ILLICIT DEMAND FOR DRUGS

World situation with regard to drug abuse

Report of the Secretariat

I. THE EXTENT AND PATTERNS OF DRUG ABUSE IN THE WORLD

A. Drug abuse by drug type

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5. CANNABIS-TYP DRUGS refer to cannabis products such as hashish and marijuana. The concentration of the active substance tetrahydrocannabinol (THC) varies widely, depending on the part of the plant used and where it is grown. Hashish refers to cannabis resin, while marijuana usually refers to the dried parts of the plant.

6. Cannabis is the most frequently reported drug of abuse, with all regions of the world reporting its abuse. Through the annual reports questionnaire data, an estimated 48.5 million abusers were reported by 73 countries. In terms of annual prevalence of cannabis abuse, Oceania was the subregion with the highest reported prevalence (Papua New Guinea 23.5 per cent, the Federated States of Micornesia 11.4 per cent and Australia 10.3 per cent) while east and south-east Asia had the lowest reported rates (Nepal 0.7 per cent, Maldives 0.2 per cent). The Netherlands stands out with a reported monthly prevalence of 4.4 per cent. Other high annual prevalance countries in Europe are Slovenia (4 per cent), Denmark (3.3 per cent), Switzerland (2.4 per cent), Croatia (1.9 per cent), Czech Republic (1.5 per cent), Germany (1.2 per cent) and Portugal (1 per cent). In the Middle East, Israel has reported high annual prevalence (1.5 per cent). (...)

7. OPIATE-TYPE DRUGS, according to the annual reports questionnaire classification, include opium, heroin, morphine, other opiates and synthetic narcotic analgesics, including pethidine, meperidine, methadone and fentanyl. Opiate-type drugs provide relief of pain, calm nerves, may reduce hunger pain and reduce nausea and vomiting, and may produce euphoria. The risk of contracting infections like hepatitis and human immunodeficiency virus (HIV) because of sharing of injecting equipment is well known. Opiate abuse may mask underlying medical problems such as inflammation and infections because of the analgesic effect of the drugs. Death can be caused by difficulty in breathing and cardiac arrest.

8. Opiate-type drugs were the second most frequently reported drugs of abuse, with 69 countries reporting 1.2 million abusers. It should be noted, however, that even though the number of reporting countries was comparatively high, several major opiate consumption countries did not provide any estimates of the number of abusers in their countries. It can therefore be assumed that the reported number of abusers represents a considerable underestimation of the real number of abusers in the world.

9. Most of the countries reporting opiate abuse also reported a steadily increasing trend. High rates of opiate abuse have been reported by all regions of the world except for the Caribbean. High prevalence of heroin abuse was reported by the United States of America (1.8 per cent), Brazil (1 per cent) and Portugal (0.6 per cent). As for other types of opiates, Bolivia reported an annual prevalence of abuse of synthetic narcotic analgesics amounting to 0.9 per cent, while the Lao People's Democratic Republic reported the same prevalence rates for annual and daily opium abuse.

10. SEDATIVE-TYPE DRUGS refer to barbiturates, benzodiazepines and other sedatives, for example, methaqualone. Barbiturate overdose may result in poisoning death. Benzodiazepines such as flunitrazepam (Rohypnol), diazepam (Valium) and chloridiazepoxide (Librium) are more popular than barbiturates.

11 Abuse of sedatives has been reported by 55 countries with an estimated 46.4 million abusers. Many countries reporting illicit consumption of sedatives reported a gradual stabilization of consumption. Among the countries reporting high annual prevalence are Brazil (25 per cent) and Papua New Guinea (22.9 per cent). Other high-prevalence countries are Honduras (7.6 per cent), Chile (5.5 per cent), Colombia (3.4 per cent), Ghana (3 per cent), Namibia (2 per cent), Bolivia (1.8 per cent), Mexico (1.3 per cent), Israel and United States (both 1 per cent). Denmark reported a daily prevalence of 2.7 per cent.

12. COCAINE-TYPE DRUGS refer to cocaine (base and salts) and coca paste. Cocaine is a stimulant to the central nervous system. It is also a local analgesic. It can be inhaled ("snorting"), but can also be injected or applied directly to a mucous membrane. Overdoses of cocaine can lead to convulsive fits, heart paralysis of hig fever.

13. Cocaine abuse was reported by 51 countries and the number of abusers estimated at 10.9 million. Cocaine consumption seems to be stabilizing. Countries reporting high annual prevalence were Argentina (4.4 per cent), Brazil (2 per cent) and the United States (1.7 per cent). There were no reports of cocaine abuse in south and central Asia, but seizures of cocaine have been reported in India.

