SUBSTANCE ADDICTION
A-GENERAL EVALUATION
With a global point of view, today substance abuse is a state at which an individual makes himself/herself a slave. Because addiction reaches a process where it is established between the individual and his/her substance and which later on removes the autonomy and the freedom of the individual. Because of its devastating effects on the human attitude, behavior, and feeling, it makes the individual a desperate slave against the substance he/she has chosen. In this manner, the society is deprived not only of the contribution, power, and labor of the individual at every level, but also from the individual himself/herself as a being. If we assume that a wide population of many nations on earth–depending on the place- has been shaken by this effect, we can easily detect the dimensions of the losses all societies would face.
In relation to these determinations, substance abuse and addiction, which is defined as the most important problem of our age has all societies, nations under its effect, and is becoming a prior issue of mutual precautions and policies among states. Therefore, the importance of a mutual language and bridge of understanding related only to this matter becomes evident. In this manner, it will also be possible to act together.
Through out the ages however the change and development acceleration of social order, economy and technology has been, the acceleration of substance abuse and addiction problem has been in the same trend and moved forward, accordingly.[1]
Drug abuse is a global phenomenon. Although its dimensions and characteristics vary from country to country, almost all the countries in the world are affected from narcotic drugs. In the past few decades, drug abuse among the youth has shown a serious increase. The high level of drug abuse has brought problems such as increase in violence and crime, increase in HIV/AIDS diseases, and collapse in the social structure. Although statistics reveal that some parts of the society use drugs more extensively, drug addiction can come out from any part of the society. For example, men use more drugs compared to women, married people use more drugs compared to single ones, people living in the city use more drugs compared to people living in the country, youngsters use more drugs compared to older ones.[2]
The situation of drug abuse varies from region to region and from country to country. According to the World Drug Report published by the UNDCP, a total of 180 million people abuse drugs worldwide. Hashish is the most commonly abused drug with 141 million users. That figure corresponds to 2.25 % of the world population.
According to the UNDCP reports, the use of synthetic drugs, especially ATS (Amphetamine Type Stimulants) is displaying a very rapid increase. About 30 million people worldwide are using stimulants. Compared to the 1980s, the use of ATS has shown a rapid increase especially in Europe, the North America and the Southeast Asia in the 90s. On the other hand Ecstasy, has become the most abused synthetic drug of the industrialized world.
Narcotic drugs derived from the coca plant are the most abused substances in the American continent, after hashish. The most demand for treatment comes from the cocaine addicts. Even though a decrease has been experienced in the abuse of cocaine in the world during the last decade, cocaine is still the most popular drug in the countries of the American Continent. Very limited abuse exists in Asia. Coca abuse problem has been emerging in the countries of the southern Africa, after they became trafficking transit countries. According to the UNDCP estimates, 13 million people are using cocaine worldwide.[3]
The abuse of heroin is less widespread when compared to other drugs. Again, UNDCP estimates that 8 million people worldwide are consuming opium based narcotic drugs, with the majority being in Europe, South and Western Asia. In general, people abusing these substances are less than 2 % of the population of the mentioned regions. However, narcotic drug abuse is at a more serious level in some opium growing areas. An increase is being experienced in the use of opiates in the recent years in the West European and Central Asian countries.[4]
B- EVALUATION FOR OUR COUNTRY
A scientific study towards to calculate the prevalence of overall drug abuse in our country has not been realized. When police records are considered for the determination of the level of the users, it is seen that the problem not at an unavoidable level.
