Drug Abuse in the Global Village
Drug Abuse in Asia
Nepal

EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE

Extent of Drug Abuse

In 1993, the number of persons abusing drugs other than alcohol, tobacco and cannabis was estimated at 25,000 (Nepal 1993). Heroin is reported as the most abused illicit drug. Opium is reported as an important drug of abuse along with cannabis (U.N. 1990) which has long been accepted as part of the local culture (ESCAP 1993), but no information regarding the prevalence or extent of abuse of cannabis is reported. Other reported drugs abused are benzodiazepines, codeine based cough syrups, codeine tablets, amphetamines and methaqualone (Nepal 1993).

No national surveys on the prevalence of drug abuse have been carried out in Nepal, nor has a drug abuse registry been kept. The Government of Nepal has expressed the need for a national survey on alcohol and drug abuse (Nepal 1993).

A number of small scale studies have been undertaken providing some insight into the alcohol and drug abuse situation in Nepal. Results of a school survey carried out in Kathmandu (including Lalitpur) in 1992 (sample size 6,218) showed lifetime prevalence of 29.4 per cent for tobacco, 22 per cent for alcohol, 6.1 per cent for cannabis, 4.5 per cent for codeine based cough syrups, 3.3 per cent for tranquilizers, 2.5 per cent for amphetamines, 2.5 per cent for opium and 2.5 per cent for heroin (Nepal 1993).

Abuser Characteristics

The majority of drug addicts in treatment centres are males (94.5 per cent in 1986) (Nepal 1993).

Small scale studies have shown that 90 per cent of drug addicts were between 15 and 30 years old and the majority (90 per cent) had started taking drugs before the age of 25 (Nepal 1993). According to a school survey, the mean age of initial drug abuse including tobacco and alcohol is between 14 (tobacco) and 16 (heroin) years. Cannabis is reported abused by persons in the 14 to 40 age range, heroin in the 15 to 30 age group, opium in the 20 to 45 age range and psychotropic substances between 14 and 38 years old (U.N. 1990).

Drug abusers are reported to come from all social classes. Unemployment and low income are reported to have some correlation with drug abuse (CMO 1991).

Regional Variations

Drug abuse is reported mainly in urban areas, but cannabis abuse is also reported, to a limited extent, in rural areas (U.N. 1990). Among the estimated 25,000 drug dependents (excluding tobacco, alcohol and cannabis abusers), 13,000 are reported to live in the Kathmandu valley (Nepal 1993).

Trends

The estimated number of abusers of drugs other than alcohol, tobacco and cannabis has increased from 50 in the late 1960s to 25,000 in 1993 (ESCAP 1993).

Mode of intake

In 1989, 37 per cent of a surveyed sample of heroin abusers reported injecting the drug. Heroin injecting, reported previously rare, is on the increase (Nepal 1993). In 1990, cannabis was reported smoked, cocaine smoked and sniffed, and psychotropic substances taken by mouth and injected (U.N. 1990). An increase in the intravenous route of administration is reported for 1993 (Nepal 1993).

COSTS AND CONSEQUENCES OF ABUSE

By the end of 1992, a total of 72,000 persons were tested for HIV infection, of which 612 were drug abusers. No intravenous drug abuser had been found HIV positive. But 5 cases of HIV positive drug abusers have been reported where the mode of transmission is believed to be sexual (Nepal 1993a).

ACTION TAKEN TO IMPLEMENT INTERNATIONAL DRUG CONTROL TREATIES*

Treaty adherence

Nepal is party to the 1961 Single Convention on Narcotic Drugs as amended by the 1972 Protocol and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

NATIONAL RESPONSES TO DRUG ABUSE

National Strategy

The Narcotic Drugs Control Section of the Ministry of Home is the national drug abuse control unit. A National Coordination Committee was appointed in 1991 to oversee policies and plans in the drug control field. The Committee is composed of, inter alia, representatives from the Health, Education, Finance, Law and Justice, Labour and Social Welfare, Communication and Foreign Affairs ministries (Masterplan 1992). The Master Plan for Drug Abuse Control (1992-1997) was launched in 1992 and encompasses both law enforcement and demand reduction sectors. Demand reduction activities are carried out by the Ministry of Health, and law enforcement by the Home Ministry (Nepal 1993).

The effectiveness as well as collection of drug related data by the Narcotic Drugs Control Section is reported limited by the lack of funds, trained personnel and equipment (CMO 1991).

