Relationship between psychological factors and perceived stigma of addiction among women with substance use disorders, Thailand.

BACKGROUND: Substance use disorders (SUDs) are one of the most stigmatized health conditions that impact drug user's treatment engagement. However, to date, little is known about perceived stigma and its correlates with psychological factors among high-risk groups such as people with SUDs in the criminal justice system. This study aimed to determine the association of psychological factors and perceived stigma of addiction among women with SUDs. MATERIALS AND METHODS: This cross-sectional design was conducted on 652 women with SUDs who were treated in all 7 compulsory drug detention centers in Thailand with consecutive sampling technique. The data were collected by standardized interviewers with interviewing questionnaire. Multiple logistic regression was applied to examine the effect of psychological factors and perceived stigma. RESULTS: More than half of SUD patients (57.2%) were methamphetamine abuse or dependence, approximately 69.9% reported high level of perceived stigma, 56.7% had mild depression, 34.8% had low level of perceived social support, and the average perceived stress score was 19.2 (standard deviation, 7.5). The perceived stigma was positively related to depressive symptom and perceived stress while was inversely related to perceived social support. CONCLUSION: The psychological factors were strongly associated with perceived stigma of addiction. Thus, the detection of psychological problems among SUD patients may be benefit clinicians for identifying which patients are most at risk of perceived stigma and are the potential targets of intervention to reduce stigma in clinical practice.

The Perceived Stigma of Addiction and Treatment Utilization among Cannabis Addicts in Thailand.

CONTEXT: A major social problem among clients with substance use disorders is stigmatization related to health conditions, which contributes to poor mental and physical health circumstances and becomes hazardous to substance abuse treatment. Meanwhile, decreased stigmatization among cannabis users might occur because some people use cannabis without experiencing harm or believe it to be a harmless substance and might not be receiving treatment. Several studies have investigated stigma toward substance use disorder and treatment. However, less is known about how stigmatization influences treatment. AIMS: To investigate the association between the perceived stigma of addiction and treatment utilization among cannabis addicts. MATERIALS AND METHODS: A cross-sectional design was conducted with consecutive sampling techniques among 977 cannabis users recruited from all 7 compulsory drug detention centers in Thailand. The data were collected by standardized interviewers with a structured interviewing questionnaire. Binary logistic regression was applied to determine the effect of perceived stigma of treatment utilization. RESULTS: Most clients were male (84.5%), had a family history of drug problems (54.5%), and had a history of mental health problems (5.1%). Most of them reported moderate-to-high levels of perceived stigma (87.2%) and received treatment (28.9%). Greater perceived stigma was associated with decreased treatment for cannabis abuse. CONCLUSIONS: The perceived stigma of addiction is a barrier to cannabis abuse treatment utilization. Thus, a better understanding of stigma could reduce its negative impact on seeking and engaging in treatment.

The Risk of Drug Abuse among Preschool Students in Phuket, Thailand.

BACKGROUND: There have been scientific studies on risk and protective factors associated with child outcomes. However, how risk factors interact to produce outcomes is not clearly understood. We assessed the association between school location, grade, and drug abuse risks among preschoolers. METHODS: This cross-sectional study included 3353 participants aged 2-6 yr (mean: 4.6, SD: 1.03) enrolled in childcare centers and kindergarten classes in 2016 in Phuket, Thailand. The risk of drug abuse was measured using questionnaires, completed by teachers and caregivers. Data were analyzed using descriptive statistics, odds ratio with 95% confidence intervals and Chi-square. RESULTS: The prevalence of drug abuse risk factors was as follows: sleep problems=1.28%, aggression=1.10%, attention-deficit hyperactivity disorder (ADHD)=3.61%, learning disabilities (LDs)=4%, family members' substance abuse=12.53%, parents' changing marital status=6.53%, conflict between parents/guardians=1.88%, family poverty=3.37%, and easy access to drugs in the community=5.16%. Sleep problems in children were significantly related to family members' substance abuse, family poverty, and easy access to drugs in the community (PS<.05). LDs were significantly related to parents' changing marital status, conflict between parents/guardians, family poverty, and easy access to drugs in the community (PS<.05). ADHD was significantly related to family members' substance abuse, parents' changing marital status, conflict between parents/guardians, and family poverty (PS<.05). CONCLUSION: The prevalence of drug abuse risks among preschoolers was 25.86%. Multidisciplinary teams should provide appropriate interventions.

The prevalence and associated factors of new psychoactive substance use: A 2016 Thailand national household survey.

