This paper presents the results of a retrospective study of 1,382 patients admitted to the Narcotics Treatment Centre for Hill Tribes in Thailand, which was operated by the WHO/UN/Thai Programme for Drug Abuse Control. The study revealed widespread opium addiction among the hill tribes. Of these, the Karen were the largest group. Mean age on admission for treatment was 35 years. The male:female ratio was 7:1. Sixty-six per cent were heads of households. About one-third came from households with more than one addict. The mean duration of daily opium use before admission was 7.9 years. Over 90% of them were addicted to opium; there were eight heroin users. The mean amount of opium used daily was 3.9 g for males and 3.2 g for females. About three-quarters of them used salicylate analgesics with opium. Illness, in particular abdominal pain, was the most frequent cause of their addiction.
This paper presented data on reported narcotic users in Canada from 1956 to 1975 based on the narcotic users index maintained by the Bureau of Dangerous Drugs and reported in their annual reports. The major findings were as follows: There was a substantial increase in the number and rate of reported illicit narcotics users in Canada.The greatest increases took place between 1969 and 1973. Decreases in the number of licit and professional users, which took place between 1956 and 1973, have been reversed by slight increases during the period 1973 to 1975. There continues to be a concentration of known illicit narcotics users in British Columbia. There are, however, indications that this trend is slowing down. There were generally more reported male users than female users in all groups, a trend that increased over the total time period. Increases in the numbers and rates of reported users within the 20-24 year age groups have continued to characterize the national picture. There increases, however, were most dramatic between 1969 and 1973. Between 1973 and 1975 the total number of male illicit narcotics users first reported to the B.D.D. remained stable, with variation by age category. Among females, there was a decline in numbers and rates for all age groups under 30. Rates and numbers of first reported users decreased in British Columbia and increased outside of British Columbia.
Information on reported narcotic users aids in the development of drug control policy as well as programmes of prevention, treatment, and rehabilitation. In Canada, such information may be obtained from a narcotic users index which classifies known narcotic drug users into three categories: "illicit", "licit", and "professional". This paper presents trend data on known narcotic users in Canada from 1956 to 1973 by category, location, initially reported drug, sex and age. Between 1956 and 1973, the number of known "licit" and "professional" narcotic drug users steadily decreased, while the number of "illicit" narcotic drug users increased by 283 per cent, with the greatest increase taking place after 1969. Heroin was the most frequent initially reported drug (representing between 80 per cent and 89 per cent of known "illicit" narcotic drug users). Cocaine, as an initially reported "narcotic", had the largest proportional increase from 1956 to 1973. There were generally more reported male users than female in all age groups, a trend that increased over the time span considered. There were recent dramatic increases in the numbers and rates of reported users in the 20-24 year-old group, which has become the dominant pattern among new cases in recent years. Although the index on which this paper is based does not provide figures on total narcotic use in Canada, it is a valuable resource for epidemiologic research. This narcotic user index may be used to make minimum estimates of the extent and geographic and social distribution of narcotic-related problems in Canada.
A survey of the composition of 4,933 exhibits submitted for laboratory analysis by the Drug Squad of the Irish police during the years 1968-1978 indicated an increase in the level of non-medical drug consumption in the Republic of Ireland. Cannabis was the most widely encountered drug. Barbiturates constituted a considerable proportion. Amphetamines were rarely found; this was attributed to the unique legislation controlling the storage and sale of amphetamines. Various substances were sold as drugs of abuse. For example, Datura was sold as cannabis which caused a considerable concern because of its toxicity. The recognition of a drug-related problem of some significance in Ireland during 1968 led to the formation of a drug squad in the Irish police. Since that time a total of 4,933 exhibits arising from arrests and drug seizures have been submitted for laboratory analyses. These exhibits ranged from "normal" pharmaceutical formulations (tablets, ampoules, etc.) to unknown powders and a large number of more unusual items (table 1). The drugs were identified using an appropriate combination of microscopic, chromatographic and spectroscopic techniques (1, 2).
Five hundred and seventy-five opiate addicts (455 male, 120 female) who were treated at two clinics in London between 1968 and 1975 had their current situation reviewed in October 1975. Fifty-two per cent were still in treatment (258 at the clinics, 42 elsewhere), 28 per cent were not in treatment and not known to be using opiates, 11 per cent had died, 6 per cent were in custody and 3 per cent had left the country. Sixty-one per cent of the patients in treatment had remained so continuously. Twenty-eight per cent had also had in-patient hospital treatment. Some patients were very unstable and those treated as in-patients in hospital two or more times for drug abuse had an average of nine hospitalizations. Forty-six per cent of patients in clinic treatment said they were working regularly at the end of the study (23 per cent at entry). Some 7-8 per cent of patients left treatment each year and the death rate remained between 2 and 3 per cent each year. The prescribing of heroin for addicts was gradually superseded by the prescribing of injectable methadone. The authors concluded that a methadone maintenance programme probably had some value in the treatment of opiate dependence.
