Giver of delight or Liberator of sin: Drug use and "addiction" in Asia

Sections

I. Introduction 3
II. History
III. Present pattern and extent of use
IV. Production and traffic

Details

Author: Joel FORT, M.D.
Pages: 1 to 11
Creation Date: 1965/01/01

Giver of delight or Liberator of sin: Drug use and "addiction" in Asia 1

Joel FORT, M.D. 2
"It is better to journey hopefully than to arrive" Chinese proverb

I. Introduction 3

If one seeks to understand the use and abuse of mind altering drugs in a given culture or society, it is desirable to view the phenomenon within the broadest possible context, a context which will reveal the roles played by a particular drug, the inter-relationship with the use of other drugs, and the complex socio-psychological forces causing, and being affected by the drug use. In a like manner, narrow, parochial or ethnocentric attitudes of individual commentators, specialists, agencies and countries can benefit from an understanding of the drug abuse picture in other less publicised, less frequented areas of the world. Therefore, let us examine a vast area of the world, Asia, which uses and produces vast quantities of narcotics (opiates) and cannabis for varied historical, sociological, and economic reasons. An understanding of the Asian "addiction" pattern along with a study of that region's attempts to change and control the use of these drugs, can illuminate not only the Asian "delight or sin" but also related situations in America, Africa and Europe.

1

The term Asia as used here does not include the Asian portions of the USSR, the Near East, (Turkey, Syria, Lebanon, Jordan, Israel) and the Arabian peninsula.

2

Formerly: Lecturer, University of California School of Criminology; Consultant, World Health Organization.

3

This article will be published in two consecutive numbers of the Bulletin. The first part, in the present issue, contains the first four chapters indicated in the table of contents; the full table has been given here for the convenience of readers.

Flowering poppy field

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The author has been fortunate in having had the opportunity to study this subject at first hand in Asia on three occasions: first, in 1960 on a personal and professional visit, and again in 1963 and 1964 as a Consultant for the World Health Organization. During these visits to Asia he was able to make a study of sixteen countries stretching from Japan to Iran, their way of life and their problems, including those of drugs. He also studied extensive collections of books and documents relating to drug "addiction". In each country he had discussions with medical and health officials as well as with law enforcement and prison personnel, customs agents, probation and parole staffs, members of university faculties and research institutes, representatives of international and bilateral aid programmes, journalists, drug users and "addicts", and ordinary citizens. He visited offices, hospitals, prisons, laboratories, "dens" and related places where these substances are obtained and used. Factual comprehensive information, both verbal and written, has been sought in as unbiased a manner as possible and cross-checked against as many other sources as possible. Problems of cultural bias and language differences cannot of course be completely overcome.

The territory herein discussed encompasses an area of 3,755,000 square miles (excluding the almost equal area of the People's Republic of China which could not be visited but is discussed at some length) and a population of about 972,000,000 embracing diverse languages, cultures, histories and patterns of drug use.

The major psychoactive drugs used are opium, heroin, cannabis, and alcohol but in several of the countries there is also considerable use of manufactured sedative and stimulant drugs, and of indigenous substances.

Since the region as a whole is in the category of being socio-economically under-developed it is not surprising Since the region as a whole is in the category of being socio-economically under-developed it is not surprising that the typical users of what the laws refer to as "narcotics", come from the lower classes and are uneducated. They are generally male and between the ages of 20 and 50. In many of the countries and with many of the users in most of the countries the use is traditional and has been culturally tolerated although usually the actual present-day laws prohibit this use. Because the laws and governmental practice usually reflect "Western" values on the matter, all users of "narcotics" are referred to and handled as addicts although many, and in some countries most, are occasional or intermittent users or use substances that are not addicting (producing tolerance and an abstinence syndrome) from a pharmacological standpoint. Recently the term "dependency" has been recommended by the World Health Organization to replace "addiction" and in the past some made a distinction between psychological and physical "addiction".

The major drug abuse problems of Asia occur in Hong Kong, Thailand, Iran, and in a different sense, as will be seen, in India and Pakistan. Several other countries are involved in the illicit production or distribution of opium or cannabis (to be discussed in a subsequent section) and India is a licit producer of opium used principally for the manufacture of analgesic alkaloids.

