Less than eight per cent of drug users worldwide have access to a clean syringe programme. Credit: Fahim Siddiqi/IPS

By Thalif Deen
UNITED NATIONS, Feb 26 2015 (IPS)

As the call for the decriminalisation of drugs steadily picks up steam worldwide, a new study by a British charity concludes there has been no significant reduction in the global use of illicit drugs since the creation of three key U.N. anti-drug conventions, the first of which came into force over half a century ago.

“Illicit drugs are now purer, cheaper, and more widely used than ever,” says the report, titled Casualties of War: How the War on Drugs is Harming the World’s Poorest, released Thursday by the London-based Health Poverty Action."This approach hasn’t reduced drug use or managed to control the illicit drug trade. Instead, it keeps drugs profitable and cartels powerful." -- Catherine Martin of Health Poverty Action

The study also cites an opinion poll that shows more than eight in 10 Britons believe the war on drugs cannot be won. And over half favour legalising or decriminalising at least some illicit drugs.

The international treaties to curb drug trafficking include the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances and the 1988 United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

But over the last few decades, several countries have either decriminalised drugs, either fully or partially, or adopted liberal drug laws, including the use of marijuana for medical reasons.

These countries include the Netherlands, Portugal, Czech Republic, Uruguay, Argentina, Brazil, Colombia, Guatemala, Ecuador, Honduras and Mexico, among others.

According to the report, the governments of Mexico, Colombia and Guatemala seek open, evidence-based discussion on U.N. drugs policy reform.

And “both the World Health Organisation (WHO) and UNAIDS not only share this view, but have called for the decriminalisation of drugs use.”

Asked if the United Nations was doing enough in the battle against drugs, Catherine Martin, policy officer at Health Poverty Action, told IPS, “The problem is that the U.N. is doing too much of the wrong things, and not enough of the right things.”

She pointed out that an estimated 100 billion dollars worldwide is poured into drug law enforcement every year, driven by U.N. conventions on drug control.

“However, this approach hasn’t reduced drug use or managed to control the illicit drug trade. Instead, it keeps drugs profitable and cartels powerful (fuelling corruption); spurs violent conflict and human rights violations; and disproportionately punishes small-scale drug producers and people who use drugs,” she added.

The report says UK development organisations have largely remained silent, while calls for drugs reform come from Southern counterparts, British tycoon Sir Richard Branson, current and former presidents, Nobel prizewinning economists and ex-U.N. secretary-general Kofi Annan.

The charity urges the UK development sector to demand pro-poor moves as nations prepare for the U.N. general assembly’s special session on drugs next year.

Many non-governmental organisations (NGOs), including British groups, have no lead contact or set process for participating in the session, says the report.

The report claims many small-scale farmers grow and trade drugs in developing countries as their only income source.

And punitive drug policies penalise farmers who do not have access to the land, sufficient resources and infrastructure that they would need to make a sustainable living from other crops.

Alternative crops or development programmes often fail farmers, because they are led by security concerns and ignore poor communities’ needs, the report notes.

The charity argues the militarisation of the war on drugs has triggered and been used to justify murder, mass imprisonment and systematic human rights violations.

The report stresses that criminalising drugs does not reduce use, but spreads disease, deters people from seeking medical treatment and leads to policies that exclude millions of people from vital pain relief.

Less than eight per cent of drug users have access to a clean needle programme, or opioid substitution therapy, and under four per cent of those living with HIV have access to HIV treatment.

In West Africa, people with conditions linked to cancer and AIDS face severe restrictions in access to pain relief drugs, amid feared diversion to illicit markets, according to the study.

Low and middle-income countries have 90 per cent of AIDS patients around the globe and half of the world’s people with cancer, but use only six per cent of morphine given for pain management.

Health Poverty Action states the war on drugs criminalises the poor, and women are worst hit, through disproportionate imprisonment and the loss of livelihoods.

Drug crop eradication devastates the environment and forces producers underground, often to areas with fragile ecosystems.

Asked what the U.N.’s focus should be, Martin told IPS the world body should focus on evidence-based, pro-poor policies that treat illicit drugs as a health issue, not a security matter.

