The tribal people are known to have traditionally used opium as a medicine, a cash or barter crop, and as a drug. Drugs produced in this area generally move northward on routes into China. The Punoi practice an ethnic religion, which is often a blend of animism and ancestor worship . These spirits help find or grow food, cure illness, and avert danger. Through sacrifice and ritual, the worshipper tries to manipulate the spirit into helping him.
Ancestor worship involves praying to deceased relatives for blessings, protection, and guidance.
It is believed that these spirits are alive and need to be fed and cared for. Laos is one of the poorest countries of Southeast Asia. Malaria, influenza, dysentery, and pneumonia are the major health problems, and malnutrition is widespread. Infant mortality rates are high, and life expectancy is low. Many of the elite fled the country in 1975, including most of the country's physicians, which created a serious problem for the new government.