14. AMPHETAMINE-TYPE DRUGS refer to amphetamine, methamphetamine ("ice") and other amphetamines. They are central nervous system stimulants and anorectics. They can be taken as tablets or capsules, be inhaled or injected. Over time, the suppression of the sensations of hunger and fatigue can lead to malnutrition and complete exhaustion and collapse, a cause of traffic accidents among truck and bus drivers who abuse these drugs. Methylenedioxymethamnphetamine (MDMA) ("ecstasy") has both a stimulant and a hallucinogenic effect.

15. The number of abusers of amphetamine-type drugs was estimated at 6 million from among 37 reporting countries, with Europe being the leading region, followed by the Americas. A majority of countries reported ingestion as the most frequent method of administration, followed by injection. Honduras (7.6 per cent), Brazil (2 per cent) and Australia (1.7 per cent) were the countries that, through the annual reports questionnaires, reported the highest annual prevalence rates.

16. HALLUCINOGENS such as lysergic acid diethylamide (LSD) may produce an altered state of consciousness with auditory and/or visual perceptions.

17. There were some 2.9 million hallucinogen abusers reported from 26 counries covering most regions except western Asia. The countries reporting high prevalence were Australia (1.3 per cent), Brazil and the United States (both just under 1 per cent).(...)

B. Drug abuse by injection

18. Injecting drug users (IDUs) are the second largest group at risk for HIV infection in the Americas and Europe. Injecting drug use practice is not limited to intravenous injecting, but also include intramuscular or subcutaneous injecting. The generic term "injecting drug use" has therefore been considered to reflect more accurately the actual practice and behaviour.

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20. Almost all the countries reporting injecting drug use also reported injection of opiate-type drugs (118 out of 121). Cocaine and amphetamine injecting was reported in Africa, east and south-east Asia, South America and eastern and western Europe. Injecting practices of amphetamine-type drugs were reported also in central Asia. Hallucinogen injection was reported in eastern Europe and South America.

21. According to the United Nations Joint and Co-sponsored Programme on HIV/AIDS (UNAIDS), about 5 to 10 per cent of HIV infections are the result of contamination through drug injection equipment. The exact extent of HIV infection among IDUs have been targeted for HIV testing, 72 per cent of the IDU population was found to be infected. For Ukraine, where the number of HIV cases rose from 183 in 1994 to 5,360 in May 1996, 70 per cent of the infected individuals were injecting drug abusers.

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25. Besides HIV/AIDS, hepatitis and tuberculosis are the most important infections among drug injecting users. The incidence of acute cases of hepatitis B (being some 10 times more infectious than HIV) has for long been considered to be an indirect indicator of the incidence of injecting drug use. More recently, the occurrence of hepatitis C among IDUs has attracted concern. Hepatitis C causes chronic hepatitis, cirrhosis and liver cancer. The hepatitis C virus has much in common with HIV. A person infected with hepatitis C becomes infectious for others, but it takes at least nine months before the infection can be confirmed by laboratory test. Screening tests have been developed but they are costly and are in practice not available in the particularly affected developing countries.

II. EMERGING PATTERNS AND TRENDS BY REGION

26. About 60 per cent of the countries that reported on trends in illicit consumption of drugs reported an increase or a large increase. Another 30 per cent reported a stable situation, while the remaining 10 per cent reported a decrease or a large decrease. Each drug shows a different pattern. Generally speaking, the abuse of amphetamines, cannabis and opiates seems to be on the increase, while the abuse of cocaine and hallucinogens is stable.

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A. AFRICA

28. Regular monitoring of the drug abuse situation is particularly uneven in Africa. Among the countries reporting, the main picture is that of an overall increase of drug abuse, with the possible exception of cocaine and hallucinogens, where the picture is more varied. (...)

29. Cannabis grows wild and is cultivated in many African countries. Ethiopia, Morocco and South Africa are major producers of cannabis and eastern and southern African seaports are frequently used for the trans-shipment of cannabis resin from Asia to Europe or North America. Cannabis is widely consumed in all subregions of Africa. (...)

30. The lack of effective control over the pharmaceutical supply system and the existence of illegal street markets at which pharmaceuticals are sold facilitate the availability of sychotropic substances. Both Chad and Kenya reported a large increase in the consumption of sedatives in 1995 while Morocco and South Africa reported some increase. (...)

31. Increase in illicit consumption of amphetamine was reported by Chad, Congo, Cote d'Ivoire, Nigeria and South Africa. South Africa reported injection of amphetamine-type drugs. Chad reported a large increase, reaching an annual illicit consumption level of 0.5 per cent in 1995.

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33. Heroin and raw and processed opium are transported from south-west and east and south-east Asia to African seaports and airports and on further to Europe and North America. (...)

34.(...) Illicit consumption of cocaine and crack was reported to be on the increase in Congo, Ghana, Morocco, Namibia, Nigeria and South Africa, while Chad reported a large decrease in cocaine consumption. South Africa reported the practice of cocaine injecting.

B. AMERICAS

35. In the Americas, the most salient pattern is the increase in the abuse of opiates, alongside a stabilization of cannabis abuse.(...)