The Single Convention on Narcotic Drugs, 1961, as amended by the 1972 Protocol Amending the Single Convention on Narcotic Drugs, 1961, and the Convention on Psychotropic Substances 1971 have been implemented in the Federal Republic of Germany as follows: (a) No distinction is made between narcotic drugs and psychotropic substances; all substances which are controlled and non-exempted preparations containing such substances fall under the legal designation of "narcotic drugs"; (b) The same control measures as for narcotic drugs apply to all substances in Schedules II, III and IV of the 1971 Convention, i.e. control of manufacture, trade, import and distribution; (c) Under the new Narcotics Act of the Federal Republic of Germany, which entered into force on 1 January 1982, preparations containing substances listed in Schedules II and III of the 1971 Convention are subject to the same full control measures, including mandatory special prescriptions, with the exception of approximately 50 preparations from substances in Schedule III of the 1971 Convention. These 50 preparations are also subject to import, export and transit controls under the Narcotics Act; (d) The approximately 50 preparations containing substances in Schedule III of the 1971 Convention, as well as all preparations containing substances in Schedule IV of this Convention (about 340), are treated as "exempted preparations" under the Narcotics Act. These preparations, however, may only be dispensed under medical prescription which is in conformity with the provisions of article 9, paragraphs 1 and 2 of the 1971 Convention; (e) Within the meaning of the Narcotics Act, the term "exempted preparations" denotes that no mandatory special prescriptions are required for these preparations but only the normal medical prescriptions. A number of regulations of the Narcotics Act apply to these exempted preparations, including: (i) Licence of manufacture; (ii) Records of dispensing of exempted preparations by the manufacturer to the first acquirer; (iii) Import, export and transit regulations for the exempted preparations containing substances listed in Schedule III (Schedule III B in the Narcotics Act); (iv) Export bans for countries which have prohibited import.
This paper presents data on contacts with a Canadian drug information and crisis centre over a three year span (July, 1971 to June, 1974). The following trends emerged: (1) Although there was only a small change in the total number of contacts, there were substantial decreases in the number of "crisis" and "information" contacts and a substantial increase in the number of "counselling" contacts; (2) The number of "crisis" contacts involving each drug decreased over the time span, particularly those involving "psychedelic hallucinogens" other than L.S.D., solvents, cannabis and opiates. The number of alcohol-involved crisis contacts declined least and alcohol came to account for the second largest proportion of crisis contacts after L.S.D.; (3) There was little change in the age distribution of "crisis" contacts over the period; (4) Crisis contacts in the most recent period (1973-74) were more likely to be rated serious than in the earlier periods; (5) Crisis contacts were less likely to be sent to hospitals in the most recent period.
The paper describes the principal achievements of the UN/Thai programme for drug abuse control which was carried out during the years 1972-1979. The programme was of a pilot nature and covered five selected key villages and 25 satellite villages in the north of Thailand. The major components of the programme were crop replacement and community development, treatment and rehabilitation, and drug information and education. The Royal Thai Government has accepted the achievements of this project as models for greatly expanded programmes for the eradication of the opium poppy cultivation. Two key villages-Ban Mae Tho and Hui Tund Jaw which were included in a pilot programme have provided to be opium free.
The Calgary Distress Centre/Drug Centre is a "street level" agency that deals with both drug and non-drug related crises. Telephone and drop-in service is available 24 hours a day, seven days a week. The Centre has approximately 60 non-professional volunteers and a paid staff of six. Data about crisis information and counselling contacts over the period 1972-76 are presented and discussed. The Distress Centre/Drug Centre is perhaps a useful model on which to base other crisis intervention facilities. Furthermore, the systematic compilation of data regarding contacts with the agency provides significant insight regarding trends in drug use and evolution of the agency.
This paper presents the work and functioning of the distress Centre/Drug Centre, an agency in Calgary, Alberta, Canada, which has evolved from a youth-oriented drug centre to a general crisis centre. It is staffed by volunteers who are supported by professional staff, and offers a 24-hour telephone service throughout the week. The paper reviews the continuing evolution of this service, the drugs most frequently noted in contacts involving crisis and suicide attempts, and the role of crisis centres that use volunteers as front-line workers. The years 1975-1978 were a period in which alcohol was the drug most frequently reported to be associated with crisis and attempted suicide.
