Exploring Drug Issues and Their Impact on Recovery Community in Eastern Shan State: A Study of Social, Psychological, and Economic Dimensions

Exploring Drug Issues and Their Impact on Recovery Community in Eastern Shan State: A Study of Social, Psychological, and Economic Dimensions

Rosalinn Win

Myanmar Institute of Theology, Myanmar

DOI: https://dx.doi.org/10.47772/IJRISS.2025.90300355

Received: 13 March 2025; Accepted: 17 March 2025; Published: 21 April 2025

ABSTRACT

This study delves into the social, psychological, and economic impacts of drug addiction on individuals and communities in Eastern Shan State, Myanmar. A mixed-methods approach, incorporating in-depth interviews with two caregivers and surveys of 52 recovering drug users, was employed to understand the multifaceted challenges. The study findings underscore the critical role of family support, community resources, and accessible healthcare in facilitating recovery. Conversely, economic hardships and political instability emerged as significant barriers for recovery communities, families, and recovery centers to effectively manage recovery services. To address these issues, the study recommends comprehensive interventions, including strengthening family support systems, enhancing community-based recovery programs, improving healthcare services, and advocating for policies that promote economic stability and opportunities and areas of security in cooperation with state actors, ethnic armed groups, the international community, and CSOs.

INTRODUCTION

Myanmar (formerly Burma) is one of the highest producers of illicit drugs in Southeast Asia regions and has the peak record of illegal poppy trafficking in the globe. In early century Myanmar, opium was cultivated and applied mostly for traditional medicines among the tribal habitats, particularly from the hinterlands. The origin of opium and its production in Myanmar was complex to track since it might have been different in geography. However, Hlaing (2008) discussed that opium is believed to have entered Myanmar through India in 1581 and started to spread throughout the country’s civilization, though its use may not have been prevalent. It is noteworthy that the manufacturing of drugs became massive in quantities and expansion of cultivation areas in the hilly regions of Myanmar, Kachin, and Shan states. This chapter will introduce the background, rationale of the study, research objectives, and questions.

Background and Rational of the Study

Starting from 1885, although the utilization of opium was restricted across Myanmar under the administration of the British Indian government, this restriction had the exception for the registered consumers and licensed shops. Nevertheless, Burma became a part of the Indian Empire in 1886, and the semi-autonomous Shan, Kachin, and Wa regions were involved in the widespread cultivation, usage, and trading of poppies (Collins, 2018). Under the British colonial administration, the Shan state was mostly managed by the Sawbwas depending on the regions of Shan state such as Keng Tung’s Sawbwa from Eastern Shan state and Nyaung Shwe’s Sawbwa from Southern Shan state. Likewise, it appeared that opium production and restriction were organized under the administration of autonomous Sawbwas in Shan state. Collins (2018) expressed that the Sawbwas and their representatives were fully authorized over the growing of poppies, and according to the rule “any other opium found in the State” was illegal and might be seized by the state government. The Federated Shan States was formally established as a colonial region under the governor of Burma in 1922, and following Burma’s 1937 separation from India, the supremacy over the production and distribution of opium in the trans-Salween region of the States became a significant concern by Maule (2012). Notwithstanding the regulation, opium’s utilization, growth, and trading had significantly increased in the Shan state regions; notably northern and eastern Shan regions, and several critical reasons stood behind the production of the illicit market.

One major reason behind the production of opium was that the government had a huge number of profits for the reselling and trading of opium, and Shan state was determined as one of the highest poppy sources of the government. Therefore, Collins (2018) debated that since Burma would probably lose considerable amounts of money economically in the form of government revenue if opium disappeared, it started to turn to the Shan States and its sources of opium cultivation. Furthermore, the socio-political landscape of Shan State presented complex due to the influenced factors like economic disparities, diverse ethnicity and history, and instability in the regions. Thus far, the poppy processing has still recorded and remained high production because Meehan (2021) mentioned that Shan State is the location where more than 90% of the nation’s opium crops are grown.

Eastern Shan state comprised 4 main districts; Keng Tung, Mong Hpayak, Mong Sat, and Tachileik of a total of 10 townships, and is the home of more than 3 million diverse ethnic communities such as Shan, Burma, Wa, Akha, Lahu, Kachin, Lisu, Chinese, etc. and the diversity in ethnicities has both enriched cultural tapestry and contributed to social tensions between the groups. The region had witnessed conflicts not only between the military (Tatmadaw) and ethnic armed organizations (EAOs) such as the United Wa State Army (UWSA) and Shan State Army (SSA) but also between the armed groups. Though its region is endowed with rich natural resources like minerals, timber, and agricultural lands, however, the region’s economy and development endured underdeveloped due to the poor infrastructure, limited investment, remote geography, and specifically the complicated security situation and specification of the region control between the ethnic armed groups and the Tatmadaw.

In addition, the people from the remote regions of Eastern Shan State have remarkably suffered socioeconomic disparities in terms of access to education, healthcare, and basic infrastructures due to the practicing of the centralized ruling system by the military regime for more than six decades. The creation of alternative income-generating opportunities that secure stable markets is limited and inaccessible in most of Eastern Shan state, and the illicit drug business such as growing, processing, and production is still recorded as the main income generation factor for many households. According to UNODC (2022), opium farming has contributed 23% of the country’s total opium production whereas the opium yield has documented a 46% inclined farming in Eastern Shan State (18.6 kg/ha in 2022). The vast levels of production and opium cultivation have persuaded the community around these areas to initiate opium smuggling as well as consumption which then led to drug addiction. Hla and Phu (2023) highlighted that the vulnerability of young people to drug usage has risen due to their proximity to large-scale drug production.

Study’s Objectives

The purpose of this research study is to explore the drug issues and social, psychological, and economic impacts that contribute to the well-being of individuals who are on the journey of rehabilitation. The research also aims to investigate the perspectives of recovery service providers who support recovering persons what are the influencing factors and how these lead to persons in recovery in Eastern Shan State. The following are the four main objectives of this research.

• To investigate the unique needs and challenges faced by drug users and service providers affected by drug use in Eastern Shan States
• To determine the particular social, psychological, and economic factors on the recovery process of drug users
• To examine the coping strategies and networks of support that communities utilize to mitigate the effects of drug use
• To recognize how risks related to drug use, displacement, and armed conflict interact

Research Questions

• How do Social, Psychological, and Economic factors influence the recovery process and overall well-being of individuals within the recovery community in Eastern Shan State?
• What are the effective alternative interventions to enhance the resilience of the recovery community in Eastern Shan State?

