Substance Abuse in Central Asia: An Old Problem with a New Twist
Nina Kerimi, WHO Regional Office For Europe
Copenhagen, Denmark

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Draft: not to be cited without the author's permission
The views expressed by the author are solely the responsibility of the author and do not represent the views or opinions of the World Health Organization, The Central Eurasia Project or the Open Society Institute.

Introduction

This paper focuses on the psychoactive substances used/abused in Central Asia, mostly analysing the illegal drug related situation. Presentation of all other relevant data is adjusted to this goal. Despite lack of data based on rigorous research, the descriptive information presented below gives a general understanding of the current drug related situation in Central Asia, highlighting patterns of drug use, the consequences and social contexts of drug abuse.

It is preceded by a brief overview of a global perspective of illicit drug use based on the World Drug Report 2000 issued by UNODCCP.

A Global Perspective of Drug Use

Drug abuse is a global phenomenon. There is hardly any country in which it does not take place. Most frequently used/abused are plant-based drugs Out of 134 countries reporting drug abuse problems, cannabis is consumed in 96%, the opiates in 87% and cocaine-type substances in 81%, synthetic drugs (i.e. amphetamine-type stimulants ) in 73%, benzodiazepines in 69%, various volatile substances or inhalants –69% [1].

The definition of a problem drug relates to the extent to which use of a certain drug leads to treatment demand, emergency room visits, drug related morbidity and mortality, and other drug related social ills, such as drug-related crime and violence. The main problem drugs in the 1990s were opiates, primarily heroin, and cocaine [1].

The data below relate mainly to cannabis and opiates, other substances may be just mentioned due to their presence on the drug related scene in Central Asia.

Production

Cannabis

Cannabis (hemp) is grown across the globe in almost all geographic locations. Illicit cannabis products can originate from three qualitatively distinct sources of supply: outdoor illicit cultivation; naturalized cannabis plants (wild growing cannabis); and plants cultivated indoors by means of sophisticated growing technology. While outdoor illicit cultivation has traditionally been the primary source of cannabis, the importance of wild growing cannabis and indoor-cultivated cannabis as sources for illicit markets has been growing.

There are indications that cannabis cultivation in Latin America is now lower that a decade ago, but it apparently increased in Europe, Central Asia, South-East Asia and Africa. Cultivation estimates (including wild growth) based on the reports from UN’s Member States in the 1990s range from 670,000 hectares to 1, 850.000 hectares (the last figure is eight times the area under opium poppy or 10 times the area under coca). UNDCP estimates worldwide cannabis production to be about 30,000 tonnes [1].

Opium

The global area under opium poppy cultivation is at its lowest level since 1988, some 17% smaller in 1999 than 1990. As illicit opium production has been eliminated in several countries, so it becomes increasingly concentrated in Afghanistan and, to a lesser extent, Myanmar. UNDCP estimates that approximately 91,000 hectares of opium poppy were cultivated in Afghanistan in 1999 an increase of more than 40% on the previous year. In 2000 cultivation declined by some 10% to 82,000 hectares. A stronger fall was recorded in the opium output in 2000 from the 1999 recorded high of 4,565 tonnes. Some of the decline was due to eradication and alternative development efforts in the limited areas where UNDCP ran its project activities; most of the decline, however, had simply to do with unfavourable weather conditions. Opium production in 2000 remained 22% above the 1998 levels [1].

Trafficking

Within the general pattern of drug trafficking a number of key trafficking routes can be identified:

Opiates from Afghanistan via Pakistan, Iran, Turkey and the Balkan route (and its various branches) to countries of the European Union and the European Free Trade Association;

Cannabis herbs from Mexico to the USA; Cannabis resin from Morocco via Spain to other European countries.

Among other recent diffusion of the principal trafficking routes, worth mentioning, is opium trafficking from Afghanistan via Central Asia to Europe. Seizures in the five Central Asian republics rose from negligible levels a few years ago to 3% of global seizures in 1997-98 [1] .

Consumption

The most widely consumed drug is cannabis. It is used in almost all countries across the globe. By contrast, the abuse of opiates is concentrated in Asia and Europe, and cocaine in the Americas, and to a lesser extent in Europe. Abuse of synthetic drugs, notably amphetamine-type stimulants (ATS) and benzodiazepines, is concentrated in Europe. Consumption of the various substances of the ecstasy group is concentrated in Europe, though spreading to other regions as well [1].

Drug abuse continued spreading in the 1990s particularly in the countries located along the main trafficking routes. Compared with the fist half of the 1990s, the most striking features appear to be: declining levels of opiate abuse in Western Europe and USA, and an increasing abuse problem in drug transit countries, notably Central Asian and East European countries, along the Balkan route, Southern and Eastern Africa. An increase has been noticed in all countries of Asia and in Australia. The most salient changes compared with the mid-1990s were decline in cannabis consumption in much of Asia (except for Kazakhstan) and the increase in Europe [1].

The indicators of annual prevalence among general population and population aged 15 and above are used by UNDCP to estimate the extent of illicit drugs consumption in countries and worldwide. The indicators were developed with the aim to "standardize" the very heterogeneous data obtained from countries, for this purpose all available estimates were transformed into one single indicator – the annual prevalence. Based on this approach, the total number of drug users is estimated to be some 18 million people, equivalent to 3% of global population or 4.2% of the population aged 15 and above. Of the latter age group 3.4% - use cannabis, 0.7% amphetamine-type stimulants, 0.3% cocaine and 0.3% opiates (of which heroin users comprise 0.22% ) (Table 1) [1].

The highest rates of per capita opiate abuse have been reported from the Islamic Republic of Iran, reflecting its proximity to Afghanistan. Iranian authorities have also reported increases in the consumption of opiates over the last few years, including in 1999, they calculated the prevalence of overall drug abuse in the country to be 1.2 million people (one study showed that 73% of all drug abusers in Iran take opium, 39% heroin, 22% hashish), or 2.0-2.8% of the population of age 15 and above.

Countries in Central Asia reported the strongest increases in opiate consumption over the last few years, including in 1999. The average prevalence in Central Asia is around 0.7% of the population aged 15 and above [1].

Table 1
Estimated number of cannabis and opiates abusers (annual prevalence)

Source: World Drug Report 2000, UNDCP (2001)

The diffusion of drug injecting to an increasing number of developing countries where previously the behaviour was often unknown, and the accompanying risk of human immunodeficiency virus (HIV) infection remains a serious global concern. Data from UNAIDS suggests that intravenous drug use (IDU) is the main, or a major, mode of transmission for HIV infection in many regions, Central Asia among them.

The world’s steepest HIV curve for 1999 was recorded in the newly independent states of the former Soviet Union, where the proportion infected doubled between the end of 1997 and the end of 1999. The HIV epidemic in the region appears to have started first in Ukraine, around 1994 to 1995, and subsequently moved to the Russian Federation. In 1997 and 1998 the first cases of HIV among IDUs began to be detected in the Baltic states, the Caucasus and the Central Asian countries. Whilst the absolute number of HIV cases remain low, IDUs are increasingly accounting for the majority of new infections.

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Posted April 12, 2001 © Eurasianet
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