DEMAND REDUCTION ACTIVITIES

Primary Prevention

Some non-governmental organizations (NGOs) have organized awareness raising and educational activities in schools and colleges, especially in urban areas. Drug education is reported in 1993 to have been introduced in the school curriculum (Nepal 1993a). Efforts are reported to have been made to raise public awareness on drug abuse matters through the mass media. However, it is reported that these preventive messages are not taken seriously because they are based on a "scare model" (Nepal 1993a). Governmental as well as non-governmental organizations have developed leaflets giving information on the harmful consequences of drug abuse (CMO 1991). In 1993, work places and health care services are reported not used significantly to convey drug abuse preventive messages (Nepal 1993a).

A small scale school survey in 1988 showed that about 95 per cent reported having heard or seen anti-drug messages. The most reported source of anti drug messages was the radio (83 per cent), followed by television (75 per cent) and newspapers (64 per cent). Two thirds of the respondents reported that anti-drug messages had brought positive changes, and 6 per cent reported that it had adversely affected them. More than a quarter reported that the risks related to drug abuse were exaggerated (Nepal 1993).

Needle exchange programmes were not reported despite the rise in intravenous drug abuse in 1993  (Nepal 1993a).

Treatment and Rehabilitation

The existence of a separate specialized centre for the treatment of alcohol or drug addicts is not reported. Treatment for addicts is carried out in the psychiatric hospital, a general hospital and the St. Xavier Social Services Centre which is run by an NGO. The Drug Abuse Prevention Association of Nepal (DAPAN) had run (from 1989 to 1992) a 20 bed treatment centre in Kathmandu, which was closed down due to lack of funds. Generally, only the addicts for whom community based treatment has failed are admitted to the psychiatric hospital (Nepal 1993a).

Acupuncture is used for detoxification by one centre since 1986 and is reported as more successful and cheaper than the previous method using neuroleptic drugs, and is said to provide more relief from withdrawal symptoms (Nepal 1993a).

It is reported that since rehabilitation services are virtually absent in the country, more than 90 per cent of the detoxified addicts relapse within 3 months of treatment. Only one rehabilitation centre is reported in operation (Freedom Centre). Services provided include individual counselling, group dynamics, job placements and family meetings. The cost of these services to the ex-addicts is small as most expenses are borne by the centre itself. Methadone maintenance is reported being considered as a treatment modality (Nepal 1993a).

SUPPLY REDUCTION ACTIVITIES

Arrests, Convictions and types of Offences

Results of small scale studies have shown that violent crimes by drug addicts are rare. Eighty four per cent of those surveyed are reported not to have committed crimes after becoming addicts (Nepal 1993).

The number of persons arrested for drug related offences has increased from 312 in 1990 to 529 in 1992. The majority of those arrested are male Nepalese (395 in 1992). The number of foreigners arrested has increased from none in 1990 to 100 in 1992 (HONLEA 1993).

Seizures

Drugs reported seized in 1992 were 2.1 tonnes of herbal cannabis, 968 kg of cannabis resin, 21.395 kg of heroin and 737 grams of opium (HONLEA 1993).

Supply Sources of Drugs

Cannabis is reported to grow wild in the hilly areas of the country or illicitly cultivated in small plots in the plains. Heroin (brown sugar) is reported smuggled across the open borders with neighbouring countries. Nepal is reported used as a transit country for heroin (white heroin) from Thailand destined for a third country. Psychotropic substances and other abused medical preparations are reported to be legally imported into Nepal, mainly from India, but reach the illicit market due to inefficient control mechanisms (HONLEA 1993).

References and notes

* 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 Annual Reports Questionnaires for the years .... (not yet received from CND)

Reference for general background......

U.N. 1990. Reply to the UNDCP Annual Reports Questionnaire for the year 1990.

CMO 1991. Reply to the Questionnaire concerning the seven targets of the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control (CMO) for the year 1991.

Nepal 1993. Country paper of Nepal presented at the Workshop of National Focal Points on Drug Abuse Demand Reduction: Golden Crescent Countries. Bangkok, Thailand, 16-20 August 1993.

ESCAP 1993. The Drug abuse situation in Asia and the Pacific. Senior Officials Meeting on Strengthening of the Regional Network of National Focal Points on Drug Abuse Demand Reduction. Bangkok, 1-4 February 1993.

Nepal 1993a. Paper presented to the Senior Officials Meeting on Strengthening of the Regional Network of National Focal Points on Drug Abuse Demand Reduction. Bangkok, 1-4 February 1993.

Masterplan 1992. Masterplan for Drug Abuse Control in Nepal, The Sector Plans. The Ministry of Home in cooperation with UNDCP, 1992.