These go-go drugs are now consumed in practically every region of the world, posing a significant problem in North America, Europe and South-East Asia. And experts believe their usage could expand. "We think this is likely to become one of the largest drug problems in the next century", says Pino Arlacchi, Executive Director of the United Nations International Drug Control Programme (UNDCP). "Through the 1990s, we have evidence that the growth rate in illicit manufacturing, trafficking and the spread of abuse has been greater for amphetamine-type stimulants than it has been for heroin and cocaine."
The saddest impact of prolonged abuse of these drugs is the damage done to users who sought some chemical help with life's problems - to do a job better, appear more cheerful, stay awake longer or lose weight quickly - only to find themselves overwhelmed with feelings of anxiety, hyperstimulation and paranoia.
From 8 to 10 June 1998 in New York, the United Nations General Assembly will convene a special session on the world drug problem. At the meeting, Governments are expected to agree on a set of target dates for concrete action to help reduce the demand for and supply of illicit drugs, including amphetamine-type stimulants.Overview of the problem
Amphetamine-type stimulants are not recent creations. Many of these drugs were synthesized at the turn of the century for medical use. In the Second World War, amphetamines were prescribed for fighter pilots and others who had to stay awake and alert. The initial problem started with diversion or overprescription from the licit medical area. The exception is Ecstasy, or MDMA, which although used by some psychiatrists to treat certain conditions, was never marketed as a pharmaceutical drug.
Today, amphetamine-type stimulants are not widely used for medical purposes. But while the legal market has shrunk, the black market is thriving.
One of the most worrisome drugs appears to be the highly addictive methamphetamine. According to the International Narcotics Control Board (INCB), an independent body based in Vienna that monitors the global drug control situation, methamphetamine abuse is on the rise in Central America, South-East Asia, Europe, the United States, Australia and New Zealand.
In the United States, the abuse of methamphetamine seems to be growing despite the introduction of a comprehensive law enforcement, treatment and prevention strategy. A June 1997 study by the White House Office of National Drug Control Policy indicated that many long-time crack addicts are switching to methamphetamine. In the Philippines, it is the most widely abused drug. And in Japan, Thailand, Taiwan, Malaysia and the Republic of Korea, abuse is on the rise.
* In the United States, there were over 2,400 methamphetamine-related deaths between 1991 and 1995 (about 90 per cent involved multiple drugs).
* In Japan, almost 90 per cent of all violations against drug control laws are related to methamphetamine.
* In the Philippines, methamphetamine has been the most widely abused drug since the early 1990s.
* In the Republic of Korea and Australia, methamphetamine abuse ranks second after cannabis.
* In the United Kingdom, amphetamine seizures have quadrupled since 1987.
Anyone with a basic knowledge of chemistry can "cook" methamphetamine in two to four hours. Recipes are available on the Internet, along with ingredient price lists.Links to organized crime
UNDCP reports a clear link between organized crime and the trafficking of amphetamine-type stimulants and their precursor chemicals. There is evidence that trafficking groups involved in the classic drugs are beginning to diversify into synthetic drugs. In South-East Asia, for instance, some of the groups that were involved in heroin trafficking are now moving into methamphetamine or amphetamine, according to UNDCP. The New York Times reported on 19 April 1998 that hill tribes in Myanmar, near the Chinese border, are making more money from methamphetamine than from heroin and refine both drugs themselves using chemicals smuggled in primarily from China.
The Mexican Mafia also plays a key role. "Mexico is a major player both in the production of methamphetamine that is smuggled into the United States and as a source for precursor chemicals for clandestine methamphetamine laboratories in the United States", says Harold D. Wankel, former Chief of Operations of the Drug Enforcement Administration (DEA) of the United States. Testifying to the U.S. Congress, Mr. Wankel said, "The majority of the methamphetamine available in the United States is controlled by traffickers from Mexico who manufacture the product in Mexico, or in major labs in California and the southwest."
But even more ominous than cross-border shipments is the trend towards the manufacture of amphetamine-type stimulants in the same area or country in which they are being sold. With the elimination of long-distance trafficking routes, the job of law enforcement becomes much tougher.
