Report of the International Narcotics Control Board for 2012

Report of the International Narcotics Control Board for 2012

II. Functioning of the international drug control system

A. Promoting the consistent application 2. Evaluation of overall treaty compliance in of the international drug control selected countries treaties 59. The Board reviews on a regular basis the drug control

situation in various countries and overall compliance by Governments with the provisions of the international drug 54. In discharging its mandate under the international control treaties. The Board’s review covers various aspects drug control treaties, the Board maintains an ongoing of drug control, including the functioning of national drug dialogue with Governments by various means, such as control administrations, the adequacy of national drug regular consultations and country missions. That dialogue control legislation and policy measures taken by has been instrumental to the Board’s efforts to assist Governments to combat drug trafficking and abuse and Governments in complying with the provisions of the Governments’ fulfilment of their reporting obligations treaties.

under the treaties.

Governments concerned as part of the ongoing dialogue 55. As at 1 November 2012, the number of States parties between the Board and Governments to ensure that the to the 1961 Convention or that Convention as amended by international drug control treaties are fully implemented. the 1972 Protocol stood at 185. Of those States, 183 were parties to the 1961 Convention as amended by the 61. In 2012, the Board reviewed the drug control 1972 Protocol. A total of 11 States have yet to accede to the situation in Benin, Canada, Mozambique, Myanmar and 1961 Convention: 2 States in Africa (Equatorial Guinea and the United States of America, as well as measures taken by South Sudan), 1 in the Americas (Plurinational State the Governments of those countries to implement the of Bolivia), 1 in Asia (Timor-Leste) and 7 in Oceania international drug control treaties. In doing so, the Board (Cook Islands, Kiribati, Nauru, Niue, Samoa, Tuvalu took into account all information available to it, paying and Vanuatu). particular attention to new developments in drug control in those countries.

56. The number of States parties to the 1971 Convention

remained at 183. A total of 13 States have yet to become (a) Benin parties to that Convention: 3 States in Africa (Equatorial 62. Benin is faced with a serious level of transit trafficking Guinea, Liberia and South Sudan), 1 in the Americas in drugs. While the volume of drugs transiting Benin is (Haiti), 1 in Asia (Timor-Leste) and 8 in Oceania (Cook unclear, there are indications that large cocaine shipments Islands, Kiribati, Nauru, Niue, Samoa, Solomon Islands, originating in South America and heroin from South-West Tuvalu and Vanuatu).

Asia enter Benin on maritime vessels and in cargo 57. With the accession by the Holy See in January 2012 containers for distribution in West Africa and Europe. and Nauru and Niue in July 2012, the number of States Methamphetamine coming from Cotonou has been seized parties to the 1988 Convention increased to 187. A total of in Belgium, Japan, Malaysia, Thailand and Viet Nam. 9 States have yet to become parties to that Convention:

63. The Government of Benin has stepped up its efforts 3 States in Africa (Equatorial Guinea, Somalia and to counter illicit drug trafficking. A specialized police unit South Sudan), 1 in Asia (Timor-Leste) and 5 in Oceania for drug trafficking (OCERTID) was established to (Kiribati, Palau, Papua New Guinea, Solomon Islands investigate all drug-related cases in Benin, including and Tuvalu).

trafficking in psychotropic substances and precursors. In 58. The Board welcomes the accession by the Holy See, 2010, the global Container Programme jointly carried out Nauru and Niue to the 1988 Convention and urges those by UNODC and the World Customs Organization was States that have not done so, particularly those in Oceania, extended to the port of Cotonou, Benin, and international the region with the largest number of non-parties, to take cooperation with the International Criminal Police the steps necessary to accede to all the international drug Organization (INTERPOL) in fighting drug abuse and control treaties without further delay. drug trafficking has been strengthened. While the Board

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

welcomes those measures, the capacity of the Government measures presently in force in Canada are not fully in to face those challenges needs to be increased. The Board compliance with the provisions of the 1961 Convention, in calls upon the international community to provide the particular articles 23 and 28 of the Convention. The Board necessary technical support to the Government of Benin, as has, on several occasions requested the competent appropriate. authorities to provide the Board with detailed clarifications.

69. Efforts have been made by the Government of 64. The Board notes that Benin, a party to all three international drug control treaties, is committed to the Canada to address prescription drug abuse: initial steps objectives of the drug control treaties. The Government has have been taken to identify problematic use of pharmaceuticals and to develop strategies to detect, prevent adopted a national drug control policy to address drug abuse and drug trafficking and has established an and treat the abuse of prescription drugs and over-the-interministerial committee for the control of narcotic drugs counter drugs. Furthermore, an ongoing general population survey, the Canadian Alcohol and Drug Use and psychotropic substances (CILAS). The country’s national drug control legislation appears to be adequate. Monitoring Survey, was developed to track trends in the Illicit drug manufacture and trafficking are criminalized, as abuse of drugs, including prescription drugs. The Board encourages the Government to continue its efforts in this is the laundering of the proceeds of drug trafficking. The law authorizes the use of certain special investigative area, particularly with regard to the setting-up of a national techniques and provides for the freezing, seizure and standardized monitoring system for systematic reporting on the prevalence and nature of drug abuse nationwide.

confiscation of proceeds of crime. 65. Laws and decrees govern the pharmaceutical sector 70. The Board notes that, as part of the National and the importation and distribution of precursor Anti-Drug Strategy, the Government of Canada will enhance its law enforcement efforts to combat illicit use of chemicals and pharmaceuticals, establishing penalties for the diversion of these substances. Benin has functional drugs and increase the capacity of the criminal justice administrative structures in place for control over the licit system to investigate, interdict and prosecute offenders.

The Government is also planning to implement a national movement of narcotic drugs, psychotropic substances and precursor chemicals and for fulfilling its reporting campaign for the prevention of drug abuse aimed at young obligations to the Board. Overall, reporting performance people and their parents, to provide treatment services for drug abusers and to support referral and treatment has been satisfactory. The Board encourages the Government to continue its efforts to ensure that further programmes for young people.

progress is made in these areas. 71. The Board, while taking note of the recent decision of the Supreme Court and the Government’s views on the 66. The Board notes that the Government’s capacity to reduce illicit drug demand remains limited. While the drug injection room in Vancouver, wishes to reiterate its Government continues to address drug abuse and position on that issue as expressed on numerous occasions, namely that the provision of such facilities for the abuse of trafficking through education and enforcement of anti-drug legislation, no reliable data are available on the drugs is contrary to the international drug control treaties,

extent of drug abuse in the country. particularly article 4 of the 1961 Convention, under which States parties are obligated to ensure that the production, (b) Canada manufacture, import, export and distribution of, trade in and use and possession of drugs are limited exclusively to 67. The Board notes that, following its continuous medical and scientific purposes. dialogue with the Government of Canada over the past few years, the Government has significantly improved its level (c) Mozambique of cooperation with the Board and intensified its efforts to curb illicit drug manufacture, trafficking and abuse. The 72. After a protracted civil war, Mozambique has made Government is committed to taking an integrated approach some progress in the implementation of the three to ensure that controlled substances are handled effectively international drug control treaties, to which it is a party. and that their diversion from licit distribution channels is However, more efforts need to be made to address the drug countered through effective control measures.

control problems of the country. The Government’s focal 68. The Government announced in June 2011 that it was point for drug control has the overall responsibility for considering amendments to the Marihuana Medical Access coordinating measures against drug trafficking and abuse programme. The amendments would be implemented in and works closely with law enforcement bodies. The line with new regulations to become operational in late Government has adopted a strategic plan for the prevention 2012. The Board remains concerned that the control of drug abuse and combating drug trafficking for the

period 2010-2014. While the comprehensive strategy of opium increased by 5 per cent from 2010 to 2011, addresses all aspects of drug control, it lacks a sufficiently reaching an estimated 610 tons. With illicit opium poppy detailed implementation plan. cultivation on the rise, Myanmar appears not to be on track to meet its goal of becoming drug-free by 2014.

73. National controls over the licit movement of narcotic drugs, psychotropic substances and precursor chemicals, as 78. The Board notes that in Myanmar there continue to well as the Government’s compliance with its reporting be challenges in providing legitimate alternative livelihoods obligations under the drug control treaties, need to be for farming communities engaged in illicit opium poppy improved. The availability of opioids for pain management cultivation. While acknowledging the efforts of the remains very limited, and supplies do not cover the Government of Myanmar to eradicate illicit opium poppy country’s basic needs. With limited abuse and treatment cultivation, the Board encourages the Government to work options and no treatment programmes specifically with the international community to address that problem designed for drug abusers, those seeking assistance are and to take adequate measures to provide legitimate often referred to the psychiatric wards of general hospitals.

alternative livelihoods for those farming communities.

74. Mozambique has emerged as a major transit hub for 79. There has been an increase in illicit manufacture, illegal drugs such as cannabis resin and cannabis herb, consumption and export of synthetic drugs, especially cocaine and heroin destined primarily for Europe, and for

amphetamine-type stimulants, since 2006.

methaqualone (Mandrax) that is abused primarily in South Methamphetamine production, which takes place on a Africa. The Government is increasingly aware of the large scale in Myanmar, fuels the abuse of that substance in challenge posed by drug trafficking but lacks the capacity many countries in East and South-East Asia. While and resources to tackle it. Government seizure figures are recognizing the difficulties that the Government of at variance with seizure data of other countries suggesting Myanmar has faced in expanding its control over areas in that in 2010, multi-ton shipments of cocaine, heroin and cannabis resin were landed in Mozambique for the country where illicit drug-related activities take place, transportation onward to illicit markets in Europe and the Board urges the Government to continue strengthening North America. Furthermore, illicit consignments of its efforts to address the illicit manufacture of amphetamine-type stimulants have been seized while en methamphetamine, in cooperation with the Governments route from Mozambique to South Africa. of neighbouring countries.

75. The Board will continue its dialogue with the (e) United States of America Government of Mozambique with a view to promoting the country’s compliance with the international drug control 80. The Board notes with serious concern the ongoing treaties. The Board urges the Government to consider move towards the legalization of cannabis for non-medical requesting UNODC and other international bodies to purposes in some parts of the United States of America provide the necessary technical assistance in this regard. and, in particular, the outcomes of recent ballot initiatives that took place in the states of Colorado and Washington in

(d) Myanmar November 2012.

76. Myanmar lies in a region that for many years was the 81. Following these developments, the two states would world’s main area of illicit cultivation of opium poppy. legalize the non-medical use of cannabis for persons Since 1999, the Government of Myanmar has been 21 years and older, impose state-level taxes on the drug and implementing a 15-year drug control plan aimed at allow its sale at special stores. This constitutes a significant eliminating all illicit drug production and trafficking by challenge to the objective of the international drug control 2014, and sustained efforts of the Government to ensure treaties to which the United States is a party. the eradication of opium poppy have, over the years, achieved significant results in the first half of the 15-year 82. The Board underlines that the Single Convention on

period covered by the drug control plan. Narcotic Drugs of 1961 establishes, in its article 4 (“General obligations”), that the parties to the Convention shall take 77. The Board is concerned, however, that illicit opium such legislative and administrative measures as may be poppy cultivation in Myanmar has increased constantly necessary to give effect to and carry out the provisions of since 2007. In 2011 the illicit crop survey jointly carried out this Convention within their own territories and to limit by the Government and UNODC revealed that for the fifth exclusively to medical and scientific purposes the year in a row, the area of opium poppy cultivation production, manufacture, export, import, distribution of, increased to a new record amount. In addition, production trade in, use and possession of drugs.

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83. The Board stresses the importance of universal 88. Progress to address issues related to drug abuse raised implementation of the international drug control treaties during the 2005 mission has been limited. There are by all States parties and urges the Government of the indications that drug abuse is increasing and spreading to United States to take necessary measures to ensure full rural areas. Tablets containing methamphetamine are compliance with the international drug control treaties in increasingly being abused, as is Phensidyl, a cough syrup its entire territory. containing codeine. The availability of treatment services in the country is low compared with the estimated number of

3. Country missions injecting drug abusers — primarily abusers of buprenorphine — as evidenced by the open abuse of drugs 84. In pursuing its mandate under the international drug by injecting drug users on the densely populated streets of control treaties and as part of its ongoing dialogue with old Dhaka.

Governments, the Board undertakes a number of country missions every year to discuss with competent national (b) Bolivia (Plurinational State of) authorities measures taken and progress made in various areas of drug control. The missions provide the Board with 89. A high-level mission of the Board, led by the an opportunity to obtain not only first-hand information President of the Board, visited the Plurinational State of but also a better understanding of the drug control Bolivia in December 2011. The mission met and exchanged situation in each country it visits, thereby enabling the views with the President of the Plurinational State of Board to provide Governments with relevant Bolivia and the highest national authorities on matters recommendations and to promote treaty compliance. relating to the implementation of the provisions of the international drug control treaties. Discussions 85. Since the previous report of the Board, the Board has concentrated on the denunciation by the Plurinational sent missions to the following countries: Bangladesh, State of Bolivia of the 1961 Convention as amended by the Bolivia (Plurinational State of), Brazil, Cuba, Dominican 1972 Protocol in June 2011 with the intention of Republic, Ecuador, Nigeria, Pakistan, Peru, Portugal, re-acceding to that Convention with a reservation Republic of Korea, Saudi Arabia and Turkey.

regarding coca leaf, and on the serious implications of that course of action for international drug control.

(a) Bangladesh 90. The Board regrets that the Government of the 86. A mission of the Board visited Bangladesh in Plurinational State of Bolivia has not reconsidered its January 2012. The primary focus of the mission was to decision to withdraw from the 1961 Convention as discuss with relevant authorities issues related to precursors amended by the 1972 Protocol. The decision of the control, specifically precursors in the form of Government became effective on 1 January 2012. The pharmaceutical preparations, and to engage in dialogue on Board also notes that shortly after the Board’s mission to the Government’s compliance with the three international the country, the Government on 29 December 2011 drug control conventions, to which the country is party. submitted to the Secretary-General of the United Nations

The Board’s last mission to Bangladesh took place in 2005. an instrument of accession to the 1961 Convention as amended by the 1972 Protocol containing a reservation 87. Several developments have taken place since the with respect to coca leaf. The reservation was submitted Board’s last mission to the country in 2005. The control of in accordance with article 50, paragraph 3, of the precursor chemicals, specifically pseudoephedrine in the 1961 Convention as amended by the 1972 Protocol.

form of pharmaceutical preparations, remains problematic, The Government confirmed that its accession was subject with inconsistent use of the Pre-Export Notification Online to the acceptance of the reservation by States parties to (PEN Online) system. Intragovernmental and the Convention.

intergovernmental communication related to activities to counter the smuggling of precursors and related law 91. Should the proposed reservation be deemed to be enforcement efforts are inadequate, particularly with permitted (that is, if less than one third of States parties regard to the quality of information disseminated from the have objected to it by the end of 12 months after the date of highest organizational levels to rank-and-file staff. Staffing notification by the Secretary-General, i.e. by 10 January levels are inadequate, and there is a lack of basic materials, 2013), the Plurinational State of Bolivia will be authorized equipment and training, particularly in the area of to accede to the Convention with the reservation. In that precursor control. The Board has previously reported on a case, in accordance with article 50, paragraph 3, of the significant number of smuggling cases originating in Convention, States which have objected to the reservation

Bangladesh beginning in 2009. need not assume towards the reserving State any legal

obligation under this Convention which is affected by the treaties, and the Government is committed to the reservation. The accession of the Plurinational State of implementation of the treaties. Brazil’s geographic location Bolivia will enter into force, and the State will once again be bordering all but two countries in South America, long land a party to the Convention on the thirtieth day after the borders and coastline constitute major challenges to law deposit of its instrument of accession. enforcement efforts against drug trafficking. Although Brazil continues to be a major transit country for cocaine 92. The Board, while welcoming the country’s intention produced in neighbouring countries, INCB notes that the of rejoining the 1961 Convention, is disappointed at the Government of Brazil has taken important measures to Government’s decision to make its re-accession to that bolster its law enforcement capacity, in particular through Convention dependent on the acceptance of its proposed the deployment of surveillance drones, container scanners reservation with respect to coca leaf. The Board wishes to and body scanners and through the establishment of a drug point out that irrespective of the denunciation of the laboratory.

