ROLE OF NATIONAL GOVERNMENTS
THE PROBLEM OF DRUG ABUSE
Pages: 43 to 48
Creation Date: 1966/01/01
The Annual Report of the Permanent Central Narcotics Board 1 to the Economic andSocial Council on its work in 1965 figured on the agenda of the Commission on Narcotic Drugsat its twentieth session and is taken note of by the Council by resolution 1107 (XL) dated 4 March 1966 at its fortieth session. Before giving its annual statistical data on production, manufacture, conversion, consump-tion, seizures in illicit trafficking etc. of the principal narcotics and raw substances, the report presents a general aperçu of the narcotic situation as seen from an international point of view. The following are excerpts from this latter part of the report: 2
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Since the coming into force of the Single Convention on 13 December 1964 the present Board as constituted under the provisions of Chapter VI of the 1925 Convention is required for the time being to carry out functions of the future International Narcotics Control Board which is in due course to be set up under the terms of the new treaty.
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The Board recently received information that some countries wished to start opium production for export. It strongly recommends that the Governments concerned should reconsider their plans and refrain from such an enterprise. While it fully appreciates the need for developing agriculture and increasing income derived from exports, it feels there must be other lines of economic development which are less undesirable from the view point of the general international interest and are at the same time more profitable.
The treaty name of this organ established by the International Convention on Narcotic Drugs of 19 February 1925 is "Permanent Central Board ". In the past the Board has added to its name the word "Opium" calling itself "Permanent Central Opium Board" to indicate more clearly the nature of its functions. In view of the importance of the synthetic narcotic drugs, i.e. of drugs not derived from opium, the Board decided that the use of the word "Narcotics" in place of "Opium" with its name would help in preventing misunderstandings which have sometimes arisen with respect to the nature of its work.
Document E/OB/21, November 1965.
In making this recommendation the Board is guided by economic considerations as well as those of international narcotics control. Opium is still the principal raw material for the manufacture of morphine and thus for codeine, which is a widely used and essential medicine; but it is increasingly being replaced by poppy straw, a cheap by-product obtained from the cultivation of the poppy for other purposes, principally for the seeds, or by "concentrate of poppy straw ". Whereas in 1959 about 80 per cent of the world's production of morphine was still made from opium the proportion is now about 65 per cent. The decline has recently slowed down due to a shortage of poppy straw, but in the long term the gradual replacement of opium by poppy straw can be expected to continue. The competitive position of opium may also be affected by the further development of synthetic narcotic drugs, particularly if a fully satisfactory synthetic substitute for codeine can be found and generally adopted by the medical profession.
In the short view also the profitability of new opium production is dubious. World opium prices are often depressed and have been particularly so of late. From the recent price of 11 U.S. dollars per kg. of opium containing 12 per cent of morphine little is left for the farmer after deducting the overhead costs of a Government monopoly; and these costs are bound to be high if Governments strive to comply with their duty to international society to prevent diversion into illicit channels. Since present opium production already exceeds the world's needs additional production can only lead to a further fall in prices.
International considerations however ought to be overriding. Effective control of opium production requires techniques and special skills which were acquired by the present opium-producing countries over a great number of years; and even these cannot prevent considerable leakage into the illicit traffic. Countries embarking on production for the first time might well be unable to exercise effective control and opium-addiction might spread in these regions thus creating a serious problem of public health. Coping with the consequent illicit traffic would also be a burden to the national police forces and might give rise to embarrassing international problems.
Moreover there being no present need for additional opium any new cultivation would conflict with the Single Convention which requires parties to avoid over-production in the world; and even States not parties to the Single Convention would be ill-advised to run counter to a rule so manifestly in the international interest.
The Board has observed that economists, assigned to developing countries under programmes of multilateral or bilateral technical assistance, have occasionally recommended the cultivation of narcotics plants, or the manufacture of narcotic drugs, as a means of expanding the national economy. The Board suggests that intergovernmental organizations and national Governments rendering assistance of this kind should enlighten such advisers on the dangers implicit in such policies and on the need to have regard to the national and international interest in narcotics control.
