Drug Abuse in the Global Village
EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE
Extent of Drug Abuse
In general, opium poppy and cannabis derivatives are the most commonly abused drugs in Uzbekistan. Derivatives of opium poppy are more likely to be abused by drug dependent abusers seeking treatment than cannabis or any other drug. Drug abusers appear to favor concoctions derived from the bulb and upper stem of opium poppy through boiling, to produce a poppy tea ("koknar"). Alternatively, the concoction is mixed with acetic anhydride, among other chemicals to produce a crude heroin for injection ("chimka"). Raw opium is also converted to another injectable crude heroin ("Chanka"). Abuse of derivatives of opium poppy is more common in urban areas than in rural areas, where smoking and eating raw opium poppy is common for medicinal and traditional uses (Rensselaer 1993).
Abuse of prescription drugs such as tranquilizers, hypnotics, sedatives, narcotics analgesics, anti-Parkinsonian and anti epileptic drugs is reported. In spite of prescription requirements, these drugs are readily available in the illicit market. There are indications that prescription practices may be lax, or alternatively, over prescription is common. Abuse of morphine, polamidone and other opiates is reported (WHO 1992).
Abuse of volatile substances have been reported, especially among children of European background (WHO 1992).
Estimates of drug dependence rose from 12.3 per 100,000 in 1985 to about 20 in 1989 and 1990, declining to 19 per 1991 (Russian Research Institute in Rensselaer 1993). Further, first time users registration in narcological and psychiatric institutions increased from 0.7 per 100,000 in 1980 to 5.3 in 1987 and declined steadily through 1988 and 1989 to 3.3 in 1990 (Russian Narcology Institute in Rensselaer 1993).
The Ministry of Internal Affairs reports that the number of registered drug dependent abusers is considerably higher than the number of those registered (about 5,000 in 1993) (U.N. 1993).
Estimates provided in reports reviewed vary significantly depending on the reporting source. Selected data in this report are reported only for illustration and should be interpreted with caution. In general, information to assess the drug situation appears to be weak, especially after the break down of the USSR. Assistance in this area is needed (U.N. 1993, Rensselaer 1993, WHO 1992).
Opium tea ("koknar") is consumed by the elderly but it appears that it is contained by tradition and may be serving self medication purposes (among children too), and "rejuvenation" (WHO 1992; RPF 1995; UNDCP 1993). Cannabis abuse is pronounced among youth 15 to 25 years of age (WHO 1992).
According to Health Ministry sources, the high risk group for drug abuse are teenagers out of school, well-off students who are doing poorly in schools and children of drug abusers. Initiation to drug abuse occurs during the teenage years but drug dependence is pronounced mostly among the 20 to 30 years old age group (UNDCP 1993).
Cultivation of opium poppy and cannabis is widespread in all areas (U.N. 1993). Drug dependence is pronounced in Samarkand, Karakalpak and Tashkent and its surroundings (see table 1)
Selected Rates of Drug Dependence in Uzbekistan per 100,000, by Locality
National average 19.0
Above national average
Tashkent city 28.9
Tashkent area 19.6
Below national average 18.8
Sources: Ministry of Health, Uzbekistan. Cited in Rensselaer 1993.
Consumption of cannabis (“anasha”) is considered traditional. Abuse of heroin and stimulants is a new pattern. Increases in drug dependence have been attributed to opening of the borders and increased trafficking (U.N. 1993).
It is estimated that most drugs abused in the country and the Central Asia region are of local sources. Raw opium has been consumed traditionally. It is widely believed that it has “rejuvenating” effects. According to some reports, a significant increase in opium use occurred following restrictions on alcohol use imposed by the Soviets in 1985. Abuse of opiates and other drugs such as tranquilizers, ephedrone, antiparkinsonian drugs, LSD and cocaine among youth is rising. Drug injection is gaining significant grounds (RPF 1995). Much of the drug abuse among youth is attributed to unemployment and Western influence (UNDCP 1993).
Volatile substances abuse is decreasing, mostly due to the emigration of Europeans who were the main abusing group. Cannabis abuse appear to be stable except in selected towns, where its abuse is increasing (WHO 1992).
According to statistics cited above, it seems that drug dependence has peaked between 1987 and 1990 in Uzbekistan, like elsewhere in CIS countries, and began a to decline as of 1991 (Rensselaer 1993).
Mode of Intake
Raw opium is consumed orally by elderly and children. Raw and processed opium, serve as alternatives to heroin and are injected. Smoking of opium is not common (WHO 1992). Heroin, morphine are injected, while opium is injected and ingested. According to the chief narcologist, half of the drug abusers inject drugs (CPF 1995). Cannabis is smoked (U.N. 1993).
