Drug Abuse in the Global Village and Related Control Measures in 1993

                                                      Drug abuse: extent, patterns and trends

                                                                         CONTENTS

                                                                                                Paragraphs                   Page

Chapter

            INTRODUCTION ..................................................               1                       2

I.          PATTERNS AND TRENDS IN REPORTING ON ISSUES             
            RELATED TO DRUG ABUSE .................................             2 - 9                   2

II.         OVERVIEW OF WORLD PATTERNS AND TRENDS IN                             
            DRUG ABUSE BY REGION ....................................             10 - 69             6

                                                                             Annexes

I           A Global Survey of the Annual Count of Cocaine, Cannabis
            and Heroin Abusers by Year and Country, 1985-1991..............                       16
           
II          Figures Given by Countries for Annual Count, Daily Abusers and
            Registered Abusers of Cannabis, Cocaine and Heroin.............

                                                                  INTRODUCTION

    I.  PATTERNS AND TRENDS IN REPORTING ON ISSUES RELATED TO DRUG ABUSE
 
2.         Any analysis of the world-wide extent, pattern and trends of drug  abuse is limited not only by the number of responses from Govern­ments but also by the quality of information provided. Since 1983, only 13 Governments have been able to respond every year to Part B of the Annual Reports Questionnaire and 26 countries have responded eight out of the last nine years.  Twenty-five Parties to the Single Convention have not responded at all. (See figure I and annex I for more details).
3.         As mentioned above, only 40 countries had responded to the 1991 questionnaire by 15  January 1993.  The response rate is normally higher, ranging from 81 in 1990 to 115 in 1983. Although the response rate has declined recently, there is a clear indication that it could be higher. Furthermore, in recent years many countries have failed to respond in a timely fashion, thus pinpointing the need to review survey and reporting procedures. (See Table 1 and annex I for more details).

               Table 1.  Year of Reporting to Annual Reports Questionnaire (Part B) by Number
                                                          of Countries which Reported.

            * Latvia, Moldova, Namibia and the Russian Federation reported for the first time in 1991. Includes only reports received by January 1993.
   
4.         The quality of information provided by Governments did not meet data collection objectives.  Firstly, the quality of data is influenced by high response variability which fluctuates significantly from region to region. European countries report most frequently with 44% in 1991, followed by the Asia and the Pacific 20%, Near and Middle East 18%, Africa 13% and finally the Americas with 11%. This regional response rate follows the pattern of previous years. (See Table 2 and annex I for more details)

       Table 2.  Response to Annual Reports Questionnaire expressed in Percentages by Regions
                                                                for the period 1983-91

5.         Response variability is further affected by inconsistent reporting within each region. For example, two thirds of the African and American countries responded to the questionnaire five times or less. In addition,  partial completion of the questionnaire was very common, thus reducing the specific item response rate significantly.  Secondly, Government access to data varies depending on the state  of research in each country. In 1991, national registers were available in 21 of the 40 responding countries, survey data in 18, qualitative studies in ten, attitude studies in 14 and cost and consequences studies in one. (See table 3)

                                Table 3. Global survey of type of information by region, 1991

Since 1985, there has been a steady increase in the numbers of registries of known drug abusers as indicated in figure II.

6.         In response to the Annual Reports Questionnaire, 21 of the 40 Gov­ernments have expressed a clear desire to set up monitoring and information systems.  However, in order to do so, ten Governments have indicated that they need financial help; 11 require professional support in training; nine need help with equipment, and 15 Governments require assistance in the legal, expert, technical and manpower fields (see table 4).

                      Table 4. Global survey of number of Countries requesting assistance and
                                                      type of assistance by region, 1991

            * All formerly part of the USSR or Eastern Europe.

7.         Annual counts for cannabis, cocaine and heroin abuse are reported in the annex I. Governments used a variety of sources (e.g. health and police records, surveys, a combination of all three of these as well as estimates of an unspecified nature) to report on the number of drug abusers in their respective countries. Additionally, there has been inconsistency in reporting since this survey was begun in 1985.  Consequently, the data presented here is subject to high response variability and the findings must be interpreted with caution. Furthermore, although the Annual Reports Questionnaire specifically requests figures for annual and daily counts and registered abusers for each drug type, many countries only complete one or two of these categories or provide figures which cannot be used for statistical purposes.  Given all of the above, it is not possible to advance valid summary statistics in this report and all findings should be considered as rough indicators.

8.         To conclude, although the response rate to the Annual Reports Questionnaire was relatively low in 1991, it is evident from past experience that a better rate could be achieved. For this purpose the questionnaire and reporting procedures will need to be reexamined in coming years. The main concerns, however, will remain the consistency of reporting and its quality. Much work needs to be done to boost timely reporting, to increase the consistency of reports from year to year and to better the quality of the questionnaire and the responses to it.

9.         It is imperative to review systematically the state of research and related data collection in all countries which are Parties to the international drug control treaties. Such a review is essential to establish guidelines for basic international reporting and efficient planning of incremental and realistic objectives. This approach  should take into consideration special concerns with new and locally known illicit which do not fall under international control, as well as  special constraints due to limited resources and differing priorities relating to monitoring of the drug problem.  Overall, countries have demonstrated willingness to set up drug monitoring systems but many have indicated that they need assistance to do so.

