Yaba, known as “crazy medicine” in Thai, is a highly potent drug blending methamphetamine and caffeine, originating from Southeast Asia in the 1990s. Initially utilised to counter fatigue and boost productivity in countries like Thailand and Myanmar, its addictive nature and adverse health impacts soon became significant concerns. The drug, typically in tablet form, induces euphoria, energy and alertness but can lead to paranoia, hallucinations, aggression, severe insomnia and damage to vital organs with prolonged use. Overdose risks are high, potentially fatal. Awareness and treatment for Yaba addiction involve professional rehab, counselling, support groups, behavioural therapies and medical interventions to address both physical and psychological dependencies.

These brightly colored tablets, often orange or green with logos like R and WY, are usually consumed orally, sometimes flavored like candy, or used in a method known as “chasing the dragon” where the tablet is heated on foil and its vapors inhaled. Yaba’s use is hard to quantify in the as data often doesn’t distinguish it from other methamphetamines but it’s notably prevalent among young people and at parties similar to those where MDMA is consumed.

The risks of yaba use include rapid heart rate, increased blood pressure, potential for stroke and severe psychological effects or physical dependence. Its illegal status stems from containing methamphetamine, a Schedule II controlled substance recognised for its high potential for abuse.

Long-term yaba abuse leads to strong dependence with users needing increasingly larger doses to achieve the same effect, risking convulsions, seizures, respiratory failure, stroke, or heart failure. Additionally, yaba use can incite aggressive behaviour and psychiatric issues. Initially popular among workers like truck drivers in East Asia for its stimulating effects, yaba’s use has significantly infiltrated youth culture over the past decade, beginning in Thailand and spreading to Laos, Cambodia, Vietnam and more recently, the Indian subcontinent.

In 2007, Bangladesh saw a record seizure of 1.2 million yaba tablets, indicating a large potential market. The drug’s affordability and addictiveness have facilitated its rapid spread with costs ranging from as low as 1 USD in Cambodia to 5 USD in Bangkok. Yaba’s synthesis is relatively easy with access to specific precursor materials, allowing for production scales of up to 10,000 tablets per hour in covert labs. The synthetic nature of yaba means it can be produced almost anywhere, complicating efforts to monitor and control its spread due to the portable and hidden aspects of its manufacture and the varying strengths of law enforcement and chemical regulation worldwide.

In Thailand, amphetamine-type stimulants have become deeply embedded in youth culture with the legal cough suppressant dextromethorphan (DM) also emerging as a commonly misused substance among young people. These tablets are considerably more affordable than their crystalline counterpart and have found a particular niche in the Mekong region countries. Yaba remains the stimulant of choice among those employed in physically demanding jobs such as construction, manufacturing and agriculture, as well as by individuals working in the nightlife entertainment industry.

Cannabis still leads as the primary drug of choice but methamphetamine, available in crystalline form and in less pure tablet forms is a close second. These tablets are often smoked after being crushed, a method particularly popular among teenagers, young adults and women of childbearing age.

Methamphetamine is notably prevalent among peripartum women, detected frequently in urine tests and associated with complications during and after birth. While DM has become a drug of choice among middle and high school students, easily bought over the counter and often consumed with soft drinks at social events. Its metabolism into dextrorphan induces euphoria; however, individuals who metabolize the drug poorly may experience adverse effects. The misuse of methamphetamine and dextromethorphan presents a significant challenge in Thailand, demanding attention not only to the toxicological but also to the emotional and social repercussions on the country’s youth.

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