Census of drug addicts in Brazil - The incidence and Nature of drug addiction

Abstract

The Commission on Narcotic Drugs continues to pay particular attention to the incidence of drug addiction, the nature of such addiction, its causes (etiology and epidemiology), the methods of preventing it, and the treatment and rehabilitation of drug addicts. At its seventeenth session, the Commission on Narcotic Drugs adopted resolution 2(XVII) requesting States Members of the United Nations or of the specialized agencies to encourage research into illegal drug consumption, with special emphasis on its socio-economic and medical aspects and to furnish the Secretary-General with reports on the results and findings thereof; the resolution further requests the Secretary-General to present a written report on the question.

Details

Author: DÉCIO PARREIRAS
Pages: 21 to 23
Creation Date: 1965/01/01

Census of drug addicts in Brazil - The incidence and Nature of drug addiction

Professor DÉCIO PARREIRAS Member of the Permanent Central Opium Board and the Drug Supervisory Body

The Commission on Narcotic Drugs continues to pay particular attention to the incidence of drug addiction, the nature of such addiction, its causes (etiology and epidemiology), the methods of preventing it, and the treatment and rehabilitation of drug addicts. At its seventeenth session, the Commission on Narcotic Drugs adopted resolution 2(XVII) requesting States Members of the United Nations or of the specialized agencies to encourage research into illegal drug consumption, with special emphasis on its socio-economic and medical aspects and to furnish the Secretary-General with reports on the results and findings thereof; the resolution further requests the Secretary-General to present a written report on the question.

Over a period of four years, the Brazilian Government carried out two censuses of drug addicts. When the National Commission for the Control of Narcotic Drugs (the technical agency of the Brazilian Government) came to carry out the Second Census of Addicts in Brazil, it fully appreciated what a difficult and exacting task it is to conduct a census in a country of such vast size - almost a sub-continent - and with a population of nearly 70 million. Despite the numerous, technical difficulties involved, the results produced by this second investigation were far. more reliable and encouraging than those of the first.

The National Commission for the Control of Narcotic Drugs 'realizes 'how difficult it is to determine the precise extent of drug addiction, both in Brazil and in the world as a whole; not merely its extent, but its fundamental causes, which, generally speaking, are little known.

A thorough and systematic study of the social and psychological aspects of the various forms of drug addiction is required, and this must be preceded by questioning and by social, economic and medical investigations. Nevertheless, the starting point must be an inquiry into the nature and incidence of these various forms of addiction; after that will come supplementary inquiries into the etiology of drug addiction (an ex- tremely complicated matter), its treatment (which some regard as a debatable matter), rehabilitation and prevention. The National Commission for the Control of Narcotic Drugs is confident that all this will be accomplished in due course.

The first difficult problem was how to define the meaning of " addict " and how to classify such persons. Can a person who from time to time uses an intoxicant - be it morphine or alcohol - be described as an addict? The members of the National Commission for the Control of Narcotic Drugs agreed unanimously that the term " drug addict " should be applied only to persons who had been at some time hospitalized or registered as out-patients by reason of ill-health caused by the use and abuse of one or more intoxicating drugs.

This was the definition adopted, and it was followed in the large-scale census carried out in 1962. This means that each of the figures referred to in the results of the 1962 investigation covers persons in respect of whom there was a diagnosis duly signed by a doctor after the necessary clinical examination and laboratory tests had been made.

The second difficult question was .where to obtain the samples for this medico-social investigation. In so vast a country, which regions or states and which types of welfare institution should be covered by the inquiry? Should it cover general hospitals, specialized hospitals, or both?

The National Commission 'for the' Control of Narcotic Drugs decided to base itself on the geopolitical division of Brazil into five regions - viz., northern, north-eastern, west central, east central and southern.

The northern region comprises the States of Amazonas, Pará and Acre and the Territories of Roraima, Amapá and Rondônia.

The north-eastern region comprises the States of Maranhão, Piauí, Ceará, Rio Grande do Norte, Paraiba, Pernambuco, Alagoas and the Territory of Fernando Noronha.

The west central regioncomprises the States of Mato Grosso, Goiás and Brasilia (Federal District).

The east central region comprises the States of Sergipe, Bahia, Espirito Santo, Minas Gerais, Rio de Janeiro and Guanabara.

The southern region comprises the States of São Paulo, Paraná, Santa Catarina and Rio Grande do Sul.

The National Commission for the Control of Narcotic Drugs decided that its investigations and inquiries should cover all the states and territories of Brazil.

It is common knowledge that the various groups of the Brazilian population, which is made up of a mixture of three distinct races, have different political, moral, mental and social problems.

