Illicit Drug use in the Asia Pacific Region - Burnet Institute

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Situational analysis of illicit drug issues and responses in the Asia–Pacific region xx 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 . xxi Executive summary
Situational analysis of illicit drug issues and responses in the Asia–Pacific region xxii A concern of Pacific Island authorities is that the development of the cannabis industry may allow for profits to be invested in other commodities such as the production of methamphetamines . The Pacific Islands region is developing into a significant transit and potential consumption area for crystal methamphetamine . For example, there was a large seizure of a crystal methamphetamine ‘super laboratory’ in Fiji on 9 June 2004 . The major form of trafficking, for the six countries reviewed, is transhipment: drugs produced elsewhere transit Pacific Islands for the destination market . The geographic position of countries in the Pacific region facilitates the drug trade, both eastbound and westbound throughout the region . South American cocaine is transported into Southeast Asia and Australia, while Southeast Asian heroin and methamphetamine are transported by couriers into Canada, and to a lesser extent into the United States . There have been reports of a number of large seizures in the region . Since the drug market in the region is small, shipments of large quantities are reported to indicate that the drugs are destined for larger markets . Availability and demand for cocaine remain limited in Oceania, with the exception of Australia . Seizures at the Australian border in 2001 doubled from the preceding year . Seizures have been made in recent years in Tonga and Fiji, and seizures in Australia have also indicated that the drugs transited some Pacific Islands . Large seizures of heroin have been made in Vanuatu and Fiji, destined for other markets . The concern for the Pacific region is, if large amounts of illicit drugs are moving through local communities, then seepage of the drugs into those communities will result and the social impacts of drug dependency will be experienced . Drug-related crime Official law enforcement figures could not be obtained for this review . Information about drug-related crime for the region was derived from various sources including newspapers, case studies and regional reviews . Concerns include: • violence against women and family, particularly in Melanesian countries (Papua New Guinea, Solomon Islands, Fiji), after abuse of cannabis and home-brewed alcohol; • significant association between alcohol consumption and cannabis smoking with crimes committed by youth; • in Papua New Guinea serious law and order issues prevail — murders, armed robberies, rape and car jacking are daily occurrences; • corruption and white collar crimes are written about constantly in the newspapers; • there are particular concerns regarding the association between cannabis cultivation and the trade for illegal guns; • money laundering of proceeds of illicit drug trafficking . Agreements and treaties Fiji and Tonga are party to all three international drug conventions, the 1961 Convention on Narcotics Drugs, the 1971 Convention on Psychotropic Substances, and the 1988 Convention against Illicit Trafficking in Narcotic Drugs and Psychotropic Substances . Samoa and Vanuatu are not party to any of the Conventions . The Solomon Islands have ratified only the 1961 Convention on Narcotics Drugs . Papua New Guinea has ratified the 1961 and 1971 Conventions and adherence to the 1988 Convention is under discussion . Regional/country illicit drug control policy and legislation Presently, there is no overall regional or country-based illicit drug policy in the Pacific . Moreover, the inability of current illicit drug legislation within the region to provide a common base for law enforcement agencies to operate from both a national and a regional basis has been noted with some concern at the Forum Regional Security Committee (FRSC) meeting . In 2002, a joint working group was established to address this complexity and to begin to devise a common approach to illicit drug control across the Pacific . The working group has developed new legislation for illicit drug control . The purpose of the Illicit Drug Control Bill is to repeal existing laws and put in place laws addressing aspects of illicit drugs trade that have not otherwise been addressed under current laws, or that require strengthening to allow for more effective investigation and enforcement . The Forum Secretariat leaders have signed off on the Bill and endorsed its adaptation to local environments . The Bill calls for illicit drug legislation to be consistent in the region with respect to offences, penalties, classes of illicit drugs, and investigation and enforcement (search, seizure and forfeiture) . The Illicit Drug Control Bill has been used as the basis of legislation in Tonga and Fiji (as well as in the Northern Mariana Islands) . Law enforcement response to illicit drugs In general, the principal law enforcement agencies in the region are the Police and Customs and Excise Departments, and Immigration . However, more recently the region has taken a whole-of-government approach to transnational crime issues and is working closely with the Navy, Defence, Police and Customs . Due to a lack of resources and training and the constraints of ineffective legislation, the police and customs administrations have difficulty fulfilling their extended role as drug enforcement agents and generally cooperate with other countries on illicit drugs enforcement as needed . Treatment responses and services There is limited publicly available documented information on prevention and treatment interventions for drug users in the Pacific . Discussions with key informants point to the same conclusion: with the exception of the northern Pacific, programs or interventions do not specifically address drug users . Drug use/abuse issues are generally incorporated as part of life counselling or other programs undertaken by NGOs and churches: topics include employment, family conflict, sexually transmitted infections, marijuana use/abuse, alcohol (particularly home-brew), unplanned pregnancies and domestic violence . In Papua New Guinea the psychiatric units in Port Moresby General Hospital and some other hospitals in the provinces, and the National Psychiatric Hospital located at Laloki (on the outskirts of Port Moresby) treat some patients whose condition is linked to drug use (mainly alcohol and cannabis) . Like Papua New Guinea, treatment of drug use issues in Fiji and the Solomon Islands is conducted by general or psychiatric hospitals . For example, St Giles in Fiji treats people who experience cannabis-induced psychoses . xxiii Executive summary
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