These policies must protect human rights and end the harm that current policies do to the poor and marginalised, she said.

“Drug policy reform should support and fund harm reduction measures, and ensure access to essential medicines for the five billion people worldwide who live in countries where overly strict drug laws limit access to crucial pain medications,” Martin said.

Meanwhile, the report says that drug policy, like climate change or gender, is a cross-cutting issue that affects most aspects of development work: poverty, human rights, health, democracy, the environment.

And current drug policies undermine economic growth and make development work less effective, the report adds.

Edited by Kitty Stapp

The writer can be contacted at thalifdeen@aol.com

Coca field in an Amazon jungle village. Credit: Courtesy of Central Asháninka del Río Ene/IPS

By Jim Lobe
WASHINGTON, Sep 10 2014 (IPS)

A top-level international panel called Tuesday for a major shift in global drug-control policies from prohibition to decriminalisation and regulation.

In a 43-page report, the Global Commission on Drug Policy denounced what has been known for more than four decades as the “war against drugs” as a failure and argued that new approaches prioritising human rights and health were urgently needed.“There’s no question now that the genie of reform has escaped the prohibitionist bottle.” -- Ethan Nadelmann of the Drug Policy Alliance

“In this report, we set out a broad roadmap for getting drugs under control,” wrote former Brazilian President Fernando Henrique Cardoso, who chairs the Commission. “We recognize that past approaches premised on a punitive law enforcement paradigm have failed, emphatically so.

“They have resulted in more violence, larger prison populations, and the erosion of governance around the world. …The Global Commission on Drug Policy instead advocates for an approach to drug policy that puts public health, community safety, human rights, and development at the center,” according to Cardoso.

Such an approach would, among other changes, encourage governments to regulate markets in currently illicit drugs, beginning with marijuana, coca leaf, and certain psycho-active drugs; seek alternatives to prison for low-level, non-violent participants in the drug trade; and ensure equitable access to essential medicines, especially opiate-based pain medications, according to the report, “Taking Control: Pathways to Drug Policies That Work.” It called for a pragmatic approach that would include experimentation and trial and error.

The report’s recommendations, which come as governments prepare for the 2016 U.N. General Assembly Special Session (UNGASS) on Drugs, drew a mixed response from the U.S. government which has largely driven international drug policy since former President Richard Nixon first declared a “war on drugs” in 1971.

“We agree that we should use science-based approaches, rely on alternatives to incarceration for non-violent drug offenders, and ensure access to pain medications,” said Cameron Hardesty of the White House Office of National Drug Control Policy.

“…However, we disagree that legalisation of drugs will make people healthier and communities safer. Our experience with the tobacco and alcohol industries show that commercialization efforts rely upon increasing, not decreasing use, which in turn increases the harm associated with the use of tobacco and alcohol. In fact, if we take Big Tobacco as prologue, we can predict that that approach is likely to cause an entirely new set of problems,” she said.

Nonetheless, independent analysts said the Commission’s recommendations are likely to substantially advance the growing debate over drug policy if, for no other reason, than its membership is not easily dismissed.

In addition to Cardoso, its 21 members include former U.N. Secretary-General Kofi Annan, former U.N. High Commissioner for Human Rights Louise Arbour, former Colombian President Cesar Gaviria, former Polish President Aleksander Kwasniewski, former Chilean President Ricardo Lagos, and former Mexican President Ernesto Zedillo, as well as former U.S. Secretary of State George Shultz and former Chairman of the U.S. Federal Reserve Paul Volcker.

The report was released at a press conference that featured several of the Commission’s members in New York City Tuesday morning.

“This is a very important report that will provoke more serious discussion and debate,” Michael Shifter, president of the Inter-American Dialogue, an influential Washington-based inter-hemispheric think tank, told IPS. “There have already been significant changes at the state level [in the U.S.] and in some countries in Latin America, and this will push things along.”

In 2011, the Commission published its first report in which it also condemned the drug war as a failure and made a series of recommendations designed to “break the taboo” against considering legalisation and regulation of some drugs as alternatives.

