|The Asian Harm Reduction Network (UNAIDS, 2001, 48 p.)|
For more than a century, Asia has experienced drug-use problems in the form of largescale epidemics with devastating effects on its countries. Such epidemics caused social disintegration, civil unrest, and serious public health problems; exacerbated poverty and problems related to poverty; caused enormous direct and indirect economic costs; and impeded social and economic development. The drug trade, a multibillion dollar operation, has caused wars and abetted them financially; it continues to be a financial resource used by guerrilla armies for purchasing arms. Governments have undertaken strenuous measures to reduce drug-use problems; despite all efforts, however, drug use is not under control.
To date, the production of opiates has been reduced significantly in a number of areas. Trafficking and consumption, however, remain issues of serious concern. Over the past several years, an increasing trend from opium to heroin use has been observed in many countries. Codeine and other narcotic and psychotropic substances are also being used at a significant level, including buprenorphine products Tidigesic or Temgesic, Phensedyl, diazepam and nitrazepam. These substances are either produced in clandestine laboratories and distributed to the drug-user markets or produced legally by large pharmaceutical industries and diverted from there to illegal markets. Smoking or chasing the dragon continues to be the main route of heroin administration, though the use of injections is increasing all through the region. The trend towards injection seems to be related to the reduced availability and purity of heroin.
Figure 1: Prevalence of opiate use, selected countries
Source: Based on UNDP, Global illicit drug trends 2000, New York, 2000
Many countries in the region are currently experiencing an epidemic abuse of amphetamine-type stimulant (ATS), particularly of methamphetamine. Virtually all countries in South-East Asia are now affected to some extend. Data indicate that ATS use is generally higher among young adult males, although it is a continuing problem among special occupational groups such as truck drivers, fishermen, and construction workers. Commercial sex workers have also been identified as a high-risk group related to ATS. Because all these groups have a high degree of mobility, they are hard to reach through traditional prevention and treatment services.
In addition to the use of narcotics and psychotropic substances, endemic levels of inhalant use exist in many Asian countries. Such usage is particularly associated with street children living in impoverished, harsh conditions. Many countries have identified inhalant use as a significant drug issue in their cities. The use of cannabis in its various preparations also continues to be widespread in most countries of the region.