Summary of the Rapid Assessment on Addressing Drug Addiction Problems

in Putao Township (January 2022)

Introduction: Putao township is situated at the northernmost part of Myanmar where drug use is
highly prevalent and renowned for drug epidemic. The rapid assessment was conducted to support
the Addressing Drug Addiction Problems in Putao Township (ADAPT) activity. The ADAPT is
fully funded by USAID/Burma to HOPE (Myaw Lint Yar) organization in Putao under its Local
Works Program. The assessment was aimed to assess the extent, nature and consequences of drug
use in Putao and how to address them. It used a mixed-method of qualitative and quantitative
approach to obtain a “snap shot” of the prevailing drug use situation within a short period of time.
Methodology: The preliminary assessment interview was carried out among the local authorities,
community leaders, religious group leaders, village elders, social workers and villagers of different
backgrounds in two village tracts and three wards. The initial assessment included key informant
interview (KII), focus group discussion (FGD), mapping and estimation. There were 3 FGDs to
People who inject drugs (PWID), spouses of PWID and parents of PWID to explore the context,
drug use extent, their risk behaviors, reasons for drug use and health consequences using grids.
The community leader, religious leader, parents and volunteer answered the information of the
drug use situation, health consequences, possible reasons of drug use and difficulties among the
community, and participated in mapping.
Assessment Process: The quantitative assessment was conducted to 152 participants of 15-39 age
groups, using a convenient sampling in 3 wards and 13 villages in the township. The questionnaire
was a self-administered drug use screening inventory (DUSI) survey form with 135 questions to
detect the (psychosocial) risk factors and
protective factors for drug use. Substance
Abuse Research Association (SARA)
Myanmar was the technical lead
organization and HOPE staff collected data
under SARA supervision. Descriptive
analysis of relevant variables was
conducted and Student’s t-test was used to
conduct comparison of Means of the
relevant variables. The participants were
informed of the strict confidentiality of
their answers and the questionnaires
themselves do not include any self-
identification questions that could be used
to trace the participants.

Disclaimer: This Assessment Report is made possible by the generous support of the American people through the
United States Agency for International Development (USAID).
Findings and Discussion: The findings included four parts, including rapid assessment from
qualitative interviews, mapping of drug user’s distribution, estimation of drug use and quantitative
drug use screening survey. In Putao, the situation of drug use has been increasing, trends have
changed from opium smoking to heroin injection. Although there is needle exchange program in
Putao, the easy availability of used needles and syringes at the shooting sites encourages to use
thereby increasing the infection of HIV, Hepatitis B and C. About 40-50% of farmers work in gold
mines as they do not earn enough from farming to meet their annual income. In the gold, amber
and jade mines, about 70% of the workers use drugs facilitated by false beliefs that using heroin
prevents them from contracting local infectious diseases and enables them to work without
sleeping at night. Some women are seen travelling to the mining areas for various reasons e.g.,
working in the sex trade, recreational purposes, earning money for drug use. The most common
scenario was that the husband used drugs, mixing with alcohol or beer and the wife also took it
together. The majority of drug users (80%) injected drug while about 20% smoked it.

The health status of people who use drugs (PWUD) was severely affected by the socio-economic
condition. The PWUD’s family members had difficulty in earning and they cannot leave homes
because of the presence of PWUD at home. On some occasions, parents need to go and work while
children are left at home and the children become addicted to drugs.

There were few opportunities for youths to be engaged in self-development activities and the
youths ended up using their leisure time experimenting with drugs. The unemployment rate was
very high, about 50-70% in certain village tracts. In addition, youth unemployment, reduced
parental monitoring of their children in relation to being absent from home to work in the fields or
to find supplemental income in the mines were also factors to be considered to prevent drug use.
It was also found that the need to find supplemental income was high for the average farmer, which
was the main driver of the need to work in “high-drug use risk” jobs. There were also no vocational
skills training facilities and youths grew up without having learned employable skills, which
resulted in frustration and loss of hope for their future. Most of the interested vocational skills they
described were agriculture and motorcycle workshop.

