VZCZCXRO1821
RR RUEHCHI
DE RUEHVN #0800/01 3021052
ZNR UUUUU ZZH
R 291052Z OCT 07
FM AMEMBASSY VIENTIANE
TO RUEHC/SECSTATE WASHDC 1610
INFO RUEHBK/AMEMBASSY BANGKOK 7527
RUEHBJ/AMEMBASSY BEIJING 2206
RUEHHI/AMEMBASSY HANOI 2886
RUEHCHI/AMCONSUL CHIANG MAI 0598
RUEHVI/AMEMBASSY VIENNA 0019

UNCLAS SECTION 01 OF 03 VIENTIANE 000800 
 
SIPDIS 
 
SIPDIS 
 
DEPT FOR INL/AAE - BOULDIN 
DEPT ALSO FOR INL/C/CJ - BROWNE 
 
E.O. 12958: N/A 
TAGS: KHIV LA SNAR SOCI UNCRIME
SUBJECT: SIGNIFICANT HEROIN ADDICTION EMERGES IN LAOS FOR 
THE FIRST TIME 
 
 
¶1. (U) Summary:  Heroin abuse has not been encountered among 
the Laotian people in the past, but so far in 2007, the 
principal Lao national drug abuse treatment center at 
Somsanga has admitted more than 50 acknowledged heroin 
addicts, at least seven of whom admitted to current injecting 
drug use.  Almost all of the newly-discovered heroin addicts 
came from a few villages in the same mountainous region of 
Houaphan Province, adjacent to the border with Vietnam, and 
the majority were Lao-Hmong.  Addicts reported being 
introduced to heroin by Hmong dealers from Vietnam.  Most 
reported having shared needles and/or using needles scavenged 
from medical clinic waste; most female addicts were also 
involved to some extent in commercial sex.  UNODC and Lao 
authorities have begun an urgent survey to try to determine 
the full extent of this new aspect of illegal drug abuse. 
The capacity of Somsanga treatment center, already 
overburdened with methamphetamine and opium addicts, is 
stretched very thin by this new group, and the few qualified 
Lao drug abuse treatment professionals have no real 
experience in dealing with heroin addiction.  This 
substantial increase in injecting drug abuse also greatly 
enhances the risk of more extensive transmission of HIV/AIDS, 
hepatitis, and other blood-borne and sexually transmitted 
diseases in this country.  Action requested:  Request that 
INL/C/CJ seek to identify a US expert with experience in 
heroin abuse treatment, preferably in the environment of a 
least-developed country, whom USG could offer for short-term 
expert consultation with Lao drug abuse treatment 
specialists.  End Summary. 
 
¶3. (U) Prior to 2007, heroin abuse was encountered very 
rarely among the people of Laos.  Abuse of unprocessed opium 
was very common, especially among ethnic minorities such as 
Hmong, Mien, and Akha in remote highland areas, who grew 
opium for both sale and autoconsumption.  Abuse of 
methamphetamines, as reported in Embassy Vientiane INCSRs in 
the past several years, has reached epidemic proportions. 
However, abuse of opiates in the refined form of heroin was 
very rarely seen.  The few heroin addiction cases admitted to 
the main GOL drug abuse treatment center at Somsagna, near 
Vientiane, were generally Chinese or Vietnamese immigrants. 
There have been a number of heroin overdoses involving 
foreign tourists, several of which have been fatal because of 
the high purity of heroin available in the region.  However, 
heroin addicts who were Lao nationals (both ethnic Lao and 
ethnic minority groups) had not previously been reported. 
 
¶4. (U) During 2007, this changed dramatically, with admission 
of at least 56 admitted heroin addicts since the beginning of 
the year to the Somsagna treatment center alone.  Most of 
this new cohort arrived at Somsagna as part of three lots of 
drug abusers moved there by Lao authorities by truck from 
Houaphan Province, on the border with Vietnam.  (Note: 
Houaphan in the 1990's was one of the major poppy growing 
regions in Laos, and was the location of the first INL-funded 
Lao-American poppy reduction project, which operated there 
for ten years beginning in 1989.  At that time, the province 
had a long history of large-scale opium abuse, but no 
reported incidence of heroin addiction at all.)  The first 
such group consisted of 22 addicts who arrived in May, the 
second of 42 addicts arrived in August and the third, with 37 
addicts, on September 20.  Fifty-one of the 101 patients who 
arrived in these three movements were addicted to heroin; at 
least seven admitted to recent injecting drug use.  (NAS 
officers observed apparently-fresh needle marks on arms or 
legs of several females and at least one male who 
participated in detailed interviews.) 
 
