DEMAND REDUCTION IN DEMAND REDUCTION IN JAMAICAJAMAICA

A BRIEF CASE STUDYA BRIEF CASE STUDY

CARL STONE SURVEY 1991CARL STONE SURVEY 1991..

COCAINE & CRACK COCAINE ABUSE COCAINE & CRACK COCAINE ABUSE

MALE MALE FEMALEFEMALE 1989 1989 1991 1991 1989 1989 19911991

% % DRUG USE DRUG USE 3.02 2.75 0.12 3.02 2.75 0.12 0.090.09

Total (‘000 ) Total (‘000 ) 21.4 21.4 19.2 .84 .6319.2 .84 .63

Recommended: That Demand Reduction programmes need to be Recommended: That Demand Reduction programmes need to be intensified and expanded in the Urban and Tourism area where Drug intensified and expanded in the Urban and Tourism area where Drug dealers have apparently increased their aggressive marketing dealers have apparently increased their aggressive marketing networks.networks.

Integrated Demand Integrated Demand ReductionReduction

This is a multi-This is a multi-faceted, multi-faceted, multi-pronged strategy or pronged strategy or series of strategies series of strategies working in synergy to working in synergy to Reduce The Costs And Reduce The Costs And Effects Of Drug Abuse Effects Of Drug Abuse By Reducing The By Reducing The Demand For Licit And Demand For Licit And Illicit DrugsIllicit Drugs

Integrated Demand Integrated Demand ReductionReduction

Demand Reduction focuses primarily on Demand Reduction focuses primarily on Education and Awareness ProgrammesEducation and Awareness Programmes

It also focuses on identifying prevailing risk It also focuses on identifying prevailing risk factors that cause or lead to Drug Abusefactors that cause or lead to Drug Abuse

Activities, plans and programmes are Activities, plans and programmes are formulated to reduce these risk factorsformulated to reduce these risk factors

These Educational, Healthy Lifestyle, and These Educational, Healthy Lifestyle, and Preventative Programmes are expected to Preventative Programmes are expected to result in a reduction in the demand for result in a reduction in the demand for drugs.drugs.

Demand Demand Reduction Reduction

Measures-1Measures-1 Drug Education and Awareness Drug Education and Awareness

ProgrammeProgramme

Individual & Community Involvement Individual & Community Involvement

Economic AlternativesEconomic Alternatives

Social & Cultural ProgrammesSocial & Cultural Programmes

Sports Programmes Sports Programmes

Demand Reduction Demand Reduction Measures-2Measures-2

Public Relations/Social MarketingPublic Relations/Social Marketing

Health & Medical Measures Health & Medical Measures

(Health Promotion)(Health Promotion)

Legal ReformLegal Reform SecuritySecurity

Research & DevelopmentResearch & Development

International CooperationInternational Cooperation

DRUG ABUSE PREVENTION AND CONTROL MATRIX

INTER-MINISTERIAL COMMITTEE

NCDA COUNCIL MEMBERS

NCDA BOARD OF MANAGEMENT

DRUG ABUSE SECRETARIAT

WORKING

COMMITTEES

INTERNATIONALLINKAGES

THE COMMUNITYCODACS

PARISHESPARDACS

TREATMENT&

REHAB

ROLE OF THE COMMUNITY IN ROLE OF THE COMMUNITY IN PREVENTIONPREVENTION

Identify the problems/weaknesses in the Identify the problems/weaknesses in the environment that will threaten the existing environment that will threaten the existing healthy lifestyle in their community.healthy lifestyle in their community.

Devise action plans to address these these Devise action plans to address these these problemsproblems

Identify all relevant resources that exist in that Identify all relevant resources that exist in that communitycommunity

Identify community leadership which will Identify community leadership which will facilitate the change processfacilitate the change process

PARISH INITIATIVES PARISH INITIATIVES PARISH DRUG AWARENESS PARISH DRUG AWARENESS

COMMITTEESCOMMITTEES(PARDACS)(PARDACS)

ROLE OF THE PARDACSROLE OF THE PARDACS EDUCATION AND SENSITIZING INTEREST GROUPS IN EDUCATION AND SENSITIZING INTEREST GROUPS IN

