Drug use/abuse: A more humane approach needed…

By The Caribbean Voice

There are no reliable statistics on the amount of persons engaging in the use of illegal drugs or those described as addicts. However, a Behavioural Surveillance Survey, done by the government in 2003 found that 11% of out of school youth use drugs, as do 8% of in school youth. Other users included 17% of GUYSUCO employees, 45% of female sex workers, 74% of male sex workers and 12% of members of the armed forces. Since then there has been a steady increase in the number of persons observed on the streets coupled with those who engage in the use of illegal drugs in social environment.

Furthermore the Guyana Secondary School Drug Prevalence Survey Project (2013) found that the first drug of choice for most students appears to be inhalants with an average age of first use of 10.8 years old. The average age of first time use for crack was 14.5 years, for ecstasy 14.7 years, for marijuana 12.8 years, for cocaine 12.1 years and for stimulants from 12.0 years to 11.7 years. These figures indicate that students are using these drugs at an increasingly younger age.

As well a 2016 Household Drug Survey in Guyana revealed that 66.5% of the respondents believe that drug use has increased in Guyana, while 40.9% believe that it is easy to access marijuana. In fact almost every survey and study done over the last two decades plus found that it is easy to access drugs in Guyana, especially given that drugs dealing has become an economic activity. In fact, empirical and anecdotal evidence gathered by The Caribbean Voice indicate that in almost every community there are well known drug pushers, and that every community has well known drug addicts, often benignly treated by the communities, who engage in odds and ends work to support their habits. Also, while there are no statistics available, it has been suggested that a significant percentage of deportees, especially from North America, have developed drug habits.

The illegal drugs of choice in Guyana today are marijuana, crack cocaine, hashish and to a limited extent ecstasy (MDMA, Molly). Marijuana is the most commonly used drugs among the student population according to the 2013 survey cited above. However, a 2009 study by the Inter-American Drug Abuse Control Commission found that the highest levels of cocaine used were in Guyana, Jamaica and Haiti.

Linkages and costs

While reliable statistics are not available for Guyana, it is a fact that drugs have an overall socio-economic cost and take a toll on workplace productivity. The Guyana Human Development Report (1996) points out that “there appears to be an association between drug use and mental illness and the transmission of the HIV/AIDS virus,” that prostitution is linked to drug use and that many of the street children are into drug use. The Guyana Secondary School Drug Prevalence Survey Project (2013) showed links between drug use and absenteeism, poor academic performance, confrontations at school, difficulties at home, and thoughts of suicide. There was also a link between drug use and sexual abuse.

Furthermore, some of the studies referenced, indicate that drugs misuse and violence act as a catalyst for each other and that drug consumption is linked to drug abuse, delinquency, and anti-social behaviour in adulthood, as well as educational failure. Also they reveal that often times there is cross addiction as those who use/abuse alcohol, often gravitate to drugs after the alcohol lessens or eliminates their inhibitions.

As Minister Khemraj Ramjattan pointed out in 2015, “Not only does drug use affect physical and cognitive functions, but it also contributes to reduced physical control and the ability to recognise warning signs in potentially dangerous situations, which can make some drinkers (users) easy targets for perpetrators of criminal acts”.

Additionally, he noted that victims and children who experience and are subjected to drug related violence, strongly develop emotional and behavioural problems and are often known to seek the use of drugs as a coping mechanism. As such, he said the domino effect of drug abuse now becomes an economic burden to the State, since both the health and criminal justice sectors are directly affected.

Other substantial costs to society include property damage, job loss and health service costs. Actually, drug abuse has many potential consequences including accidental falls, burns, drowning, brain damage, impaired driving resulting in accidents, deaths and injuries, poor school performance, work productivity loss, sexual assault, truancy, violence, vandalism, homicides, suicides, lower inhibitions, increased impulsivity, risky sexual behaviour, early initiation of sexual behaviour, multiple sexual partners, pregnancy and STDs.

In fact, drug use/abuse results in a range of health related issues. Short-term effects can range from changes in appetite, wakefulness, heart rate, blood pressure, and/or mood to heart attack, stroke, psychosis, overdose, and even death. These health effects may occur after just one use. Longer-term effects can include heart or lung disease, cancer, mental illness, HIV/AIDS, hepatitis, and others. Long-term drug use can and often does also lead to addiction that not only affects the user but also families and loved ones, and can result in social trauma and family dysfunction.

Interesting to note also is that, the annual mortality rate per 100,000 people from drug use disorders in Guyana increased by 748.0% from 1990 to 2010, an average of 32.5% a year.

