Cambodia’s young adults are using methamphetamines at one of the highest rates in the world, according to a recent report by the UN’s drug watchdog, while demand for more upscale drugs like ecstasy is growing among the affluent.

In an annual report released Tuesday by the International Narcotics Control Board (INCB), the abuse of amphetamine-type stimulants is said to be the “biggest concern” in countries located in the Greater Mekong Subregion.

The endemic problem is most prevalent among those aged 15 to 29, who typically consume pills like yama, a tablet containing a mixture of methamphetamine and caffeine.

“Compared to the rest of the world, methamphetamine use is not as serious as it is in this region. The drug situation in Cambodia, specifically, is getting more serious,” said INCB board member Dr Viroj Sumyai, who has been researching drug addiction, treatment and rehabilitation in Southeast Asia for over 30 years.

Government responses to the UN Office on Drugs and Crime’s 2014 annual questionnaire, along with official reports, estimate that more than 75,000 people use illegal drugs in the country.

More than half of those are young people, whose drug of choice is methamphetamines.

“The problem is growing, and a big portion of that is yama,” National Authority for Combating Drugs (NACD) secretary-general Meas Vyrith said. “The number of people using methamphetamine in Cambodia is increasing right now among young people … because users can have entertainment and work without having any meals or sleep.”

According to Sumyai, the steady increase of yama use in Cambodia is partly a result of its proximity to the Golden Triangle, one of Asia’s two main drug-producing areas, which overlaps nearby countries Myanmar, Laos and Thailand.

“The production side of yama is Golden Triangle-heavy, and after production, it spreads in the countries along the Greater Mekong Subregion, where the drugs are transported along the Mekong River,” Sumyai said.

Apart from methamphetamines, the INCB report also noted a surge in the use of cannabis and Ecstasy in the Kingdom. Cambodia is one of the primary sources of safrole oil, the common chemical precursor to the party drug ecstasy, also known as MDMA.

Mainly found in the Cardamom Mountains, safrole has been used in the small-scale production of traditional remedies for centuries. But large-scale production ratcheted up after the international demand for MDMA peaked in 2000. Since then, crackdowns have seen safrole’s availability decline drastically, though it’s done nothing to sate local demand for MDMA.

Sumyai says the gradual rise of the drug’s popularity here can be closely tied to the rise of the middle class.

“Affluent and well-to-do people try to look for ‘better’ drugs, because they have the idea that yama is not good since it’s cheap and used by manual labourers,” he said.

While access to and the use of narcotics is soaring, however, Cambodians’ access to essential opiate-based medications containing codeine or morphine – mainstays in relieving post-operative pain – remains low for a variety of reasons, according to Sumyai.

Key to this is medical professionals’ lack of training and confidence in managing the side effects of the sometimes volatile drugs, he said.

“The situation is very serious in Cambodia because most doctors are afraid and unable to administer antidotes because they don’t have proper training,” Sumyai added.

While there is much work to be done to mitigate Cambodia’s drug situation, the government has also made some recent strides in drug control and treatment.

“The problem remains … but we can tell that 2013 and 2014 have been our best years in combatting drug trafficking and drug production locally,” NACD’s Vyrith said.

The NACD, along with partners like the UNODC and the World Health Organization (WHO), have increased community based drug treatment, which provides health and social services for drug users.

There have also been initiatives to educate border security and officers in rural areas of proper search and seizure techniques.

But according to WHO substance abuse officer Dr Yel Daravuth, those, too, require improvement.

“The [community-based] program is still in the early stage and requires continued efforts in strengthening the systems, framework and mechanisms providing results, as well as securing the necessary financial support to allow for providing more comprehensive coverage in most needed areas,” Daravuth said.

ADDITIONAL REPORTING BY TAING VIDA