Drug offenders make up more than 80% of the inmates in Phuket prisons and on a typical month, narcotics-related crime tops the monthly Phuket crime statistics.

And while the existence of the reassuring ?Welcome Clean Patong Project: Drugs-Free Zone? billboards in Patong would suggest that the problem and in fact solution lies firmly and solely there, drug use and the crimes fuelled by their circulation, abound all over the island.

Indeed Phuket town was, for the third year in a row, placed as the top district in the Southern Thailand area for cases of drug crime.

Akanit Danpitaksat, the Police Lieutenant Colonel and Head of the Drug Suppression unit of Kathu Police station said however that drug use in Phuket was not limited to one area or to just one strata of society.

?Lots of people who work in the service industry conceal their usage and the problems tend to spread among the staff. There are also many tourists and expats who come who are used to indulging in drug-taking behaviour.?

Pol Lt Col Akanit said that drug users often turn to selling as a result of a lack of money and of opportunities.

?Most drug users are people or teenagers who do not live with their family. The parents don?t really look after them, so they have a chance to get involved with drugs. Often being a user can lead to being a dealer later on.?

The debate of how to solve drug-related problems is of course not exclusive to Thailand. Like anywhere, there exists a stark distinction and active debate between proponents of rehabilitation and those who support more punitive measures.

Perhaps never was more punitive action taken than in 2003, during former Prime Minister Thaksin Shinawatra?s ?War on Drugs? campaign, where more than 2,000 known drug dealers were killed. Many were allegedly killed by their rivals.

Controversial or not, the statistics of drug-related crimes fell quite dramatically from 215,209 in 2002, to just 58,853 in 2004.

So, as the Pheu Thai political party prepares to take its seat, drug dealers up and down the island are sure to be wondering as to whether continuing to ply their trade is really worth it.

But considering the strict and some would say, harsh punishment for users and dealers, is it ever really worth it? Whether it is the brief feelings of euphoria that ya bah or cocaine professes to provide, or of the manic thoughts of XTC or even the dull contentment of marijuana, is it, was it, or will it be, ever really worth it?

The current Thai Narcotics Act stipulates the death penalty for those caught in possession of Category 1 drugs for purposes of ?disposal?. This includes methamphetamines (ya bah), cocaine, ecstasy as well as heroin.

For those caught with lesser amounts, there are two options: jail or rehabilitation. The Thai government often offers a combination of both.

The first step after the Thai police arrest a suspected drug offender is to take blood and urine samples, if the tests come back positive they are sent to a medical centre in Phuket town where they are assessed as to whether they are ?addicts? or not. Regardless of the results, the majority of the patients attend a compulsory outpatient rehabilitation course at Vachira Hospital in Phuket town in lieu of facing criminal charges.

Dr Pattaree Pinkaew is a psychiatrist at Vachira Hospital who oversees many of the 120 patients currently undergoing a drug rehabilitation course. She said, ?Treatment involves group therapy and time with a psychiatrist. They typically meet 2-3x week for a duration of 6 weeks.?

If a patient is unable to pass the course or satisfy the doctor?s expectations, then they will invariably be sent to jail. Drug dealers however always face a prison sentence and very rarely attend such courses.

This is the only government-funded drug rehabilitation centre that exists in Phuket, but Dr Pattaree said that there needs to be many more, ?All of the drug users from Patong and Karon and the rest of the island are sent here, there needs to be more, we can only do so much with the little budget we have.?

Perhaps as a result of this, sometimes even Thai temples serve as makeshift rehab centres, with the Wat Tham Krabok in Bangkok being an especially popular and successful place for heroin and crack cocaine addicts to go to.

However, this could once again showcase the dichotomy and uneasy relationship between Thai culture and Thai law; the view that drug addicts need to be, and can be, saved on a spiritual level, yet instead are punished as criminals.

Despite this, Dr Pattaree said that the situation is much better than it once was, ?It has only been very recently and under the leadership of Prime Minsiter Abhisit Vejjajiva that there was such a strong government initiative and societal shift in viewing drug addiction as a form of illness that required help and not just punishment.?

However, although the course is available and advertised on the radio, this does not necessarily mean addicts will recognise that they need the help and therefore actually accept it.

Dr Pattaree said, ?It?s not difficult to get help if they are aware that they have a problem, if they are not concerned then of course it gets much harder.?

Elsewhere on the island, Dr Kai Goh, the Singaporean founder and CEO of Phuket?s recently opened private drug rehabilitation centre, Bhavana, concurs and said that a country?s and society?s cultural and traditional viewpoint of drug use can be a hindrance to the rehabilitation process.

?Drug addiction in general, but especially in Thailand, is viewed much like a mental illness in that it has a stigma, is rather a taboo subject and not openly addressed. Often attempts are made to remedy the problem in temples, much like mental illness is.?

