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Data on drug use and dependence in Asia are limited

• There is tremendous imprecision in the data available on drug consumption and expenditures in Asia. This information is critical for understanding the revenues generated by drug traffickers and putting the amount of drugs seized into context.
• As in many countries, most Asian nations rely on surveys of self-reported behaviors to learn about substance use; issues of underreporting might be more pronounced in Asia given the stigma and harsh punitive responses.

Injection drug use contributes to the burden of disease; gaps in access to treatment remain

• Several countries in the region have reported alarming rates of blood-borne illnesses among injection drug-using populations.
• The region has employed compulsory inpatient treatment, although many countries are starting to adopt voluntary outpatient medication therapies for people who use opiates. Nonetheless, gaps in access remain and some countries have maintained restrictions on medication therapies.

Approaches to drug problems vary

• The Philippines has embarked on a violent repression of drug distribution and use. This is a particularly dubious approach for improving health outcomes and could have unintended consequences.
• The Thai government has shifted rhetoric toward treatment and reduced punishment and has reformed laws to allow medical cannabis and kratom.
• China is a leading source of legitimate chemicals for global markets. However, gaps in regulatory oversight and an abundance of manufacturers permit illicit export of precursors and synthetic drugs, including fentanyl. China has attempted to bring new chemicals under regulatory control, but producers are quick to adapt, impeding efforts to stem the flow to global markets.

Changing patterns in drug use and supply can affect the well-being and development of Asian countries in many ways: The burden of disease from injection drug use, overreliance on the criminal justice system, and rise of drug-related crime can impede economic, environmental, and social development. Historically, countries in Asia have addressed illicit drug use and supply with harsh punishments, including compulsory treatment and the death penalty. The region has long espoused the goal of creating a drug-free society, a goal that has been abandoned in other parts of the globe for being infeasible.

This report describes the illicit drug policy landscape for the Association of Southeast Asian Nations (ASEAN) + 3 countries (China, Japan, and South Korea), which account for about 30 percent of the world's population. The authors also present three case studies on the shifting drug policy landscape in Asia: (1) the violent crackdown on people who use or sell drugs in the Philippines, (2) Thailand's move from a similar crackdown toward an alternative approach of reducing criminal sanctions for drug use and improving access to medication treatment and needle exchange, and (3) China's emergence as a major source of many new chemical precursors and drugs, like fentanyl, that are exported outside Asia.

• Chapter One

  Introduction

• Chapter Two

  Drug Use and Drug-Related Disease

• Chapter Three

  Drug and Precursor Chemical Production

• Chapter Four

  Drug Policies in Asia

• Chapter Five

  Case Studies

• Chapter Six

  Recommendations for Improving Research and Policies in the Region