     II.  OVERVIEW OF WORLD PATTERNS AND TRENDS IN DRUG ABUSE BY REGION

10.       Governments were asked to assess trends in the consumption of selected illicit drugs in their countries. They were asked to identify drugs causing particular concern and to indicate whether consumption was on the increase, remained stable or was decreasing.  The data are presented in table 5 but are subject to significantly high sampling variability and should be interpreted with caution. Only a rough indication of recent changes in world-wide consumption of selected illicit drugs is intended. Subsequent revisions of the same data, once responses from other countries are received, may lead to significant changes in the current findings.

11.       The results in Table 5 indicate that increased consumption of heroin was of concern to seven countries while abuse remained stable in four and decreased in one. Increased concern was noted particularly in Africa, where three countries commented on heroin abuse, followed by Europe with two and one country each in the Asia and the Pacific and the Near and Middle East regions. Concern about amphetamine consumption increased in three countries while abuse is estimated to be stable in one and to have decreased in three. Of note is a decrease in concern over the abuse of cannabis by nine reporting countries while six considered consumption stable and two indicated an increase.

                          Table 5.  Change in global consumption of selected illicit drugs, 1991

Annual counts of abusers

12.       It is important to note that "annual counts of abusers" are a good indicator of the scope of drug abuse but not necessarily drug dependence requiring treatment and rehabilitation.  In this case, they point out the countries which may require special attention in the area of prevention programmes.  This applies to all annual counts of abusers in this report (see annex II).

Counts of daily abusers

13.       The "daily counts of registered abusers" is a good indicator of drug dependence.  It highlights the countries which may require special attention in the area of treatment and rehabilitation programmes.  This applies to all daily counts of abusers in this report (see annex II).

Counts of registered abusers

14.       "Counts of registered abusers" are derived from a variety of health and police records.  Given the differences in definitions from one source to the other, the implications of the counts for programming and policy making may vary.  These numbers may be used, however, as indications of actual contacts with drug abusers who may have required treatment or who had been arrested.

Why counts and not rates?

15.       In most comparative data analysis standard measures such as rates would have been used to compare the occurrence of drug abuse in different countries.  In this report, counts of drug abuse are reported rather than rates because the data is not really comparable due to differences in data collection practices in the world.  The counts however should not be dismissed as unreliable statistical observations because they do mean something for those who collect them and they are useful to point out levels of concern, efforts required to address given counts of drug abusers and even types of efforts required i.e., prevention versus treatment.  As stated above, daily counts indicate dependency which likely to required treatment but annual counts may include dependent abusers but also infrequent abusers for whom a prevention programme may be adequate intervention.  Registry counts are a measure of actual contacts with drug abusers who may have required treatment or been arrested.  The nature of the contact changes from country to country depending on the choice of intervention needed.  In some countries police contact is enough to qualify for registration;  in other countries a court order may be required.  Further more, in some cases neither police not judicial interventions are criteria for registration but need for treatment, usually medical treatment.

                                                                              Africa
 
Patterns of Reporting in Africa
 
16.       About one third of African countries have reported six or more times during the nine years of the drug survey. Mauritius reported each year while Cote d'Ivoire did so eight out of nine years.  Among the two-thirds of the African countries which reported five times or less, 12 countries never reported, nine reported once and another four reported only twice (see annex I). 

Availability of data on drugs in Africa

17.       Only two of the seven countries in Africa who responded to the questionnaire in 1991 kept a register, two conducted surveys, two have some qualitative studies, two indicated that they studied the attitudes held by the population towards drug abuse and none have any studies on the cost and consequences resulting from drug abuse (see Table 3).

Interest in monitoring systems in Africa

18.       Five out of seven  African countries indicated a desire to develop a drug monitoring system, but most also pointed out that they need assistance to do so. Three indicated that they need financial help, five that they need professional support in training, four need help with material and one requested assistance with legal, expert, technical and manpower problems (see Table 4).

Annual cannabis abuse in Africa

19.       Fourteen African countries have reported an annual count of cannabis abusers since 1985. Of these, only four did so in 1991. Tanzania reported the highest count of abusers with 42,000 in 1991, followed by Namibia with 27,000. Significantly behind are Sudan with 2503 abusers in 1991, Algeria with 1708 in 1988, Cפte d'Ivoire with 617 in 1991 and Rwanda with 600 in 1990 (see annex I).
 
20.       Although most of the above figures are based on sources of an unspecified nature and may have little validity from a statistical point of view, they do reflect concern relating to the scope of cannabis and other drug abuse and may be useful as rough indicators of where efforts to reduce demand should be directed. This observation applies to all the data presented in this report.

Daily cannabis abuse in Africa

21.       Thirteen countries in Africa have reported a daily count of cannabis abusers since 1985.  Of these, only three did so in 1991.  Namibia reported the highest count of daily abusers with 13,800 in 1991, followed by Tanzania with 10,000 in 1991 and Mauritius with 4,500 in 1985.  The daily count of abusers elsewhere in Africa is too insignificant to report.