Theoretical Framework and Conceptual Framework of Study

The ecological theory formulated by Urie Bronfenbrenner is the primary framework of this study to investigate the multifaceted impact of drug issues on the recovery community from Eastern Shan State. This framework acknowledges the complex interplay of factors at various levels of influence, promoting a holistic understanding of the challenges and opportunities individuals face in recovery. Based on the ecological framework, this study proposes a conceptual framework to investigate the impacts of drug issues on the recovery community. In the conceptual framework, drug issues encompass the types of drug availability, accessibility, and reasons for using drugs in the recovery community.

Additionally, individual factors such as personal experiences with trauma as well as access to positive coping mechanisms will be researched. The social norms surrounding drugs, and the social support networks and their influence on the persons in recovery will be covered in this study. The funding and healthcare support for rehabilitation centers by the community or government will be analysed. Overall, how social, psychological, and economic effects contribute to the recovery journey of drug addicts through the ecological framework. This framework will provide a comprehensive understanding of the complex challenges faced by the recovery community and identify key factors at individual, community, and policy levels that contribute to successful recovery outcomes. Above all, through this framework, valuable insights to inform interventions and support services tailored to the specific needs of the recovery community in Eastern Shan State can be determined.

Hypothesis of the Study

1. Social, psychological, and economic factors influence the recovery process of persons in the recovery community in Eastern Shan State.
2. There is a positive correlation between the strength of social support networks and the success of rehabilitation among drug recoverees in Eastern Shan state.
3. Emerging conflicts and political instability in Myanmar lead to the social, psychological, and economic challenges faced by individuals hindering their recovery process.
4. The presence of effective alternative interventions can enhance the resilience of the recovery community in Eastern Shan State.

Significance of the study

Several studies focus on illegal drug production and trading. Still, there persists a critical gap in understanding and considering the specific challenges and needs of the recovery community within the complicated socio-political context and economic challenge in Eastern Shan State. While existing research has spotted the escalation of illicit drug production and trading, and the implications of drug abuse, limited research has emphasized the lived experiences of individuals from their recovery journey. Additionally, a dearth of knowledge of whether there are specific social, psychological, and economic factors that determine the sobriety journey of addicts and hinder the development of targeted interventions and support systems for them. Therefore, this study aims to not only tackle the gaps by exploring the intricate relationship between drug issues and the well-being of recovery individuals but also investigate the social, psychological, and economic experiences faced by individuals in the recovery process. Above all, this exploration seeks to inform the development of comprehensive and culturally appropriate support programs to facilitate recovery and promote the overall quality of life for the vulnerable population. Last but not least, the research findings will contribute valuable knowledge to a critical issue affecting drug problems in Myanmar to adopt coping mechanisms and support for them.

Scope and Limitation of the Study

The purpose of this research study was to explore drug issues and the impacts of social, psychological, and economic factors on the recovery process of people in rehabilitation centers in Eastern Shant State.  Even though the target population was tentative at around 100, only 52 recovery individuals and 2 service providers were interviewed through qualitative and quantitative approaches. The study can only be confined to a single recovery center in Eastern Shan state, which limits the generalizability of findings to a broader population of drug recoveries and service providers across the entire state. Therefore, the study primarily relies on data from drug recoverees within a single recovery center and service providers, potentially limiting the exploration of broader societal factors influencing drug abuse and recovery.

LITERATURE REVIEW

In this chapter, the existing literature delves into drug issues and their impact on the recovery community by considering the social, psychological, and economic aspects. The purpose of this session is to establish a foundation for understanding the challenges encountered by the recoverees within the recovery community in Eastern Shan State, Myanmar.

Social, Psychological, and Economic Factors in Recovery

To acknowledge the influences on the recovery process, it is crucial to explore the drug issues and the impacts

of social, psychological, and economic influence on the recovery community. Because the drug addiction recovery process is a multifaceted process controlled by a complicated interaction. Therefore, this session investigates the existing literature reviews on the facts that can impact the recovery communities.

Social Factors and Their Influence in Recovery

A research study witnessed that the pervasive stigma and discrimination surrounding drug use caused a significant barrier for individuals seeking recovery. The study revealed that drug users face discrimination in addition to the stigmatization that comes with using illegal substances (Ahern et al., 2007). This is due to the concept that the lack of understanding about addiction as a medical condition. The people struggling with drug addiction are often characterized by their communities, facing shame, judgment, and even social exclusion. This experience of rejection and discrimination discouraged many drug users from seeking support, fearing the potential consequences for their social standing and relationships, and this stigma also hinders successful reintegration after recovery. Jang et al., (2023) added that one major obstacle preventing people with substance use disorders (SUD) from seeking and completing drug addiction treatment is the stigmatization and discrimination they face. Even after overcoming addiction, individuals may struggle to find acceptance and opportunities within their communities, creating a sense of isolation and increasing the risk of relapse.

On the other hand, the existing study reported that recovering individuals who have been consistently linked to social networks and received support from community members appeared to improve their recovery journey. Since supportive relationship provides emotional validation and a sense of belonging and encouragement which can motivate drug recoverees to manage their emotions and symptoms and overcome challenges along their recovery journey. In addition, achieving social support from family, friends, and surrounding communities has encouraged the persons in recovery to have a sense of social inclusion, kindness, security, in particular, enthusiasm for their road to rehabilitation and start a new life. Zaidi (2020) argued that persons with addicts who were part of the right social groups were able to find meaning and purpose in their lives, healthily deal with guilt, and cope with their psychological problems.

Psychological Factors and the Recovery Journey

Another important factor that can shake the recovery process is whether recoverees are securing mental health well-being or not during their journey to recovery. Mental health is imperative to consider because it can complicate the rehabilitation process by creating barriers to emotion regulation, self-esteem, and interpersonal relationships with family, friends, and surroundings.  Many psychological issues, including mental diseases with suspicions, intense anxieties, mood disorders, and despair, are brought on by drug use (Wani and Sankar, 2016). The persons in recovery, depending on their conditions and specification of mental health, require tailored treatment approaches and support systems. For instance, recoverees with mental illness should consult with not only counselors and medical persons but also follow-up medical therapy as necessary because obtaining the right coping mechanism influences the journey of recovery.

Economic Factors Shaping Recovery

According to the literature, people in recovery from drug use face numerous challenges on their road to addiction recovery. Laudet et al. (2000) proclaimed that individuals who have emotional and economic obstacles have a substantial impact on their capacity to manage various aspects of the recovery process. The socio-economic disparity tended to be the cause of massive drug production as the main income source for living, particularly, in the areas where lack of livelihood opportunities and alternative solutions to meet basic needs. Consequently, the production of drugs has led many individuals in those regions into severe drug addiction due to the accessibility, attainability, and availability of drugs. Chen and Xu (2022) specified that a person is considered to be deprived if their income is so low that they are unable to meet their necessities and those in poverty strongly correlated with drug addiction.