Opium smoker

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Among the major questions to be considered in this article are: the causes or reasons for drug use in different cultures; the effects of this use on the individual and on society; and the value of present policies for coping with the problem. A number of trends in drug "addiction" in Asia have become apparent in recent years, some of which are dealt with here, including: the increasing use of heroin particularly by the young; the emphasis on law enforcement approaches and on "strict" penalties; the absence of adequate or comprehensive treatment and rehabilitation programmes; lack of attention to the underlying socio-economic bases of addiction; a dearth of research and of educational and professional training programmes; and continuation and growth of the illicit traffic in narcotics despite national and international "control" policies.

II. History

Although there are individual and different patterns involved in the history of drug use in each country, two major traditions of drug use have been dominant in the region and will be discussed at some length here, namely, the Chinese and the Indian. An understanding of these traditions is essential for an adequate appreciation of the contemporary picture of use and abuse, and the degree of success to be expected from present approaches.

China

In China it appears that opium was used as far back as the Tang Dynasty (618-907 A.D.) for medicinal, and perhaps also non-medicinal, purposes. Some say that in Asia the drug was first introduced in Persia and India by Arab traders who did not carry it to China until the ninth century. The Portuguese (until 1769) and the British (who took over control of the trade in 1773) in association with local merchants tried to expand the consumption (by smoking in combination at first with tobacco) of opium, and by the late seventeenth century the practice had become widespread. In the early eighteenth century the British were importing 30,000 pounds of opium per year into China from India, an amount which progressively increased to 750,000 pounds per year in the first decades of the nineteenth century. By that time other countries were competing for the trade as, for example, the United States which was importing Turkish opium.

Apparently, an attempt was made in the fourteenth century to suppress the opium trade; in 1800 the Chinese government made the importing of opium illegal; and in 1879 an Imperial Edict was issued forbidding the sale or smoking of opium, but all of these efforts were unsuccessful.

The two Opium Wars which took place between 1834 and 1858 dramatized the continuing conflict between Chinese prohibition efforts and British trade, the first war being precipitated when the Chinese Imperial Commissioner for the Suppression of the Opium Trade seized 20,000 chests of imported opium in Canton at a time when the annual importation amounted to 40,000 chests (6,000,000 pounds). The penalty paid by the Chinese for losing the war was $21,000,000 including $6,000,000 for the opium they had seized, and the ceding of Hong Kong to England. The opium trade rapidly became the major economic activity of the island, employing some 80 clipper ships and most of the working population. By 1850 Hong Kong was handling three quarters of India's crop (which in toto was providing one fifth of the Indian government's revenue). In the meantime, in 1845 the first local opium monopoly was established when the government sold the rights to the highest bidder, a Chinese businessman. Throughout this period the expressed Western attitude was that opium use was harmless (for Chinese) and profitable.

In an attempt to end the trade, the Chinese fought (and lost) the second Opium War which ended in 1858 with Britain (aided by France) obtaining through the Treaty of Tientsin the opening of five major ports to foreign trade and the full legalisation of opium importation and the cultivation of the opium poppy.

Against this background of attempts by the Chinese government to suppress opium use (presumably because it was felt to be detrimental to the country's development) it was not until 1891 that the English House of Commons criticized the trade and in the same year the Hong Kong authorities placed controls on the official trade (which by 1898 fell to 34,292 chests with proceeds of $357,666). Further restrictions occurred in 1913 and 1924 but the trade in continental China continued to provide a significant, although decreasing portion of the national revenue up to and including the period of active dissemination of drug use during the Japanese occupation which began in 1937.

In the early years of the twentieth century it was estimated that 8,000,000 people in China were using opium and that the annual consumption was 22,500 tons. In the 1920s an official committee estimated that 25 per cent of the adult population (including 2 per cent of the females) of Hong Kong and the rest of China were using opium and that there was general public support, or at least acceptance, of this use, even among the upper classes. It was further noted that both smoking and less often, eating of opium, were increasing with only half the consumption being legal. Illegal opium was available at low cost without limitation, but it was of lower "quality". In the mid-1930s it was estimated that 10,000,000 people were using opium.

In terms of what was to become a much more serious problem in later years, in the 1930s, mention was made of heroin as appearing relatively frequently in Hong Kong and being manufactured in Macau and in Manchuria (by the Japanese).

