WORLD HEALTH ORGANIZATION
ORGANISATION HONDIALE DE LA SANTII
IUGIONAl OFFICE FOil
THE WESTEIlN PACIFIC
IUREAU Il~GIONAl DU PACifiQUE OCCIDENTAL
RIDIONAL COMMITl'EE Twenty-fifth session Kuala IJ.unpur 2-10 September 1974 Provisional agenda item 13 DROO DEPENDENCE
WPR/RC25/7 30 May 1974 ORIGINAL: ~LISH
Progress Report by the Regional Director 1.
IN'lRODUCTION
The Regional Committee at its twenty-fourth session adopted resolution WPR/RC24.R8 whioh requested the Regional Direotor: (a) "to obtain from Member States information on the nature, extent of drug dependenoe and the availability of treatment and rehabilitation oentres in their respeotive countries;" (b) "to stimulate and develop activities in the field of the oontrol of drug abuse and drug dependence;"
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(c) "to explore further the possibility of inter-regional cooperation with the South-East Asia Regional Office after completion of the pilot project and to submit to the Committee at its twenty-fifth session a report on the progress made." 2. ACTION TAKEN
2.1 Two oonsultants visited Malaysia and, after reviewing available information, made recommendations for the development of a training programme whioh oould eventually also serve other countries in the Region. Steps are now being taken to try to arrange the neoessary training of national staff. Due to other commitments, one of the consultants was unable to fulfil a similar mission to the Philippines but a replaoement is being found and it is expeoted that the mission will be aooomplished later in 1974. Financial assistanoe was provided by the United States Government and the Aw Boon Haw Foundation of Hong Kong.
WPR;llC25/7 page 2
2.2 To develop these aotivities turther within the Region, arrangements are being made to reeru1t a teohnical offioer with expertise in this field in 1974.
2.3 SUpport has been obtained from the United Nations Fund for Drug Abuse Control (UNPDIlC) for the establ1ahllent of a treatment centre in the Republ10 of Viet-Name Pour fellowships have been provided, a oonsultant is being reorui ted, and UNF'DAC has indioated that it is ] tkely to assist with the provision of materials reoommended by the consultant.
2.4 Information on drug dependence activities has been exchanged with the South-East Asia Regional Offioe of WHO. Cooperation has been agreed on and., as a first step, ,it 1s expected that two partioipants from oountries in the Westem Paoifio Region will be invited to attend a seminar in the SouthEast Asian Region in late 1974. 2.5 A questionnaire ..s prepared and sent to countries and territories in the Westem Paoific Region. This was designed to obtain information on the extent and type of drug dependence and the nature and adequacy of available servioe. The tindings are given in section 3. 3. QUESTIoNHAIRE PINDINGS
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Twenty-three oompleted questionnaires were reoeived, one oountry ..s unable to supply any information, the origin of one questionnaire could not be identified and tive oountries did not reply. The analysis of the replies is given in Armex 1. indioates that: In summary, this
(a) Drug dependence (exoluding aloohol) is a major problem in two oountries, a moderate problem in seven, and a minor or negligible problem in fourteen. In terms of population represented by the responses, 25.~ lived in oountries with a major or moderate problem, whioh was mostly thought to be inoreasing. Elsewhere it was regarded a8 statio or decreasing. (b) Alcohol was the most commonly used drug and sixteen countries, representing 67~ of the population, regard alcohol consumption as a major or moderate problem. (0) Thereafter, the most oommonly used drugs were cannabis and opiates, usually illegally imported or looally produoed, followed by sedatives and amphetamines, whioh were most often diverted from legal channels or illegally imported.
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(d) With one or two exoeptions, all the above drugs (excluding alcohol) were under some form of legal restriotion.
WPRjRC25/7 page 3/4
<e) The most common users were 20 to 29 year old males from middle class urban areas, there being more ditterence in the type of users by country . than by drug. (f) Most oountries with a _jor or moderate drug problem had special facilities for the deteotion, treatment and follow-up of drug abusers, but few considered these adequate. (g) The types 01' a.sistan.e most trequ~~tly mentioned a. required were: epidemiologioal studies and information on trends and treatment; training of medical and soo1al personnel; health education of the public. PROPOSED FU'roRE ACTION
4.