Government Approach?

Speaking in 2015, at the launch of the 2013 Guyana Secondary School Drug Prevalence Survey Project, Minister Khemraj Ramjattan, indicated that a final strategy (to tackle drug use/abuse) was yet to be worked out but he spoke about a “multi-pronged” approach to include a number of ministries and agencies that will focus on all levels of drug use– the demand, supply, treatment, and development of a skilled workforce to deal with the issue. That NGOs, FBOs and CBOs were not included in this approach leaves one scratching one’s head, especially given that these are the entities that have their fingers on the pulse of communities throughout Guyana, are also best located to be first responders and cannot be left out in any approach that is holistic and collaborative. Meanwhile for how long more should we continue to hold our breath while we await the transforming of words into action, especially given that we’re now in 2017, two years after that approach was touted?

Minister Ramjattan further said that the approach will focus on reducing the demand for drugs by creating alternative opportunities. Particularly in terms of youth, he said that activities such as sports and music must be looked at to allow young people to meaningfully occupy their time. He added that community support and positive parenting will be necessities going forward. What the minister did not state and what has not, to date, been revealed, are the mechanisms and programmes to ensure all of this happen. Of course The Caribbean Voice makes it clear that no previous government has ever addressed drug use/abuse in any concerted and substantial manner and the unchecked incremental increase in the drug culture has resulted in the distressing current situation.

One also has to wonder about the Guyana Drug Information Network (GUYANADIN), which seems to be a paper tiger.

Suggested Strategies

Various studies on Guyana have found the following reasons for drug use/abuse: seeking to be sociable, building confidence, helping to concentrate, enhancing excitement and energy at parties, improving sexual experiences, relieving stress and anxiety, wanting to fit in, family influence, curing ailments/self -medication, boredom due to the absence of gainful activity, experimentation and curiosity, peer pressure, seeking to enhance the thrill effect during recreational activities.

Recommendation to address this situation from the various studies and stakeholders include:

  • regular sensitisation on the harmful effects of drug use and prevention messages via various media (including traditional and social media), and public access mechanisms (flyers, posters, booklets, billboards…) appropriate for different age ranges and inclusive of alternatives to drug use;
  • developing an appropriate instrument to enable individuals to self-evaluate problematic drug use;
  • giving greater priority to drug use/addiction in health promotion and disease prevention programmes such as what is currently being given to diseases such as HIV/AIDS;
  • continued training of persons who have shown an interest in the field of treatment and prevention and the establishment of more treatment and rehab centres across the country (currently only two non-governmental and two governmental treatment centres exist);
  • creation of more recreational centres and spaces so time can be meaningfully occupied;
  • expansion in job training and economic insertion activities;
  • creating/implementing mentorship programmes for youths from communities and households that display risk factors for illicit drug use;
  • ongoing parental education relating to drug free lifestyles and strategies to help their children stay drug free;
  • integration of mental health care into the physical health care system to include substance abuse-related education, assessment, intervention, treatment and recovery services;
  • exploring new funding sources from donor communities for behavioral health programmes, services, and providers and increasing gov’t funding for same.
  • partnering with NGOs, FBOs and CBOs to implement evidenced-based prevention programmes focusing on personal responsibility for one’s health;
  • providing relevant, ongoing professional development and training for all health care providers;
  • leveraging technology/infrastructure by implementing an electronic health record (EHR) system to track treatment and ensure follow up, among other things;
  • establishing at least one Rehabilitation Treatment Centre in each of Guyana’s ten regions;
  • strengthening the inter-institutional coordination or collaboration between Ministries of Health and other government agencies, (i.e. Drug Commissions or Councils and stakeholder)
  • allocating adequate resources and finances to increase capacity building within the health and other relevant sectors to address drug use disorders;
  • encouraging international cooperation to share evidence-based practices;
  • strengthening the capacity to collect real time data and generate ongoing evidence’

While the government hopefully begins to take concrete action to address the increasing drug use/abuse situation, The Caribbean Voice and its partners echo the call by current activists and care providers for use of the ‘Humane Approach’ advocated at the launch of the United Nations 2009 World Drug Report by more than 40 international groups and experts worldwide. This more humane approach is based on harm reduction principles and respect for human rights and includes laws and policies that do not drive drug users underground, keep people away from life-saving HIV services and/or allow AIDS to spread. In this respect there is urgent need to re-examine laws pertaining to penalties for possession of small amount of marijuana for personal use as well as the need to develop policies to address stigma and discrimination associated with drug use and drug use disorders.

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