The paper provides an outline of a wide-ranging drug abuse control programme undertaken by the Government of the Socialist Republic of the Union of Burma with support and assistance from the United Nations. The components included law enforcement, crop substitution, measures for treatment and rehabilitation and a nationwide programme for drug education. The overall effort was co-ordinated by the Ministry of Home and Religious Affairs, through a Central Committee for Drug Abuse Control on which the Deputy Ministers of the Ministries concerned were members. Liaison between the executing Burmese agencies and the United Nations assisting organizations was effected through a small United Nations office established in Rangoon. The promising result of the programme has led to a further Agreement between the government and the United Nations for the continuation of the programme for a further five years from May 1981.
The author begins with a discussion on trends in drug abuse and trafficking in Italy in the period 1979-1990, when the country was experiencing major heroin-related problems and the situation with regard to cocaine trafficking and abuse was rapidly deteriorating. He then describes the organization of the anti-drug services in Italy and identifies strategies pursued by the Italian Government with a view to intensifying its activities in international drug control.
An epidemiological study on opiate use among young men undergoing examination for army draft was carried out in 1980 and 1982. The following six cities and surrounding provinces were selected for the study: Bologna, Florence, Genoa, Milan, Rome and Turin. There were 15,266 respondents in 1980 and 15,874 in 1982. For each respondent, a urine sample was tested for the presence of opiates and a questionnaire on demographic and socio-economic variables was completed. The study revealed 247 opiate cases with a prevalence rate of 1,618 per 100,000 in 1980, and 339 opiate cases with a prevalence rate of 2,136 per 100,000 in 1982. The number of opiate cases and demographic and socio-economic characteristics of respondents varied greatly from province to province. The group of unemployed respondents had significantly higher prevalence rates than the other occupational groups. A methodology was used that made it possible to estimate the number of opiate abuse cases that did not come to the attention of the authorities. On the basis of the study it was estimated that there were 68,000 opiate users in 1980 and 92,000 in 1982 in the entire country.
A conference was held in London in March 1980 on the use and misuse of psychotropic substances. The conference noted that there was a preponderance of medical practitioners who prescribed psychotropic substances. The topics covered ranged from the extent of use of psychotropic substances to the effects of their use in producing different types of morbidity. Consideration was given to controls of psychotropic substances, including steps to reduce their misuse without restricting their legitimate use.
From 1982 to 1986, there was an overall increase in the number and amount of illicit cocaine seized at São Paulo. There was a total of 1,552 seizures of illicit cocaine, which were confirmed by testing in the laboratory of the Technical Service of Forensic Toxicology, a section of the Medical-Legal Institute of São Paulo. The increase in cocaine seizures was accompanied by an increase in cocaine-related mortality. Although there were no cocaine-related deaths reported in the city before 1982, there was an increasing trend in the number of such deaths during the five-year period that followed.
Trafficking in illegal narcotics and dangerous drugs exists mainly because it yields immense profits and it can be eradicated only by depriving traffickers of their drug derived profits and economic power. With that in mind and to cope more effectively with the problem, the United States Congress recently enacted the Comprehensive Forfeiture Act of 1984, which revised and strengthened the existing laws and procedures. This Act is comprised of four parts. Part A amends the forfeiture proceedings of the Racketeer Influenced and Corrupt Organization (RICO) statute. Part B adds a new criminal forfeiture statute to the Comprehensive Drug Abuse Prevention and Control Act of 1970, which permits forfeiture in all drug felony cases. This newly created section of the Act also adopts other measures, a number of which are identical to those contained in part A of the RICO amendments. In addition, part B contains a civil forfeiture provision to reach land and buildings used to facilitate felonious drug offenses. Part C, inter alia, establishes a revolving fund for the use of the Department of Justice in enforcing forfeiture laws and amends existing provisions regarding the disposition of forfeited property. Part D sets up a Customs Forfeiture Fund.
The herbicide (2,4-dichlorophenoxy)-acetic acid (2,4-D) is considered to be the most cost-effective for eradicating illicit coca plants. Since coca leaves are chewed by the natives of coca producing areas, and, since coca paste and cocaine are widely abused, a study was undertaken to determine whether 2,4-D is translocated into the leaves and transferred to coca paste when coca plants are treated with this herbicide. The study concluded that basal treatment of coca plants with 2,4-D ester resulted in translocation of 2,4-D into the leaves, and this herbicide was detected in high concentrations one week after treatment. Coca paste prepared from leaves obtained from basally treated plants did not contain 2,4-D. Foliage spraying resulted in extremely high concentrations of 2,4-D in the leaves, with significantly high concentrations of the herbicide found one week after spraying. Trace amounts of 2,4-D were detected in coca paste prepared from plants sprayed by the foliage method.