Hansen et al. (2008) mentioned that there was a 9.2% chance that 22.6 million individuals aged 12 and above

had illicit drug use or dependency issues, however, roughly 2.5 million individuals accessed treatment for substance misuse at specialized clinics in 2006. The limitation to access to treatment occurred as a primary obstacle for the recovery community, especially the conflict-affected and fragile areas. According to Leis and Rosenbloom (2009), services for addiction to substances are scarce and difficult to access for populations impacted by conflicts. A study by Fazel et al. (2021) mentioned the limitations of clinic availability and treatment options like methadone maintenance programs. tended to be the challenge for persons in recovery. In these volatile environments and low-income developing countries, healthcare infrastructure is often severely strained, with a lack of resources and trained personnel hindering the widespread implementation of such crucial treatment options. This scarcity leaves individuals struggling with addiction with limited tools to manage their condition, significantly impacting their chances of achieving long-term recovery.

In conclusion, to manage effectively the recoverees through rehabilitation programs, it is worthy to ultimately understand the social, psychological, and economic factors. According to previous studies, eliminating social stigma and discrimination, enhancing constructive relationships, and fostering mental health literacy contribute as significant remedies for both recoverees and the communities. The economic disparities including lack of legitimate economic opportunities and employment have driven individuals into poverty and drug addictions, and this chain should be broken through creating guaranteed opportunities that not only meet their basic needs but also earn income for achieving quality of life and well-being.

Coping Strategies for Managing Cravings and Triggers

Drug use recovery is a challenging but rewarding process because of different coping strategies to alleviate the effects of drug substances and face triggers. To overcome the recovery journey, a robust support system plays an essential role in achieving long-term outcomes. This session explores the works of literature on coping strategies and the effectiveness of diverse helping strategies for individuals in drug recovery. The study stated that coping mechanisms play a critical role in recovery because they have a significant impact on the attainment of successful recovery outcomes (Setiawan et al., 2024). They added that good coping strategies enable people to manage stress experienced throughout recovery, resist the need to use drugs again, and create a happy, healthy life free from addiction to drugs. The self-care practices like healthy eating, regular exercise, and adequate sleep can boost overall well-being and reduce the potential of relapse in recoverees.

Even though some coping strategies prioritize directly managing cravings through exercises as well as mindfulness therapy, other strategies focus on physical and mental support from peers and friends. The helping hands from the close ones of individuals remarks as an incredible coping tool for the persons in recovery. Research by Setiawan et al. (2024) illustrated that the support from peers, relatives, or friends who are going through similar recovery journeys is seen to be a helpful first step in helping people with rehabilitation. The shared experiences with peers who fully realize the challenges faced by the recoverees can initiate a sense of belonging, hope, and security for their road to recovery.

Additionally, the interaction between family members and recoverees plays a major contribution to the recovery process. The sense of security, accountability, and encouragement retained from family environments contributed to constructive benefits for the individuals in recovery. The family intervention program could prove beneficial in helping family members who are undergoing drug addiction treatment and rehabilitation (Baharudin et al., 2014). Nonetheless, it is tremendous to consider that dysfunctional family dynamics can prevent the recovery process, addressing underlying family issues alongside the recovery process might be necessary.

The role of faith-based communities in the recovery process is a valuable source for the persons on the road to their recovery journey. Sanchez and Nappo (2008) mentioned that religion’s networks can promote drug abstinence through asocial resources for life reconstruction, religion also promotes drug abstinence. The contribution to faith-based communities can offer a sense of life purpose and moral guidance to start a new life during and after the recovery process. What is more, this interaction may also give practical assistance like mentorship through worship, praying, meditation, and reconciliation with their believed God, further aiding the journey of recoverees. However, the effectiveness of the recovery process may vary depending on the individual beliefs and the methods of practice applied by the religious communities.

In summary, coping strategies and support systems are intertwined aspects of successful drug use recovery. Effective coping strategies empower individuals to manage cravings and triggers, while robust support systems provide encouragement, accountability, service, and a sense of motivation and inclusiveness. Therefore, understanding the effectiveness of various coping strategies and support systems is crucial for developing comprehensive recovery programs that cater to the individual needs of those seeking to overcome drug use.

Drug Production and its Impact in Eastern Shan State

In this session, the conducted studies about drug production, consumption, and the impacts of illicit drugs on the communities in Eastern Shan State will be examined to acknowledge how and what factors influence for mitigation of illegal drugs’ growth.

Eastern Shan State: Home for Diverse Community

Eastern Shan State, home to diverse ethnicities, is known for being rich in cultural tapestry, geographical admiration, and complex history. This area specifies borders with China, Laos, and Thailand, forming it a junction of Southeast Asia. The Shan plateau overshadows the landscape, covered by towering mountains, valleys, and the life-giving Salween River (Thanlwin River), offering breathtaking sightseeing and views. The majority ethnicity is “Shan”, also known as “Tai”, but other distinct ethnicities like Lahu, Akha, Wa, Pa-O, Kachin, Palaung, Burma, and Chinese the cultural richness, composing diverse dialects, customs, and traditions.

Agriculture, livestock, and farming practices in Eastern Shan State are known as the backbone of the economy, with rice, tea, coffee, and poppy being major crops. Furthermore, handicrafts, particularly textiles are a significant source of income and cultural pride for the community. The majority (almost 85%) of residents are Buddhist, the dominant religion in that area, but other religions like Christianity, Islam, Hinduism, and even animistic beliefs are also practiced by many ethnic groups. The various festivals and ceremonies, depending on the specific ethnicity, organized throughout the year reflect the fascinating blend and harmony of the people in that area.

Complex Security Dynamics and Illicit Drugs

The presence of Ethnic Armed Organizations (EAOs), the central government, the military (Tatmadaw), and its backed groups; people milia, in Eastern Shan State, leads to a complex issue not only in political landscapes but also in the social and economic aspects. The Restoration Council of Shan State/ Shan State Army (RCSS/SSA) is one of the EAOs that has historically sought greater autonomy and influence over Shan people and ethnic minorities existing in Eastern Shan State. The influence of other ethnic armed groups such as the Shan State Progressive Party/Shan State Army (SSPP/SSA), National Democratic Alliance Army (NDAA), and Lahu Democratic Union (LDU) influence the ethnicities in Eastern Shan State. Even though the ceasefire agreements have brought a degree of stability, the tensions between the ethnic armed groups especially RCSS and SSPP, and the military and ethnic armed groups occasionally resurface.