INTRODUCTION: Analyzing the situation and risk factors associated with using new psychoactive substances (NPS) is essential for preventing and controlling health consequences. This study explored the prevalence and associated factors of NPS use in the Thai population. METHODS: This descriptive study was conducted in participants (N = 30,411, mean age = 42.4 ± 13.4 years, range = 15-64 years, 50.3% women) from urban and rural areas of Thailand. The participants were chosen using multistage sampling for large populations. The data were collected in July-December 2016 and analyzed using frequency, percentage, mean, standard deviation, chi-square, multiple logistic regression, and odds ratio with 95% confidence intervals (CI). RESULTS: The prevalence of lifetime NPS use was 49.7% (95% CI, 49.1-51.3), past-year use was 31.3% (95% CI, 30.8-31.8), and current (past-month) use was 14.9% (95% CI, 14.5-15.3). Among current users, 29.5% were habitual users (over 20 days). The factors associated with current NPS use were sex (male/female) (adjusted odds ratio [AOR] = 1.145; 95% CI, 1.075-1.221; p < 0.001), age group (25-64/15-24 years) (AOR = 1.126; 95% CI, 1.090-1.358; p < 0.001), educational attainment (elementary or secondary education and higher) (AOR = 1.634; 95% CI, 1.529-1.747; p < 0.001), and employment status (AOR = 1.842; 95% CI, 1.683-2.016; p < 0.001). CONCLUSIONS: The prevalence of NPS use in Thailand is high, which reflects abuse behavior that could potentially harm users. Understanding the prevalence and risk factors of NPS use could benefit policymakers.

Trends in the use of illicit substances in Thailand: Results from national household surveys.

INTRODUCTION AND AIMS: Thailand borders some of the world's largest methamphetamine and opioid producing countries and trafficking routes. Thailand's 'War on Drugs' campaign was launched in 2003. This study reports trends in illicit substance use in Thailand over the period 2001-2011. DESIGN AND METHODS: National Household surveys on illicit drug use were conducted in 2001, 2003, 2007, 2008 and 2011. A stratified multi-stage cluster random sampling technique was implemented for each survey. Provinces in four regions were systematically selected using a probability proportionate to the size of the targeted population. Participants were interviewed using structured questionnaires on their history of substance use. RESULTS: The prevalence of illicit drug use within the past drastically decreased from 4.5% in 2001 to 1.0% in 2003 (P < 0.05). Since 2003, the prevalence of illicit use within the past year varied between 1.0% and 1.3%. By 2011, it was estimated that 0.84% have used kratom (a substance derived from Mitragyna speciosa) within the past year. Around 0.20% and 0.19% reported using cannibis and yaba (metamphetamine tablet) within a year of the 2011 survey. Other types of illicit drugs were less commonly used in Thailand. DISCUSSION AND CONCLUSIONS: There was a decrease in prevalence of illicit drug use within the past year between 2001 and 2003 in Thailand. Since 2003, the past year prelavence of illicit drug use has remained relatively stable. From 2001 to 2011, cannabis, kratom and yaba have remained the three most commonly reported types of illicit drugs used in Thailand.

Associations of the Neighborhood Environment With Substance Use: A Cross-sectional Investigation Among Patients in Compulsory Drug Detention Centers in Thailand.

OBJECTIVES: To identify the associations of characteristics of the neighborhood environment with substance abuse among clients receiving treatment for drug abuse in Thailand. METHODS: A cross-sectional study was conducted of 1128 drug addicts from 28 neighborhoods who were receiving treatment at all 7 compulsory drug detention centers in Thailand. A trained interviewer conducted structured interviews with the subjects about substance use and the perceived neighborhood environment in their community. A multilevel logistic regression model was applied to estimate the effects of the neighborhood environment on substance use. RESULTS: The majority of participants, 53.8% only used methamphetamine pills, 31.3% used other illicit drugs as well as methamphetamine pills, and 14.9% used an illicit drug other than methamphetamine. Three neighborhood characteristics were associated with substance use. A 1-unit increase in the perceived neighborhood cohesion score was associated with a 15% reduction in methamphetamine pill use and an 11% reduction of the use of both methamphetamine pills and another illicit drug. Conversely, a 1-unit increase in perceived neighborhood crime predicted 19 and 14% increases in the use of methamphetamine pills and the use of both methamphetamine pills and another illicit drug, respectively. In addition, a 1-unit increase in the scores for stigma surrounding addiction corresponded to a 25% increase of the use of methamphetamine pills and a 12% increase in the use of both methamphetamine pills and another illicit drug. CONCLUSIONS: Substance use among drug addicts was influenced by characteristics of the neighborhood environment. Therefore, prevention and intervention strategies should be designed based on a consideration of the impact of neighborhood context on substance use behaviors.

