syringe
exchange programmes, opioid substitution
For every 10 new HIV infections in the
therapy (methadone maintenance therapy in
country, nearly 3 occur among people
who inject drugs. The highest number of
new HIV infections for the period 2015-
2020 is projected to be among people
who inject drugs.17
Only 1 in every 7 people who inject
drugs currently has access to methadone
maintenance therapy.18

Sources: Integrated biological and behavioural

survey among people who inject drugs, Myanmar, 2014. Health education session at a health centre
HIV Estimates and Projections. Asian Epidemic Model, offering harm reduction services to drug users,
AEM (2015) Myanmar. National Drug Abuse Control Kachin State
Programme, Ministry of Health, 2015. Photo credit: Mdecins du Monde (MdM)

3
Myanmars context), HIV testing and treatment Even if some may disapprove drug
and overdose prevention and management. use, lets not forget that drug users
are also members of our communities.
The results are encouraging, as HIV prevalence
They are sons and daughters, husbands
and wives, fathers and mothers
among young injecting drug users (under 24 of
Public health is everyones concern.
age) fell from 66% in 2000 to 17% in 2014;19 A community that is free from HIV
however, coverage is still insufficient. It is and other blood borne disease is
therefore urgently required to scale up those fundamentally a safer community.
services to better protect Myanmar peoples Eamonn Murphy, UNAIDS Country Director
health and ensure safer communities. in Myanmar25

Needle and syringe distribution and HIV prevalence among people who inject drugs (2003 - 2014)

Source: Global AIDS Response progress report (2015), Myanmar, National AIDS Programme
Figure 1: The provision of sterile needles and syringes has increased rapidly following the start of harm reduction
services. Meanwhile, HIV prevalence among people who inject drugs has started to decrease.

Harm reduction services have an impressive In addition, a large body of evidence also shows
record of effectiveness, supported by extensive that harm reduction services:
scientific evidence from around the world. In fact, Do not increase drug use;23
harm reduction services have been proven to: Are highly cost-effective. For example,
Significantly reduce the transmission of a study conducted in Australia recently
blood-borne diseases such as HIV and documented how the Australian
Hepatitis C;20 Government saved as much as 4 USD for
Improve the uptake of medical, legal and every 1 USD invested in harm reduction
social services and medical treatment services.24
for drug dependence;21
Result in reduced criminality.22

4
The need for voluntary and Intervention 1 - Key
evidence-based dug treatment recommendations
The United Nations has called on all States
to close compulsory drug detention and Explicitly recognise the protection of
rehabilitation centres and implement public health and community safety as
voluntary, evidence-informed and rights- a central objective of drug policies.
based health and social services in
communities.26
Provide a legal basis, through specific
provisions in the Law, for evidence-
based prevention, voluntary treatment
and harm reduction interventions.

Increase public expenditure for the
provision of essential health services,
including harm reduction, for drug
Methadone dispensing at a Government-run hospital users. Pro-actively support and
in Kachin State. Access to methadone, a highly effective
treatment for opiates dependent users, is still insufficient facilitate the implementation of health
and should be further scaled-up.
services for drug users by non-state
Photo credit: Mdecins du Monde (MdM) actors (NGOs, CSOs etc.) in all affected
The number of hospitals and specialised areas.
facilities currently offering evidence-based
drug dependence treatment services
in Myanmar is disproportionally low,
Scale up voluntary and evidence-based
especially in regions that are severely drug treatment, including methadone
affected by injecting drug use. In addition, programmes, and rehabilitation for
compulsory treatment is still being drug users. Explicitly ban the use of
extensively used despite there being no forced or compulsory treatment as a
evidence that it is effective in treating
systematic alternative to incarceration
people with drug addiction problems.
for drug use.
Depriving people of their liberty, or forcing
them to undertake treatment without their
consent, does not create an environment
that is conducive to long term recovery,
and relapse rates as high as 90% have been
reported following release from those
centres in China and Cambodia.27 Moreover,
compulsory drug treatment necessarily
takes place in closed settings, where both
human rights and health-related concerns,
such as increased vulnerability to HIV and
TB infection, often arise.