¶5. (U) On October 2, NAS Director and staff accompanied UNODC 
Laos Country Rep and staff members, along with the Acting 
Deputy Chairman of Lao National Commission on Drug Control 
and Supervision (LCDC) to Somsanga to discuss this new group 
with treatment center staff, and to interview some of the 
newly-arrived heroin addicts.  During initial discussion with 
Somsagna Director and staff, the Director emphasized both the 
extent to which these new arrivals had strained his 
already-overburdened treatment capacity, and the fact that 
the existing staff at Somsanga had no experience in dealing 
with the addiction syndrome exhibited by heroin abusers, 
which differs markedly from that of opium or methamphetamines 
users, with which his staff were familiar.  The Director 
noted that before arrival of these most recent groups, he had 
already been dealing with a patient population of over six 
hundred, and he had only three qualified drug abuse 
counselors to work with them all. 
 
VIENTIANE 00000800  002 OF 003 
 
 
 
¶6. (U) Interviews with the 51 recently-arrived heroin addicts 
from Houaphan by UNODC and Somsanga staff found an age range 
of 26 to 55 years.  All were members of the Hmong ethnic 
minority.  (Comment: Interviews with addicts for the most 
part had to be translated from Hmong to Lao for the entire 
visiting group, and then into English.  End comment.)  Most 
claimed their primary occupation as upland subsistence 
farmers, in Xieng Kor, Sao Bao and Van Vieng districts of 
Houaphan Province.  Ten of the group were female.  All of 
those interviewed reported having used, or being addicted to, 
opium before having been introduced to heroin. 
 
¶7. (U) In these interviews, addicts reported an "alarming" 
extent of heroin addiction, speaking of several villages in 
Houaphan Province in which every family has at least one 
heroin addict in the house.  In most villages, according to 
those interviewed, addicts go to the houses of dealers and 
buy drugs freely there.  Reportedly, in such villages, 
injecting drugs is not seen as behavior that should be 
concealed, although most residents are aware that the 
practice should not be seen by district or provincial 
authorities.  According to those interviewed, opium was still 
cheap enough two years ago to be the commonest form of abuse. 
 When heroin was found, it was typically used for smoking 
("chasing the dragon", in vernacular phrase).  However, when 
the price of unprocessed opium began to rise as its 
availability diminished, Vietnamese Hmong dealers encouraged 
opium users to switch to heroin and taught them how to inject 
heroin intravenously to increase its impact.  (Comment: 
According to these addicts, the average cost in their region 
of heroin for a day is about 25,000 kip, or not quite three 
U.S. dollars.  Opium, which is normally smoked two or three 
times per day, can now cost several times that much for each 
use, where one heroin injection per day is enough for most 
users.  Those interviewed said this relative economic 
advantage of using heroin was emphasized by the dealers 
selling it.  End Comment.) 
 
¶8. (U) Addicts, including those interviewed with NAS officers 
attending, reported that, generally, heroin addicts in such 
villages used syringes or needles scavenged from waste at 
local health centers or hospitals or needles that had been 
used and discarded by other users.  Most addicts made some 
minimal attempt to clean such needles by wiping them with 
alcohol before re-using them.  Some addicts reported a 
practice of injecting water from water pipes used by other 
persons to smoke heroin.  (Comment:  As UNODC observed, these 
practices, along with the number of female addicts involved 
in commercial sex, may lead to a significant increase in 
HIV/AIDS, hepatitis, or other blood-borne or 
sexually-transmitted diseases.  End Comment.) 
 
¶9. (U) Most of the heroin addicts admitted to Somsagna this 
year, as noted above, have been Hmong from Houaphan Province, 
and most have previously used opium for lesser or greater 
periods.  However, UNODC reported interviewing one young 
female heroin addict from Luang Prabang who described a group 
of 13 young people, none with any previous history of opium 
use, all of whom had taken up heroin use for recreation.  Dr. 
Khamnoan Hsam, drug demand reduction consultant to UNODC 
Laos, told Acting NAS Director October 17 that UNODC and LCDC 
have initiated an urgent survey effort in Houaphan and nearby 
areas in an attempt to better define the actual extent and 
scope of this new problem of heroin addiction.  She said, 
however, that even without having completed this survey, the 
number of Lao-Hmong heroin addicts newly admitted at Somsanga 
within the past six months and the reports they had provided 
of the extent of visible heroin addiction in the areas they 
came from led her to conclude that heroin abuse is already 
established as a significant new aspect of the overall 
problem of illegal drug abuse among both ethnic Lao and 
ethnic minorities in Laos. 
 
¶10. (U) ACTION REQUESTED:  NAS Vientiane requests that 
INL/C/CJ attempt to identify an expert with experience in 
treatment of heroin abuse, particularly in socio-economic 
context (and within the treatment capabilities) of a 
least-developed country.  If the UNODC-LCDC survey confirms 
that heroin abuse already exists as a significant new problem 
in Laos, as appears at this point likely, NAS would like to 
be in a position to promptly offer LCDC the earliest possible 
opportunity to consult in Laos with a qualified expert in 
heroin addiction in order to begin to more effectively define 
and implement treatment protocols and practices appropriate 
 
VIENTIANE 00000800  003 OF 003 
 
 
to this emerging heroin addition problem. 
HUSO