In order to continue the collection of epidemiological information, to assist the design of natioD&! programmes and to coordinate the work of short-term consultants advising in partioular sub-fields, it is proposed to oontinue the post of interoountry officer through 19i1. In 1976 and 1977, an additional provision has been made for oonsultant months so that assistanoe may be provided. in speoialized areas wi thin the drug abuse field. In late 1974, a working group on measures for the prevention and control of drug abuse and dependenoe is expected to be held. This will be used to advise the RegioD&! Direotor on the strategy the Region should follow. This working .roup will not be repeated in 1975 but one on health education programmes for young people concerning drug abuse will be held. In 1976, a working group on early intervention programmes in drug abuse is proposed, and in 1977, a further working group on health education programmes for young people conoerning drug abuse.
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EXTENT OF IMI'OR'Iru£E \p
ABUSE PRClBiEM AND mUGS ABUSED (EXCWDIW.HOL)
• Drugs abused cOlllllOl'lly I
moo ABUsE Objective data Drugs abused less cOlllllOnly .... i .... 4_h"' .......
Severity of problem ,====== A.~
Problem increasing/
¥
~
~'railable --_..., I _ ..
laos Republic of Viet-Ham B. ModeNte"
Static static
No No
Sedative, amJ'iletamine, hallucinogen, volatile solvent Sedative, &mJ'betamine
T~biS' I Opiate cannabis
opiate
berican
samoa
AustNUa GUUI
Malaysia New ClUedonia Hew Zealand
Sedative, amJ'betamine, cocaine, opiate Sedative, &mJ'iletamine, Sedative, amJ'iletalline, volatile solvent Sedative, amJ'iletamine Sedative, amphetamine, AmJ'iletam1ne, coc&ine
hallucinogen, hallucinogen, oplate hallucinogen, coca1ne,
cannabis cannab1s, oplate cannabis, opiate cannabis, hallucinogen C&mlabis, opiate. sedative, hallucinogen Cannabis. opiate. sedative
opiate
Su.a.pore IC,~
AmP1etam1ne
Japan
xm-r ~pua
Republic New Hebrides Hew Guinea
Sedative. amphetam1ne. oannabis. volatile solvent. hallucinogen. op1ate Sedative. cannabis. opiate Sedative. cannabis. opiate Sedative. hallucinogen Sedative, cannabis. opiate AmJ'iletam1ne
Sedative
......0
Opiate
Republic of Korea Westem SSmoa D. N<>n-ex1stent"
Br1 t1sh Solomon
- none Sedative. cannabis, opiate - none - none Sedative, cannabis, opiate - none - none ==~=='==_
- none -
Islands ProtectcNte Brunei Cook Islands French Polynesia Fiji Gilbert and EIUce Islands Tooga b===-====-:o::====~= ___ =J'I-_~
~
'"" !2 .....
'" ..
11
~
~
:E
",0
___
==-c=--=====
'" ~
"POPUlatIon (millions) Major ••••••••••• 22.1 (ll~) Moderate •••••••• 28.6 (14.4~) Minor ••••••••••• 146.8 (74%) Non-existent •••• .-.!..:..! (0.6%; Total 198.6 (1~)
OQ~B~ CD.~ >< 0 .... 1\)
~ USE AND SOURCE OF DRUG GROUPS
~ss
used oormnonly Commonly Drug
Drug group
Source of drug* 111ioi t local Diversion Illioit produotion from legal importation n~""A6a
Drug
is not legally restrioted* 1
Number of Countries cannabis Opiates Sedatives Amphetamines Halluoinogen Cocaine Volatile solvents Others (paint, etc.) Khat -
6 8 14
8 8 3 0 2
8 12
8 3
5 10 4
1 0 0 2
11
7 6 7 1
1 2
6 3 3 1 0
1 2
1 0
0 0 1 0
-
-
-
-
-
7 1 2
-
*Few oountries gave oomplete details
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•
"
~
.. MAIN
.. usms aJ! MUGS ~1a1
"
4&e DRUG GROOP
(yearll)
10-19
20-29
30+
Male
Female . o f
01& ___ -
Number 5
Upper I Middle o 0 u n t r 1 e _ 5
IDwer
Urban
Rural
C&nnabia
10 11
Op1ate Sedative Amphetam1ne Halluo1nogens Co0&1ne Volatile solvents Other TOTAL '----
7 4 5 5
.