Amphetamine-type stimulants that are sold on the black market are manufactured clandestinely in laboratories which can be located anywhere - from a neighbour's kitchen or garage to a warehouse or even within a legitimate pharmaceutical company.
In Australia, more than 60 laboratories detected in 1995 and 1996 were engaged in the clandestine manufacture of amphetamine or methamphetamine, according to the International Narcotics Control Board. The chemicals used to make the drugs were usually diverted from legal domestic sources.
In the United States, methamphetamine accounted for 98 per cent of all clandestine laboratory seizures in 1996. Between January 1994 and July 1996, the DEA raided 1,015 methamphetamine laboratories in the U.S., and state law enforcement agencies seized hundreds more. The chemicals ephedrine and pseudoephedrine were used as the precursor material in most of the labs.
Since ephedrine, one of the starter chemicals, is now tightly controlled by the U.S. Government, many manufacturers are now using pseudoephedrine, which can be purchased from mail-order companies or from local drugstores through over-the-counter drugs which contain the ingredient.
The DEA reports that large-scale operators in Mexico, who relied in the past on ephedrine, have found alternative sources of supply from countries such as China, the Czech Republic and India.
Once chemicals become difficult to obtain, manufacturers turn to new recipes and ingredients. A chemical that is now being used to manufacture methamphetamine is phenylpropanolamine.
Once labs are detected, they must be dismantled. This requires technical expertise - to protect human health and the environment - and money. According to Luke Galant of the U.S. Department of Justice, the average cost to clean up a methamphetamine laboratory in California, for instance, is $3,100, but can reach $150,000.
Very little is known about the long-term health effects of Ecstasy. Acting simultaneously as a stimulant and hallucinogen, it depletes a very important chemical in the brain, serotonin, which affects mood, sleeping and eating habits, thinking processes, aggressive behaviour, sexual function and sensitivity to pain. Studies with rats and monkeys show that the use of Ecstasy can reduce serotonin levels in the brain by 90 per cent for at least two weeks.
While animal studies point to possible brain damage from the prolonged use of Ecstasy, there is no conclusive evidence that this would be the same for human beings. "We need more research and there is a need for caution", says Mr. Arlacchi. "We do have enough evidence to say that we have to proceed cautiously with these drugs."
Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells and causes enhanced mood and increased body movement.
But prolonged use of methamphetamine impairs the brain's ability to manufacture dopamine, which is essential for the normal experience of pleasure and psychological functioning.
"This effect may persist for up to a year after the individual has stopped taking the drug", says Dr. Alan Leshner, Director of the U.S. National Institute on Drug Abuse. "The truth is that prolonged use of methamphetamine modifies the brain's systematic waves. This is a dangerous consequence, and the public must be educated about it."
Initially, small doses of methamphetamine increase one's ability to concentrate. However, it is highly addictive and users can develop a tolerance quickly, needing more and more to get high, and going on longer and longer binges. Some users avoid sleep for 3 to 15 days while binging.
Psychological symptoms of prolonged methamphetamine use can resemble those of schizophrenia. One of the well known effects of long-term methamphetamine use is "amphetamine psychosis", which is associated with paranoia. Long-term use can also lead to violent behaviour. In one case in California, a man under the influence stole a National Guard tank and crunched cars on a San Diego freeway until police killed him.Reducing demand
Experience has shown that, in order to be effective, prevention efforts must be comprehensive, culturally sensitive and targeted to specific drugs, populations and locations. To address rising methamphetamine abuse in the United States, the Partnership for a Drug-Free America is mounting a national campaign using public service announcements to explain the dangers of the drug.
Treating methamphetamine addicts poses special problems. "We need to face the fact that we are dealing with people whose brains have been changed by drugs and who are literally in a different brain state", explains Dr. Leshner. "Law enforcement officers on the street understand this problem from experience, but we all must understand this if we are to solve this problem."
