Es­ca­la­tion of the world drug problem

Sunday Times (Sri Lanka) - - COMMENT - By Pro­fes­sor Ravin­dra Fer­nando

The amount of nar­cotic drugs seized by the po­lice had in­creased in Sri Lanka, ac­cord­ing to the lat­est re­ports pre­sented to Par­lia­ment. A to­tal of 388,722 Kgs of nar­cotic drugs had been seized in 2016 com­pared to 13, 548 Kgs in 2015. This in­cluded 36,817 Kgs of ganja, 15 Kgs of opium, 27 Kgs of hashish, 205 Kgs of heroin, and 1,302 Kgs of co­caine seized by the po­lice in 2016.

The to­tal amount of ganja seized in 2015 was 13,253 Kgs, while four Kgs of hashish, 44 Kgs of heroin and 44 Kgs of co­caine were found in the same year.

Year 2016 can be con­sid­ered as a year in which dan­ger­ous in­tox­i­cant drugs had been seized on a large scale. The num­ber of re­ported of­fences re­lat­ing to this sub­ject re­mains at a sim­i­lar level as those re­ported last year. The po­lice was able to main­tain a solv­ing per­cent­age sim­i­lar to that of the pre­vi­ous years, which was 98%.

Last month, Min­is­ter of Law and Or­der and South­ern Devel­op­ment Sa­gala Rat­nayaka stated that a spe­cial anti-nar­cotic force has been cre­ated to curb the in­ter­na­tional nar­cotic trade in Sri Lanka.

"We have a re­spon­si­bil­ity to the na­tion, to the re­gion and to the world to stop these ac­tiv­i­ties," he said adding that Sri Lanka hopes to carry out pro­grammes with in­ter­na­tional as­sis­tance to erad­i­cate the drug me­nace.

The min­is­ter pointed out that Sri Lanka is lo­cated strate­gi­cally at a piv­otal point for ma­jor drug car­tels to utilise as a tran- sit hub and some of the nar­cotics that pass through Sri Lanka re­mains in the coun­try.

"We are fight­ing this on two an­gles. One is our re­spon­si­bil­ity to the re­gion and the world and also to en­sure that there are no drugs in Sri Lanka. We are go­ing to fight both very hard," he said.

The min­is­ter said Sri Lanka is work­ing very closely with the coun­tries in the re­gion to erad­i­cate the drug trade, and also within Sri Lanka, a new po­lice unit called “Or­ga­nized Crime and Nar­cotics Range” has been cre­ated. The unit is headed by a se­nior DIG and he has been given a very tal­ented team to work on the task, the min­is­ter added.

Min­is­ter Rat­nayaka stated that Sri Lanka had be­come a tran­sit point for mass scale drug traf­fick­ing by ma­jor drug car­tels due to the pro­longed il­licit ac­tiv­i­ties of the Tamil tiger rebels.

Con­firm­ing the min­is­ter’s state­ment, Sri Lanka Cus­toms has ar­rested a 54- year- old Pak­istani na­tional at­tempt­ing to smug­gle 376 grams of heroin worth 3.7 mil­lion ru­pees last month at the Ban­daranaike In­ter­na­tional Air­port. He has ar­rived from Bangkok. The heroin was found con­cealed in the sus­pect's hand lug­gage.

In­ter­na­tion­ally, the drug sit­u­a­tion is get­ting worse. The fed­eral govern­ment of the USA just put out new statis­tics for drug over­dose deaths in 2016. They are very, very grim.

The pre­lim­i­nary fig­ures from the Na­tional Cen­ter for Health Statis­tics ( NCHS) sug­gest that there were more than 64,000 drug over­dose deaths in 2016. In a shock­ing, but not quite sur­pris­ing rev­e­la­tion, syn­thetic opi­oids like fen­tanyl over­took both heroin and pre­scrip­tion pain- killers in terms of over­dose deaths.

