Ah Chao first came across drugs as a teenager, when his cousin asked him to hold his tourniquet while he shot up heroin.

Now a stocky 32-year-old in jeans and a black nylon jacket, Ah Chao (not his real name) recalls between slurps from a bowl of noodles how frightened he was.

“Heroin did not appeal to me at all,” he says. But the experience did not put him off other drugs.

Instead, a few years later, like a growing number of young Chinese, he turned to bingdu (ice), as methamphetamine is known.

Ah Chao is a witness to the silent spread of crystal meth into China’s vast rural areas, a blight sweeping the countryside – but out of the public eye – in a striking echo of America’s experience. In China today, says Zhang Yongan, a drug policy expert at Shanghai University, “the era of synthetic drug abuse is arriving secretly.”

Nobody can yet put exact numbers on the phenomenon; it has barely been studied. But researchers who have looked say ketamine and amphetamine-type stimulants (ATS) such as meth are more and more plentiful, even in out-of-the-way towns and villages.

“I cannot say with certainty the degree of the problem, but I can say with 100 percent certainty that the problem exists and it is substantial,” says Marek Chawarski, an associate professor of psychiatry at Yale University who is pioneering the study of rural drug users in China.

Chinese officials say they believe meth has now overtaken heroin as the most widely used addictive drug in China, and that it poses a greater threat: Meth is easily made, its users seem unaware of the dangers it poses, and there is no equivalent of methadone, a substitute drug that China has used widely to combat heroin addiction.

“In my village, when I was growing up, there were no drugs,” adds Deng Qijian, a doctor working with Professor Chawarski in the central province of Hunan. “In the last few years ice has become very popular. Many, many people use it.”

“Five years ago or so, ATS were mostly used by rich people,” says Lu Lin, a drug abuse expert who now runs Peking University’s No. 6 Hospital, which specializes in mental health. “Now it’s mainly poorer people who are taking them.”

A 150-year-old problem

China’s drug problem dates back more than 150 years to the days when the British began forcibly importing huge amounts of opium from India. By the end of the 19th century, historians have estimated that 1 in 5 Chinese men was an opium addict.

That debilitating drug use is intimately bound up with the ruling Communist Party’s narrative of “national humiliation” at the hands of foreigners. Within a few years of the 1949 revolution, China’s new rulers had all but eliminated drugs from national life – a feat that eluded the defeated Nationalist government.

But as China opened to the world in the 1980s, a boom in foreign trade, a steady rise in incomes, and the introduction of Western habits brought drugs back into China.

Until recently the drug of choice was heroin, smuggled into the country from the so-called Golden Triangle where Myanmar (Burma) borders Thailand and Laos or, more recently, from Afghanistan, the world’s biggest opium exporter.

Last year, though, for the first time since the Chinese authorities began keeping records, the number of registered users of ATS – mostly methamphetamine – outstripped the number of those using opiates such as heroin.

A report issued by the National Narcotics Control Commission (NNCC) at the end of March said that 49.4 percent of registered drug users – those known to police – use ATS, while 49.3 percent use opiates. Ten years ago, 86 percent of registered users used opiates.

Officials acknowledge that their figures are sketchy. The new report puts the number of registered drug users at 2.95 million, up nearly threefold in the last decade, but the head of the police’s Narcotics Control Bureau, Liu Yuejin, said last November that “the actual number of drug addicts is estimated at 13 million ... and about half are suspected of taking methamphetamine.”

“China is facing a grim task in curbing synthetic drugs including ice, which more and more Chinese drug addicts tend to use,” Mr. Liu warned.

If Liu’s estimate is accurate, it means that China has a much lower overall rate of illegal drug use than the United States. But China’s estimated rate of methamphetamine abuse – 0.5 percent of the population – is more than double that in the US, where 595,000 people – 0.2 percent of the population – are current meth users, according to the US Substance Abuse and Mental Health Services Administration.

Rich Clabaugh/Staff Meth surge in Asia

Heroin use down after an education effort

Though it is hard to be precise in the absence of widespread studies, Chinese drug experts say that a noticeable drop in the use of heroin has clearly been matched by a rise in the use of ATS such as meth.

Heroin use is down partly because of the success of public health campaigns in schools, says one drug counselor in Beijing, a former heroin addict herself who asked not to be identified.

“After so many years of education people know the harm and the dangers of heroin,” she says.

“Ice today is like heroin in the ’90s,” she adds. “People say it gives them energy, makes them feel good, and they don’t think it’s addictive.”

In an academic survey last year in Changsha, researchers found that 59 percent of meth users believed occasional use posed them no danger, and 57 percent said that even regular use was only moderately risky.

Not long ago, meth was the rich kids’ party drug in China. Today, according to the little research that has been done, it is also popular among truckers, migrant workers, and other laborers who value the energy burst they get from amphetamines, both for work and pleasure.

