The Hindu Business Line : Drug abuse: Asia on a new high

THE International Narcotics Control Board (INCB), a quasi-judicial body monitoring the implementation of the United Nations (UN) international drug control convention, has warned that drug abuse is on the rise in the African and Asian region. For India, which already has a high percentage of people infected with HIV, the health hazards documented in the INCB's 2005 Annual Report, released by the UN office in New Delhi on March 2, is disturbing.

The INCB's legitimate concern over South Asia's access to drugs - given its proximity to major opium production areas such as the Golden Crescent and the Golden Triangle, and the widespread domestic cultivation of cannabis - needs to be taken serious note of by member-countries.

According to the report, India carried out its first national survey on the extent and pattern of and trends in drug abuse in 2004. In the survey, the high rate of abuse and the growing incidence of intra-venous drug abuse were identified as areas of serious concern.

The survey also found an increase in the abuse of pharmaceutical products such as codeine-based cough syrups, anxiolytics in tablet form and injectable analgesics.

Considering that 2.58 per cent of the 1,02,733 AIDS patients who reported to the National AIDS Control Organisation (NACO) were intra-venous drug users, it is vital that all licensed blood banks screen every unit of blood for HIV, Hepatitis B, Hepatitis C, syphilis and malaria. The INCB President, Mr Hamid Ghodse, in his introduction to this year's report said: "The rate of HIV/AIDS infections among intra-venous drug abusers has been increasing rapidly in some parts of the world, particularly in Eastern Europe and Asia. In many cases, the alarming spread of HIV/AIDS and other infectious diseases is associated with shockingly low levels of awareness about the basic facts of the disease and the methods of its transmission."

While the authorities have been lauded for their control over imports and exports of internationally controlled substances, control over the licit manufacture of, trade in and distribution of narcotics and psychotropic substances has been found to be "inadequate".

This is explained by the Centre's "incomplete reporting to the Board (INCB) and the diversion of pharmaceutical products manufactured in India".

Emphasising the need to monitor domestic distribution channels for narcotics and psychotropic substances, the INCB has called on the Centre to step up its law enforcement effort, especially at the retail level, and to carry out awareness campaigns for pharmacists and the general public on how narcotics and psychotropic substances are abused. This after the Finance Ministry simplified the procedure for movement of psychotropic substances on March 4.

The domestic Narcotics Control Bureau last month raided pharma wholesalers and retailers after detecting large volumes of psychotropic drugs being illegally diverted to Pakistan, Nepal, Dubai and Nigeria.

Though domestic pharma companies, both wholesalers and retailers, by and large cannot be blamed for the diversion, laxity in implementing the rules is regrettable.

The report holds pharmacies in India responsible by identifying them as "supply sources for trafficking". It states that the abuse of analgesics, anxiolytics and sedative hypnotics has increased in the region. On account of lower prices and accessibility to pharmaceutical preparations, needles and syringes, the intra-venous abuse of buprenorphine has been found to have escalated.

On narcotics, the report notes, that cannabis continues to be produced and abused in large quantities in South Asia. While Bangladesh and India are important sources for cannabis herb, Nepal is a major source for cannabis resin, which is smuggled into countries in Asia and the Pacific, Europe and the US.

The largest seizures of cannabis resin from Nepal have been reported in India; cannabis resin in India is sold locally in the illicit market or smuggled into Europe. The report further notes that certain quantity of licitly produced opium continues to be diverted into illicit channels despite intensified law enforcement drives. Most seizures are made within the poppy cultivation and opium production areas. The diverted opium is abused locally or processed into heroin in clandestine laboratories to be later sold in illicit markets outside the production areas. The laboratories generally produce a low-quality heroin base known as "brown sugar" that is sold locally in the illicit market or smuggled to the Maldives and Sri Lanka.

The total volume of heroin seized in India has been decreasing since 2001, averaging less than one tonne per year. International airports at Mumbai, New Delhi, Thiruvananthapuram, Kochi and Chennai continue to be used by trafficking groups to ship heroin to countries in East and West Africa, West Asia and Europe, and Sri Lanka.

In recent years, there has been a fall in heroin trafficking along the air route from India to Sri Lanka; majority of the seizures is now happening along the sea-route from South India to Sri Lanka. Heroin from Pakistan is smuggled into Bangladesh, India and Sri Lanka.

The report highlights the dismal fact that abuse of pharmaceuticals containing narcotics, such as codeine, remains widespread in the region. In addition, low price and easy availability have made intra-venous abuse of propoxyphene as prevalent as that of heroin, in India. The abuse of prescription drug Ketamine, an anaesthetic, has been detected in Goa. The abuse of inhalants, prevalent among the poorer segments of society and street children, is widespread in South Asia, including in India. Even as the 2005-06 Budget by Mr P. Chidambaram announced fresh initiatives in health with the launch of the National Rural Health Mission, the timely warning by the INCB to be pro-active in preventing drug abuse and strengthening narcotic drugs control machinery ought to receive his attention and that of the UPA Government.

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