Drivers, facilitators, and sources of stigma among Akha and Lahu hill tribe people who used methamphetamine in Thailand: a qualitative approach

Abstract

Background The stigma related to drug use has several impacts, including effects on users’ physical and mental health. Methamphetamine is a major drug that is used among hill tribes living in the border areas of Thailand and Myanmar. This study aimed to understand the drivers, facilitators, sources and outcomes of the stigma surrounding drug use, including the expectations among Akha and Lau hill tribe people who use methamphetamine in Thailand. Methods Qualitative data were used to elicit information from key informants and members of the hill tribes who used methamphetamine. The questionnaire was developed from a literature review and tested for validity before use. In-depth interviews were used to confidentially gather information from the participants in private rooms in villages. Each interview lasted 45 min, and a thematic analysis was conducted to examine the findings. Results A total of 46 participants were recruited to provide information; 95.7% were male, and 50.0% were aged 15–34 years. The majority were married (47.8%), 76.1% were Christian, and 45.7% graduated high school. Six drivers of stigma were detected: being poor, illiterate, unemployed, working aged, female, and married. Culture and tribe acted as facilitators of the stigma attached to methamphetamine use. Four sources of stigma were found: self, family members, peers, and community members. Three outcomes of stigma were determined: poor physical health, mental health, and relationships with others. There were four levels of expectations: no expectations, expectations for themselves, expectations for their family members, and expectations for their community members. Conclusions Many personal traits, people living nearby, and socioeconomic factors, including culture and tribes, act as drivers, facilitators, and sources of stigma among hill tribe people who use methamphetamine. A program to reduce methamphetamine use among hill tribes should be implemented, which could eventually minimize stigma.

Cross-border Activities Associated With Pattern of Amphetamine-type Stimulants Usage Among Drug Users in Southwest of China

“…ATS users were predominantly male minorities with mono-ATS usage about 34 years old, which is consistent with other findings. 18 , 25 It may be that the population in this area was dominated by ethnic minorities’ especially Dai people. 35 Additionally, ATS was a stimulant with unique qualities that induced a faster metabolism in humans, which the young sought thrills and excitement by ATS use as well as difficult detection ATS metabolites.…”

“… 24 It was nearly 14% using methamphetamine among ethnic minorities of Thailand’s border due to easily accessible to illegal drugs. 25 Residents in the border areas of Yunnan have a high mobility of cross-border activities such as family visits and marriages because of border trade with low foreign drug prices and high border penetration. 26 Studies showed that injecting drug users living in Ruili City often crossed the border into Myanmar for works, friends’ visits and illicit drugs acquisition.…”

Investigating the spatiotemporal patterns and clustering of attendances for mental health services to inform policy and resource allocation in Thailand

“…Furthermore, stigma related to drug use has multifaceted impacts on physical and mental health, influenced by personal traits, community dynamics, and socio-economic factors, including culture and tribes. Implementing a program to reduce drug and substance use among hill tribes holds the potential to minimize this stigma [ 41 ].…”

Evaluation of a depression care model for the hill tribes: a family and community-based participatory research

“…Additionally, several factors have hindered the hill tribes from accessing appropriate psychosocial health services. These factors include cultural practices and beliefs, inadequate income, low education, language barriers, lack of access to roads [ 9 ], absence of Thai identification documents [ 12 ], social inferiority, and stigma associated with illegal methamphetamine and opium use, among others [ 13 ]. Following the studies of other populations, where the family unit plays a crucial role in supporting patients with mental illness [ 14 – 16 ], we found that family-related factors, such as being female, 50 years or older, married, Christian, and living with a relative, were associated with depression in hill tribe individuals [ 17 ].…”