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 150 Newman, R . (2004) . Hong Kong: Building a Large Scale, Low Threshold Methadone Program. Breaking Down Barriers: Lessons on Providing HIV Treatment to Injecting Drug Users . New York: Open Society Institute, International Harm Reduction Development . O’Higgins, N . (2002) . Youth Employment in Asia and the Pacific: analytical framework and policy recommendations . Bangkok: International Labour Organization . Reid, G . and Costigan, G . (2002) . Revisiting the ‘Hidden Epidemic’: a situation assessment of drug use in Asia in the context of HIV/AIDS . Melbourne: Burnet Institute, Centre for Harm Reduction . Social Welfare Institute (2003) . Report on Drug Control, Macao, 2002 . Macao: Social Welfare Institute . United Nations Office of Drug Control and Crime Prevention (2001) . Global Illicit Drug Trends 2001 . New York: UNODCCP . United Nations Office on Drugs and Crime (2004a) . Amphetamine-type Stimulants in East Asia and the Pacific . Bangkok: UNODC, Regional Centre for East Asia and the Pacific . United Nations Office on Drugs and Crime (2004b) . Statistics on Drug Trafficking Trends in East, South-East and South Asia, Oceania and Worldwide: Twenty-Eighth Meeting of Heads of National Drug Law Enforcement Agencies, Asia and the Pacific . Bangkok: UNODC . United Nations Office on Drugs and Crime (2004c) . World Drug Report . Volume 1: Statistics . Vienna: United Nations . United States Department of State, Bureau for International Narcotics and Law Enforcement Affairs (2003) . International Narcotics Control Strategy Report. Washington DC: US Department of State, Bureau for International Narcotics and Law Enforcement Affairs . United States Department of State, Bureau for International Narcotics and Law Enforcement Affairs (2004) . International Narcotics Control Strategy Report: South East Asia . Washington DC: US Department of State, Bureau for International Narcotics and Law Enforcement Affairs . Wan, S . and Rassool, G . (2003) . Silent voices: women and substance abuse in Hong Kong: right access to services? Journal of Addictions Nursing 14: 57–61 . Westermyer, J . (1976) . The pro-heroin effects of anti-opium laws in Asia . Archives of General Psychiatry 33: 1135–1139 . Wong, K ., Lee, S ., Lim, W . and Low, H . (2003) . Adherence to methadone is associated with a lower level of HIV-related risk behaviours in drug users . Journal of Substance Abuse Treatment 24: 233–239 . World Health Organization (2004) . Country Health Information Profile: Hong Kong, SAR, China . Manila: WHO, Western Pacific and Southeast Asia . A5 . Indonesia Geography Located in south-eastern Asia, archipelago between the Indian Ocean and the Pacific Ocean . Borders with Timor- Leste, Malaysia and Papua New Guinea . Mostly coastal lowlands; larger islands have interior mountains . Arable land: 11 .32% Permanent crops: 7 .23% Other: 81 .45% (2001) Government Republic Chief of state: President Susilo Bambang Yudhoyono (since 20 October 2004) and Vice-President Muhammad Yusuf Kalla (since 20 October 2004); Note: The President is both the Chief of State and Head of Government Head of government: President Susilo Bambang Yudhoyono Elections: President and Vice-President are elected by direct vote of the citizenry Population 238,452,952 (July 2004 est .) Urban: 44 .5% of total (2002) Median age: 26 .1 years Age structure: 0–14 years: 29 .4% 15–64 years: 65 .5% 65 years and over: 5 .1% (2004 est .) Human development index HDI rank 111 (177 countries) Unemployment rate 8 .7% (2003 est .) Language Bahasa Indonesia (official, modified form of Malay), English, Dutch, local dialects, the most widely spoken of which is Javanese Literacy % Age 15 and over can read and write: Total population: 87 .9% Male: 92 .5% Female: 83 .4% (2002) Religion Muslim 88%, Protestant 5%, Roman Catholic 3%, Hindu 2%, Buddhist 1%, other 1% (1998) 151 Country profiles: Indonesia
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 152 Health Life expectancy: 69 .26 years Male: 66 .84 years Female: 71 .8 years (2004 est .) Infant mortality: 36 .82 deaths/1000 live births (2004 est .) HIV prevalence: 0 .1% (2003 est .) Economics GDP: purchasing power parity — $758 .8 billion (2003 est .) Population living below the national poverty line (27 .1%), 1990–2001 A5 .1 Narrative summary of drug vulnerabilities The Asian financial crisis of 1997 impacted severely upon Indonesia, leading to major economic and political upheaval . A consequence of this period was massive migration and a continuous influx of individuals from the countryside to the cities . This led to substantial strains upon urban services, and afflicted the urban poor the most . Rapid inflation swept the nation, followed by a surge in unemployment, under-employment and hunger, and an overall