The scarcity of epidemiological data makes it difficult for an accurate and comprehensive assessment to be made of the drug abuse situation in countries of the Andean subregion. Available evidence, however, indicates that in Bolivia, Colombia and Peru prevalence and incidence rates of drug abuse, particularly of the abuse of basic cocaine paste, are relatively high. Studies indicate that in Bolivia 4-5 per cent of youth are habitual cocaine users and that in Colombia drug abuse was in 1984 the seventh leading cause of psychiatric morbidity. A survey in Peru shows that 37 per cent of secondary school students use drugs, while 27 per cent of the respondents used basic cocaine paste as their first drug. It appears that the abuse of basic cocaine paste has spread evenly across urban social classes. The illegal cultivation of the coca bush has drastically increased in countries of the Andean subregion. For example, it is estimated that more than 135,000 hectares of coca bush are cultivated in Peru, producing approximately 135,000 tons of coca leaves a year, while the amount needed for legitimate purposes in that country is estimated at 10,000 tons a year. In the same country, seizures of basic cocaine paste increased from 4,755 kg in 1980 to 7,168 kg in 1983, and of macerated coca leaf from 2,570 kg in 1979 to 27,822 kg in 1984. The demand for illicit cocaine has substantially increased in the world. It is estimated that the total amount of illicit cocaine consumed in the world was 33-45 tons in 1981 and 50-61 tons in 1983.
A study of 35 cases of deep-seated Candida albicans candidiasis, affecting heroin addicts in the Paris region, revealed that the lesions observed were mainly cutaneous (88 per cent) and ocular (65 per cent), along with a number of instances of osteoarticular and pleuropulmonary attacks. The clinical and epidemiological findings indicated the possibility that Candida albicans might be transmitted through the heroin. This paper also presents the diagnostic techniques, and the novelty of the clinical picture, in which cutaneous and ocular lesions are frequently associated (57 per cent).
Twenty-one 25 acutely overdosed heroin addicts had abnormalities noted on their admission electrocardiograms. The most common findings were nonspecific ST-T changes in 17 patients, sinus tachycardia in 11, and left or right atrial enlargement in 8. Five patients had more serious arrhythmias (4 atrial fibrillation and 1 ventricular tachycardia). For the entire group the initial PaO2 was 74.8 +/- 48.2 torr. This degree of oxygenation was only achieved with the use of high dose supplemental oxygen. The 5 patients with the more serious arrhythmias had comparable PaO2s but this was only achieved with higher supplemental oxygen concentrations. We conclude that electrocardiographic alterations (other than arrhythmias) are very common in acute heroin overdosage and may be related to hypoxemia. The abnormal cardiac rhythms may be due to the direct effects of heroin or its metabolites. Heroin addiction is associated with a multitude of medical complications which can affect various organ systmes including the heart (1). Within the last six years several reports have appeared documenting electrocardiographic abnormalities in heroin users (2-5). These studies dealt with either a small series of patients or patients who used methadone or heroin in a chronic fashion. No one, to our knowledge, has extensively studied the electrocardiographic changes which occur in patients with acute heroin overdosage. This retrospective analysis of the electrocardiograms (ECG), arterial blood gases and selected electrolytes in 25 consecutively hospitalized patients acutely overdosed on heroin is an attempt to correct this deficiency.
The first part of the article describes the nature and extent of drug abuse in Peru, with particular reference to the illicit cultivation of the coca plant and the national responses to these problems. It is estimated that between 150,000 and 200,000 hectares are under illicit coca plant cultivation, although less than 18,000 hectares are sufficient for meeting the legitimate needs for this plant in the country. It was estimated that 1.3 million children and youth were at risk of drug abuse in 1985. Both the problems and national responses are analysed in the context of historical and current developments that have influenced Peruvian drug abuse control policy, as well as in terms of the adequacy of programmes carried out within the social sectors involved in such control. The second part of the article summarizes the salient points extracted from the new national comprehensive plan for drug abuse control, which is intended to achieve a maximum reduction in drug abuse concurrently with the elimination of drug trafficking and the eradication of illicit coca plant cultivation in the country. The plan clearly defines the objectives, the strategies and the division of responsibilities in its implementation, involving the following four major sectors of activity: prevention, treatment and rehabilitation; control and monitoring of substances used for legitimate purposes; suppression of the illicit drug traffic; and the eradication of illicit coca plant growing together with the promotion of agricultural, agro-industrial and forestial development. It is pointed out that the whole nation needs to be mobilized in the implementation of the plan in order to achieve its objectives fully.
The abuse of drugs in Poland, a lesser problem than that of alcoholism, has only recently become a subject of interest. Although at present it is not of crucial importance in the pathology of social life, it may still have serious effects on the individual and society. This paper discusses the results of several surveys carried out by different researchers in Poland to assess different aspects of the drug abuse phenomenon. Drug abuse patterns in Poland, as in other countries, change rapidly. Therefore, yesterday's situation may not be considered as valid today. The first part of this article presents some of the characteristics that were observed since 1968, when the phenomenon appeared, up to 1976. The second part describes the provisions of the Polish criminal law to fight drug abuse, and envisages some measures to better control this phenomenon in the future.