Effectiveness of Drug Camps in Treatment of Substance Abuse in Thailand.

Various drug camps have been introduced in Thailand since the 2000s. This study explored the effects of drug camps in Thailand. Four provinces were selected to represent different region throughout Thailand. Assessments of 2679 drug users were carried out longitudinally, age ranging from 11 to 67 years old; assessments occurred before camp, after camps, and after a 1 year follow-up. Two hundred twenty-six camps organizers, community leaders, and lay people were selected as key informants. Twenty communities were observed prospectively and 400 lay people were studied. Self-administered questionnaires were utilized as well as interview guidelines and documents. It emerged that the effectiveness of drug camp was 51.3% (intention-to-treat), whilst poly drug use increased significantly from before camp and 3 months after camp (repeated ANOVA p < 0.001) particularly among users aged 15 years old and over. Drug camps could be considered as an alternative measure for drug users; however, negative impacts should be considered.

Development of the Model for Local Drowning Surveillance System in Northeastern Thailand.

BACKGROUND AND OBJECTIVE: There is growing evidence that the drowning fatality rate in Thailand has been increasing, particularly among children. The use of public health surveillance system in accident injury, specifically from drowning, at a community level is limited. This study aimed to develop a surveillance system to reduce risk of drowning in a rural area of Thailand. MATERIAL AND METHOD: A 7-step process was used to develop a model for local drowning surveillance system based on community participation. The target population consisted of 182 informants, 562 participating surveillance networks, and 21,234 villagers in two sub-districts of Ubon Ratchathani Province, northeastern Thailand. Two similar sub-districts were chosen as comparison areas. RESULTS: Fifteen months after implementation of the model for local drowning surveillance system (MLDSS) was introduced, improvements were found in all identified risk factors, and the incidence rate ratio of injury in the comparison areas was 23.36 times higher than in the target areas. CONCLUSION: In the developing world where community bonds remain strong, governments need to encourage local officials, the private sector and the wider community to work together in solving the problem of drowning in their local areas. Such schemes will require national promotion and basic funding.

Size Estimation of Injecting Drug Users through the Network Scale-Up Method in Thailand.

BACKGROUND AND OBJECTIVE: Hard to reach populations such as injecting drug users (IDU) is one, among the most at risk, for HIV infection in Thailand. This study examined an indirect methodfor estimating the size of IDU population in Thailand. MATERIAL AND METHOD: A household survey was conducted among 3,790 individuals who were 12-65 years old, stayed at least 3 months in the sample households. Through, reference groups and summation procedure, personal network size was estimated. The participants were asked to identify the number of their acquaintances whom they perceived to be IDU. Using the survey results with the network scale-up method, the IDU population size was estimated. RESULTS: The personal network size was estimated to be 71,000 ID Us. The estimated prevalence of total population in Thailand was 110 IDUs in 100,000 population. CONCLUSION: Estimating population sizes through the network scale-up method appeared to be an effective method in terms of time, simplicity, and low cost as compared with more-conventional methods.

Using Population Based Data on Drugs Abuse to Estimate the Relative Need for Medical Services in Thailand.

BACKGROUND AND OBJECTIVE: Epidemiological background shows a trend in drug abuse and essential need for revising its strategic plans, allocating resources, and advocating services for populations. The relative need for drug abuse prevention and medical services across different geographic areas of Thailand, which has been examined through an analysis of existing population-based datasets and reported routinely. The objective was to develop an indicator of relative need for drug abuse prevention and medical services. MATERIAL AND METHOD: Qualitative data were collected as primary data sources from 10 focus group discussions throughout Thailand. The primary data were integrated into study framework with the result from literature review. Data sets in 2011 were retrieved from the national databank to obtain variables regarding drug abuse. Multiple regression and factor analysis were undertaken using the district as the unit of analysis. RESULTS: A factor analysis, which revealed six factors that explained 64% of the variance in the data set. Factors identified in the analysis were taken as indicators of variation in the need for services as all of the drugs-related variables loaded strongly on these factors. The distribution of ranks for factor scores (determined through regression) obtained for these factors across districts in Thailand showed that scores were highest in urban and suburban areas. CONCLUSION: In terms of practical implications, the study results could be used for resource allocation in medical service plans for community drug abuse.