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... In its last report the Board concluded that the annual quantity of opium available for illicit purposes might in the aggregate exceed the total volume of the world's opium production for medical purposes, which has been around 1,300 tons in recent years. This conclusion rested upon estimates that about 200 tons of opium were annually diverted from cultivation in countries which apply measures of control in accordance with the requirements of the narcotics treaties and that a further 1,000 tons came from uncontrolled or illegal production in South-East Asia. In addition considerable illegal production of opium is known to exist in several countries in other regions.
This quantity of raw material could yield approximately 120 tons of morphine or even somewhat more of heroin. Assuming that an addict daily consumes no more than three therapeutic doses of morphine or heroin, the opium could annually supply more than ten million morphine addicts or more than twenty million heroin users; but it is scarcely possible in the present state of knowledge to arrive at an accurate estimate of the average quantity of drugs (opium, morphine or heroin) which addicts consume, nor is it known what proportion of them uses opium, morphine or heroin.
Assuming a higher average rate of consumption the number of addicts may range from 700,000 to several millions. Consumption at a daily equivalent of more than three therapeutic doses of morphine has in fact been found in many cases. The choice of an intermediate figure between the highest and lowest extremes depends of course also on what assumptions are made as to the relative proportions of addicts using morphine, heroin or opium.
Part of the 1,200 tons of opium is consumed locally, particularly in the opium-producing regions of South-East Asia. This affects the evaluation of the quantities which appear in the international traffic, but not the extent of the problem of abuse.
Even the lowest figure of 700,000 addicts would represent an alarming situation. The actual total however is certainly much higher. For one thing the world average daily consumption of addicts may not significantly exceed the equivalent of three therapeutic doses of morphine or heroin. There is also little doubt that far more than 1,200 tons of opium is in fact annually available for illicit purposes; large additional amounts flow into the international illicit traffic either in the original form or transformed into morphine or heroin from widespread illicit cultivation in countries of the Middle East and other regions including the Western Hemisphere. All in all the number of addicts to opium and opiates supplied by the illicit traffic must surely run into several millions.
A computation relating to 1961, the last year in respect of which such a calculation is available to the Board, shows that the total world consumption of narcotic analgesics (natural and synthetic) for medical purposes was equivalent in potency to about 7,300 kg. of morphine while consumption of antitussives (natural and synthetic) under international control amounted to an equivalent of about 112,000 kg. of codeine. Expressed in terms of opium these figures represent a total of about 1,190 tons of opium or approximately the same quantity as is available for illicit purposes from uncontrolled cultivation in South-East Asia and by diversion from controlled production in the Middle East alone. If account is also taken of the large quantities flowing into the illicit traffic from other parts of the world illegal consumption far exceeds use for all medical purposes (analgesic and antitussive).
According to the statistics furnished to the Board the world's total annual harvest of coca leaves would amount to about 12,000 tons, of which by far the greatest part is chewed and only a small fraction used for the manufacture of cocaine or of a flavouring substance for beverages. The annual quantity required for cocaine may range between about 220 and 520 tons of leaves depending on their cocaine content.
The figures reported by Governments however do not represent the whole crop, but generally only that part within the cognizance of the authorities which administer the taxes levied on the leaves. Nowhere is the cultivation of the coca bush yet subjected to the control regime required by the Single Convention and therefore nowhere really is it effectively controlled, while in large regions it is not controlled at all. From information at its disposal the Board estimates the world's annual harvest of the leaves at between 32,000 and 38,000 tons, i.e. more than two and a half or even three times as high as the figure furnished by Governments. South America is the only region in which coca leaves have been reproduced in large quantities in post-war years, the pre-war production in Asia having been reduced to insignificant proportions. Depending on their quality 32,000 tons of South American leaves contain between 80 to 192 tons of cocaine, most of which is ingested by the millions of coca leaf chewers of the Andean region with grave effects on their health and economic productivity. A considerable portion also appears in the international illicit traffic. The importance of this non-medical consumption of cocaine in the form of the leaves or of the manufactured drug can be gauged from the fact that the annual medical consumption of cocaine is about 1.3 tons.