Based on the NCHS fig­ures, tra­di­tional opi­oid painkillers, such as OxyCon­tin and Per­co­cet ( a com­bi­na­tion of parac­eta­mol and oxy­codone) were in­volved in about 14,400 over­dose deaths in 2016, and heroin was in­volved in more than 15,400. Per­co­cet is used to re­lieve mod­er­ate to se­vere pain. Non- methadone syn­thetic opi­oids like fen­tanyl were linked to more than 20,100 over­dose deaths. The re­main­ing over­dose deaths in­volved other drugs, such as co­caine.

If these num­bers hold up (and fi­nal fig­ures will come out later this year), it so­lid­i­fies the opi­oid epi­demic as Amer­ica’s dead­li­est over­dose cri­sis ever! (In com­par­i­son, more than 58,000 US sol­diers died in the en­tire Viet­nam War, nearly 55,000 Amer­i­cans died of car crashes at the peak of such deaths in 1972, more than 43,000 died due to HIV/ AIDS dur­ing that epi­demic's peak in 1995, and nearly 40,000 died of guns dur­ing the peak of firearm deaths in 1993.)

The num­bers show the evo­lu­tion of the opi­oid epi­demic. It orig­i­nally be­gan as a cri­sis rooted in the dra­matic over-pre­scrip­tion of opi­oids. But over time, many users moved onto other opi­oids, par­tic­u­larly heroin and fen­tanyl. Fen­tanyl is an opi­oid pain med­i­ca­tion with a rapid on­set and short du­ra­tion of ac­tion.

In the mid-1990s, Fen­tanyl was in­tro­duced for pal­lia­tive use with the fen­tanyl patch. As of 2012, Fen­tanyl was the most widely used syn­thetic opi­oid in medicine. Fen­tanyl patches are on t he Wo rl d H e a l t h Or­gan­i­sa­tion's List of Es­sen­tial Medicines, the most ef­fec­tive and safe medicines needed in a health sys­tem. Fen­tanyl is an ap­proved drug in Sri Lanka.

Med­i­cal ex­am­in­ers and coro­ners in the USA are in­creas­ingly test­ing for opi­oids due to much greater aware­ness of the cri­sis. Some of the in­creases in num­bers are partly at­trib­ut­able to the fact that peo­ple are look­ing for these deaths now. Still, a bulk of the in­crease is likely due to a gen­uine rise in over­dose deaths.

The lat­est drug epi­demic is not solely about il­le­gal drugs. It be­gan, in fact, with a le­gal drug. Back in the 1990s, doc­tors were per­suaded to treat pain as a se­ri­ous med­i­cal is­sue. There is a good rea­son for that: About 100 mil­lion US adults suf­fer from chronic pain, ac­cord­ing to a 2011 re­port from the In­sti­tute of Medicine.

Phar­ma­ceu­ti­cal com­pa­nies took ad­van­tage of this con­cern. Through a big mar­ket­ing cam­paign, they got doc­tors to pre­scribe prod­ucts like OxyCon­tin and Per­co­cet in droves, even though the ev­i­dence for opi­oids treat­ing long-term, chronic pain is very weak (de­spite their ef­fec­tive­ness for short- term, acute pain), while the ev­i­dence that opi­oids cause harm in the long term is very strong.

Painkillers pro­lif­er­ated, land­ing in the hands of not just pa­tients but also teens rum­mag­ing through their par­ents’ medicine cab­i­nets, other fam­ily mem­bers and friends of pa­tients, and the black mar­ket!

As a re­sult, opi­oid over­dose deaths trended up - some­times in­volv­ing opi­oids alone, at other times in­volv­ing drugs like al­co­hol and ben­zo­di­azepines, typ­i­cally pre­scribed to re­lieve anx­i­ety. By 2015, opi­oid over­dose deaths to­taled more than 33,000 - close to two- thirds of all drug over­dose deaths.

Yet many peo­ple who lost ac­cess to painkillers are still ad­dicted. Some who could no longer ob­tain painkillers turned to cheaper, more po­tent opi­oids: heroin and fen­tanyl.