Developing a Substance Literacy Scale for Thai Population.

OBJECTIVE: To develop a substance literacy scale for Thai population. MATERIAL AND METHOD: The research design was divided into 8 steps as follows: 1) devising the items, 2) exploring construct validity of each factor 3) validating reliability of each factor, 4) generating construct validity of scale, 5) testing conceptual construct ofthe scale, 6) constructing alternated rating scales, 7) conducting cognitive test, and 8) conducting pilot test. There were 15 experts involved in the content validation of scale. The research was conducted with 3,824 samples of Thai population aged between 12-65 years old from all over the country using the Stratified Three Stages Cluster sampling technique. RESULTS: Two substance literacy scales were developed. A standard has questionnaire of 37 items. The scale content validity index was 0.65, concurrent validity was 0.648. A short has questionnaire of 32 items. The scale content validity index was 0.86, concurrent validity was 0.667. CONCLUSION: Both scales are simple and easy to use. Scale characteristics are appropriate to assess the substance literacy of population. It can be beneficial to planners for strategic development to respond to the problem more accurately.

The Prevalence and Associated Factors of Alcohol Consumption: A Cross-Sectional Study in Khon Kaen, Thailand.

BACKGROUND AND OBJECTIVE: Knowledge of the situation and risk factors associated with alcohol consumption are essential for prevention and control measures of health consequences. This study aims to explore the prevalence of alcohol consumption and the factors associated with alcohol consumption in the population aged 12-65 years. MATERIAL AND METHOD: This was a descriptive study. This survey used multi-stage sampling and face-to-face interviews, carried out in both urban and rural areas. Those interviewed were a representative sample of 876 people in the ratio ofone male and one female to represent the household. Data were collected by interviewers between 1 January and 28 February 2012. The data were analyzed by frequency, percentage, mean, standard deviation, Chi-square, multiple logistic regression, OR and 95% CI of OR. This study was approved by the ethics and research institutional review board of Khon Kaen University No. HE53121. RESULTS: The mean age of the respondents was 41.7 years (SD 13.6). The majority of the respondents were the head of the family (33.9%), those educated to primary school level (44.6%), living in rural areas (55.9%), who were married (70.7%), and who were farmers (35.3%). The prevalence of alcohol consumption during the previous week was 6.3% (95% CI: 4.7 to 7.9), during the previous month was 35.2% (95% CI: 32.0 to 38.3), and during the previous year was 41.0% (95% CI: 37.7 to 44.2). The factors associated with alcohol consumption were gender (male/female) AOR 6.5 (95% CI 4.4 to 8.9, p-value < 0.001) age group (25-44/45-65) AOR 1.6 (95% CI 1.1 to 2.4, p-value = 0.011) location (rural/urban) AOR 1.7 (95% C1 1.3 to 2.4, p-value < 0.001) educational attainment (bachelor or master degree/primary school) AOR 1.7 (95% CI 1.1 to 2.8, p-value = 0.031) and the occupation (laborer) AOR 1.6 (95% CI 1.1 to 2.4, p-value = 0.015). CONCLUSION: Knowing the prevalence and factors associated with alcohol consumption are essential to understanding the situation, solving related problems and using the information in the campaign for the prevention and control of alcohol consumption

Effectiveness of Culturally Appropriate Initiative on Drug-Related Harm Reduction for Sex Workers on the Thai/Malaysian Border.

BACKGROUND AND OBJECTIVE: Drug use can harm to sex workers. Abstinence intervention, however, may not be appropriate since drug use fosters their career performance. The objective was to develop the culturally appropriate model for sex workers participation on drug demand reduction at the Thailand/Malaysian border MATERIAL AND METHOD: This study was a pre-post quasi-experimental design. Tripartite participation was used to develop the model aiming to reduce harm regarding drug use. The study carried out during June 2010-May 2011. Data were collected from 150 key informant interviews, 56 focus group discussions, 22 participant observations in various situations, and numerous related materials. Descriptive statistics, survival analysis and 95% confidence interval were utilizedfor quantitative data. Qualitative data were analyzed by content analysis. RESULTS: Drug related harm reduction was evaluated at two-week time along implementation period of 12 months. 89.5% of all sessions introduced could decrease drug related harm. Of all sex workers participated in the study, intended to treat analysis showed 86.9% success rate (95% CI; 77.1, 96.7). Of these, 32.6% became abstinence, 39.1% reduced most of drug related harm. 13.0% reduced partial drug related harm either lessfrequency, less quantity, less concentration, decrease types of drugs/switch to safe drugs or safer method of administration. 2.2% was infancy stage, which needed further support. CONCLUSION: Key success ofthe model was tripartite participation. With active leaders and strong support, sex workers were continually motivated to reduce harm regarding drug use.