These huge quantities of raw material available for the clandestine manufacture of opiates and cocaine form the heart of the problem now confronting international narcotics control.
Only a few years after the coming into force of the 1925 and 1931 Conventions, which dealt a powerful blow to the international illicit traffic, it began to be recognized that the most important obstacle to further progress in the campaign against this traffic lies in the lack of control or effective control over the production of opium in many regions and the practical non-existence of control over the cultivation of the coca bush.
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The ordinary observer may sometimes find it strange that organized international society has not yet been able to overcome the gangs of international traffickers, however well organized they may be or however ingenious their methods, and that the world-wide contraband movement of narcotics continues to flourish in defiance of powerful governments, trained police staffs and international organizations linking up most countries of the world. The international bodies however cannot be held responsible for this lack of success and it would be as wrong to reproach the Commission on Narcotic Drugs, the World Health Organization or the Board for the persistence of large-scale illicit traffic as it would be to blame the United Nations as a whole or its individual organs for other shortcomings in international life.
The international organs undoubtedly play an essential role in the campaign against the traffic, but it should be remembered that they do not exercise any direct administration; they have no supra-national character but are organs of an association of sovereign States. They can help by establishing standards of international conduct in treaties or recommendations, by arranging international co-ordination, by general and specific advice as to remedial measures and occasionally also by helpful criticism. But there are limits to the pressure which they are able to exercise. The ultimate remedy lies in fact in the hands of individual Governments.
The last report of the World Health Organization's Expert Committee on Dependence-Producing Drugs * has this to say on the subject:
"The present weaknesses of international narcotics control are lack of interest, inadequacy of reports on local situations and insufficient international solidarity.''
From its own observations the Board can confirm the correctness of this summing-up of a complex situation.
In some countries drug addiction is not in fact a significant problem, but many more greatly underestimate the size of their problem. Several countries which thought that they had only slight addiction were later obliged to report that many of their people were abusing narcotic drugs. Moreover drug addiction, which is closely related to basic human characteristics, is a pervasive evil and no country can safely regard itself as immune from it in some form or another.
Because of their inadequate appreciation of their internal narcotics situation quite a few Governments do not fully recognize the need for greater efforts in their own territories as well as on the international plane. They are understandably reluctant to commit more of their often very slender resources to a task which they do not regard as of primary national importance. They do not sufficiently realize that their own national interest would be served by an improvement in the drug situation in other countries; and those of them who are in a position to help are not always willing to devote to international assistance in the field of narcotic drugs a sufficient share of their resources which, it has to be recognized, are by no means unlimited and are also under demand for numerous other purposes of international life.
* World Health Organization, Technical Report Series, No. 312, p. 6.
The complacency in some countries in regard to the narcotics problem is reflected in a number of ways: some government officials, fortunately few, do not fully comprehend the evils of addiction and of illicit trafficking; the reports sent to international organs under the terms of the narcotics treaties are sometimes prepared by officials who are not fully equal to their tasks, do not wholly appreciate the importance of their work or do not even know all the relevant factors in the situation on which they have to report; some even lack the authority to obtain the necessary data from the various Government agencies concerned with different aspects of the narcotics problem. There are also Governments which have not yet set up the special organs or provided the co-ordination required by their international obligations. In some instances the work is left to officials who are so burdened with other tasks that they cannot possibly devote the necessary time to the preparation of narcotics documents.
Reports often give an incomplete picture of the several elements of the narcotics situation which they purport to reflect. Essential data are missing; the word "nil" or the phrase "does not apply" are frequently used in reply to important questions. Some simply repeat corresponding sections of preceding reports and give no consideration to recent developments; at times the information is even incorrect, as could readily be seen by an observant traveller in the country concerned; different reports from the same country occasionally contradict one another; documents which ought to be prepared by officials fully versed in the subject show unmistakable signs of having been written in a routine fashion. Such deficiencies not only hamper the efforts of the international organs but also those of other Governments co-operating in the international endeavour.