THE PARISH ABOUT THE NEGATIVE CONSEQUENCES THE PARISH ABOUT THE NEGATIVE CONSEQUENCES OF DRUG ABUSEOF DRUG ABUSE

ORGANIZE AND CONDUCT PUBLIC FORA, PANEL ORGANIZE AND CONDUCT PUBLIC FORA, PANEL DISCUSIONS AND DEBATES AS A MEANS OF EDUCATING DISCUSIONS AND DEBATES AS A MEANS OF EDUCATING THE PUBLIC ON THE CONSEQUENCES OF DRUG ABUSETHE PUBLIC ON THE CONSEQUENCES OF DRUG ABUSE

SOME MEMBERS ARE TRAINED IN BASIC AND SOME MEMBERS ARE TRAINED IN BASIC AND ADVANCED COUNSELLING AND ASSIST IN THE SOCIAL ADVANCED COUNSELLING AND ASSIST IN THE SOCIAL REINTEGRATION OF RECOVERING ADDICTS REINTEGRATION OF RECOVERING ADDICTS

1997 SURVEY ON PATTERNS OF SUBSTANCE 1997 SURVEY ON PATTERNS OF SUBSTANCE ABUSE AND USE AMONG POST PRIMARY ABUSE AND USE AMONG POST PRIMARY

STUDENTS IN JAMAICASTUDENTS IN JAMAICA GRADES 9 TO 13 WERE SURVEYED, APPROXIMATELY 8,000 GRADES 9 TO 13 WERE SURVEYED, APPROXIMATELY 8,000

QUESTIONNAIRES ADMINISTERED AMOUNG STUDENTS IN 63 QUESTIONNAIRES ADMINISTERED AMOUNG STUDENTS IN 63 SCHOOLS (ALL-AGE,SECONDARY AND TECHNICAL)SCHOOLS (ALL-AGE,SECONDARY AND TECHNICAL)

OVERALL RESULTS (COMPARISON BETWEEN 1987 AND 1997)OVERALL RESULTS (COMPARISON BETWEEN 1987 AND 1997)

DRUGDRUG 19871987 19971997

( ( % OF SCHOOL POPULATION)% OF SCHOOL POPULATION)

CIGARETTES CIGARETTES 29.I 27.2 29.I 27.2

ALCOHOL ALCOHOL 76.3 70.9 76.3 70.9

MARIJUANA MARIJUANA 19.8 26.9 19.8 26.9

INHALANTS INHALANTS 15.8 15.8 15.8 15.8

CRACK COCAINECRACK COCAINE 1.5 1.9 1.5 1.9

TRANQUILIZERS TRANQUILIZERS 3.8 5.5 3.8 5.5

THE E.U FUNDED NATIONAL PROJECTTHE E.U FUNDED NATIONAL PROJECT

PROJECT OBJECTIVES:PROJECT OBJECTIVES:

REDUCE THE INCIDENCE OF DRUG ABUSE AND REDUCE THE INCIDENCE OF DRUG ABUSE AND OTHER UNHEALTHY BEHAVIOUR.OTHER UNHEALTHY BEHAVIOUR.

REDUCE THE DEMAND FOR DRUGSREDUCE THE DEMAND FOR DRUGS

PROMOTE HEALTHY LIFESTYLESPROMOTE HEALTHY LIFESTYLES

REDUCE YOUTH DELINQUENCY.REDUCE YOUTH DELINQUENCY.

OUTPUTS FROM E.U PROJECTOUTPUTS FROM E.U PROJECT A NATIONAL SURVEY ON THE LEVEL OF DRUG ABUSEA NATIONAL SURVEY ON THE LEVEL OF DRUG ABUSE

FORMATION OF SIX NEW COMMUNITY DRUG AWARENESS FORMATION OF SIX NEW COMMUNITY DRUG AWARENESS COMMITTEES (CODACS)COMMITTEES (CODACS)

A TOTAL OF 180 PERSONS FROM THESE NEW CODACS TRAINED TO A TOTAL OF 180 PERSONS FROM THESE NEW CODACS TRAINED TO IMPART INFORMATION ON DRUG ABUSE AND PROMOTE HEALTHY IMPART INFORMATION ON DRUG ABUSE AND PROMOTE HEALTHY LIFESTYLES.LIFESTYLES.