Disability-Adjusted Life Years among Drug Users in Khon Kaen: An Evidence-Based Approach.

OBJECTIVE: To examine the Disability Adjusted Life Years (DALYs) among drug users in Khon Kaen. MATERIAL AND METHOD: A cross-sectional descriptive study was conducted between January 2014 and February 2015. Patients' medical records, supported by the Khon Kaen Provincial Public Health Office, were used for data regarding the treatment ofthe drug users between October 2013 and September 2014. SPSS version 19.0 for windows was used to analyze descriptive statistics and Pearson's correlations. RESULTS: A review of medical records revealed a total number of drug users were 3,605 males (92.25%) and 303 females (7.75%). A total of 2,195 cases (56.17%) were drug dependence. 20 drug users died due to drug-related causes. A total DALYs were 6,772.26 and a prevalence rate of DALYs was 3.76/1,000 populations. The correlation analyses showed significantly factors related to the DALYs among drug users were age, occupation, pattern of drug use, levels of severity, drug-related death and treatment services. CONCLUSION: The DALYs were apparently high among male drug users, who completed primay school education, were drug-dependent and being treated in group therapy. The health authorities may use these associated factors in order to develop or improve programs related to prevention, harm reduction and treatment services effectively.

Effectiveness of community participation in a surveillance system initiative to prevent drowning in Thailand.

This study had a 2-group pre-post quasiexperimental design and was conducted in 2 selected areas of Ubon Ratchathani province, Thailand. The objective was to evaluate the extent to which the surveillance system that was developed helped in drowning prevention. The development process involved extensive participation from the community. System efficiency was evaluated, and the drowning rates were compared. The system demonstrated 82.8% system sensitivity and 87% positive-predictive value. There were 90.0% rescues with no injury during the study period. The relative risk of drowning injury suggests that the control area was at 5.6 times more at risk for drowning injury than the intervention area (95% CI = 1.58, 20.12). Local knowledge and participation from the community were found to be key issues in the success of the surveillance system, and such systems can be applied to other areas with similar problems.

Follow-up the outcome of treatment of inhalant users in Northeastern Thailand.

BACKGROUND: Drug treatment in Thailand is categorized into three types, namely voluntary system, correctional system, and compulsory system. The latter is under Inhalants Law and Drug Addict Rehabilitation Act 2002 A.D. OBJECTIVE: Follow-up the outcome of the compulsory system treatment in inhalant user on probation program and evaluate hospital referrals and the process of follow-up in community. MATERIAL AND METHOD: A survey questionnaire adopted from KKU-VOUDIT was used in the present study in nine selected provinces of Thailand. Nine hundred ninety two people formed the study population and were divided into 95 administrators, 71 stakeholders, and 760 inhalant users. RESULTS: Inhalant users were classified as experimental (56.8%), harmful (24.2%), dependent (13.9%), and psychosis (5.1%). Majority of inhalant users were male (95.0%), 12 to 19 (61.3%), single (83.4%). In this group, 15.5% were students while 45.1% were temporarily employed, and 40.3% were unemployed. Most inhalant users never reused (72.2%). However some users re-used but were not incarcerated (12.2%) while others re-used and were incarcerated (15.5%). CONCLUSION: As the targets are youths, sub-district administrative organization, basic education office, and primary healthcare organizations should come together to bring about necessary changes.

Knowledge of and attitude towards HIV/AIDS and condom use among construction workers in the Kathmandu Valley, Nepal.

BACKGROUND: Nepal is seeing a surge in physical infrastructure in the past few years. Numerous workers enter the Kathmandu Valley to join the construction sector. OBJECTIVE: This was a descriptive survey that set out to understand the knowledge of and attitudes towards HIV/AIDS along with the use of condoms among construction workers in the Kathmandu Valley. MATERIAL AND METHOD: The study was conducted in 8 different construction sites in the Kathmandu Valley. Systematic sampling was done to select a total of 317 samples that were either interviewed or handed the questionnaire for self-administration. RESULTS: 84.6% of the construction workers had sufficient knowledge regarding HIV/AIDS and 61.8% had positive attitude towards HIV/AIDS. 50.5% of those who had sex in the past 1 year had used a condom the last time they had sex. Those with insufficient knowledge were found to have negative attitude (p<0.05) and were more likely to have not used a condom the last time (p<0.05). Multiple logistic regression analysis showed that use of condom the last time was most affected by gender and level of knowledge. CONCLUSION: Despite adequate knowledge, attitude and use of condom was found to be unsatisfactory. There is an urgent need to resolve this gap.