Registered cannabis abusers in Africa

22.       Ten countries in Africa reported having registered cannabis abusers since reporting began in 1985. South Africa listed 623, Cפte D'Ivoire 576 and Ghana 392. Two more countries reported having 100 or more registered cannabis abusers (see annex II).

Annual cocaine abuse in Africa

23.       Only seven African countries have reported an annual count of cocaine abusers since 1985 and of these only five did so in 1991.  Mauritius reported 436 abusers in 1991. In 1990, only Ghana mentioned cocaine as a problem.  Abuse appears to be common among young adults who acquire the habit while abroad. According to the data submitted, cocaine problems are negligible in Africa. Since 1985 only four countries in Africa have identified cocaine as a problem drug with only
Nigeria and Cote d'Ivoire consistently reporting so (see annex I).  However, changes in trafficking patterns may strongly influence future trends.

Daily cocaine abuse in Africa

24.       Only two countries in Africa have been reporting a daily count of cocaine abusers since 1985, both did so in 1991.  Mauritius reported with 175 daily abusers in 1991.  Daily counts are a good indicator of drug dependence.  In this case, they point out the countries which may require special attention.  The daily count of abusers elsewhere in Africa is too insignificant to report (see annex II).

Registered cocaine abusers in Africa

25.       Three countries in Africa reported having registered cocaine abusers since reporting began in 1985. South Africa listed 34 and Cפte D'Ivoire 21 (see annex II).

Annual heroin abuse in Africa

26.       Nine African countries have reported an annual count of heroin abusers since 1985.  Of these only four did so in 1991.  Mauritius reported 491 abusers in 1991, followed by Cפte d'Ivoire with 113, Tanzania with 100, Chad with 50 and Ghana with 25. Abuse appears to be common among young adults who acquire the habit while abroad.  Accordingly, heroin problems require some attention but are far from being a serious concern in Africa. (see annex I)

27.       One country voiced fears that it was beginning to be  used as a transit country by a neighbour. Its concern focussed primarily on the likelihood that greater availability of heroin would result in increased abuse. 

Daily heroin abuse in Africa

28.       Two countries in Africa have reported an annual count of heroin abusers since 1985, both did so in 1991.  Mauritius reported 175 daily abusers, followed by Tanzania with 50 (see annex II).

29.       One country voiced fears that it was beginning to be  used as a transit country by a neighbour. Its concern focussed primarily on the likelihood that greater availability of heroin would result in increased abuse. 

Registered heroin abuse in Africa

30.       Three countries in Africa reported having registered heroin abusers since reporting began in 1985. Cפte d'Ivoire listed 114 and South Africa 17 (see annex II).

Other drug abuse in Africa

31.       Benzodiazepines were reported by a total of 13 countries as presenting problems at some time during the past six years.  Significant abuse was reported in North and West Africa, but  Madagascar, Mauritius and South Africa reported more frequently that these drugs presented problems in their countries. 

32.       Several Governments reported on the consumption of khat and other indigenous plants which do not fall within the control of the international drug control conventions. The pattern of drug abuse in South Africa appears different from the rest of the continent in so far as more drugs were reported abused, and a persistent problem with inhalants and methaqualone was noted.

33.       Drug abuse in Africa does not appear to be a severe problem according to the data supplied in the Annual Reports Questionnaire.  There is however a need to monitor closely patterns of consumption of cannabis in Tanzania and Namibia, of cocaine and heroin in Mauritius and of heroin in Cפte d'Ivoire, and to encourage these countries to initiate programmes of demand reduction.

                                                                        The Americas
Patterns of Reporting in the Americas
 
34.       About one third of the American countries have reported six or more times during the nine years of the drug survey. Chile, Ecuador, Guatemala and Uruguay reported each year while Canada, Mexico, Cuba and Venezuela did so seven out of nine years.  Among the two-thirds of the American countries who reported five times or less, three countries never reported, five reported twice and another eight reported only three times (see annex I). 

Availability of data on drugs in the Americas

35.       Only two out of five of the countries in the Americas who responded to the questionnaire in 1991 kept a register, three conducted surveys, two have some qualitative studies, four indicated that they studied the attitudes held by the population towards drug abuse and none have any studies on the cost and consequences resulting from drug abuse (see Table 3).

Interest in monitoring systems in the Americas

36.     Four out of five American countries indicated a wish to develop a drug monitoring system and two of them point out that they need assistance to do so. Two indicated that they need financial help  and professional support in training, and two require assistance with equipment (see Table 4).

Annual cannabis abuse in the Americas

37.       Sixteen countries in the Americas have reported an annual count of cannabis abusers since 1985. Of these, only three did so in 1991. The United States of America reported the highest count of abusers with 21,099,000 in 1991, followed by Canada with 1,022,239, Mexico with 803,000, Ecuador with 205,887, Suriname with 40,000, Costa Rica with 32,605, Uruguay with 21,000 and Saint Lucia with 10,000 (see annex I).