At this point it should be noted that this information about Hong Kong and China shows only the broad outlines of the historical pattern of use but tells very little of how and why opium became popular, and whether the attempts to suppress it were based upon economic, social or other reasons. Despite the gaps in the (translated) historical material it seems evident that use had been widespread for several centuries and, from accounts as recent as the 1930s, Chinese of all social classes used opium on occasion as an integral and duly accepted part of business and social life (analogous to the use of alcohol in most Western countries), and some used it regularly and frequently.

Some time in the third millenium B.C. the euphoric properties of the female Cannabis sativa plant became known to the Chinese and the drug was described in the pharmacopoeia of Shen Nung written circa2730 B.C. There being some then, as now, who considered pleasure or happiness immoral, the plant came to be called the "Liberator of Sin" by them. Others, perhaps the majority who used it not only as a euphoriant but for different ailments or diseases such as arthritis, malaria, and constipation, referred to the plant as the "Delight Giver". It is from these early polarized concepts which people continue to argue today that the title of this article is taken. The subsequent pattern of use in mainland China or in Hong Kong is practically unknown except that some believe that it continues to be widely used including use in indigenous medical preparations. Formerly use occurred mainly in Sinkiang Province, which also exported charas to India. 4

Chasing the dragon

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Alcohol, particularly in the form of wine from rice, millet and grapes, has a history of use which is impossible to date but must be of several thousand years' duration. Its use for religious purposes, entertainment, and medical treatment has been described. The extent of alcohol consumption among the Chinese or the "European" population of Hong Kong has not been measured but it is generally believed that alcoholism among the Chinese population is uncommon because of the traditional sanctions against excessive drinking, public drunkenness, and drinking apart from meals.

India - Pakistan

The history of the use of opium in India is said to have begun in the ninth century A.D. through the influence of Arab traders. Over the next several hundred years the opium poppy came to be widely cultivated in many regions of the country; it became an important trade commodity with China and other Asian countries; and it was consumed by eating, drinking or smoking in all social classes. In the sixteenth century the drug came under a state monopoly which later passed to local private merchants, then to the British East India Company, and finally back to government control.

The historical pattern of opium use in India is well illustrated by the report of an 1893 Royal Commission which concluded that the main use was for oral consumption by adults and children: that this use was by a "small" percentage of the total population and was generally moderate with no evidence of harmful physical or moral effects; that the use was due to the universal tendency of mankind to take some form of stimulant to comfort or distract themselves and to a popular belief in the medical effectiveness of the drug; and that it would be impractical and unenforceable to prohibit use or to limit it to medical purposes because of the ceremonial and social uses to which it was put and its acceptance by Hindus, Moslems and general public opinion. An increased consumption of alcohol was also feared if opium was prohibited.

The medical uses of opium in India including what is now Pakistan have been somewhat better documented than the social and ceremonial uses. The drug was introduced into the Hindu system of Ayurvedic medicine in the fourteenth century and probably into the Moslem system of Unani medicine not long after. 5 The materia medica of each contains eight basic preparations which were and are used for diarrhoea, pain, to increase sexual power, and to produce sensations of pleasure and vigour. The drug became widely used as a household remedy. The recommendations of shopkeepers, as well as the climate, and varying religious and caste attitudes also played a role in the frequency of use.

4

See Bulletin on Narcotics, Vol. V, No. 1.

5

See Bulletin on Narcotics, Vol. XVII, No. 1.

All in all, prior to the twentieth century, there is general agreement that in India opium use (by eating or drinking) was very common among all social classes and both sexes without any social stigma. It is not known how many used it regularly or frequently or how many may have been addicted, but on the basis of excise revenue, R. N. Chopra & I. C. Chopra 6 stated that the total consumption was much smaller than in China (despite the low cost and unrestricted availability). It would seem reasonable to estimate that the number of Indian users of opium ranged up to many millions in the first decades of the twentieth century.

As for cannabis, it was some centuries after its use was well known in China that it became known or reached India, probably not later than 800 B.C. How the plant came to be universally called "Indian Hemp" is not known but it is perhaps because its cultivation and use became almost a science, and was closely interwoven with religious philosophy in India. As in other countries, the plant grew relatively easily in a wild state and was also carefully cultivated in some areas to produce a maximum amount of active drug. The three main forms in which cannabis is consumed in India are: bhang which is made from the dried flowering tops of the uncultivated female plant; ganja made from the dried flowering tops of the cultivated female plant; and charas which is the pure resin extracted from the tops of the cultivated female plant.