decline in government spending in health services (Friedman & Reid, 2002; Paitoonpong, 2001; Reis, 2003; World Bank, 2003) . In 1975, an estimated 20 per cent of Indonesians were urban dwellers; by 2025, an estimated 60 per cent of the population will reside in urban centres: an increase in more destitute individuals and families residing in urban slums will be the inevitable outcome . In 1999, two out of five urban Indonesians were poor; currently, one-third to one-half of Indonesia’s population have incomes below the poverty line (Australian Agency for International Development, 2004b; BPS — Statistics Indonesia, BAPPENAS & United Nations Development Programme, 2004; World Bank, 2003) . More than half the population is aged 12–30 years, with around 38 million people aged 15–24 years (Reis, 2003; United Nations Office on Drugs and Crime, 2003b): an age group common among drug users . Of increasing concern is youth unemployment, which stood at 19 per cent in 2000; the supply of labour exceeds available employment opportunities: under-employment has been an issue for a long time (O’Higgins, 2002) . Indonesia was previously a transit rather than a destination country for illicit drug trafficking but this has recently changed, so that Indonesia is now a point of transit, a destination and a source of drugs (National Narcotics Board, 2003a) . Following the end of the Suharto era there has been considerable growth in the drug trade and there is concern as to why this may be the case . Media reports have speculated that as the under-funded security services have lost control of lucrative businesses in the democratic era, they may be supplementing income by facilitating illegal business, possibly including drug distribution (Roosa, 2003) . Historical and cultural interactions with drugs Like many other countries in the Asian region, Indonesia is a country with a long history of drug use and cultivation . In the early 17th century opium was introduced to Javanese Sultanates, and Dutch merchants recorded many incidents of Chinese and Javanese smoking opium-tobacco . During this period the colonial Dutch government controlled opium imports from India and a number of Sultans had established opium monopoly agreements with Dutch companies (Irwanto, 2001; McCoy, 1991) . By 1862 the ruling Dutch established their own opium plantations in Java and Sumatra . Opium became important socially and economically; by 1929 there were over 1000 opium dens and 100,000 registered smokers, most being Javanese (McCoy, 1991) . Prior to the Japanese invasion in 1942, opium was obtained through a rationing system under Dutch rule (Setibudhi, 1996; Setyonegoro, 1978) . By the late 1960s heroin, morphine, cannabis, barbiturates, amphetamines and small amounts of cocaine were available and in use in Jakarta and Bali; poly-drug use was identified to be fairly common (Gordon et al ., 2000; Spencer & Navaratnam, 1981; Widjono, 1979) . In the late 1990s crystal methamphetamine (commonly known as Sabusabu) and heroin (commonly referred to as Putauw) emerged as popular drug choices, while the use of cannabis and alcohol continue to increase (Irwanto, 2001; Tantoro & Fidiansjah, 1999) . A5 .2 Prevalence of drug use and profile of drug users There have been various estimations of the number of drug users in Indonesia; what is not disputed has been the exponential increase nationwide in drug use, not confined to the large urban centres . It has been suggested that there has been a threefold increase in the number of drug users from 1997 to 2000 (National Narcotics Board, 2002b; Utomo, 2003) . Estimates of the numbers of illicit drug users are in the range of 1–3 per cent of the total population: 1 .3–6 million people (Centre for Harm Reduction, 2004b; Moore, 2003a; Mumtazah, 2003; National Narcotics Board, 2003a, 2003b) . One estimate has suggested one million drug users in the Jakarta region alone (National Narcotics Board, 2003a), although only 3217 individuals have been officially reported by the Ministry of Social Welfare (United Nations Office on Drugs and Crime, 2004a) . Access to drugs has become increasingly easy, with drug use spreading to all sections of society . It is unclear from the data available as to what constitutes ‘drug use’, thus some drug use estimates are questionable . For example, if one million in Jakarta use drugs and 80 per cent of them are males 15–30 years of age (as most service records show), then six out of ten men in this age group are consuming drugs: the credibility of such a figure would have to be disputed (E . Pisani, personal communication, 2005) . 153 Country profiles: Indonesia
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Illicit Drug use in the Asia Pacific Region - Burnet Institute

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