5
2. End the criminalisation of drug Today, evidence clearly indicates that this theory
users and small-scale farmers that harsher punishments will result in lower
drug use and availability is incorrect. Drugs
are widely available in Myanmar and high rates
The criminalisation of drug use and poppy
of problematic drug use continue to prevail in
cultivation largely relies on the assumption
many regions,32 despite thousands of arrests33
that fear of being arrested and punished will
and a significant intensification of poppy
deter people from using drugs and growing eradication campaigns in the past few years.34
illicit crops. Myanmar policies are still based This phenomenon is not specific to Myanmar
on this principle, and severe punishment for and has also been documented internationally.
drug-related offences were introduced as early Several studies conducted around the world
as 1974.28 Sanctions were greatly reinforced in show that there is no correlation between the
1983,29 and the current 1993 Narcotic Drugs severity - or the intensity - of law enforcement
and the prevalence of drug use in a given
and Psychotropic Substances Law remains one
country.35
of the harshest drug policies in the world.30

Estimated number of drug users in the world Estimated number of People Who Inject Drugs
(Millions) in Myanmar

Source: World Drug Report 2015, UNODC Source: Myanmar Ministry of Health
Figure 2: the overall number of drug users in the world Figure 3: there are no estimates for the overall number
continues to increase despite the intensification of of drug users in Myanmar. However, estimates for the
global efforts to reduce drug supply and demand. number of injecting drug users suggest the population is
increasing.

The UN Conventions and the In addition to its ineffectiveness to curb drug

criminalisation of drug use use and availability, considering drug use as
a crime and subsequently punishing drug
Prison penalties for drug use are falsely users has highly negative consequences for
believed to derive from the obligations
public health and community safety: Evidence
contracted by Myanmar under the UN
collected in Myanmar shows that the fear
Drug Control Conventions. In fact, the
UN Conventions do not require Member of arrest and detention pushes drug users
States to criminalise drug use itself or its underground and drives them away from harm
possession for personal use.31 reduction and other essential health services.36

6
Punishment hinders access to sterile injection
equipment, fuels riskier injecting practices The example of Portugal
such as sharing injecting equipment and
subsequently leads to higher transmission of Portugal experienced a severe epidemic of
HIV and Hepatitis C.37 Moreover, the regular heroin use during the 1980s and 1990s.
harassment of drug users for the possession of In 2001, the Government decided to
needles and syringes pushes them to discard experiment a different approach to drug
used needles in the open,38 thus increasing the control based on health, human rights and
risks of needle prick injuries for children or support rather than repression. The new
other members of the community. law reclassified drug use and possession
for personal use as an administrative
offence, as opposed to a criminal offence.
It also allocated significantly greater
Criminalisation is the resources to health and social services for
opposite of a pragmatic, people using drugs.

health-centred, harm
While some groups warned the
reduction approach it is, government that drug use may increase,
in effect, a policy of harm none of those fears turned out to be
maximization. justified. Instead, Portugals drug policy
has been recognised as one of the most
The Global Commission on Drug successful in the world due to its wide
Policy range of benefits:

HIV infections dramatically decreased;41
In contrast, countries that have abolished Deaths by overdose plummeted;42
prison penalties for minor drug offences - The number of people entering drug
such as drug use or possession for personal dependence treatment programmes
use have achieved impressive health and increased dramatically;43
The number of drug users and
social outcomes, especially when they have
problematic users, especially among
simultaneously invested in health and social
adolescents, fell.44
interventions. 39 The key benefits include:
Overcrowding in the criminal justice
A decrease of blood-borne virus system reduced;45
transmission and lethal overdoses; Crimes related to drug consumption,
An increased uptake of drug dependence especially petty thefts, declined.46
treatment;
Reduced costs to the criminal justice
system.40

7
Similarly, criminalising small-scale poppy Intervention 2 -
farmers has not led to a reduction in poppy
cultivation.47 On the contrary, such policies
Key recommendations
have often resulted in fuelling corruption with
law enforcement and Government officials Abolish criminal penalties for minor,
extorting money from poppy farmers in return non-violent, drug offences drug
for not arresting them or refraining from use and possession for personal
eradication.48 use, and small-scale cultivation. If
full decriminalisation is not deemed
possible, reclassify low-level drug
offences as administrative violations,
for which no incarceration is
foreseen.