Dr Goh, who has practiced in rehabilitation clinic for the stars, the Priory Clinic in England, said that it was not his intention to disassociate the spiritual from the healing/recovery process but to add other elements to aid the treatment.

And Bhavana, an ex-resort set in a secluded beachfront location of Cape Panwa, certainly offers an abundance of other elements: qualified and accredited international psychiatrists, meetings and lectures with industry experts, luxurious live-in rooms, fully intensive and tailored assessment of a patient?s history and the latest in addiction treatments, all in a wonderfully resplendent setting. It also offers treatments for gambling addiction, Internet addiction and sex addiction.

This, of course, all comes at quite a cost, (12,000-27,000 baht a day) but one that Dr Goh believes is quite justified. ?When guests were at the Priory Clinic in England, they often said, ?For what we?re paying we could be staying at the Ritz.? I would always reply, ?Yes, but you don?t get doctors on call 24 hours a day at the Ritz.?

Although patients are not forced to stay for any particular period of time, residential care, including access to trained psychiatrists, tends to be restricted to between 4-6 weeks (?Long enough to be effective, without feeling isolated?).

Dr Goh said, ?About 70% of people who suffer from drug addiction also suffer from some form of mental illness, whether that be depression or schizophrenia. Likewise, if a patient is suffering from a mental illness, they are much more prone and likely to use drugs.?

Dr Goh has been a practicing psychiatrist, specialising in adult psychiatric disorders and alcohol and drug addiction treatment since 1998.

He trained in psychiatry at University College London Hospital (UCLH) and has held senior clinical and management positions in several NHS teaching hospitals, and at several world-class private healthcare institutions in the UK.

For him, the decision to open a clinic in Phuket was an easy one to make, ?There?s nothing of this standard elsewhere in South East Asia. I have been to Thailand many times, and Phuket was a natural choice. It has access to an international standard of doctors, great hospitals nearby for additional support, and also has the appeal to get international staff to come and stay.

Dr Goh added, ?There are great links from the airport so people can fly directly to the treatment centre and of course there are the great views and treatments. It?s a one stop shop for everything you need!?

Although research has shown that the drug of choice may vary depending on social class, and although few of the ya bah-taking, motorbike-speeding young Thai men on the island would realistically be able to afford a stay at Bhavana, Dr Goh believes that what a patient needs, regardless of nationality, ethnic background or financial status is more or less the same.
?Drug use and addiction affects all spectrums of society, the treatment is slightly different between private and public health care, but the principals are now relatively similar; namely abstinence and group therapy,? Dr Goh said.

He added, ?Addiction affects all, regardless of cultural expectations and views of addiction. Many of our patients are from the Middle East and China, which in many ways carries a bigger stigma than Thailand with regards to addiction.?

A common modern-day perception of drug addiction and a tenant of its treatment is that it is not only a physiological problem, but also a psychiatric one. This level of awareness, both doctors agree needs to occur in every aspect of society, not just in the hospitals, and drug rehabilitation centres, but also in homes and schools.

This, Dr Goh believes, is the first step in solving the local drug problem on the island, "It?s all about education. The kids who take ya bah need to be aware of how destructive it can be, so that they can choose to resist the peer pressure and temptation.

?It?s like smoking ? which Thailand is actually pretty good at - there needs to be steps taken to inform people that a) it?s dangerous and b) there is help ?theoretically? out there to help you quit.?

Dr Pattaree concurred, but said that it would take time for such changes to occur, ?Although we keep in contact with teachers and sometimes give talks at schools, we would like to do more and have more staff in order to do more.?

?We would also like to have huge billboards that advertise a hotline for people to call for help. But unfortunately such a number does not exist. Of course we would like to provide information to addicts and have more radio spots, but we have very little budget.?

In an ideal world then, the second step would be for the government to provide more funding to build more drug rehabilitation centres around Thailand.

And although they may not turn out to be as equipped or luxurious as Bhavana, Dr Goh hopes that the centre may act as a sort of beacon and inspiration for future centres to be opened.

Pol Lt Col Akanit however, believes that instead, more effort should be spent on the suppression of drugs, ?The most important way {to remedy the problem} is to try to prohibit drugs from being spread around.?

He also said that key to the police?s success in dealing with drug crime was communication. ?We try to cooperate with everybody in the community. It's a good way for police to get more information about people who are involved with drugs. Everybody should participate; it?s a valuable way to prevent drugs from spreading,? Pol Lt Col Akanit said.

Then, perhaps in the future there will be huge billboards and signs providing information, help and guidance for addicts alongside those that boast of the government?s 100% drug free areas and 0% tolerance warnings.

There is irony in opening such a rehabilitation centre retreat as Bhavana, on an island partly famed for its residents? lives of excess, but despite that, its existence, what it symbolises and what it could usher in could mark the beginning of a new Phuket, of new Phuketians and of new Phuket visitors.