title: Initiation of methamphetamine use among young Thai drug users: a qualitative study.
abstract: OBJECTIVE
  Methamphetamine (MA) has become the leading drug of abuse in northern Thailand over the past several years, particularly among youth. The current qualitative study examines factors associated with initiation of MA use.
  
  
  METHODS
  Between March 2002 and January 2003, 48 in-depth interviews with young MA users were conducted in advance of a randomized, MA harm reduction, peer outreach intervention trial. The interviews were conducted in the city of Chiang Mai and the surrounding district. Data were inductively analyzed using the constant comparative method common to grounded theory methods. Atlas-ti was used for data management.
  
  
  RESULTS
  Participants were 57% male and had a median age of 20 years (range 15-31 years). A culture of MA ubiquity characterized participants' initiation stories. Drug ubiquity encompassed three elements: the extent of MA use within peer networks; the availability of MA; and exposure to MA before initiation. All participants were introduced to MA by people close to them, most often by their friends. Internal reasons for trying MA were curiosity, a way to lose weight or to enhance hard work, and a way to "forget life's problems." With the prevalence of MA use among participants' peers, initiation seemed inevitable.
  
  
  CONCLUSIONS
  Initiation was characterized as ubiquitous in terms of peer networks' use and availability. Because of the prevalent norm of MA use, these data indicate that interventions targeting social networks and young Thais before MA initiation are needed.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. ssherman@jhsph.edu
authors.forename: Susan G
authors.initials: SG
authors.lastname: Sherman
authors.forename: Danielle
authors.initials: D
authors.lastname: German
authors.forename: Bangorn
authors.initials: B
authors.lastname: Sirirojn
authors.forename: Nick
authors.initials: N
authors.lastname: Thompson
authors.forename: Apinun
authors.initials: A
authors.lastname: Aramrattana
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001290:Attitude; D000697:Central Nervous System Stimulants; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007407:Interviews as Topic; D008297:Male; D008694:Methamphetamine; D009042:Motivation; D010379:Peer Group; D012307:Risk Factors; D012309:Risk-Taking; D012932:Social Facilitation; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*; D013785:Thailand / Q000453:epidemiology
chemical_list: D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D008694:Methamphetamine