Alternative Development Develop alternatives to prison

sentencing for minor drug offences -
requires an appropriate drug use or possession for personal
use - such as drugs confiscation,
policy-legal framework, warnings, fines, referral to health and
treatment services, or community
one that allows illicit-crop service. Explicitly rule out the use
growers to be treated of forced treatment as a systematic
alternative to incarceration.
first as candidates for

development rather than Provide a solid legal basis for the

provision of harm reduction services,
as criminals. including specific references in
the new law to needle and syringe
exchange programmes, peer
Evaluation of Commission on education, opioid substitution
Narcotic Drugs (CND), 2005 therapy and overdose prevention and
management.

Abolish the death penalty for drug-

related offences.

8
3. Refocus law enforcement efforts Another seriously negative consequence of
on violent organised crime and Myanmars drug policy is the huge strain it
puts on the criminal justice system. Thousands
large-scale drug production and
of arrests are conducted every year and a
trafficking
large proportion of Myanmars nearly 60,000
prisoners are people who were sentenced to
Myanmars current legal framework categorises long-term jail terms for mostly small drug-
all drug offences as criminal offenses that related offences.51
are subject to heavy prison penalties. Law
enforcement agencies therefore primarily
focus their efforts on low-level violations such Myanmars prison population
as drug use, drug possession for personal use
or small-scale poppy cultivation. In fact, drug There were 5,740 drug-related arrests
users, petty dealers or small-scale poppy in Myanmar in 2012 alone,52 and 6,414
farmers are simply easier targets than major drug cases brought against 9,188
traffickers, who may benefit from high-level suspects in 2015.53
relationships and can use their money and In Myitkyina, more than two thirds of
influence to obtain protection.49 In practice, the all prisoners are incarcerated for minor
criminalisation of low-level drug offences today drug offences.54
results in the monopolisation of the polices Myanmar prisons are currently
limited human and financial resources to deal occupied at 150% of their maximum
with minor, mostly non-violent law violations, capacity.55
while only few efforts are being made to fight
organised and violent crime and large-scale
drug production and trafficking.

Look at the arrests taking place

[in Myanmar]. Its the truck
drivers, the couriers, the relatively
easy [targets]. Myanmar needs to
concentrate on those running the
businesses those making all the
money.
Jeremy Douglas, UNODC regional
representative for Southeast Asia and
the Pacific50

Drug user held in custody in Kachin State

Photo credit: Transnational Institute (TNI)

9
In contrast, the decriminalisation of low- the level of crops eradicated. Those are merely
level, non-violent drug offences drug use, quantitative outputs that fail to measure the
possession of small quantities for personal outcomes or the impact of those policies.
use or small-scale cultivation would allow
refocusing law enforcement efforts on more New indicators are urgently needed to better
disruptive forms of criminality, such as violent assess the success of drug policies in terms of
and organised crime, large-scale trafficking, their harms and benefits for individuals and
corruption, or money-laundering. This change communities. These criteria could, for instance,
of focus would greatly alleviate the burden of include: the level of overdose deaths and the
law enforcement agencies and reinforce their level of HIV or Hepatitis C infection among drug
ability to effectively reduce more serious forms users; the level of corruption generated by drug
of crime. In addition, some of the resources that markets; the level of petty crime committed
are currently used for punitive drug control by dependent users or levels of social and
activities - police, justice and prisons could economic development in communities where
be reallocated to far more cost-effective health drug production, selling or consumption are
and social interventions for drug users. highly prevalent.

Intervention 3 -
Since big traffickers are difficult
Key recommendations
to catch, police officers working

on the ground mostly arrest drug
users and petty dealers to please Refocus law enforcement efforts
and priorities toward the reduction
their superiors with case numbers. of large-scale drug trafficking and
Instead, law enforcement efforts organised and violent crime.

should be focused on big time
dealers and traffickers. Of course, Define new criteria to measure
the outcomes of drug policies in
this also means having access to
terms of harms and benefits for
more sophisticated intelligence individuals and communities, rather
gathering, better equipment than current quantitative-only
and advanced trainings in outputs.

collaboration with neighbouring
countries. Reallocate part of the resources
that are currently spent on policing
U Hkam Awng, Retired Police Colonel, efforts and criminal justice for low-
former Joint Secretary and Head of level drug offences to health and
Department, Office of CCDAC
social interventions.