However, despite the ceasefire agreements after the 1980s, Hla and Phu (2023) reasoned that strong commercial ties have been forged between the military and these ethnic armed organizations, particularly in the manufacture of drugs and illicit goods. Studies showed that the aspirations of “people militia groups” have also emerged as a result of the Myanmar military’s (Tatmadaw) efforts to establish stronger control over contested regions. While some “people milia groups” are driven by economic interests, others are inspired by ethno-nationalist ideology. Nevertheless, the majority of these groups were established by the military (Tatmadaw) to carry out various security and counter-insurgency tasks in their respective regions. Some of these groups are the most influential players influencing the social, political, and economic dynamics of the borderlands, and they have become deeply embroiled in the drug trade throughout Shan State including Eastern Shan State.

Consequently, Eastern Shan State is one of the prominent hotspots for the production of illicit drugs,

particularly methamphetamine and opium. Myanmar stood as the world’s second-largest opium manufacturer, with Eastern Shan State comprising an estimated 23% of the national crop to the report of the United Nations Office on Drugs and Crime (UNODC). The complex interplay of socioeconomic and political situations fuelled the high production of illicit drugs in Eastern Shan State. Among them, many residents have been encouraged towards poppy growing as a means of survival tool due to poverty, and poverty plays a major factor in drug substances. According to the UNODC Myanmar Opium Survey Report (2022), there is a relationship between poverty and poppy cultivation in the region due to limited access to livelihoods and other alternative options. It is noteworthy that the communities may be drawn to prompt income offered by illicit drug growing and trading when legal economic opportunities are absent.

The consequences of high drug production in Eastern Shan State have a significant impact on the accessibility and affordability of drugs for individuals in the surrounding areas. Even though opium was once applied as traditional medicine in Myanmar because Sassaroli (2022) claimed that opium has been grown and consumed for generations; its usage is socially accepted as a way of life, and some of it has traditionally been used medicinally. The ready availability of drugs has driven many individuals particularly young people to become drug addicts, most importantly, it acts as a major challenge to recovery efforts by individuals themselves and service providers from recovery centres. Based on the research study, it should come as no surprise that young adults exposed to widespread drug production, armed conflict, and violence are more likely to abuse drugs, and labour migration brought on by economic transition creates new communities in border towns where drug use and informal economies are common (Hla and Phu, 2023). The readily and affordability of drugs have created a source of temptation for those who struggling with addiction.  

Risks of Drug Use, Displacement, and Armed Conflict

The presence of an ongoing civil war in Myanmar between armed groups also contributes to the high production of drugs and trading. The profits from poppy cultivation have a huge benefit for the armed groups to purchase defense equipment. In addition to arming themselves and growing the number of their members, the EAOs, and militia groups which were supported by the military, have employed their drug production and trading earnings in casinos, hotels, petrol stations, gold shops, and construction firms (Hla and Phu, 2023). The military regime (Tatmadaw) has purposively involved and allowed the production of opium and trafficking since this supports their interest as well as the economic growth of local communities. Barba (n.d.) articulated that it has been noted that the military regime in Myanmar allows drug trafficking rather well because it enhances regional communities’ economies and frees up resources for more pressing issues. All these landscapes such as the ignorance of illicit drug production and trading by the relevant stakeholders, prohibit the development of legitimate economic opportunities, perpetuating the cycle of poverty and drug production in Myanmar.

Since Eastern Shan state is located near the border areas of the Golden Triangle region, it is known as the place of migrants from across the country along with political and economic instability. Not only the people residing in Eastern Shan State but also the migrants become more vulnerable to drug use. Disruption of social structures, loss of livelihoods, and economic can increase the risk of seeking solace in drugs. In addition, this can also create a cycle, as addiction weakens one’s ability to rebuild their life, potentially pushing one back towards displacement.

Review Theoretical Framework

In this session, the selected theoretical framework, the Ecological Theory by Urie Bronfenbrenner will be revisited and elaborated. The analysis of this session will clarify how the chosen framework helps the interaction between Individual, community, and social factors resulting in the recovery journey. Because understanding the challenges and needs of the recovery process for the individual in Eastern Shan State is vital a framework that gives the nature of individual vulnerabilities and the surrounding social environment and the ecological theory developed by Urie Bronfenbrenner, supports a powerful lens for exploring the drug issues and impacts. According to Otengah and Rono (n.d.), Urie Bronfenbrenner designed the five systems—Microsystems, Mesosystem, Exosystem, Macrosystem, and Chronosystem—that comprise roles, norms, and regulations and have a significant impact on how individuals develop.

Fig.1 Ecological Theory Image from Brown and Strommen (2018)

In the ecological theory formulated by Urie Bronfenbrenner, the individual defines the person’s sex, age, health, and personality of the recoverees in this study. The immediate environmental impacts on the people in recovery will be examined at the Microsystem level. This level focuses on the recovery community itself and it stands as an essential tool to be able to examine how immediate relationships of recoverees with their service providers, family dynamics, and peers within the recovery community Humphreys et al. (2018) demonstrated that the support of immediate environment has a huge influence on the success of development process.

Additionally, the Mesosystem level investigates how the recovery community interacts with the broader social context. Aspects like access to educational opportunities, employment options, and community resources play an important role for people in recovery. Individuals suffering from alcoholism or other drug addiction encounter considerable challenges while trying to acquire health insurance, suitable medical attention, jobs, aid from the government, training and education opportunities, and housing (Leis and Rosenbloom, 2009). Conversely, the limitation to receiving these resources can lead individuals in recovery to reintegrate into society and maintain sobriety. Research proved that the tendency will be negative since there is only a limited amount of employment available for treatment individuals, and those positions decrease as treatment effectiveness increases (Duffy and Baldwin, 2013).

The further level, Exosystem, emphasizes the broader social and political structures. This system encompasses the rule and regulation of government policies about illicit drugs and drug use, the accessibility and quality of recovery centers, and political and economic opportunities within Eastern Shan State. These overall factors and environment can impact both illicit drug availability and the support systems accessibility for the recoverees. Meehan et. al., (2022) indicated that community care might be enhanced in situations where the dangers that young people experience are compounded by existing drug control efforts and when structural drivers of drug hazards are firmly ingrained.

Additionally, the Macrosystem level examines the cultural norms and attitudes of society towards individuals, and this will apply to consider the norms, culture, and society of society influence towards drug addictions and the recovery process. The impacts such as stigma or discrimination against drug substances can cause individuals to lessen their willingness and motivation to start a new life. Leis and Rosenbloom (2009) argued that the path to being accepted as a contributing member of the community is nevertheless lined with obstacles. They also added that the addicts battle the stigma associated with addiction and encounter prejudice from a variety of sources, including the government and even members of their own families. Therefore, there are whether stigma or discrimination through culture, norms, and attitudes of society in the recovery community in Eastern Shan State will be analyzed through the Macrosystem.