AN EVALUATION OF THE PREVENTION EDUCATION PROGRAMME IN AN EVALUATION OF THE PREVENTION EDUCATION PROGRAMME IN SCHOOLSSCHOOLS

450 TEACHERS, 40 TEACHER TRAINERS, 75 GUIDANCE 450 TEACHERS, 40 TEACHER TRAINERS, 75 GUIDANCE COUNSELLORS, 28 EARLY CHILDHOOD EDUCATION OFFICERS AND COUNSELLORS, 28 EARLY CHILDHOOD EDUCATION OFFICERS AND 60 EDUCATION OFFICERS TRAINED IN SUBSTANCE ABUSE 60 EDUCATION OFFICERS TRAINED IN SUBSTANCE ABUSE PREVENTION AND 150 STUDENTS TRAINED AS PEER PREVENTION AND 150 STUDENTS TRAINED AS PEER COUNSELLORSCOUNSELLORS

EDUCATIONAL AND SUPPORT MATERIALS PRODUCED FOR EDUCATIONAL AND SUPPORT MATERIALS PRODUCED FOR TRAININGTRAINING

Risk Factors for Drug Abuse – Risk Factors for Drug Abuse – Youth(NIDA)Youth(NIDA)

Ineffective ParentingIneffective Parenting Chaotic Home EnvironmentChaotic Home Environment Lack of Mutual Attachments/ NurturingLack of Mutual Attachments/ Nurturing Inappropriate behaviour in the Inappropriate behaviour in the

classroomclassroom Failure in school performanceFailure in school performance Poor social coping skillsPoor social coping skills Affiliation with deviant peersAffiliation with deviant peers Perception of approval of drug using Perception of approval of drug using

behaviours in the school, among peers behaviours in the school, among peers and community environments. and community environments.

FAMILY ISSUESFAMILY ISSUES

Breakdown in the structure and Breakdown in the structure and patterns of families.patterns of families.

Poor parenting skills.Poor parenting skills.

Diminished family lifeDiminished family life

Teenage parents.Teenage parents.

CHANGING FAMILY SYSTEMSCHANGING FAMILY SYSTEMS

Extended family disturbed.Extended family disturbed.

More persons living alone/ isolation.More persons living alone/ isolation.

Shifting values.Shifting values.

PSYCHOSOCIAL ISSUESPSYCHOSOCIAL ISSUES

Feeling of alienationFeeling of alienation

Feel inadequate, low self esteem, devalued sense of Feel inadequate, low self esteem, devalued sense of self and of life.self and of life.

Male marginalization.Male marginalization.

Distorted value system (supported by music, popular Distorted value system (supported by music, popular culture and attitude to minorities.)culture and attitude to minorities.)

Lack of a father figure.Lack of a father figure.

Attitudes to authority/ policeAttitudes to authority/ police

PSYCHOSOCIAL ISSUES contd.PSYCHOSOCIAL ISSUES contd.

High unemployment or unemployableHigh unemployment or unemployable

Lack of citizenship.Lack of citizenship.

Lack of civic pride.Lack of civic pride.

Lack of hope.Lack of hope.

DISORDERS AMONG YOUTHDISORDERS AMONG YOUTH SUBSTANCE ABUSESUBSTANCE ABUSE

DEPRESSIONDEPRESSION

VIOLENCEVIOLENCE

IRRESPONSIBLE SEXUAL BEHAVIOURIRRESPONSIBLE SEXUAL BEHAVIOUR

.. SUICIDESUICIDE

NATIONAL DRUG USE 2002.NATIONAL DRUG USE 2002.SUBSTANCE ESTIMATED NO. OF USERS IN

POPULATION 12-55 YEARS (N = 1.5 MILL)

TOBACCO 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

1,600 800 1,600 800

Excerpt from 2001 National Survey

ESTIMATES OF SUBSTANCE USE ESTIMATES OF SUBSTANCE USE AND TREATMENT NEEDSAND TREATMENT NEEDS

5.9% of population or 92,800 Jamaicans 5.9% of population or 92,800 Jamaicans have alcohol related problems.have alcohol related problems.

7.9% of population or 124,000 Jamaicans 7.9% of population or 124,000 Jamaicans have drug related problems.have drug related problems.

11.9% of population or 187,100 Jamaicans 11.9% of population or 187,100 Jamaicans have either alcohol or drug related have either alcohol or drug related problems or both.problems or both.

