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 102 Arrest and seizure data Amphetamine-type substances In 2004, law enforcement agencies dealt with 234 cases relating to ATS offences, compared with 184 cases in 2003 and 77 cases reported in 2002 (National Authority for Combating Drugs, 2005) . A total of 510 people were arrested for ATS-related crimes in 2004 (National Authority for Combating Drugs, 2005) . This is a 46 per cent increase from 349 arrests in 2003, and a 128 per cent increase from 223 arrests in 2002 (United Nations Office on Drugs and Crime, 2002, 2003) . The substantial increasing trend continues with the number of tablets seized from 2002 to 2004 . A total of 875,702 tablets were seized in 2004 (National Authority for Combating Drugs, 2005), 209,527 in 2003, and 126,221 in 2002 (increases of 317% and 600% respectively) (United Nations Office on Drugs and Crime, 2002, 2003) (see Table A2 .1) . There is little evidence as to where ATS are being manufactured in Cambodia (United Nations Office on Drugs and Crime, 2003) . In 2003, one methamphetamine tableting machine was seized in Battambang Province, but no laboratories were seized during the year . In 2002, a methamphetamine production facility close to the Cham Yeam (Koh Kong) international border crossing with Thailand was found by local police and confiscated in November 2002 (United Nations Office on Drugs and Crime, 2003) . Heroin In 2004, the number of cases, arrests and seizures relating to heroin were significantly lower than those of 2003, but similar to those of 2002 (National Authority for Combating Drugs, 2005; United Nations Office on Drugs and Crime, 2002, 2003) . Three cases were reported in 2004 compared to seven in 2003 and one in 2002 . Two people were arrested for heroin-related offences in 2004 compared to 22 people arrested on heroin trafficking charges in 2002, and one arrest in 2002 . Just over 2 kilograms of heroin were seized in 2004 compared to a total of 46 .72 kilograms of heroin seized in 2003 (one seizure was approximately 35 kilograms) and almost 2 kilograms in 2002 (see Table A2 .1) . Cannabis Official reports of cannabis seized and/or destroyed during 2004 are of 14,341 square metres, a significant reduction from the reports in 2003 of 63,454 square metres, although similar to cannabis seizures in 2002 (United Nations Office on Drugs and Crime, 2003) . Seizures of cannabis made outside of the country (but cultivated within Cambodia) totalled more than 350 kilograms in 2003 . During 2003, 52 people were officially reported to be detained for the cultivation of cannabis . Of these, six were sent to court and 46 were ‘educated’ . This is a marked increase from the two detainees in 2002 (United Nations Office on Drugs and Crime, 2003) . Precursor chemicals According to UNODC reports (United Nations Office on Drugs and Crime, 2002, 2003), there has been an increase in the seizure of precursor chemicals by police and customs in Cambodia . Such chemicals have been seized in the southern provinces of Takeo, Kandal and Kampot and further seizures have been made in Banteay Meanchey and Battambang provinces which would indicate that precursors are being imported to Cambodia from Vietnam and Thailand . In 2004, 2624 kilograms of sulphuric acid was seized by law enforcement officials (National Authority for Combating Drugs, 2005) . Table A2 .1 . Summary of illicit drug-related arrests and seizures in Cambodia by law enforcement agencies, 2002–2004 Drug Year Cases Arrests (people) Seizures ATS 2004 234 510 875,702 tablets 2003 184 349 209,527 2002 77 223 126,221 Heroin 2004 3 2 2 .15 kg (no data available for Dec 04) 2003 7 22 46 .72 kg 2002 1 1 1 .9 kg Cultivation destroyed Cannabis 2004 14,341 .25 m2 2003 63,454 m2 2002 11,950 m2 Ketamine 2004 3 6 25,150 bottles (no data available for Dec 04) Precursors 2004 1 2624 kg of sulphuric acid Sources: National Authority for Combating Drugs, 2005; United Nations Office on Drugs and Crime, 2002, 2003 103 Country profiles: Cambodia
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 104 A2 .4 Drug-taking practices, risk factors and trends HIV, sexual practices and drug use The first case of HIV in Cambodia was detected in 1991 (United Nations Office on Drugs and Crime, 2004) . HIV prevalence via all transmission routes is 2 .8 per cent (United Nations Office on Drugs and Crime, 2004) . Due to the lack of surveillance data, the true nature and extent of drug-related HIV prevalence and risk in Cambodia remain unclear (United Nations Office on Drugs and Crime, 2003, 2004) . From the limited data available, there is evidence to suggest an increase in injecting drug use in major urban centres, and, based on lessons from other countries in the