Having broken the taboo, the Commission offered political cover for some Latin American leaders, including former Mexican President Felipe Calderon, Colombian President Juan Manuel Santos, Guatemalan President Otto Perez Molina, and Uruguayan President Jose Mujica (whose country last December became the world’s first to regulate the legal production, distribution, and sale of marijuana), to endorse far-reaching reform.

In mid-2013, the Organisation of American States (OAS) also released a report commissioned by the region’s reads of states that included legalisation as a policy alternative and that strongly favoured the view that drugs should be seen increasingly as a public health, rather than a security issue.

Among other measures, it proposed legalising and regulating marijuana production, distribution and sales – a recommendation that has since been adopted by voters in the U.S. states of Colorado and Washington. Nearly half of all U.S. states have legalised cannabis for medical purposes, and 17 states have decriminalised personal possession.

Virtually all observers agree that the drug war has been a signal failure. As prices drop for drugs that are have become purer with each passing year, governments have been spending an estimated 100 billion dollars annually on enforcement measures. The U.N. has estimated the value of global illicit drug trade at over 350 billion dollars.

The Commission offered a number of general recommendations in its report, beginning with a call for a “fundamental re-orientation of policy priorities” that would replace traditional goals and measures — such as amounts of drugs seized, the number of people arrested, prosecuted, and convicted for drug law violations – with “far more important” benchmarks, such as reducing drug-related harms, such as fatal overdoses, HIV infections, crime, violence, human rights abuses, and the power of criminal organisations that profit from the drug trade.

In addition to calling for equitable access to essential medicines, regulating markets for some drugs, and relying on alternatives to incarcerating non-violent, low-level participants in illicit drug markets, such as farmers and carriers, the report called for governments to be “far more strategic” in efforts to reduce the power of criminal organisations.

It noted that militarised “crackdowns” may actually increase criminal violence and public insecurity without actually deterring drug production, trafficking or consumption.

“…(I)n the longer term, drug markets should be responsibly regulated by government authorities. Without legal regulation, control and enforcement, the drug trade will remain in the hands of organised criminals. Ultimately this is a choice between control in the hands of governments or gangsters; there is no third option in which drug markets can be made to disappear,” according to the report.

“The idea behind this report and its timing is to ensure that there can be no repeat of the empty slogans, such as “a drug-free world, we can do it,” which was the theme of the UNGASS on Drugs in 1998, said John Walsh, a drug-policy expert at the Washington Office on Latin America (WOLA).

“To avoid a repeat, the idea is to ensure that a genuine debate will be unavoidable. That doesn’t mean that the world’s countries will rally around this new paradigm of legal regulation instead of prohibition, but the hope is that these issues cannot be ignored.”

“There’s no question now that the genie of reform has escaped the prohibitionist bottle,” said Ethan Nadelmann, the veteran director of the Drug Policy Alliance (DPA). “The former presidents and other Commission members pull no punches in insisting that national and global drug control policies reject the failed prohibitionist policies of the 20^th century in favour of new policies grounded in science, compassion, health and human rights.”

Jim Lobe’s blog on U.S. foreign policy can be read at Lobelog.com. He can be contacted at ipsnoram@ips.org

Edited by Kitty Stapp

International bodies and local campaign groups have repeatedly criticised Russia for not doing anywhere near enough in terms of providing prevention services or access to medical treatment for HIV/AIDS sufferers. The fourth Eastern Europe and Central Asia (EECA) HIV/AIDS Conference, which finished in Moscow last week, has not put a stop to that criticism.

Boycotted by many domestic and international organisations working with HIV/AIDS sufferers and those most at risk of contracting the disease, the conference – and the Russian authorities’ overall approach to HIV/AIDS – was accused of blatant hypocrisy.

The critics said that the hosting of the event in Russia, which has one of the world’s highest HIV/AIDS incidence rates, is a slap in the face for people in Russia with the disease or at risk of contracting it.

And as ministers trumpeted their supposed good work, sufferers were continuing to be denied prevention services and treatment widely available in other developed states, campaigners said.