The indicators that are used to measure

Dedicate specific resources to fight
the outcomes of current drug policies are against corruption, bribery and
traditionally based on the number of arrests money laundering at various levels.
conducted, the quantities of drugs seized, or

10
4. Promote development projects in for instance, poverty, food insecurity, armed
opium growing areas conflict, lack of basic infrastructure and access
to essential services, limited access to land,
Myanmars current drug policies attempt to absence of viable employment opportunities,
reduce drug supply and demand primarily weak state institutions or lack of good
through a punitive approach, without addressing governance.
the driving factors of problematic drug use In Myanmar, the vast majority of people who
and illicit crops production. Opium poppy grow opium are impoverished small-scale
cultivation and to a lesser extent problematic farmers from various ethnic minorities living
drug use are, in fact, largely symptomatic of in the remote mountains of Shan and Kachin
other underlying conditions. Those include, States who grow opium as a way to survive.56

Villagers collecting poppy seeds in dry opium bulbs

Photo credit: Transnational Institute (TNI)

Cultivation and eradication of opium poppy Forced eradication in those regions, where most
from 2006 to 2015, Myanmar (Hectares)
of the above-mentioned underlying conditions
still prevail, is a futile effort. In fact, despite
the intensification of eradication campaigns in
the country in recent years, opium cultivation
almost tripled between 2006 and 2013.57

Source: GOUM/CCDAC; UNODC (Southeast Asia Opium

Survey 2015)
Figure 4: Poppy cultivation almost tripled between 2006
and 2013 despite higher levels of eradication.

11
 Opium harvest in southern Shan State
Photo credit: Transnational Institute (TNI)

In practice, forced eradication campaigns often

target the most vulnerable communities, pushing
them further into poverty. Paradoxically,
eradication therefore acts as a powerful The case of Thailand
incentive for farmers to move into more remote
areas and increase cultivation the following In 1969, Thailand started implementing a
year in order to compensate for losses and long-term cooperative approach to opium
repay debts.58 control that encouraged income generation
alternatives to opium cultivation - rather
The most wasteful and than law enforcement. Authorities, under
ineffective programme that I the leadership of the late King Bhumibol
have seen in 40 years. Adulyadej, invested substantially in
development programmes in poppy
Richard Holbrooke, former US special
representative for Afghanistan and growing areas to ensure that ethnic groups
Pakistan, on US-supported poppy living in the north of the country had
eradication in Afghanistan
viable alternatives to opium. By 1985,

Numerous international organisations opium cultivation in Thailand had declined

Governments, UN Agencies, donors and financial by 78%, from 145 metric tons to 33
institutions have acknowledged the failure metric tons - without forced eradication.
of forced eradication and recognised that the Production dropped by another 50%
driving factors of illicit crops cultivation should
the following year despite the fact that
be addressed in the first place. In November
eradication efforts were very limited
2015, more than 250 participants from 40
countries, including Major General Aung Soe in scope. As of today, Thailand opium
(Deputy Minister for Home Affairs), reaffirmed production has reached negligible levels.59
at the 2nd International Conference on Alternative
Development (ICAD2) in Thailand, that alternative
development should be one of the fundamental
pillars of international drug control.

12
Current support to alternative development
projects in Myanmar is extremely limited, Intervention 4 -
as only a few communities have received
Key recommendations
assistance. Several projects were implemented

by UNODC in Southern Shan, and the Mae Fah
Luang Foundation supported community- Recognise alternative development as
development programmes in Eastern Shan. one of the cornerstones of Myanmar
However, some officials have showed a growing drug control strategy. Include
interest in expanding alternative development alternative development as a high-
programmes and adopting a more development- level priority in national drug policies,
oriented approach to illicit poppy cultivation.60 with specific references to its key
principles (people-centred and long-
term approach, non-conditionality and
The government should proper sequencing to ensure sustained
not carry out any forced income).

eradication of our opium fields
unless and until they have Invest and implement alternative
development projects in impoverished
provided access to sustainable poppy growing areas, and include
crop substitution programmes alternative development within a
and alternative livelihoods broader national rural development
strategy.
to our communities. []

Instead of only eradicating our
Facilitate access and administrative
poppy fields, and demanding processes for organisations willing to
bribes and illegal taxation, implement alternative development
government officials should projects in poppy growing areas.

provide basic services and
long-term support to develop Rule out the use of forced eradication
until people have access to alternative
our communities. This livelihoods opportunities (proper
should include food security, sequencing).
education and health services,
electricity, infrastructure and
communication.