Daily cannabis abuse in the Americas

38.       Twelve countries in the Americas have reported counts of daily cannabis abusers since 1985.  Of these, only one did so in 1991.  The United States of Americareported the highest count of daily abusers with 7,268,205 in 1988, followed by Chile with 557,668 in 1991,Mexico with 129,000 in 1989, Surinam with 20,000 in 1987 and Ecuador with 18,717 in 1988.

Registered cannabis abuse in the Americas

39.       Twelve countries in the Americas reported having registered cannabis abusers since reporting began in 1985.  Mexico listed 435,000, Uruguay 1147 and Jamaica 340. Five countries reported having 100 or more registered cannabis abusers, including the three mentioned above (see annex II).

Annual cocaine abuse in the Americas

40.       Only 16 American countries have reported an annual count of cocaine abusers since 1985. Of these, only three did so in 1991. This count was highest in the United States with 8,208,000, followed by Argentina with 200,000, Mexico with 88,000, Chile with 46,472, Bolivia with 40,044 and Ecuador with 28,075. The number of cocaine abusers, although more significant than in African countries for example, remains modest in other parts of America (see annex I).

41.       In 1989, abuse of cocaine and crack in Canada was prevalent among 1.4% of the population over the age of 15, i.e. among 283,990 abusers. There are indications that cocaine consumption has since been declining.

Daily cocaine abuse in the Americas

42.       Fourteen countries in the Americas have reported a daily count of cocaine abusers since 1985, only one did so in 1991.  The United States of America reported 1,242,027 daily abusers in 1987, followed bu Argentina 180,000 in 1987, Mexico 58,000 in 1989, Chile 18,589 in 1991, Bolivia 5000 in 1985 and Ecuador 4,679 in 1988. The daily count of abusers elsewhere in the Americas is too insignificant to report (see annex II).

43.       Over the past seven years, there has been an increase in the number of Caribbean countries reporting a cocaine problem.  In 1985, the British Virgin Islands, the Cayman Islands, Dominica and the Netherlands Antilles reported cocaine as a problem but since then, Saint Kitts and Nevis, Trinidad and Tobago, the Turks and Caicos Islands, St. Lucia and the Bahamas have also done so.  In addition to an increase in cocaine consumption, many Caribbean countries reported the abuse of crack, as a direct result of cocaine traffickers using the islands.  Spillage from this trade has created a sudden explosion in the number of cocaine abusers from about 1985 onwards, but countermeasures on both the supply and demand side appear to have stabilized the situation and the problem is actually diminishing in some of the countries concerned.

44.       As indicated by the counts above, some Latin American countries report significant cocaine abuse.  Some of these countries refer to coca chewing and to the use of basuco, a paste which is an intermediate product in the production of cocaine.  The use of basuco has even more serious health consequences than does cocaine and the high count of users in Latin America is a matter of serious concern.

Registered cocaine abuse in the Americas

45.       Thirteen countries in the Americas reported having registered cocaine abusers since reporting began in 1985.  Mexico listed 63,000, Bolivia 11,044 and Canada 3514 (see annex II).

Annual heroin abuse in the Americas

46.       Four American countries have reported an annual count of heroin abusers since 1985. Of these, none did so in 1991. The United States reported 500,000 abusers in 1988, followed by Mexico 28,000, and far behind Suriname with 55 and the Netherlands Antilles with 28. Heroin problems, according to the data submitted, require attention mainly in the United States and Mexico. Some heroin abuse exists in other countries in the Americas, (e.g. Canada) but no annual count has been estimated in the Annual Reports Questionnaire (see annex I).

Daily heroin abuse in the Americas

47.       Three countries in the Americas have reported a daily count of heroin abusers since 1985, none did so in 1991. United States reported 492,000 daily abusers, followed by Suriname with 200 (see annexII).

48.       No other countries in the Americas report heroin as a problem drug.  Cannabis was reported by Mexico and the United States as a problem, and all three reported an abuse problem associated with cocaine.  In Mexico, cocaine consumption is again increasing but the sharpest increase is  found in the consumption of benzodazepines and inhalants.  In the United States a downward trend is reported for all drug consumption by young people, but among older age groups heroin abuse shows a slight increase.  In 1989, Canada reported 81,140 abusers of either LSD, amphetamines or heroin. Drug abuse in Canada appears to have stabilized in recent years and even started to decline.

Registered heroin abuse in the Americas

49.       Four countries in the Americas reported having registered heroin abusers since reporting began in 1985. Canada listed 347, the three other countries 50 or less (see annex II).

Other drug abuse in the Americas

50.       In Mexico, cocaine consumption is again increasing but the sharpest increase is  found in the consumption of benzodazepines and inhalants.  In the United States a downward trend is reported for all drug consumption by young people, but among older age groups heroin abuse shows a slight increase.  In 1989, Canada reported 81,140 abusers of either LSD, amphetamines or heroin. Drug abuse in Canada appears to have stabilized in recent years and even started to decline.

51.       The abuse of trihexaphenidil has been consistently reported from many countries in South America.  Although it is licitly used to treat Parkinson's disease and is not a controlled substance, it may produce hallucinations when taken orally.  There has been a parallel development between the use of PCP in North America and trihexaphenidil in South America. Abuse of the latter substance is not reported anywhere else in the world.

