Illicit Drug use in the Asia Pacific Region - Burnet Institute

Situational analysis of illicit drug issues and responses in the Asia–Pacific region
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A national surveillance survey undertaken in
Jakarta in 2002 found that about 34 per cent
of male high school students had consumed
illicit drugs; for females, the figure was only
6 per cent . Close to half of the boys and
15 per cent of the girls said they had been
offered drugs, and one-third of boys but
fewer than one in ten of the girls stated
they had been approached by a drug dealer
(Ministry of Health, 2003) . A national survey
in 2003 with 13,699 participants from 26
provinces covering 179 junior high schools,
143 senior high schools and 57 universities
found 5 .9 per cent of the total had ever used
various types of illicit drugs, 3 .9 per cent in
the past year (2 .8 per cent in past month) and
that there was a pattern of illicit drug dealing .
The drugs commonly used included cannabis,
sedatives, ecstasy, methamphetamine and
heroin (National Narcotics Board, 2004b) .
In 2005, national surveillance data from
Jakarta high schools show that 42 per cent
of boys and 6 per cent of girls have tried
drugs (among the boys this is a substantial
rise from 2003), but that injecting is not
increasing — the data show that 1 .5 per cent
of the males had been injecting . The most
consumed drug is cannabis, but 10 per cent
of high school students say they are using
methamphetamines and 9 per cent are
using ecstasy (E . Pisani, personal communication,
2005) . In a study of adolescents
from Indonesia, Nepal, the Philippines and
Thailand, the proportion of adolescent
boys having ever used illicit substances
was reportedly highest among those from
Indonesia (Choe et al ., 2004) .
Estimates of injecting drug users range from
124,000 to 196,000 (Ministry of Health,
2003; Riono & Jazant, 2004; United Nations
Office on Drugs and Crime, 2004a), although
it has been suggested the figures could be
considerably higher (Aceijas et al ., 2004b) .
Quality control as to what information is
entered into the databases is often lacking,
thus some higher estimates can lose credibility
(E . Pisani, personal communication, 2005) .
Since the late 1990s there has been an increasing
trend towards the use of heroin,
amphetamines and cannabis: heroin is the
most common drug for which treatment is
sought at treatment facilities . In recent years
there has been some increase in the use of
cocaine (United Nations Office on Drugs and
Crime, 2004a) .
The majority of drug users are male, most
commonly aged between 15 and 25 years
(60–80%): females on average make up
8–20 per cent of the total number of drug
users: the data available do not identify if
the suggested percentages relate to drug
use and/or injecting drug use . It is believed
that drug users are becoming increasingly
younger, with many from junior and senior
high schools . A retrospective study undertaken
by the Asian Harm Reduction Network
of 500 current IDUs in Jakarta, Bogor,
Tangerang, Bekasi and Depok reporting on
their drug use history found that most began
drug use at 13 or 14 years of age . Most began
with minor tranquillisers such as valium,
while others used cannabis . The primary
causes for initiating drug use were seen to be
linked with wider availability, curiosity and
peer pressure (Centre for Harm Reduction,
2005; National Narcotics Board, 2003a,
2003b; United Nations Office on Drugs and
Crime, 2004a) . Behavioural surveillance
among injecting drug users (IDUs) in Jakarta,
Bandung and Surabya in 2002 found most
IDUs lived with their parents, were 20–24
years (49–75%); less than 13 per cent had
formal employment but the average monthly
income (Rs700,000/US$80) was higher than
the minimum wage (Ministry of Health,
2003) . Illicit drug use is not limited to the
lower socio-economic groups but occurs also
among the more affluent sectors of society
(Riono & Jazant, 2004) .
Data collection systems in place
There are various potential sources of information
on illicit drug use in Indonesia including
school surveys, studies on drug use, estimates
of drug user numbers, drug-related HIV, treatment
demand data, mortality data and arrest
and seizures . However, there are substantial
gaps in the data largely because the coverage
of the sources is not comprehensive and
often does not include the entire country .
The majority of data collected focused on
Jakarta; examples include government drug
treatment centre admissions, which focus on
the only specialised hospital of its kind in
the country, the Drug Dependency Hospital
(RSKO), and studies of drug use linked to
patchy HIV surveillance .
The HIV surveillance system has just one
official sentinel site among drug injectors
(RSKO), which began in 1996 . Other drug
injector sites exist in other provinces but they
report sporadically and it is not always clear
which population is sampled (sometimes it is
incarcerated IDUs; sometimes it is drug users
in treatment, but not necessarily restricted
to injectors) .
Behavioural surveillance among IDUs began
in Jakarta in 2000, and was expanded to
three cities (Jakarta, Bandung and Surabya)
in 2002 . The systems were taken over by
the National Bureau of Statistics (BPS) in
conjunction with the Ministry of Health in
2004 . The 2004–2005 round will add a fourth
city, Medan . As of early 2005 only the data for
Surabaya and Bandung have been submitted
(E . Pisani, personal communication, 2005) .
Data on arrests and drug seizures were the
most developed, but are limited to drug
supply trends .
A recent assessment of the drug reporting and
recording (R/R) system in six provinces found
that information on prevalence of drug use in
the provinces is incomplete; there is no R/R
system on drug use in most health facilities/
drug treatment-related institutions (the focus
was on morbidity reporting); drug use recording
forms from various data sources have limited
variables (a particular problem when reporting
on amphetamine-type substance issues)
and are generally unavailable or, if available,
not used . The National Narcotics Board website,
the Ministry of Health’s database and
the Information Centre for Drug Abuse collect
and share drug information between different
agencies, departments and institutions; the
BNN and NGOs apparently have monthly
meetings to share information .
Overall, the data collection systems in place
have various shortcomings, including limited
hardware/software for the recording and
reporting of drug use (most is still done
manually); competence in R/R of drug use is
under-developed . The size of the country, its
nature as the largest archipelago in the world,
and decentralisation all hinder the communications
and sharing of information; and
coordination and communications between
related institutions are limited (National
Narcotics Board, 2004b; United Nations
Office on Drugs and Crime, 2004a) .
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Country profiles: Indonesia