Research Paper
Post-Soviet Central Asia: A summary of the drug situation

https://doi.org/10.1016/j.drugpo.2014.05.004Get rights and content

Highlights

  • A system for ongoing monitoring, analysis and reporting is being built in Central Asia.

  • The level of drug use in the school population is low when compared to developed countries.

  • Despite that, levels of injecting drug use in young people and adults are very high.

  • HIV and viral hepatitis C are driven by injecting drug use and high.

  • Treatment for drug users has low availability and mostly does not reflect modern standards.

  • Seizures of opiates have decreased in the last few years; seizures of cannabis have increased.

Abstract

Background

The paper aims to provide a snapshot of the drug situation in Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan using the EU methodology of “harmonised indicators of drug epidemiology.”

Methods

Most of the data reported here were gathered and analysed within the framework of the EU-funded CADAP project in 2012. Together with members of CADAP national teams, we conducted extraction from the databases of national institutions in the field of (public) health and law enforcement, issued formal requests for the provision of specific information to national governmental authorities, and obtained national grey literature in Russian. In specific cases, we leaned on the expert opinions of the national experts, gathered by means of simple online questionnaires or focus group. In the rather scarce cases where peer-reviewed sources on the specific topics exist, it is used for comparisons and discussion.

Results

All the post-Soviet Central Asian countries lack information on drug use in the general population. School surveys are relatively well developed in Kazakhstan, and Kyrgyzstan benefited from an international survey project on health in schools organised by private donors in 2009. For Tajikistan and Uzbekistan, the most recent available data on drug use in the school population are from 2006 and as such are of little relevance. Problem drug use is widespread in Central Asia and estimates of its prevalence are available for all four countries. All the post-Soviet Central Asian countries use a rather outdated system of narcological registers as the only source of data on drug users who are treated (and those investigated by the police), which was inherited from Soviet times. The availability of treatment is very low in all the countries reported on here except Kyrgyzstan; opioid substitution treatment (OST) was introduced first in Kyrgyzstan; Kazakhstan and Tajikistan are piloting their OST programmes but the coverage is extremely low, and in Uzbekistan the OST pilot programme has been abolished. HIV and hepatitis C virus (HCV) infections are concentrated in injecting drug users (IDUs) in Central Asia, with the situation in Kazakhstan having stabilised; HIV is on the increase among Kyrgyz IDUs. The sharp decrease in HIV and VHC seroprevalence among IDUs in Uzbekistan and Tajikistan still awaits an explanation. The system for monitoring of fatal drug overdoses needs substantial improvement in all the countries reported on here. Overall mortality studies of drug users registered in the narcological registers were performed in Uzbekistan, Kazakhstan, and Tajikistan; the highest excess mortality among registered drug users was found in Uzbekistan, and in all three countries, it was substantially higher for women than men. The seizures of illegal drugs are by far the highest in Kazakhstan; however, wild-growing cannabis represents 90% of these seizures. Uzbekistan was the country with the highest number of drug arrests. In Kazakhstan, after the decriminalisation of drug use in 2011, the number of reported drug-related offences dropped to below 50% of the figure for the previous year.

Conclusion

The drug situation monitoring system in the four post-Soviet countries of Central Asia still needs substantial improvement. However, in its current state it is already able to generate evidence that is useful for the planning of effective national and regional drug policies, which would be of the utmost importance in the forthcoming years of the withdrawal of the International Security Assistance Force from Afghanistan.

Section snippets

Background

The post-Soviet Central Asian Republics have an area of approximately 3,500,000 km2 (2/3 of the area of the EU) occupied by Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan, with a population of almost 60 million people of more than one hundred ethnicities (Embassy of the Republic of Kazakhstan, 2014).

All five countries gained their independence from the collapsed Soviet Union in 1991. The World Bank classifies these countries as transitional economies; however, major differences

Methods

This paper aims to provide the reader with a quick but sufficiently deep insight into what is known about the drug situation of four post-Soviet countries in Central Asia – all but Turkmenistan (see below). For this purpose, we use the system of harmonised key indicators (and core indicators) of drug epidemiology as established, constantly developed, and promoted by the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA; www.emcdda.europa.eu) in Lisbon. The EMCDDA system of drug

Drug use in the population

Reliable data on drug use and its patterns in the general population of the countries of Central Asia are not available. Historically, the only Central Asian survey targeting the use of addictive substances in the general population was conducted in Kazakhstan in 2001, and neither the sampling nor the quality of the questionnaire corresponded with international standards which is why the results of that survey are seen as irrelevant recently (Yusopov et al., 2012).

The situation is better in the

Discussion

The systematic efforts to build sustainable and self-developing national monitoring systems for the drug situation in post-Soviet Central Asia only started in the early 2000s. Given the number of acute infrastructure, economic, health, security, and other problems the developing/transitional economies have had to solve in the first decades of their sovereignty, it would probably not have been possible without the help of international organisations and donors. Besides the UNODC, for which the

Conclusion

The drug monitoring system in the four post-Soviet countries of Central Asia still needs substantial improvements in its structure and in the reliability of the data. Turkmenistan has completely failed to report any drug-related data so far, and for Uzbekistan, the relatively high availability of wide spectrum of data is somehow undermined by the impossibility of any external checking – a situation to some extent similar to Tajikistan.

However, the drug monitoring systems in all four countries

Conflict of interests

The authors declare that they have no conflicts of interest.

Funding

CADAP is funded by the European Union with the Grant Contract “External Actions of the European Union 229-666”. The work on this paper was supported by the Czech programme for institutional scientific support PRVOUK-P03/LF1/9.

Acknowledgements

The authors of this paper wish to acknowledge the continually excellent work of the EMCDDA on the scientific methodology in the drugs field, and its many-sided support to the process of building high-quality drug situation monitoring around the world. We also want to express our deep thanks to the “DAMOS core groups” – teams of national experts in the post-Soviet Central Asian countries that work with us in the countries and strive to build and institutionalise drug monitoring systems within

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