Following the drug trail

A Burmese businessman fed up with the illegal drug business in his country gives a detailed account of how shipments are smuggled into Thailand and elsewhere

The production and smuggling of ya ba from Burma into Chiang Rai Province had doubled in the past three months, with Shan militias playing an increasing role in the trafficking, according to a businessman close to local drug cartels.

MAKING A POINT: Mr Leng, left, with an interpreter in the Thai border town of Mae Sai, draws a map of some drug smuggling routes. PHOTO: MAXMILIAN WECHSLER

Following several major drug busts in Bangkok and other regions in the past months, Spectrum arranged a meeting with a Shan merchant in Mae Sai identified as Mr Leng. He says he has relatives working in the drug trade in the Shan State, including a high-ranking member of a pro-government armed militia in the east of the state. Other relatives are dealing with drug gangs in northern and southern Wa regions, close to the Thai border, Mr Leng said.

He says he also knows people involved in the cultivation of opium and the production of heroin, ya ba, crystal methamphetamine, or ice, and others who traffic narcotics from Shan State to Chiang Rai province.

During a lengthy interview at a hotel in Mae Sai - after Mr Leng had crossed the border from Tachilek on the Burmese side - he described how the drugs were smuggled, current prices and how traditional drug lords were becoming more reliant on the militias to act as smugglers.

A high-rank Thai anti-narcotics official in Bangkok described Mr Leng's information as credible and has requested a meeting with him to get a briefing.

Through an interpreter, Mr Leng said he was speaking out because he hated drugs and the growing negative impact they are having on people living in Shan state, which has led to more addiction and crime.

"Dozens of militia groups - they could be described as armed village volunteers - located in various parts of Shan State are increasingly involved in the illicit drug trade, which was traditionally done in the past by several ceasefire groups such as the United Wa State Army (UWSA)," Mr Leng said.

There are 20 unofficial border crossing 18km west of Mae Sai where travellers can cross without showing a passport or ID, at which Thais, Chinese and Burmese carry merchandise due to a "mutual understanding" by officials from both sides. But drugs are rarely taken through these transit points as their cargo is considered too risky, Mr Leng said.

ROAD TO CHINA: In front of the Thai Immigration office in Mae Sai. The sign-post reads 165km to Kientung in Burma and 385km to Sipsongpanna in China.

Instead, the drug smugglers usually travel by foot to Thailand via routes 30-40km west of Mae Sai.

"Generally, there are two ways ya ba pills are delivered on Thai soil. The smuggler and the Thai buyer make an appointment to collect the pills at a certain uninhabited and isolated place in Thailand, or the Thai buyer meets the smuggler inside a Thai village," Mr Leng said.

"The smuggling is done during the day or night. The one who actually carries the drugs is usually accompanied by a guide and security person, a minimum of three people for one trip. The smuggler will usually carry about 100,000 pills, packed in 50 packages on his back.''

Before the delivery, the Thai buyer must pay an amount in advance, sometimes it may be the total cost. An additional fee must also be paid to the couriers for the risk they have undertaken.

''The Thai buyer has to pay extra money to the carrier for the transportation. The amount depends on the place of delivery. If ya ba is delivered at an isolated place, it would be three baht per pill, and if it is the village, it would be five baht. The price is higher because the smuggler has to take more risk to be arrested or even killed by the authorities. Sometimes the smugglers carry weapons. Also, the smuggler must give money to the village headman or share some with other villagers as well.''

Mr Leng said Shan militias are now playing a major role in the smuggling due to the Burmese junta's push to bring the ceasefire armies _ the traditional producers of illegal drugs _ under greater control by forcing them to join a border patrol group.The United Wa State Army (UWSA) is considered the fiercest fighting force and traditionally the biggest drug producers.

ROAD TRIP: A Burmese-registered car makes its way past the Thai checkpoint on its way back into Tachilek in Burma.