Convention by the Government, and the proposed re-accession to the Convention with a reservation, coca 96. The Board also notes that substantial resources have leaf remains a narcotic drug under the provisions of the been invested in drug prevention programmes, as well as in 1961 Convention, and all aspects of national and the establishment of an extensive community-based international control upon its cultivation, production, treatment and rehabilitation network. The mission of the import, export and use will continue to remain in force. Board encouraged the competent authorities of Brazil to consider extending treatment and rehabilitation 93. The Board reiterates that universal adherence to the programmes to prison populations. The mission also 1961 Convention and the other international drug control discussed the growing problem of “crack” cocaine abuse conventions, which together form the basis for the with the Brazilian authorities, as well as the work being international drug control regime, is an indispensable done in the country to identify treatment strategies for requirement for the effective functioning of international “crack” addiction. Among the issues discussed were the drug control. Therefore, in the Board’s opinion, the availability of analgesics for medical use, which remains reservation proposed by the Plurinational State of Bolivia is low; and the need to adopt measures to address that contrary to the fundamental object and spirit of the important issue.

1961 Convention. The Board believes that the approach taken by the Government — of denunciation of the (d) Cuba Convention and re-accession with a reservation with respect to coca leaf — might create a dangerous precedent 97. In July 2012, a mission of the Board visited Cuba, its with incalculable consequences that could jeopardize the first mission to the country since 1999. The Board notes very fundament of the international drug control regime in that the Government of Cuba, a party to all three the long run. If the international community were to accept international drug control conventions, is firmly an approach whereby States parties used the mechanism of committed to the goals and objectives of those treaties. denunciation and re-accession with reservations to The national drug control policy is primarily focused on overcome problems in the implementation of certain treaty the prevention of drug abuse, and health services are provisions, the integrity of the international drug control provided free of charge to the entire population. Active system would be undermined. counter-narcotics efforts have prevented drug trafficking from having a significant impact on the country. There is 94. The Board calls upon the Government of the no evidence of any major illicit cultivation of drug crops or Plurinational State of Bolivia to very seriously consider all illicit manufacture of drugs in the country.

the implications of its actions in this regard, and invites it to do so in the context of the shared responsibility of all 98. The controls applied to the licit movement of narcotic countries in dealing with the universal drug problem. drugs and psychotropic substances are satisfactory. The The Board hopes that the Government will take Government regularly provides to the Board the appropriate action to resolve any existing problems related information required under the international drug control to the issue of coca leaf in a manner that is consistent with treaties, although with some delay and minor the 1961 Convention.

discrepancies. The mission discussed with the Government, among other things, the availability of narcotic drugs for (c) Brazil the treatment of pain, which is lower in Cuba than in some 95. In August 2012, a mission of the Board visited Brazil. other countries in the Caribbean. According to the latest The Board’s last mission to Brazil was carried out in 2006. survey, conducted in 2006, the prevalence of drug abuse in Brazil is a party to all three international drug control the country is low. The mission also discussed with the

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Government the need for a new survey on drug abuse to 102. The Government is undertaking a reform of the enable a comparison of drug abuse data and identify any legislative basis for drug control and of the structure of the new trends in drug abuse in the country. police service to enable the police and the judiciary to better respond to trafficking in drugs and precursors.

(e) Dominican Republic Preventive alternative development programmes have been initiated in vulnerable areas bordering areas of illicit 99. In October 2012, a mission of the Board was sent to cultivation of drug crops, with a view to providing the the Dominican Republic. A previous mission had visited population in those areas with licit sources of income. the country in 2001. The Dominican Republic is a party to Further initiatives are assessing the extent and types of the three drug control conventions and is committed to drug abuse in the country. The Board’s mission examined fully implementing the provisions of the conventions. The with the authorities their efforts to expand demand Dominican Republic continues to be used significantly as a reduction activities, the administrative mechanisms for the transit country for the smuggling of drugs from South control of narcotic drugs, psychotropic substances and America to consumer markets in North America. However, precursor chemicals with a view to preventing their the Government has increased its interdiction efforts, in diversion and the measures taken against the abuse of particular through increased international cooperation pharmaceutical preparations containing narcotic drugs or with the law enforcement authorities of other countries in psychotropic substances. Also examined were measures to the region, leading to a decline in trafficking through the ensure the rational use of controlled substances, including country. opioid analgesics, and their availability for medical 100. The mission discussed with the Government the legal purposes. The Board communicated to the Government framework applicable to drug control in the country and comprehensive recommendations aimed at strengthening measures to prevent and punish drug trafficking and the drug control situation in Ecuador. related criminal activities such as money-laundering. In particular, the Board welcomed the adoption since its last (g) Republic of Korea mission of a special law on money-laundering. The mission 103. A mission of the Board visited the Republic of Korea noted, however, that enforcement of the law may need to be in June 2012. The Republic of Korea is a party to the three strengthened, in particular with respect to the use of international drug control treaties, and the Government casinos to launder the proceeds of illegal activities. The remains fully committed to the implementation of the mission also discussed the need to ensure adequate provisions of those treaties. The Board welcomes the availability of analgesics used for the treatment of pain in progress that has been made by the Government in the Dominican Republic and noted that more work was implementing the Board’s recommendations following its needed on the development of treatment and rehabilitation last mission to the country in 2007. Particular progress has for persons suffering from drug dependency. been achieved in strengthening the control and monitoring of licit activities involving narcotic drugs and psychotropic (f) Ecuador substances, as well as of precursor chemicals in the form of raw material. Furthermore, the Government has increased 101. A mission of the Board visited Ecuador in June 2012.

its efforts in strengthening the capacity of drug law The Board’s previous mission to the country took place enforcement and enhancing international and regional in 2003. Ecuador is a party to all three international drug cooperation in drug control.

control treaties. The competent authorities expressed their commitment to complying with the provisions of the 104. The Board notes, however, that significant challenges international drug control conventions. Because of its remain. Evidence shows that the Republic of Korea has strategic location, Ecuador continues to be used by become an important source for traffickers of ephedrine traffickers as a transit country for illicit consignments of and pseudoephedrine contained in pharmaceutical cocaine being transported from neighbouring countries to preparations, which are used for the illicit manufacture of more distant countries. Furthermore, coca paste produced amphetamine-type stimulants. The Board considers that in Colombia and Peru is smuggled into Ecuador for the Government of the Republic of Korea should processing into cocaine and then shipped onward, and the strengthen controls over the international trade in and country is a source of chemicals used in the illicit domestic distribution of pharmaceutical preparations manufacture of cocaine and heroin. The prevalence of drug containing ephedrine and pseudoephedrine in order to abuse in Ecuador appears to be low but increasing, and prevent trafficking in these substances. Furthermore, current facilities for treatment, rehabilitation and social although the Republic of Korea has made notable progress reintegration of drug abusers are inadequate. in providing treatment and rehabilitation services to drug

abusers, the full extent of the overall drug abuse situation in levels. Institutional changes, as well as legislative and the country is unknown, due to the lack of comprehensive administrative measures and policies, have also been assessments of drug abuse among the general population. adopted at the federal and provincial levels to address the emerging challenges in drug control in the country.

(h) Nigeria However, the devolution of responsibilities from the federal to the provincial level, foreseen under the eighteenth 105. A mission of the Board visited Nigeria in amendment to the Constitution in 2010, has yet to October 2012. The Board notes that since its last mission to fully materialize.

Nigeria in 1997, the Government has made some progress in certain areas of drug control. The Board notes the 109. The Board, while noting those positive developments, commitment of the country’s National Drug Law remains concerned over the continued weaknesses in the Enforcement Agency and the National Agency for Food Government’s capacity to monitor licit activities related to and Drug Administration and Control to ensuring narcotic drugs and psychotropic substances and, at the compliance with the provisions of the international drug same time, to ensure their adequate availability for medical control treaties to which Nigeria is a party. In particular, and scientific purposes. In particular, inadequacies in the the Government has taken some steps to address the control of pharmaceutical preparations containing emerging problems of drug abuse and drug trafficking in psychotropic substances at the retail level have led to the country, as well as the transit of illicit drugs, for increased abuse of such substances, causing additional example by strengthening border control, enhancing law health problems. The lack of a monitoring mechanism for enforcement capacity and carrying out drug abuse precursor chemicals has increased the risk of their prevention programmes targeting young persons. diversion into illicit channels. The Board welcomes the establishment of the Drug Regulatory Agency, as well as 106. However, significant challenges remain. Nigeria additional measures for the control of precursor chemicals.

continues to be used as a transit country for illicit drug The Board trusts that the Government will take necessary consignments, particularly cocaine from countries in South steps to ensure that the Drug Regulatory Agency becomes America, which is transported onward to Europe.

fully functional, that the country’s provinces assume the 107. Although drug abuse, particularly of cannabis, responsibilities recently devolved to them by the appears to be significant in the country, no recent Constitution, particularly in the field of demand reduction, epidemiological studies of the drug abuse situation have and that the provisions of the international drug control been carried out, and therefore precise information on the treaties are fully implemented. extent of drug abuse in the country is not available.

(j) Peru Furthermore, the availability of narcotic drugs and psychotropic substances for medical and scientific 110. A high-level mission of the Board, led by the purposes remains low. There is a need for the Government President of the Board, visited Peru in May 2012. The to take the necessary measures to address those problems. purpose of the mission was to examine developments that had taken place since its previous mission to that country

(i) Pakistan in 2006, in particular, the increasing illicit cultivation of coca bush and manufacture of cocaine in Peru, and to 108. A mission of the Board visited Pakistan in discuss with the competent national authorities measures September 2012 to review the Government’s compliance for countering such cultivation and manufacture and with the international drug control treaties and progress trafficking and abuse of drugs.

made in the implementation of the recommendations made by the Board following its previous mission in 2004. 111. The Board notes with appreciation that the Pakistan is a party to all international drug control Government has launched a comprehensive national drug treaties. The Government of Pakistan is endeavouring to strategy for the period 2012-2016 that places emphasis on implement its national drug control master plan for alternative development, the fight against illicit coca bush the period 2010-2014 and has made advances in some cultivation and drug trafficking and the prevention and areas, most notably in the field of supply reduction and treatment of drug abuse. Implementation of the national law enforcement. Through the establishment of an drug strategy is efficiently coordinated by an inter-agency task force on narcotics control and other interministerial coordinating mechanism. Control over the mechanisms, the Government has improved the licit movement of narcotic drugs, psychotropic substances coordination of various law enforcement agencies in and precursor chemicals continues to function well. The combating drug trafficking. The Government has also Board welcomes the measures taken by the Government to made increased efforts to counter drug abuse at various strengthen its drug interdiction capacities, and invites the

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international community to support, as appropriate, Peru’s including opioid analgesics and benzodiazepine anxiolytics, alternative development efforts, including the improvement for medical purposes. of market access for products coming from such programmes. (l) Saudi Arabia

112. However, Peru remains one of the two largest 115. A mission of the Board visited Saudi Arabia in coca-growing countries of the world. There is a danger that September 2012 to review the progress achieved in the illicit coca bush cultivation may increase even further country to implement the provisions of the international unless vigorous action is taken against such cultivation. In drug control treaties since the Board’s last visit to the that connection, the Board notes that the Government country in 2005. The Board notes the commitment of the continues to permit cultivation of coca bush for traditional Government of Saudi Arabia to comply with its obligations domestic uses (chewing of coca leaf) and for certain under the three international drug control conventions to industrial purposes that are in contravention to the which it is a party and commends the country’s 1961 Convention. Yet the Government does not even seem government agencies involved in drug control for their to be in a position to take effective control over the commitment and efforts in the fight against drug abuse and 9,000 tons of coca leaf that are used annually for such drug trafficking. purposes. The Board calls upon the Government to take 116. The Board takes note that although the Government appropriate measures to enable the National Coca has developed a comprehensive national drug control Company to fully comply with its mandates in conformity strategy, further coordination efforts among all with articles 23 and 26 of the 1961 Convention as amended implementing institutions involved may facilitate greater by the 1972 Protocol.

achievements in drug control. Control mechanisms on the licit movement of narcotic drugs and psychotropic (k) Portugal substances under international control are efficient. The 113. A mission of the Board visited Portugal in June 2012. Board also discussed with the Government of Saudi Arabia The previous mission took place in 2004. The Board notes further measures to strengthen precursor control that the Government of Portugal, a party to all three mechanisms and to enhance information exchange among international drug control conventions, is fully committed all authorities involved in drug control. to the objectives of those treaties. The drug control strategy 117. Trafficking in and abuse of counterfeit amphetamine is clearly defined and is implemented through a sold as Captagon and cannabis continue to be the major comprehensive national plan. The Government regularly drug problems in Saudi Arabia although there are signs of evaluates the effectiveness of its drug control efforts. The growing trafficking in and abuse of heroin in the country. available data indicate an increase in drug abuse in The Board calls upon the Government to develop the Portugal in the past decade. Drug abuse by injection appropriate mechanisms to accurately assess the extent of continues to be associated with a significant number of new drug abuse in the country in order to better evaluate and cases of diagnosis of HIV infection. Cannabis abuse among adapt the efficiency of the drug control policies. The Board youth is of a major concern. Drug traffickers continue to commends the Government of Saudi Arabia for the use Portugal as a transit country, in particular for the multifaceted and comprehensive care system developed for smuggling of cocaine and cannabis resin. The Board notes the treatment of drug abuse. The mission included a visit to with appreciation that the Government is committed to the Al Amal mental health complex, which provides strengthening the primary prevention of drug abuse, with a treatment, counselling and aftercare for drug-dependent special emphasis on cannabis. The Board trusts that the patients. Government will provide adequate resources for the implementation of measures against trafficking in and (m) Turkey abuse of drugs, in spite of the present economic constraints. 118. A mission of the Board visited Turkey in 114. The mission discussed with the Government November 2011. Turkey is a party to all three international cooperation in maintaining a global balance between the drug control conventions and has demonstrated its licit supply of and demand for opiate raw materials. Other commitment to complying with the provisions of the issues discussed by the mission included the experience Conventions. The Board notes the comprehensive activities gained through the work of the commissions for the of the Government in supply reduction law enforcement dissuasion from drug addiction and their contribution and the extensive capacity of the authorities in that regard. towards preventing drug abuse. Also discussed were Effective cooperation between the various law enforcement measures to ensure rational use of controlled substances, agencies in the country was evident. Turkey is a transit

country through which large amounts of heroin are (a) Argentina trafficked to Western Europe, although the quantity of 123. The Board notes with appreciation that the heroin seized over the previous two years had decreased Government of Argentina has taken comprehensive due to the increasing importance of trafficking via North measures to extend prevention programmes and treatment Africa and by sea container and cargo shipments. The and rehabilitation facilities to all sectors of the population, quantity of cocaine seized in the country more than including at the provincial level. Those measures include

doubled from 2009 to 2010. integrated drug-abuse prevention programmes in educational institutions, for families, in the workplace and 119. The Board noted some positive developments in in prisons; community drug abuse prevention programmes; demand reduction since the previous mission of the Board the organization of awareness-raising events and in 2003, and encourages the Government to strengthen its promotional activities; the provision of assistance and efforts in this area, including in the evaluation of the extent training for technical teams and health-care professionals of drug abuse and in prevention and treatment. The providing prevention and treatment services. Through mission took note of activities being initiated with the aim registers of service-providing institutions and agencies, the of ensuring the adequate availability of internationally Government provides public access to welfare and controlled substances for medical purposes. Turkey is a licit treatment services. Specialized programmes cater to the producer of opium poppy, and the mission was of the view needs of specific population groups, such as the treatment that control measures in the licit cultivation of opium programme for low-income patients, support programmes poppy and production of alkaloids were adequate. for families and friends of drug-dependent persons, programmes for care after discharge from hospital and for