Overall, after examining how these levels interact and influence each other, the study will gain a more comprehensive acknowledgment of the factors impacting the recovery community in Eastern Shan State. This helps to identify the interventions that tackle the complexities of drug issues and promote practical recovery outcomes for individuals within Eastern Shan State’s recovery community.

Chapter Summary

This chapter researched the interplay of social, psychological, and economic aspects dominating the road to recovery of individuals struggling with drug addiction. The research underscored the prominent challenges posed by stigma, discrimination, and limited access to mental and physical health care services. Economic adversities, including poverty, unemployment, and lack of opportunities to access business, were recorded as the main factors in both drug addiction and recovery journeys. Furthermore, it is noteworthy that the importance of social support networks, including family, friends, and peers was influenced to fostering resilience and promoting sustained recovery. Importantly, the role of faith-based communities was also explored as potential avenues for rehabilitation as an effective coping strategy. This session further investigated the specific context of Eastern Shan State by highlighting the area’s unique challenges related to drug growth, trafficking, and consumption. Eastern Shan State with its complicated security issues, instability, lack of economic autonomy, poverty, migration, and unemployment was illustrated to intensify drug-related issues and mitigate recovery efforts into effective outcomes.

All in all, the literature review stressed the multifaceted nature of drug addiction and recovery actions, focusing on the necessity for comprehensive interventions that can solve social, psychological, and economic determinants. The former findings also underlined the critical paramount of specific approaches, especially the regions like Eastern Shan State, where security challenges and drug production and trading interacted with the economic interests of the groups. It is notably imperative to identify the key research gaps to understand the recovery context in Eastern Shan State. Therefore, this chapter subscribed to the foundation to be able to explore the experiences and challenges faced by recovering drug users in Eastern Shan State.

METHODOLOGY

Research Design

The research design of this study applies mixed methods to be able to examine the impact of drug use on the social, psychological, and economic well-being of the recovery community in Eastern Shan State. Both qualitative and quantitative data collection methods are included in this study to obtain a comprehensive understanding of the challenges and needs faced by the persons in recovery and explore the potential solutions for them.

To answer the research questions:

• How do Social, Psychological, and Economic factors influence the recovery process and overall well-being of individuals within the recovery community in Eastern Shan State?
• What are the effective alternative interventions to enhance the resilience of the recovery community in Eastern Shan State?

By using a qualitative survey, 52 individuals from the rehabilitation center were interviewed throughout the study. This survey used a combination of 32 closed-ended and open-ended questions. Closed-ended questions were constructed to acknowledge the standardized data on the prevalence and characteristics of social, psychological, and economic effects experienced by recoverees. Furthermore, open-ended questions allowed participants the opportunity to share their unique perceptions and experiences on their challenges and needs. The recovery individuals’ demographic characteristics are summarized in Table 1. More than fifty of the recoverees are between 25 and 35 while about thirty-five are equal to and above 36 years old. The youngsters who are aged between 19 and 24 are nearly ten percent and the age under 18 records nearly two percent of the respondents. The majority of recovery participants are male which reached a total of ninety-eights and only one female (about two percent) is involved in this research study. The marital status of interviewees is mostly single around sixty, and there are about twenty-five married recovery persons and less than ten percent are divorced. Since Eastern Shan State is home to diverse communities, there are Shan, Akha, Burma, Lahu, Chinese, and Wa participants in this research. In terms of religion, more than half of the recovery participants are Buddhist, 36.5% (n=19) are Christian, and two participants are Animism. More than half of the participants are from Tachileik, and around one in ten are from Keng Tung but the participants are also from Mong Pyat, Mong Sat, and Mang Ton regions as well. Even though the majority of substance recovery 40.4% (n=21) had the experience of joining high school, 4 participants had no schooling background.

Table 1. Demographic Characteristics of Recoverees

To gain deeper insights and information, two in-depth interviews were conducted with service providers working in the recovery center and their demographic data is listed as below in Table 2. These qualitative interviews provided for more exploration of the research questions by capturing the experiences and perspectives of service providers on the frontline through 16 semi-structure interview guides. This input can support to identify effective interventions currently in use and explore further new strategies to boost the resilience of the recovery community.

Table 2. Demographic Characteristics of Service Providers

Sampling Plan

This study employed a non-probability sampling method due to the challenges of receiving a complete sampling frame of the recovery community and service providers in Eastern Shan State. With non-probability sampling, purposive sampling methods were applied to ensure the sample reflects the characteristics of study interests and the diversity of the recovery community. The selection criteria of the participants included 1) individuals who are currently residing in Eastern Shan State, 2) Individuals or Service Providers who self-identified in a recovery program or providing services for the recoverees, 3) Individuals who can self-report history of drug use and share their experiences and perspectives voluntary.

Sample Size and Recruitment Strategy

Among non-probability sampling, purposive sampling was used in this research study. The target sample size for the quantitative survey is a total of 52 recoverees (n=52), and a qualitative interview is 2 service providers from the recovery community. Before the data collection, several virtual meetings between the researcher and local service provider were performed to acknowledge the characteristics of the study and identify potential participants of this study. Information about the study including the objectives of the research and author was unpacked to enhance trust not only between the author and local service provider but also between the recoverees and interviewer.

Data Collection and Instrumentation

Before data collection, the informed consent form was created in advance of the data collection and survey collection training for the enumerator. All the participants were recruited by voluntary participation with the following verbal informed consent agreement. To earn the participants’ trust, respect, and guarantee of confidentiality, this document and the author’s details were added to the consent form. Following the data-gathering procedure, the convenient participants were interviewed via Zoom for comprehensive responses. Ensuring participant consent and confidentiality enabled the collection of recordings and notes by using an anonymous identity. Following the data gathering, the author personally transcribed all of the data and carefully reviewed them. The actual transcripts and recordings are stored safely. The initial phase in the analytic procedure was to create themes and each of these topics was then given a relevant participant quotation. The results, findings, and discussions were finally written down.

RESULTS AND DISCUSSION

This study explored the perspectives of drug recoveries and service providers from the rehabilitation center, which originated in Eastern Shan State, Myanmar. The purpose of this research was to investigate the drug use and social, psychological, and economic influences in recovery communities in Eastern Shan State, Myanmar.

Mixed-method Analysis

A total of 52 (n=52) drug recovery community members and two service providers, who have been working in the recovery center for more than 5 years, are interviewed in this study. According to the respondents, half of the recovery participants were doing their own business, farming, and livestock, however, nearly one-third of respondents were unemployed before rehabilitation. About sixty-five percent mentioned that they started using drugs at their younger age of less than 18 years and around one-third reported in their age between 19 and 24 years. While exploring reasons for starting drugs, “peer pressure” was the highest number of participants mentioned for their initial contact with drugs, and several participants stated the reasons; “Just want to try it”, “I like it” and “To have fun” as their intention for using drugs. Regarding the type of illicit drugs used by respondents, Wyoming (WY) was described most often used drug item, followed by alcohol, poppy, khe, and heroin (oral).