52.       Another characteristic of the Latin American States was the frequency with which inhalants were reported as a problem.  Since 1985, 11 countries have reported their abuse.  Most often the abuse of inhalants was associated with "street children",  young people who have no home or means of support. 
 
53.       In 1990, for the first time, inhalants were reported as a problem  in the Caribbean, but only by Dominica.  Cannabis is identified as a problem by those Caribbean States which responded to the Annual Reports Questionnaire but no estimates are given of its prevalence.  There have been no reports of heroin abuse in this subregion over the past six years, nor of any intravenous drug  abuse.
 
54.       In all of the Americas, only Argentina, the United States of America and Venezuela report intravenous abuse of drugs.

55.     To conclude, the prevalence of abuse of cocaine, cannabis and heroin in the Americas is the highest in the world. The United States, Mexico, Argentina, Ecuador and Canada should be targeted to monitor drug abuse and to develop programmes to curb demand.

                                                                   Asia and the Pacific

Patterns of Reporting in Asia and the Pacific

56.       Four out of ten countries in Asia and the Pacific reported six or more times during the nine years of the drug survey. The Philippines  and Singapore reported each year while  seven other countries did so eight out of nine years. Among the 62% of the countries in Asia and the Pacific which reported five times or less, five countries never reported, eight reported once and another four reported only twice (see annex I). 

Availability of data on drugs in Asia and the Pacific

57.       Six out of the seven countries in Asia and the Pacific which responded to the questionnaire in 1991 kept a register. Four conducted surveys, one had conducted some qualitative studies, one indicated that it studied the attitudes held by the population towards drug abuse and one conducted studies on the cost and consequences resulting from drug abuse (see Table 3).

Interest in monitoring systems in Asia and the Pacific

58.       Five out of the eight countries in Asia and the Pacific who responded to the Annual Reports Questionnaire indicated a wish to develop a drug monitoring system. Many of them point out that they need assistance to do so. Three indicated that they need financial help, three professional support in training, one assistance with equipment and six assistance with legal, expert, technical and manpower problems (see Table 4).

Annual cannabis abuse in Asia and the Pacific

59.       Seventeen countries in Asia and the Pacific have reported an annual count of cannabis abusers since 1985.  Of these only four did so in 1991.  New Zealand reported the highest count of abusers with 250,000 in 1989, followed by Bangladesh with 25,000 in 1985, Japan 15,000 in 1989, Polynesia 15,000 in 1990, Papua New Guinea 10,000 in 1985, Korea 7,200 and Myanmar 2080 in 1991 and Malaysia 2070 in 1988. Significantly lower counts were reported elsewhere (see annex I).

60.       Cannabis abuse in most of Asia and the Pacific has not been the cause of much concern since reporting began in 1985.  Yet consumption levels indicated by the above counts point out that attention should be given to demand reduction in all countries listed above.

Daily cannabis abuse in Asia and the Pacific

61.       Fourteen countries in Asia and the Pacific have been reporting a daily count of cannabis abusers since 1985.  Of these, only three did so in 1991.  New Zealand reported the highest count of daily abusers with 25,000 in 1989, followed by Korea with 3,600 in 1991, Polynesia with 3,500 in 1990, Malaysia with 1,703 in 1988, the Philippines with 1,617 in 1991 and Bangladesh with 1,000 in 1985. The daily count of abusers elsewhere in Asia and the Pacific is too insignificant to report.

Registered cannabis Abuse in Asia and the Pacific

62.       Fourteen countries in the Americas reported having registered cannabis abusers since reporting began in 1985. Papua New Guinea listed 5,000, the Philippines 2156 and Japan 1620. Eight countries reported having 100 or more registered cannabis abusers, including the three mentioned above (see annex II).

Annual cocaine abuse in Asia and the Pacific

63.       Only eight countries in Asia and the Pacific have reported an annual count of cocaine abuse since 1985.  Of these, only one did so in 1991. This count was highest in Japan with 15,000, followed by Malaysia 2552, the Philippines 540, and French Polynesia 275. The count of cocaine abusers elsewhere in the region is negligible, based on the reported data (see annex I).  Cocaine abuse was reported as a problem by Australia and Japan in previous reporting years, the latter reporting some increase in 1990.

Daily cocaine abuse in Asia and the Pacific

64.       Five countries in Asia and the Pacific have been reporting a daily count of cocaine abusers since 1985, only Korea did so in 1991.  The highest daily users count reported is in the Philippines: 50 cases in 1991. The daily count of abusers in Asia and the Pacific is insignificant according to the data reported (see annex II).

Registered cocaine abuse in Asia and the Pacific

65.       Nine countries in Asia and the Pacific reported having registered cocaine abusers since reporting began in 1985. Japan listed 1,620, Malaysia 1,550 and Korea 838 (see annex II).