4. Evaluation of the implementation by social and occupational rehabilitation, and provincial care Governments of recommendations made by network programmes. the Board following its country missions 124. According to the Government, there has been an increase in the number of illicit laboratories processing 120. As part of its ongoing dialogue with Governments, coca base detected in Argentina in recent years. Most of the Board also conducts, on a yearly basis, an evaluation of those laboratories were intended for processing coca paste Governments’ implementation of the Board’s for domestic abuse. In response, the Government has recommendations pursuant to its country missions. In undertaken a number of measures to strengthen 2012, the Board invited the Governments of the following Argentina’s law enforcement capacities in the area of drug six countries, to which it had sent missions in 2009, to control, notably through the provision throughout the provide information on progress made in the country of specialized training courses on countering drug implementation of its recommendations: Angola, Australia, trafficking and related crime and on preventing the Hungary, Jordan, Morocco and Sudan.

diversion of precursor chemicals, for law enforcement 121. The Board wishes to express its appreciation to the personnel and officials of the judicial system and the public Governments of Hungary, Jordan and Morocco for prosecution service. Other measures include the submitting the information requested. Their cooperation preparation of a voluntary code of conduct for the chemical facilitated the Board’s assessment of the drug control industry; implementation of the federal inspection plan for situation in those countries and the compliance of the entities working with controlled substances, with an Governments with the international drug control treaties. emphasis on precursors used in the illicit manufacture of Information from the Government of Australia was cocaine; and the maintenance of a 24-hour hotline to reply received too late to be reviewed by the Board, and the to queries from security and police officers regarding outcome of its review will be included in the annual report checkpoint procedures. The Board welcomes such

for 2013. initiatives and encourages the Government to continue expanding its activities in that area.

122. In addition, the Board reviewed the implementation of the recommendations it made following its 2008 mission (b) Ethiopia to Ethiopia, which did not provide the requested information in time for review in 2011. The Board notes 125. The Government of Ethiopia has acted on the Board’s with appreciation additional information provided by the recommendations following its mission to the country in Government of Argentina with regard to the 2008, and progress has been made in a number of areas of implementation of the Board’s recommendations following drug control. The Board notes with appreciation that a

its 2006 mission to that country. comprehensive national drug control master plan that

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

addresses most of the recommendations of the Board has country in 2009. The Government has taken measures to been elaborated and adopted, and an interministerial strengthen the control of licit activities related to precursor committee has been established to monitor and guide the chemicals, particularly with regard to the distribution and implementation of that master plan. use of acetic anhydride. Additional steps have been taken with a view to identifying the diversion of acetic anhydride 126. The Board welcomes the measures taken against the illegal cultivation of cannabis plant and against drug from licit trade into illicit channels. The Government trafficking. The drug control division of the national police appears committed to fulfilling the requirements of has stepped up its eradication efforts in collaboration Economic and Social Council resolution 1999/32, entitled with the local communities in the areas most affected by “International regulation and control of trade in poppy illicit cannabis plant cultivation, and drug interdiction seeds”, and has expressed its intention to nominate an capacities at the Addis Ababa international airport have authority empowered to certify the origin of poppy seeds been significantly strengthened. Measures taken include produced in Hungary, as recommended by the Board. the establishment of an inter-agency coordination team 131. Progress has also been made in the rational use of to improve operational cooperation at the airport among narcotic drugs and psychotropic substances. Legislative the relevant drug law enforcement entities, as well as amendments adopted in July 2011 provide for stricter capacity-building training sessions for law enforcement controls on medicinal products containing narcotic drugs personnel such as police staff, airport administration and psychotropic substances. The control of retail personnel, regional police supervisors and customs pharmacies and storage of controlled substances by officials.

health-care providers has also been strengthened, and new 127. The Board notes that in 2009, legislation to counter regulations in respect of the prescription of narcotic drugs money-laundering was adopted and a financial and psychotropic substances for medical purposes have intelligence centre was established to investigate cases of entered into force. The Board trusts that the Government money-laundering and to enhance public awareness and of Hungary will continue strengthening its efforts to ensure understanding of matters related to money-laundering.

adequate availability of narcotic drugs and psychotropic 128. The Government has made progress in demand substances for medical and scientific purposes and, at the reduction and the prevention and treatment of drug abuse. same time, prevent their diversion into illicit channels. Under the country’s national drug control master plan, 132. While welcoming those measures, the Board notes programmes have been adopted and measures have been that continued efforts need to be made in the area of drug taken by national and regional institutions to counter abuse prevention and treatment. Although Hungary has substance abuse. To address the low availability of opioids established a comprehensive system for the treatment and for medical use in Ethiopia, including for palliative care, rehabilitation of drug abusers, further development of the the authorities have provided capacity-building sessions, system is required to fully respond to needs. The Board and training sessions for raising awareness have been encourages the Government to increase its efforts in the given to health-care providers and medical practitioners primary prevention of drug abuse among youth and to to manage effectively the rational use of opioids for ensure that activities in this area address all commonly medical purposes.

abused controlled substances, including pharmaceutical 129. The Board invites the Government to further preparations containing such substances. strengthen cooperation with it in the control of precursors and to provide prompt responses to the Board’s inquiries (d) Jordan on the legitimacy of orders for export of precursors to 133. The Board notes that some progress in drug control Ethiopia, in particular, by using the PEN Online system.

has been made by the Government of Jordan since the The Board encourages the Government to continue its mission of the Board to that country in 2009. The efforts in the area of drug control and to keep the Board Government has introduced a number of measures to informed of the drug control situation in Ethiopia and strengthen coordination among the relevant Government further measures taken against drug trafficking and abuse agencies under the coordination of the Food and Drug in the country.

Administration of Jordan, the main coordinating body for drug control in the country. The Government has also (c) Hungary strengthened its cooperation in the exchange of 130. The Board notes that efforts have been made by the information on precursor chemicals with the neighbouring Government of Hungary in the implementation of the countries participating in several international initiatives. Board’s recommendations following its mission to that The Board remains concerned that only limited

information on drug trafficking and seizures in Jordan 138. Action against international drug trafficking continues to be available. networks is a priority of Morocco’s national drug strategy.

The Board notes that in order to counter the use of the 134. Since 2009, the National Narcotics Control Council national territory as a transit area for international drug launched a new national strategy to combat abuse of trafficking, the Government has taken a number of narcotic substances. A new centre for the treatment of measures such as operational capacity-building for various addicts with 250 beds has been opened. The Board security sectors, the introduction of a policy for border and welcomes the measures taken by the Government to reduce coastal control, the provision of continuous training drug demand through programmes to raise awareness programmes for law enforcement officers, the utilization of about drug prevention and programmes for the treatment new detection technologies in seaports and airports, the of addiction, rehabilitation and social reintegration. development of strategies to prevent and combat the use of light aircraft in drug trafficking and improved international 135. The Board notes that little progress has been made in cooperation activities with other countries, in particular ensuring the availability of narcotic drugs for medical through INTERPOL.

purposes in Jordan. The availability of opioids for the treatment of pain in medical institutions continues to be 139. The Board notes that the issue of accessibility of inadequate. The Board requests the Government to medicines, including opioids, has been included in the plan examine the current situation and take the steps necessary of action for the period 2012-2017 of the Ministry of to ensure that narcotic drugs, particularly opioids, are Health of Morocco, with a view to addressing regulatory made available for medical purposes. constraints at the national level. The Board welcomes this measure and encourages the Government to make further progress in improving the availability of licit drugs for (e) Morocco medical purposes.

136. The Board notes with appreciation that the Government of Morocco has implemented the recommendations of the Board following its mission to that B. Action taken by the Board to ensure

precursor chemicals have been further improved through the introduction in January 2011 of harmonized

1. Action taken by the Board pursuant to

administrative procedures and the use of standardized

article 14 of the 1961 Convention and

forms. The national commission on narcotic drugs of

article 19 of the 1971 Convention

Morocco has taken steps to improve dissemination of information on demand reduction. Furthermore, the Board 140. Article 14 of the 1961 Convention (and that was provided with a compilation of studies carried out in Convention as amended by the 1972 Protocol), article 19 of Morocco on the extent and pattern of drug abuse in the the 1971 Convention and article 22 of the 1988 Convention country. set out measures that the Board may take to ensure the execution of the provisions of those Conventions. Such 137. Morocco is one of the major producers of cannabis measures, which consist of increasingly severe steps, are resin. According to the Government, the area under illicit taken into consideration when the Board has reason to cannabis plant cultivation stood at 47,400 hectares (ha) in believe that the aims of the Conventions are being seriously 2010. The Government employs a multifaceted strategy endangered by the failure of a State to carry out the that encompasses law enforcement efforts, eradication of provisions of those Conventions.

illicit drug crops, alternative development programmes and demand reduction and treatment efforts to overcome the 141. The Board has invoked article 14 of the cannabis plant-growing culture that has historically existed 1961 Convention and/or article 19 of the 1971 Convention in northern Morocco. The Board notes the steps taken by with respect to a limited number of States. The Board’s the Government to share its experience and good practices objective has been to encourage compliance with those in the field of combating illicit cannabis plant cultivation. Conventions when other means failed. The States The Board encourages the Government to continue its concerned are not named until the Board decides to bring efforts against illicit cannabis cultivation and trafficking, to the situation to the attention of the parties, the Economic continue to collect and analyse pertinent statistical data on and Social Council and the Commission on Narcotic Drugs the extent of cannabis cultivation in the country, and to (as in the case of Afghanistan). Following continuous share its experiences with the international community. dialogue with the Board pursuant to the above-mentioned

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

articles, most of the States concerned have taken remedial opium decreased by 36 per cent, from 5,800 tons in 2011 to measures, resulting in the Board’s decision to terminate 3,700 tons in 2012, due to the lower yield caused by plant action taken under those articles vis-à-vis those States. disease and adverse weather conditions in the main opium poppy-growing areas.

142. Afghanistan is currently the only State for which action is being taken pursuant to article 14 of the 148. The Governor-led eradication force is estimated to

1961 Convention as amended by the 1972 Protocol. have eradicated 9,672 ha of opium poppy in 2012, a 154-per-cent increase compared with the area eradicated

of the country’s 34 provinces. The increase in the area

1961 Convention

eradicated in 2012 was much less than the increase in the 143. At the invitation of the Board, a high-level area of opium poppy cultivation that same year and also Government delegation, headed by the Minister of much less than the area eradicated in 2003 (21,430 ha) and Counter-Narcotics of Afghanistan, attended the 2007 (19,047 ha). The Board urges the Government to 103rd session of the Board in February 2012. The address all impediments to the goal of its national drug delegation was composed of Government officials from control strategy and take effective measures to ensure that various ministries responsible for drug control in sustained progress is made in reducing and preventing Afghanistan. illicit opium poppy cultivation in the country.

144. The Board heard a report presented by the delegation 149. Illicit cultivation of cannabis plant and production of on the drug control situation in Afghanistan and measures cannabis resin continue to pose a significant challenge to taken by the Government to address the drug problem, drug control in Afghanistan. Cannabis cultivation has particularly with regard to the illicit cultivation of opium become increasingly lucrative, with revenues similar to or poppy and related illicit activities. The delegation expressed even surpassing those earned from the cultivation of opium the commitment of the Government of Afghanistan to drug poppy. In 2011, the number of Afghan households growing control and continued cooperation with the Board in the cannabis plant as a cash crop leapt by more than a third, to implementation of the international drug control treaties.

about 65,000 compared with 47,000 in 2010. Fifty-eight per Pursuant to the meeting, the Board communicated its cent of households cultivating cannabis plants also reported recommendations to the Government and requested a having cultivated opium poppy in the previous growing progress report on the implementation of those season, with three quarters of farmers surveyed citing high recommendations.

sale prices as the reason for cultivating cannabis plant.

145. The Afghan delegation attended the Board’s session Afghanistan’s importance as a source of cannabis resin for as part of the continuing consultations under article 14 of world markets has been growing due to the continued high the 1961 Convention. The information provided by the level of cannabis plant cultivation and the high yield delegation and subsequent follow-up has facilitated an obtained. The Board notes that little has been done in this adequate assessment by the Board of the current drug regard and urges the Government to take the necessary control situation in Afghanistan and the progress made by measures to address the problem in accordance with the the Government in complying with its treaty obligations.

international drug control treaties.

146. Pursuant to the decision made by the Board at its 150. In 2012, the Government of Afghanistan updated its 104th session held in May 2012, the Board has proposed to national drug control strategy, placing a particular the Government that a high-level mission of the Board to emphasis on adopting a partnership approach in order to Afghanistan be scheduled as a matter of priority in order to ensure joint, effective implementation and coordination; continue consultations with the highest authorities of the capacity-building of law enforcement bodies at all levels of country under article 14 of the 1961 Convention.

government; and support for a functioning system to monitor progress using measurable, time-bound targets.

(a) Current drug control situation in Afghanistan Furthermore, the Government developed three national 147. In 2012, the total area under illicit opium poppy drug control policies: on alternative livelihoods, countering cultivation reached 154,000 ha, an increase of 18 per cent drug trafficking and drug demand reduction. The Board compared with 2011 (131,000 ha). The southern and welcomes those positive developments and expects the western regions continued to be the centre of illicit opium Government to translate those policies into specific actions poppy cultivation, accounting for 95 per cent of the total and make continuous progress towards achieving the goals cultivation in the country. Potential illicit production of set out in those policies.

(b) Ensure full compliance with treaty obligations 155. The drug control problem in Afghanistan and the neighbouring region remains of grave concern and requires 151. The Government of Afghanistan informed the Board the consolidated effort and the long-term commitment of that it was considering undertaking a pilot project, entitled all stakeholders. While the focus remains on combating “Poppy for Medicine”, under a scheme referred to as illicit production and trafficking in opiates, the emerging “controlled cultivation under licence”. The Board is situation of illicit cultivation of and trafficking in cannabis seriously concerned about that proposal to legalize opium should not be overlooked. More also needs to be done to poppy cultivation in Afghanistan, where illicit opium prevent the diversion of precursor chemicals from licit poppy cultivation remains widespread and continues to sources into illicit channels in the region. The Board calls pose a significant challenge to Afghanistan’s compliance upon the Government of Afghanistan and the international with the international drug control treaties, and requests community to pursue a balanced approach among supply the Government to attend to the Board’s concern about this and demand reduction measures in accordance with the matter at its highest level.

international drug control treaties and the relevant 152. The Board underlines that the licit cultivation of resolutions on drug control of the General Assembly and opium poppy and the production of opiate raw materials the Economic and Social Council. are subject to control measures pursuant to the provisions of the 1961 Convention and that Convention as amended (d) Conclusions by the 1972 Protocol. The Board believes that, until such 156. Afghanistan remains the centre of illicit cultivation of time as the Government is able to put in place credible and opium poppy worldwide, seriously endangering the aims of sustainable control measures and to effectively exercise control over narcotic drugs, psychotropic substances and the international drug control treaties. The emerging precursors, an enforceable ban on opium poppy cultivation situation of illicit cultivation of cannabis plant requires in Afghanistan is the most suitable and realistic measure to urgent action by the Government of Afghanistan with the address the drug problem in the country. assistance of the international community. The Board, while noting the political will and commitment expressed 153. In that context, the Board recalls the Government’s by the Government, remains concerned over the lack of prior rejection in 2007 of a proposal to legalize illicit opium progress and urges the Government to step up its efforts cultivation in the country, as well as its commitment to and take a sustained approach to implementation of its fulfilling its obligations under the international drug national drug control strategy and policies and to ensure control treaties, in particular its obligations under article 22 ongoing progress in alternative development, efforts of the 1961 Convention. The Board trusts that the against drug trafficking and drug demand reduction. The Government will take adequate measures to address the Government of Afghanistan should also strengthen its drug problem in accordance with the provisions of the international drug control treaties. capacity to monitor licit activities related to narcotic drugs, psychotropic substances and precursors in the country and (c) Cooperation by the international community to prevent their diversion and abuse.

