Drug Abuse in the Global Village

Trends in Drug Abuse
Extent of Drug Abuse: Volatile solvents are reported to be the most prevalent drugs abused in Bolivia (about 3 per cent annually), followed by sedatives (2 per cent). Other drugs of concern are synthetic narcotic analgesics (annual prevalence 1 per cent), coca paste (0.2 per cent) and hallucinogens (0.08 per cent) (U.N. 1991).
A 1991 study on illicit drug use among school and university students shows volatile solvents to be the most abused drugs (3.6 per cent annually); abuse is more prevalent among university students (1.99 per cent) than school students (1.61 per cent) and women consume less than men for both school and university populations. According to the same study, other drugs abused include: cannabis (2.38 per cent), cocaine (1.66 per cent), sedatives (0.63 per cent) and hallucinogens (0.58 per cent) (CONAPRE 1991).
Abuser Characteristics: Registries of drug (and alcohol) abusers admitted to one treatment centre in 1986 indicate that 65 per cent of registered abusers (N=86) are 15-30 of age, 48 per cent are 15-25 of age, all males, 78 per cent live in La Paz, the capital, 67 per cent are employed and 12 per cent are unemployed, 5 per cent are students and 16 per cent are professionals (U.N. 1986).
According to a 1990 study conducted by the Bolivian Red Cross in La Paz, drug abusers tend to be male, between the ages of 17 and 25. Abusers of low socio-economic status are reported to abuse volatile solvents while those of high socio-economic status abuse cannabis and cocaine (CONAPRE 1991).
Abuse of sedatives is reported more prevalent among men (about 4 per cent) than women (about 3 per cent) and is more pronounced among those aged 35 and over (7 per cent) (U.N. 1992).
Regional Variations: The 1990 Bolivian Red Cross study among a population ranging from 10 to 45 years of age in five Bolivian cities indicates that the highest ever abuse prevalence is in Santa Cruz (13.40 per cent), followed by Riberalta (12.30 per cent) (table 1).

Table 1: Proportion of the Bolivian population, 10 to 45 years of age, abusing drugs, 1990.

CITY                                      EVER                      DAILY
                                                PREVALENCE      CONSUMPTION
                                                   %                           %
RIBERALTA                         12.30                       0.40
COCHABAMBA                 6.80                        0.70
TARIJA                                 3.80                        0.20
ORURO                                    7.00                       2.30
SANTA CRUZ                     13.40                       0.60
Source: Bolivian Red Cross 1990 quoted in CONAPRE 1991.

Trends: In the 1980-1990 period, there has been a reported increase in the abuse of illicit drugs. Both the annual and daily abuse increased (2 per cent and 1 per cent respectively) over approximately one decade (U.N. 1991).
There has been some increase in the abuse of heroin, synthetic narcotic analgesics, cocaine and coca paste, hallucinogens, sedatives and volatile solvents. The increase in abuse is attributed to migration from rural to urban centres, unemployment, and insufficient incomes to sustain the typically large Bolivian families. Drug abuse is also attributed to family disintegration and unemployment among non migrants (U.N. 1991).
Mode of Intake: Intravenous drug abuse is not significant in Bolivia (CMO 1991). Opium and coca paste tend to be smoked. Cocaine is both smoked and sniffed. Heroin is sniffed. Synthetic narcotic analgesics, hallucinogens and other sedatives are ingested and volatile solvents are inhaled (U.N. 1991).

Cost and Consequences of Abuse
The estimated monthly costs of treatment for drug abusers is US$ 500-1,000 in private settings, US$ 100-300 in public settings and US$ 100-500 in religious communities settings. There are two state centers, one in La Paz and another in Tarija, with an annual budget within the US$ 10,000-19,000 range. There is no health insurance to cover treatment and rehabilitation expenses (CMO 1991).

National Responses to Drug Abuse
National Strategy: Measures to reduce illicit demand are led by National Board on Drug Abuse Prevention, Treatment, Rehabilitation and Social Reinsertion (DINAPRE), Educational Campaign Against Drugs (CESE) and SEAMOS, a private sector organization (CMO 1991).  Prevention, treatment and rehabilitation programmes target the general population, as well as populations at risk such as street children (CMO 1991).
The 1988 Coca and Controlled Substance Law regulates production, distribution and commercialization of coca, as well as the sales of precursors, trafficking and consumption of controlled substances. In addition, it contains a plan for the gradual and progressive substitution of illegal coca cultivations (U.N. 1991).
Structure of National Drug Control Organs: The central government unit responsible for liaison and coordination of national drug control policy is the Consejo nacional contra el uso indebido y trבfico ilםcito de drogas (National Council against Drug Abuse and Illicit Drug Trafficking), an independent Government unit. The Council is presided by the President of the Republic and consists of the following member: Minister of External Affairs and Culture (Vice President of the Council) who acts as president in the absence of the president, the Minister of Interior, the Secretary of National Defense who acts as Secretary to the Council, the Minister of Land and Economic Development and the Minister of Human Development.