Table 3. Respondents’ Demographic Factors Related to Drug Initiation

*Participants can select more than one answer.

Microsystem and Mesosystems; Immediate Environment Impacts on Drug Recoverees

This session will outline the influences of microsystem and mesosystem of ecological theory with the primary finding results in comparing to secondary data of the study.

The Role of Family in Drug Recovery

The findings revealed that the support of family members marked a critical aspect for the individuals in their recovery journey. According to the primary data, more than three-quarters of respondents (82.7%) expressed that their journey to the recovery center began by receiving motivation as well as pressure from their family members. Additionally, the foremost reason that their determination to break the use of drugs most initiated by “pressure of family” because more than two-thirds of respondents (n=37) chose this option apart from many other reasons like “I can’t control myself”, “to be able to re-do my job”, and “I want to start a new life”. According to Sari et al., (2021), drug abusers’ ability to heal will depend on how much assistance they receive from their families. A service provider who has been joining this rehabilitation center disclosed that

“Individuals in recovery seemed very delightful when their family visited them. The help of family members assured to recover 100% from their addictions. They appeared more enthusiastic to overcome their recovery journey with hopes. We noticed that the support as well as frequent encouragement and visits of family members to persons in the recovery center has a significant benefit to their recovery within a short period. Conversely, the lack of visitors and phone contacts of recovery family members to individuals in the recovery center has a great effect on the success of their recovery process. Only a very few relatives of recoverees came and visited them.” IDI-P2

It is noteworthy that challenging behaviour exhibited by drug recoverees while at home discouraged family members from visiting them in rehabilitation centers. This was because the problematic behaviours displayed by drug users created shame and barriers to familial support during their treatment. In the survey results, 84.6% of recoverees witnessed that they had no experience of getting hands from their families and community before they joined the recovery center, and only a very few numbers of drug addicts (15.4%) had received the care of their relatives in the middle of using drugs.

The second service provider who has 10 service years and in charge of the recovery center, said “I found that it is only 30% of individuals in the recovery process have got hands from their family and relatives both financial and mental supports. Their family members left enough money for food and other things for them for their recovery journey. The remaining families are incapable of taking care of recoverees due to their financial adversity and mainly their unwillingness to support and accept those addicts because of their disruptive behaviour in the community before recovery center.”

In addition to providing and determining the psychological, communicational, and emotional connections

between the members of the household and in social interactions, the family plays a crucial role in the growth of the individuals who consume drugs as well (Nimtz et al., 2014). Nevertheless, the findings also showed that nearly eighty-five percent of respondents described the use of drugs and addiction to drugs had a prominent obstacle to their relationships with their family members and relatives. They affirmed that it was due to their lack of listening to their family’s admonishment, no time and take care of their family time, and being unable to contribute family’s business.

The Role of Community in Drug Recovery

It is impossible to ignore the role of external environments; service providers, religious leaders, friends, and community members which play an essential factor in defeating drugs by persons in recovery along their road to recovery process. After family members, the surrounding people including religious leaders, friends, and community members were mostly mentioned by the substance respondents. The findings reported that religious and community members including drug recovery friends supported them while they were under drugs, and they even motivated them to be able to join the recovery journey from their addictions to the rehabilitation process. Nonetheless, according to interviews with service providers, there are only a very few numbers of external communities that are immensely interested in drug abusers and aid them both financially and mentally. The first interviewer of serviced providers stated, “For those who faced a struggle to afford their expenses for recovery journey, they are supported in ratio by their relevant families, church, and community members.”

Furthermore, the other service provider declared that the community’s involvement and attention toward drug users have proven instrumental in helping individuals break free from addiction and rebuild their lives. Moreover, the provision of financial and mental support by the community has significantly contributed to the success of these recovery journeys. Most importantly, to mitigate the use of drugs by individuals, it is vital to halt the sales of drugs and prohibit the availability of drugs in the surrounding communities. According to the finding results, 73.1% (n=38) of respondents have witnessed that different types of drugs especially WY are easily accessible without effort in their environments. Therefore, it is better to restrict the availability of drugs to lessen drug addictions, however, participation and collaboration of the community in those areas are critical to improving this approach. The first service provider said “Effectively prohibiting drugs within a community necessitates the active involvement of local leaders and residents. For instance, there is a village where the village’s elders successfully curtailed drug sales by collaborating with the police to apprehend dealers in Eastern Shan State. This strong community-driven approach has significantly deterred drug trafficking. It would be ideal if all communities adopted similar strategies to combat drug-related issues.”

Additionally, the skills and dedication of rehabilitation center staff have significantly impacted recovering addicts throughout their journey. The encouragement, counselling, and motivation provided by these service providers, many of whom are former addicts themselves, are invaluable to the patients who are struggling with the same experiences as them. As the first service provider shared, “I’ve been here for five or six years now. My motivation is to help the addicts to be able to start a new life because I was once addicted and recovered here.” In addition to these services, the mental and psychological support offered by the service center’s staff has proven to be highly beneficial for individuals in recovery. This approach often involves spiritual guidance, such as teaching words of God, prayer, and fellowship, to foster encouragement. According to Noegroho et. al., (2018), it is extremely difficult for drug addicts to fully recover, so religious counseling is a prerequisite as a kind of informal education or support. They claimed that this process gives them hope for recovery and independence so they can be reintegrated into their families and communities and resume their social lives. Similarly, physical activities, including traditional games like Chinlone or Cane Ball, as well as football competitions organized by the recovery center or other entities, have also contributed to the recovery process. While such activities were frequently coordinated with civil society organizations during the previous National League of Democracy (NLD) government, the center is currently encountering financial constraints in constructing an indoor futsal facility for recovering patients due to Myanmar’s ongoing political and economic instability.

The Devastating Effects of Drug Addictions on Work and School

The majority of study participants indicated that drug use and addiction had a detrimental impact on their occupational and academic performance. Specifically, 67.3% (n=35) reported that drug addiction negatively affected their studies. Among these individuals, 48.6% (n=17) described difficulties concentrating on schoolwork, 40.0% (n=14) reported challenges completing school assignments, and 23.1% (n=12) stated that they had to drop out of school due to their drug use. These findings align with Mensch and Kandel’s (1988) argument that a correlation exists between drug use and school dropout rates, potentially attributable to shared characteristics among drug users and individuals who drop out of school.