''The Burmese drug dealers and even Wa people from the North now have to pay the militia forces for security and transportation to ensure that the shipment arrives safely to the customer in Thailand,'' he said.

''The influence of the ceasefire groups began to diminish last year with the order by the Burmese government to incorporate them into the Border Guard Force (BGF), which some agreed to and others, like the UWSA, didn't until this time,'' Mr Leng said.

The street price for one ya ba pill in Tachilek is about 50 baht, in Mae Sai and Chiang Rai about 100 baht, in Chiang Mai 150 baht and in Bangkok 300 baht, he said. ''I don't know who the smugglers, distributors, big buyers, or the networks for ya ba in Thailand are, but I know most of them on the Burma side,'' Mr Leng said.

He said a ''fake'' or less potent form of ya ba was now on the market. The drug is an imitation of the WY pill produced by the Wa people in the north, which is still trafficked to Thailand.

''However, more and more militias, especially in eastern and southern Shan State, are now making fake WY pills,'' he said.

''One can't distinguish immediately whether it is an original WY or a fake. The genuine pill will affect you right away. It has a quicker effect on the person and also a pleasant smell. The imitation will not affect you straight away, but it works slowly. It smells unpleasant and tastes bitter. Both the original and the imitations come in orange, light red, dark red, or pink. The ecstasy pill, also called 'ya E', is not made or sold much at this moment.''

A fake WY pill sells for 30 baht in Tachilek. Mr Leng said he did not know whether anyone in Thailand was aware of the fake ya ba, but added he believed most of the ya ba seized recently in Thailand was low quality or the imitation WY.

HEAVY TRAFFIC: The bridge across the Mae Sai River separating Burma and Thailand. PHOTOS: MAXMILIAN WECHSLER

Mr Leng said ya ba can be made virtually anywhere, as the drug manufacturers could make a press or buy one in Thailand.

''Most of the ya ba makers won't keep too much stock, maybe only a few million pills,'' he said. ''The militia and the Wa will usually start making it after the order is made because if they make a large quantity of pills and can't sell it immediately then it is a a burden on the manufacturer. It is more convenient to store only the precursors that can be kept for a long time,'' he said.

An important ingredient in the production of ya ba _ caffeine _ can be obtained legally in Thailand, but transporting a large shipment across the border can bring the manufacturers to the attention of authorities.

Mr Leng also gave details of the production and smuggling of other drugs.

''Ice is smuggled to Thailand also across the mountains. The buyers of ice are Thais, Thai/Chinese and Taiwanese. Many buyers come from Taiwan. They will enter Burma as well. The Taiwanese also arrange the smuggling of ice to other countries, including Laos and Cambodia.

''Ice is made by the Wa and Kokang. The militias are also making it, but it is of much lower quality. The good quality ice, ya ba and heroin is made only by the Wa.

''The price for low quality ice in Burma is a little bit over 500,000 baht per kilogramme. The best quality stuff costs more than 750,000 per kilogramme.''

As for opium poppy cultivation, Mr Leng said farmers are growing more than in previous years, but the output has fallen because of bad weather.

''For example, if you grew three viss (one viss is 1,640 grammes) in the 2008-2009 season, then in 2009-2010 you might have managed only 1 viss if you are lucky,'' he said.

Some opium farmers have completed their harvest.

Last year, in the 2008-2009 season, the price for opium was good and farmers made good money.

''That's why in the 2009-2010 season, so many people are cultivating. Also, some big investors and various militias have joined the business. They hired people and encourage them to cultivate it.

''They told the growers: 'If you need the capital, if you need to borrow money, we will give it you, but you must sell it only to us.'

''The demand for opium is quite high at this time,'' he said, adding the price for 1 viss of opium is now about 32,000 baht.

Heroin continues to be smuggled to Thailand, but the shipments have become more infrequent recently because the opium has just been harvested and farmers want to hold on to it and wait until buyers offer them higher prices.

Large shipments of heroin are rarely smuggled into Thailand now, except in orders of maybe 10-20kg or so which are brought in by the same routes as ya ba and ice, near Mae Sai.

''However, if you need 100kg or more, it will be sent to the Golden Triangle, about 40km east of Mae Sai. The heroin will be carried by men and some transported on trucks to the Golden Triangle and then to Laos and onwards to other countries.

''The price for No4 heroin in Shan State depends on who manufactured it. If made by the Wa, which is more white and compact, it will be sold for about 320,000 baht per block (one block is 700 grammes).

The lower quality heroin, made by the militias, sells for 270,000 to 300,000 baht for a 700-gramme block. ''I don't know the price in Thailand, but it would be much more.

''As for westerners, I am told they are coming to buy drugs in Mae Sai or across the border. They are not allowed to travel beyond Tachilek. They can stay in the town only.

''I was told, however, that some white foreigners are actually going to the Golden Triangle to buy heroin with US dollars, not in Thai baht.

''A lot of heroin is smuggled to China. Some drug people say that China is a black hole for heroin.''

Buyers who choose to go without a militia's help do everything at their own risk.

''The security of your goods improves if the militia helps you but it will cost you more. Sometimes, Thai or Burmese traders might give them even six baht a pill. The traffickers usually make contact with the militia leaders in Tachilek.

''Areas along the border at Mae Sai are important smuggling points for drugs.

''Regarding communication, the smugglers and people connected with them usually use mobile phones or messengers.

''As for the suppression of drugs, Burmese law enforcement agencies will investigate and arrest people with drugs in big cities. However, they rarely venture outside the city limits.

''Even in the cities, if police have a connection with militia leaders, they won't take action because they have an understanding between each other. But with ordinary civilians, they will be caught easily.

''As for large shipments of drugs from Burma to Thailand, you wouldn't be able to do them unless the authorities on both sides of the border and the drug gangs were colluding.''

Mr Leng said the Thai Narcotic Suppression Bureau is the most feared by Thai drug people, because it is the cleanest.

''The Wa now have difficulties moving ya ba and other drugs from place to place.

''To transport those drugs, they depend on various militia forces that are also con centrated on the Burma-Thai border. The influence of the Wa in southern Shan State has diminished.''

Mr Leng said that most of the big seizures are usually made in Bangkok because the informers could end up in trouble if the drugs are seized in their own locality.

''The police want to do it far away. This is to protect their informers, who usually carry the drugs themselves.

''They will deliver drugs to the buyer and sometimes the police can catch them at the point of delivery.

''However, they don't do it every time. Sometimes the informant will tell the police about the shipment and the police will follow and arrest the suspect in Bangkok, for example.

''Or, police will arrest some traders in Bangkok or in Chiang Mai and tell them: 'We won't take any action if you give us information about other drug dealers or carriers.' ''The police cannot seize shipments of drugs every time they hear about them, because their informant would get burned.

Mr Leng said Burma has many addicts, most of them on ya ba.

On the Burmese side, the people involved in the drugs are the Wa, militia forces, some Burmese authorities and some Thai investors.

On the Thai side, it is Thai and Thai/Chinese. The drug trade is an enormous business in Shan State.

''Some people say: 'The government authorities tell us that they are seizing drugs and arresting drug dealers, then why are drugs still available everywhere?'

''The government used to favour the ceasefire groups, but now looks after the militias. The Wa were once able to engage in the drug business with impunity, but now that impunity is enjoyed by the militias,'' Mr Leng said.

Khuensai Jaiyen, the editor-in-chief of the Shan Herald Agency for News (SHAN), described Mr Leng as a walking drug encyclopedia.

A high-ranking Thai drugs official in Bangkok described Mr Leng's information as credible.

About the author

Writer: Maxmilian Wechsler

Position: Freelance writer

Thailand's Drug registration needs overhaul

Consumer advocates say the present system allows potentially harmful medications to stay on the shelves indefinitely, with no restrictions on their sale

When her young daughter had a fever, Suda (not her real name) would buy cheap medicine in a small shop in her village. With a picture of a child on its packaging, she assumed that the medicine was safe for children. One day she looked at the small print on the label, however, and saw a warning not to give the medicine to children under 18 years of age. Unfortunately there are a number of medicines registered as safe and effective on the shelves of local Thai pharmacies when in fact they may not be safe for children, and in many cases for adults either. Consumer advocates argue that warning labels are often ineffective because people don't bother to read them.

Part of the difficulty in choosing the right medicine lies in the sheer number of products on the market. As of April last year, a total of 25,026 drugs were registered with the Food and Drug Administration (FDA). Of the total, 19,462 are locally made and 5,544 are imported.

Under the Drug Law (1967), the FDA withdraws a drug formula registration only when the drug is proved to adversely affect health, or after a manufacturer stops producing a product for two years.

According to Dr Niyada Kiatying-Angsulee, director of the Social Research Institute and manager of the Drug System Monitoring and Development Programme under the Faculty of Pharmacology at Chulalongkorn University, the drug formula registration system is flawed because the registration never needs to be renewed.

''It can stay forever. Many drugs have been registered since 1983 and they remain on the market,'' she said. Prior to 1983 the law required that a drug's registration had to be renewed every five years. In 1979 there was a change in the 1967 Drug Act to abolish the drug renewal system, which went into effect in 1983.

According to FDA reports, a total of 230 drug formulas still on the market were registered in 1983. Dr Niyada said that those ''old medicines'' might not be suitable today, in part because since then there have been advancements in treating many illnesses.

Dr Niyada proposed that drug registrations should be renewed every five years as before.

''Most countries renew drug registrations every three to five years so as to pull out the unsuitable drug formulas before they cause irreversible damage,'' she said.

She added, however, that this move alone wouldn't solve the problem of dangerous or inappropriate medicines on the shelves, and urged the FDA to establish an efficient post-approval safety evaluation system to thoroughly review a product's safety and efficacy records.

''The FDA needs sufficient information to support decisions on whether to renew or not to renew medicines,'' she said.

While the authorities are not shy about approving drug formulas _ 1,241 remedies were approved in 2000 _ they are slow or reluctant to seek withdrawals of registration, even after receiving complaints or reports of significant harm to consumers. Dr Yaowaluk Amsiriampai, of the Faculty of Pharmacology of Silpakorn University, wrote in a report on drug evaluation that just 17 registered drug formulas had been withdrawn from 2002 to 2008.

Dr Niyada cited the example of one locally produced drug, Anapromine syrup, which is used as an appetite stimulant for children (see sidebar). The product was linked to abnormal sexual organ development in two patients, a four-year-old boy and a two-year-old girl. A doctor at Ramathibodi Hospital exposed the problem to warn the public.

However, rather than withdraw the syrup, the FDA required that the manufacturer list its ingredients and dispense it by prescription only.

Consumer advocate groups disagreed with this solution and strongly demanded that the FDA withdraw the formula. In June 2009 the FDA ordered a withdrawal of the registration.

This case points to another major and very real problem with the Thai system. Despite the fact that the registration has been withdrawn, the drug has remained on the market because of a lack of monitoring and enforcement by authorities. The FDA warns that 13 other withdrawn drugs _ including diet pills, pain killers and antibiotics _ probably remain on the market as long as there are supplies available.

WHAT HAZARDS AWAIT?: A typical drug store has a staggering number of drugs and medical treatments. Under the present system there is no established procedure to review their efficacy and safety records.

Dr Niyada, a member of the National Drug Committee, said: ''We can work more aggressively to protect the public.'' She praised FDA officials for working more systematically to serve the public's interests in recent years. Last year a number of drug registrations were withdrawn for safety reason, and during the past two years the FDA has ordered drug companies to pull lots, or batches, of some 30 drugs from the market because of substandard ingredients.

DANGEROUS DRUGS

Following a survey in communities in ten provinces _ Samut Prakan, Chiang Mai, Chiang Rai, Uttaradit, Khon Kaen, Yasothon, Chaiyaphum, Surat Thani, Tak and Chachoengsao _ the Rural Pharmacist Society (RPS) said it had found a large number of medicines in shops and even in hospitals that were unsafe or ineffective. The society and its network took four months to do the survey last year.

''In rural communities we can find drugs which people in big cities like Bangkok have never heard of,'' said Darin Jeungpattavadee, a pharmacist in Loei province who chairs the society. ''Actually, a large number of drugs found during the survey raise our concerns. Different areas have different problems, with varying levels of severity. Therefore, we need new approaches.'' She added that a number of registered medicines contain mixtures of ingredients that should not be taken together.

''For instance, an anti-tussive [cough suppressant] drug is mixed with a medicine for head cold symptoms. Each of them has a different therapeutic quality. The anti-tussive will ease coughs and act as an expectorant. The anti-cold medicine makes sputum condense, leading to acute coughing symptoms,'' Ms Darin said.

The group identified four medicines which it says should be pulled from the shelves immediately. ''We have a list of unsuitable drugs or medications that includes some banned from the market in at least five countries and others which are not approved for registration in some countries,'' said Ms Darin.

''There is enough medical and scientific information to support our assertion that their potential risks outweigh their claimed potential benefits.''

The four medications are an antidiarrhoeal combination, an antibiotic powder, a widely used tablet for kidney problems and common aspirin _ which the RPS says should never be given to children.

ANTIDIARRHOEAL COMBINATION: The World Health Organisation suggests using oral rehydration salts to treat diarrhoea. Antibiotics are not recommended since they have no proven efficacy for the treatment of diarrhoea. Besides, they may cause side effects and result in antibiotic resistance, which is at present an important public health problem in Thailand and around the world. However, antidiarrhoeal combinations, in both tablet and syrup forms, are easily found on pharmacy shelves and even in small community markets. The RPS says these medicines normally are comprised of four or five chemical compounds and each of them may cause side effects such as fever, rash and nausea, as well as hinder the absorption of important nutrients. One of the chemical compounds commonly found in these medications is furazolidone, which has been shown to cause cancer and induce abortion in mice.

AMOXYCILLIN POWDER: The antibiotic powder is promoted for the treatment of infections of the respiratory tract, stomach, bladder, intestine and kidney. The RPS objects to placing the antibiotic in the bag, as it says this makes it difficult to manage. For example, the label states that a child up to two years old should be given only half of the amount in the bag. But in practice few people weigh or meter out the exact amount of powder as recommended. Consequently, there is a possibility that the patients do not receive a proper dose of medicine, leading to overdose or treatment failure.

Another problem, said Ms Darin, is that the powder in the paper bag will not stay stable and will probably decompose before its expiration date. What's more, a number of registered amoxycillin powders also contain ''inappropriate ingredients''.

A small bag containing amoxycillin in pow der form with the trade name ''Ka Ou Lin'' and two parrots on a cup as its trademark is a very old and recognisable medication in Thailand. In fact the manufacturer has discontinued the product, but according to the RPS surplus stocks of the product can still be found in many shops in rural Thailand.

As noted above, according to regulations, if the manufacturer stops producing a medication its registration will automatically expire. Ms Darin said this is an ineffective procedure as it allows for abuse of the system.

''It would be better if the authorities withdrew the formula to make sure that it will not resurface under a different brand name,'' she said.

KIDNEY TABLETS: The RPS says that because of unclear efficacy and a high risk of overdose, these tablets should be withdrawn from the market. The drug is claimed to improve kidney function, reduce backaches and improve urination. The best selling brands in Thailand are Cystosin, Marwitt and Zoro.

The survey team talked to 43 persons who regularly take the pills and 29 shop owners who sell them. Most of the users were working people who said they took the medication once a day for back pain and trouble urinating. Many reported side effects including nausea, vomiting and blue urine.