2
12
6
13
6 6 12
8 10 12
8 8 6 4 3
11
4 3 1 1-
6
14 14 11
9 10
9 4
13 10
8 5 3
8 • 3 0
1 0
7 3 3
7 4 1 0
9 7 3 2 2 53
8 3
1 1 0
1 2
1 0
1 0 0 30
1 0 23
1 30
1
2 63
1
1
3 2 66
1 12
52
37
29
Jig ~
It It ~ 1-'1\)
--I)Ct"$
~
~.Iit (Xl~f3 ~ REIATIVE IMPORTANCE OF VARIOUS MEANS OF C()[t1MTnIl DROO ABUSE
Very effeo"tive
Fairly effeotive Number of oountries
No
~"ting
given
Legal oontrol of drug traffio Effioient treatment and atter-oare of drug abu8ers Instruo"tion in schools Community aotion group8 in affeoted areas Eduoation of publio through mass media Sooial workers oonoentrating on at-risk groups Involvement of religious bodies
15
6
2
9
8 8
6
8 7 6 5 0
7
7 11
9 5 10
8 14
9
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..
WPR/RC25/7 Annex 1 page 9
RESOURCES AND FACILITIES FOR DETECTION. 'mEATMENT AND AFrER-CARE OF DRUG ABUSEH3
7
COUNTRY
Resources for deteotion MAtH ""'1.1
Treatment facilities °lvw~ ..t
After-care faoilities :
: : '--
Nonmedical
: Adequacy* Present !
: Adequacy
A. With major problem Laos Republic of Viet-Nam Yes Yes
none
,
Yes Yes
Suff. N. suff'.
Plan Yes
Insuff.
-
B. With moderate American samoa Australia Guam MIllaysia New Caledonia New Zealand Singapore
~oblem
Yes Yes Yes none Yes Yes
Yes Yes Yes Yes
-
Yes Yes Yes Yes Yes Yes Yes
N. suff. N. suff'. Insuff. Insuff. Insuff. Suff. N. suff.
Yes Yes Yes Yes Yes Yes
-
N. suff., N. suff., Insuff. Insuff. Suff. Insurf. N. suff.,
C. With minor problem
,
Japan Khmer Republio New Hebrides Papua New Guinea Macao Republic of Korea Western samoa D. With no problem British Solomon Islands Protectorate Brunei Cook Islands Frenoh Polynesia Fiji Gilbert and Ellice Islands Tonga .
Yes none none none Yes none
Yes
Yes
-
Yes Yes Yes Yes Yes Yes
Suff. N. suff. Suff. N. suff. Suff.
Yes none none Yes Yes none
Suff. Suff. N. suff.,
-
-
-
r
none none none none none none none
Yes none none none none none Yes
Suff.
none none none Yes Suff. none none
-
Suff.
*Suff. = SuffiCient N. suff. ~ Nearly suffioient Insuff. R Insufficient
WPR/RC25/7 AIUlex 1 page 10
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PRCBIEM OF AICOHOL CONSUMPl'ION
----------------,,-._-_._--_._._------..... Severity of problem A. Major Fiji, Guam, New caledonia, New Hebrides, New Zealand, Papua New Guinea B. Moderate Amerioan samoa, Australia, British Solomon Islands Proteotorate, Cook IBlands, Freno~ Polynesia, Gilbert and Ellioe Islands, Japan, Khmer Republio Singapore, Tonga C. Minor laos, Malaysia, Macao, Republ1 of Viet-Nam, Western samoa D. Non-existent Brunei, Republic of Korea TOTAL 127.1 (64%) population (millions) 6.2 (3%)
33.2 (17%)
32.1 (16%) (1O~)
198.6