Bulletin on narcotics最新文献

A country-wide needs assessment study undertaken in 1994 by the Government of Kenya and the United Nations International Drug Control Programme (UNDCP) revealed that drug abuse has permeated all strata of Kenyan society, youth and young adults being the most affected groups. The traditional cultural values and discipline of African society prescribed the circumstances under which drugs and intoxicants could be obtained, used and consumed. Perhaps as a result of the erosion of the powers of censure and control at the family and community levels, fewer stigmas are associated today with the use of intoxicants (especially alcohol and tobacco). One of the main recommendations of the study is that the Government of Kenya should set up specific demand reduction programmes to enlighten and educate the public on the problem of drug abuse. The need for a reassessment of government policy on the treatment of addicts is stressed, and it is suggested that the establishment of non-stigmatizing treatment and rehabilitation centres should be considered. Intersectoral collaboration between different government departments and non-governmental organizations is also proposed.

This paper describes a rapid assessment of the drug-injecting situation in Viet Nam. The study, which was carried out over a five-week period during October and November 1993, focused on the cities of Hanoi and Ho Chi Minh City. A multi-indicator inductive methodology was adopted that mixed qualitative and quantitative measures. As only limited background epidemiologic and official statistics were available, the study involved the generation of original data, through, for example, the construction of "cognitive maps" describing broad patterns of drug use, semi-structured interviews (for the collection of baseline data), focus groups, in-depth interviews and ethnographic observations. The study revealed that the injection of "blackwater" opium proliferated, often in combination with a range of pharmaceutical preparations. High-risk injecting practices were common at both Hanoi and Ho Chi Minh City, drug scenes and congregation sites being more public and visible at Ho Chi Minh City. The implications for policy and practice are discussed, emphasis being placed on the need for outreach and peer intervention.

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.

A rapid assessment of drug abuse in Nepal was conducted at different sites, including eight municipalities in the five development regions of the country. To interview various groups of key informants, such methods as semi-structured interviews, in-depth interviews and focus group discussions were used. A snowball sampling strategy for respondents who were drug abusers and a judgemental sampling strategy for the non-drug-using key informants were applied. About one fifth of the sample was recruited from the treatment centres and the rest from the community. Drug abusers in prison were interviewed, and secondary data from treatment centres and prisons analysed. The study revealed that the sample of drug abusers had a mean age of 23.8 years and was overwhelmingly male. Most respondents lived with their families and were either unemployed or students. About 30 per cent of the sample was married. A large majority of the sample had a family member or a close relative outside the immediate family who smoked or drank alcohol and a friend who smoked, drank or used illicit drugs. Apart from tobacco and alcohol, the major drugs of abuse were cannabis, codeine-containing cough syrup, nitrazepam tablets, buprenor-phine injections and heroin (usually smoked, rarely injected). The commonest sources of drugs were other drug-using friends, cross-border supplies from India or medicine shops. The commonest source of drug money was the family. There has been a clear trend towards the injection of buprenorphine by abusers who smoke heroin or drink codeine cough syrup. The reasons cited for switching to injections were the unavailability and rising cost of non-injectable drugs and the easy availability and relative cheapness of injectables. About a half of the injecting drug users (IDUs) commonly reported sharing injecting equipment inadequately cleaned with water. Over a half of IDUs reported visiting needle-exchange programmes at two of the study sites where such programmes were available. Infection by the human immunodeficiency virus (HIV) appears to be low among IDUs, although systematic surveillance is absent. Two thirds of the sample had experienced sexual intercourse. The last sex partners reported by respondents were commercial sex workers, wives or girl friends. Condom use was low with primary partners and relatively high with sex workers. Treatment facilities, mostly located in the central urban areas of the country, are meagre. An overwhelming majority of drug abusers felt the need to stop abusing drugs. Cost-effective drug treatment and HIV prevention programmes for IDUs are urgently needed in all areas of the country.