Correspondingly, Badel and Greaney (2013) argued that individuals experience a rise in the likelihood of using illegal drugs when they transition from being employed to unemployed. According to the findings, a significant proportion of participants, 78.8% (n=41), reported that substance abuse harmed their employment opportunities. This was primarily due to the inability to work consistently, as reported by 51.2% (n=21) of participants whose drug addictions interfered with their daily lives. Additionally, 43.9% (n=18) indicated difficulty concentrating on their jobs and completing assigned tasks. Finally, 17.1% (n=7) of participants reported avoiding employment altogether due to a lack of confidence in reintegrating into society.

The Ecosystem and Recovery: How Indirect Environments Shape Recovery Journeys

This session will examine how the ecosystem, or indirect environments, influences individuals in recovery. The study will examine the impact of political climates, socioeconomic conditions, and healthcare access on recovery communities.

The Political Climates and Addiction Treatment

The fragile political situation of Myanmar has had a profound and detrimental impact on its population including residents in Eastern Shan State, leading to not only a surge in illegal drug production and trading but also an incline in drug use and addictions. Research findings indicate a direct correlation between the onset of political instabilities and the initiation of drug use among individuals. As mentioned by the service provider, political instability has created a conducive environment for the growth of illicit drug production and trafficking. This is attributed to the inability to effectively implement and enforce regulations governing the production of illicit drugs. In addition, a significant portion of the study participants, representing 38.5% (n=20) of the total sample, appeared to commence drug use only after the country descended into political turmoil. Furthermore, the accessibility and availability of drugs have markedly increased, contributing to the escalating problem. When inquired about the motivations of drug use to the persons in recovery, the majority of participants expressed personal preference and a considerable number of cited factors such as the drugs’ affordability and readily available nature. This trend aligns with existing research, which posits that political, economic, and social disruption creates an environment favourable to the proliferation of illicit drug use and trafficking (Odejide, 2006).

Moreover, staff at rehabilitation centers have stated a commendable effort by civil society organizations and other networks to support individuals in recovery during the politically stable status. These entities have been instrumental in providing both emotional encouragement and practical vocational training to equip recovering addicts with the skills necessary for reintegration into society. However, the prevailing political instability has significantly halted the capacity of these support networks to deliver comprehensive physical and mental health services to the recovery community in the center and this circumstance exacerbates the vulnerability of the recovery community twofold. They are severely inhibited in their rights to access crucial opportunities for physical and mental empowerment programs offered by humanitarian and religious organizations.

Economic Barriers to The Road to Recovery

The research findings indicate a strong interaction between the economic conditions in Eastern Shan State and the prevalence of drug production, trafficking, and consumption in the region. The lack of substantial economic development and limited opportunities have driven many residents, particularly those in remote areas, to become involved in the illicit drug trade as a means of survival. Historically, agriculture and farming have been the primary sources of income for most people in the region. However, the political unrest triggered by the massive drug production and consumption has plunged the area into an economic crisis.

Similarly, the underdevelopment of the economy has created a climate of uncertainty for households, making it increasingly difficult for residents to generate a stable income. This economic instability has led to widespread unemployment and financial hardship, affecting not only drug users but also their families and support networks. As a result of the financial tightness imposed by drug addiction, many individuals and their loved ones have found themselves unable to afford the costs of rehabilitation treatment. Per the first service provider, it will cost at least 3,300,000 MMK (550USD) per recovery person to stay at the recovery center for 3 months to ensure their stability and recovery, and further costs such as medicine and follow-up were excluded in the calculation. Consequently, drug use has often resulted in significant debt and financial challenges, creating an invincible barrier to accessing essential recovery services.

Additionally, quantitative data from the study revealed that a substantial majority of respondents, specifically 82.7% (n=43), reported experiencing financial difficulties for themselves and their families as a consequence of drug use. The overwhelming majority of participants described a situation marked by joblessness, lack of income, and even debt accumulation amidst the broader economic instability. These findings align with the observations of Casal et al. (2020), who argued that economic downturns are associated with increased unemployment rates. It is noteworthy that as economic crises deepen, the vulnerability of recovery communities increases, which in turn contributes to a rise in drug use among individuals.

Healthcare Accessibility: Essential for Sustained Recovery

Access to both physical and mental healthcare is of paramount importance for individuals within recovery communities as they navigate their path to recovery. Research findings indicate that a substantial majority of respondents, constituting 80.8% or 42 individuals, reported that drug addictions adversely affect both physical and mental well-being. Additionally,19.2% of 10 respondents disclosed detrimental impacts on social health.

On the one hand, throughout the recovery process, the availability of healthcare and treatment services is crucial for recovery communities to achieve positive outcomes. Unfortunately, individuals recovering from drug addiction in Eastern Shan State encounter significant challenges in accessing quality healthcare systems and recovery centers. This observation aligns with the findings of McCoy et al. (2001), which established a correlation between illegal drug use and obstacles to receiving essential medical care. Furthermore, the study also revealed a limited number of recovery centers in Eastern Shan State, with only one facility possessing official registration. While some centers adopt a religious or spiritual approach to recovery, others emphasize a power-based or authoritarian model, particularly those affiliated with ethnic armed organizations (EAOs). However, it is noteworthy that none of the recovery centers in Eastern Shan State, regardless of registration status, incorporate a systematic healthcare management system. This may be due to constraints in resources and insufficient involvement from the community and government, none of the rehabilitation centers can be equipped to provide comprehensive physical and mental healthcare for individuals in recovery.

According to interviews with second service providers, the primary response to emergency cases among recovering individuals who experience relapse or mental breakdowns is to transfer them to the nearest clinic which is 13 km away. For non-emergency healthcare needs, recovering individuals rely on care provided by service providers, who are predominantly non-medical personnel. A former drug user and current service provider expressed the need for an increased number of rehabilitation centers to enhance access to services and improve outcomes for individuals in recovery. Given the financial burdens associated with recovery, the establishment of multiple, high-quality, and free recovery centers would be immensely beneficial for both recovering individuals and their families.

Macrosystem Perspective: Society’s Attitudes Toward Drug Users

Societal attitudes exert a profound influence on individuals grappling with addiction and their subsequent recovery trajectories. Research findings indicate a prevalent negative perception of drug users within the community, characterized by a reluctance to accept and support individuals affected by substance use disorders. This negative outlook is largely attributed to the disruptive and often harmful behaviours exhibited by some drug users, which can engender feelings of annoyance and insecurity among community members. Indeed, the challenges posed by individuals experiencing substance use disorders can overwhelm households and neighbourhoods, frequently necessitating referral to rehabilitation facilities. The historical association of these individuals with problematic behaviours often leads to hesitation among family members and community members to visit and encourage them during their recovery process.