Opium and to a certain extent cannabis were the only drugs of abuse in Burma until the early 1970s when heroin addiction spread rapidly among young people, reaching epidemic proportions. Heroin addiction has caused serious social and health problems that prompted the authorities to adopt new legislation in 1974, the Narcotic and Dangerous Drugs Law, which provided for compulsory treatment and severe penalties for drug-related infractions, including the death sentence for certain categories of drug trafficking. The authorities in Burma consider that legislation, drug-law enforcement, prevention, treatment and rehabilitation, and community measures are important and interrelated strategies in combating drug abuse among young people. Various forms of drug-abuse preventive programmes are carried out for such groups as youths, parents, community leaders and professionals dealing with the problems of the young. Preventive school programmes include lectures and discussions; exhibitions; essay writing and other forms of competition for students; in-service training for teachers; healthy alternatives to drug use; a scheme for talented students; and participation in a national mass movement for literacy. Young people are also encouraged to take active part in various community programmes such as the "Red Cross" and voluntary fire brigades as well as in specially designed programmes that are carried out at the local level to prevent and reduce drug abuse. As the extended family still prevails in Burma, with parents and elders being respected by the young, this important resource is utilized in coping with drug abuse among young people.(ABSTRACT TRUNCATED AT 250 WORDS)
1. The two major drugs abused in Afghanistan are hashish and opium. Opium is either smoked or eaten. Hashish is only smoked. 2. Solitary abuse of one single drug, either hashish or opium, is the common feature of drug abuse in Afghanistan. 3. Abuse of other patent drugs as well as multiple drug abuse by the same individual, increasingly common elsewhere, is quite rare. 4. Self-treatment is a major cause of drug abuse in Afghanistan while escape from boredom and lack of work and motivation is another. 5. Hashish as well as opium is commonly abused by people of a low socioeconomical standard. 6. Alcohol, a more recent introduction by the upper class, is becoming popular among city dwellers with major risks involved for the future. 7. Drug abuse in Afghanistan has so far not created problems comparable to those in the West, although there is no guarantee that in future it will not do so. Coercive measures aimed at depriving an individual of his drug of choice may involve the greater risk of drug substitution which will then be an even more difficult problem to manage. 8. Factors involved in prevention as well as cure of the drug-dependent population in Afghanistan have been discussed.
The article focuses on countries and areas of South-East Asia, which are seriously affected by drug abuse and the problems associated with it. Opium has traditionally been used for treating illnesses and alleviating physical and mental stress, as well as for recreational and social purposes. The prohibition of the sale and use of opium in Burma, Hong Kong, Malaysia, Singapore and Thailand forced many habitual opium users to switch to heroin. Over the past two decades there has been an increasing trend towards drug use, often involving experimentation with more than one substance, among youth in and out of school. For example, a survey of students at teachers' colleges in northern Thailand showed that at some time in their lives 30-40 per cent of the male respondents and 3-6 per cent of the female respondents had used cannabis, and that 18-20 per cent of the males and 12-27 per cent of the females had sniffed volatile solvents. The same survey showed that 5-10 per cent of both the males and females had used stimulants and nearly 2 per cent had used heroin. During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature, predominantly affecting young people in many countries of South-East Asia. While opiates, including heroin, have been abused by inhaling and by smoking, there has recently been an increasing trend towards injecting heroin of high purity (80-90 per cent pure heroin). Heroin addiction spread first to the populations of capital cities and then to other cities and towns and even to the hill tribes, as studies in Thailand have revealed. Most recent studies have shown that heroin abuse has spread further in Asia, both socially and geographically, involving such countries as India and Sri Lanka, which had no previous experience with the problem. Studies have also shown that the abuse of manufactured psychotropic substances has been increasing and that heroin addicts resort to these substances when heroin is difficult to find. The article also briefly reviews the history of opium use in China and the history of drug abuse in Japan, particularly with regard to the problem of methamphetamine abuse, which has appeared in two epidemic-like waves. The first followed the end of the Second World War and disappeared at the end of the 1950s; the second reappeared in 1975 and since then has gradually been increasing in size.
A wide range of non-governmental organizations are involved in the prevention and reduction of drug abuse in the Philippines. The numerous activities and substantive achievements of non-governmental organizations in combating the problems of drug abuse are manifestations of their commitment to and involvement in an avowed partnership with the Government to promote care for young people and quality of life in general. The Dangerous Drugs Board, the Government's policy-making and co-ordinating body, has facilitated and encouraged the development of existing approaches and strategies and, in co-operation with non-governmental organizations, has made drug-abuse prevention programmes more viable and relevant. This co-operation strengthened agency relationships, encouraged resource-sharing and generated a more balanced approach towards programme planning and implementation. The various government services, in co-operation with non-governmental organizations, have adopted the models and strategies that are action-oriented activities, primarily intended to promote positive values, attitudes, self-development, creative productivity and skills of young people.