Anya Sarang, head of the Moscow-based Andrei Rylkov Foundation for Health and Human Rights group, told IPS: “Giving any support to this conference is verging on the criminal. The conference shows not just the hypocrisy of a country with the worst HIV policy in the region, if not the world, but is also a waste of valuable money.

“It is much easier [for Russia] to organise a conference and talk about how much money has been spent on HIV than to build effective systems to deliver HIV prevention and care.”

Russia has one of the world’s fastest growing HIV/AIDS epidemics, according to groups like UNAIDS and the World Health Organisation (WHO) and HIV incidence has continued to rise in recent years. There were 77,896 new cases officially registered in 2013 – 10.1% higher than in 2012 – according to the Russian Federal AIDS Centre.

Russian officials speaking at the conference, however, praised their own work on tackling the disease.

“It is much easier [for Russia] to organise a conference and talk about how much money has been spent on HIV than to build effective systems to deliver HIV prevention and care.”
Health Minister Veronika Skvortsova pointed out that Russia’s HIV infection rate is currently 463 out of every 100,000 people, but that “in other countries that boast of their preventive efforts, the prevalence is higher. In the United States, 600 out of 100,000 people are infected and, in Brazil, the infection rate is about 500.”

Critics point out though that there is no way of independently checking these figures as Russia does not supply such data to UNAIDS or the WHO.

Meanwhile, other officials lauded the 3.2 billion dollars that the country had spent on HIV/AIDS between 2006 and 2013 and said that treatment and detection programmes were well funded.

But international bodies and local campaign groups are also attacking what they say that the government is allowing, or even actively encouraging: the discrimination of at risk groups, particularly drug users.  The latter group, they argue, is key to halting the spread of the disease because research has shown that the epidemic in Russia is being driven by intravenous drug use.

Critics point to repressive drugs legislation, the stigmatisation and discrimination of drug users in society and many primary health care facilities as well as a ban on opioid substitution therapy (OST). Meanwhile, harm reduction programmes, including needle and syringe exchanges, are very limited and receive little or no central government support.

Photo courtesy of Nabarezhnye Chelny NGO

This comes despite the fact that prevention programmes, including OST, are widely implemented in many countries around the world, are recommended by the World Health Organization (WHO), and have been proved to be successful in halting the spread of HIV/AIDS.

Speaking at the conference, Michel Sidibe, Executive Director of UNAIDS, explained how authorities in China, which had once operated a zero tolerance approach to drug use, had seen dramatic success in its fight against the disease following the introduction of OST programmes.

Describing progress in China on HIV prevention as “remarkable”, he said that over the course of six years more than 385,000 patients were enrolled in 800 methadone substitution clinics and that today new HIV infections among patients receiving methadone were close to zero.

“The data from China are bold and clear – harm reduction and substitution therapy are evidence-based programmes that save lives,” he said, adding that drug users in EECA countries should “not be treated like criminals” but given help.

However, the lack of prevention services is not all that is hampering a more effective response to the disease. There are problems for those already diagnosed. Access to anti-retroviral treatment is very low – with as little as eight percent of all those in need of it being able to obtain it in Russia.

Systematic care of those diagnosed with the disease is also inadequate and UN officials have previously told IPS that a lack of integration of patients with HIV into the primary health care system means that they are given a referral to a special treatment centre following diagnosis and then largely forgotten about by their doctors.

Meanwhile, doctors have warned that persecution of homosexuals, drug users and people with HIV/AIDS means that it is impossible to collect accurate data on the spread of the disease.

Gay men are often fearful of admitting to doctors how they became infected and instead say that they contracted it through heterosexual sex. Drug users, who can face long prison sentences in some countries in the region, do the same.

Recent legislation banning the promotion of same sex partnerships and long-standing travel restrictions in some parts of the region for people with HIV have only further marginalised groups in which the disease is spreading rapidly. This presents a major problem in effectively dealing with the epidemic, say doctors, because it prevents them from gaining a clear view of the disease’s epidemiology.

People with HIV/AIDS in Moscow say they have no hope of any help from a government they say has essentially abandoned them.