Annual heroin abuse in Asia and the Pacific

66.       Twelve of the countries in Asia and the Pacific have reported an annual count of heroine abusers since 1985. Of these, only three did so in 1991.  Australia reported 100,000 abusers in 1987, followed by Sri Lanka with 37,500 and Myanmar with 16,660 in 1991, Malaysia with 14,578 and Hong Kong with 12,284 in 1990, Bangladesh with 10,000 in 1985 and Singapore with 4171 in 1991. According to the data submitted, heroin problems require attention in all the countries listed above. Some heroine abuse exists in other countries in Asia and the Pacific but has not been reported in the Annual Reports Questionnaire (see annex I).
 
67.       Heroin and opium are major drugs of abuse in the region.  Only Singapore reported an increase in heroin abuse, but Sri Lanka had reported an increase in each of the previous three years.  All other countries report that consumption is stable or decreasing.  Nepal is the only country to report an increase in opium consumption.

Daily heroin abuse in Asia and the Pacific

68.       Eight countries in Asia and the Pacific have reported a daily count of heroin abusers since 1985, two did so in 1991. Australia reported 40,000 daily abusers in 1987, followed by Malaysia with 12,723 in 1988, Myanmar 8,330 in 1991, New Zealand 4,000 in 1989, Bangladesh 3,000 in 1985 and India 1,458 in 1989 (see annexII).
 
69.       Heroin and opium are major drugs of abuse in the region.  Only Singapore reported an increase in heroin abuse, but Sri Lanka had reported an increase in each of the previous three years.  All other countries report that consumption is stable or decreasing.  Nepal is the only country to report an increase in opium consumption.

Registered heroin abusers in Asia and the Pacific

70.       Ten countries in Asia and the Pacific reported having registered heroine abusers since reporting began in 1985. Thailand listed 55,051, Hong Kong 37,509 and Myanmar 11,947 (see annex II).

Other drug abuse in Asia and the Pacific

71.       Australia, Japan,  New Zealand and the Philippines report an amphetamine problem, with the Philippines reporting a severe increase in amphetamine abuse over the past three years.
 
72.       One disturbing trend in the region is the increasing use of syringes, particularly for administering heroin but also for opium.  This practice has led to the spread of HIV infection  among  previously unexposed populations.  Australia, Bangladesh, Hong Kong, Japan, Myanmar, New

Zealand and Thailand all report intravenous abuse of drugs, which was previously the preferred means of administration of a number of drugs only in Australia and New Zealand.

                                                                             Europe

Patterns of reporting in Europe

73.       Seventy percent of the European countries reported six or more times during the nine years of the drug survey. Among the remaining 30% of the European countries which reported five times or less, three countries never reported and two reported once (see annex I).

Availability of data on drugs in Europe

74.       Eleven out of the seventeen European countries which responded to the Annual Reports Questionnaire in 1991 kept a register of drug abusers, eight conducted surveys, five had conducted some qualitative studies, six indicated that they studied the attitudes held by the population towards drug abuse and none conducted studies on the cost and consequences resulting from drug abuse (see Table 3).

Interest in monitoring systems in Europe

75.    Five out of the seventeen European countries who responded to the questionnaire indicated a wish to develop a drug monitoring system, all of which are successor States of the former Soviet Union. All of them point out that they need assistance to do so, none indicating a need for financial help. Of the multiple requests, one requested professional support in training, two assistance with material and six assistance with legal, expert, technical and manpower problems (see Table 4). 

Annual cannabis abuse in Europe

76.       Sixteen European countries have reported an annual count of cannabis abusers since 1983. Of these only nine did so in 1991. Spain reported the highest count of abusers with 1,560,776 in 1991, followed by Italy with 700,000 in 1990, the Netherlands with 300,000 in 1985, Norway with 85,000 in 1991, Finland with 45,000 in 1991, Denmark with 25,000, Iceland with 10,000 in 1987 and Turkey with 2000 in 1989. Significantly lower counts were reported elsewhere (see annex I ).

77.       Cannabis consumption, although concentrated mainly in Spain, Italy and the Netherlands, is also widespread in Scandinavian countries, and appears to be gaining popularity  in Eastern Europe. Hungary has re­ported cannabis as a problem for the past five years and the Russian Federation for the past two years. Given the considerable demand for cannabis in Europe and the opening of new markets and routes of trafficking, special attention might be required to curb demand in all countries listed above as well as selected Eastern European countries which demonstrate special concern.

Daily cannabis abuse in Europe

78.       Fourteen countries in Europe have reported a daily count of cannabis abusers since 1985. Of these, five did so in 1991. Spain reported the highest count of daily abusers with 312,156 in 1991, followed by Switzerland with 150,000 in 1990, Greece with 40,000 in 1989, Denmark with 30,000 in 1991, Germany with 20,100 in 1985, the Netherlands with 12,500 in 1990 and far behind Turkey with 1728 in 1989. The daily count of abusers elsewhere in Europe is too insignificant to report.

Registered Cannabis Abuse in Europe

79.       Fourteen countries in Europe reported having registered cannabis abusers since reporting began in 1985. The former USSR listed 50,000, France 16,014 and Greece 1529. Ten countries reported having 100 or more registered cannabis abusers including the three mentioned above (see annex II).