While cannabis consumption in Egypt has a centuries-long tradition, recent evidence on drug abuse shows new patterns and trends: young people from all socio-economic strata of society are increasingly involved with both traditional drugs, such as hashish, and the new pharmaceutical psychotropic substances that are emerging. A recent survey of the university students in Egypt, carried out by the author and others, showed that 34 per cent of the students who had succeeded in their studies and 42 per cent of those who had failed used drugs. In addition to the situation in Egypt, the article briefly reviews drug abuse among young people in some other Arab countries. To cope more effectively with the problems of drug abuse among the young, the author suggests that comprehensive community-based programmes need to be organized to improve the personal and social functioning of drug-dependent persons, to promote drug education and to increase understanding between younger and older generations. Epidemiological studies of the nature and extent of drug abuse, as well as evaluative studies of ongoing prevention and treatment programmes, need to be organized and carried out with a view to improving the effectiveness of drug abuse intervention among the young in the Arab countries.
The present article is an attempt to demonstrate that a broad-based approach to matters directly affecting children, with special emphasis on meeting their non-material and spiritual needs, can effectively contribute to drug abuse prevention, in particular, by promoting personal values that encourage constructive use of goods and time. The International Catholic Child Bureau (ICCB) has adopted its approach to drug abuse prevention, particularly in respect of "street children", and, through its vast network of experts and practitioners familiar with intercultural and interdenominational education, has implemented a number of projects in Africa, Europe and Latin America, primarily involving the use of therapeutic communities, workshops and "street educators". The religious dimension of the work of ICCB is particularly important because it highlights a fundamental aspect for youth of all cultures, i.e. integrated preparation for life as responsible members of the community. ICCB is of the view that it is imperative to provide children with possibilities for a life that is free of substance dependence, once they are able to make the right decisions.
The Pompidou Group, a co-operation group to combat drug abuse and illicit trafficking in drugs, has functioned at the Council of Europe since 1980 as a section of the Directorate of Economic and Social Affairs. Owing to its specific features, it is the only organization of its kind in Europe that deals with all areas of drug control, including the work of police and customs authorities, as well as work on prevention, treatment, rehabilitation, epidemiology and research. It also deals with fellowship programmes. The political and technical activities of the Pompidou Group are described in this article, illustrating how it operates in the area of combating drug abuse at the international level.
The World Assembly of Youth (WAY), a non-governmental organization promoting the cultural and economic advancement of youth, includes in its programme activities the prevention of youth substance abuse and assistance to the large number of youth currently using drugs. Recognizing that the problem stems from the user, WAY works to provide information and alternatives leading to a responsible decision on the part of youth regarding their consumption.
To overcome the blanket of secrecy developed by many drug-abusing populations, special strategies have been used to generate more reliable and valid data on the extent and nature of the problem. The epidemiological rationale for eight strategies to identify cases of drug abuse are reviewed along with their limitations and examples of their application. The choice of strategies in any given setting will depend upon the drug-use patterns and legal framework of the particular society, the form of social organization developed by drug abusers and the types of contact they have with formal institutions such as law enforcement and treatment agencies.
Monitoring systems are useful epidemiological instruments for assessing the problem of drug abuse. The rapid growth of the drug dependence problem in Malaysia led to increased awareness of the need for a system for continuous monitoring of the situation. Preliminary work on the design of an appropriate monitoring system was initiated in 1976. A fully integrated national reporting system was established in 1978, linking all public services and agencies coming into contact with drug-dependent persons, including law enforcement agencies, drug abuse treatment and rehabilitation centres, and social and welfare institutions. The information system included a mechanism for systematic gathering, processing, analysing and presenting essential data on the prevention, control and management of drug abuse problems. It also included reporting on drug-related events, such as hospitalizations and arrests, as well as data on known drug-dependent persons and new cases of dependence. The system has been used for routine monitoring of the extent, trends, patterns and other characteristics of drug abuse problems in Malaysia, providing basic information for policy-making and programme planning. On the basis of data generated by the system, it was estimated that the prevalence rate of drug-dependent persons per 100,000 population increased from 84.3 in 1976 to 754.6 in 1986. It was estimated that there were 119,001 drug-dependent persons in Malaysia in 1986.