19% of pop. meet the criteria for 19% of pop. meet the criteria for depression. Rates of depression highest depression. Rates of depression highest among persons dependent on alcohol or among persons dependent on alcohol or illicit substances. illicit substances.

ESTIMATES OF TREATMENT ESTIMATES OF TREATMENT NEEDS ADOLESCENT NEEDS ADOLESCENT

POPULATIONPOPULATION( 18 TO 24 YRS )( 18 TO 24 YRS )

ALCOHOLALCOHOL 60.6% of population ever used 60.6% of population ever used 44.2 % used in the month of survey.44.2 % used in the month of survey. 2.6% of adolescents abuse alcohol2.6% of adolescents abuse alcohol 2.% are dependent on alcohol2.% are dependent on alcohol

Nb.* 4.6% or 15,000 adolescents have Nb.* 4.6% or 15,000 adolescents have alcohol related problems.alcohol related problems.

ESTIMATES OF TREATMENT ESTIMATES OF TREATMENT NEEDS ADOLESCENT NEEDS ADOLESCENT

POPULATIONPOPULATION(18 TO 24 YEARS(18 TO 24 YEARS))

Illicit DrugsIllicit Drugs 26.5% used Ganja26.5% used Ganja 0.6% used Crack Cocaine0.6% used Crack Cocaine 10.2% or 33,500 adolescents have 10.2% or 33,500 adolescents have

drug related problems.drug related problems.

n.b.* 12.6% or 41,500 adolescents n.b.* 12.6% or 41,500 adolescents have both alcohol and drug related have both alcohol and drug related problems.problems.

NCDA Prevention NCDA Prevention ProgrammeProgramme

Community/Interest Group Community/Interest Group EngagementEngagement OrganizingOrganizing for prevention for prevention

programme/initiativesprogramme/initiatives PlanningPlanning for ongoing prevention efforts for ongoing prevention efforts Training & DevelopmentTraining & Development of a cadre of of a cadre of

persons to manage ongoing drug persons to manage ongoing drug prevention programmesprevention programmes

FacilitatesFacilitates the ongoing work of the the ongoing work of the CODAC or interest groupCODAC or interest group

NetworksNetworks with relevant agencies to with relevant agencies to support the work of the CODACS or interest support the work of the CODACS or interest groups groups

TYPES OF PREVENTION TYPES OF PREVENTION PROGRAMMES.PROGRAMMES.

NCDA Prevention Education NCDA Prevention Education ProgrammesProgrammes• PEPPEP• SqueakySqueaky• READ & READ +READ & READ +• Lignum VitaeLignum Vitae• RosebudRosebud• Drug Education & Training ProgrammesDrug Education & Training Programmes• Sports Initiatives Sports Initiatives • Alternatives to Drug Abuse/Economic Alternatives to Drug Abuse/Economic

ProgrammeProgramme PARDAC/CODACPARDAC/CODAC

TYPES OF PREVENTION TYPES OF PREVENTION PROGRAMMESPROGRAMMES..

RosebudRosebud Targets PTA's and Targets PTA's and presents a presents a challenge to challenge to develop Drug develop Drug Abuse Public Abuse Public Education projects. Education projects.

Youth/ Parents Youth/ Parents

Squeaky Squeaky Designed to Designed to identify drug abuse identify drug abuse influences on the influences on the group and to group and to assess intention to assess intention to useuse

5-14/5-14/Community Community

TYPES OF PREVENTION TYPES OF PREVENTION PROGRAMMESPROGRAMMES..

Lignum Lignum VitaeVitae

Uses a Uses a combination of combination of sports and music sports and music to build a to build a resiliency of resiliency of character in character in adolescents to adolescents to resist drug abuse.resist drug abuse.

Community/ Community/ Students Students

READ & READ & READ +READ +

Behaviour change Behaviour change initiative aimed to initiative aimed to increase increase awareness of drug awareness of drug abuse and abuse and HIV/AIDSHIV/AIDS

6-8, 9-12 6-8, 9-12 aged aged students students

Types of Prevention Types of Prevention ProgrammesProgrammes..

