1. DEMAND REDUCTION IN JAMAICA A BRIEF CASE STUDY

2. CARL STONE SURVEY 1991. COCAINE & CRACK COCAINE ABUSE COCAINE & CRACK COCAINE ABUSE MALE FEMALE MALE FEMALE 1989 1991 1989 1991 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.

3. 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 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

4. Integrated Demand Reduction Demand Reduction focuses primarily on Education and Awareness Programmes Demand Reduction focuses primarily on Education and Awareness Programmes It also focuses on identifying prevailing risk factors that cause or lead to Drug Abuse 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 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. These Educational, Healthy Lifestyle, and Preventative Programmes are expected to result in a reduction in the demand for drugs.

5. Demand Reduction Measures-1 Drug Education and Awareness Programme Drug Education and Awareness Programme Individual & Community Involvement Individual & Community Involvement Economic Alternatives Economic Alternatives Social & Cultural Programmes Social & Cultural Programmes Sports Programmes Sports Programmes

6. Demand Reduction Measures-2 Public Relations/Social Marketing Public Relations/Social Marketing Health & Medical Measures Health & Medical Measures (Health Promotion) (Health Promotion) Legal Reform Legal Reform Security Security Research & Development Research & Development International Cooperation International Cooperation

7. DRUG ABUSE PREVENTION AND CONTROL MATRIX INTER-MINISTERIAL COMMITTEE NCDA COUNCIL MEMBERS NCDA BOARD OF MANAGEMENT DRUG ABUSE SECRETARIAT WORKING COMMITTEES INTERNATIONAL LINKAGES THE COMMUNITY CODACS PARISHES PARDACS TREATMENT & REHAB

8. ROLE OF THE COMMUNITY IN PREVENTION Identify the problems/weaknesses in the environment that will threaten the existing healthy lifestyle in their community. 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 Devise action plans to address these these problems Identify all relevant resources that exist in that community Identify all relevant resources that exist in that community Identify community leadership which will facilitate the change process Identify community leadership which will facilitate the change process

9. 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 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 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 SOME MEMBERS ARE TRAINED IN BASIC AND ADVANCED COUNSELLING AND ASSIST IN THE SOCIAL REINTEGRATION OF RECOVERING ADDICTS

11. 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) 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) OVERALL RESULTS (COMPARISON BETWEEN 1987 AND 1997) DRUG 1987 1997 DRUG 1987 1997 ( % OF SCHOOL POPULATION) ( % OF SCHOOL POPULATION) CIGARETTES 29.I 27.2 CIGARETTES 29.I 27.2 ALCOHOL 76.3 70.9 ALCOHOL 76.3 70.9 MARIJUANA 19.8 26.9 MARIJUANA 19.8 26.9 INHALANTS 15.8 15.8 INHALANTS 15.8 15.8 CRACK COCAINE 1.5 1.9 CRACK COCAINE 1.5 1.9 TRANQUILIZERS 3.8 5.5 TRANQUILIZERS 3.8 5.5

12. 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.

13. 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

14. Risk Factors for Drug Abuse – Youth(NIDA) Ineffective Parenting Ineffective Parenting Chaotic Home Environment Chaotic Home Environment Lack of Mutual Attachments/ Nurturing Lack of Mutual Attachments/ Nurturing Inappropriate behaviour in the classroom Inappropriate behaviour in the classroom Failure in school performance Failure in school performance Poor social coping skills Poor social coping skills Affiliation with deviant peers Affiliation with deviant peers Perception of approval of drug using behaviours in the school, among peers and community environments. Perception of approval of drug using behaviours in the school, among peers and community environments.

15. FAMILY ISSUES Breakdown in the structure and patterns of families. Breakdown in the structure and patterns of families. Poor parenting skills. Poor parenting skills. Diminished family life Diminished family life Teenage parents. Teenage parents.

16. CHANGING FAMILY SYSTEMS Extended family disturbed. Extended family disturbed. More persons living alone/ isolation. More persons living alone/ isolation. Shifting values. Shifting values.

17. PSYCHOSOCIAL ISSUES Feeling of alienation Feeling of alienation Feel inadequate, low self esteem, devalued sense of self and of life. Feel inadequate, low self esteem, devalued sense of self and of life. Male marginalization. Male marginalization. Distorted value system (supported by music, popular culture and attitude to minorities.) Distorted value system (supported by music, popular culture and attitude to minorities.) Lack of a father figure. Lack of a father figure. Attitudes to authority/ police Attitudes to authority/ police

18. PSYCHOSOCIAL ISSUES contd. High unemployment or unemployable High unemployment or unemployable Lack of citizenship. Lack of citizenship. Lack of civic pride. Lack of civic pride. Lack of hope. Lack of hope.

19. DISORDERS AMONG YOUTH SUBSTANCE ABUSE SUBSTANCE ABUSE DEPRESSION DEPRESSION VIOLENCE VIOLENCE IRRESPONSIBLE SEXUAL BEHAVIOUR IRRESPONSIBLE SEXUAL BEHAVIOUR. SUICIDE SUICIDE

20. NATIONAL DRUG USE 2002. Excerpt from 2001 National Survey

21. ESTIMATES OF SUBSTANCE USE AND TREATMENT NEEDS 5.9% of population or 92,800 Jamaicans have alcohol related problems. 5.9% of population or 92,800 Jamaicans have alcohol related problems. 7.9% of population or 124,000 Jamaicans have drug 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. 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. 19% of pop. meet the criteria for depression. Rates of depression highest among persons dependent on alcohol or illicit substances.

22. ESTIMATES OF TREATMENT NEEDS ADOLESCENT POPULATION ( 18 TO 24 YRS ) ALCOHOL 60.6% of population ever used 60.6% of population ever used 44.2 % used in the month of survey. 44.2 % used in the month of survey. 2.6% of adolescents abuse alcohol 2.6% of adolescents abuse alcohol 2.% are dependent on alcohol 2.% are dependent on alcohol Nb.* 4.6% or 15,000 adolescents have alcohol related problems.

23. ESTIMATES OF TREATMENT NEEDS ADOLESCENT POPULATION (18 TO 24 YEARS ) Illicit Drugs 26.5% used Ganja 26.5% used Ganja 0.6% used Crack Cocaine 0.6% used Crack Cocaine 10.2% or 33,500 adolescents have drug related problems. 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.

24. NCDA Prevention Programme Community/Interest Group Engagement Community/Interest Group Engagement Organizing for prevention programme/initiatives Organizing for prevention programme/initiatives Planning for ongoing prevention efforts Planning for ongoing prevention efforts Training & Development of a cadre of persons to manage ongoing drug prevention programmes Training & Development of a cadre of persons to manage ongoing drug prevention programmes Facilitates the ongoing work of the CODAC or interest group Facilitates the ongoing work of the CODAC or interest group Networks with relevant agencies to support the work of the CODACS or interest groups Networks with relevant agencies to support the work of the CODACS or interest groups

25. TYPES OF PREVENTION PROGRAMMES.  NCDA Prevention Education Programmes PEP PEP Squeaky Squeaky READ & READ + READ & READ + Lignum Vitae Lignum Vitae Rosebud Rosebud Drug Education & Training Programmes Drug Education & Training Programmes Sports Initiatives Sports Initiatives Alternatives to Drug Abuse/Economic Programme Alternatives to Drug Abuse/Economic Programme  PARDAC/CODAC

26. TYPES OF PREVENTION PROGRAMMES. Rosebud Targets PTA's and presents a challenge to develop Drug Abuse Public Education projects. Youth/ Parents Squeaky Designed to identify drug abuse influences on the group and to assess intention to use 5-14/Community

27. TYPES OF PREVENTION PROGRAMMES. Lignum Vitae Uses a combination of sports and music to build a resiliency of character in adolescents to resist drug abuse. Community/ Students READ & READ + Behaviour change initiative aimed to increase awareness of drug abuse and HIV/AIDS 6-8, 9-12 aged students

28. Types of Prevention Programmes. PEP Educational curriculum to promote knowledge of the effects of drug abuse and peer resistance training School Based Alternatives Economic initiatives to create income generating opportunities for community groups to sustain drug awareness programmes Community

29. Types of Prevention Programmes. Drug Education & Training Provision of universal education programmes focusing on the effects of substance abuse Community, Workplace, Professionals CODAC/ PARDAC Community and parish groups to strengthen community based organizations awareness on substance abuse Community

30. O.I.D support to Jamaica Rapid Assessment Surveys (R.A.S) Rapid Assessment Surveys (R.A.S) Treatment and Rehabilitation Treatment and Rehabilitation Sentinel Sites Sentinel Sites Low Literacy Youth in School (squeaky) Low Literacy Youth in School (squeaky) Equipment Equipment Data Sharing Data Sharing

31. NCDA EPI-SIDUC Summary 2001-2003 Total of 1,242 clients seen in T&R Centres Total of 1,242 clients seen in T&R Centres Age of First Use (onset drug) 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.

32. SQUEAKY PRETEST- KNOWLEDGE OF USERS DRUG5-7 8-10 8-10 11-13 11-13 14-16 14-1617-19TOTAL GANJA 11 4% 164 6.2% 169 6.4% 86 3.3% 9 3% 443 16.7% S/SPLIFF 3 1% 26 1% 6 2% 5 2% 42 1.6% COCAINE 1 0% 20 8% 8 3% 4 2% 34 1.3% CRACK 1 0% 10 4% 4 2% 3 1% 19 7% HEROIN 9 3% 6 2% 3 1% 18 7% ECSTASY 2 1% 31 1.2% 48 1.8% 26 1.0% 1 0% 108 4.1% ALCOHOL 32 1.2% 568 21.5% 587 22.2% 153 5.8% 8 3% 1357 51.3% TOBACCO 98 3.7% 130 4.9% 45 1.7% 3 1% 278 10.5%

33. Challenges Internal data maximization Internal data maximization Epi-Sudic software upgrade Epi-Sudic software upgrade Ongoing feedback from OID Ongoing feedback from OID

34. The Way Forward Improved data sharing Improved data sharing Upgrading software and hardware Upgrading software and hardware Integrating methodologies Integrating methodologies