Careful cultivation to obtain a maximum yield of the active drug consists of preparing and manuring the soil, sowing the seeds (usually in August), trimming the plants in November, removing weeds, and when the flowers begin to form hiring a "ganja doctor" to cut down all male plants which would otherwise fertilize the female plants and cause the flowers to form seed. The female plants then mature in January and the crop is harvested about a month later. In 1893 the Indian Hemp Drug Commission reported the total area under cultivation to be 6,000 acres but there was no estimate of the extensive wild growth of the plant.

Both ganja and charas came to be most commonly smoked in earthenware or water pipes sometimes mixed with tobacco, datura or opium. Bhang is sometimes smoked and sometimes chewed, but most commonly it is taken as a beverage (as is ganja sometimes) or confectionery. Numerous preparations in combination with various other ingredients exist and go by many different names. The effects produced are believed to be similar, with ganja four or five times as potent as bhang, and charas two or three times as potent as ganja.

6

See Bulletin on Narcotics, Vol. VII, Nos. 3-4.

Block of "999" morphine

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Cannabis consumption in India was most frequently a group phenomenon and had many social aspects such as passing the "chillum" for smoking or drinking bhang from a common bowl in some Hindu, Sikh, and Moslem religious centres. The plant is considered holy by the Hindus, having been described as a sacred grass during the Vedic period. In one legend the guardian angel of mankind is believed to live in its leaves and in another account the plant sprang from nectar dropped to earth from heaven.

In the 1830s cannabis preparations began to be used in India as part of modern or "western" medicine. Pain, insomnia, and depression were among the symptoms treated with it. Similar preparations have been used in Ayurvedic medicine since the seventh century A.D. and in Tibbi medicine since the tenth century A.D. The range of complaints for which it was (and is) given included haemorrhoids, dysmenorrhoea, arthritis, diarrhoea, gonorrhoea, malaria, mental illness, pain and insomnia. 7

Cannabis use and growth remained unrestricted in India until 1881 when a law to limit use of the drug was passed.

In 1894 the most detailed study that has been made of cannabis was published (3,000 pages), the Report of the (1893) Indian Hemp Drug Commission, which found no significant evidence of mental or moral injury or disease arising from the moderate use of cannabis drugs. It stated that regular moderate use produced the same effects as moderate use of whisky, and added that moderation did not lead to excess any more than it did with alcohol. Certain restrictions were recommended, however, and an act was passed in 1896 limiting and licensing cultivation, importation and sale.

7

See Bulletin on Narcotics, Vol. XVII, No. 1.

As with opium and cannabis, the production and use of alcohol in India has a multi-century history but is much less documented. Religious, dietary, medical and entertainment uses have each been involved in the use of beverages fermented from rice, grain, sugar, molasses and honey. A substance called "soma" is believed to have been one of the earliest fermented beverages.

Other countries

In the other Asian countries less is known about the historical aspects of drug use. In some, such as Persia, individual traditions developed, whereas in others there occurred variations or combinations of the Chinese and Indian patterns.

The use of opium in Iran (Persia) was mentioned in 850 B.C., 371 B.C., 900 A.D., 1000 A.D., and 1051 A.D. with records of medical studies in the tenth century A.D. and subsequent introduction into therapeutics. It is commonly believed that the Arabs, using the drug to allay their hunger during desert crossings, introduced it to Iran. In the sixteenth century a beverage called Kooknar made from the opium poppy boiled in water was widely drunk in some regions of the country. By the mid-nineteenth century cultivation of the opium poppy and the use of opium became widespread, including extensive use as a remedy for many diseases. A lucrative export trade, mostly to the Far East, also developed. In the Persian language (Farsi) the drug is referred to as Taryak meaning panacea rather than Afioon which is the Greek name for opium. In 1910 legal measures were promulgated to prohibit completely the non-medical use, but this met with no apparent success. In 1928 a law was passed to establish a government monopoly of opium and effect a gradual decrease in cultivation leading to a total ban after ten years, with heavy penalties for illegal use or traffic. Again in 1938 a ban on cultivation was issued for 25 districts of the country but this was not enforced. As the middle of this century was reached, it was estimated that there were as many as 1,500,000 opium users ("addicts") in Iran, an annual harvest of 700-1,200 tons (with 90 tons exported), daily smoking of 2,000 kg, widely available public opium smoking houses, frequent prescribing of the drug by physicians, and social acceptance of its use. Opium production and the consumption were prohibited by a law of October 1955. 8

8

See Bulletin on Narcotics, Vol. VIII, No. 3.