154. In 2012, the international community demonstrated

its continued commitment to assisting Afghanistan in C. Governments’ cooperation with the

addressing the drug problem, as evidenced by the ongoing Board efforts of the international community in various areas of

drug control, as well as in the areas of security, governance 1. Provision of information by Governments to and reconstruction and development. The convening of the

the Board

Third Ministerial Conference of the Paris Pact Partners in Combating Illicit Traffic in Opiates Originating in 157. The Board is mandated to publish each year two Afghanistan, held in February 2012, and the Vienna reports (the annual report and the report of the Board on Declaration at the Conference further demonstrated the the implementation of article 12 of the 1988 Convention) spirit of common and shared responsibility in curbing the and also publishes technical reports based on information menace of illicit Afghan opiates. That commitment was that parties to the international drug control treaties are reaffirmed at the Tokyo Conference on Afghanistan held in obligated to submit. These publications give Governments July 2012, as evidenced by the number of high-level detailed analyses on estimates and assessments of representatives in attendance and the scale of financial requirements, manufacture, trade, consumption, utilization pledges made at the Conference. and stocks of internationally controlled substances.

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

158. The analysis of the data provided is crucial in order The Board notes that the Governments of three countries for the Board to monitor and evaluate treaty compliance that trade in such substances failed to submit any quarterly and the overall functioning of the international drug form for 2011. control system. If issues or problems are identified, 163. As in previous years, up to 50 per cent of countries measures can be recommended by the Board to help and territories in Africa, the Caribbean and Oceania did prevent the diversion of narcotic drugs and psychotropic not submit the required statistical forms on psychotropic substances into illicit markets. The provision of data also substances, which might be an indication that those helps account for the legitimate use of narcotic drugs and Governments have yet to establish the necessary legal or psychotropic substances for medical and scientific administrative structures to enable their competent purposes.

authorities to collect and compile the required information. It is also an indication that those Governments may not be

2. Submission of statistical reports

fully aware of the specific reporting requirements on 159. Governments are obliged to furnish to the Board psychotropic substances as they relate to their territories each year, in a timely manner, statistical reports containing and that they require capacity-building in that regard. information required under the international drug control 164. Among the countries that did not submit the conventions.

required information for 2011 or were not able to submit 160. As at 1 November 2012, annual statistical reports on the annual statistical report on psychotropic substances narcotic drugs (form C) for 2011 had been furnished by before the deadline of 30 June 2012 were major 159 States and territories (representing 75 per cent of the manufacturing, importing and exporting countries, such as States and territories requested to submit such reports), Argentina, Brazil, India, Israel, Pakistan and the United although more Governments are expected to submit their Kingdom. The Board understands that those shortcomings reports for 2011 in due course. In total, 180 States and were mainly due to changes in the Government structure territories provided quarterly statistics on their imports responsible for reporting to the Board or to changes of staff and exports of narcotic drugs in 2011, amounting to 85 per within the competent authorities. However, some cent of the States and territories required to provide such Governments continued to experience difficulties in statistics. A large number of Governments in Africa, the collecting the required information from their national Caribbean and Oceania do not submit their statistics stakeholders due to legislative or administrative regularly, despite repeated requests by the Board to do so. shortcomings.

161. In 2012, several Governments either did not submit 165. The Board notes that, in 2012, a total of 43 countries their annual statistical reports on narcotic drugs to the and territories submitted data on consumption of some or Board on time or submitted incomplete reports, including all psychotropic substances in accordance with countries that are major manufacturers, exporters, Commission on Narcotic Drugs resolution 54/6, which is importers and users of narcotic drugs, such as Brazil, Israel, 12 per cent more submitting countries and territories than Pakistan, Romania and the United Kingdom of Great in 2011, the first year when such data were requested. The Britain and Northern Ireland. This delays the Board’s Board appreciates the cooperation of the concerned analysis of global trends and makes it difficult for the Governments and calls upon all other Governments to take Board to prepare its annual report and the technical the necessary steps allowing them to furnish information publication on narcotic drugs. The Board has contacted the on the consumption of psychotropic substances with a view Governments concerned and have requested them to to promoting their adequate availability for medical and improve their reporting. scientific purposes while preventing their diversion and abuse.

162. As at 1 November 2012, annual statistical reports on psychotropic substances (form P) for 2011, in conformity 166. Pursuant to article 12 of the 1988 Convention, parties with the provisions of article 16 of the 1971 Convention, are obliged to report information on substances frequently had been submitted to the Board by a total of 146 States used in the illicit manufacture of narcotic drugs and and territories, amounting to 69 per cent of the States and psychotropic substances. As at 1 November 2012, such territories required to provide such statistics. In addition, information had been submitted by a total of 129 States and 97 Governments voluntarily submitted all four quarterly territories, which was an improvement on last year’s statistical reports on imports and exports of substances submission rate. However, some Governments continue to listed in Schedule II, in conformity with Economic submit blank or incomplete forms, fail to report or miss the and Social Council resolution 1981/7, and a further reporting deadline of 30 June of each calendar year. The 65 Governments submitted some of the quarterly reports. Board reminds all States parties that reporting, as outlined

in the 1988 Convention, is an obligation and urges them to years, the Board had to establish estimates for those States submit a single completed form D, using the latest version and territories that had not submitted their estimates on available, in a timely manner. The latest version of form D time, in accordance with article 12 of the 1961 Convention. is available in all six official languages of the United 170. Failure to submit adequate estimates or assessments Nations from the Board’s website (www.incb.org). The Board stands ready to assist any Government in meeting for narcotic drugs and psychotropic substances may their reporting obligations. undermine drug control efforts. If estimates or assessments are lower than the legitimate requirements, the importation 167. According to data provided on form D for 2011, or use of narcotic drugs or psychotropic substances needed 59 Governments effected seizures of substances in Tables I for medical or scientific purposes may be impeded or and II of the 1988 Convention. However, details regarding delayed. Submission of estimates or assessments the seizures, other than the amounts seized, are not significantly higher than legitimately required increases the provided by a majority of Governments. Parties to the risk that imported narcotic drugs and psychotropic Convention are required to provide qualitative data about substances will be diverted into illicit channels. The Board seizures, the provision of which is essential to develop a calls upon all Governments to ensure that their estimates greater understanding of the modus operandi used by drug and assessments are adequate but not excessive. When traffickers. The Board reminds Governments effecting necessary, Governments should submit to the Board seizures of their obligation to provide comprehensive supplementary estimates for narcotic drugs or inform the information on methods of diversion, stopped shipments Board of modifications to their assessments for and illicit manufacture.

psychotropic substances. INCB invites all Governments, in 168. In March 2012, the Board launched the Precursors particular those of countries and territories with low Incident Communication System (PICS) during the levels of consumption of controlled substances, to use the fifty-fifth session of the Commission on Narcotic Drugs.

Guide on Estimating Requirements for Substances under The system was developed by the Board as a response International Control, developed by the Board and to the rapidly changing trends seen in drug development the World Health Organization (WHO) for use by (e.g. the emergence of non-scheduled substances and competent national authorities, which was published in “designer drugs”) with a view to complementing traditional February 2012.

reporting mechanisms on individual precursor seizures. Registered users of PICS have access to secure, real-time 171. In recent years, several countries have requested the data on incidents and can use the system to communicate Board to clarify certain parts of the estimates and with relevant counterparts in order to help launch assessments systems. In particular, Governments have bilateral/regional investigations into seizures and identified indicated that the adjustment to stocks procedure, which is cases of diversion of chemicals. The system is helping the an important component of the system of estimates for Board and users to quickly identify emerging patterns of narcotic drugs, was difficult to fully comprehend due to its diversion of precursors. As at 1 November 2012, there were complexity. Therefore, in September 2012, the Board 237 users representing 58 Governments and 8 international organized training sessions for interested countries in order and regional agencies registered with PICS. The Board to explain the estimates system in general and the encourages all Governments to register their law adjustment to stocks procedure in particular. The Board enforcement, regulatory and intelligence authorities trusts that on the basis of information provided during the involved in the control and monitoring of chemicals used training, countries will be able to submit adequate in illicit drug manufacture with PICS and to use the system supplementary estimates and prevent stocks of narcotic without delay.

drugs from dropping to levels below actual requirements. The training also focused on assessments for psychotropic

3. Submission of estimates and assessments

substances and on how to avoid having imports and 169. Pursuant to the 1961 Convention, States parties are exports exceed the quantities set out in the estimates and assessments. Future training sessions will be organized for obliged to provide the Board each year with estimates of their requirements for narcotic drugs for the following year. those countries expressing an interest in them. As at 1 November 2012, a total of 162 States and territories 172. Similar to the situation with the control of narcotic had submitted estimates of their requirements for narcotic drugs, pursuant to Economic and Social Council drugs for 2013, representing 76 per cent of the States and resolutions 1981/7 and 1991/44, Governments are territories required to furnish annual estimates for requested to provide the Board with annual assessments of confirmation by the Board. As was the case in previous requirements for psychotropic substances contained in

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

Schedules II, III and IV of the 1971 Convention for medical 177. The number of Governments and the number of and scientific use. substances in Tables I and II for which estimates of annual legitimate requirements are provided have steadily 173. As at 1 November 2012, Governments of all countries increased. As at 1 November 2012, 150 Governments had and territories, except for the Government of South Sudan, provided those estimates for at least one substance.

had submitted to the Board at least one assessment of their First-time submissions were provided by Bolivia annual medical and scientific requirements for (Plurinational State of), Brunei Darussalam, Curaçao, psychotropic substances. The assessments of requirements for psychotropic substances for South Sudan were Eritrea, Faroe Islands, France, Greenland, Japan, Maldives, established by the Board in 2011, in accordance with Norfolk Island, Qatar and Tunisia. Economic and Social Council resolution 1996/30, in order 178. The Board wishes to remind all Governments that the to allow that country to import such substances for medical totals of estimates of annual medical and scientific purposes without undue delay. requirements for narcotic drugs, as well as assessments for 174. Assessments for psychotropic substances remain in psychotropic substances, are published in yearly and force until Governments modify them to reflect changes in quarterly publications and that monthly updates are available on the Board’s website (www.incb.org). Updated national requirements. The Board recommends that Governments review and update the assessments of their information on annual estimates of legitimate requirements annual medical and scientific requirements for for precursors of amphetamine-type stimulants is also available on the website.

psychotropic substances at least every three years. Since 1 November 2011, a total of 101 countries and

submitted modifications to assessments for one or more 179. The provision of statistical data by Governments substances as at 1 November 2012. Governments of allows the Board to overview the functioning of the drug 13 countries and one territory have not submitted any control systems. This in turn helps to address concerns revision of their legitimate requirements for psychotropic about possible diversion and illegitimate use of substances.

substances for at least three years.

180. Countries that provide accurate statistical data to the 175. In accordance with Economic and Social Council Board in a timely manner typically have well-established resolution 1995/20, Governments provide data on their licit national drug control agencies with the adequate human trade in, uses of and requirements for substances in Tables I and technical resources required to carry out their and II of the 1988 Convention, which enables the Board to responsibilities that are operating on the basis of identify trends in the international trade in precursors appropriate legislation and administrative regulations.

as well as unusual or suspicious trade patterns. As at Those agencies are also given the necessary authority to 1 November 2012, 109 States and territories had provided fulfil their role under the international drug control information on licit trade and 101 had provided data on treaties. Further, they provide clear guidance at the national licit uses of and requirements for precursors.

level on the requirements for engaging in the manufacture 176. In its resolution 49/3, the Commission on Narcotic and trade of internationally controlled substances, which improves cooperation between national drug control Drugs requested that Member States provide the Board authorities and industry. Such national drug control with estimates of their annual legitimate requirements for systems contribute significantly to the effective functioning the import of four substances frequently used in of international drug control.

the manufacture of amphetamine-type stimulants (3,4-methylenedioxyphenyl-2-propanone (3,4-MDP-2-P), 181. Late submission and the submission of incomplete or pseudoephedrine, ephedrine and 1-phenyl-2-propanone inaccurate data required under the international drug (P-2-P)) and to the extent possible, estimated requirements control treaties and resolutions of the Economic and Social for imports of preparations containing those substances. Council and the Commission on Narcotic Drugs may The information on legitimate trade for precursor significantly obstruct examination and overall analysis of chemicals for amphetamine-type stimulants assists the the data by the Board. Some Governments, among them competent authorities of exporting countries in preventing major manufacturing countries, experience difficulties in exports of substances in quantities exceeding the legitimate reporting accurately and in a timely manner after changes requirements of the importing countries, which could of staff, or after restructuring of the competent authorities. potentially be diverted to illicit channels. To avoid such difficulties, the Board encourages all

Governments to take the necessary steps to establish substances, or are not required to do so in time for the mechanisms that allow competent authorities to maintain authorities to furnish comprehensive reports to the Board. the knowledge base of the staff with regard to reporting The Board is concerned about those gaps in national requirements under the drug control convention at times of legislation as they may also prevent adequate monitoring change. In particular, training of new staff should be by competent authorities.

envisaged. 184. The Board notes the development by UNODC of 182. Many Governments are making use of new the project “Building national capacity in regulatory developments, in particular in the area of information control of internationally controlled substances”. As part technology, to enhance established drug control systems. In of the project, the Board’s Secretariat and UNODC particular, electronic systems are used to collect and will provide regional workshops and electronic learning compile data required under the Conventions in order to tools with the aim of improving drug control facilitate timely and accurate processing of the large administration at the national level. The Board invites volumes of data related to internationally controlled drugs. Governments to support UNODC in carrying out However, the Board notes that, in some countries, the that project. quality of information collected from national stakeholders using electronic tools is low. One possible reason for this might be that the companies or other national stakeholders D. Ensuring the implementation of the are not sufficiently familiar with the tools in question or are provisions of the international drug not sufficiently aware of which information should be

control treaties

submitted, and therefore may not furnish the required data. The Board reminds Governments that it is their 185. The international drug control regime was responsibility to ensure that all national stakeholders are established with two equally important aims: first, to fully aware of the reporting requirements and that any ensure the availability of narcotic drugs and psychotropic electronic system used at the national level for collecting substances for medical and scientific purposes; and second, data and reporting to the Board is used in a way that is to prevent the diversion of controlled substances into illicit compatible with the provisions of relevant international channels for subsequent sale to drug abusers or, in the case treaties. The Board notes that Governments that provide of precursor chemicals, for use in the illicit manufacture of regular training sessions for all national stakeholders on the narcotic drugs and psychotropic substances. The drug use of these tools, as well as on the reporting requirements control regime comprises the international drug control under the international drug control conventions, submit accurate data. The Board invites all Governments of major conventions and additional control measures, adopted by manufacturing and trading countries to establish regular the Economic and Social Council and the Commission on training events at the national level and stands ready to Narcotic Drugs to enhance the effectiveness of the assist Governments in this endeavour in accordance with provisions contained in the drug control conventions to its mandate. achieve the two main goals. Pursuant to its mandate, the Board regularly examines action taken by Governments to 183. The Board reviews the reports received from implement the treaty provisions and related resolutions of Governments to identify any systematic shortcomings in the Council and the Commission, points out problems that those reports that may be the result of inadequate continue to exist in this area and provides specific implementation of the provisions of the drug control recommendations on how to deal with such problems.

treaties, and can recommend appropriate action. It is also an obligation of Governments and their competent

1. Preventing the diversion of controlled

authorities to rectify errors in the collection and processing of data. In that regard, the Board recommends that substances competent authorities use screening mechanisms to check (a) Legislative and administrative basis the validity of the data they receive prior to sending it to the Board. By implementing such measures, inconsistencies 186. Parties to the conventions need to adopt and enforce and gaps can be identified more easily, clarifications can be national legislation that is in line with the provisions of the sought and Governments will be able to compile and international drug control treaties. They also need to submit accurate national reports to the Board. amend the lists of substances controlled at the national Furthermore, it appears that, due to gaps in national level when a substance is included in a schedule of an legislation, national stakeholders are not required to report international drug control treaty or transferred from on all or some of their activities involving controlled one schedule to another. Inadequate legislation or

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

implementation mechanisms at the national level or delays measures to strengthen their controls over the import and in bringing lists of substances controlled at the national export of precursors. In view of the continued level into line with the schedules of the international drug identification of cases of diversion of pharmaceutical control treaties result in inadequate national controls being preparations containing ephedrine or pseudoephedrine, the applied to substances under international control. In some Board welcomes the fact that many countries, including cases such deficiencies have led to the diversion of most recently China, the Republic of Korea and Thailand, substances into illicit channels. have broadened their legislation to address particularly such diversion.

187. The Board notes that some Governments appear to 192. Despite the foregoing, the Board is concerned that have difficulties in reflecting changes that have been introduced in the scope of control of the international the controls applied to domestic distribution and end-use treaties in their national legislation. For example, although of precursors are still inadequate in many countries, which facilitates their continued diversion. Such controls should in 2001 zolpidem and gamma-hydroxybutyric acid (GHB) were added to Schedule IV of the 1971 Convention, even in have, as a minimum: a system of end-user registration and 2012 some Governments of countries where those declarations of end use; knowledge of legitimate requirements in order to set realistic limits to importation, substances are used for medical purposes have not yet amended their national lists of controlled substances particularly for chemicals with little or no legitimate use; accordingly, although the 1971 Convention stipulates that and notification of all exports prior to their departure. To help stop the efforts of illicit trafficking organizations, the such amendments should be enforced 180 days after receipt of the appropriate notification of the Secretary-General. Board urges Governments to review existing domestic control systems, determine whether weaknesses exist and 188. As stated in paragraphs 159-168 above, when work to close existing gaps. reviewing the statistical reports the Board determined that in some countries the control measures foreseen in the 193. In this context, the Board wishes to remind all international drug control conventions were not adequately Governments that the ability to monitor the international trade of precursors is fundamentally linked to effective reflected in the national laws or regulations, which resulted in an absence of data or incomplete data. In the countries monitoring of manufacture and distribution at the concerned, some stakeholders, or some geographical areas, domestic level. The Board is concerned that without information about the domestic market and stakeholders, are not monitored by the competent authorities. In some other countries with federal structures, weak federal laws Governments are at risk of not being in a position to prevent the national competent authorities from enforcing comply with their obligations related to preventing diversion.

at the state level the control measures foreseen at the national level. In all the examples cited above, entities that 194. With a view to strengthening the monitoring of the are not monitored adequately could unintentionally or international trade in precursors, in March 2012 the Board intentionally contribute to the diversion and abuse of signed a memorandum of understanding with the World controlled substances. Customs Organization, which institutionalizes its constructive, long-standing cooperation with that 189. The Board notes that such deficiencies seem to be Organization. One point of such cooperation is to establish particularly common with regard to provisions of the unique Harmonized System codes for pharmaceutical 1971 Convention, which are already weaker than the preparations containing ephedrine and pseudoephedrine.

control mechanisms of the 1961 Convention. The Board is concerned that some Governments seem to neglect the (b) Prevention of diversion from international trade monitoring of psychotropic substances, possibly under the misconception that the consequences of diversion and Estimates and assessments of annual abuse of psychotropic substances are less serious than those requirements for controlled substances

of diversion and abuse of narcotic drugs. 195. One of the main control measures used to prevent the diversion of controlled substances from international trade 190. The Board requests all Governments to review their is the system of estimates or assessments of legitimate laws and regulations to verify that they are in line with all annual requirements for controlled substances, since this the relevant provisions of the drug control treaties and with enables exporting and importing countries alike to ensure the current schedules and tables of the international drug that the trade stays within the limits determined by the control treaties, and to amend their laws as necessary.

importing Governments. For narcotic drugs, such a system 191. More action is also needed with regard to precursor is mandatory under the 1961 Convention, and the control. The Board is aware that Governments maintained estimates furnished by Governments need to be confirmed

by the Board before becoming the basis for the limits of respective estimates. The Board contacted the manufacture or import. The system of assessments of Governments concerned and requested them to ensure full annual requirements for psychotropic substances and the compliance with the relevant treaty provisions. system of estimates of annual requirements for selected 199. For psychotropic substances, too, the system is well precursors were adopted by the Economic and Social respected and the assessments of annual requirements have Council and the Commission on Narcotic Drugs, become more accurate, showing that Governments are respectively, to help Governments to identify unusual increasingly aware of the actual requirements for transactions that might reflect attempts by traffickers to psychotropic substances. In 2011 the authorities of divert controlled substances into illicit channels.

14 countries issued authorizations for substances for which 196. The system of estimates or assessments can be they had not established any assessments or in quantities effective only if both exporting and importing countries that significantly exceeded their assessments, and most adhere to it: Governments of importing countries should exporting countries paid attention to the assessments ensure that their estimates and assessments are in line with established in importing countries and did not knowingly export psychotropic substances in quantities exceeding their actual requirements and that no import of controlled those assessments. A frequent cause of excess imports was substances in quantities exceeding those requirements is imports destined for re-export, which are difficult to assess taking place. If the actual requirements are found to have in advance. The system of assessments for psychotropic increased beyond the requirements submitted previously to substances has therefore been amended slightly: as of 2013, the Board or to have decreased substantially from those Governments will no longer be requested to include requirements, importing countries should inform the estimates for exports or re-exports in the annual Board immediately of such changes. Governments of requirements for psychotropic substances. The Board trusts exporting countries should set up a mechanism to check all that the change will make the system of assessments for export orders involving controlled substances against the psychotropic substances even more transparent and estimates and assessments of importing countries and allow effective.

exports only when they are in line with legitimate

requirements in the importing countries. 200. The estimates of annual licit requirements for the four substances used in the illicit manufacture of 197. In accordance with its mandate to identify loopholes amphetamine-type stimulants,15 which have been in the implementation of the control systems that could published by the Board since 2006, have proved to be a very lead to diversion, the Board regularly investigates cases useful tool to assist Governments in verifying the involving possible non-compliance by Governments with legitimacy of shipments of precursors. They have also the system of estimates or assessments. In this connection, allowed the Board to identify emerging regional trends in the Board provides advice to Governments on the details of the diversion of precursors, and several major the estimates and assessments systems, as necessary. For investigations into cases of diversion have been launched as example, during the consultations organized by the Board a result. The positive momentum generated in such a short in September 2012, the components of the international period by this new tool needs to be maintained.

Methodologies employed by some Governments when drug control system relating to observance of import estimating their requirements must be improved, since and export limits were discussed (see para. 171 above).

some Governments made estimates far in excess of their Participants were informed about the procedures to actual legitimate annual requirements (see para. 223 identify import and export excesses and about the rules below). The regular review of annual licit requirements for that should be observed to avoid such excesses. In this precursors and the submission of updated figures, as respect, the Board would like to remind Governments to necessary, reflecting changing market conditions, as well as utilize the training material on narcotic drugs and the participation of Governments that have not yet psychotropic substances whenever clarifications on the submitted such estimates, would improve this system.

international drug control system are needed. The Board is also at the disposal of Governments to respond to specific Requirement of import and export authorizations questions on the matter.

201. The requirement for import and export 198. As in previous years, the Board has found in 2012 authorizations is another main control measure to prevent that the system of estimates for narcotic drugs continues to the diversion of controlled substances from international be respected by most countries. Through its analysis, the __________________ Board determined that in 2011 six countries authorized 15 3,4-MDP-2-P, pseudoephedrine, ephedrine and P-2-P imports or exports of narcotic drugs in excess of the and preparations containing those substances.

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

trade, since it allows the competent national authorities to exempted from the import authorization requirements that check the legitimacy of individual transactions prior to are normally enforced in their country certain preparations shipment. Import and export authorizations are mandatory containing psychotropic substances included in for a transaction involving any of the substances controlled Schedule III or IV to inform the Board of such exemptions under the 1961 Convention or listed in Schedule I or II of without delay, so that other Governments can be advised the 1971 Convention. The competent national authorities accordingly. The Board further wishes to remind all are obliged to issue import authorizations for transactions Governments that exempt certain preparations containing involving the importation of such substances into their psychotropic substances in accordance with the provisions country. The authorities of exporting countries must verify of article 3 of the 1971 Convention that they should inform the authenticity of the import authorizations before issuing the Secretary-General of such exemptions, as applicable. the export authorizations required to allow the shipments 205. The Board shares with the competent authorities containing the substances to leave their territory. Moreover, information on the import authorization requirements for upon receipt of the consignments, the authorities in substances listed in Schedules III and IV of the importing countries must inform the authorities of 1971 Convention that are applied in countries and exporting countries of the actual quantities received.

territories, as well as of the exemptions, as applicable, to 202. The 1971 Convention does not require import and assist in monitoring international trade in psychotropic export authorizations for trade in psychotropic substances substances while preventing traffickers from targeting listed in Schedule III or IV of the Convention. However, in countries in which controls are less strict. For instance, this view of widespread diversion of those substances from information can be reviewed on the secure area of the international trade in the 1970s and 1980s, the Economic Board’s website, which is accessible only to specifically and Social Council, in its resolutions 1985/15, 1987/30 and authorized Government officials. 1993/38, requested Governments to extend the system of 206. The Board is increasingly informed about import and import and export authorizations to cover all psychotropic export authorization requirements applied to precursors.

substances. In 2012 the Board has been informed by the According to the most recent information, about Governments of Azerbaijan, Chile, the Russian Federation, 70 Governments now require individual export Tajikistan and Ukraine that they recently imposed import authorizations for all precursors included in Tables I and II authorization requirements for international trade of the 1988 Convention. Those Governments that have involving some or all of the substances in Schedules III either no controls or require only general permits for and IV. In addition, the Governments of Christmas Island, the export of Table I and Table II substances may not be the Cocos (Keeling) Islands, French Polynesia, Norfolk in a position to comply with their treaty obligations.

Island, Saint Helena and Sint Maarten informed the Board The Board therefore urges all Governments to ensure that that they implement the same regulations as their sovereign they are able to provide pre-export notifications, Governments.

particularly to the importing countries that have officially 203. The Board notes that most countries and territories requested such notifications. now require import and export authorizations for most of the psychotropic substances in Schedules III and IV of the Verifying the legitimacy of individual

Governments that do not yet require import and export 207. Individual import authorizations are sometimes authorizations for all psychotropic substances are invited to falsified by traffickers to obtain substances from legitimate extend such controls to all substances in Schedules III and international trade. The Board therefore reiterates its IV as soon as possible and to inform the Board accordingly.

request to the authorities of exporting countries to verify 204. Some Governments, although in principle they the authenticity of all import authorizations using new or require import and export authorizations for substances unknown formats, bearing unknown stamps or signatures, included in Schedules III and IV, have exempted certain or that were issued by an unrecognized national authority, specific preparations containing those psychotropic as well as of authorizations for consignments containing substances from the import/export authorization substances known to be frequently abused in the region of requirements otherwise in place in their countries, without the importing country. The Board notes with appreciation informing other Governments or the Board accordingly. that many Governments of exporting countries, including This has sometimes created confusion among trading those of Belgium, Denmark, France, Germany, Hungary, partners and resulted in undue delays of transactions. The India, Switzerland, the United Kingdom and the United Board therefore requests all Governments that have States, are verifying the legitimacy of import authorizations

directly with the competent national authorities of a system-design document and the cost estimate for importing countries or with the assistance of the Board. In developing and maintaining the electronic system. this regard, the Board assists in such verifications, 212. In March 2012, Governments further strengthened particularly in cases where the authorities of exporting their support for that initiative by adopting the countries did not receive feedback from the authorities of Commission on Narcotic Drugs resolution 55/6. The the importing countries, or when there is a concern that resolution encourages Member States to provide the fullest transactions might not fully comply with the requirements possible financial and political support for developing, set out in the international drug control system.

maintaining and administering an international electronic 208. The Board wishes to remind the Governments of import and export authorization system for narcotic drugs importing countries that it is in their interest to respond in and psychotropic substances. It also requests UNODC to a timely manner to all queries regarding the legitimacy of undertake the development and maintenance of the system transactions that they receive from competent authorities and invites the INCB secretariat to administer the or from the Board. Failure to respond quickly in such cases international system during the start-up phase in the may hinder the investigation of diversion attempts and/or biennium 2012-2013. Furthermore, the resolution invites cause delays in legitimate trade in controlled substances, Member States and other donors to provide extrabudgetary thus adversely affecting the availability of those substances contributions for those purposes. for legitimate purposes.

213. The Board, which has regularly reviewed the progress achieved in that initiative, notes with appreciation that a Developing an international electronic import number of Governments have pledged, contributed to or and export authorization system for narcotic are considering contributing to the funding required for drugs and psychotropic substances developing and maintaining the electronic system. Thanks to such contributions, the initial development of the system 209. Governments will recall that in the report of by UNODC is assured, and UNODC has commenced the the International Narcotics Control Board for 2011 development work. The Board invites all Governments to (paras. 212-219), the Board informed Governments of the continue providing voluntary contributions to UNODC in initiative of developing an international electronic import order to ensure the continued maintenance of the and export authorization system for narcotic drugs and electronic system after the first, development phase. The psychotropic substances. In that report, the Board also Board wishes to stress that the administration of such a highlighted the joint efforts of the international community system implies the monitoring of Governments’ compliance since 2009 to identify how the proposed system could assist with the control provisions for international trade in national drug control authorities in their daily work, while narcotic drugs and psychotropic substances. As reflected in at the same time ensuring that the system functions in a Commission on Narcotic Drugs resolution 55/6, the Board way that fully complies with the requirements set out in the is best placed to administer the system, once developed. international drug control conventions.