Myanmar Opium Farmers Forum,

Loikaw, 9 May 2016

13
5. Include civil society and affected
Intervention 5 -
communities in policy reform
Key recommendations

The involvement of affected communities
in policy design is a key principle of good
Involve representatives of drug users
and poppy farmers in drug policy
governance and a commonly accepted practice
design and reform and programme
worldwide. In fact, involving the people most
implementation.
affected by a particular problem in defining the
response can lead to much improved long-term
outcomes. In addition, it can also help reduce
Invite civil society organisations to
take part in discussions on drug-
stigma and discrimination. Nevertheless, related policies.
drug users and poppy farmers, who are by
far the most directly affected by drug-related
problems, today continue to be marginalised in
Sensitise and raise awareness among
the public on evidence-based drug
the drug policy debate in Myanmar, and their policies based on public health, human
voices are still insufficiently heard. rights and development.

Policy makers and political leaders are often

reluctant to adopt a different approach to
drug policy, as they assume public opinion is
predominantly conservative and in favour of
CONCLUSION
hard-line strategies. This, however, is not
necessarily true for the entire population even In November 2015, an overwhelming majority
though many have been influenced by years of of Myanmar people voted for change. Millions
authoritarian rule and punitive approaches of electors granted the National League for
to drug issues. In reality, Myanmar peoples Democracy, and its leader Daw Aung San Suu
apparent support for punitive actions rather Kyi, unequivocal support to initiate this change:
derives from the frustration and exasperation to break from the countrys authoritarian past
that are, in fact, caused by the inefficiency of and adopt a different approach to politics.
existing drug policies.
It is time for Myanmar to acknowledge that
Achieving ambitious reforms always requires punitive approaches to drug-related problems
political courage, as Myanmars recent have failed to result in any tangible benefits for its
history and political transition well illustrate. people. Instead, the country should refocus efforts
Meaningfully engaging with civil society on proven and effective policies based on public
and communities directly affected by drug- health, community safety, human rights and
related problems and policies will therefore development. It is time for Myanmar to become
be a crucially important step to ensure public again a democratic, progressive and inclusive
support and backing for new drug policies. society that truly acts to protect its people. It is
time for Myanmar to reaffirm its prominence
on the international scene, and prove that more
Its time for change. humane and effective drug policies are not only
Daw Aung San Suu Kyi possible in distant countries, but also in Myanmar
and Southeast Asia.

14
Endnotes

1 Myanmar Drug Policy Advocacy Group includes the following organisations: HIV / AIDS Alliance, Myanmar Anti-Narcotics Association
(MANA), Transnational Institute (TNI), Mdecins du Monde (MdM), Myanmar Opium Farmers Forum, Save the Children, Population Services
International (PSI) and National Drug Users Network Myanmar (NDNM).

2 The Golden triangle is a major opium producing area that overlaps the mountains of three countries of Southeast Asia: Myanmar, Laos and
Thailand.

3 UNODC, Southeast Asia Opium Survey 2015, Lao PDR, Myanmar.

4 UNODC, Souhteast Asia Opium Survey 2012, Lao PDR, Myanmar.

5 Bouncing back, relapse in the golden triangle. TNI - June 2014

6 Found in the dark The impact of drug law enforcement practices in Myanmar TNI and National Drug Users Network Myanmar (NDNM)
September 2016

7 Scott Green, Happy Hour for Heroin in China, China Digital Times, September 26, 2013, http:// chinadigitaltimes.net/2013/09/china-
demand-heroin- outpacing-golden-triangle-supply/.