region, there is a strong suggestion that factors for HIV transmission through IDU already exist in Cambodia (United Nations Office on Drugs and Crime, 2003) . In 2003, through their pilot needle and syringe program, the NGO Mith Samlanh–Friends contacted 47 IDUs living in Phnom Penh — of these, 15 agreed to be tested for HIV/AIDS, with 45 per cent found to be HIV positive (Mith Samlanh– Friends, 2002) . Heroin and opium are the main injected drugs, according to almost all reports . The drugs are reported to be injected either raw or cooked . In the raw method, drugs are not mixed with a liquid or cooked before being put into the syringe . The drug is put into the syringe in a powder form, blood is drawn into the syringe, and the drug is dissolved in the blood before being pushed back into the vein . The cooked method mixes the drug with a liquid (distilled water, drinking water, coconut juice) (O’Connell, 2005) . The I-RARE study (O’Connell, 2005) reported that every injecting drug user they interviewed (exact sample size not reported) said they reused needles and syringes . The majority reported sharing, borrowing or lending, or using equipment after others had used it . Most reported that they would rinse the needles and syringe with water before reusing or sharing it; some mentioned cleaning the needle with a cloth, paper or a burning cigarette; no reports of using bleach . The majority of those interviewed reported buying and injecting drugs in groups . The authors identified several reasons for the previously listed risk behaviours: cost of needles and syringes ($US 0 .5–0 .7); access and availability of syringes is limited; residual drugs remaining in the equipment may be enough to get someone high; and knowledge of HIV transmission is lacking among drug users . Data from IDUs showed that 60 per cent reported that HIV was spread through the needle, compared to the syringe, or barrel . The study (Mith Samlanh–Friends, 2002) showed that 18 per cent of youth interviewed in Phnom Penh reported injecting a drug (aged 16–22 years) . All were polydrug users and most took at least two injections of heroin per day, with half having injected for more than one year . Most admitted to sharing equipment and paraphernalia, even though they knew it could lead to HIV transmission . The methods of administration of glue and amphetamines do not pose a risk of HIV transmission, although behaviours associated with their use do increase HIV vulnerability (blue book) through high-risk sexual behaviour (non-condom use) . Half of the interviewees in the I-RARE study (O’Connell, 2005) reported using drugs, particularly yama, in conjunction with sex (i .e . sex immediately after using drugs) . Participants reported that smoking yama increased their sex drive and prolonged sex . In contrast, sex workers reported using yama for stamina and energy rather than to increase arousal . Most respondents reported sex with multiple partners, described as: sex workers, girls, sweethearts, clients, spouses . Sex workers reported having sex with both IDUs and non-IDUs and some men reported having both male and female sexual partners . Group sex was also reported . Forty per cent of participants reported irregular or no use of condoms . In the past year there has been evidence of injecting of methamphetamine in Phnom Penh . A2 .5 Summary table In Cambodia there is a culture of injecting related to health and wellness (Mith Samlanh–Friends, 2002) . Cambodians commonly use injections for pharmacy medicine . For example, it is usual for a family to inject each other, using the same injecting equipment for the whole family, with vitamins or serum . The argument has been made by Mith Samlanh–Friends (2002) that these practices in the general population are likely to have implications for blood-borne virus transmission and to make the transition from oral drug use to injecting drug use relatively uncomplicated . There is no legal restriction on the distribution of needles and syringes; in practice, syringes are available without prescription from pharmacies (Burrows, 2003) . Selling blood The data from the I-RARE study confirmed selling, brokering and collection of blood donations through multiple data sources (O’Connell, 2005) . This behaviour is carried out in ‘teams’ taking turns to sell their blood in order to pool money to buy drugs . Blood sellers report no counselling or education is provided before or after blood collection . Estimated number of drug users 520,000 Main drugs used Amphetamines (yama) Drugs injected Heroin and methamphetamine Estimated prevalence of HIV infection among IDUs 37% amongst youth in Phnom Penh 105 Country profiles: Cambodia
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