The study revealed that a substantial majority of respondents, constituting 78.8% (n=41), reported significant negative impacts of drug use on their social relationships. Social exclusion, isolation, and limited participation in social activities were commonly cited consequences. These findings align with previous research emphasizing the importance of societal support in facilitating recovery and reintegration. Kapoor et al. (2021) underscored the pivotal role of positive community attitudes in providing individuals with a second chance to overcome addiction and re-establish a normal life within their community. Consequently, cultivating a more supportive and inclusive environment for individuals in recovery is imperative for both their personal rehabilitation and successful reintegration into society. To achieve this, it is essential to challenge negative stereotypes and norms related to drug use through comprehensive community education and the implementation of policies that prioritize the safety and well-being of both the community and individuals in recovery.

Chapter Summary

Overall, ‘Microsystem and Mesosystems; Immediate Environment Impacts on Drug Recoverees’ explored the influence of immediate environments on individuals’ recovery journeys. According to the results, family support emerged as a critical factor in the recovery process. While it was a primary motivator for seeking recovery, challenging behaviours often hindered family involvement. The absence of consistent family aids negatively impacted recovery outcomes. In the healing journey, the community contributions including religious leaders, friends, and service providers, also played a significant role. It is also noteworthy that limited community resources and involvement, and ineffective drug prevention strategies were identified as challenges. Besides, drug use and addiction had severe consequences on both academic and occupational performance. Many participants reported difficulties in school and work, leading to dropouts and unemployment due to lack of concentration and incomplete assigned responsibilities. In conclusion, this session focuses on the importance of supportive environments in facilitating recovery while highlighting the challenges faced by individuals and communities in addressing drug addiction.

Furthermore, the ecosystem highlights how indirect environmental factors significantly influence recovery journeys in Eastern Shan State. Without a doubt, political instability in Myanmar plays a major role. This fragile condition has fuelled the production, trafficking, and use of illicit drugs, creating a more challenging environment for individuals seeking recovery. Additionally, political turmoil has hindered crucial support networks and limited access to essential recovery services such as humanitarian support.

Economic crises in the country are another key factor. Poverty and widespread unemployment in Eastern Shan State drive people, particularly those in remote areas, towards the drug trade as a means of survival. This economic hardship extends beyond drug users, impacting their families and support networks. Likewise, the financial burden of addiction and family makes it difficult for individuals to afford rehabilitation treatment, creating a cycle of debt and relapse.

Limited access to quality healthcare, particularly physical and mental health services, further complicates the recovery process. The research revealed a shortage of recovery centers in Eastern Shan State with only one officially registered facility. While some centers offer religious or spiritual guidance, none incorporate a systematic healthcare management system. This lack of comprehensive care, coupled with the reliance on non-medical service providers, significantly thwarts recovery efforts. In conclusion, the chapter summarizes that negative stereotypes and stigma create barriers to treatment and reintegration, while positive community support is essential for successful recovery.

CONCLUSION

The research outcomes highlight the complex interrelationship of the environmental framework: the microsystem, mesosystem, ecosystem, and macrosystem elements conceptualized by Urie Bronfenbrenner in forming the recovery groups encountering difficulties with drug dependency in Eastern Shan State. The discoveries emphasized that the insufficiency of physical and mental resilience from familial and communal support, stigma and emotional wounds experienced by both individuals recovering and their familial and communal units, and the inaccessibility of obtainable healthcare and recovery assistance centers in Eastern Shan State significantly produce obstacles to recovery endeavours efficiently. Of paramount importance, the impact of political instability and financial adversity drives individuals in Eastern Shan State towards the production, distribution, and utilization of unlawful substances due to the absence of effective regulations and policies that fortify economic advancement and substitute options to guarantee economic security in Eastern Shan State. Developing comprehensive recommendations and solutions for the complex issue of drug addiction in Eastern Shan State is challenging due to the illicit drug trade’s profitability for certain groups and the intricate power dynamics between armed groups and the military junta, which exacerbate the problem. Nevertheless, to alleviate the suffering of affected communities, four key strategies are proposed.

Firstly, international organizations and civil society organizations (CSOs) should prioritize empowering families and communities to strengthen their support for individuals undergoing rehabilitation. Addressing the trauma and stigma experienced by families, communities, and recovering individuals is essential through mental health support and counselling to facilitate reintegration. Furthermore, sustained funding and technical assistance from CSOs and international organizations are vital for drug users and rehabilitation centers to break drugs and provide effective care services. Equipping recovering individuals with vocational skills and capacities, in collaboration with rehabilitation centers, is crucial for successful reintegration into society. Furthermore, the establishment of high-quality and affordable recovery centers for vulnerable drug users and their families is paramount. To complement these facilities, CSOs and international organizations should bolster community-based recovery support systems by empowering community leaders and members to implement addiction prevention and harm reduction strategies.

On top of that, the critical shortage of healthcare services for individuals struggling with substance use disorders in Eastern Shan State necessitates a comprehensive approach. Expanding access to treatment through an increased number of rehabilitation and treatment facilities is essential. To enhance the effectiveness of these services, healthcare providers require specialized training in addressing substance use disorders. Collaboration with state actors, ethnic armed groups, the international community, and CSOs can be explored to enhance the effectiveness of these initiatives.

Finally, yet the most challenging, concerted efforts to stabilize the region and improve security are essential to halt the huge production of illicit drugs and trafficking in Eastern Shan State. A peaceful and secure environment is crucial for fostering recovery and the overall well-being of communities including victims of drugs in those areas. Besides, economic policies should be implemented to stimulate job creation and poverty reduction in Eastern Shan State. By creating sustainable livelihoods, particularly in rural areas, the economic pressures that contribute to drug involvement can be mitigated. Lastly, amid the challenging situations, collaboration with state actors, ethnic armed groups, and international organizations is paramount to providing humanitarian aid and supporting recovery initiatives. By working together, it is possible to address the complex interplay of economic and political factors that contribute to the drug crisis.

Proposed Further Research  

The future study on existing drug policies, corruption, the role of ethnic armed groups, and the military in drug production and trafficking are vital for understanding the broader context of the drug crisis and prevention of illicit drugs in Eastern Shan State. Research on economic opportunities and economic empowerment programs can shed light on the economic drivers of drug production, consumption, and the potential for sustainable recovery. In conclusion, the discovery of assessing the long-term outcomes, cost-effectiveness, and integration of traditional healing practices into treatment programs is essential for improving intervention strategies.

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 LIST OF TABLES

• Table 1. Socio-Demographic Characteristics of Recoverees
• Table 2. Demographic Characteristics of Service Providers
• Table 3. Respondents’ Demographic Factors Related to Drug Initiation