Even though, the number of individuals charged with drug abuse slightly increases, when compared with the countries of region, it is seen that the number of drug addicts in our country is quite low. In Bulgaria, a country situated on the Balkan Route among others, there are about forty to fifty thousand drug addicts, and in Iran 1.2 million, in Pakistan 4.5 million drug addicts exist, which are countries situated on our East
Article 58 of our Constitution states that; necessary precautions shall be taken by the state in order to protect youngsters from excessive alcohol addiction, drugs, crimes, gambling and similar bad influences and from ignorance. It has been envisaged that a structure shall be formed through the mutual work carried out with the relevant institutions, in order to provide a synchronicity among the units struggling against drugs and to determine national strategy and policies in the struggle against drugs. To this end, “Higher Council for Surveillance and Orientation for the Struggle against Drug Use” and “Lower Council for Surveillance and Orientation for the Struggle against Drug Use” were established, as per the advisory decision of the National Security Council dated 26 April 1996 and numbered 393. Following institutions and Ministries have been assigned to the above mentioned Councils in accordance with the Council of Ministers Decision dated 25 July 1997 and numbered 97/9700:
The Ministry of Justice,
The Ministry of National Defense,
The Ministry of Interior,
The Ministry of Foreign Affairs,
The Ministry of National Education,
The Ministry of Health,
The Ministry of Labor and Social Security,
Directorate of the Council of Higher Education (YÖK),
General Secretariat of National Security Council (MGK),
General Directorate of Security (Department of Anti-Smuggling and Organized Crime)
Directorate of Religious Affairs,
General Directorate of Turkish Radio and Television (TRT),
General Directorate of Youth and Sports,
General Directorate of Social Services and Child Protection Institute (SHÇEK),
Undersecretariat of State Planning Organization (DPT),
General Command of Gendarmerie,
Directorate of Higher Council of Radio and Television,
Directorate of Family Research Institution,
The aims of these councils are; to carry out the struggling activities against drugs and stimulants abuse and addiction; to prevent the misuse of substance; to coordinate the works between institutions, determining the measures that will be taken.
- Substance Abuse:
The data that display the level of the drug abuse in our country is based on the seizures made by the Police. Even though the number of arrested individuals for drug abuse has remained stable in general, we must take into account that same person may have been subjected to more than one legal proceeding over the years.
When the distribution of drug users that are in the police records is examined, it is seen that even though hashish users exist in many cities, the number for İzmir is higher than the others.
51 % of heroin users and 92 % of cocaine users that have been subjected to a legal proceeding live in the city of İstanbul.
As for synthetic drugs, it is seen that abuse is widespread in a few cities, mainly in İstanbul.
- The Survey:
In order to create a general profile of people that have been subjected to a legal proceeding for abuse of drugs, the Department of Anti-Smuggling and Organized Crime has conducted a survey by questionnaire among all persons arrested charged and sent to court for drug use offences as of 1996. The “Substance Addiction Questionnaire” has been distributed to the field units in 1996. Socio-economic and cultural status of substance abusers were tried to be determined in the mentioned questionnaires. However, since these forms are filled out on a voluntary base, the number of people that have been subjected to a legal proceeding for the abuse of drugs throughout the year and the number of people contributing to the survey does not correspond to another. For example, in 2001, legal proceedings have been carried out for 3314 individuals and only 2037 of these accused persons have involved in the survey.
The survey results provide valuable information on addiction and profile of addicts. When it is considered that no significant changes were observed in the number of the last three years’ questionnaires, it can be concluded that the results are close to the reality.
The evaluation of the last three years for the results obtained is as follows:
I- Age Group
When the age group of drug abusers is taken into account, it is seen that like the rest of the world, narcotic substance use is widespread in the age group of 16-30 in our country. Even though the age group of 15-24 or 12-22 is not defined as a risk group in literature, the increasing number of users in the young and young adult group (16-45) indicates the possibility of the substance use becoming a cultural norm. Therefore, there is a need to inform the older age group on the “cultural appropriation” besides carrying out regular protection and prevention programs.
Moreover, the 16-45 age group has a relation with the process related to the meeting, using, addiction of drugs and the consequences of addiction.
II- Age of Start
The behavior for starting to abuse a substance in the age group younger than 16 is significant. The age group of 16-30 has significant importance as per the protection and prevention policies. Thus, realizing the education activities directed towards this age group in field of substance abuse is very important for the prevention. The increase in the year 2001 in the age group of 31-45 as compared to the years 1999 and 2000 is rather significant. The result is rather interesting at this age interval, which symbolizes the active working era, and shows that other criteria has become part of the addiction process (employment-unemployment, marriage-divorce, etc.).
III- Sex
In Turkey, mostly men commit drug-related crimes and are more inclined to addiction than women, just like it is so in the other countries It can be considered that this situation is related to the social status of the women in our country.
Even though women seemingly participate more in the social life, their actions remain limited to the roles attached to them. Substance abuse by women is a serious problem, because they cannot easily express their requests for help. Therefore there is a need to design a specific program targeting women.