If the lack of international solidarity deplored by the World Health Organization's Expert Committee is largely attributable to imperfect realization by certain Governments of the seriousness of their respective addiction problem it is also a facet of a general phenomenon: the unfortunate lag between the rapid advance in modern technology and man's ability to adapt himself to it.
It is axiomatic that the success of the international narcotics treaties largely depends on the extent to which they are universally applied and fully implemented. Unfortunately however a few countries, particularly among those where opium is produced or the coca bush is cultivated, are still unable to make their full contribution to the international effort. Yet it is precisely in this sector that improvement is most urgently needed if real progress is to be made towards mastery of the problem. There are various reasons for the handicaps under which these Governments labour and they are not necessarily the same in all the countries concerned.
The pattern of control organization prescribed in the international narcotics treaties calls for specialized skills on the part of those operating them. Where it is simply a matter of lack of experienced personnel - as may be the case in some of the newly independent countries - adequate training will bring about the necessary improvement. International aid of the kind already granted is required and the Board would like to see it increased.
In a number of countries however the difficulties are much more serious. The stages of economic, social and administrative development in different parts of the world vary enormously. They range from a bare subsistence economy through varying degrees of poverty unable to make adequate provision for even the most elementary social tasks, to the industrialized countries of the atomic era which not only provide a high living standard for the whole population but can also support a costly apparatus of government and advanced social services.
Retarded economic and social development may be reflected in a low educational level, in lack of skilled personnel for government administration, or in dependence on a single crop. In some areas of special interest to international narcotics control there is even a measure of dependence on the provision of narcotic raw materials for illicit purposes. A retarded level of development also affects the attitude of the population towards social problems including that of narcotics. The administrative authority of the government may be ineffectual in some areas and in others may even be non-existent; and this is unfortunately the case in large areas where the opium poppy, and in a few districts where the coca bush, is grown. Situations of this kind are frequently accompanied by political instability.
Cultivation of the poppy for opium and of the coca bush, whether for legitimate or illicit purposes, is itself often a symptom of a relatively low level of economic development. Industrially advanced countries may occasionally produce opium for reasons of policy, including perhaps a desire to be self-sufficient; but as a rule opium and coca leaves yield only a small return to the farmer (even if sold to an illicit trafficker) and their production is only economic in areas where wages are very low.
The greatest obstacles to further progress in international narcotics control are to be found in territories with a "drug economy ", i.e. whose economies depend on the sale of opium for illicit purposes or on that of coca leaves either for the illicit traffic or for chewing which, though not yet everywhere illegal, is definitely harmful and highly undesirable. The difficulty arising from economic needs is aggravated by the weakness or virtual absence of government control particularly in some opium-producing districts. Basic features of the drug economy are sometimes related to the structure of society. The population has no knowledge of and naturally no understanding for the international needs of narcotics control. Many inhabitants themselves abuse the locally produced drugs; those who chew coca leaves are often doing so as an antidote to hunger. They are of course opposed to reform or at best are indifferent. The population of some opium-producing districts lives moreover under the primitive conditions of a semi-nomadic tribe. Opium is often almost the only cash crop. Governmental reforms imposed on unwilling populations have little hope of success.
In such circumstances measures aimed at immediate suppression would be liable to cause widespread personal hardship and perhaps starvation due to lack of income. Popular resistance would aggravate the endemic political instability. Both the authors of the 1953 Protocol and those of the Single Convention realized the complexity of the problem and have permitted a gradual approach.
What is required is a series of far-reaching economic and social measures providing alternative means of livelihood and in some places also for evolution from the somewhat archaic structure of society. It may even be necessary to encourage people to move to areas more suited to economic development. Difficulties will also arise from the fact that in several of the districts concerned a considerable portion of the population has been physically and mentally debilitated by excessive consumption of narcotics. Intensive educational campaigns are needed to influence the attitude of the people. The costs of such measures will be high: some of the regions are distant from adequate means of communication and are without the "infrastructure" essential for alternative economic activities. Local resources of material and personnel will obviously be wholly in adequate and liberal foreign aid will be needed.