Actions Taken to Implement International Drug Control Treaties **
Treaty Adherence: Bolivia is party to the 1961 Single Convention on Narcotic Drugs as amended by the 1972 protocol, the Convention on Psychotropic Substances, 1971, the Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances and the 1988 Convention, which was ratified in 1990.

Measures Taken with Respect to Drug Control:

Laws and regulations: In July 1988, Law 1008 was enacted which sanctioned all forms of drug trafficking.
Licensing system for manufacture, trade and distribution: There is a licensing system. However, in 1988 it was reported that the system's effectiveness is low due to bureaucracy.

Control system:
(i) Prescription requirement: There is a prescription requirement for supply or dispensation of preparations containing narcotic drugs and psychotropic substances.
(ii) Warnings on packages: The law requires warnings on packages or accompanying leaflet information to safeguard the users of preparations containing narcotic drugs and psychotropic substances.
(iii) Control of non-treaty substances, if any: None reported.

Social Measures:
Penal sanctions related to social measures : In 1988, treatment, education, after-care, rehabilitation or social reintegration were not used by the court, neither as alternatives nor additions to sentencing.
Other social measures: None reported.

Demand Reduction Activities
Primary Prevention:
In the period of 1987-1991, drug prevention education targeted secondary schools students, teachers, mothers, and other youth. Teachers were trained in drug prevention education in selected regions and plans were in place to extend the training to teachers elsewhere. Similar training is given to doctors, psychologists, social workers, nurses, social therapists, health technicians and the police. Leisure activities for high school students were organized during 1990 as a drug prevention activity (CMO 1991).
Treatment and Rehabilitation: The Health Ministry and DINAPRE coordinate the supervision of treatment and rehabilitation centers to ensure operation according to set standards. DINAPRE has offices in major cities, where, in addition to coordination, it provides services such as preventive education, training, research on drug abuse, social development, inter-institutional coordination and communication (CMO 1991).
There are about 20 treatment centers in Bolivia, including psychiatric hospitals, general hospitals, specialized detoxification services and unspecified other services. There is no health insurance to cover treatment and rehabilitation expenses. However, people in need are entitled to free treatment upon approval by Social Services (CMO 1991).
 The reported total number of abusers who received treatment or rehabilitation services during the year of 1991 was about 4,200 men and 1,050 women. Most were abusers of cocaine and volatile solvents. The number of drug abusers who sought treatment for the first time the same year was 5,080, of which 4,050 were men and 1,030 women (see table 2)(CMO 1991).
Table 2: Number of abusers* who received or sought treatment and rehabilitation services, by sex, 1991.

Drug                       Abusers who                        Abusers
Category                received services who
                                                                                for the
                                                                                first time
                                men         women   men         women
Cocaine  2,000         500                        4,000       1,000
Cannabis                  200           50                             50            30
 solvents                2,000          500                      
Total                       4,200       1,050                       4,050       1,030
 * estimates only
Source: Reply to CMO, 1991.

Supply Reduction Activities
Arrests, Convictions and Types of Offenses:
In 1992, 1,226 persons were arrested for traffic or possession of illicit drugs (CICAD 1993).
Seizures: All significant seizures involved cocaine:  12 tonnes in 1990, 8.4 tonnes in 1991 and 10.1 tones in 1992. Cannabis seizures increased from 15.6 kg in 1990 to 85,650.5 kg in 1991.
Supply Source of Drugs: No information reported by 31st December 1993.

References and Notes

U.N. 1986, 1991, 1992. Replies to the UNDCP's annual reports questionnaires for the years 1986, 1991 and 1992.

CICAD (1993), First Report of the Inter-American Data Bank. Mimeo.

CMO 1991. Replies to UNDCP questionnaire concerning the seven targets of the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control.

CONAPRE (1991), El Uso Indebido de Drogas en Bolivia: Estudio Realizado en Poblacion Estudiantil Urbana, La Paz. Mimeo.

** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on the annual reports questionnaire for the year 1988 as well as a letter from a letter from the Permanent Mission of Bolivia dated 25 November 1993.