CHRISTOPHER DAVY

Drug users at a Lashio drop-in centre set up in 2004 by the United Nations Office on Drugs and Crime. The centre works to reduce drug use in the local community and the health risks, particularly HIV/AIDS, associated with the use of shared needles.

Outreach workers based at the clinic travel to the outskirts of town where they try to encourage drug users to use clean needles. The areas are known as "shooting galleries".

Dr Aung Myint and another UNODC staff member. The UN estimates that in 2004 there were between 90,000 and 300,000 injecting drug users in Myanmar. Out of these, between 30 and 90 percent are infected with HIV/AIDS.

Those who are not dealing must find the money for their fix by other means. According to the UNODC, a large number of addicts are dependent on their parents, which has massive implications for family life.

One outreach worker says a client poured boiling water over his mother until she gave him money. Another addict made cuts along his arm to force his parents to pay for his next hit of heroin.

It costs just K50 (0.05 US cents) to buy a clean needle, but fear of arrest, inconvenience and ignorance all play a part in the high numbers of drug users relying on dirty needles.

“Daytime is a favourite time for injecting,” says Dr Aung Myint, who works at the drop-in centre, “although addicts require at least two hits a day.”

Drug users can deposit their used needles anonymously at the front of the drop-in centre. They are collected in a large bin and deposed of safely.

Regulars of the drop-in centre enjoy a free lunch.

A UNODC doctor inspects a leg x-ray of a drug user who was involved in an accident. The drop-in centre focuses its resources on health and safe drug use rather than getting injecting drug users to kick their habit altogether.

One of the most dangerous aspects of heroin use is that users do not know what else is being mixed with the product as it passes along the supply chain. Chalk powder, milk powder, crushed paracetamol and soap powder are regularly used.

Dr Aung Myint holds a medical consultation with Mya Myint's father-in-law, a decades-long drug user. He says smoking opium helps relieve the aches and pains of old age.

Before the drop-in centre opened in 2004 and began collecting needles, children would often find them in the street and play with them.

In Shan State, the large number of disenfranchised youth, high unemployment rate, lack of educational opportunities and ready availability of drugs contribute to what UNODC calls an "epidemic".

The chances of sharing [needles] the first time you try is very high. "About 50 percent of those we ask say they shared the first time they injected," says Dr Htet Aung.

Building trust with injecting drug users and creating a safe, non-judgemental atmosphere are important to the success of the Lashio drop-in centre.

Sixty percent of incarcerated people in Myanmar are charged with drug offences. Even the UNODC outreach workers are sometimes worried about the risks of being found carrying needles.

The government drug rehabilitation centre in Lashio offers injecting drug users a place to try and overcome their addiction.

Despite registering some 5000 injecting drug users since 2004, staff at the UNODC drop-in centre say only a few dozen have managed to overcome their addiction.

The Voluntary Social Workers Association (VSWA) in Lashio has some 20 volunteers who visit recovering drug addicts to offer support and assistance.