The South American Agreement on Narcotic Drugs and Psychotropic Substances (ASEP), which entered into force on 26 March 1976, has enhanced co-operation between South American countries in the struggle against drug problems. This co-operation has promoted the regional responsibility and the use of regional resources in coping with the drug problem in South America and has helped to increase the regional support for international drug control initiatives. The established machinery and instruments within ASEP, which are designed to suit best the circumstances in South America, include the annual conference of States parties, the Permanent Secretariat, the regional centres, the technical advisory committees and other co-ordinated programmes and activities intended to reduce drug problems. Each of the five regional centres that have been or are being established focuses on one of the following subject areas: treatment and rehabilitation, preventive education, suppression of illicit drug trafficking, documentation, and customs techniques. With regard to the eradication of narcotic crops, ASEP considers the idea of integrated community development to be an appropriate approach to eradicating coca plantations in those areas where the growing of coca bush is part of the cultural tradition.
The Salvation Army has been involved in the control of drug abuse since it was founded over 120 years ago, when alcohol was the predominant concern. Today, alcohol is still the most commonly abused substance, but the Salvation Army is increasingly tackling other forms of substance abuse as well. High priority is given to prevention of all levels and by all means through a network of over 200 specialized rehabilitation centres throughout the world, in addition to programmes within hostels for the homeless, where there is a high proportion of alcohol and other substance abusers. The Salvation Army endeavours to help drug-dependent persons to abstain from using drugs and achieve a healthy and happy life. It is of the view that, as drug dependence is usually a manifestation of deeper needs, the spiritual component is vital in dealing with drug abuse of all types.
The authors recently completed a set of monographs on culture and drug use and abuse in a tribal district in Gujarat in western India where changes have occurred in alcohol consumption, two districts in Karnataka in south India where widespread use of cannabis is prevalent, six districts of Gujarat where extensive opium drinking is common, and also on the drug abuse situation in Goa, Delhi and Bombay. On the basis of those studies, the authors call for decentralized planning and a review of the Single Convention on Narcotic Drugs of 1961, and they critique some of the dominant practices in contemporary prevention and rehabilitation of addicts. The role of the family is examined as a socialization institution for transmittal of culture. The limits posed by patriarchy on the extent to which the family can be an agent of primary or secondary prevention of drug use and abuse are indicated.
A study of drug and substance abuse at Addis Ababa and in 24 towns across Ethiopia was conducted from June to November 1995. Five categories of respondents were selected for the study: street children, commercial sex workers and street vendors; medical, social and public health workers; law enforcement officials; leaders of religious institutions and educational establishments, youth leaders and personnel of non-governmental organizations providing social service to communities; and focus groups comprised of men and women from the various places covered in the study. All categories of respondents agreed that the problem of substance abuse was becoming increasingly serious in Ethiopia; that adolescents and young adults were the most affected group; and that addictive substances were easily obtainable in the country. The study also found that there was a significant increase in the number of Ethiopians chewing khat (Catha edulis). Khat, previously known to grow mainly in the eastern part of Ethiopia, was widely cultivated in all parts of the country. Khat consumption, traditionally confined to a certain segment of the population, had become popular among all segments of the population. Some of the respondents reported that khat-chewing often led to the abuse of illicit substances.
In a comparative study of a group of experimental and control subjects in Argentina, Brazil, Costa Rica, Japan, Jordan, Italy, Malaysia, Singapore and the United States of America (State of New York), and of the results of independent studies conducted in Sweden and the United Kingdom of Great Britain and Northern Ireland, a rather close association was found to exist between drug abuse, criminal behaviour and social attitudes to such problems. Both drug abuse and the socio-legal systems varied greatly in the countries involved. No correlation was found between the level of foreseen or actual harshness of the socio-legal system and the level of seriousness of drug abuse and its associated criminality, but there was a significant correlation between knowledge of the law and the efficacy of the socio-legal system. In each country informal control systems, such as the family, church, school, neighbourhood and work environment, were active. Approximately one half of the subjects that were interviewed from countries with the most punitive socio-legal systems perceived informal controls as harsh and punitive while in the other countries such controls were generally perceived as positive. The study encouraged the review, testing and implementation of alternative measures to penal sanctions, particularly with a view to creating a genuine therapeutic approach to correcting the deviant behaviour of drug abusers.
Recently, the abuse of ketum, an indigenous psychoactive plant, has received a lot of attention in Malaysia. To help national law enforcement agencies control its abuse, the laboratory of the Forensic Division has developed a procedure for its positive identification. Botanical identification may not be practical or conclusive, owing to the wide range of ketum materials available on the market, including dry macerated leaves, powdered leaves and drinks. In order to confirm that a substance is, in fact, ketum or that a preparation is derived from ketum, gas chromatography-mass spectrometry is used to definitively identify the presence of the psychoactive principle mnitragynine.
Interest in drug abuse has recently increased in Denmark and other Scandinavian countries, in particular with regard to certain aspects of the problem. This paper reviews the questions of voluntary versus compulsory treatment, the high death rate among young drug-dependent persons and the problems of the young drug-dependent woman and her child. Although it is difficult to predict future developments in drug abuse, the paper concludes that ways and means must be found to provide children and young people with a more meaningful life. This will mean tackling the social, economic and psychological situation of those at risk of becoming drug-dependent.