Annual cocaine abuse in Europe

80.       Only 13 countries in Europe have reported an annual count of cocaine abuse since 1983. Of these, eight did so in 1991. This count was highest in Spain with 624,311, followed by the Netherlands with 75,000, Italy with 13,538, Denmark with 10,000, Norway with 2500 and Finland with 2200. The count of cocaine abusers elsewhere in Europe is negligible based on the reported data (see annex I).

81.       Germany, Greece, Monaco, Netherlands, Norway, Spain and the United Kingdom reported cocaine abuse as a problem in 1990.  Cocaine abuse appears to be spreading through several countries in southern Europe.  Overall, however, the reports signal a decrease over the previous year, when ten countries reported a problem. 

Daily cocaine abuse in Europe

82.       Nine countries in Europe have reported a daily count of cocaine abusers since 1985, only Moldova did so in 1991.  The highest daily count in Europe is reported in Spain with 39,879 in 1989, followed by Switzerland with 16,000 in 1990 and Germany with 1,500 in 1985. The daily count of abusers elsewhere in Europe is insignificant according to the data reported (see annex II).

Registered cocaine abusers in Europe

83.       Fourteen countries in Europe reported having registered cocaine abusers since reporting began in 1985. Germany listed 2,308, the United Kingdom 1,085 and France 108 (see annex II).

Annual heroin abuse in Europe

84.       Eleven of the European countries have reported an annual count of heroin abusers since 1985. Of these only four did so in 1991. Italy reported with 183,336 abusers in 1991, followed by Spain with 60,000 in 1986, the United Kingdom with 50,740 in 1990, Greece with 7400 in 1991, Norway with 7,000 in 1991, the Netherlands with 5,000 in 1985, Malta with 1000 in 1987, Ireland with 798 in 1985 and Turkey with 483 in 1990. According to the data submitted, heroin problems require attention in all the countries listed above. Some heroin abuse exists in other countries in Europe but has not been reported in the Annual Reports Questionnaires (see annex I).

85.       Italy, Spain and the Netherlands lead West European countries in the annual prevalence of abuse of cannabis, cocaine, and heroin. Multiple drug abuse in these countries is likely to be very common and require much attention, according to the data submitted in the Annual Reports Questionnaires.

86.       In Eastern Europe, the pattern of abuse tends to be different. Some heroin abuse exists and is characterized by the consumption of various products derived from locally grown poppy straw. 

Daily heroin abuse in Europe

87.       Twelve countries in Europe have been reporting a daily count of heroin abusers since 1985, one did so in 1991.  Spain reported 57,288 daily abusers in 1988, followed by the Netherlands 20,000 in 1990, Switzerland with 18,000 in 1990, Germany with 12,300 in 1985, Greece with 9,500 in 1989 and Sweden with 1,250 in 1990. The daily count of abusers elsewhere in Europe is too insignificant to report (see annex II).

88.       Italy, Spain and the Netherlands lead West European countries in the annual prevalence of abuse of cannabis, cocaine, and heroin. Multiple drug abuse in these countries is likely to be very common and require much attention, according to the data submitted in the Annual Reports Questionnaires.

89.       In Eastern Europe, the pattern of abuse tends to be different. Some heroin abuse exists and is characterized by the consumption of various products derived from locally grown poppy straw. 

Registered heroin abuse in Europe

90.       Fourteen countries in Europe reported having registered heroin abusers since reporting began in 1985. Italy listed 50,000, the United Kingdom 14,497 and Germany 1,620. Eight countries reported having 100 or more registered heroine abusers including the three mentioned above (see annex II).

Other drug abuse

91.       Amphetamine abuse has been reported as a problem mainly by the Northern and Western European countries in past years. It is now emerging as a problem and causing concern in Eastern Europe too.

                                                                 Near and Middle East

Patterns of Reporting in the Near and Middle East

92.       Thirty five percent of the countries in the Near and Middle East reported six or more times during the nine years of the drug survey. Egypt and Pakistan reported eight out of nine years. Among the remaining 65% of the countries in the Near and Middle East who reported five times or less, only Afghanistan never reported, three reported once and another reported twice (see annex I). 

Availability of Data on Drugs in the Near and Middle East

93.       None of the three countries in the Near and Middle East who responded to the Annual Reports Questionnaire in 1991 kept a register of drug abusers. Only one conducted surveys, none have qualitative studies, one indicated that it studied the attitudes held by the population towards drug abuse and none conducted studies on the cost and consequences resulting from drug abuse (see Table 3).

Interest in monitoring systems in the Near and Middle East

94.       Two of the three countries in the Near and Middle East who responded to the Annual Reports Questionnaire wish to develop a drug monitoring system. Both of them pointed out that they need assistance to do so, and both indicated a need for financial help. Both requested a combination of legal, expert, technical and manpower assistance (see Table 4).
 
Annual cannabis abuse in the Near and Middle East

95.       Six countries in the Near and Middle East have reported an annual count of cannabis abusers since 1985. Of these, only two did so in 1991. Pakistan reported the highest count of abusers with 854,085 in 1989, followed by Israel with 80,000 in 1991.  Far behind are Syria with 1910 in 1991, and Jordan with 1,000 in 1989.  Consumption of cannabis appears to be negligible elsewhere in this region based on the data received (see annex I).

