Handlings of the Problem on Traditional Drug Misuse: Case Study of Payanaka Tonics

Abstract

Objective: To find out the explanation of what contributed to the recreation use of Payanaka tonics,   to evaluate the risk of being drunk by taking this tonics and to suggest how to handle the misuse of  alcohol containing traditional drugs. Method: There were 3 parts of the study. The first part involved finding the explanation of factors contributing to recreation use of Payanaka tonics by in-depth interviewing 11 officials from the Food and Drug Administration (FDA), Provincial Health Offices, and community hospitals who had been working in 4 provinces where problems with the drug were reported in the past or still existed at present, including Ubon Ratchathani, Udon Thani, Nongbualamphu and Sisaket. The researcher also conducted 4 field works to gather the information on selling pattern of the drug in drugstores and groceries. The researcher also searched for the information on advertisement of this drug on various websites. Study 2 was a risk assessment of this drug by calculating possible blood alcohol levels when taking the drug. The third part of the study was the preparation of proposal to resolve the problem by in-depth interviews with 7 officials of FDA, Provincial Health Offices and community hospitals, and a focus group discussion among 4 heads of consumer protection and public health pharmacy in the 10th health region. Results: The misuse of this drug was contributed by 1. product factor or the amount of alcohol in the drug formulation and 2. eight external factors including name of tonics, label of the product similar to the other similar products, label with unclear warnings (background and text color for warning were in the same red color), packaging and sizes of drug containers, selling channels, channels for advertising and ordering, advertising for indication of tonics or improving physical strength (man lifting his arms to show the strength of his muscles) and buying this drug for monks as tonics by the public. Drinking one bottle or 150 ml of this drug containing about 15 grams of alcohol/100 ml of alcohol which was equivalent to 2.25 standard drinks, led to blood alcohol of 33.75 to 45 mg% close to 50 mg%, which was considered by law to be intoxicated. Suggestions for resolving the problem included 1) legislation to regulate alcohol content in traditional medicines and traditional household remedies and revision of the registration licenses of alcohol containing drug 2) legislation on labeling and warnings with the requirement on the contrast of background color and text color 3) regulations on the label differentiation between traditional medicines and household remedies, especially for those with the same trade name. 4) strict law enforcement and controlling the distribution of alcohol containing traditional drugs under the Alcohol Beverage Control Act. 5) Provision of the information on the drug to monks by the collaboration with the Religious Affairs Department, the Sangha Supreme Council of Thailand and consumers. Conclusion: The study provides suggestions for resolving the problem of the misuse of Payanaka drug. The suggestions may be applicable to the problem of misuse of other traditional medicines.