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 74 2 .13 Vietnam Population: 82,689,518 2 .13 .1 Overview of recent drug trends The drug of choice is heroin among the youth, particularly in the urban centres, while opium use remains popular mainly among the elderly and ethnic minority groups in rural areas, especially in the north-west regions . Other drugs used include cannabis, MDMA and methamphetamine, with the last two becoming increasingly popular nationwide . The use of MDMA and methamphetamines is not confined to youth, but is expanding into the general population . Cannabis is used but its popularity is not widespread . Cocaine is seldom used, probably due to poor availability . The use of glue as an inhalant appears to be increasing . ‘Blackwater opium’ is still used and injected by older users . A variety of pharmaceuticals are used to enhance the effects of opium or heroin . 2 .13 .2 Prevalence of drug use Estimations of the number of drug users vary . Nevertheless there is agreement that the number of registered drug users is increasing each year . Figures released by the Ministry of Public Security in 2004 showed 170,400 registered drug users nationwide . There are no official estimates available on how widespread drug use is in the general population, but the real figure is far greater than those that have registered, according to many sources . The number of injecting drug users (IDUs) is elusive, but recently reported estimates range from a low of 70,000 to a high of 156,000 with a mid-range of 113,000 . 2 .13 .3 Drug supply As of 2003, it was reported that 1000 hectares of opium poppy were under cultivation . This is said to be mostly cultivated by ethnic minorities for local use: mainly by Hmong highlanders, in the provinces of Lai Chau, Son La , Nghe Anh and other north-western and central provinces bordering Laos and China . Cannabis is grown in remote parts of the Mekong Delta in the south and in some north-western highland areas, especially those bordering Laos and China . While most is grown for commercial hemp, some is cultivated for illicit consumption . The production and stockpiling of amphetamine-type substances (ATS) are relatively new practices, found mainly in large cities . There is a trade in illegal harvesting of sassafras trees, which produce an essential oil called safrole, a precursor chemical for MDMA production . Other precursor chemicals used in the production of illicit drugs are known to have origins in Vietnam . While Vietnam does not produce substantial amounts of illicit drugs, it has for some years been an important transit country, but imported drugs are increasingly servicing the domestic market . Most heroin and some opium enter the country from the Golden Triangle, from either Thailand or Laos . 2 .13 .4 Drug-taking practices, risk factors and trends The favoured method of administration for heroin is injecting, a method that appears to be increasing . The pooling of money to purchase drugs and the sharing of needles are common . While most drug users used unboiled water, boiled water or sterile water, blood has also been reported as being used to mix with the drug . The number of drug users who share any one needle varies, but it has been reported that in gaol around 30–50 would share the same syringe . 2 .13 .5 Summary table The HIV epidemic is currently concentrated among IDUs, with 60 per cent of all notified HIV cases . The movement of HIV from highrisk groups such as IDUs and sex workers to other groups in society is now well underway, with 40–120 people infected every day . HIV prevalence among IDUs has increased substantially nationwide from 10 .1 per cent in 1996 to 32 per cent in 2002 . There are, however, sites in Vietnam where sentinel surveillance has reported HIV prevalence among IDUs of 40–80 per cent . Co-infection with HIV and hepatitis C is endemic among IDUs . Estimated number of current drug users As of 2004, there were 170,400 registered drug users . Unofficial estimates vary between 200,000 and 500,000 . Main drugs used Heroin, opium, methamphetamine, ecstasy, cannabis, blackwater opium, diazepam, glue Drugs injected Heroin, blackwater opium, diazepam Estimated prevalence of HIV infection among IDUs 60% of HIV cases are found among IDUs . HIV prevalence among IDUs is 40–80% in at least 8 provinces . 75 Country summaries: Vietnam
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 76 2 .13 .6 Country responses Policy and legislation Agreements and treaties 1961, 1971, 1988 UN Drug Conventions . Signatory to ASEAN declaration for a drug-free ASEAN by 2015 . National drug control policy Main drug control legislation Drug control policy lead agency National Drug Control Action Plan 2001–2005 . The aim is to reduce the number of drug users by 10–20% annually . Approaches include mobilising all sectors of the community to fight against drug use, eradicate narco-plant cultivation, search for alternative development against re-cultivation, enhance drug control efforts to stop illegal trafficking, and to update the legal system on drug prevention and suppression . Law on Narcotic Drugs Prevention and Suppression (2001), which acknowledges that drug use is a social problem and that drug users should be viewed as needing assistance rather than as offenders or criminals . Standing Office on Drugs Control under the Ministry of Public Security and the National Committee for the Prevention and Control of AIDS, Drugs and Prostitution Law enforcement bodies Standing Office on Drugs Control, General Department of Customs, Border Army and Maritime Police Drug use addressed in last Yes National HIV/AIDS Plan Possession of Yes (but only for those recorded or suspicious as an IDU) N&S unlawful Harm reduction Harm reduction programs have been piloted and expanded in Vietnam since 1993 . Support for the harm reduction approach is not uniform, with some local governments more supportive than others . There is a strong perception that current drug control laws are in direct conflict with the harm reduction approach . Harm reduction programs are usually of short duration (1 to 3 years), pilot in nature and dependent on international funding . Needle and syringe Yes (minor in number and limited in scope) programs (NSPs) Peer-based approaches Yes (minor in number and limited in scope) Supply reduction Authorities impose strict penalties for drug offenders, including the death penalty . Government has established and strengthened cooperation among relevant agencies controlling border areas, such as customs authorities and the border army . Bilateral cooperation with neighbouring nations has been implemented to stop trafficking along Vietnam’s borders . Crop eradication Yes Demand reduction An enhancement of educational anti-drug messages and programs aims to prevent and suppress drug-related crimes and drug use . Such activities are both plentiful and diverse, reaching various sectors of the community — from school students to village and commune residents . There has been a major expansion of the number of treatment and rehabilitation facilities throughout the country . Treatment In 2003, the network of treatment centres expanded, with 74 such centres at provincial level and a further 700 detoxication bases at the district, ward and village level . Currently drug users stay in government treatment centres for two years . Treatment often involves the use of traditional medicines . Voluntary or self-referral Yes Compulsory Throughout the nation drug users are being rounded up and placed into such facilities or into prisons . Methadone for detoxification No, but it is possible it will be used with methadone, soon to be introduced . Substitution therapy No, but pilot study soon underway . Most common type of treatment provided Rehabilitation includes medical and psychological treatment, and ‘moral education’ . Relapse prevention, rehabilitation and integration back into the community do not appear to have a high priority . Primary prevention Yes School-based education Yes (but details have not been supplied) Community education Yes (but details have not been supplied) 77 Country summaries: Vietnam
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