38. Cocaine abuse continued to rise in Costa Rica, Ecuador, Honduras, Paraguay and United States, but was reported to be stable in Canada, the Dominican Republic and Panama, and even decreasing in the Bahamas, Belize, Colombia and Grenada. The practice of cocaine injection was reported in Argentina.

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C. ASIA

41. The overall trend in Asia is an increase in the abuse of all drugs but cocaine and hallucinogens. The increase is particularly evident with regard to opiate-type drugs and sedatives, even though the prevalence figures for the latter are comparatively low. Pharmaceutical preparations containing narcotic drugs or psychotropic substances are still widely availabl throughout Asia without a medical prescription. (...)

42. Illicit cultivation of cannabis and opium poppy, opium production, heroin manufacturing and large-scale illicit trafficking in opiates constitute the major drug problem in Asia. Asia remains the major suplier of illicit opium, accounting for approximately 95 per cent of global production. (...)

Heroin injecting practices have been reported in their annual reports questionnaires by India, Indonesia, Malaysia, Philippines, Sri Lanka and Uzbekistan. Half of the countries reporting drug use also reported HIV infection among the injecting drug abusers.

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D. EUROPE

46. The rapid transition in central and eastern Europe, States members of CIS and the Baltic States has contributed to an increase in drug abuse in the region. The dominant trends in Europe are increases in the abuse of amphetamines (including MDMA) and hallucinogens, followed by cannabis, cocaine and opiates. (...)

47. In western Europe, abuse of amphetamines continues. The fastest growth rates are reported for MDMA. The countries most affected are the United Kingdom of Great Britain and Northern Ireland and Denmark (0.6 per cent annual prevalence), followed by the Benelux countries, Sweden (0.2 per cent) and Germany (0.1 per cent). Large increases in the abuse of amphetamines have been reported by Belgium, Germany, Iceland, Liechtenstein, Lithuania and Monaco. Another synthetic designer drug, sodium oxidate (gamma-hydroxybutyrate (GHB), also konown as "liquid X" or "fantasy") is beginning to show in Europe. Large increases in cannabis abuse were reported in 1995 by Belarus, Belgium, Lithuania and the Republic of Moldova.

48. Heroin injecting was reported on the annual reports questionnaire by Belarus, Belgium, Czech Republic, Denmark, France, Italy, Liechtenstein, Luxembourg, Norway, Portugal and Switzerland. Cocaine injecting was reported in Czech Republic, France, Liechtenstein, Luxembourg and Switzerland. Injecting of amphetamine-type drugs was reported by Belarus, Belgium, Czech Republic, France, Lithuania, Luxembourg, Republic of Moldova, Russian Federation, Sweden and Switzerland.

E. NEAR AND MIDDLE EAST

49. The drug abuse reporting was very sketchy in this region. It seems that opiates and non-opiate sedatives are the two major types of drugs abused in the region, followed by cannabis and cocaine. Both opiates and sedatives were reported to be on the increase. (...)

50. Heroin abuse was reported by Islamic Republic of Iran, Iraq, Jordan, Oman, Syrian Arab Republic and United Arab Emirates. (...)

51. Incrase in cocaine abuse was reported in Israel, the Syrian Arab Republic and Turkey. No increase in the illicit consumption of amphetamine was reported.

F. OCEANIA

52. The most frequently reported drug consumed in this subregion is cannabis. (...)

53. The Federated States of Micronesia, Papua New Guinea, Fiji and New Zealand reported increasing cannabis consumption. The annual consumption prevalence was estimated at 10.3 per cent in Australia, 11.4 per cent in the federated States of Micornesia and 23.5 per cent in Papua New Guinea. (...)

54. In Austalia, amphetamine continues to be the most commonly used illicit drug after cannabis. Ecstasy has been reported to be popular among those involved in the "rave" scene.

55. Australia is the only country in the region that reported abuse of opiate-type drugs. However, the geographical location of Oceania as a drug transit point between producers in Asia and markets in the Americas creates a vulnerable situation.

III. YOUNG PEOPLE AND DRUG ABUSE

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57. Drug abuse by young people seems to be on the increase in most parts of the world. An increase in cannabis abuse has been reported by many countries in Europe. For example, the United States reported an upward trend in marijuana use among 11th and 12th-grade students between 1992 and 1995 and a doubled prevalence among 8th-grade students during the same period. While it is difficult to obtain actual numbers, Governments in Africa and in Oceania have reported that in addition to the traditional consumption of cannabis by older persons there is increasing abuse among younger persons.

58. Opiate-type drug abuse is growing in almost all regions of the world, particularly in Europe and in North Amrica.

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61. Furthermore, there are indications that the initiation into drug abuse is more frequently taking place at an earlier age than before. (...)

In the United States, almost two thirds of the LSD abusers seeking treatment in 1995 were under the age of 20.