IV- Marital Status
It is, in general, argued that being single constitutes a risk for many psycho-social problems, but when the martial status of users of narcotic substances are examined, the survey results reveal a reverse case. The results show that most of the substance users are married. Living alone and getting a divorce are two choices that are out of the borders of social acceptance. So therefore, accepting the continuing marriages as “problem free” and thinking that the risk is decreased does not really get along well with the reality.
V- Education
It is seen that drug users and persons committing drug-related have a low level of education. When the fact that elementary education being 8 years is considered, this situation becomes clearer. Education and investing in the human beings are the tools in liberating men and making them autonomous and in shaping general requirements of a social life and the expected formation of citizenship. Humankind acquires fundamental characteristics like protecting and saving for one’s self through education. These data reveals that education decreases the tendency for committing a crime.
VI- Type of Drug
Hashish is the main drug of abuse. This is because that drug abusers usually starts their habit by consuming hashish and later moved forward to hard drugs such as heroin due to the tolerance and dissatisfaction. Moreover, the reason for the decrease in the number of heroin and cocaine users in the year 2001 is because of the increase in the cost and the difficulty of obtaining them. This situation indicates that the struggle directed especially towards the supply reduction is successful.
VII- Reason to Start
Research indicates that the drug abuse starts because of curiosity and recreational reasons, and people are mostly introduced to drugs through groups of friends.
As a human behavior people that are sharing the same curiosity tend to come together. This increases the determining power of the core interest at the focus of the relationships. The initiative is drug abuser-based in groups that have been formed in this respect. Such groups are introverted and act within their own rules.
VIII- Crime committed to Obtain Drug
However results of the questionnaires yield that drug abusers are not involved intensely in crime to supply the substance that they have been using and deterrent power of law enforcement is increasing gradually; yet they also reveal the relation between crime and substance abuse, which is not very high. Accordingly, it is seen that rehabilitation programs at national level directed towards offenders are of vital necessity.
IX- Work Situation
When the job status of drug users, in line of the questionnaire is evaluated, it can be said that the irregularity of work or unemployment enables the possibility of drug abuse, or drug abuse causes problems affecting his-her job at work place.
This table, which exhibits the relation between drug abuse and unemployment/irregular employment on a causal level, points to the preventive value of individual prosperity in respect of the national policies.
X- Criminal Background
It is seen that more than half of the drug abusers have a criminal record whether it is related to a substance or not. The fact that the number of those with a criminal record related to a substance display a course on the same level pointing out to the existence of a sub-culture in this respect. Moreover, it reveals the importance of protective/preventive and informative activities within the legal system (jail, reformatory, juvenile jail, etc.)
XI- Family Situation
We see that there are no causal relations between the drugs and the family, when the last three years are examined. The lack of family might be interpreted as the nonexistence of support system, however, the fact that most of the abusers have families make it difficult to comment on the relation of drug abuse and crime.
However, the fact that most of the narcotic drug users have families and they live together with their families refutes the thesis that only people who are alone and living lonely will start using drugs.
Therefore, education of families shall be in a manner to cover the problems that will arise in case of an addict exists within a family. Because, the families being uninformed about substance addiction makes it harder for the individual to get rid of the substance addiction. This situation once more draws attention to the importance of the protection of the family.
XII- Domicile
It is very expressive that the majority (86.6 %) of the drug abusers live together with their families. This situation once more reveals the necessity and the fact that the family has a central importance and that it must be examined from every aspect.
XIII- Income Situation of the Family
Studies related to substance abuse do not unfold a significant relation with the socio-economic status. Since the drug abuser numbers’ are close to each other in medium and low-income classes, that might either point to a relation with education or be the reflection of the socio-economic dimension in our country.
XIV- Treatment Demand
It is known that there is a reverse relation between the treatment demand and the desire to use drugs. In fact, the results of the questionnaires verify this relation. Drug abusers generally say that they are not addicted to drugs and they do not need treatment.
Moreover, the lack of demand for treatment may also be due to the fact that the treatment services are expensive, they are not widespread, and that users are not well informed about treatment options.
3- Prevention Activities
Narcotic Units, besides their main task of supply reduction, carry out necessary activities in order to fight the abuse and addiction of drugs, which at present, is not at worrying levels. The activities carried out within the prevention field could be listed as follows: