Questions/Answers

The issue area are mountainous forests with a lot of difficulties to access which make it almost impossible to approach.Cultivating opium and using it as a welcome gift and medicine which caused a lot people to become addict into opium. Those opiate addicts are mostly unhealthy and not be able to proceed with their careers. This made their families have to carry them as their burdens. Furthermore, there are no health service units nearby and those tribal people are poverty-stricken. This caused them to become inaccessible to any rehabilitation system.This project aims to 1) Reduce opiate addiction rate and raise a quality of life for the opiate addicts and their families. Spouses of the opiate addicts will not have to bear burdens of the families, and their children will deserve rights and suitable educational opportunities for their ages; therefore, they can rely on themselves and sustain their own lives. These would also help return self-esteem to the opiate addicts. 2) To upgrade all public sector services in a section of fieldworks which cover every aspect by focusing on benefits of the communities.3)To support prevention and solution to drug issue, and promote Thailand’s national security .

“Transform people’s live: Return Self-esteem to Human Lives” initiative is an innovation which aligns with the 2nd field; Ensuring Integrated Approaches in the Public-Sector Institutions”, consideration criteria (number 2.3). This initiative promotes collaboration between government sectors and NGO in order to approach ethnic opiate addicts by utilizing proactive collaborative service from all sectors. Public health sectors lead the suppression role and form the alliance with related-authorities that will finally form the brainstorming, cooperating power, and administration system which suits the area context.

“Transform people’s live: Return Self-esteem to Human Lives” initiative is a proactive collaborative service from all sectors innovation which aligns with the 3rdfield; assurance of people’s good life quality and promote wellness for people of all ages and genders. This will be done by establishing inner strength for opiate addicts by using methadone as a replacement therapy, providing consulting services, cooperate with citizen alliance to provide community level assistance, and promoting careers. These action resulted in people’s readiness in self-development, social development, and strength sustainability in the community.

People especially in highlands and country border areas cannot access both public and private utilities , and the public sector cannot provide utilities to cover all areas because of difficulties in transportation, limited resources, and separated and disunited public operations. Drug addict’s treatment was formerly the role of Public Health sector which had passive operation which lead to unsustainability for the solution. This resulted in drug patients becoming addicted to drugs again which cause them to be trapped in underprivileged and poor status,their spouses have to bear family burdens, insecure, unpleasant, and self-incompetent community.Therefore, a drugs addict’s treatment strategy has to be improved holistically concerning system administration including healthcare, economy and social continuously. This improvement should be performed by the cooperation of the Public Health sector and relevant organizations by adhering to Harm Reduction model to provide proactive services and maintain the benefits of opiate addicts and their families in the number of 4,425 households and 115 villages. This model should include healthcare service establishment for opiate addicts, acceptance from their families, educational opportunities for their children, better quality of life, secure community, pleasant environments, and self-dependent strength.

Formerly opiate addicts solution separated operations. Opiate addicts were considered as criminals. Collaboration on the Hill due to Opium Problem or “ CHOP ”is a new drugs administration system with integrated from all sectors in order to unlock limitations of government service system. Proactive service method are collaborations between people and leaders to law legislations will be edited to allow the use of narcotics categoryII in the community . This action will be established of mobile clinic servicer and Drop-in center and continuously treatment until opiate addicts become normal people and have better quality of life.

Harm Reduction-based service has challenges to be handled in the rural areas along with complexity with the issues. These challenges can be solved by adhering “everything is possible” mindset. New administration method has to be changed by eliminating operational obstacles, lessening the dispensing regulations in order to allow outside drugs usage, adjust attitudes of the officers who are afraid to work on new method. Plan Do Check and Act processes will be used in many cycles to create collaborative learning innovation in order to form appropriate treatment procedures for both area contexts and community’s way of lives.

The operation will be processed by the establishment of a Drop-in center in the community which is a collaboration between the government sectors and NGOs. Moreover, knowledge assets will also be integrated in order to form services that will cover all aspects and working results. Successful initiatives were instructed and applied to other communities from 7 communities to 25 communities. Furthermore it was taken as a role model in solution to drugs conference of ONCB; and it was treated as case studies for both domestic and foreign countries, such as Malaysia, Indonesia, and the International Drug Policy Consortium.