Such measures are above all required in South-East Asia, Latin America (particularly the Andean Highlands) and the Middle East, three regions whose economic and social progress and peaceful development constitute an important international interest. It is not of course expected that international aid on this scale will be given only in the context of narcotics, but rather for wider and more weighty considerations. Obviously, too, such a programme of development is outside the terms of reference and competence of the specialized organs of international narcotics control; but it is vital nonetheless that the narcotics aspect be taken into account in the planning of economic and social development of regions which have a drug problem and particularly those which produce opium or coca leaves; and that the opinion of the Commission on Narcotic Drugs should be consulted.
While the Board recognized and indeed urges the need for liberal international assistance it is nevertheless in duty bound to state that lack of sufficient foreign aid alone does not justify a failure to do what is possible. There are some districts which produce the raw materials for clandestine manufacture of narcotics and have been centres of the illicit traffic for several decades. Even the existence of a problem was for a long time not acknowledged by the local authorities. The Board is by no means satisfied that sufficient efforts have everywhere been made to remedy the situation, even to the limited extent possible within the restricted resources of the government concerned.
The Board continues to be preoccupied with the various aspects of the narcotics situation in Latin America: the coca leaf problem and cocaine traffic; illegal production of opium; international illicit traffic in opiates and cannabis (marihuana) originating thence; and the failure of some governments to furnish required statistical information.
In addition to the large-scale production of coca leaves in Bolivia and Peru the coca bush is also extensively cultivated in the departments of Cauca, Huela and Santander of Colombia as well as in the Sierra region, especially in the Loja province of Ecuador. Bolivia and Peru continue to be cited by reporting governments as sources of cocaine appearing in the illicit traffic; but the uncontrolled cultivation of the coca bush in Colombia and Ecuador also gives rise to anxiety as a possible source of raw materials for the clandestine manufacture of cocaine.
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It is in fact extremely difficult to obtain an accurate estimate of the extent of addiction. Some of the obstacles arise from constitutional, legal and administrative conditions differing from country to country; others from the professional secrecy observed by medical practitioners in some countries or from the fact that cases of addiction can often be discovered only by the detection of illegal activities such as purchases from the illicit traffic and that in the nature of things only a percentage of breaches of the law come to light. Certain of these factors could be remedied by changes in the law, the structure of the national narcotics organs or in the procedure of collecting the data; others however are not easily corrigible.
While the measures to be taken may differ from country to country some improvement could and should be achieved. Scrutiny of narcotics prescriptions retained by pharmacists, or other records kept by them, may yield useful and sometimes surprising results. A few Governments have already found this. Means might also be sought which would be acceptable to the medical profession and would ensure its co-operation in compiling statistical data on addicts.
Better knowledge of its aetiology is certainly of great importance in the campaign against this evil. The Board therefore follows with great interest the research plans and the studies undertaken in respect of the causes of addiction and in particular also of those related to economic and social factors.
It is generally recognized that the causes are not identical in different countries. In particular it has been found that there is a fundamental difference between the non-medical use of opium, coca leaves and cannabis in territories where such practices have been traditional and often not subject to any social stigma, and the dependence on manufactured drugs and cannabis in the industrially more developed countries or in places of quick social change entailing dissolution of ancient social ties such as tribal organization, accompanying rapid urbanization and industrialization. In the second of these differing situations, personality weaknesses of a basically pathological nature play a great part.
There are, however, few topics on which it is more difficult to obtain general agreement than on the motivation of human behaviour, which is basically a question of the nature of man. Such factors as the influence which heredity or environment (including of course economic and social factors), religion and education have on the formation of the human character; laws of psychology; the relevance of psycho-analytical theory and the acceptance of a particular psychoanalytical school of thought; all these and other considerations come into play. Widely different views are held on all these factors and they are related to the principal philosophical and ideological questions of our time.
While it seems hardly possible to obtain international agreement on all the aspects of the causes of addiction, national studies may yield valuable results which could form a useful basis for action within the economic and social framework of a particular country. International exchange of information on such studies would also be of value.
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