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 18 2 .3 China Population: 1,298,847,624 2 .3 .1 Overview of recent drug trends The drug of choice for drug users in China is heroin, followed by benzodiazepines (including triazolam, diazepam, clonazepam and nitrazepam), other opiates such as morphine and opium, cannabis, ketamine and amphetamine-type substances (ATS), such as ‘ice’ and ‘ecstasy’ . In China’s growing urban centres, use of MDMA (‘ecstasy’) has become increasingly popular while cannabis use is widespread in Xinjiang . The use of ATS was rare until 1995 but is currently expanding rapidly: there is a perception that ecstasy and methamphetamine are the most popular drugs consumed . 2 .3 .2 Prevalence of drug use The Government of China acknowledges that the number of drug users is much higher than those who are registered . As of late 2003, the number of registered drug users was 1,050,000, a 15-fold increase, accounting for 0 .081 per cent of China’s total population . Officially, some suggest the number of drug users ranges from an estimated 6–8 million; unofficially, estimates are as high as 12 million . However, it must be stated this is not based on scientific or epidemiological studies . The estimated number of injecting drug users (IDUs) ranges from a low of 356,000 to 3,500,000 with a mid-range figure of 1,928,000 . 2 .3 .3 Drug supply The growing of illicit opium is minor, and manufacturing of heroin within China’s national borders has not yet been identified . Most heroin produced in Myanmar is reportedly trafficked through China, which has become an important transhipment route for the international market . This proliferation of drug trafficking in China largely emerged as a result of new routes from Afghanistan into western China, particularly Xinjiang Province . Cannabis is grown mainly in Xinjiang and Yunnan, primarily for domestic use . The ephedrine plant grows wild in many parts of north-east China and the chemical extracted from the plant is processed for pharmaceutical purposes . Methamphetamine laboratories are located in various provinces along the eastern and south-eastern coastal areas . China in recent years has become a major source of methamphetamine for many Southeast Asian and Pacific rim nations . Chinese law authorities also note a surge in the production of MDMA, mostly for the domestic market in Beijing, Shanghai, Nanjing, Guangzhou and Shenzhen . China also produces the chemical potassium permanganate, known to be sold to Latin America to refine cocaine . 2 .3 .4 Drug-taking practices, risk factors and trends Smoking of heroin is still popular but the trend towards injecting is well established . Ecstasy is generally taken orally or by smoking, while ‘ice’ is usually inhaled or smoked: there are reports of injecting methamphetamine, sometimes mixing it with heroin, but it is difficult to gauge how widespread the practice is . Reports show that unsafe injecting is widespread among drug users, the greatest risk factor being the sharing of syringes . 2 .3 .5 Summary table Sexual risk behaviours among drug users are alarming, with multiple sexual partners common and the rate of condom use in sex being low . By 2002, HIV was found among drug users in all 31 provinces, autonomous regions and municipalities . In 2001, 70 per cent of all HIV cases were found among IDUs, but as of 2003 the proportion of reported HIV among IDUs had dropped to 44 per cent: IDU remains the main HIV transmission route in China . The prevalence of hepatitis C among IDUs was mostly above 70 per cent . Estimated number of current drug users 1,050,000 registered but an estimated 6–12 million in total . Estimated number of injecting drug users ranges from 356,000 to 3,500,000 Main drugs used Heroin, benzodiazepines, amphetaminetype substances (methamphetamines, ecstasy), cannabis, opium, ketamine Drugs injected Heroin, methamphetamine, diazepam, pethidine, morphine Estimated prevalence of HIV infection among IDUs As of 2003 the proportion of reported HIV among IDUs was 44% . In some areas the prevalence rises above 80% . 19 Country summaries: China
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 20 2 .3 .6 Country responses Policy and legislation Agreements and treaties 1961, 1971, 1988 UN Drug Conventions . While China is not a full member of ASEAN, it has become a signatory to the ASEAN and China Cooperative Operations in Response to Dangerous Drugs (ACCORD) for a ‘drug-free ASEAN by 2015’ . National drug control policy Main drug control legislation Drug control policy lead agency Focused on prohibiting drug trade, drug consumption, crop cultivation and manufacturing of drugs, drug eradication programs and closure of drug trafficking routes . The State Council of China promulgated the Procedures for Narcotic Drugs Control (1987) and the Procedures for Psychotropic Substances Control (1988) . The Prohibition Against Narcotic Drugs adopted in 1990 sets out penalties for drug trafficking, possession and use . National Narcotics Control Commission (NNCC) Law enforcement bodies Ministry of Public Security, Ministry of Public Health (regulates pharmaceutical industry) and the Customs General Administration . Within the Ministry of Public Security, the Narcotics Control Bureau is responsible for all criminal investigations and the anti-trafficking of illicit drugs . Drug use addressed in last Yes National HIV/AIDS Plan Possession of No N&S unlawful Harm reduction NSPs, outreach and peer education programs appear to be expanding but still have limited scope . Substitution therapy programs are expanding . Harm reduction appears to be gaining a gradual acceptance among the authorities but serious operational difficulties are encountered . Needle and syringe Yes (limited) programs (NSPs) Peer-based approaches Yes (limited) Supply reduction The overall position of Chinese law enforcement is zero tolerance . According to Chinese law, drug users must be rehabilitated, and consequently the country has adopted compulsory treatment as its main principle . The smuggling, trafficking or manufacturing of illicit drugs can result in either death or a life sentence . Crop eradication Statistics on eradication of illicit opium are not available . Demand reduction Anti-drug campaigns and education prevention programs for schools and the wider community are in place . The government’s policy is to actively rehabilitate drug users, first by admission into either voluntary or compulsory rehabilitation centres; and, if unsuccessful, drug users are sent to re-education through labour centres . Substitution therapy programs are currently gaining much wider acceptance . Treatment Arrested drug users are first sent to a compulsory rehabilitation centre (CRC) for 3–6 months . There are 583 CRCs in the country . If relapse occurs, the user is sent to re-education through a labour centre (RELC) for an average of two years and a maximum of three years . Residents are forced to undergo re-education coupled with physical labour . There are 165 RELCs in the country . Voluntary or self-referral Yes Compulsory Yes Methadone for Unknown detoxification Substitution therapy Yes . At the end of 2005 it is anticipated there will be 100 methadone maintenance treatment programs operating in various parts of China . Most common type of treatment provided Primary prevention Yes School-based education Yes Community education Yes Rehabilitation includes medical and psychological treatment, legal education and ‘moral education’ . The moral and psychological education entails exercises such as rote repetition of slogans, marching, exercises and shouting of numbers . 21 Country summaries: China
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Illicit Drug use in the Asia Pacific Region - Burnet Institute

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