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DEMAND REDUCTION IN JAMAICA A BRIEF CASE STUDY CARL STONE SURVEY 1991. COCAINE & CRACK COCAINE ABUSE MALE 1989 1991 % DRUG USE Total (‘000 ) FEMALE 1989 1991 3.02 2.75 0.12 0.09 21.4 19.2 .84 .63 Recommended: That Demand Reduction programmes need to be intensified and expanded in the Urban and Tourism area where Drug dealers have apparently increased their aggressive marketing networks. Integrated Demand Reduction This is a multi-faceted, multi-pronged strategy or series of strategies working in synergy to Reduce The Costs And Effects Of Drug Abuse By Reducing The Demand For Licit And Illicit Drugs Integrated Demand Reduction Demand Reduction focuses primarily on Education and Awareness Programmes It also focuses on identifying prevailing risk factors that cause or lead to Drug Abuse Activities, plans and programmes are formulated to reduce these risk factors These Educational, Healthy Lifestyle, and Preventative Programmes are expected to result in a reduction in the demand for drugs. Demand Reduction Measures-1 Drug Education and Awareness Programme Individual & Community Involvement Economic Alternatives Social & Cultural Programmes Sports Programmes Demand Reduction Measures-2 Public Relations/Social Marketing Health & Medical Measures (Health Promotion) Legal Reform Security Research & Development International Cooperation DRUG ABUSE PREVENTION AND CONTROL MATRIX INTER-MINISTERIAL COMMITTEE NCDA COUNCIL MEMBERS WORKING NCDA BOARD OF MANAGEMENT COMMITTEES DRUG ABUSE SECRETARIAT THE COMMUNITY CODACS TREATMENT & REHAB INTERNATIONAL LINKAGES PARISHES PARDACS ROLE OF THE COMMUNITY IN PREVENTION Identify the problems/weaknesses in the environment that will threaten the existing healthy lifestyle in their community. Devise action plans to address these these problems Identify all relevant resources that exist in that community Identify community leadership which will facilitate the change process PARISH INITIATIVES PARISH DRUG AWARENESS COMMITTEES (PARDACS) ROLE OF THE PARDACS EDUCATION AND SENSITIZING INTEREST GROUPS IN THE PARISH ABOUT THE NEGATIVE CONSEQUENCES OF DRUG ABUSE ORGANIZE AND CONDUCT PUBLIC FORA, PANEL DISCUSIONS AND DEBATES AS A MEANS OF EDUCATING THE PUBLIC ON THE CONSEQUENCES OF DRUG ABUSE SOME MEMBERS ARE TRAINED IN BASIC AND ADVANCED COUNSELLING AND ASSIST IN THE SOCIAL REINTEGRATION OF RECOVERING ADDICTS 1997 SURVEY ON PATTERNS OF SUBSTANCE ABUSE AND USE AMONG POST PRIMARY STUDENTS IN JAMAICA GRADES 9 TO 13 WERE SURVEYED, APPROXIMATELY 8,000 QUESTIONNAIRES ADMINISTERED AMOUNG STUDENTS IN 63 SCHOOLS (ALL-AGE,SECONDARY AND TECHNICAL) OVERALL RESULTS (COMPARISON BETWEEN 1987 AND 1997) DRUG 1987 1997 ( % OF SCHOOL POPULATION) CIGARETTES ALCOHOL MARIJUANA INHALANTS CRACK COCAINE TRANQUILIZERS 29.I 76.3 19.8 15.8 1.5 3.8 27.2 70.9 26.9 15.8 1.9 5.5 THE E.U FUNDED NATIONAL PROJECT PROJECT OBJECTIVES: REDUCE THE INCIDENCE OF DRUG ABUSE AND OTHER UNHEALTHY BEHAVIOUR. REDUCE THE DEMAND FOR DRUGS PROMOTE HEALTHY LIFESTYLES REDUCE YOUTH DELINQUENCY. OUTPUTS FROM E.U PROJECT A NATIONAL SURVEY ON THE LEVEL OF DRUG ABUSE FORMATION OF SIX NEW COMMUNITY DRUG AWARENESS COMMITTEES (CODACS) A TOTAL OF 180 PERSONS FROM THESE NEW CODACS TRAINED TO IMPART INFORMATION ON DRUG ABUSE AND PROMOTE HEALTHY LIFESTYLES. AN EVALUATION OF THE PREVENTION EDUCATION PROGRAMME IN SCHOOLS 450 TEACHERS, 40 TEACHER TRAINERS, 75 GUIDANCE COUNSELLORS, 28 EARLY CHILDHOOD EDUCATION OFFICERS AND 60 EDUCATION OFFICERS TRAINED IN SUBSTANCE ABUSE PREVENTION AND 150 STUDENTS TRAINED AS PEER COUNSELLORS EDUCATIONAL AND SUPPORT MATERIALS PRODUCED FOR TRAINING Risk Factors for Drug Abuse – Youth(NIDA) Ineffective Parenting Chaotic Home Environment Lack of Mutual Attachments/ Nurturing Inappropriate behaviour in the classroom Failure in school performance Poor social coping skills Affiliation with deviant peers Perception of approval of drug using behaviours in the school, among peers and community environments. FAMILY ISSUES Breakdown in the structure and patterns of families. Poor parenting skills. Diminished family life Teenage parents. CHANGING FAMILY SYSTEMS Extended family disturbed. More persons living alone/ isolation. Shifting values. PSYCHOSOCIAL ISSUES Feeling of alienation Feel inadequate, low self esteem, devalued sense of self and of life. Male marginalization. Distorted value system (supported by music, popular culture and attitude to minorities.) Lack of a father figure. Attitudes