The cultivation and use of cannabis or as it is known in Iran, hashish, has been known to exist for hundreds of years but is little documented and since present-day use appears to be relatively small in the country, it will not be discussed here.

Likewise, it is difficult to reconstruct the historical pattern of alcohol use or to document current practices in regard to the drug, but it is known that there has been and is at present widespread use and some abuse despite the Moslem religious prohibition against such use. Legends and archeological fragments indicate ancient alcohol production from grapes, dates, and a flower known as haoma.

With Burma which was under British rule for some decades, prior to its becoming independent again in 1948, there was apparently no tradition of opium use in most parts of the country and some segments of public opinion opposed it, so England was unable to develop its customary free trade in opium and instituted a system of excise control which, however, did not affect the several Burmese States which were governed separately. Although there are reports indicating that the excise control was not effectively enforced, licensed opium shops were opened to sell to licensed smokers. It was stated that opium was necessary for the Indian and Chinese population of the country. The revenue from these shops averaged 5,500,000 Indian rupees per year. This system was interrupted by the Japanese occupation and was not resumed after independence. The poppy has been traditionally cultivated and widely used in the frontier hill areas of the country, particularly the Kachin, Shan, and Wa States. It is also part of the traditional medical system.

Prior to the Japanese occupation there were government shops in at least Rangoon and Mandalay selling cannabis (ganja) primarily to the Indian population of Burma.

Opium use in Ceylon occurred to an unknown extent; under a 1910 Opium Ordinance, procedures were established for consumers to register and receive through a government officer raw or prepared opium at a fixed price. Parts of this law were repealed in 1929 and following that addicts were not registered or licensed, although opium remained available through special shops until 1948.

Cannabis has been widely used and cultivated in Ceylon for many years. Indigenous medical systems have made extensive use of the leaves and seeds for preparations used for relief of fatigue, improvement of appetite, insomnia, and aphrodisia.

Indonesia had a government opium monopoly until 1944 under the Dutch, and briefly under the Japanese. Licensed stores would sell to licensed users who were supposed to use the opium only in certain sections of the city. Use was thought to be mainly among the Chinese population and in 1925 an estimate of 500,000 smokers was made.

Despite Japan having spread the use of narcotics in enemy and captive countries, in Japan itself prior to the Second World War "addiction" was considered to be almost non-existent and it was believed that the "national character" prevented it.

Opium was introduced to Korea as early as the third century B.C., while morphine was introduced in 1905 and became widely used during a 1919-20 cholera epidemic.

In Laos (and the rest of Indo-China prior to 1954) licensed opium dens were established by the French, and addicts, after hospitalization and determination of proper dosage, were sold their necessary supplies. The Meo and Yao and other hill-tribes people have for hundreds of years smoked or eaten opium and used it as a remedy for a wide variety of ailments.

Until 1909 in Singapore opium was legally imported and sold by licensed traders but after that year a government monopoly was established. A registration law was passed in 1929 and in the mid-1930s the British banned any further registration, except for male Chinese adults.

One half of the total revenue came from prepared opium which was selling at the rate of 250,000 pounds per year (an estimated 2 ounces per month per "addict"). After new registrations were prohibited, others bought opium illegally (at the same price) or shared the rations of the registered addicts. The opium shops closed for more than a year during the Japanese occupation and then re-opened with closer controls. In the pre-war period there were thought to be more than 40,000 regular users. The situation in Malaya (now part of Malaysia) developed in an apparently similar manner with opium dens not being officially closed until 1948.

The smoking of opium (at first mixed with tobacco) in the Philippines goes back at least to the tenth century A.D. when it is believed to have been introduced by the Chinese. In the sixteenth century opium eating was popular, but under Spanish control, use by the Filipinos was banned. Under the United States the tariff on opium was reduced in order to discourage smuggling and large quantities were imported, but in 1905 use of the drug was prohibited.