And away from the bright lights of China’s megacities, meth is spreading into small towns and villages where “there is not much in the way of entertainment,” says Yale’s Chawarski. “Taking meth is like taking a short vacation.”

A tale of drug addiction

Ah Chao may have stayed clear of heroin, but when he met some young women in a karaoke bar who told him about ketamine, a hallucinogenic drug that is popular in East Asia, it was not long before he was taking it several times a week. That was his gateway to meth, or ice.

For a couple of years, he says, “Ice is all I’d do, all I thought about. I’d take a room in a hotel with another guy and a couple of girls. We’d smoke the meth, have sex, and then play cards. We’d get high for three or four nights and days in a row, take a break for a day or so to eat and sleep, and then do it again.”

Living in a small town 70 miles southwest of Changsha, a regional capital, Ah Chao makes money as a loan shark, a profitable but illegal business. A meaty young man who says he is glad not to be doing a regular job and not afraid of living in the shadows, he agrees to talk freely about his meth habit over lunch on the condition that he stays anonymous.

Nowadays, he says, he is not making enough money to party 24/7. But every week or so “when friends call and ask me to go do drugs with them I can’t say no. I regret it later, but I still go.”

Meth use, Chawarski says, like drug use elsewhere, is “an infectious disease. The most frequent way of getting into the drug scene is through friends. If you have one drug user in a village, pretty soon you have two, then five, then 20.”

Whether it is closer to one or to 20 is almost impossible to tell in most places in China. “Government narcotic control management in rural areas is still loose,” says Professor Zhang. “Many places are still at the stage of non-management.”

But it is clear that ATS “are very easy to get in the countryside as well as in the cities,” says Li Jianhua, head of the Yunnan Institute for Drug Abuse in the southwestern city of Kunming. “They are easily made, and easily bought.”

Drug bust yields 2.4 tons of meth

That is largely because such drugs are now made in enormous quantities in China, replacing illicit imports from Myanmar and, reportedly, from North Korea. Last year the NNCC warned that “the problem of domestic drug manufacture is increasingly deteriorated.” This year’s report noted that “almost all the crystal methamphetamine and Ketamine in the domestic drug consumption market were locally manufactured.”

There have been some spectacular busts. In February, police seized 2.4 tons of meth from a lab in the southern province of Guangdong. In December 2013 some 3,000 police and paramilitary forces raided the village of Boshe, a notorious center for drug manufacturing in Guangdong, confiscating nearly three tons of meth and arresting 182 people, including the village’s former Communist Party secretary.

But the Boshe raid did nothing to reduce the street price of meth, says a US Drug Enforcement Administration official who follows the drug trade in China, suggesting that many other meth labs picked up the slack.

“China has robust chemical and pharmaceutical industries,” says the DEA agent, who asked not to be identified. “A lot of precursors and reagents are going to these [illegal] labs.”

They are also going abroad; Mexican police have confiscated shipments of Chinese chemicals destined for meth labs making drugs for sale in the US. And things work the other way, too; two years ago Chinese police arrested a Mexican meth cook who had set up his facility in a remote pig farm in central Hunan Province.

Detox centers and prison time for users

Since 2006, the Chinese authorities have tackled heroin abuse by decriminalizing the drug’s use and opening nearly 900 methadone clinics to wean addicts off it. But no drug like methadone that would help methamphetamine users break their habit has been found, so no such medical approach has been possible.

Some caught using meth are encouraged to attend voluntary detoxification centers; most – especially if they are caught a second time – are sent to compulsory detox facilities in former prisons and held for as long as two years with no judicial or medical intervention.

Ah Chao is not afraid of being caught. Once, somebody in a hotel reported him to the police. He was locked up in a cell for seven days, but then he was released. If he is caught again, he could be sent to a detox camp for two years, “but if you’ve got connections it can be less. I could get out quickly,” he says.

In 2012, the United Nations urged member states to close drug detention camps, a message aimed at China and other countries in East Asia. The UN appeal said there was “no evidence that compulsory drug detention and rehabilitation centres represent an appropriate and effective environment for the treatment of drug dependence.”

Government agencies in China are divided on what to do with ATS users, says Jia Ping, a lawyer seeking reform of the current detox system. He has “not seen any concrete steps or plans” to try an alternative approach.

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Meanwhile, even as the police ramp up campaigns against manufacturers, traffickers, and users of methamphetamine, their own statistics suggest that so far they are fighting a losing battle. And as meth abuse becomes more than just an urban phenomenon, the battle will only get harder.

“We have a big population in China,” says Dr. Lu at Peking University’s No. 6 Hospital. “If rural people start using these drugs the police could not control such an epidemic. This is tomorrow’s problem for China.”