Effective treatments deal with the biological, behavioural, environmental and social aspects of addiction. The problem, according to Dr. Leshner, is that there are virtually no biological treatments for methamphetamine addiction. "The absence of medications for stimulant addiction is probably at the core of our inability to get a handle on this issue", he says. He has declared the development of anti-stimulant addiction medications as a top priority.Local action favours treatment over jail
Jackson County, Missouri, has become a model in the United States for its methamphetamine eradication strategy. Voters approved a county-wide drug tax (a 0.25 per cent increase in sales tax), the first of its kind in the country, to deal with the problem. It raises about $13 million a year for drug prosecutions, jails, prevention, treatment and a diversion programme called Drug Court, which gives non-violent offenders the chance to choose treatment over the county jail. Defendants who complete a 12 to 18 month treatment programme have their criminal charges dismissed. Compliance rates are reportedly running at 50 to 70 per cent.
Experts agree that any strategy to reduce demand for amphetamine-type stimulants must be complemented by measures to curtail supply.
The most important conclusion to draw, according to Mr. Arlacchi, is one on which UNDCP bases practically all of its policies - "that you will never get anywhere if you deal exclusively with trying to control the supply of substances or exclusively trying to deal with the demand. You have to do both together."
The international control system
Over 100 hallucinogens, amphetamines, barbiturates, sedatives and tranquilizers are controlled under the 1971 Convention on Psychotropic Substances. Between 1971 and 1995, there was a nearly fivefold increase in the number of amphetamine-type stimulants under international control. The 1971 Convention lists drugs in four categories or schedules. Drugs in schedule one, the most tightly controlled category, have the least medical use and the highest perceived public health risk, while those in schedule four are widely used for medical purposes and believed to pose the least risk to public health. Schedules two and three fall in between these on a sliding scale.
Ecstasy and related designer drugs are under schedule one of the 1971 Convention, because they have virtually no medical use, while amphetamine and methamphetamine are under schedule 2 because they began life with medical use. But even though they are scheduled, the system is not really working for these illegally produced drugs.
One of the main limitations of the control system is that the Psychotropic Convention was not designed to control illicit markets. It was designed to control and regulate legitimate pharmaceutical markets to prevent their diversion into illicit markets.
There is a proposal to improve the control system by increasing the flexibility of scheduling drugs under the 1971 Convention. Experts acknowledge that the "substance-by-substance" approach is unlikely to keep pace with the perpetually innovative capacity of illicit markets. Another proposal involves amending drug-control treaties to make them more responsive to the present situation.
U.S. Government works with drugstore chain
In April 1997, the United States DEA and the retailer Wal-Mart announced that they would work together to reduce the availability of certain over-the-counter drugs used to manufacture methamphetamine illegally. The cash registers in every Wal-Mart, some 2,300 across the country, were programmed to limit sales to three to six packages of some allergy, cold and diet products containing ephedrine and pseudoephedrine. Signs were posted in all stores informing customers about the cooperation with the DEA. The chain-wide policy is even stricter than U.S. government regulations under the Methamphetamine Control Act of 1996, which went into effect in October 1997. When the partnership with Wal-Mart was announced, DEA Administrator Thomas A. Constantine said, "Wal-Mart is breaking new ground with this initiative and we hope that other retailers will follow their lead."
The problem of amphetamine-type stimulants is on the agenda of the United Nations General Assembly special session on the world drug problem, from 8 to 10 June in New York. An action plan drawn up for the session calls on Governments to reduce demand through targeted prevention and treatment programmes, disseminate accurate information about amphetamine-type stimulants and their effects, and improve mechanisms for controlling their manufacture and distribution. The action plan is to be implemented by 2003 to produce concrete results within a decade.
Published by the United Nations Department of Public Information - DPI/1985 - May 1998
UN Department of Public Information
Bill Hass, tel. (212) 963-0353,
Ann Marie Erb, tel. (212) 963-5851, or
Tim Wall at (212) 963-1887.
Fax: (212) 963-1186
UN web site: http://www.un.org
Sandro Tucci, Spokesman
UN International Drug Control Programme
Vienna International Centre, Room E 1448
P.O. Box 500
A-1400 Vienna, Austria
Tel: (431) 21345-5629;
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