Clandestine heroin laboratory

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Thailand has a history of opium use dating back at least 200 years, always considered a "problem" of the Chinese population. Numerous edicts were issued by the Kings, including those of 1811 totally banning opium consumption and sale; in 1839 prohibiting the buying and selling of opium; and in 1852 establishing licensed opium farms and restricting smoking to the Chinese. In 1908 there was a plan to reduce consumption gradually and in 1912 the government took over control of the import and sale of the drug. Over the succeeding years various governments emphasized the desirability of abolishing opium use but the situation continued. Finally in 1959 all production, sale and consumption of opium was banned.

III. Present pattern and extent of use

Drug use having come to be considered a clandestine activity, one cannot obtain a precise census of drug users, but estimates based upon the historical pattern, drugs cultivated or seized, numbers arrested or hospitalized, reports of various officials, and users themselves, etc. form the basis of the estimates arrived at in this article.

The present extent of use of the drugs under discussion in the People's Republic of China cannot be estimated, but what little information is available suggests a significant decrease. Of the three other predominantly Chinese communities, Hong Kong has an estimated 150,000 illicit narcotic (mostly heroin) users; Macau 6,000 (mostly opium); and Taiwan (Republic of China) 40,000 (mainly heroin and morphine). In these and several other countries of the region, following abrupt postwar bans on opium use, heroin which is much easier to hide and consume and is much more dependence-producing, has largely replaced opium. Overall, the most common method of administration is by inhalation for heroin, and pipe smoking for opium (some eat it), but intravenous injection is also employed on a significant scale, particularly in Taiwan. The procedure known as "chasing the dragon" is the preferred means of inhalation: heroin, usually along with a barbiturate powder is placed on a flat piece of tin foil to which a flame is directly applied, producing fumes which are inhaled through a paper tube, through a match box cover ("playing the mouth organ"), or occasionally directly. Less: commonly tobacco cigarettes to which heroin has been added or applied to the tip (" firing the ack-ack gun") are smoked. 9

Secret compartment in doll

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In contemporary India where widespread indigenous, medical, quasi-medical, and illicit use all occur, there may be as many as 1,000,000 regular users of opium and 1,000,000 of cannabis (bhang and ganja), most consumption being by eating or drinking with only limited smoking occurring. The government officially estimates around 200,000 users of each of these drugs.

There are also millions of illicit (since varying degrees of prohibition exist in most states) users of alcohol and on a much smaller scale, use of barbiturates, chloral hydrate and cocaine (in the 1930s 500,000 users were estimated).

The present situation in Pakistan probably parallels that of India proportionately but is not as well documented. The practices in East Pakistan are different from those in West Pakistan but together they probably have more than 200,000 opium users. The drug is taken by mouth and for the most part is obtained from licensed vendors. There is widespread use of cannabis, including ganja, bhang and charas which is the main "problem" in West Pakistan. The method of use is similar to that described for India. Alcohol is widely consumed despite religious, and sometimes legal, prohibition.

9

See Bulletin on Narcotics, Vol. X, No. 3.

Iran now has an estimated 500,000 opium and 20,000 heroin users. The traditional opium use was banned in 1955 and in recent years there has been a steady increase in heroin use, particularly among the young, and in Teheran. Opium is both smoked (in pipes of different design than the Chinese ones) and eaten. The latter method has increased as the price has risen. Heroin is sniffed directly, or inhaled as in the Hong Kong "chasing the dragon" method, and less commonly, injected. Seizures indicate some cannabis use but the extent cannot be estimated.

In Malaysia there are probably approximately 40,000 users (10,000 in Singapore and 30,000 in Malaya), mostly Chinese. Opium is the drug of choice and is smoked (mostly in "dens") but there is also some use of morphine by injection.

Japan would also seem to have about 40,000 illegal narcotic users, consuming predominantly heroin (by injection) but also opium and morphine. More than 90 per cent of these users are Japanese and the rest Koreans and Chinese who used to comprise almost half of the "addicts". This narcotic problem appears to have developed after the Second World War and after there was a serious problem of amphetamine abuse. This latter problem has persisted to a lesser extent, and there is also significant use and abuse of barbiturates, alcohol, and a locally produced drug, Spa, which has mixed pharmacological effects.