Anyone who examines with care the final results of the present census will be struck by the dissimilarity in the composition of the population and notably by the difference in the percentages of foreigners as between the north-eastern and southern regions and of males and females as between the northern and southern regions.

These differences in the composition of the population are reflected in marked differences in drug-taking and drinking habits. As Dr. W. F. Quinn has said, " The problem, while a world-wide one, must be viewed in the light of the individual areas, the cultural susceptibility and the philosophical attitudes of the population of the nations involved." [ 1]

In addition, it was essential to inquire into the nature and incidence of addiction in the different types of welfare institution. The census of addicts took place in large general hospitals in the major towns, in regional hospitals in rural areas, in military prisons, surgical hospitals, maternity clinics, convalescent homes, mental hospitals, casualty hospitals, anaesthetists' rooms, veterinary centres, health centre dispensaries, geriatric clinics, spiritualist hospitals and dispensaries for arteriosclerosis. A thorough statistical inquiry was necessary, and superficial conclusions had to be avoided.

The results of the 1962 census are summed up in table 1; they may be modified slightly by the continuous process of checking which is still going on, but this will not affect the general picture.

It is evident from table 1 that the really serious problem in Brazil is alcoholism, which is the reason for the hospitalization of 94% of the persons deemed to be addicts; even so, the figure is much lower than that for the major cities and countries in the world. In Brazil's population of 70 million, the incidence of alcoholism is 0.01%.

TABLE 1

 

Total

%

Number of hospitals visited
187
-
Number of doctors on duty
193
-
Number of patients covered by census
225,198
-
Addicts
9,992 4.4
Number addicted to
   
Alcohol
9,385 94.0
Barbiturates
243 2.0
Tranquillizers
151 1.5
Cannabis
114 1.1
Pervitine (stimulant)
92 0.9
Morphine
4 0.04
Paregoric elixir
4 0.04
Ether
4 0.04
Cocaine
4 0.04
Opium (smoking)
1 0.01
Heroin
0 0
Coca leaves
0 0
Codeine
0 0
Dionine
0 0
Number of addicts who were:
   
White
9,658 96.0
Coloured
220 2.3
Students
82 0.9
Pharmacists
12 0.1
Doctors
11 0.1
Hospital staff
6 0.06
Drug traffickers
3 0.03

Serious drug addiction - that is, addiction to the so-called " smart" drugs - heroin, morphine, opium, ether, cocaine - is gradually disappearing as a result of greater awareness on the part of doctors and of the stringent control of drugs introduced in 1928.

What might be called the lesser forms of addiction (to barbiturates, stimulants and tranquillizers) are now being brought under control by legislation dating from 1961.

The inference that can be drawn from these 1962 figures is that, in order to carry out his daily work, the Brazilian man, subjected to the rigours of a tropical climate and depressed by intense heat for eight months in the year, is far more in need of something that arouses and stimulates him than of something that depresses him like the so-called narcotic drugs.

In the South American continent, there are two entirely distinct problems requiring separate solutions: the problem of the dwellers in the lowlands - including the Brazilians - who need to be stimulated (by alcohol, pervitine and cannabis) in order to be able to work; and that of the dwellers on the high Andean plateaux, who find in the coca leaf and its derivatives a way of mitigating the rigours of life at high altitudes.

Document E/CN.7/439, issued by the United Nations, gives particulars of the incidence of drug addiction in 162 countries and territories; these are divised into three categories: (1) countries where there is one addict per 1,000 or less population, of which there are 27; (2) countries where there is one addict per 1,000-5,000 population, of which there are 32; and (3) countries where there is less than one addict per 5,000 population, of which there are 103.

Brazil occupies a very respectable place in category 3. The statistical investigation carried out in the course of the 1962 census also yielded data concerning the incidence of drug addiction in particular occupational groups, as shown in table 2.

Special attention was also paid to the problem as it affects members of the medical and allied professions in Brazil. As is well known, drug addiction takes a heavy toll of these valuable members of hospital staffs, who daily handle dozens of ampoules and pills containing drugs that alleviate the pain and suffering of their patients. Thus they are all the time exposed to perilous contact with potent addiction-producing drugs.

TABLE 2

Occupation

Number of addicts

%

Students
82 0.9
Pharmacists
12 0.1
Physicians
11 0.1
Hospital staff
6 0.06
Dentists .
0
-
Veterinary surgeons
0
-
Drug traffickers
3 0.03
TOTAL
114  
1

See Bulletin on Narcotics, Vol. XV, No. 1, p. 11.