North Korea’s opioid epidemic

To make up for financial shortfalls in the early 1980s, North Korea’s ruling Worker’s Party began mass producing and distributing opium through its infamous Office 39 and Finance and Accounting Department.

To this day, the North Korean government maintains a monopoly within the country over the production and distribution of drugs from the opiate family, including morphine and codeine. The poppy extract is a primary ingredient used to manufacture stimulants like methamphetamine, ephedrine, cough medicines, and alkaloids.

Production and distribution of opioids

The Workers’ Party quickly designated the country’s northern mountainous region as its base of operations when it began undertaking the production and distribution of opiates in the early 1980s. Although poppy plants can be found growing naturally throughout North Korea, most are found in the mountainous provinces of North Hamgyong, Ryanggang, and Chagang due to their temperate climates. Many of the farms in these areas have stopped growing their traditional crops in favor of poppy farming for opiate production.

An area representative of this change is the flatlands beyond the vast Kaema Highlands. In the past, locals grew typical crops like corn, potatoes, and wheat. However, the area is now known for its low harvest yields and infertile land.   

Since ancient times, opiates have been used for a variety of purposes, including as sedatives and painkillers. But in addition to side effects like nausea, hyperventilation and diarrhea, opiates are highly addictive, and addicts attempting to kick their habits often find themselves experiencing powerful withdrawal symptoms.  

The opiates produced in today’s North Korea are used as active ingredients in medicines for routine ailments as well as more potent preparations. Every harvest season, workers are mobilized to work on the poppy farms, where they harvest unripe poppy pods to collect the extract. Poppy plants from the mountainous areas produce a latex-like liquid. This is dried in clumps at Party facilities before eventually making its way to Office 39.  

North Korea’s primary pharmaceutical factories (including Nanam Pharmaceutical Factory in North Hamgyong Province and Hungnam Pharmaceutical Factory in South Hamgyong Province) began installing the machinery necessary to mass produce opiates in the 1980s. Processed morphine can contain 10% opiate content and is referred to as “Opium Horse.” These “horses” are then distributed to hospitals, the military, and other organizations to be widely used as pain relievers.  

The Workers’ Party closely monitors the entire process of production and distribution of heroin and morphine through state-run pharmaceutical factories. The Party has maintained its monopoly over the drug trade and individuals caught producing or selling drugs outside of the State apparatus face severe punishment. After 1982, drug-related crimes including simple possession or use resulted in lighter punishments such as short term prison sentences, fines or forced labor sentences. But serious violations like trafficking were met with severe punishments, and even the death penalty.  

Despite the penalties, addiction rates have continued to rise in North Korea. After the year 2000, punishment for drug offences sometimes resulted in public execution, which can be interpreted as unofficial acknowledgement by the government of drug-related crime as a wider societal problem.

However, officials routinely turn a blind eye as morphine and heroin packages make their way across the country through various intermediaries, such as hospitals and markets. The majority of citizens obtain their drugs from street sellers.

The government has recently made efforts to censor “anti-socialist” activities, including drug trafficking. One example is the breaking up of a large scale poppy seed peddling ring in Hyesan and Pochon. However, many citizens still commonly carry between 1-10 kg of opium for emergency situations. Possession of such amounts is not considered a punishable offense.  

Opioids are used extensively in medicines available throughout North Korea. North Korea’s medical dictionary and pharmacology textbooks contain entire chapters for opioids as a medicinal ingredient. Additionally, some of the opiate extracts from state-run factories are used to make cough medicine from codeine.

The North Korean Ministry of Health has been complacent in its regulation of medicines that contain opiates. It has even given tacit approval for mass-prescriptions. Due to the lack of regulatory oversight, it is common for ordinary citizens to use morphine and other highly potent pain relievers to treat simple illnesses. This has naturally led to misdiagnoses of sedatives and pain relievers, resulting in an increasing number of patients becoming addicts.

Although it is difficult to obtain health statistics for North Korea in general, the estimated number of drug-related deaths has been on the rise.

The regular price of opium in North Korea is 25 Chinese RMB, 3,452 KPW, or 0.40 USD for one gram. Liquid medicine (1 ml) containing 5% morphine typically sells for 1.60 USD.

North Korean Methamphetamine (Ice): Production and Distribution

Crystal methamphetamine, or ‘ice’ is the latest drug wreaking havoc in North Korea. The drug was originally imported from China and Russia for use in ephedrine formulations (cough medicine). However, it is now covertly produced by military-run pharmaceutical factories in Pyongyang and Sangwon for North Korea’s elite.

The demand for ice has skyrocketed as it has slowly spread throughout society. Residents in the country’s markets can often be overheard saying that dealing ice is a pathway to riches. Not only limited to the upper class, ice has now become the drug of choice for the middle class as well, from bureaucrats to university students.

The primary areas for ice production are in Pyongyang at a pharmaceutical factory in the Sangwon district and a laboratory in the Unjung district, as well as chemical factories in the South Hamgyong Province city of Hamhung. While it is well known that a proportion of the drugs are shipped to the border regions to be smuggled into China, the majority of the consumption appears to be domestic.

The price of ice depends on its purity, which can be roughly discerned by taste. There are two grades, 1 and 2. A gram of grade 1 ice usually goes for around 50,000 KPW (6.30 USD), while the price for grade 2 is 19,800 KPW (2.50 USD).

One of the reasons opiates have become rampant in North Korea society is due to the extreme levels of stress, poverty and oppression that citizens suffer at the hands of the state. Recently, the economy has taken a turn for the worse as official rations have been unable to cover living expenses, while rising inequality and unemployment have led to financial insecurity for a significant proportion of the population. To make matters worse, the prices for medicines sold on the black market have gone up.

The centrally-planned economy has negatively impacted the country’s healthcare system. While treatment is supposed to be free, in reality there is very little in the way of healthcare infrastructure and medicine has become increasingly unaffordable on the black market. This had led more and more people to turn to opiates like morphine or ice.

*Translated by Nate Kerkhoff

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