Budget will be funded by DMS in order to share knowledge, adjust attitudes , and form the cooperation from all sectors.The NHSO will support for medication cost compensation with 35 baht/person/day. Highland Research Institute will promote careers, and support for both plant and animal species. Volunteers, community leaders, and Local Administrative Organization will utilize budget to bring patients into drugs treatment system and will follow up on patients’ rehabilitation. District health Promoting Hospitals and the community will be used as the settlement of Drop-In center. These actions will result to better patient sustainability in the treatment system.

Sustainability will occur from these aspects; having related people in all sectors with good attitude, acceptance, and collaboration on planning appropriate treatment for opiate addicts in the areas by adhering to the harm reduction principle and having effective administration system in opiate addict healthcare covering in every aspects;determining collaboration agreements by establishing Narcotics Control Board for the district and assigning roles and duties for each division clearly in order to allocate budget in expanding services covering all areas and persuade people who could quit using opium to volunteer helping and taking care and motivating other opiate addicts to stop using opium.These actions will result in better family relationships and careers. Their children can resume to educate. People in the community will instead seek treatments for their symptoms instead of using opium. The community will finally be secure, calm, and peaceful for their lives and properties. Number of opiate addicts who participated in the treatment system were continually increased from 300 in the first years, increased to 1,003 in 2016, and increased to 2,285 in 2018. These operations will be executed with service schedules by using their own resources and administrative system.

Yes

The initiative has been externally evaluated by Department of Medical Services ( DMS) and National Institute on Drug Abuse Treatment by monitoring the local operations and compiled a proposal to the directors. Moreover, a research on collaboration with the community by discussing with the rehabilitation teams and quality of life of opiate addicts after the rehabilitation was conduct by using descriptive research method.

Indicators of the evaluation are : 1) A number of the opiate addicts who participated in the treatment system were increased from 300 to 2,284 : 2) Persistency rate of opium addict treatment system is 83.41%:3) Opium withdrawal rate is 19.26%: 4) The number of Drop-in center establishments increased from 7 to 25 centers: 5) Quality of life of the opiate addicts after the treatment from Drop-in centers is in High level (average = 3.65):6) The participation of communities in solving opium issues and related activities :and 7) The number of opium addicts in communities decreased.

The opiate addicts that remained in the opium rehabilitation and withdrawal system will become healthier and be able to resume their role as breadwinner for their families. Their spouses will not suffer bearing the burdens of their families and will be able to fully focus on nurturing their children. Their children will receive appropriate education which makes their lives better.Their community will be safe from any potential harms from drug addiction. The opiate addicts will no longer deforest to plant opium , and also turn to plant economic crops which improve their community economy.

This initiative is the collaboration of many organizations whose roles are; 1) Princess Mother National Institute on Drug Abuse Treatment (PMNIDAT) cooperate in forming the master plan, administering the project as Project Manager, transfering knowledge on rehabilitation, monitoring and promoting the policies; 2) Chiangmai and Mae Hong Son Thanyarak Hospital perform as a supervisor in order to obtain the objectives; 3) Community hospital/District health promoting hospital provided rehabilitation and treatment services for the opiate addicts and coordinate with local organizations; 4) Security Affairs Section including soldiers and policemen facilitate and take care of security; 5) Community Section including Provincial Administrative Organizations, Subdistrict Headman, Village Headman, Community Leader and NGO are helping to find, forward and monitor the opiate addicts ; 6) Teachers/non-formal education groups are educating and advising youth and housewives groups; 7) Highland Research Institute promotes and supports careers for the opiate addicts;8) Offices of the Narcotics Control Board (ONCB) allocate budget, coordinate operational guidelines by the policies, integrated process by planning and holding meetings periodically in order to monitor working progress, evaluate working results in the previous year, troubleshoot occurred obstacles, and collaborate to solve problems in order to achieve the results.

1) Analyze the issues by local participated people ;2) Establishing networks of responsible authorities with relationship as families; 3) Form collaborative working method, cooperate administration and budget utilization with integrity in order to create local shared initiative ownership in the area;4) Harm Reduction principle is an innovative idea . Utilizing methadone to rehabilitate patients in the community which require collaborations from all sectors has formed Community-Based Treatment Model;5) Bring statelessness people to public health service system, nationality verification, and possession of further improvement idea of this project by expanding application effects in each individual and different contexts.