Transition from nonmedical prescribed opioids to non-injection heroin use among young integrated Thai male users in Bangkok

Abstract

Opioid use and misuse are understudied in Thailand despite evidence suggesting that a portion of young Thai male integrated drug users are initiating use of non-medical prescribed opioids with some transitioning to heroin. This study aims to capture and analyze the individual and social factors influencing these transitions. Twenty in-depth semi-structured interviews were conducted between December 2019 and January 2020 in the Bangkok metropolitan area with young male opioid users who transitioned to heroin. Sixteen respondents initiated opioid through a Tramadol cocktail named “YaPro” and tended to transition to heroin use within 21 months. The interaction of specific social and individual factors such as joining recreational activities, curiosity or experimentation gradually modified the opioid-related meanings, attitude and practices of Thai users, who ultimately transition to heroin use. These results indicate that drug prevention programs in Thailand should encompass young opioid users in their intervention and further research need to focus on nonmedical use of prescription opioids in Thailand.

Keywords:

• Nonmedical prescription opioid use
• integrated drug user
• heroin use
• non-injection heroin use
• Thailand

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Notes

1 Information collected from various online websites and Twitter accounts selling Tramadol suggest that the price per wholesale 500 capsules ranging from 1,500-2,000 THB per medicine bottle or 3-4 THB per capsule (approx. 45-60 USD and 0.090-0.12 USD respectively), which is 2-3 times costlier than in the past.

Additional information

Funding

The first author received partial funding supports from Center for Alcohol Studies (CAS) and Thai Health Promotion Foundation.