Friday, Mar 17, 2006
The continuing diversion of pharmaceutical preparations containing narcotic drugs from domestic distribution channels in many countries is cause for concern.
India's success in the pharmaceuticals segment is widely acknowledged in the post-patent regime; drug majors have made a name for themselves in the high-end product segment in sophisticated Western markets. Even as this is a triumph for manufacturing excellence in generics and drug formulations, there is another side to the story.
India being a major drug maker — accounting for approximately 10 per cent of the global pharmaceutical manufacture — medicines continue to be diverted for nefarious purposes and subsequently smuggled to countries of South Asia and elsewhere, notwithstanding the vigilance of the authorities.
The United Nations International Narcotics Control Board's (INCB) latest annual report draws attention to the dangerous diversion of pharmaceutical preparations containing narcotic drugs from domestic distribution channels and their continuing abuse in many countries.
The drug route
The report expresses concern over trafficking in such substances, particularly codeine-based cough syrups, dextropropoxyphene and buprenorphine, to Bangladesh, Nepal and Sri Lanka. Pharmaceuticals from India are being smuggled into Myanmar, Pakistan (via Dubai) and members of the Commonwealth of Independent States. Diazepam and nitrazepam are also being diverted within India or smuggled abroad.
The report contends that India remains the main illicit manufacturer of methaqualone. Most of it, illicitly manufactured, is smuggled to other countries, primarily South Africa, its main consumer.
In 2004, authorities dismantled a laboratory in South India manufacturing methaqualone on a large scale. Apprehending that drug trafficking organisations may be using acetyl-chloride for the illicit manufacture of methaqualone, the report says that using acetyl-chloride, which is currently not under international control, as a substitute chemical makes it more difficult for the authorities to identify the illicit manufacturers.
Taking note of the growing illicit trade in the substance commonly called "synthetic heroin" in India, the INCB report says that it is a drug prepared by crushing tablets of Phenobarbital, a psychotropic substance under Schedule IV of the 1971 Convention. While synthetic heroin is cheaper to manufacture than the organically derived heroin, it is sold by drug traffickers in India at roughly the same price as heroin.
As it is believed that synthetic heroin is manufactured mainly in North Indian cities, the INCB has urged the authorities to combat this scourge. The report maintains that increasingly large quantities of heroin of West Asian origin are being seized in India. Significant quantities of heroin manufactured in India also continue to be seized; the consignments were headed for illicit markets, not only in India, but also in Sri Lanka and to countries in Europe!
As the number of heroin manufacturing facilities dismantled by the government in recent years has been small, the INCB has urged the authorities to beef up their law enforcement effort in that area.
Drug abuse patterns
The low-quality heroin base known as "brown sugar" continues to be abused widely in India, the report states. It adds that there seems to have been a shift in the drug abuse pattern in India in recent years, from inhaling to injecting (intravenous) drugs (mainly heroin and buprenorphine).
Stating that in South Asia, illicit cannabis plant cultivation and abuse continue, the INCB report says that cannabis resin, besides being abused locally, is smuggled to other countries, particularly India. A national survey conducted in India estimated that there were approximately 8.7 million cannabis abusers in India.
The report lauds Indian authorities for persisting with penal measures against the diversion of legally cultivated poppy, as most of the illicit heroin laboratories dismantled were located near poppy fields. The total area under legal poppy cultivation in India decreased in 2004 as a result of self-imposed restrictions by the government.
It is also gratifying to note that the Minister of State for Finance, Mr S. S. Palanimanickam, told the Lok Sabha in a written reply on March 3 that the area under poppy cultivation has to be strictly controlled as opium is prone to abuse. Only the quantity of opium that is required for medical and scientific purposes needs to be produced. The maximum area a cultivator is licensed to grow opium on has been reduced from one-fifth of a hectare to one-tenth since the crop year 2004-05, he said.
Nature of abuse
Taking a regional perspective, the INCB report says the drug trafficking and abuse problem in South Asia continues to be both serious and multifaceted. Particularly in Bangladesh, India and Nepal, lapses in the control of pharmaceutical preparations containing narcotic drugs and psychotropic substances have led to their rampant abuse by all segments of the population, the report said. These pharmaceuticals are generally diverted from domestic distribution channels and sold without prescription in pharmacies and other retail outlets.
The report says that intravenous drug abuse was becoming one of the main causes for the increase in the HIV/AIDS infection rate in South Asia, in particular, India and Nepal.
Though HIV/AIDS prevalence among adults is not high in India (0.8 per cent), its prevalence rate in different parts of the country varies widely. In some North-Eastern States, intravenous drug abuse is the predominant mode of transmission of HIV infection; it accounted for 56 per cent of the infections in 2003, the last year for which the data are available.
The report says that in urban areas with incidence of drug addiction, the HIV/AIDS prevalence rate was around the critical level of 5 per cent.
It is also revealing to note that approximately 8-10 per cent of the over 12,000 prison inmates in India are addicted to drugs, mainly heroin. Many of them had a history of heroin addiction.
What the INCB report has dealt with is only a part of its findings. It says the methods used by drug traffickers to divert those products include pilferage from factories and wholesalers, pretended export, fake prescriptions, and the supply of substances by pharmacies without prescriptions.
As India goes ahead with liberalisation, it is incumbent on the part of authorities to protect the youth, and ensure that enforcement agencies have the wherewithal and the time to tackle drug abuse and trafficking.