Addressing Drug Use, Increasing Treatment of Drug Use Disorders and Preventing HIV/Aids

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The state of drug use in the Central Asian countries remains high, given a wide range of external and internal factors impacting their development. The Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Tajikistan, and the Republic of Uzbekistan are included in the so-called “Northern Route” for the narcotic drug traffic from Afghanistan to Russia and the European countries.

Data regarding drug use in Central Asia is limited and subject to availability. It is suspected that the actual rates of persons affected by drug use and dependence are much higher in the region than currently estimated. Some continuing similarities in drug use patterns may be observed in the region, but specific new trends seem to have appeared in some countries. Similarly, similarities and differences are present in the area of drug situation monitoring. The level of knowledge on the extent of drug use in the general population remains low in the region.

Cannabis and opioids are typically the most commonly used drugs in Central Asia. According to the UNODC estimates based on annual report questionnaire data and other official sources, there are 1.53 million (0.5-2.5 million) cannabis and 0.53 million (0.46-0.6 million) opioid users in the region.

In the region, the definition of “high-risk drug use”/“problem drug use” is limited to “current injecting drug use” due to specific local features and for practical purposes. Injecting drug use has remained widespread with 185,500 PWID in 2021. HIV and Hepatitis C prevalence among PWID is from 5.3 to 14.3 and from 20.9 to 60.9 respectively.

Over the past decade, the spread of synthetic drugs and new psychoactive substances (NPS) in the Central Asian countries has continued. Synthetic drug seizures represent the largest increase. The number of drug trading platforms on social networks has also been on the rise. Online drug markets play a more significant role in drug sales, but still comprise only a small share of the global market.

There has been an 18% decrease in the total number of drug users registered in treatment centers from 2018 (43,500) to 2022 (35,500) as well as a downward trend in the number of addicts who use opiates and cannabis. The number of addicts who use other drugs, including synthetic drugs, has doubled from 2018 (2,000) to 2022 (4,000). The opiates and cannabinoids market are being replaced with more affordable synthetic drugs and the possibility to locally manufacture synthetic drugs. COVID-19 restrictions have also given a boost to the manufacturing of synthetic drugs and the increasing use of synthetic drugs, polydrugs, and pharmacy medicines.

Each of the Central Asian countries has introduced various interventions in the field of prevention, treatment, and rehabilitation for people with drug use disorders. Similar laws and orders of the Ministries of Health have been adopted at the legislative level in each country. Standards, guidelines, and clinical protocols for the treatment of substance use disorders (SUDs) have been developed. However, it should be noted that each of the Central Asian countries has its own capacity and resources to provide qualified treatment and monitoring services for people with SUDs. Issues such as the structure and capacity of medical facilities providing drug treatment to PWUD, the availability, and quality of free psychosocial treatment, and preventive services at the city and regional levels require special attention due to their variability. Additionally, the emergence and spread of new potentially dangerous psychoactive substances in the Central Asian countries pose a significant challenge for the alertness of mental health specialists and the drug treatment system as a whole.

Main challenges in Central Asia in the field of drug demand reduction

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Central Asia faces several challenges in the field of drug demand reduction. These challenges stem from various factors, including social, economic, and political circumstances. Here are some of the main challenges:

Stigma and Discrimination: Stigma and discrimination associated with drug use and addiction pose significant barriers to effective drug demand reduction efforts. People who use drugs often face social exclusion, prejudice, and limited access to healthcare and support services. Overcoming stigma and discrimination is crucial to ensure that individuals seeking help can access appropriate treatment and support without fear of judgment or reprisal.

Limited Awareness and Education: There is a need to increase awareness and education about drug use and its consequences in Central Asia. Lack of knowledge and misinformation can perpetuate misconceptions and hinder prevention efforts. Comprehensive drug education programs targeting schools, families, and communities are important to promote understanding, prevention, and early intervention.

Socioeconomic Factors: Socioeconomic factors such as poverty, unemployment, and limited educational opportunities contribute to drug use vulnerability. Addressing these underlying social determinants is crucial to prevent drug use and support individuals in recovery. Creating employment opportunities, improving access to education and vocational training, and addressing income inequality can help reduce the risk factors associated with drug use.

Lack of Treatment Services: Access to quality drug treatment services is limited in many parts of Central Asia. Insufficient availability of treatment facilities, trained healthcare professionals, and evidence-based treatment modalities pose challenges. Expanding the coverage and quality of treatment services, including medication-assisted treatment (MAT) and psychosocial support, is essential to meet the demand for effective care.

Dual Diagnosis and Comorbidity: Substance use disorders often co-occur with mental health issues. However, the integration of mental health services with substance use treatment is still limited in Central Asia. Addressing the complex needs of individuals with dual diagnosis or comorbidity requires comprehensive and integrated approaches that encompass both mental health and substance use treatment.

Inadequate Funding and Resource Allocation: Insufficient funding and resource allocation for drug demand reduction programs pose challenges to their effective implementation and sustainability. Limited financial resources can hinder the establishment of treatment facilities, prevention programs, and harm reduction services. Securing adequate funding and ensuring efficient allocation of resources are crucial for a comprehensive response to drug use.

Data Collection and Monitoring: Central Asia faces challenges in collecting accurate and up-to-date data on drug use and related trends. Reliable data is essential for evidence-based decision-making, monitoring the effectiveness of interventions, and identifying emerging issues. Enhancing data collection systems, ensuring data sharing and analysis, and conducting regular surveys and research are important steps in addressing this challenge.

Addressing these challenges requires a comprehensive and multi-dimensional approach, involving collaboration among government agencies, civil society organizations, healthcare providers, and other stakeholders. It is crucial to prioritize investment in prevention, treatment, harm reduction, and social support services to effectively reduce drug demand and promote the well-being of individuals and communities.

To effectively address drug use situations in Central Asia, comprehensive strategies are required, encompassing prevention, treatment, harm reduction, and law enforcement. Some key areas of UNODC focus include:

  • Strengthening drug prevention efforts through education, awareness campaigns, and targeted interventions aimed at vulnerable populations.
  • Expanding access to evidence-based drug treatment services, including opioid substitution therapy, detoxification programs, and psychosocial support.
  • Implementing harm reduction measures such as needle and syringe exchange programs, opioid overdose prevention, and HIV/HCV testing and treatment services.
  • Enhancing cross-sectoral collaboration between health, law enforcement, and social welfare sectors to develop integrated approaches to drug use issues.
  • Supporting capacity building initiatives for healthcare professionals, law enforcement agencies, and civil society organizations involved in drug use prevention, treatment, and harm reduction.
  • Fostering international cooperation and collaboration to address drug trafficking networks and improve information sharing across borders.

It's important to note that the drug use situation and response strategies may vary among the Central Asian countries. Therefore, tailored approaches that consider each country's specific context and challenges are crucial.