8 Country Report: Burma, Bureau of International Narcotics and Law Enforcement A airs, 2015 International Narcotics Control Strategy
Report, US Department of State. Link: http://www.state.gov/j/inl/ rls/nrcrpt/2015/vol1/238952.html.

9 Situational analysis on drug use, HIV and the response in Myanmar: looking forward. UNAIDS, May 2015

10 Global AIDS Progress report Myanmar, 2014, National AIDS Program, MoH

11 Public health and international drug policy, the Lancet Commissions, Vol 387, April 2, 2016. http://www.thelancet.com/journals/lancet/
article/PIIS0140-6736(16)00619-X/fulltext

12 The global Commission on Drug Policy is an organisation composed of 23 political leaders and high profile personalities, including 10
former Heads of States.

13 Myanmars Government financial contribution to Harm Reduction services in the country is estimated around 12%, while the remaining
88% are funded by International Donor Agencies (UNAIDS Do No Harm Health, Human Rights and People Who Use Drugs 2016). Besides
the provision of Methadone services, only few Drug Treatment Centres are fully operational (only 2 for the whole of Kachin State). In addition,
most rehabilitation centres under the Ministry of Social Welfare are not functioning due to a lack of funding (National HIV Legal Review
UNAIDS, UNDP, Pyoe Pin September 2014).

14 HIV prevalence among PWID is estimated to be at 28.3% in 2014 Source: Integrated Biological and Behavioural Survey among People
Who Inject Drugs, Myanmar, 2014.

15 HIV prevalence among PWID: 28.5%; HIV prevalence among general population: 0.6%.
Integrated Biological and Behavioural Survey Among People who Inject Drugs, Myanmar, 2014. HIV Estimates and Projections. Asian
Epidemiological Model. Myanmar. December 2014.
National Drug Abuse Control Programme, Ministry of Health, 2015.

16 HIV prevalence among PWID in Bamaw township: 45%; HIV prevalence among PWID in Waimaw township: 47%; Integrated Biological and
Behavioural Survey Among People who Inject Drugs, Myanmar, 2014. HIV Estimates and Projections. Asian Epidemiological Model. Myanmar.
December 2014.

17 28% of new HIV infections occur among PWID;

Integrated Biological and Behavioural Survey Among People who Inject Drugs, Myanmar, 2014. HIV Estimates and Projections. Asian
Epidemiological Model. Myanmar. December 2014.

18 12,488 people were accessing Methadone Maintenance Therapy programs as of December 2016.
Methadone program annual review, December 2016, Yangon.

19 HIV Sentinel Surveillance (HSS), National AIDS Program (NAP), 2000 2014

20 Evidence for action technical papers. Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug
users. Geneva, World Health Organization, 2004.
Wodak A, Cooney A. Do needle syringe programs reduce HIV infection among injecting drug users: a comprehensive review of the international
evidence. Substance Use & Misuse, 2006, 41(6-7):777813.

21 Evidence for action technical papers. Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug
users. Geneva, World Health Organization, 2004.
World Health Organization, United Nations Office on Drugs and Crime, Joint United Nations Programme on HIV/AIDS.
Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva, World
Health Organization, 2012 revision.
Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations. Geneva, World Health Organization, July 2014.

15
22 Breaking the link: The role of drug treatment in tackling crime. London, NSH National Treatment Agency for Substance Misuse, 1997.
The effectiveness of criminal justice and treatment programmes in reducing drug-related crime: a systematic review. London, UK, Home Office
online report. (http://www.crim.cam.ac.uk/people/academic_research/david_farrington/olr2605.pdf)

23 Evidence for action technical papers. Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug
users. Geneva, World Health Organization, 2004.

24 Kwon JA, Anderson J, Kerr CC, Thein HH, Zhang L, Iversen J et al. Estimating the cost-effectiveness of needlesyringe programs in Australia.
AIDS. 2012;26:220110.

