Illicit Drug use in the Asia Pacific Region - Burnet Institute

Situational analysis of illicit drug issues and responses in the Asia–Pacific region
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Treatment services in some places are free or
subsidised, but generally fees are payable by
those detained, to be paid by the detainee or
by families and friends; for those unable to
pay, it is difficult to discover what arrangements
are in place . Certainly in some places,
incarceration in prison is the only option .
Private voluntary treatment and rehabilitation
centres appear to be flourishing in some
Asian countries, but the fees required are
beyond the reach of the ordinary drug user
and their family; there is a belief that many
private treatment centres lack understanding
of the complexities of addiction . From the
data gathered it appears that there are few,
if any, youth-specific drug services in Asia;
as a result, young drug users are integrated
with adults .
Substitution therapy programs are expanding
in some Asian countries, while in others such
approaches are under consideration . Hong
Kong is currently the only Asian state with
methadone maintenance treatment (MMT)
programs that are considered by international
opinion to be of a high quality and with wide
coverage . MMT programs, implemented in a
variety of ways — often pilots, more recently
in private practice — can be found in mainland
China, Indonesia, Malaysia and Thailand .
Following the successful piloting of MMT
programs in China, the current strategic plan
is to have 1500 MMT programs in operation
by the end of 2007 .
In 2004, the Indonesian Narcotics Control Board
signed a Memorandum of Understanding with
the National AIDS Commission, paving the
way for the introduction of harm reduction
measures such as needle and syringe programs
and methadone programs, including those
to be prison-based . The Central Committee
for Drug Abuse Control in Myanmar has increasingly
become an important player in
health policies such as harm reduction within
Myanmar but the impact of such involvement
is too recent to measure .
Other responses
School-based educational programs targeting
students ranging from primary to university
level are common in Southeast Asian
countries: the focus is to promote antinarcotics
education, often by promoting
a life skills curriculum through lectures,
seminars and workshops on the dangers of
drugs; in some nations this also includes a
HIV/AIDS component .
Community development approaches are
also common, using a range of government
agencies and NGOs to mobilise and heighten
the level of awareness among society of antidrug
campaigns through events, exhibitions,
and radio and television advertisements,
among others .
In Myanmar, Thailand, Laos and Vietnam
there have been several long-term alternative
development projects to diminish the need
among impoverished communities to grow
opium, with varying degrees of success .
Indonesia, Malaysia, Thailand, China and
Vietnam have all witnessed the emergence
of harm reduction working groups with
representatives of government and NGOs
advocating innovative and alternative ways
of addressing problems experienced by drug
users: fundamentally the focus has been to
control the further spread of HIV and other
public health consequences associated with
unsafe drug use and sex practices .
Illicit drug issues and
responses in the Pacific
Vulnerabilities to drug use
The geographical proximity of the Pacific to
illicit drug-producing countries, such as in
East Asia, only serves to facilitate the illicit
drug trade . Additionally, the isolation of the
coastal regions offers useful transit points
for drugs . Moreover, the terrain of the Pacific
makes it very difficult for effective government
administration of all territories and creates
challenges for effective law enforcement .
The region has developed as a world tourist
destination . Subsequently, expansion of
transportation links with Asia and North and
South America has produced fears that the
islands will be used as transhipment routes
for trafficking .
Social indicators for the Pacific region, such
as increased youth population, urban migration,
unemployment and low literacy rates
(in some countries), are reported to increase
the vulnerability of people to licit and illicit
drug use and abuse and its concomitant
social and economic consequences .
Current illicit drug situation
Pacific societies have a tradition of drug use
incorporated into their culture . A range of
psychoactive substances, including betel nut
and kava, have traditionally been used across
the Pacific region . Rapid socio-economic
changes have led to changing patterns of
consumption of these and other licit and illicit
substances and the potential for abuse .
According to key informants, the prevalence
of drug use varies between the six countries
reviewed, but cannabis is by far the most
common and widespread illicit drug used . It
is reported that cannabis is the drug of choice
due mainly to its availability and low cost . Key
informants and published reports indicate that
cannabis is generally consumed with alcohol .
Regionally, cannabis is mainly smoked but
it is also chewed and sometimes baked with
flour . All data sources agreed that cannabis use
is strongly gender-linked, with significantly
more male than female users . The majority of
cannabis users are young, aged approximately
15–20 years . Cannabis is also used in the expatriate
community and by tourists .
Key informants offered that drugs such as
heroin, methamphetamines and cocaine are not
commonly used in the six countries reviewed
due to their high cost compared to the average
income . It is concerning to authorities that
methamphetamine abuse could become an
issue for other Pacific Island countries in the
near future . Injecting drug use is believed to
be very small . A number of anecdotal reports
from key informants indicated inhalant use in
these countries was under investigation . The
most widely used inhalant is petrol .
Drug supply and trade
Limited options and market opportunities in
the agricultural sector have resulted in illicit
cultivation of cannabis, predominantly for
domestic consumption . The Pacific environment
provides ideal growing conditions for
cannabis and allows for continuous yearround
growing cultivation . Wild growth
occurs in all of the countries listed for this
review . According to key informants, cannabis
cultivation is most significant in Papua New
Guinea and Fiji .
The development and greater organisation
of the cannabis industry in recent times have
resulted in an oversupply of cannabis to local
markets . As such, cannabis has been exported
to other markets in the region, for example,
from Samoa to American Samoa and from Fiji
to Tonga . The only documented international
trading of drugs from the Pacific is cannabis,
coming from Papua New Guinea, trafficked
mainly to Australia .
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Executive summary