This article reports on a rapid assessment conducted in the Czech Republic during the second half of 1995. The main aim of the assessment was to describe patterns of illicit drug use, particularly in the capital, Prague. A Rapid Assessment Board was established to oversee the study, and both secondary and original data were collected from a range of sources. Illicit drug use was found to have increased throughout the country in the preceding five years, with amphetamines being the most popular substance. Polydrug use is common. There has been an increase in the use of the so-called "dance drugs", especially lysergic acid diethylamide (LSD), among younger people, and heroin, especially in the main urban areas. Injecting is on the increase, too. There is an urgent need to expand both fixed-site and community-based services.

The present paper describes a rapid assessment carried out in 1996 at Santa Cruz de la Sierra, Bolivia, with a view to defining the sociocultural groups at risk and gaining insight, through the comments of those interviewed, into their perceptions of the phenomenon of drug abuse, their reasons for abusing drugs, the drugs most frequently abused and the psychological and social factors involved when they enter, remain in and finally leave drug-abusing circles. By using qualitative methodology and techniques it was possible to gain access to the typical world inhabited by the interviewees, and thus to characterize the subjects of the study in the light of their closest social reference points (family, peer group, education and work). Among the conclusions of the study are the following: drug abuse is a complex and dynamic phenomenon that has occurred throughout the society of Santa Cruz, fostered by cultural and economic factors; there is a need for society, and especially the Government, to devise a specific, focused and diversified range of services, both in prevention and in rehabilitation, with integration and participation being key features of such initiatives; and the mechanisms for controlling the production of drugs and drug trafficking need to be strengthened.

Current evidence reveals a continuing upward trend in the misuse of illicit drugs in Slovenia. However, the science of estimating the prevalence of drug abuse and related problems is still undeveloped. Because of current data gathering practices, the data that are available are often of poor quality. In this paper the author describes two methods for estimating the prevalence of heroin abuse, the key informant approach and the nomination technique, which were used because there were no other reliable sources of information. These methods produced estimates and brought to light a number of problems that researchers would have to solve in their pursuit of more reliable, relevant and useful data. However, speculating about the extent of illicit drug use in the country is still problematic. Basic data collection and analyses at the national level must be improved. It is of vital importance to develop strategies and methods for obtaining estimates and thus more adequate information on which to base demand reduction strategies, to increase the number of epidemiologists and to establish a central information unit in the country.

Crime prevention is usually given a lower priority and underestimated as an area of policing. Detection and seizures attract priority and headlines, not the prevention of delinquency and breach of peace, which have all the potential of violent crime. Policing is for people: therefore, people must be made partners in policing. Once that goal is achieved, the whole system becomes transparent and accountable. Resources that cannot come from the police or Government alone come from participative policing. The present article describes a unique and innovative programme in substance abuse management by a combined initiative of community and police officials, which led to the establishment of the Navjyoti Delhi Police Foundation for Correction, De-Addiction and Rehabilitation.

The abuse of alcohol and other drugs presents a multiplicity of problems for the abuser, family members and the wider community. The psychosocial, as well as the economic, problems can produce an environment of chaos and misery. Women in families in which there is an abuser are challenged in a variety of ways and, depending on the severity of the situation and their capacity to cope, they may confront the problem, seek help of withdraw from it. The present article reviews the impact of drug abuse within the family on Jamaican women from the viewpoint of treatment and rehabilitation specialists and the women themselves and on the basis of case histories and the work experience of the author. Although there have been efforts through demand reduction strategies and culturally relevant treatment and rehabilitation programmes to control the epidemic of drug abuse, the specific needs of women have been left largely unattended. Both men and women are however critical in the fight against drug abuse and women have the skills and experience that can contribute to making such programmes achieve their desired objectives. Addressing their needs would not only help them, but also the family and the wider community. In order to address these needs effectively with the limited resources available, however, a credible basis for action has to be established, which can only be done by research and analysis so that the issues can be clearly defined and a plan of action developed.