In terms of drug use prevention, there was little

knowledge on how to prevent drug use although
they were aware that drug use prevention,
treatment and recovery efforts are in urgent
need. The poor road condition and remoteness
cause difficult access to treatment services.
There is also a financial barrier for the PWUD’s
family to accompany them for drug treatment.
There is also no drug rehabilitation center in
Putao. Moreover, there were People who use
drugs (PWUD) who took methadone
maintenance therapy misused methadone. They
share it with other PWUD who could not effort travel cost to get methadone regularly. PWUD
takes service at Medical Action Myanmar (MAM) Clinic in Putao that provides Methadone from
the Government hospital.

Disclaimer: This Assessment Report is made possible by the generous support of the American people through the
United States Agency for International Development (USAID).
The distribution of drug use was seen from mapping of 3 wards and 13 villages. The overall drug
use (both People who inject drug - PWID and PWUD) proportions is higher in the rural areas than
the urban areas. The main reason of high drug use was that they had a “traditional trend” of being
involved in opiate business since many years ago.
From estimation, the overall drug
user population is 4,774 in total
4,099 PWIDs and 675 PWUDs. The
estimated sex and age group specific
point prevalence of PWID is 26 per
100 at risk population and PWUD is
4 per 100 at risk population. The
estimated sex and age group specific
total all drug use point prevalence
for Putao is 30 per 100 at risk
population.
The findings from drug use screening inventory survey showed that the biological, psychological
and social factors were influencing an individual to use drugs at least once in their lifetime. The
findings also showed that people who had never used drugs were also suffering from at least a
form of psychological distress. Therefore, drug use prevention interventions should also be
targeted on non-drug users who are almost on the “verge” of falling into the drug use trap.
From the survey, it was found that people who had used drugs in their lifetime (PWHUD) had
behavioral problems during the treatment and recovery process. There was high level of
connection between mental health of drug users and their addiction problem. Treatment providers
should consider the behavioral problems and provide mental health screening tests (e.g., GHQ-12)
during the treatment process. Moreover, PWHUD had problems in social relationships skills to
face in real life and care givers need to tackle this issue by encouraging the social skills.
Experimentation with drugs and other addictive substances usually occurred during their leisure
time, and boredom was also closely associated with use of drugs.
Therefore, parents should manage their
child’s leisure time activities to avoid
the risky environment and create
opportunities to engage in personal
development, sports, music or arts. It
was found that peer relationship was
one of the factors to relapse drug use.
Parents need to teach drug refusal
skills, assertiveness skills and decision-
making skills as an important part in
preventing relapse of drug use. It was
also found that good family
relationships, good health in general

Disclaimer: This Assessment Report is made possible by the generous support of the American people through the
United States Agency for International Development (USAID).
and good relations within the workplace environment act as “protective factors” for drug
experimentation.
Limitations of the Study:
1. There were challenges on data collection during the sensitive political situation and COVID-
19 infection.
2. On-line communications also posed some challenges during the qualitative data collection
process for which the Yangon Team was assigned to do.
3. Access to the Law Enforcement and Judiciary records could not be done, and this reduces the
scope of the study, as this information will complete the drug use situation assessment.

Recommendation:
1. Awareness raising and educational trainings sustainable with local leaders in drug use
prevention, drug refusal skills, assertiveness skills and decision-making skills to
community members throughout the year
2. Facilitation of youth activities in personal development, sports, music and vocational
activities
3. Providing vocational trainings to local people in line with local context and creating
employment opportunities to upgrade the community status
4. Establish local drug rehabilitation center
5. Educate drug users to take treatment and encourage their family members to involve in
strengthening family and social relationship of the drug users to prevent them to reuse
drugs
6. A broad-based coordination structure with relevant community sectors, non-governmental
and governmental sectors in drug use prevention, treatment and community development

Photo of field data collection 1 Photo of field data collection 2

If you need more information please contact to:

Simon Thaung (Executive Director) Myaw Lint Yar – HOPE, Phone: [+959250041058
Office Address: No. 16, Mulashidi Street, Mulashidi Ward, Putao, Kachin State, Burma

Disclaimer: This Assessment Report is made possible by the generous support of the American people through the
United States Agency for International Development (USAID).