Substance abuse among migrant workers of Thai-Laos border, Thailand.

OBJECTIVE: Study the impact of substance abuse among migrant workers along the Thai-Laos border region in Nakhon Phanom Province. MATERIAL AND METHOD: The target population included migrant workers aged 15 years and over and were selected using the snowball technique. Data were collected from 300 migrant workers and in-depth interviews and focus group discussion were carried out. Data analysis used content analysis, descriptive statistics, and multivariate logistic regression. RESULTS: Fifty-five point seven percent of migrant workers used stimulants namely tobacco, energy drinks, coffee, and methamphetamine. Males were at greater risk for substance abuse than females (AOR 16.03; 95% CI 8.43-30.45) and those who received news and information from community radios and news broadcasting towers were at more risk than other media (AOR 5.38; 95% CI 2.88-10.05). The impact of substance abuse were found to be chronic cough, moodiness, lack of interest in food, headache, wakefulness, sleeplessness, tremor heart palpitation, and accidents. CONCLUSION: Health promotion strategy must be implemented to minimize the harm. Motivating behavioral modification while keeping in mind the lifestyle, work, and environment of these people could help.

The incidence of accidents in child care centers of the local government organizations.

OBJECTIVE: To study the incidence of accidents and the environment around the building of child care centers of the local government organizations under the Health Promoting Center 6. MATERIAL AND METHOD: This was a descriptive study carried out among 1,871 child care centers of the local government organizations under the Health Promoting Center 6 within eight Northeastern provinces. The self administered questionnaires were handed out in the process of this study and data were collected between January 1 and February 28, 2011. RESULTS: One thousand eight hundred seventy one child care centers answered the questionnaires. The ratio of children per caregiver was found to be 17:1. In 2010 the incidence of injury in children was 7.17 per 100 persons. Ratio of injury between boys and girls was 1.9:1. The places mostly reported for the accidents were outside the building, the playground instruments, and inside the classrooms. Most child care centers were located on the street side and had no fence near the water sources (pool, pond) and trees. Only 22.9% had children water closets and those with adult water closet provided no support for holding. Most (93.3%) of the toilets had water containers inside. CONCLUSION: Environment around the child care center building may be the cause of many accidents. If the child care centers comply the convention instructions, children will be safe during they stay.

Model development for substance abusing surveillance system in communities.

BACKGROUND: There is growing evidence that the number of substance abusers have increased. Use of public health surveillance system in substance abuse at the community level is limited. OBJECTIVE: Study and develop a suitable Model for Substance Abusing Surveillance System (MSASS) in communities. MATERIAL AND METHOD: Thirty-eight volunteers, including five direct responsible officers, five local leaders, five people representatives and four university specialists participated in the development of the model. The present study utilized ten sets of database, reported on a monthly basis. These included substance abuse arrested cases, substance abuse treatment seekers, anonymous notification of drug abuse, notification of obstacles and problems of the responsible organizations and notification of substance abuse by the local community leaders. The seven approaches of the model included situational analysis, prototype design, trial test, system design, system running test, model improvement and model dissemination. The study was conducted in 47 communities in four sub-districts in Phakdichumphon District, Chaiyaphum Province. RESULTS: The MSASS model application was created at the community level. The model assessed and monitored substance abuse practices of population aged 12 to 65 years and triggered prevention and control actions in communities. The five important constituents of the model were 1) organizations of substance abuse networks, 2) indicators of substance abuse situations, 3) criteria for investigation of magnitude of the problems, 4) data collection tools and 5) dissemination of information. The model comprised of six core activities (detection, registration, confirmation, reporting, analysis and feedback) and four support activities (communication through meeting and brainstorming, training, supervision and resource-provision). After one year the authors were able to develop indicators and criteria for measuring magnitude of the substance abuse problems. The current developed MSASS was effective in terms of representativeness (93.0%), sensitivity (92.7%), timeliness (84.7%), prediction ability (84.5%), acceptability (82.5%), simplicity (82.5%) and validity (80.3%). CONCLUSION: The developed MSASS is an effective form of public health surveillance suitable for communities at a district level.