ASPIRIN FOR CHILDREN: The RPS says children should never take aspirin. Studies have linked the use of aspirin or aspirin-containing medications to development of Reye's syndrome _ a disease which most often strikes children or teenagers, and sometimes adults as well, during or soon after a viral disease. It affects all body organs, the liver and brain most seriously. The main symptoms include persistent vomiting, lethargy or sleepiness. In the later stages those stricken may exhibit irrational behaviour, confusion, severe weakness and loss of consciousness.

In 2007, the FDA issued a regulation for aspirin-containing medications to print warnings or recommendations on package labels. The warnings prohibit the use of the medication for children under 18 unless it is prescribed by a doctor. They also prohibit use by any persons who are suffering or recently recovered from a viral disease such as influenza, dengue fever or chicken pox. Treatment for body pains and aches is prohibited, as is use by pregnant and breast-feeding women. Moreover, the FDA warns against long-term use because of the risk of bleeding in the stomach, asthma and liver and kidney damage.

The RPS and its network are upset with the authorities' solutions, as they feel safety information and recommendations on the label won't solve the problem.

''The authorities cannot rely on labelling precautions to resolve the safety concerns. People who use aspirin are often simple workers or farmers and their children. They do not read the recommendations. They understand that the drug can be used to treat children with fever because pictures of children are displayed on the packaging,'' said Ms Darin.

''Besides, it is difficult to read the companies' tiny printed warnings and recommendations.''

In 2008, the Ministry of Public Health issued another regulation saying that aspirin can be used for juvenile rheumatoid arthritis and for Kawasaki disease. Ms Darin said that those who have these illnesses need to be treated by doctors who will prescribe the appropriate medicines.

The RPS submitted its proposal to withdraw the four medications to the Ministry of Public Health last November. ''We asked the authorities to take three months to review the proposal and then to withdraw the four drugs to protect the people,'' said Ms Darin.

A PROLONGED WITHDRAWAL

In 1989, the Ministry of Public Health ordered the withdrawal of two medicine formulas for safety reason. One was a combination of the anabolic steroid methandienone, vitamins and/or cyproheptadine, an antihistamine which is sometimes used to promote weight gains. The other formula contained the anabolic steroid as a significant ingredient and was used as an appetite stimulant for children.

In 1990, the ministry revised its earlier order, saying that it only applied to formulas used for children. A formula administered for adult sufferers of diabetes or bone disease was exempted.

In 1993, a medicine formula combining methandienone and cyproheptadine in syrup form under the brand name Anapromine was registered with the FDA. However, it was classified as a prescription drug.

In 1999, a doctor at Ramathibodi Hospital and faculty member of the hospital's medical school, Assistant Professor Patt Mahachoklertwattana, gave a report to the FDA of a two-year-old girl suffering from abnormal sexual organ development after she had taken Anapromine syrup. He suggested the formula's registration should be withdrawn. However, the FDA insisted that since it was sold only by prescription it was already adequately controlled.

In December, 2007, Prof Patt reported another case, this time of a four-year-old boy suffering the same symptoms after he had taken Anapromine syrup.
To warn the public he decided to call a press conference in which the child's mother said that the syrup had been a popular appetite stimulant for children for a long time.

Again, the FDA insisted that the syrup was regulated as a prescription drug and therefore would not be approved for children.

In January, 2008, consumer advocate groups submitted a letter demanding the withdrawal of the formula after it was discovered that despite the FDA prohibition it was being sold over-the-counter and children were continuing to use it.

In May, 2008, the National Drug Committee agreed that the FDA should withdraw the medicine formula. However, it took a year, until June, 2009, for the FDA to issue an announcement to withdraw the drug formula. Besides Anapromine, two other medicines use the formula _ Cetabon tablets and Azolol plus.

After the announcement was issued it took another two months to publish the order in the Royal Gazette.

About the author

Writer: Tunya Sukpanich

Position: Reporter