Pre-export notifications for precursor chemicals 210. The proposed electronic system is aimed at facilitating the exchange of electronic import and export 214. Only 81 countries have made use of article 12, authorizations between the competent national authorities paragraph 10 (a), of the 1988 Convention, which makes it of importing and exporting countries. The system would be mandatory for exporting countries to inform the able to check the quantity of a shipment against the latest competent authorities of those countries of a planned estimate or assessment for the narcotic drug or export of precursors to their territory prior to actual psychotropic substance in question. Online endorsement shipment. Without this control measure, the more than would also be an important feature of the electronic system. 100 other parties to the 1988 Convention, in particular countries in parts of Africa, Central America and the All of those important features would be designed to help Caribbean, Central Asia, South-East Asia and Governments to meet their obligations under the South-Eastern Europe, are at risk of being targeted by international drug control treaties and would enhance the traffickers. The Board wishes to remind all Governments monitoring of international trade in narcotic drugs and that the provisions of article 12, paragraph 10 (a), if used psychotropic substances and the prevention of their and implemented by all, would create a robust and practical diversion.

mechanism for control of international trade in scheduled 211. Since the end of 2011, that initiative has gained great chemicals. Governments that have not yet invoked momentum. On the basis of extensive consultations with article 12, paragraph 10 (a), of the 1988 Convention should interested Governments and the Board, UNODC presented do so without delay, since it would oblige exporting

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

countries to issue notifications of all shipments of identified in recent years. From time to time, attempts to precursors destined to their country. divert narcotic drugs and psychotropic substances from international trade are detected by vigilant competent 215. The Board notes with satisfaction that the number of national authorities, which often work in close cooperation registered users of the Board’s PEN Online system now with the Board. In such cases traffickers seem to be fully stands at 136, with an average of 1,800 pre-export aware of the control measures that are applied by most notifications sent per month. Since the Board’s last report, Governments and circumvent them whenever possible. For 10 additional States and territories — Armenia, Benin, the example, falsified import authorizations continue to be British Virgin Islands, Chad, Ethiopia, Kazakhstan, Nepal, used by traffickers in attempts to divert controlled Qatar, Senegal and Serbia — have registered with the PEN substances. The Board recommends that Governments Online system. The information that is shared through remain vigilant and scrutinize the import and export PEN Online assists national competent authorities, and the orders involving controlled substances to ensure that they Board, in identifying and confirming the legitimacy of are destined for legitimate purposes.

individual shipments of precursors and in suspending or stopping suspicious shipments in an efficient and timely 218. Diversion from international trade appears to manner. As such, it is an important tool for the continue to occur when the substances involved do not international community to help to monitor international require import and export authorizations, as is the case in trade in scheduled chemicals in order to help to prevent some countries for substances listed in Schedules III and IV diversion. The Board reminds all Governments exporting of the 1971 Convention, including most of the commonly scheduled chemicals to countries that have invoked diverted benzodiazepines, and for the preparations article 12, paragraph 10 (a), of their obligation to issue included in Schedule III of the 1961 Convention. For notifications of such shipments prior to departure and example, diversion from international trade was the recommends that they use the PEN Online system for such primary method noted by the Government of Indonesia for notifications, pursuant to Security Council resolution 1817 the diversion of benzodiazepines. The Board therefore (2008). The Board also encourages all Governments to reiterates its call to all Governments that do not yet require actively review pre-export notifications sent to their import and export authorizations for all psychotropic country and to communicate via the PEN Online system so substances to extend the import and export authorization that an unbroken chain of monitoring trade in chemicals requirement to all psychotropic substances as soon as can be maintained. possible. The Board also urges the countries that have in principle introduced such authorization requirements for 216. The Board launched Operation Ephedrine and all psychotropic substances, but that have subsequently Pseudoephedrine Intelligence Gaps in Africa (Operation exempted some preparations from the import and export EPIG) in June 2012, to gather strategic information on the authorization requirements, to consider revoking the licit trade, trafficking and illicit use of ephedrine and exemptions with regard to international trade, where pseudoephedrine, including in their pharmaceutical appropriate.

preparation forms, in countries of Africa. The Operation, which lasted for three months and in which the 219. With regard to the diversion of precursor chemicals, Governments of 51 countries either in Africa or trading preparations containing precursor chemicals such as with countries in Africa participated, brought about a more ephedrine and pseudoephedrine continue to be diverted active use of PEN Online by the authorities of participating from international trade to be used in the illicit countries. The Operation also showed the extent of manufacture of amphetamine-type stimulants, as reported trade in ephedrines to African countries. However, since by the Governments of Australia and New Zealand, among pre-notification of exports of pharmaceutical preparations others. containing those substances, while recommended, is not mandatory, there is likely to be unaccounted trade in such (d) Prevention of diversion from domestic preparations through and to African countries. distribution channels

220. The diversion of narcotic drugs, psychotropic (c) Effectiveness of the control measures aimed at substances and precursors from licit domestic distribution preventing the diversion of controlled channels has become a main source for supplying illicit substances from international trade markets. For narcotic drugs and psychotropic substances, 217. The control measures described in paragraphs 195-216 the substances involved are diverted mainly in the form of above continue to be effective. Very few cases involving pharmaceutical preparations. The problems associated with diversion of narcotic drugs or psychotropic substances the diversion of preparations containing narcotic drugs or from international trade into illicit channels have been psychotropic substances, which are predominantly diverted

for subsequent abuse, and the actions to be taken to tackle requirements for imports of ephedrine and those problems are described in paragraphs 303-315 below. pseudoephedrine in some countries in Asia,16 since those high levels of requirements put those countries at risk of 221. The availability of “medical cannabis” in California being targeted by traffickers seeking to divert the and other states in the United States constitutes a major substances for use in the illicit manufacture of challenge to compliance by the Government of the United amphetamine-type stimulants. Recent multiple seizures States with the international drug control treaties, in have borne out the concerns of the Board in this regard.

particular the 1961 Convention. The Board notes that the Following large-scale disappearances of tablets containing so-called “medical cannabis” scheme in California has pseudoephedrine from hospitals in Thailand, the annual contributed to an increase in cannabis abuse, due to a lack legitimate requirement for the import of the substance was of the required institutional framework for regulating the reduced considerably and investigations were launched.

sale of cannabis for “medical” use. In particular, the The Government of Pakistan started investigations into number of “medical cannabis” dispensaries, selling allegations that companies imported excessive quantities of cannabis and drug paraphernalia, has increased ephedrines. The Board encourages all countries that exponentially in California in recent years. There has also identify significant diversions of precursors for been an increased number of unregulated cannabis retailers amphetamine-type stimulants to re-evaluate their in some parts of that state. Furthermore, it has been noted requirements for those substances and to inform the Board that more than 90 per cent of “patients” registered with about changes without delay.

“medical cannabis” dispensaries do not present medical histories associated with such dispensing and 70 per cent of 224. When trying to obtain acetic anhydride, trafficking the users of such dispensaries are under 40 years of age. organizations rely nowadays on diversion from domestic The real outcome of such a scheme has been to make distribution channels. In order to address this situation, cannabis more readily available for recreational purposes. the establishment and maintenance of an effective The Board urges the Government of the United States to domestic regulatory control system, as described in take necessary steps to ensure that internationally paragraphs 191-193 above, is essential. controlled substances are used only for medical and 225. The control measures applied to international trade scientific purposes and to prevent their diversion and in potassium permanganate have been effective and abuse, in accordance with the international drug control have forced the trafficking organizations to obtain treaties.

potassium permanganate for use in the illicit manufacture 222. The diversion of precursors from domestic of cocaine from other sources. There is evidence of that distribution channels increasingly involves pharmaceutical substance, as well as other chemicals, being illicitly preparations containing those precursors. Most manufactured. As laboratories illicitly manufacturing prominently, preparations containing ephedrine and cocaine are increasingly being dismantled outside the pseudoephedrine have often been targeted by traffickers for three coca-producing countries along cocaine trafficking use in the illicit manufacture of amphetamine-type routes, all Governments, particularly those along known stimulants. For instance, such preparations have been trafficking routes, should remain vigilant so as to prevent diverted from domestic distribution channels in China and chemical trafficking organizations from establishing their the Republic of Korea, where there are a significant number activities in locations that were previously free from illicit of legitimate manufacturers of those preparations, and manufacture. smuggled to Australia and New Zealand for the illicit

as prohibiting the sale of such preparations by Internet 226. In line with its mandate to ensure the availability of pharmacies, ascertaining the points in the domestic supply internationally controlled substances for medical and chain that are most vulnerable to being exploited by __________________ traffickers, investigating the origin of seized preparations to 16 See, for example the report Precursors and Chemicals identify their sources and points of diversion, and the Frequently Used in the Illicit Manufacture of Narcotic sharing of information by law enforcement authorities of Drugs and Psychotropic Substances: Report of the the countries concerned, and to apply those International Narcotics Control Board for 2011 on the

recommendations, as appropriate. Implementation of Article 12 of the United Nations Convention against Illicit Traffic in Narcotic Drugs and

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

scientific purposes, the Board carries out various activities level that conforms to the actual requirements for those related to narcotic drugs and psychotropic substances. The materials worldwide, in order to prevent the accumulation Board monitors action taken by Governments, of excessive stocks. All producing countries should carefully international organizations and other bodies to support the attend to this important issue and prevent the accumulation rational use of controlled substances for medical and of excessive stocks that might be a source of diversion. scientific purposes and their availability for those purposes. 231. Global demand for opiate raw materials rich in morphine and opiate raw materials rich in thebaine is (a) Supply of and demand for opiate raw materials expected to rise in the future, in line with the trend of previous decades. It is expected that the worldwide efforts 227. The Board has an important role to play in the supply of raw materials required for the manufacture of all to ensure the adequate availability of opioid analgesics, medications containing opiates. Pursuant to the which are encouraged and supported by the Board and 1961 Convention and relevant resolutions of the WHO, will contribute to the continuing rise in global Commission on Narcotic Drugs and the Economic and demand for opiates and opiate raw materials. Social Council, the Board examines on a regular basis developments affecting the supply of and demand for (b) Consumption of narcotic drugs and opiate raw materials. The Board strives, in cooperation psychotropic substances with Governments, to maintain a lasting balance between 232. Disparities in consumption levels of narcotic drugs supply and demand for those materials. In order to analyse between countries and regions remain as described in the the situation regarding supply of and demand for opiate 2010 Report of the International Narcotics Control Board on raw materials, the Board uses information from the Availability of Internationally Controlled Drugs:

Governments of countries producing opiate raw materials, as well as from countries where those materials are utilized Ensuring Adequate Access for Medical and Scientific for the manufacture of opiates or substances not controlled Purposes.18 The availability of opioids for pain management under the 1961 Convention. A detailed analysis of the is still inadequate in a large number of countries. While current situation with regard to the supply of and demand global consumption has significantly increased during the for opiate raw materials is contained in the 2012 technical last 10 years, it remains concentrated in a limited number report of the Board on narcotic drugs.17 The following of countries. For example, consumption of fentanyl grew by

paragraphs are a summary of that analysis. more than 280 per cent between 2002 and 2011, but the major part of that increase was reported by high-income 228. The Board recommends that global stocks of opiate countries in North America and Europe. The increase in raw materials be maintained at a level sufficient to cover consumption of hydrocodone is almost exclusively, and the global demand for approximately one year, in order to increase in consumption of oxycodone mostly, attributable ensure the availability of opiates for medical needs in case of to the high consumption rates in the United States.

an unexpected shortfall of production, for example, caused Although a large part of the growth in consumption of by adverse weather conditions in producing countries.

morphine is also due to elevated consumption rates in the 229. In 2012, according to the information available to the United States and some European countries, increasing Board, global production of opiate raw materials rich in consumption has also been noted in many other countries morphine, as well as opiate raw materials rich in thebaine, of the world. In many regions, much remains to be done to was above the levels required to satisfy global demand. For ensure availability of opioids at levels adequate for medical 2013, Governments of producing countries are envisaging a requirements. further increase in the production of those materials.

233. With regard to the consumption levels of Global stocks of opiate raw materials rich in morphine are psychotropic substances, it is more difficult to come to expected to reach a level covering global demand for a reliable conclusions than in the case of narcotic drugs.

period of almost two years, and global stocks of opiate raw Nevertheless, it appears that more action is needed to assess materials rich in thebaine are expected to reach a level the current adequacy of the availability of psychotropic covering global demand for a period of more than one year.

substances and to promote changes, as necessary.

230. The Board has been in contact with the major 234. The analysis of the consumption levels of producing countries of opiate raw materials to request them psychotropic substances is still hindered by the lack of to ensure that their future production is maintained at a adequate data, since the 1971 Convention does not require __________________ Governments to submit data on the consumption of such 17 Narcotic Drugs: Estimated World Requirements for 2013 __________________ — Statistics for 2011 (United Nations publication,

Sales No. T.13.XI.2). 18 United Nations publication, Sales No. E.11.XI.7.

substances to the Board. The Commission on Narcotic order to overcome underconsumption and at the same time Drugs, in its resolution 54/6, encouraged all Governments prevent overconsumption. to furnish such data to INCB. In accordance with that 237. In order to support countries in estimating their resolution, over 50 Governments have started to furnish requirements, the Board and WHO have developed the consumption data for 2010 or 2011 to the Board. INCB Guide on Estimating Requirements for Substances under welcomes this development, which will enable it to analyse International Control, which was launched during the more accurately the consumption levels of those substances fifty-fifth session of the Commission on Narcotic Drugs, in in the countries and territories concerned. However, most March 2012, and was brought to the attention of all Governments, including those of some manufacturing Governments through a letter of the Board.20 The Guide is countries for which the calculated consumption levels intended to assist competent national authorities in appear to be very high and for which those levels might be identifying methods for calculating the quantities of overestimated in the absence of better data, have yet to controlled substances required for medical and scientific follow suit. The Board wishes to remind those purposes. Furthermore, the Guide provides assistance to Governments that it is in their interest to collect such data, national authorities in preparing the estimates and following the definition of consumption of narcotic drugs assessments of annual requirements for controlled contained in the 1961 Convention,19 and to provide them substances that countries are required to furnish to to national and international bodies, including INCB, to the Board.

enable the monitoring of consumption trends and the

identification of unusual or unwanted developments. 238. The Board hopes that the Guide will help Governments in their efforts to ensure appropriate 235. On the basis of the limited data available, it would consumption levels of internationally controlled substances appear that there are no major changes with regard to the for their countries. The Board is at the disposal of consumption levels of psychotropic substances. If anything, competent national authorities to support them in the use the disparities in consumption levels of psychotropic of the Guide and to provide any clarification required.

substances between countries and regions, as described in the 2010 Report of the International Narcotics Control Board (d) Activities of intergovernmental and on the Availability of Internationally Controlled Drugs:

non-governmental organizations Ensuring Adequate Access for Medical and Scientific Purposes, appear to be increasing, with most of the 239. A number of international organizations, consumption of all psychotropic substances taking place in intergovernmental bodies and non-governmental a limited number of countries. The Board has requested the organizations are undertaking activities focusing on the countries concerned to determine whether there are uneven accessibility of opioids for pain management. problems of oversupply and possible misuse and to 240. UNODC, WHO and the Union for International promote the rational use of the substances in question.

Cancer Control have developed plans for a joint initiative to enhance access to internationally controlled drugs for (c) Guide on Estimating Requirements for the relief of pain while preventing diversion and abuse. The Substances under International Control, aim of the initiative is to coordinate activities at the developed by the International Narcotics Control international level and to contribute to in-country progress, Board and the World Health Organization beginning with three pilot countries in different regions, 236. The Board has for a number of years noted with with the intention of scaling up the initiative in the years concern the global disparities in the availability of narcotic ahead. The initiative will cover various areas of activity, drugs and psychotropic substances. As impediments to including data collection; regulatory revision and reform; adequate availability of internationally controlled training on estimates and statistics for narcotic drugs; substances vary, national authorities need to recognize awareness-raising and public education; procurement and country-specific impediments and take appropriate action. distribution; community-based health care; and standards As a first step, countries should identify their actual of care in health-care facilities. The objective is to requirements for internationally controlled substances in contribute to the implementation of Commission on Narcotic Drugs resolutions 53/4 and 54/6 and the __________________ recommendations contained in the 2010 Report of the 19 See article 1, paragraph 2, of the 1961 Convention:

__________________ “For the purposes of this Convention a drug shall be regarded as ‘consumed’ when it has been supplied to²⁰The Guide is available, in all six official languages of the any person or enterprise for retail distribution, medical United Nations, on the website of the Board use or scientific research; and ‘consumption’ shall be (www.incb.org/incb/en/publications/guidelines-for-use-construed accordingly.” by-competent-national-authorities.html).