According to a WHO report, about 75% of the drug dependent abusers admitted to hospitals inject drugs, are promiscuous and are considered high risk in contracting HIV. Awareness as to the spread of HIV remains, however, low (WHO 1992).
COSTS AND CONSEQUENCES OF ABUSE
The costs of drug abuse are estimated to be “fairly high” and crime is rising . Increases in criminal behavior, family disruption, road accidents, disruption in the workplace and school and violence are attributed to drug abuse (U.N. 1993). Similar observations were reported by WHO (WHO 1992).
Volatile substances related brain damage has been reported among children. Toxic Psychosis and behavioral deterioration has been reported among cannabis abusers. Alcohol related problems appear to be more significant (an estimated 80% of detoxification related hospital beds (WHO 1992).
NATIONAL RESPONSES TO DRUG ABUSE
The government announced the creation of a drug control inter-ministerial coordinating committee in 1994, as well as a secretariat consisting of 6 experts, representing different ministries (CPF 1995).
LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**
Uzbekistan is party to the 1961 Convention (with effect from 23 September 1995) and the 1971 Convention (with effect from 10 October 1995). With respect to the 1988 Convention, it was reported that the necessary documentation for acceding to it was being prepared.
STRUCTURE OF NATIONAL DRUG CONTROL ORGANS
No data supplied.
MEASURES TAKEN WITH RESPECT TO DRUG CONTROL
Recently enacted laws and regulations
Licensing system for manufacture, trade and distribution
No data supplied.
No data supplied.
Penal Sanctions related to social measures
In 1993, courts applied measures of treatment, education, after-care, rehabilitation or social reintegration for a drug-related offence in addition to conviction or punishment.
Other social measures
Drug abusers are punished and receive compulsory treatment.
DEMAND REDUCTION ACTIVITIES
Despite the lack of an elaborate drug demand reduction strategy, there are adequate human resources and treatment facilities in Uzbekistan. Authorities appear to be motivated to develop a guiding policy and related programmes to reduce the demand for drugs. Nonetheless, the government requires the advice of experts in the development and implementation phases (WHO 1992).
Media, such as television and newspapers, are active in promoting drug prevention messages. The media, health professionals and government ministries collaborate in the promotion of drug prevention messages (U.N. 1993). Specialized literature, lectures and mass media programmes aim to increase the public’s awareness as to negative consequences of drug abuse (UNDCP 1993).
Educational programmes on prevention have been planned, in consultation with UNDCP. There are educational programmes on television (U.N. 1993). According to other sources, prevention activities are taking place in schools, vocational schools and high education institutions, among other places (UNDCP 1993).
Basic and further training courses are provided to doctors and law enforcement personnel, while further training courses are provided to social workers and teachers. A chair in university specializes in drug related training and treatment studies (U.N. 1993; UNDCP 1993).
Demand reduction activities are carried out in the workplace (U.N. 1993).
Professional organizations, religious groups and sports clubs are involved in the formulation and implementation of prevention programmes (U.N. 1993). However, community participation and NGO's involvement need to be developed and strengthened (WHO 1992).
Treatment and Rehabilitation
The Narcological Service established in 1976, is responsible for coordinating treatment programmes. Treatment is provided in emergency aid centres, among other places and includes detoxification therapy, general health‑restoring therapy, psychotherapy and symptomatic therapy. Both voluntary and compulsory treatments are provided. General medical care, detoxification, drug counseling and counseling on drug related diseases are available to drug dependent offenders (U.N. 1993). The treatment network consists of about 1700 beds and 300 specialists. There are indications that a crude early identification programme is in place (UNDCP 1993).
According to a WHO report, treatment facilities are well staffed and some of the medical staff are dedicated and offer very good services to clients in need. However, most medical staff requires some training exposure to similar services abroad (WHO 1992).
Most admissions to treatment facilities are based on self referrals. Over prescription during treatment is common and treatment tend to last up to a year. Alternative treatment methods are rare and exposure to community based treatment is needed (WHO 1992).
Rehabilitation includes the restoration of the drug dependent abuser’s social status and support to families of drug dependent abusers (U.N. 1993).
References and Notes
U.N. 1993. Replies to the UNDCP "Annual Reports Questionnaire" for the year 1993.
CPF 1995 UNDCP “Strategic Country Profile for Uzbekistan” for the year 1995.
Rensselaer W.L.III 1993 "Dimensions and Significance of the Central Asian Narcotics Trade" A Study prepared on contract for The National Council for Soviet and East European Research.
RPF 1995 “UNDCP Subregional Programme Framework 1995"
UNDCP 1993 Uzbekistan Mission report prepared by B. Kidwell September 1993
WHO 1992 Mission to the Central Asian Republics, Spring 1992
** 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 Part I for the year 1993.