Ivan Anoshkin, a sufferer from Togliatti in south-west Russia, told IPS: “I don’t have any regular income but they won’t give me any invalidity benefits and I have to do manual work just to make sure I don’t die from hunger.

“HIV/AIDS is hard to treat and in view of the fact that there are no social services or clinics to help, it means I’m on my own with everything. I have to make sure I don’t break down just so I won’t die.”

Over 120,000 Afghan women and 60,000 children admit to being addicted to drugs. Credit: Anand Gopal/IPS

By Giuliana Sgrena
KABUL, May 24 2013 (IPS)

Located on a narrow street in a quiet neighbourhood in Kabul, the Sanga Amaj Women’s Treatment Centre is the only one of its kind in Afghanistan: named after the 22-year-old journalist who was assassinated in 2007, the facility caters exclusively to Kabul’s massive population of female drug addicts.

Out of respect for its residents’ privacy, the centre does not disclose its location and strictly monitors all visits. Here, a kind and professional staff dressed in white aprons attend to 25 women and an equal number of children between the ages of five and 11who spend most of their time in a cosy playroom filled with toys.

The entire facility is split between two floors, housing dormitory-style rooms with 12 beds each and an array of common rooms.

The clean, pleasant settings belie the desperate circumstances of the building’s occupants.

Most of the women here say they started out using opium and hashish, but turned to harder drugs like heroin in order to cope with “economic hardships, family violence, or psychological problems,” Storai Darinoor, one of the young coordinators at the facility, told IPS.

“In many cases husbands introduce their wives to drugs, often forcibly. When either one of the parents are addicts, the children generally become addicts, too,” she added. Women and children tend to favour oral intake of drugs, either eating or smoking their fix, but one 11-year-old in the centre was found to have been using injections.

Though the female residents declined to speak with IPS, staff members said that patients have admitted to taking heroin as “medicine” to ease the stresses of daily life.

“Young children are fed opium by their mothers to keep them quiet, while older children, in addition to consuming drugs themselves, provide drugs for their mothers,” according to Storai.

She says 80 percent of female addicts turned to drugs upon returning to the country from Iran and Pakistan, where they lived as refugees during the Taliban’s reign from 1996 to 2001.

The Sanga Amaj Centre receives funding through the drug advisory programme of the Colombo Plan – a U.S.-backed regional initiative designed to coordinate strategies for reducing demand and supply of narcotics in Asia – but only enough to provide the most basic therapy.

“Treatment typically lasts 45 days,” Dr. Huma Mansouri, director of the facility, tells IPS, beginning with a 10-day period of detoxification.

“After that we proceed to administering daily doses of buprenorphine (a semi-synthetic opioid) since we do not have access to methadone.” When this is inadequate to stop severe withdrawal symptoms – crying, screaming or beating their heads against a wall – staff members resort to “water therapy”: short, cold showers that help patients to relax.

After the first 10 days, medication is limited to daily doses of vitamins. The rest of the time in the facility is spent on rehabilitation, attending awareness sessions on the harmful effects of drug use and classes on different subjects including health, psychology and religion, “because drug use is forbidden in Islam,” Mansouri said.

The women then move into a three-month vocational programme, learning sewing and computer skills, which open up employment opportunities once they leave the centre.

One of the facility’s 12 staff members is then assigned to “follow” the women for a two-year period, making weekly house visits, offering support or advice, and providing counselling free of charge.

Not all of the women have a place to go after being discharged. Some are abandoned by their families as a result of their addiction and have no way of supporting themselves. Whenever possible, the centre hires its old patients to work as cleaners in the facility.

To date, the centre has treated over 1,100 women, of which “only 145 have relapsed,” according to Storai.

But the vast majority of women in Afghanistan have no access to such treatment, and often live out their days in a cycle of violence and poverty made worse by their addiction.

According to a survey conducted by the United Nations Office on Drugs and Crime (UNODC) in 2010, the last time such data were gathered, roughly one million Afghans between the ages of 15 and 64 were addicted to drugs, or three percent of the population of 35 million.