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

International Narcotics Control Board on the Availability of sector in Jamaica for the first time. In May 2012 the Internationally Controlled Drugs: Ensuring Adequate Access Ministry held a meeting on the National Strategic Plan for for Medical and Scientific Purposes. The Board welcomes the Prevention and Control of Non-Communicable

the initiative and invites Governments to support it. Diseases in Jamaica for the period 2012-2017. As a result of that meeting, the Ministry agreed to include palliative care (e) National activities services in the strategic plan, as well as to work towards 241. The Board notes that action has been taken in several developing a separate, comprehensive cancer control plan, countries to increase the level of consumption of which will consist of policies for palliative care, including internationally controlled substances, in particular opioid the use of opioids to treat cancer pain. analgesics.

245. In Nepal, health-care practitioners’ efforts to work 242. In Georgia, the National Programme for Palliative with government and industry to address the availability of Care for 2011-2015 was adopted by the parliament. The all necessary formulations of opioid analgesics have Ministry of Labour, Health and Social Affairs seeks to continued, with support from international experts. The improve the availability of opioid analgesics for outpatients. production of sustained-release morphine tablets has been In the spring of 2012, the parliament of Georgia adopted an under way since August 2012. The local production of an amended law on narcotic drugs, psychotropic substances additional formulation of morphine will ensure a more and precursors that takes into account current medical and continuous availability of all essential morphine scientific knowledge. The amendments included the formulations for patients in Nepal than was possible in the addition of a paragraph concerning the indispensability of past. These advances in opioid availability have been opioid use for medical reasons, which reflects the principle coupled with ongoing efforts to educate health-care of ensuring adequate availability of narcotic drugs for professionals about pain relief and the rational use and safe medical purposes. To facilitate the rational use of opioid handling of essential controlled medicines.

analgesics, the Ministry has agreed to support the organization of training courses for physicians who care for 246. In the Russian Federation, the Ministry of Health has patients with chronic pain. At the request of the Ministry, been working with pain-relief experts to evaluate the guidelines on chronic pain management were developed, mechanism governing the medical use of preparations along with recommendations for patients. Those guidelines containing narcotic drugs in order to improve the were adopted by the Ministry in July 2012 and all treatment of pain in the country. The lack of knowledge on medical facilities were requested to create corresponding the part of health-care professionals regarding the treatment protocols. treatment of pain has been identified as one of the main impediments to the use of opioid analgesics. Health-care 243. In Guatemala, there have been recent improvements professionals are also wary of the consequences of errors in in the availability of low-cost opioids. Previously, complying with administrative requirements for the use of inexpensive morphine was available only in injectable form narcotic drugs. The Ministry is preparing a full range of and only for patients who were hospitalized. In programmes at both the pre- and postgraduation stages of January 2012, a local pharmaceutical company obtained a training to provide health-care professionals with the licence to manufacture immediate-release oral morphine, knowledge and skills for using such medicines. The which became available at the national reference hospital Ministry is also drawing up legislation to simplify for cancer beginning in February 2012. As new opioid requirements for the prescription and administration of analgesic formulations are being made available in medical preparations containing narcotic drugs and Guatemala, the important process of educating and psychotropic substances. The new legislation would extend training physicians about how to safely prescribe opioids to the validity of prescriptions for controlled substances and treat pain was initiated in February 2012, with the facilitate access to opioid analgesics for patients released implementation of a new postgraduate course in palliative from hospitals. In 2011, the issue of palliative medical care care at the university level, which consists of over 300 hours was introduced in the federal legislation regulating the of training over nine months.

health system of the Russian Federation (art. 36 of Act 244. In 2011, the Ministry of Health of Jamaica No. 323 of 21 November 2011 on Federal Health Protection administered a survey to measure access to and availability in the Russian Federation). In 2012, new methodological of opioids at all Government hospitals and to identify the recommendations for oncologists and general practitioners storage and handling capabilities of those facilities. A need regarding palliative treatment with narcotic drugs for was identified for immediate-release oral morphine tablets, outpatients were issued by the Herzen Oncological which became available in April 2012 in the public-health Research Institute.

247. In Serbia, following the enactment of the new Law on effective only for a short time, if at all, and excessive Psychoactive Controlled Substances in early 2011, a consumption of the substances concerned continues to be governmental commission was established to monitor the noted. implementation of the new Law and to draft implementing 251. The use of psychotropic substances for medical regulations. As new opioid formulations such as purposes is indispensable, as stated in the preamble to the immediate-release morphine are being made increasingly 1971 Convention. They are useful in the treatment of a available in Serbia, palliative-care experts have consulted variety of mental and other diseases and, if properly with Government officials to clarify modern medical and prescribed and dispensed in line with the provisions of the scientific pain management prescribing standards. For 1971 Convention, will reduce human suffering and example, in early 2012, the Serbian Republic Institute for Health Insurance published an explanation allowing improve the quality of life of patients and their families. physicians to prescribe transdermal fentanyl along with 252. The Board trusts that the lessons learned from the immediate-release morphine for the treatment of activities to improve the availability of medications that are breakthrough pain and issued a new list of prescription used in the treatment of pain will help to support rational medicines allowed to be prescribed. In 2012, the use of psychotropic substances in all countries and regions. prescription of methadone for the treatment of severe In addition, the Board recommends that Governments cancer pain was also allowed for the first time. continue to (a) collect reliable data on the consumption of 248. The Board acknowledges these national efforts to psychotropic substances and share them with the Board to improve the availability of controlled substances for allow accurate analysis of their consumption levels; medical and scientific purposes. Countries where health (b) investigate whether there are other medications administrations face similar problems may use them as containing substances that are not internationally examples of possible remedial measures. The descriptions controlled that are used in their territories to treat mental above of positive developments in some countries should and other diseases commonly treated with psychotropic not obscure the fact that enormous discrepancies exist substances, and determine whether their use might have an between countries with regard to the accessibility of impact on the consumption of internationally controlled internationally controlled substances. INCB underlines substances; (c) taking into account those findings to the once again the need for WHO and the international extent possible, compare their consumption levels with community to support efforts of countries concerned those in other countries and regions with a view to to improve availability. At the same time, countries need identifying inadequate or excessive consumption; and to raise awareness of the risk of abuse of those (d) take the appropriate actions to promote the rational use substances and to ensure the prevention of their of psychotropic substances in their country. diversion into illicit markets.

(g) Replenishment of medical kits on board ships (f) Need for targeted action for psychotropic docked in foreign territorial waters substances 253. The Board was asked by the competent authorities of 249. The Board is not aware of any intergovernmental, some countries to clarify the legal rules applicable to the regional or national initiatives in the countries and regions replenishment of medical kits on board ships docked in where access to psychotropic substances is low to promote foreign territorial waters under the international drug adequate availability and accessibility of medications control conventions. Ships are, in principle, expected to containing psychotropic substances. Most actions taken to restock their medical kits in the country in which they are improve the availability of controlled substances have registered. However, in some situations, it may be necessary focused heavily or exclusively on opioid analgesics. to use the narcotic drugs or psychotropic substances contained within the medical kits during the journey to 250. Similarly, among countries where consumption of treat members of the crew or passengers. This would psychotropic substances has been very high, some require the replenishment of the ship’s medical kit prior to Governments showing high consumption levels have not its return to its country of registry and possibly while it is yet taken the necessary actions to address their apparent docked in territorial waters of a foreign State.

excessive use and to promote rational use of those substances. In addition, even when the Board has been 254. When the ship is docked in foreign territorial waters, informed of action taken by Governments to prevent given that the resupply of the controlled substance would inappropriate use of psychotropic substances, it would take place entirely within the jurisdiction of the foreign appear that such action has been effective in only a few port in which the ship is docked, the conditions under countries; in most other countries, the action has been which it would be undertaken would be those set forth in

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

the national legislation of that State. For the replenishment conditions to be determined by a regulation, for the of first-aid kits, the crew of the ship would have to comply purpose of non-medical use. with regulations related to the purchase or acquisition of 258. The Board wishes to point out that such an initiative, narcotic drugs and psychotropic substances valid in the if it were to be implemented, would be contrary to the territory in which such a purchase or acquisition takes provisions of the international drug control conventions.

place. Once these substances have been obtained and The 1961 Convention and the 1988 Convention require all placed in the ship’s medical kit, article 32, paragraph 1, States parties to limit the use of narcotic drugs, including of the 1961 Convention and article 14 of the cannabis, exclusively to medical and scientific purposes. 1971 Convention, which allow for the carriage of controlled Non-compliance by any party with the provisions of the substances in medical kits across territorial waters, would international drug control treaties could have far-reaching apply, allowing the ship to continue its onward journey, negative consequences for the functioning of the entire while it would be the responsibility of the country of international drug control system. registry to prevent the improper use of those substances.

259. The Governments of those States, which are parties 255. The Board trusts that all countries will facilitate the to the international drug control treaties, have replenishment with narcotic drugs and psychotropic demonstrated over many years their commitment to the substances of medical kits of ships docked in their aims and object of the international drug control territorial waters to ensure the availability of those drugs conventions, extending their valuable cooperation to the and substances on those ships in case of their need for Board in the implementation of the treaties. The Board medical use. Adequate control measures should be applied stands ready, in line with its mandate, to continue a dialogue with all Governments in order to promote to prevent any misuse of that procedure for the diversion of universal compliance with the provisions of the controlled substances.

international drug control treaties.

E. Special topics 2. New psychoactive substances

260. The term “new psychoactive substances” denotes

1. Global drug policy debate substances of abuse that are not subject to international 256. The Board takes note of recent calls by some control measures but that have effects similar to those of controlled drugs. It is a generic term that includes Governments for a review, by States Members of the United emerging drugs of abuse sometimes referred to as “designer Nations, of the approach to the global drug problem drugs”, “herbal highs”, “research chemicals” and “legal hitherto adopted by the international community, with the highs”. It also includes substances that are not necessarily aim of adopting a balanced approach in enhancing the new but which have recently been increasingly abused.

effectiveness of the strategies and instruments used by the world community in confronting the challenge of the drug 261. In the past several years, the warnings about the problem and its effects. The Board welcomes and supports dangers posed by new psychoactive substances have initiatives by Governments aimed at further enhancing multiplied. Public health officials and drug control international drug control, undertaken in conformity with stakeholders have been raising awareness of the emergence the international drug control conventions. of new psychoactive substances which are outside the scope of international control for some time. In its annual report 257. At the same time, the Board notes with concern for 2010, the Board warned Governments of this growing recent declarations and initiatives reported from some threat and recommended that they take concrete steps to countries in the Western hemisphere proposing the monitor the emergence of new psychoactive substances legalization of the possession of narcotic drugs and with a view to adopting national control measures intended psychotropic substances for purposes other than medical or to stem the manufacturing, export, import, distribution scientific use, and the decriminalization of the cultivation and sale of these substances.

of cannabis plant for non-medical use. In this regard, the Board notes with deep concern a proposal by the 262. The Board notes that the international community Government of Uruguay before the Parliament of Uruguay has taken notice of the problem and has turned its attention that would allow the State to assume control over and to identifying ways to address it effectively. The Board also regulation of activities related to the importation, reminds Governments that pursuant to the international production, acquisition of any title, storage, sale and drug control conventions, States parties are explicitly distribution of cannabis or its derivatives, under terms and authorized to adopt whatever national control measures

they deem necessary in addition to those existing at the prevent the manufacturing of new psychoactive substances international level. In this regard, the Board acknowledges on their territory. the adoption in many States of legislative and regulatory 266. The Board notes that several States have established measures aimed at establishing mechanisms to address the early warning systems for new psychoactive substances, public health dangers caused by the emergence of new which have been pivotal in national efforts to identify and psychoactive substances. move to control new psychoactive substances. With respect to the regional level, the Board acknowledges the leading 263. In March 2012, the Commission on Narcotic Drugs role taken by EMCDDA on the question of new adopted resolution 55/1, entitled “Promoting international psychoactive substances, particularly through its cooperation in responding to the challenges posed by new establishment of a European early warning system. The psychoactive substances”, in which the Commission Board encourages those States that have not yet done so to encouraged States to take various decisive individual and consider establishing early warning systems and to collective actions to deal with the threat posed by new establish mechanisms for the sharing of obtained psychoactive substances. Through that resolution, the information with other States and with multilateral Commission recognized that the capacity of States to stakeholders, including WHO, INTERPOL, UNODC and effectively deal with new psychoactive substances is a INCB. The Board urges those multilateral stakeholders to function of their ability to identify those substances in a continue to examine specific aspects of the problem of new timely manner, allowing for preventive measures to be psychoactive substances and to disclose their findings to taken, and, given the global nature of the problem, to share the international community. The Board also acknowledges that information with other States and relevant the particularly important role of WHO in monitoring the stakeholders in order to make concerted action possible. emerging abuse of uncontrolled substances and recommending scheduling when it deems appropriate.

264. In recent years, there has been an unprecedented increase in the emergence of new psychoactive substances 267. The Board particularly welcomes efforts made by not within the purview of the international drug control UNODC in response to Commission on Narcotic Drugs conventions. The most common categories of these drugs resolution 55/1 aimed at collecting information about new have been synthetic cannabinoids, synthetic cathinones, psychoactive substances, including through the elaboration piperazines and phenethylamines. According to EMCDDA, and distribution to national laboratories of a questionnaire the number of notifications of new psychoactive substances on the topic. The Board encourages UNODC to act as a received by the Centre averaged five per year from 2000 to focal point on the question of new psychoactive substances 2005. In 2011, the figure had increased to 49, meaning that and to gather information from States regarding new a new psychoactive substance was put on the market almost substances of abuse and measures adopted to address the problem. The Board also encourages States to continue to every week on average. Although it is impossible to know support ongoing UNODC activities regarding new the exact number of new psychoactive substances on the psychoactive substances such as the global Synthetics market, experts have advanced estimates running well into Monitoring: Analysis, Reporting and Trends (SMART) the thousands. As abuse of these substances has increased, programme.21 so too has the number of users who have experienced grave health consequences or even suffered death due to 268. A particular challenge to Government efforts to place exposure to them. In many countries, use of such new psychoactive substances under national control is the substances has manifested itself in marked increases in difficulty of identifying those substances in a timely emergency room visits for adverse health reactions caused manner, given the rapid succession of new substances by the ingestion of new psychoactive substances, as well as entering the market, their inconsistent chemical in significant increases in calls to poison treatment centres. composition and the lack of technical and pharmacological data and reference material, as well as insufficient forensic 265. The Board encourages all Governments to establish and toxicological capacity on the part of some States. The formal mechanisms aimed at collecting information Board acknowledges the recommendation contained in regarding new psychoactive substances, including Commission on Narcotic Drugs resolution 55/1 that information regarding their chemical make-up, patterns of UNODC should continue to provide technical assistance to abuse, marketing techniques, trade names, distribution and States, upon request, in order to assist them in bolstering diversion methods and countries of origin. There is the capacity of their institutions to deal with the problem of mounting evidence suggesting that many new psychoactive substances are being manufactured in China and India. The __________________

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

new psychoactive substances. The Board also encourages containing those substances that are based in their closer cooperation between States on a bilateral and territory, as well as such websites based in other countries, multilateral level, as well the provision of technical and to share information in that regard with the competent assistance where required. authorities of countries used as a base for such websites.

