Opium and the People of Laos

This chapter reflects several different studies conducted over 3 decades. The work in Laos was conducted over a single decade, 1965–1975. These studies began with data collection on opium production in Laos, proceeded to opium usage and its functions, then to an epidemiological study of opium addiction, and finally to clinical studies of opium addiction, its treatment, and course (Westermeyer 1982). During the period 1965–1975 (Westermeyer 1971) I spent a total of 3 years in Laos. The first 2 years involved work as a general physician (with the Public Health Division of USAID) and as a graduate student in anthropology. The final 12 months were spent over the period 1971–1975, with several visits of approximately 2 months each. These last visits were funded by grants from the University of Minnesota and consultations to the Ministries of Health and Social Welfare in Laos. Subsequently, I served as a consultant to the World Health Organization from 1977 to 1997. This role involved about 20 visits to Asia as a research consultant, curriculum developer, and speaker during a time when several countries of Asia were developing their own epidemiological studies and later treatment and prevention programs. During this time, I also had the opportunity to care for and study refugees from Southeast Asia who became addicted (or readdicted) to opium in the United States (Westermeyer, Lyfoung et al. 1989, 1991; Westermeyer and Chitasombat 1995). In Laos, minorities made up about half the population. To an extent greater than the ethnic Lao themselves, many minority groups were involved in opium production and commerce. Mountaineer minorities grew poppy: Akha, Hmong, Iu Mien, Khamu, Lisu, and the Tai tribes. Expatriate Asians and Europeans, living in towns along the Mekong River, conducted opium commerce; they included ethnic Chinese, Vietnamese, Thai, Cambodians, and French (usually referred to as Corsicans by other French people). Those groups straddling the borders of two or three different countries were in a unique position to smuggle opium, along with legitimate trade in raw products and manufactured goods. For example, the Iu Mien moved opium from Burma and Laos down into Thailand.