An estimated 120,000 of these addicts are women, and over 60,000 are children.

Experts attribute these dismal figures to numerous factors, including a 40-percent unemployment rate and an increase in poppy cultivation: in 2012, an estimated 154,000 hectares of farmland were dedicated exclusively to poppy.

The UNODC 2013 Afghanistan Opium Risk Assessment says cultivation in the main poppy growing areas – like the southern regions of Helmand and Kandahar, and northern provinces like Herat, Faizabad and Badakhshan – is expected to rise even further in the coming years.

The country, which used to supply about half of Europe’s heroin in 2001, now accounts for a full 90 percent of the global supply of opiates, making it the world’s largest producer by far. An estimated 26 percent of the country’s GDP comes directly from the narcotics trade, which the U.N. report says is “strongly” linked to economic insecurity and a lack of agricultural aid.

Though Afghanistan has a long history of opium use, with many families in the north taking moderate doses in order to work longer hours, addiction levels did not reach such heights until the U.S.-led invasion in 2001 forced warring mujahideen groups out of the cities and into rural areas, where they took over vast poppy fields and established “production centres and laboratories along the northern border,” Dr. Tariq Suliman, director of ‘Nejat’, one of the few drug rehabilitation centres in Kabul, told IPS.

Located in the impoverished Karte Char neighbourhood in western Kabul, Nejat sits in the middle of a huge concentration of drug users, who congregate in parks, crouch under bridges or trees, or even just sit in the middle of the road to get their fix.

While heroin is the most widely used drug – available at virtually every street corner for six dollars a gramme – hashish and opium are also readily available. For a population with an average income of just 500 dollars a year, this is a steep price to pay, and often pushes families deeper into poverty.

The government’s ministry of counter narcotics has no funds with which to implement prevention, treatment or rehabilitation programmes, leaving the onus for this work entirely on the shoulders of civil society, laments Suliman.

Experts say women bear the brunt of addiction, partly because religious and cultural taboos preventing women from consuming drugs mean that few actively seek treatment for fear of being stigmatised.

Female drug addicts here are a kind of “hidden population”, secreting themselves away in their homes, which, in turn, breeds a culture of violence against children and pushes the latter closer towards addiction.

Experts say that unless the government allocates more money for the creation of facilities like the Sanga Amaj Centre, the thousands of female addicts have no hope of a better future.

A youth smokes diamba (marijuana) at a gang base in Sierra Leone’s capital Freetown. Credit: Tommy Trenchard/IPS

By Tommy Trenchard
FREETOWN, Jan 9 2013 (IPS)

The air is heavy with the smell of marijuana as Gibrilla (23) expertly rolls a large joint at the Members of Blood (M.O.B) gang base in a poor neighbourhood of Sierra Leone’s capital, Freetown.

He is part of a generation of young people faced with a chronic shortage of jobs, many of whom have turned to routine drug use as a way to pass the time and deal with the stresses of life in what is still one of the poorest countries in the world.

“Most of the young guys smoke diamba (marijuana) here,” says Gibrilla, gesturing towards the slum neighbourhood of Susan’s Bay. He says he has been smoking since he was 11, and usually smokes about 15 joints every day. “I have my first one at about five o’clock in the morning when I wake up,” he told IPS. “It makes me feel good.”

Sierra Leone’s high unemployment rate is fuelling a culture of drug use among the country’s urban youth. Experts say the trend is responsible for acts of violent crime, while medical practitioners are concerned about serious health repercussions for long-term users, which the country is poorly equipped to address.

In another part of the city, Patrick, who estimates his age as “twenty-something”, swigs from a plastic sachet of gin as he talks of his relationship with drugs.

“I use cocaine, marijuana, brown-brown (heroin) and liquor,” he told IPS. “I did not choose to live like this. I was living the street life…sometimes I did not even have somewhere to sleep. I had nothing.”

Patrick now feels he needs drugs and alcohol just to get through the day. “I feel hopeless when I don’t have them,” he explains.