25 8th Asian informal drug policy dialogue, co-organised by TNI, GIZ and CCDAC, Nay Pyi Taw, 6 - 8 November 2016

26 For more information see UN joint statement on Compulsory drug detention and rehabilitation centers: http://www.unaids.org/sites/
default/files/sub_landing/files/JC2310_Joint%20Statement6March12FINAL_en.pdf

27 United Nations Office of Drugs and Crime, 2010

United Nations Office of Drugs and Crime. Evidence from compulsory centres for drug users in East and South East Asia. Background Paper
prepared by UNODC RE EAP for the Regional Consultation on Compulsory Centres for Drug Users, 1416 December, 2010, Bangkok, Thailand,
2010; http://www.unaids.org.cn/pics/20130719153407.pdf. (accessed 04.11.14)
Yan et al., 2013
Yan, L., Liu, E., McGoogan, J.M., Duan, S., Wu, L.T., Comulada, S. et al. Referring heroin users from compulsory detoxification centers to
community methadone maintenance treatment: A comparison of three models. BMC Public Health. 2013; 13: 747
DOI: http://dx.doi.org/10.1186/1471-2458-13-747

28 1974 Narcotics and Dangerous Drugs Ordinance was Myanmar first Drug law.

29 The 1974 Narcotics and Dangerous Drugs Ordinance was amended in 1983. Penalties foreseen for failure to register as a drug user
notably increased from 1 to 2 years previously to 3 to 5 years imprisonment, and death penalty was introduced for the most serious drug
offences.

30 1993 Narcotic and psychotropic substances Law notably foresees 3 to 5 years prison penalties for failure to register as a drug user; 5 to
10 years imprisonment for the possession of illicit drugs, including for personal use only, 10 to 20 years for drug dealing offences including
relatively minor and non-violent - and the death penalty for the production, sale and trafficking (even though death penalty is currently not
enforced).

31 Commentary on the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988, para. 3.95

32 Global AIDS Progress report Myanmar, 2014, National AIDS Program, MoH
Situational analysis on drug use, HIV and the response in Myanmar: looking forward. UNAIDS, May 2015

33 There were 5,740 drug-related arrests in Myanmar in 2012 alone Patterns and trends of Amphetamine-Type-Stimulants and other
drugs: Global SMART Programme, 2013 Challenges for Asia and the Pacific, UNODC, 2013.

34 South-East Asia Opium Survey 2015 UNODC

35 Degenhardt, L., Chiu, W.T., Sampson, N., Kessler, R.C., Anthony, J.C. et al. (2008) Toward a Global View of Alcohol, Tobacco, Cannabis,
and Cocaine Use: Findings from the WHO World Mental Health Surveys, PLoSMedicine, vol. 5, no. 7 www.plosmedicine.org/article/
info:doi/10.1371/journal.pmed.0050141 Accessed 11.07.14
European Monitoring Centre for Drugs and Drug Addiction (2011) Looking for a relationship between penalties and cannabis use www.
emcdda.europa.eu/online/annual-report/2011/boxes/p45 Accessed 08.07.14
Single, E., Christie, P. and Ali, R. (2000) The impact of cannabis decriminalisation in Australia and the United States, Journal of Public Health
Policy, vol. 21, no. 21, pp. 157-186 www.ncbi.nlm.nih.gov/pubmed/10881453 Accessed 08.07.14

36 See National HIV legal review report, review of Myanmars legal framework and its effect on access to health and HIV services for people
living with HIV and Key Affected Populations, September 2014, UNDP / UNAIDS/ Pyoe Pin

37 Global Commission on Drug Policy (2012) The War on Drugs and HIV/AIDS http://globalcommissionondrugs.org/wp-content/themes/
gcdp_v1/pdf/GCDP_HIV-AIDS_2012_REFERENCE.pdf and, Global Commission on Drug Policy (2013) The Negative Impact Of The War On
Drugs On Public Health: The Hidden Hepatitis C Epidemic www.globalcommissionondrugs.org/hepatitis/gcdp_hepatitis_english.pdf.

38 Found in the dark The impact of drug law enforcement practices in Myanmar TNI and National Drug Users Network Myanmar
(NDNM) September 2016

39 Rosmarin A, Eastwood N. A quiet revolution. drug decriminalisation policies in practice across the globe. London: Release; 2012 (http://
www.countthecosts.org/sites/default/files/release-quietrevolution-drug-decriminalisation-policies.pdf, accessed 6 April 2016).

