09DRJamaica Tucker

							DEMAND REDUCTION IN
     JAMAICA
   A BRIEF CASE STUDY
        CARL STONE SURVEY 1991.

                COCAINE & CRACK COCAINE ABUSE

                     MALE                             FEMALE
                1989     1991                      1989   1991

%   DRUG USE     3.02     2.75                     0.12         0.09

Total (‘000 )    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


                                  INTERNATIONAL
         DRUG ABUSE SECRETARIAT      LINKAGES



THE COMMUNITY   TREATMENT    PARISHES
    CODACS          &        PARDACS
                  REHAB
      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        29.I         27.2
    ALCOHOL           76.3         70.9
    MARIJUANA         19.8         26.9
    INHALANTS         15.8         15.8
    CRACK COCAINE      1.5         1.9
    TRANQUILIZERS     3.8          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                             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 /            1,600          800
TRANQUILIZERS & STEROIDS              1,600          800


                 Excerpt from 2001 National Survey
    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      Youth/ Parents
           presents a challenge
           to develop Drug
           Abuse Public
           Education projects.
Squeaky    Designed to identify 5-14/Community
           drug abuse influences
           on the group and to
           assess intention to
           use
         TYPES OF PREVENTION
            PROGRAMMES.
Lignum      Uses a combination      Community/
Vitae       of sports and music     Students
            to build a resiliency
            of character in
            adolescents to resist
            drug abuse.

READ &      Behaviour change        6-8, 9-12 aged
READ +      initiative aimed to     students
            increase awareness
            of drug abuse and
            HIV/AIDS
 Types of Prevention Programmes.
PEP          Educational               School Based
             curriculum to
             promote knowledge
             of the effects of drug
             abuse and peer
             resistance training
Alternatives Economic initiatives to   Community
             create income
             generating
             opportunities for
             community groups to
             sustain drug
             awareness
 Types of Prevention Programmes.
Drug         Provision of universal Community,
Education    education              Workplace,
& Training   programmes focusing Professionals
             on the effects of
             substance abuse

CODAC/       Community and       Community
PARDAC       parish groups to
             strengthen
             community based
             organizations
             awareness on
             substance abuse
      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    8-10    11-13   14-16 17-19   TOTAL

GANJA      11     164     169     86     9      443
           4%     6.2%    6.4%    3.3%   3%     16.7%
S/SPLIFF   3      26      6       5             42
           1%     1%      2%      2%            1.6%
COCAINE    1      20      8       4             34
           0%     8%      3%      2%            1.3%
CRACK      1      10      4       3             19
           0%     4%      2%      1%            7%
HEROIN            9       6       3             18
                  3%      2%      1%            7%
ECSTASY    2      31      48      26     1      108
           1%     1.2%    1.8%    1.0%   0%     4.1%
ALCOHOL    32     568     587     153    8      1357
           1.2%   21.5%   22.2%   5.8%   3%     51.3%
TOBACCO           98      130     45     3      278
                  3.7%    4.9%    1.7%   1%     10.5%
            Challenges
   Internal data maximization

   Epi-Sudic software upgrade

   Ongoing feedback from OID
        The Way Forward
   Improved data sharing

   Upgrading software and hardware

   Integrating methodologies