The effectiveness of Transcendental Meditation (TM) in the prevention and reduction of drug abuse has been documented in many studies in the last 18 years. The programme is not a rehabilitation programme per se but is a means for self-development. Thus, the resulting decrease in psychological problems and drug abuse is an automatic or secondary consequence of the practice of the meditation technique. Since TM strengthens the individual and produces an overall and stable state of well-being, it naturally removes the need and craving for drugs.
There has been an increasing availability and abuse of cocaine in Canada in recent years. Cocaine abuse has spread from the affluent adult sectors of society to middle-income groups and the young, involving large sections of the population. The increase in illicit demand for, and the social acceptability of, cocaine has led to an increase in illicit cocaine supply. The availability of cocaine on the illicit market has been sustained by a vast over-production of the raw materials needed to produce cocaine in coca-growing areas of South America and the activities of sophisticated trafficking organizations with large operations and profits. As a result, cocaine prices at the wholesale level in South America and Canada are declining, and at the retail level in Canada have remained relatively stable or have slightly decreased. It has been estimated that more than one half of the amount of cocaine on the illicit market in Canada was illegally produced in Colombia, but the main quantities of the raw materials used for such production originated in Bolivia and Peru. Cocaine is smuggled into Canada primarily by commercial air transport, arriving at the three principal ports of entry, namely Montreal, Toronto and Vancouver, from whence it is distributed to other parts of the country. As drug law enforcement efforts increase in one area, traffickers shift their illicit operations to other areas in an attempt to escape detection. Current evidence suggests that both the availability and abuse of cocaine in Canada are likely to increase in the coming years.
The State of Iowa in the United States of America faced a growing drug-related problem, with cocaine abuse increasing in the cities and cannabis availability spreading to rural areas. The State also experienced a concomitant rise in crime, particularly by juveniles, which was demonstrably linked to the prevalence of illicit drugs. To counter these problems, Governor Robert Ray convened a State-wide Crime Prevention Conference, provided help to communities in organizing drug abuse prevention programmes, proposed legislation to seize illegally gained assets and allocated additional funds to law-enforcement agencies for narcotics operations. The Governor's programme included, inter alia: (a) The establishment of a "crime stoppers" hot-line, providing a toll-free telephone number for citizens to report crime anonymously; (b) The outlawing of "look-alike" drugs, i.e. pills designed to look like controlled substances (usually amphetamines) but actually containing licit substances such as caffeine; (c) The outlawing of "turkey" substances, such as baking flour and detergent, which were not themselves illegal but which dealers sold as illegal substances to test whether a purchaser might be an undercover police officer; (d) The proposal for a criminal justice improvement fund to provide money to enhance State-wide law enforcement efforts.
Apart from cannabis abuse in northern and southern Africa and khat chewing in north-eastern Africa, the history of drug abuse in Africa is relatively short. The abuse of drugs in Africa is nevertheless escalating rapidly from cannabis abuse to the more dangerous drugs and from limited groups of drug users to a wider range of people abusing drugs. The most common and available drug of abuse is still cannabis, which is known to be a contributing factor to the occurrence of a schizophrenic-like psychosis. The trafficking in and abuse of cocaine and heroin are the most recent developments in some African countries that had had no previous experience with these drugs. Efforts should be made to design and implement drug abuse assessment programmes to determine the real magnitude and characteristics of the problem and to monitor its trends. A lack of funds and a shortage of adequately trained personnel have made it difficult to implement drug abuse control programmes. In addition to formal drug control involving the implementation of legislation, there is an informal system of drug abuse control operating through the family, church, school, neighbourhood and work environment, as well as healthy recreational activities. It is suggested that efforts in African countries should be directed towards strengthening not only the formal drug control system but also informal control in order to compensate for the insufficient funds and the shortage of personnel trained in implementing formal drug control measures. It is very likely that the drug problems in African countries will worsen in future unless more effective measures are implemented to arrest the current situation.
In central Anatolia (Turkey), there is a popular children's game in which various parts of plants are eaten. In 1982 and 1983, a study was carried out involving 76 children who ate psychoactive henbane plants (of the Hyoscyamus species) during such games. The study showed that the majority of the children (81.6 per cent) ate henbane plants during their games to experience pleasant sensations or to try the effects of the plants. As a consequence of these games, 20 children, or 26.3 per cent of those included in the study, were severely intoxicated and brought in for treatment: five children were in a comatose state and two died. The article points out that the abuse of henbane plants is a dangerous form of drug abuse because it is easy to obtain these plants, large quantities of which grow wild in Turkey, and because parents are not aware of the hazards involved in children's games in which such psychoactive plants are eaten.