The number of narcotic users in Thailand, including Thai (the majority now), Chinese, and hill-tribes people, probably approaches 250,000. Since the abrupt 1959 ban on opium there has been a steady increase in heroin use (mostly among the young who now predominate) although there is still extensive opium use. The heroin is taken by "chasing the dragon" and sometimes by injection, and opium by smoking. Cannabis is widely used in the country, particularly in the north-east by smoking in pipes or cigarettes or adding it to food. It is often in combination with the opiates. Amphetamine abuse has become apparent in recent years, and barbiturates are not infrequently mixed with heroin to produce a combined dependency. A plant called kratom (Mitragyna speciosa), believed to have narcotic effects, is used mainly in the south.

Korea has perhaps 15,000 users of narcotics, mostly heroin by injection. There is apparently not much use of cannabis.

Burma has an estimated 100,000 narcotic users, mostly of opium (which is smoked) and mostly in the Shah and Kachin States, and by the Chinese in cities. Cannabis is extensively used in the form of ganja, mainly by the population of Indian origin but also by Burmese villagers. Beinsa (Mitragyna speciosa) leaves are chewed or used to make a syrup or powder which is eaten, smoked or made into a "tea". Alcohol use is common and increasing.

Laos may have 50,000 users including hill-tribes people and Chinese. Opium is almost exclusively the drug of choice and is taken by smoking. Abuse of other drugs has not been noted.

The Philippines has 5,000 users, two-thirds of whom are Chinese who prefer opium by smoking, and the rest Filipino who use morphine (and less commonly heroin) by injection. There is some use of cannabis and growing use and abuse of alcohol. Barbiturates and amphetamine abuse constitutes a small but growing problem.

Indonesia has an estimated 1,000 users, mostly Chinese who smoke opium usually at small "dens". There is some intramuscular use of morphine. Cannabis is widely used, mainly in Sumatra. The use and abuse of sedatives (barbiturates and meprobamate), tranquillizers, and amphetamines is relatively common, mainly among the upper and middle classes.

Ceylon has about 5,000 opium users (probably mostly Indian and Chinese) who smoke or eat the drug. Cannabis, as ganja, is used by as many as 200,000 people. It is commonly sold as a powder which is smoked in a cigarette. The country, like India, regards alcohol use seriously and is the only country of the region to keep detailed statistics on alcohol use, which are very useful for comparison. The most commonly used and abused drug in the country is alcohol which is consumed in the form of toddy(fermented palm tree sap ), arrack(distilled toddy) and kasippu (illegal arrack).

IV. Production and traffic

The illicit traffic of opium and opiates in the region mainly arises from two major overlapping factors, the complex socio-psychological needs and problems of the users and the economic dependency of the growers (producers) on their drug-producing crops. This traffic, of course, has only developed its well-established and flourishing circuitous connexion between production and consumption through the efforts of a well-organised international "business" which takes advantage of the relative ease of concealment and transport. The business (or businesses) is headed by a combination of successful criminal tycoons, who in Asia mainly consist of Chinese residents of the various countries, local high-level investors including sometimes government officials, and some Europeans remaining from the days of French Indo-China.

The chain of distribution then includes local buyers, usually of Chinese origin, sometimes locally based armed escorts, numerous middle men, chemists to convert the raw opium into morphine and heroin, smugglers (both professional and amateur), and local distributors in the countries of use. Often involved also is collusion and corruption of police, army, customs, and other officials.

The chain of production and distribution of cannabis products is far simpler since it is easier to cultivate, requires no complicated harvesting or chemical transformation, and is less in demand, thereby being less lucrative.

Despite the number of international treaties and national laws which have as their purpose the cessation of non-medical opiate (and cannabis, etc.) use and production, the illegal trade has continued to grow and in most respects presents a far worse situation today than it it did in the past. Statistics on the number of users reveal little since figures for years long past used for comparison are little more than guesses and since most use was moderate and by adults. After the abrupt bans on opium, widespread use of the much easier to transport, conceal and administer heroin, developed, and more and increasing use by young people has occurred.

Probably at most 10 per cent, and probably much less, of illicit narcotics are seized by enforcement officials. For the entire world 40 tons of opiates per year are seized.

Several nations legally produce opium for the world's medical requirements. In the region under discussion only India is thus concerned, but it produces about two-thirds of the world's needs. Some of this goes to satisfy the needs of India's vast numbers of opium users, sometimes called "quasi-medical", with an unknown percentage escaping into the illicit traffic.

The main source of production of illicit opiates in Asia (and the world) is a four-country relatively inaccessible low mountain area of Thailand, Burma, Laos and China (Yunnan Province) where the total production may be roughly estimated at 1,000 tons a year. Those growing the crop are hill tribes who use a slash and burn type of agriculture and move on when the land is exhausted. For most, the opium poppy is their only cash crop and a large percentage also use some of the opium themselves. It is considered an acceptable way of life, and for most it is the only way they know.

The principal northern cities of Thailand, Chiengrai, Chiengmai, and Lampang and ultimately Bangkok, serve as the main destination of that opium, with a significant portion being used within the country and the major part being disseminated eastward and southward to other Asian countries and to America. Some opium also passes directly from Laos southward, usually by planes referred to jocularly as "Air Opium".

The main opium growing tribes of the region are the Meo, Yao, Lahu, Lisu, Akha, and Karen which together number in the hundreds of thousands and migrate relatively freely within the four-country area. An average 10 per cent (range 5 - 40 per cent) of these people smoke or chew opium themselves but most of the carefully cultivated crop is sold directly or traded to Chinese, sometimes referred to as "Haw tribesmen".

Only the area of cultivation in Thailand has been systematically studied. 10 Non-official estimates of the production range from 80 to 400 tons, while government estimates have indicated much lower figures.

After purchase (usually by the traders or agents sent to each village), the opium (or morphine or heroin) slowly moves southward to the above-mentioned Thai cities, by jungle trail, road and river, using people, animals, cars, trucks, boats, trains and planes. Armed guards are present for the first phases of the journey and these are often "Haw" tribesmen troops who finance themselves in this way.

The relatively simple chemical manufacture of morphine and heroin (diacetylmorphine) is sometimes done in the border areas but often in the larger cities along the way, including Bangkok. Acetic anhydride is the main chemical used in this process.

To reach their ultimate destinations the narcotics must pass through numerous middle men who often use great ingenuity in secreting their cargo.

In Burma the opium poppy is mainly grown in the Shan, Kachin and Wa States, where opium dens also exist and possession of the drug is permitted. Most commonly, what is not used locally passes on to the Thai border area where it is stored while waiting for portage into Thailand. Payment is usually made in gold bars. An estimate of 200 tons annually has been given for the Kachin production alone.

In Laos, yearly opium production has been estimated at 70 tons, some of which is considered among the finest in the world since it contains up to 18 per cent morphine. Of what is not used within the country, most passes overland to Cambodia or by air to Saigon, the Gulf of Siam, or the South China Sea. Some variations occur such as trans-shipment through Laos of illicit opium from the other countries.

The direct contribution of the adjacent provinces of China, particularly Yunnan, has not been estimated.

Typically poppy seeds are sown in the spring, are in bloom by late autumn and the harvest begins in mid January, first with the peeling off of the petals, lancing the pods, collecting the milky fluid, and pouring it into large vats of boiling water. The opium then congeals, rises to the surface, is skimmed off and roiled into balls.

10

See Bulletin on Narcotics, Vol. XV, No. 2.

This crude product is then further refined by boiling, after which it is colloquially referred to as "confiture" or "jam".

From Bangkok the drugs follow varied routes to Hong Kong where the greatest demand exists. Some goes via Malaysia and intermediate points, some via Japan and the Philippines, and some via Korea. At each of these and some other points of Asia, a portion is used locally and the rest trans-shipped to Hong Kong and eastward. As far as is known, narcotics do not pass directly from the People's Republic of China into Macau or Hong Kong.

A pound of raw opium costing $25 in a hill-tribe village may be worth as much as $1,000 if it reaches the United States as one ounce of refined heroin. The price steadily increases as the drug moves from the place of the poppies' growth to more distant cities and as it is made more concentrated.

Thus we see a highly organised, complex, dangerous, successful and destructive business which transcends frontiers and politics and which involves "primitive" farmers, professional soldiers and international criminals.

The drug cargoes travel in many different sizes and shapes, hidden in food or clothing, placed in false compartments of numerous conveyances, carried by seamen and tourists, and rarely intercepted. Few of the higher echelon of the business are ever apprehended or imprisoned and, all things considered, few objective observers would feel either satisfied or optimistic about the existing situation. The reasons for this will be made clear in subsequent chapters.