At­tor ney Gen­eral Jef f Ses­sions of the USA re­cently called drug over­dose deaths "the top lethal is­sue" in the USA and urged law en­force­ment and so­cial work­ers to "cre­ate and fos­ter a cul­ture that's hos­tile to drug use." Ses­sions spoke to the an­nual con­fer­ence of the Na­tional Al­liance for Drug En­dan­gered Chil­dren. He said pre­lim­i­nary data show nearly 60,000 over­dose deaths in the US in 2016, the high­est ever. "Our cur­rent drug epi­demic is in­deed the dead­li­est in Amer­i­can his­tory. We've seen noth­ing like it," said Ses­sions.

Ac­cord­ing to Canada’s On­tario Pro­vin­cial Po­lice (OPP), three Toronto- area men were re­spon­si­ble for al­legedly im­port­ing more than 1,000 kilo­grams of pure co­caine worth $250 mil­lion into Canada from Ar­gentina re­cently. Bricks of co­caine were hid­den in blocks of ce­ment. Three men face drug im­por­ta­tion and drug traf­fick­ing charges.

The drug problem in Asia is also get­ting worse.

The Bor­der Se­cu­rity Force in Bangladesh has seized 3,045 bot­tles of banned cough syrup Phensedyl near the In­di­aBangladesh bor­der in West Ben­gal's Ber­ham­pur. Phensedyl cough syrup con­tains chlor­pheni­ramine maleate and codeine phos­phate as ac­tive in­gre­di­ents.

The bot­tles were to be smug­gled into Bangladesh, where these cough syrups are banned and sell­ing them is pun­ish­able.

Last year, Bangladesh’s govern­ment had taken a ma­jor step to ban the man­u­fac­tur­ing of codeine- based cough syrups, which were ear­lier eas­ily avail­able at chemist shops. These syrups, which are be­ing sold un­der dif­fer­ent brand names, had be­come a ma­jor me­nace as many youths be­came ad­dicted to them.

Al­though Codeine- based cough syrups are ef­fec­tive in sup­press­ing coughs and colds, their mis­use emerged as a ma­jor problem. The ac­tive in­gre­di­ent Codeine is a nar­cotic be­long­ing to a class of chem­i­cals called opi­oids.

Delhi is rapidly turn­ing into a hub for the drug trade. In the past six months, the Nar­cotics Con­trol Bureau (NCB), to­gether with the Spe­cial Cell of Delhi Po­lice - both func­tion­ing un­der the Min­istry of Home Af­fairs ( MHA) - has seized drugs worth In­dian ru­pees 300 crore ( 3,000 mil­lion) in the na­tional cap­i­tal.

Ac­cord­ing to the anti- smug­gling cell of the NCB, start­ing from Jan­uary 2017 till July this year, the NCB, work­ing jointly with the spe­cial cell of the Delhi Po­lice, has seized drugs worth Rs. 300 crore.

An NCB of­fi­cial said that the NCB’s alert­ness has helped to crack down on the drug trade in the city and car­tels are be­ing busted. “The NCB has be­come strong and that is the rea­son why we are bust­ing one or the other drug car­tel the coun­try. The cen­tre wants to strengthen the NCB to com­bat il­licit traf­fick­ing of nar­cotic drugs, which is fu­elling ter­ror­ism on In­dian soil,” a se­nior NCB of­fi­cial said on the con­di­tion of anonymity.

Re­spond­ing to a query re­gard­ing why, de­spite the seizures, drugs are freely avail­able in the cap­i­tal, the of­fi­cial said there was a need for in­creased in­ter­ven­tion of the po­lice to curb re­tail drug ped­dling. “The NCB has lim­ited re­sources and we can­not be present ev­ery­where, some­thing which the po­lice can eas­ily do. The polic­ing sys­tem in the cap­i­tal needs to be more se­ri­ous about this. They need to take ac­tion against the small drug ped­dlers who do not come on our radar,” he said.

Sri Lanka is not alone in the fight against drugs. Led by the Min­istry of Law and Or­der and Sou th­ern Devel­op­ment, the po­lice, se­cu­rity forces, Civil De­fence For c e, Spe­cial Task Force, cus­toms, ex­cise and Na­tional Dan­ger­ous Dr u g s C o n t ro l Board of Sri Lanka are in the fore­front of this strug­gle. (The writer is the Chair­man of the Na­tional Dan­ger­ous Drugs Con­trol


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