to authority/ police PSYCHOSOCIAL ISSUES contd. High unemployment or unemployable Lack of citizenship. Lack of civic pride. Lack of hope. DISORDERS AMONG YOUTH SUBSTANCE ABUSE DEPRESSION VIOLENCE IRRESPONSIBLE SEXUAL BEHAVIOUR . SUICIDE NATIONAL DRUG USE 2002. SUBSTANCE TOBACCO ESTIMATED NO. OF USERS IN POPULATION 12-55 YEARS (N = 1.5 MILL) 187,100 ALCOHOL 666,800 GANJA 180,800 COCAINE / CRACK / HEROINE 4,000 PAINKILLERS 481,200 ANY ILLICIT SUBSTANCE 182,400 INHALANTS / AMPHETAMINES / TRANQUILIZERS & STEROIDS 1,600 1,600 Excerpt from 2001 National Survey 800 800 ESTIMATES OF SUBSTANCE USE AND TREATMENT NEEDS 5.9% of population or 92,800 Jamaicans have alcohol related problems. 7.9% of population or 124,000 Jamaicans have drug related problems. 11.9% of population or 187,100 Jamaicans have either alcohol or drug related problems or both. 19% of pop. meet the criteria for depression. Rates of depression highest among persons dependent on alcohol or illicit substances. ESTIMATES OF TREATMENT NEEDS ADOLESCENT POPULATION ( 18 TO 24 YRS ) ALCOHOL 60.6% of population ever used 44.2 % used in the month of survey. 2.6% of adolescents abuse alcohol 2.% are dependent on alcohol Nb.* 4.6% or 15,000 adolescents have alcohol related problems. ESTIMATES OF TREATMENT NEEDS ADOLESCENT POPULATION (18 TO 24 YEARS) Illicit Drugs 26.5% used Ganja 0.6% used Crack Cocaine 10.2% or 33,500 adolescents have drug related problems. n.b.* 12.6% or 41,500 adolescents have both alcohol and drug related problems. NCDA Prevention Programme Community/Interest Group Engagement Organizing for prevention programme/initiatives Planning for ongoing prevention efforts Training & Development of a cadre of persons to manage ongoing drug prevention programmes Facilitates the ongoing work of the CODAC or interest group Networks with relevant agencies to support the work of the CODACS or interest groups TYPES OF PREVENTION PROGRAMMES. NCDA Prevention Education Programmes PEP • Squeaky • READ & READ + • Lignum Vitae • Rosebud • Drug Education & Training Programmes • Sports Initiatives • Alternatives to Drug Abuse/Economic Programme PARDAC/CODAC • TYPES OF PREVENTION PROGRAMMES. Rosebud Targets PTA's and presents a challenge to develop Drug Abuse Public Education projects. Youth/ Parents Squeaky Designed to identify 5-14/Community drug abuse influences on the group and to assess intention to use TYPES OF PREVENTION PROGRAMMES. Lignum Vitae Uses a combination of sports and music to build a resiliency of character in adolescents to resist drug abuse. Community/ Students READ & READ + Behaviour change initiative aimed to increase awareness of drug abuse and HIV/AIDS 6-8, 9-12 aged students Types of Prevention Programmes. PEP Educational curriculum to promote knowledge of the effects of drug abuse and peer resistance training Alternatives Economic initiatives to create income generating opportunities for community groups to sustain drug awareness School Based Community Types of Prevention Programmes. Drug Education & Training Provision of universal Community, education Workplace, programmes focusing Professionals on the effects of substance abuse CODAC/ PARDAC Community and parish groups to strengthen community based organizations awareness on substance abuse Community O.I.D support to Jamaica Rapid Assessment Surveys (R.A.S) Treatment and Rehabilitation Sentinel Sites Low Literacy Youth in School (squeaky) Equipment Data Sharing NCDA EPI-SIDUC Summary 2001-2003 Total of 1,242 clients seen in T&R Centres Age of First Use (onset drug) Drug 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-40+ Alcohol 19 7 42 23 37 75 204 Marijuana 20 109 57 61 63 82 Tobacco 4 18 32 62 59 235 Total of 410 clients or 33% of total seen identified Tobacco as the onset drug as compared with 389 clients or 31% who identified alcohol and 392 clients or 32% Marijuana as the onset drug. SQUEAKY PRETEST- KNOWLEDGE OF USERS DRUG 5-7 GANJA 11 4% 164 6.2% 169 6.4% 86 3.3% S/SPLIFF 3 1% 26 1% 6 2% 5 2% 42 1.6% COCAINE 1 0% 20 8% 8 3% 4 2% 34 1.3% CRACK 1 0% 10 4% 4 2% 3 1% 19 7% 9 3% 6 2% 3 1% 18 7% HEROIN 8-10 11-13 14-16 17-19 9 3% TOTAL 443 16.7% ECSTASY 2 1% 31 1.2% 48 1.8% 26 1.0% 1 0% 108 4.1% ALCOHOL 32 1.2% 568 21.5% 587 22.2% 153 5.8% 8 3% 1357 51.3% 98 3.7% 130 4.9% 45 1.7% 3 1% 278 10.5% TOBACCO Challenges Internal data maximization Epi-Sudic software upgrade Ongoing feedback from OID The Way Forward Improved data sharing Upgrading software and hardware Integrating methodologies