PEPPEP Educational Educational curriculum to curriculum to promote promote knowledge of the knowledge of the effects of drug effects of drug abuseabuse and peer and peer resistance trainingresistance training

School School Based Based

AlternativAlternatives es

Economic initiatives Economic initiatives to create income to create income generating generating opportunities for opportunities for community groups community groups to sustain drug to sustain drug awareness awareness programmesprogrammes

CommunityCommunity

Types of Prevention Types of Prevention ProgrammesProgrammes..

Drug Drug Education Education & & TrainingTraining

Provision of Provision of universal universal education education programmes programmes focusing on the focusing on the effects of effects of substance abusesubstance abuse

Community, Community, Workplace, Workplace, ProfessionalProfessionalss

CODAC/ CODAC/ PARDACPARDAC

Community and Community and parish groups to parish groups to strengthen strengthen community based community based organizations organizations awareness on awareness on substance abusesubstance abuse

Community Community

O.I.D support to JamaicaO.I.D support to Jamaica

Rapid Assessment Surveys (R.A.S)Rapid Assessment Surveys (R.A.S)

Treatment and RehabilitationTreatment and Rehabilitation

Sentinel SitesSentinel Sites

Low Literacy Youth in School Low Literacy Youth in School (squeaky(squeaky))

EquipmentEquipment

Data SharingData Sharing

NCDA EPI-SIDUC SummaryNCDA EPI-SIDUC Summary2001-20032001-2003

Total of 1,242 clients seen in T&R CentresTotal of 1,242 clients seen in T&R Centres

Age of First Use (onset drug)Age of First Use (onset drug)Drug Drug 1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-40+1-4 5-9 10-14 15-19 20-24 25-29 30-34 35-40+ Alcohol Alcohol 19 7 42 23 37 75 19 7 42 23 37 75

204204Marijuana Marijuana 20 109 57 61 63 82 20 109 57 61 63 82Tobacco Tobacco 4 18 32 62 59 235 4 18 32 62 59 235

Total of 410 clients or 33% of total seen identified Tobacco as Total of 410 clients or 33% of total seen identified Tobacco as the onset drug as compared with 389 clients or 31% who the onset drug as compared with 389 clients or 31% who identified alcohol and 392 clients or 32% Marijuana as the identified alcohol and 392 clients or 32% Marijuana as the onset drug.onset drug.

SQUEAKY PRETEST- KNOWLEDGE OF USERSSQUEAKY PRETEST- KNOWLEDGE OF USERS

DRUGDRUG 5-75-7 8-108-10 11-11-1313

14-14-1616

17-1917-19 TOTALTOTAL

GANJAGANJA 11 11 4%4%

164 164 6.2%6.2%

169 169 6.4%6.4%

86 86 3.3%3.3%

9 9 3%3%

443 443 16.7%16.7%

S/SPLIFFS/SPLIFF 3 3 1%1%

26 26 1%1%

6 6 2%2%

5 5 2%2%

42 42 1.6%1.6%

COCAINECOCAINE 1 1 0%0%

20 20 8%8%

8 8 3%3%

4 4 2%2%

34 34 1.3%1.3%

CRACKCRACK 1 1 0%0%

10 10 4%4%

4 4 2%2%

3 3 1%1%

19 19 7%7%

HEROINHEROIN 9 9 3%3%

6 6 2%2%

3 3 1%1%

18 18 7%7%

ECSTASYECSTASY 2 2 1%1%

31 31 1.2%1.2%

48 48 1.8%1.8%

26 26 1.0%1.0%

1 1 0%0%

108 108 4.1%4.1%

ALCOHOLALCOHOL 32 32 1.2%1.2%

568 568 21.5%21.5%

587 587 22.2%22.2%

153 153 5.8%5.8%

8 8 3%3%

1357 1357 51.3%51.3%

TOBACCOTOBACCO 98 98 3.7%3.7%

130 130 4.9%4.9%

45 45 1.7%1.7%

3 3 1%1%

278 278 10.5%10.5%

ChallengesChallenges

Internal data maximizationInternal data maximization

Epi-Sudic software upgradeEpi-Sudic software upgrade

Ongoing feedback from OIDOngoing feedback from OID

The Way ForwardThe Way Forward

Improved data sharingImproved data sharing

Upgrading software and Upgrading software and hardwarehardware

Integrating methodologiesIntegrating methodologies