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 154 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) . 155 Country profiles: Indonesia
Situational analysis of illicit drug issues and responses in the Asia–Pacific region 156 A5 .3 Drug supply, production, availability, cost and trade Illicit drugs can enter Indonesia through any of hundreds of points throughout the world’s largest archipelagic country (17,000 islands), with a coastline of more than 8500 kilometres, with many remote, inaccessible areas, thick jungles, porous borders, steep slopes and uninhabited islands . Indonesia has a relatively weak customs service, with poorly paid officials and unsophisticated law enforcement techniques, contributing to great difficulty in control of smuggled illicit drugs (National Narcotics Board, 2003b; United Nations Office on Drugs and Crime, 2003a; United States Department of State, Bureau for International Narcotics and Law Enforcement Affairs, 2004a) . Drugs come into Indonesia from a variety of regions and nations: most of the heroin entering Jakarta has its origins in Afghanistan, entering via Pakistan . Heroin can transit from Thailand with a favoured route through Bangkok and Singapore into Jakarta (US State Dept, 2003), or from Afghanistan to Karachi (Pakistan), New Delhi (India) or Kathmandu (Nepal), and then on to Jakarta or Medan . Heroin from the Golden Triangle can be shipped though Bangkok on to Hat Yai, Penang, Medan, Denpasar and Jakarta (United Nations Office on Drugs and Crime, 2003c) . Ecstasy is smuggled into Jakarta from the Netherlands, Belgium and Germany, and increasingly from Ghuang Zhou in China . Sabu-sabu (crystalline methamphetamine hydrochloride) and ATS precursors are often trafficked from Chinese syndicates in China, Hong Kong and the Philippines, and most often in collaboration with local Indonesian Chinese . Methamphetamine pills can originate from Myanmar and Thailand . Precursor chemicals produced in China often transit through Singapore aboard commercial flights, but also have their origins in the United States, Taiwan and India . Indonesian ecstasy is smuggled into other nations, particularly Malaysia, Singapore and Australia (National Narcotics Board, 2003a, 2003b; United Nations Office on Drugs and Crime, 2003b; United Nations Regional Task Force on Drugs and HIV/AIDS, 2002) . Cocaine from the Andes travels via Brazil onwards to Hong Kong, then to Denpasar, and often to Australia . Other cocaine routes are from Santiago to Frankfurt and on to Jakarta or from Colombia, Bolivia or Mexico more directly to Denpasar (National Narcotics Board, 2003a) . Cannabis is grown and harvested in North Sumatra, and especially in the province of Aceh . Cannabis is also smuggled from Nanggroe Aceh Darussalam Province to Medan, Bandar Lampung, Jakarta, Bandung and Surabaya . Indonesian cannabis is trafficked to other Asian nations such as Malaysia and Japan (National Narcotics Board, 2003a, 2003b; United States Department of State, Bureau for International Narcotics and Law Enforcement Affairs, 2003) . Indonesia has a variety of both domestic and foreign drug trafficking networks, especially Southeast Asian and West African drug syndicates . Those with a West African origin (often from Nigeria, Ghana and Liberia) are heavily involved in the trafficking of heroin in Indonesia, but there are also heroin couriers (sometimes female) of Indonesian and Thai nationality . Europeans and smaller numbers of Americans and Australians also participate in drug smuggling (National Narcotics Board, 2003a, 2003b; United Nations International Drug Control Programme, 2002c) . In 2002, a typical wholesale price for heroin was US$38 per gram; a typical wholesale price for cocaine was US$49 per gram . Herbal cannabis in 2002 retailed on average for about US$1 per gram . One ecstasy tablet reportedly sells for about US$4–5, while a gram of methamphetamine costs about US$30–35 . Such drugs are commonly used in environments such as discos and organised drug parties (National Narcotics Board, 2003a, 2003b; United Nations Office on Drugs and Crime, 2004b) . Heroin in West Kalimantan costs Rp40–50,000 per packet and there is a market in the exchange of gemstones (a natural resource to this region) for heroin (Moore, 2003b) . Arrest and seizure data In 2004, the Jakarta police reported 4799 drug-related arrests, a 39 per cent increase from 2003, and the number of suspects apprehended increased to 6097 from 4554 in 2003 . (Arrests are those who are detained and charged, i .e . those who go before a magistrate; suspects arrested are those who are detained for questioning and then released without charge .) These included ten suspects for drug production, over 2500 for drug dealing and the rest for drug consumption . Most were aged 19–30 years, with 283 others aged 10–18 years . The occupations for those arrested varied from nightclub owners to sex workers, hospital staff to construction workers . Drug seizures in Jakarta also increased in this period: cocaine seized increased from 128 .5 grams in 2003 to 6315 grams in 2004 . Figures show that, in 2004, 8493 .3476 kilograms of cannabis leaves, 0 .6071 kilograms of hashish, 12 .71213 kilograms of heroin, 251,000 ecstasy tablets and 28 .39730 kilograms of methamphetamines were seized by the police (National Narcotics Board, 2004a) . The National Narcotics Board (BNN) data show that the number of nationwide narcoticrelated arrests has increased by 58 per cent per annum over the past five years . There were 1833 such cases in 1999, increasing to 7140 in 2003: of the latter, 87 were below the age of 15 years . The vast majority of the cases were in Jakarta, North Sumatra and East Java . BNN data also showed a sharp rise in narcotic consumption among high school students in 2004 (Centre for Harm Reduction, 2004c, 2004f) . In 2002, 392 kilograms of methamphetamines were seized nationwide along with 76,724 tablets and 100 kilograms of ecstasy powder (United Nations Office on Drugs and Crime, 2004a) . The Indonesian National Police have in the last five years destroyed 1200 tons of cannabis and confiscated over 400,000 ecstasy pills and over 400,000 grams of methamphetamine . The amounts seized varied considerably from a reported 0 .6 grams of cannabis, seized from a 14-year-old offender, to 13 .4 kilograms of cocaine intercepted in Soekarno-Hatta airport, Jakarta (Centre for Harm Reduction, 2004a; Emrys, 2004) . 157 Country profiles: Indonesia
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