40 Ibid.

41 Domosawski A. Drug policy in Portugal: the benefits of decriminalizing drug use. Warsaw: Open Society Foundations; 2011 (https://
www.opensocietyfoundations.org/sites/default/files/drug-policy-inportugal-english-20120814.pdf, accessed 6 April 2016).

42 Hughes_and_Stevens,_A Resounding Success or a Disastrous Failure:_ReExamining_the_Interpretation_of_Evidence on the Portuguese

decriminalization of illicit drugs. 107 (Sicad). Relatorio annual 2013 a situacao do pais em material de drogas e toxicodependencias 64

16
43 Ibid

44 Hughes and Stevens, What Can We Learn from the Portuguese Decriminalization of Illicit Drugs?, 999-1022; Mafalda Ferreira, Margarida
Gaspar de Matos, and Jos Alves Diniz, Risk Behaviour: Substance Use among Portuguese Adolescents, Procedia - Social and Behavioral
Sciences 29(2011): 486-92.

45 Ibid

46 See 26, Ibid

47 Poppy cultivation almost tripled in Myanmar between 2007 and 2013 - South East Asia Opium Survey 2015, UNODC

48 Transnational Institute, Bouncing back, relapse in the Golden Triangle, released in June 2014

49 Found in the dark The impact of drug law enforcement practices in Myanmar TNI September 2016

50 See interview for the Myanmar Times on the 28th of June 2016

51 Bureau of Democracy and Labor, US Department of State, Country reports for human rights practices, 2014 Burma Link: http://www.
state.gov/j/drl/rls/hrrpt/humanrightsreport/index.htm?year=2014&dlid=236428#wrapper accessed 8/12/2015

52 UNODC Patterns and trends of Amphetamine-Type-Stimulants and other drugs: global SMART programme 2013 challenges for Asia and
the Pacific

53 Myanmar Times, 19 October 2016. Data disclosed by Major General Aung Soe, deputy minister for home affairs. http://www.mmtimes.
com/index.php/national-news/mandalay-upper-myanmar/23167-four-drug-rehab-centres-to-open-in-december.html

54 September 2014, estimate by an official of the Central Committee for Drug Abuse Control (CCDAC) given to TNI

55 In February 2015 the Myanmar National Human Rights Commission reported that Insein Prison was detaining over 7,876 prisoners while
the maximum capacity is 5,000. http://www.mnhrc.org.mm/en/unofficialtranslation-the-press-statement-regarding-the-visit-toinsein-
central-prison-by-the-myanmar-national-humanrights-commission-statement-no-3-2015/
According to World Prison Brief the occupancy level was 144.3% in 2012, not taking into account labour camps. http://www.prisonstudies.
org/country/myanmarformerly-burma, accessed 7/12 15

56 Transnational Institute, Bouncing back, relapse in the Golden Triangle, released in June 2014

57 UNODC Southeast Asia Opium Survey 2015

58 UNODC, https://www.unodc.org/southeastasiaandpacific/en/myanmar/2012/05/food-distribution/story.html

59 Opium cultivation in the Golden Triangle, Lao PDR, Myanmar Thailand Thailand Opium Survey 2006 UNODC

60 The current State of Counternarcotics in Myanmar TNI

17
Financial contribution

This publication has been made possible with financial support from the Open Society Foundations.
The content of this publication is the sole responsibility of DPAG and should in no way be taken to
reflect the views of the Open Society Foundations.

Contact
DPAG Coordinator: Nang Pann Ei Kham
Ph: +95 (0) 9 799 852 080
Email: [email protected]
Drug Policy Advocacy Group-Myanmar

Drug Policy
Advocacy Group
Myanmar
The Drug Policy Advocacy Group is a discussion platform composed of a wide range
of stakeholders with an interest in drug-related policies and practices. Members
include representatives from the drug users and opium farmers communities,
civil society organisations, international and local NGOs. The groups main
objective is to advocate for the adoption of drug policies and practices based on
public health, human rights and development.

Member organisations include: HIV/AIDS Alliance, Myanmar Anti-Narcotics

Association (MANA), Transnational Institute (TNI), Mdecins du Monde (MdM),
Myanmar Opium Farmers Forum (MOFF), Save the Children, Population Services
International (PSI) and National Drug Users Network Myanmar (NDNM).