96.       Cannabis consumption, although highly concentrated in Pakistan and Israel according to the data at hand, is known to be widespread in other countries in this region. Some of the countries are either producers of importance or key transit points in the global cannabis market. Special attention might be required to reduce demand in the countries listed above. Special efforts may also be needed to curb supply from this region.

Daily cannabis abuse in the Near and Middle East

97.       Five countries in the Near and Middle East have been reporting a daily count of cannabis abusers since 1985. Of these, only Syria did so in 1991. Pakistan reported the highest count of daily abusers with 500,000 in 1987, followed by Iran with 50,000 in 1989, Israel with 38,000 in 1990 and Syria with 1,910 in 1991. The daily count of abusers elsewhere in the Near and Middle East is too insignificant to report.

Registered cannabis Abuse in the Near and Middle East

98.       Six countries in the Near and Middle East reported having registered cannabis abusers since reporting began in 1985. Pakistan listed 3,248 and Syria 1910 (see annex II).

Annual cocaine abuse in the Near and Middle East

99.       Six countries in the Near and Middle East have reported an annual count of cocaine abuse since 1983. Of these, only Israel did so in 1991. This count was highest in Israel 20,000, followed by Egypt 145.  The count of cocaine abusers elsewhere in the Near and Middle East is negligible based on the reported data (see annex I).

Daily cocaine abuse in the Near and Middle East

100.     Three countries in the Near and Middle East have been reporting a daily count of cocaine abusers since 1985, none did so in 1991.  Israel reported 1,000 daily abusers in 1986. The daily count of abusers elsewhere in this region is too insignificant to report (see annex II).

Registered cocaine abuse in the Near and Middle East

101.     Five countries in the Near and Middle East reported having registered cocaine abusers since reporting began in 1985. Egypt listed 145 (see annex II).

Annual heroin abuse in the Near and Middle East

102.     Ten of the Near and Middle Eastern countries have reported an annual count of heroine abusers since 1985.  Of these, none did so in 1991.  Pakistan reported with 1,079,635 abusers in 1989, followed by Iran with 150,000 in 1990, Israel with 19,000 in 1989, Bahrain with 2978 in 1986, Syria with 204 in 1989, Egypt with 130 in 1989 and Jordan with 100 in 1989.  According to the data submitted, heroin problems require attention in most the countries listed above. Some heroine abuse is prevalent in other countries in the Near and Middle East but has not been reported in Annual Reports Questionnaires (see annex I).

Daily heroin abuse in the Near and Middle East

103.     Six countries in the Near and Middle East have been reporting a daily count of heroin abusers counts since 1985, none did so in 1991.  Pakistan reported 425,000 daily abusers in 1987, followed by Iran 200,000 in 1989, and Israel 1,710 in 1989. The daily count of abusers elsewhere in this region is too insignificant to report. (See annex II).

104.     Heroin is the most widely abused drug in the region, followed by cannabis and cocaine.  The countries that require most attention are Pakistan, Iran, Israel and Syria.

105.     Pakistan, Iran and Israel reported an increase in heroin abuse over the past six years, with Pakistan reporting the highest increase.  Only Qatar has reported a decrease in heroin abuse.   The Islamic Republic of Iran and Pakistan have by far the largest number of heroin dependents with Pakistan reporting significantly higher figures than any other country in the region.  

106.     Within the Near and Middle East, Egypt, Jordan, Oman and the Syrian Arab Republic have reported intravenous drug abuse.

Registered heroin Abuse in the Near and Middle East

107.     Seven countries in the Near and Middle East reported having registered heroine abusers since reporting began in 1985. Pakistan listed 13,290 and Egypt 130 (see annex II).

Implementation of CMO Targets

108.     Unfortunately, insufficient replies were received to the questionnaire on Demand Reduction.  A report on the extent to which Member States, IGOs and NGOs in consultative status with ECOSOC have achieved targets 1-7 of the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control (CMO) was requested in the Global Programme of Action.  The monitoring of targets 29-35 was requested by ECOSOC Resolution 1991/45.  If sufficient replies are received from the questionnaire, an analysis of the results will be presented at the next commission in 1994.

                                                                           Annex I. 
                                                 A Global Survey of the Annual Count of 
                      Cocaine, Cannabis and Heroin Abusers by Year and Country, 1985-1991

(h) = Health records
(p) = Police records
(s) = Surveys
(c) = Combined estimation based on H, P, S
(e) = Estimation
(u) = Unspecified source

(h) = Health records
(p) = Police records
(s) = Surveys
(c) = Combined estimation based on H, P, S
(e) = Estimation
(u) = Unspecified source

(h) = Health records
(p) = Police records
(s) = Surveys
(c) = Combined estimation based on H, P, S
(e) = Estimation
(u) = Unspecified source

                                                                          ANNEX II
                                 Figures Given by Countries for Annual Count, Daily Abuse
                                  and Registered Abusers of Cannabis, Cocaine and Heroin