His friend Alimu, heavily tattooed, with the initials of his gang shaved into his hair, speaks of a similar dependence. “I don’t want to stop,” he says. “I need it now.”

Alimu is not sure how much he takes every day, only that he spends all the money he can get on drugs and alcohol.

Assistant Superintendent of the Sierra Leone Police Force, Ibrahim Samura, says he is alarmed by the “spate of drug abuse and addiction”.

“It is worse than before…amphetamines, cannabis and heroin are all a problem,” he says, adding that cannabis is the most widely available. “Cannabis is now grown in almost every district. In some places in the north it is even used as a currency for barter.”

Samura says that there was a large increase in drug use and addiction during and after the country’s eleven-year civil war. “People used drugs to deal with the stress of war,” he explains.

Dr. Edward Nahim at his clinic in central Freetown. Credit: Tommy Trenchard/IPS

Dr. Edward Nahim has been working on drug and mental health issues in Sierra Leone for over 40 years. He agrees that the problem is, to some extent, linked to the civil war. “The conflict itself might be a contributing factor, because once you’ve learnt bad habits it becomes difficult (to stop).”

But he also says that drug addiction in Sierra Leone is tied to a lack of job opportunities. “It is more common amongst the unemployed vagrants, because they don’t have any work to do. (They) are the ones who spend most of their time in the…drug abuse bases or ghettos,” he says.

Impoverished and traumatised youth even use drugs just to “kill boredom”, Samura says.

Youth unemployment in Sierra Leone stands at a staggering 70 percent, according to the World Bank, and many drug users in Freetown say that if the government provides jobs for them, they will no longer feel the need to use drugs and alcohol.

“If I have a job I will stop smoking,” says Gibrilla. “But when I don’t go to work in the morning I just sit down and smoke diamba.”

Ibrahim Jones, a Susan’s Bay resident sporting a ‘Fight Against Drugs’ wristband, also thinks reducing unemployment is crucial to addressing drug use. “People smoke because there are no jobs,” he confirmed.

Samura says he is concerned about the relationship between illegal drugs and violent crime. He sees drug use as closely related to an increase in “gangsterism” in Sierra Leone.

“There are over 250 criminal gangs in this country,” he told IPS, displaying a list with names such as ‘Gang Killers’, ‘Blood Drain’, ‘Hisbola’ and ‘Da Elusive Thugs’.

He believes drug use “spurs them to behave abnormally and do things they wouldn’t do in their right senses.” On drugs, these young people “have the guts to kill, they’ll be brave (enough) to stab.”

The combination of high-grade cannabis and other drugs, together with cheap but potent local liquor, is also having severe mental health repercussions for long-term users.

“Drug abuse is a big problem in psychiatry in Sierra Leone today,” says Nahim, who runs a small mental health clinic in Freetown. He says around 80 percent of his patients, all of whom are between the ages of 10 and 35 years, are suffering from drug-induced psychotic disorders.

“By the time they get to about 40 years they are dead from the physical and psychological complications of these drugs,” he admits.

He adds that the problem is worst with young men, “but the girls are catching up now”.

Sierra Leone lacks the means to effectively treat such victims of drug and alcohol-induced psychosis. Nahim uses what he calls the “cold-turkey method” to treat addicts, physically restraining them and administering “very strong tranquilising drugs” for sedation. “Then after ten days it’s over,” he says.

But relapse rates are high. After treatment there are few safeguards to prevent patients slipping back into drug use.

City of Rest Rehabilitation Centre  is one of only a handful of establishments catering to drug users and the mentally ill on a longer-term basis. More than half of its 40 inpatients are suffering from drug-related problems.

It is run by Pastor Morie Ngobeh, who uses religion and counselling to treat individuals with drug-induced mental conditions. “We rely on prayer, for God to renew their minds,” he says.

Abdulai Bah’s family admitted him to City of Rest to deal with his chronic alcoholism. It is the second time he has been a patient there, but he feels that with a job waiting for him he will be able to stay off alcohol when he leaves in January.

“Some of my relatives promised to help me start my own business. If I start to get myself engaged, I will not drink alcohol again,” he says with conviction.

(END)