The Board invites Governments to apply the 269. In order to raise awareness of the public health recommendations contained in its Guidelines for dangers associated with many new psychoactive substances Governments on Preventing the Illegal Sale of Internationally and, in particular, to dispel the misconception that those Controlled Substances through the Internet²⁴to the extent to substances are safe since they are not controlled, the Board which they are relevant to addressing the sale of new invites all Governments to include new psychoactive psychoactive substances on the Internet.

substances in the scope of all existing prevention programmes, and, if deemed necessary, to design specific 272. In addition to the measures listed above, States have prevention initiatives targeting this phenomenon. The taken various legislative and regulatory action to reduce the Board reminds States that it is impossible to gauge the supply of new psychoactive substances on their territory. extent of the abuse of new psychoactive substances without 273. Traditionally, national attempts to address new comprehensive data on prevalence of abuse, populations psychoactive substances have been primarily concentrated specifically at risk and patterns of abuse, and encourages within the ambit of drug control legislation. Given the Governments to include new psychoactive substances in speed with which new substances are designed, their national drug abuse surveys and to effectively manufactured and put on the market, drug syndicates are disseminate the findings of those studies to all often able to outpace existing controls by staying one step stakeholders, as well as to the public, as an additional means of awareness-raising. ahead of national legislative and regulatory norms. Further exacerbating this problem is the fact that the onus of 270. The Board also encourages States to cooperate in the identifying and evaluating the potential for harm of new development of chemical reference standards aimed at psychoactive substances generally falls upon States, and in identifying new psychoactive substances and to make those many cases no action can be taken to control the substance standards available to drug-testing laboratories as until that process has been concluded.

necessary. Where such reference samples are not available, the Board encourages States to share analytical data. The 274. The adoption of traditional national control Board is aware that in many cases, the work of forensic measures is often a lengthy and onerous process which, in laboratories in identifying new substances is hampered by many cases, has shown itself to be ill-suited for use in obstacles to the availability of test and reference samples of addressing such a dynamic phenomenon. In recognition of internationally controlled substances. INCB encourages this fact, States have increasingly developed novel States to consider the recommendations made by the Board approaches to combating the problem of new psychoactive in its Guidelines for the Import and Export of Drug and substances by supplementing traditional drug control Precursor Reference Standards for Use by National Drug measures through an innovative combination of emergency Testing Laboratories and Competent National Authorities²² control powers, consumer protection measures and food and the “Additional courses of action in support of the and drug safety mechanisms in order to expedite the implementation of the 2007 INCB Guidelines for the application of control measures to new substances.

import and export of drug and precursor reference standards for use by national drug testing laboratories and 275. Among the methods used by States to address the competent national authorities”,23 which are available on emergence of new psychoactive substances have been the the Board’s website. use of “generic” and “analogue” scheduling. In the case of analogue scheduling, a substance that is both structurally 271. A further obstacle has been the distribution of new similar and has a similar or greater psychoactive effect as a psychoactive substances through the Internet. The Board substance already controlled is deemed to be a controlled encourages Governments to monitor the activities of substance analogue and as such is also considered to be websites selling new psychoactive substances and products controlled. Under generic scheduling measures, particular __________________ variations of a core molecular structure are to be 22 United Nations publication, Sales No. M.08.XI.6 controlled. Thus, each substance does not have to be dealt (available from www.incb.org/documents/Narcotic- Drugs/Guidelines/reference_standards/NAR_Guidelines with individually, and new types of substances can be _reference-standards_en.pdf ). controlled through these approaches. However, the

23 Available from www.incb.org/documents/Narcotic- __________________ Drugs/Guidelines/reference_standards/Additional_

courses_of_action_ref_standards_EN.pdf. 24 United Nations publication, Sales No. E.09.XI.6.

analogue approach requires the availability of States and international organizations to continue to work pharmacological data to be able to demonstrate the together in sharing information, developing common similarity of psychoactive effects. strategies and exchanging best practices. In the pursuit of its mandate, the Board stands ready to assist Governments.

276. In seeking to protect the public from potentially harmful substances, States have also made increasing use of

3. Abuse of pharmaceutical preparations

“emergency scheduling” procedures that allow them to take

containing narcotic drugs or psychotropic

swift action to remove a substance from the market while a

substances

decision is pending on whether permanent control measures are to be applied to that substance. The adoption 281. Over the years, the Board has repeatedly drawn the of such emergency measures has been highly effective in attention of Governments to the increasing abuse of ensuring that the public is not unnecessarily put at risk prescription drugs containing controlled substances. In its before a comprehensive evaluation of the substance can be annual report for 2009, in particular, the Board devoted a undertaken by national authorities. special topic to this problem to highlight the need for Governments to give it increased attention and to 277. Another approach taken by States to limit the public introduce countermeasures. Since 2009, the abuse of health dangers posed by some new psychoactive substances prescription drugs has continued to spread in all regions of has been to subject such substances to requirements similar the world, and is posing serious health and social to those imposed upon manufacturers of medications. This challenges in some countries. In North America and South has meant that in order for a new psychoactive substance to be deemed to be legal and obtain market authorization, it and South-East Asia, as well as some countries in Europe must have gone through a rigorous approval process and South America, prescription drug abuse has increased backed up by toxicological data, medical trials etc. States substantially in recent years. In the United States, for having resorted to this type of control measure have example, prescription drug abuse is more prevalent than reported that the costs associated with the approval process the abuse of any other internationally controlled substance have acted as an effective deterrent for manufacturers of except cannabis. In Germany and the Russian Federation, new psychoactive substances. sedatives and tranquillizers containing benzodiazepines ranked the second most commonly abused substance 278. In many countries, recourse has been made to group. The most abused substances that have been reported provisions under consumer and health protection laws with include opioids containing buprenorphine, codeine, respect to requirements for clear disclosure of ingredients, hydrocodone, methadone and oxycodone, sedatives and labelling and instructions for use, leading to the tranquillizers containing benzodiazepines, barbiturates or confiscation of contravening products, as well as the GHB, and stimulants.

closure of retail outlets selling them.

282. The abuse of prescription drugs by injection, which 279. As noted above, the legal framework established by increases the risk of HIV, hepatitis B and hepatitis C the international drug control conventions provides the infection, has also been reported by many Governments.

possibility for States to adopt national control measures This problem is noted particularly in South Asia, where the beyond those mandated at the international level. The most commonly injected prescription drugs include a choice by each State of what type of measures to apply is variety of benzodiazepines and buprenorphine. Health-care informed by the real situation on the ground that such coverage among injection drug users in the region is low; measures are meant to address, and is also governed by the this increases the likelihood of drug abusers sharing their legal and regulatory norms and structures in place. While injection equipment.

the Board acknowledges that each State must pursue the adoption of measures tailored to its specific situation, it 283. One particular concern of the Board is the increase in remains convinced that in identifying appropriate recent years in the reported abuse of prescription drugs responses to the emergence of new psychoactive containing psychotropic substances. According to a recent substances, States may benefit from an exchange of best CICAD report on drug abuse in the Americas, the past year practices on the matter.

prevalence of the abuse of tranquillizers obtained without a 280. A global problem such as the proliferation of new prescription among secondary school students was higher psychoactive substances requires global solutions. The than 6 per cent in Bolivia (Plurinational State of), Paraguay Board notes the efforts that have been undertaken at the and Colombia. In Singapore, the Government has reported national, regional and international levels to find effective a large increase in the abuse of sedatives and tranquillizers ways to deal with this imposing problem, and encourages containing benzodiazepines. Increased deaths related to the

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

abuse of psychotropic substances have been reported by a concern in Africa, where the availability of prescription number of countries. drugs on unregulated markets outside the control of the health authorities appears to be a serious problem. As the 284. While more and more Governments have become Board outlined in its annual report for 2009, Governments aware of the increased abuse of prescription drugs should include prescription drugs containing controlled containing psychotropic substances, the problem remains substances in national drug abuse surveys to obtain largely underreported worldwide, compared to the abuse of information on the nature and extent of the abuse. In some prescription drugs containing narcotic drugs. Furthermore, countries where this has already been done, the questions the Board is concerned that the general public, in particular on the abuse of prescription drugs in the surveys tend to be youth, are not adequately informed about the damaging unspecific and do not lead to sound conclusions. In some effects of such abuse.

other countries, queries about the abuse of psychotropic 285. As with the abuse of prescription drugs in general, substances have been omitted in such surveys, perhaps the abuse of prescription drugs containing psychotropic owing to the perception that the high abuse of opioid substances has gained popularity, owing mainly to the fact analgesics is a greater concern. In all such cases, national that such abuse is less stigmatized than the abuse of illicitly surveys should be improved by making the questions manufactured drugs, the perception that such medications comprehensive as well as specific regarding the type of can be obtained legally (for example, from health-care substance abused. professionals) and the mistaken belief that the abuse of 289. Secondly, although there has been significant such substances is not damaging to health.

improvement in some countries in raising awareness about 286. Another concern of the Board relates to the role of the harmful effects of prescription drug abuse, many health-care professionals: they may intentionally or people, including from the medical profession, are still not unintentionally contribute to the problem of prescription aware that the abuse of prescription drugs containing drug abuse in different ways. According to the latest United controlled substances can be as dangerous as the illicit use States National Survey on Drug Use and Health, the of other drugs such as heroin and cocaine. Therefore, it is majority of prescription drug abusers who obtained such necessary for Governments to formulate and implement preparations from a friend or relative indicated that the effective prevention strategies; such strategies should target friend or relative had obtained them using a legitimate the general public and medical professionals, who need to prescription. Research has indicated that the training that be better educated about the dangers associated with health-care professionals have received in prescribing and prescription drug abuse. Health authorities and dispensing controlled substances and identifying substance professional organizations should develop guidelines and abuse was insufficient in many countries. In addition, the codes of conduct and enhance training programmes for dispensing of prescription drugs by pharmacists without health-care professions, with the aim of promoting rational the required prescriptions is a factor in sustaining the illicit prescription and dispensation and reducing abuse of use of prescription drugs in some regions, such as prescription drugs. South Asia.

290. In some countries, prescription drugs that have high 287. In response to the challenges posed by prescription rates of abuse have been removed from the market or drug abuse, many Governments have taken action to replaced with variants less prone to abuse. While such address this growing problem. For instance, the approaches can be part of an effective strategy to tackle the Government of Singapore requires medical practitioners to abuse of certain prescription drugs over the longer term, report information such as the duration of treatment care needs to be taken when applying such approaches periods and the dosage and quantities of prescription drugs because they might limit the availability of those substances that are prescribed to suspected drug addicts. The on the licit market. In addition, dependent abusers can Governments of Germany and the United States have switch to other forms of abuse to substitute for the formulated targeted action plans to monitor and reduce substance or substances they were abusing previously, and prescription drug abuse. However, more needs to be done. the substitutes may be even more harmful. Therefore, a balanced approach is needed to prevent abuse while at the 288. The crucial first step is to improve knowledge about same time ensuring the availability of prescription drugs the nature and extent of the abuse of prescription drugs, so for licit purposes.

as to devise a targeted response. Although a number of studies and research papers regarding prescription drug 291. Last but not least, to tackle the problem of abuse have become available recently, knowledge about this prescription drug abuse, measures need to be taken to problem in most countries remains extremely limited. The prevent the illicit supply of prescription drugs. In addition lack of information on the extent of abuse is a particular to diversion from licit channels, the clandestine

manufacture of pharmaceutical preparations containing from schools or parents to prescribe such substances to controlled substances has been uncovered in some pupils and students without a proper diagnosis of ADHD. countries. This suggests that the abuse of certain ADHD was previously considered to be mainly a problem prescription drugs has become so widespread that of schoolchildren; however, ADHD in pre-school children traffickers are seeking new methods to meet the demand. and in adults has also been increasingly diagnosed and Therefore, the Board urges all Governments to take treated with stimulants such as methylphenidate. measures to prevent the diversion and illicit manufacture of 294. Partly as a consequence of the developments prescription drugs, as an effective way to prevent abuse.

described above, global use of the substances used in the treatment of ADHD has increased during the past two 292. Some psychotropic substances, all of them central decades, although there have been changes in the use levels nervous system stimulants, are used mainly in the of the various substances mentioned above. Whereas global treatment of attention deficit hyperactivity disorder manufacture and use levels of amphetamines increased in (ADHD), a mental and behavioural disorder that usually the 1990s, when they were consistently much higher than results in learning problems, among many others.

the manufacture and use of methylphenidate, they have Methylphenidate is the most widely known and prescribed followed a downward trend since about 2000. The substance, and in some countries the only substance, used manufacture and use of pemoline were also much higher in for such treatment. Dexmethylphenidate, the more potent the 1990s and have declined since. In contrast, the global stereoisomeric form of methylphenidate (which is manufacture of methylphenidate, which increased more controlled under the 1971 Convention), is now increasingly than tenfold, from 4.2 tons in 1992 to 45.2 tons in 2011, and imported and used in some countries. Furthermore, in 2009 surpassed the combined global manufacture of all amphetamine and dexamphetamine, alone or in amphetamines, continues to grow. The calculated global combination products, are used for the treatment of consumption increased during the same period from ADHD. All three substances mentioned above are included 4.2 tons (139 million defined daily doses for statistical in Schedule II of the 1971 Convention, since they are purposes (S-DDD)) to 51 tons (1.5 billion S-DDD). While considered to be of little to moderate therapeutic usefulness the Board has no direct information on the levels of use of and their liability to abuse constitutes a substantial risk to many stimulants such as lisdexamfetamine that are not public health. On a much smaller scale, pemoline, a internationally controlled, there are signs that the total substance included in Schedule IV of the 1971 Convention, manufacture and use of central nervous system stimulants has also been used in the treatment of ADHD. More for the treatment of ADHD are not levelling off.

recently, lisdexamfetamine, a prodrug of dexamphetamine (after consumption it metabolizes in the body to 295. The high demand in the United States, where the use dexamphetamine) that is not under international control, of methylphenidate and other substances for the treatment has been developed. That substance is considered to be less of ADHD is heavily advertised, including directly to liable to abuse than amphetamines and methylphenidate, potential consumers, and is promoted at schools, has been and its use in the treatment of ADHD is spreading in some the major driving force for the manufacture and use of countries. A number of other substances that are not methylphenidate. The United States has traditionally been under international control are also used in the treatment the major manufacturer and user of methylphenidate, in of ADHD. addition to being the major importer of amphetamines used in the manufacture of preparations to treat ADHD.

293. The diagnosis of ADHD, in particular in children, is In that country, the levels of calculated consumption25 time-consuming and should follow complex assessments of of methylphenidate increased steadily and sharply medical, developmental and educational parameters to exclude the possibility that the behavioural and learning __________________

consumption of psychotropic substances. In 2011, the treatment with the help of central nervous system Commission on Narcotic Drugs, in its resolution 54/6, stimulants, primarily in children, started to grow requested Governments to submit consumption substantially in North America about two decades ago, and statistics for psychotropic substances to the Board to that growth has subsequently spread to many countries and enable it to evaluate the availability of psychotropic substances in countries and regions. Some Governments regions. Since consumption of the substances used to treat have started to submit such statistics; however, so far the ADHD improves academic performance and alleviates data received are not sufficient for the comparison of behavioural problems, there have been reports of pressure statistics between countries and years.

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

from 1.5 S-DDD per 1,000 inhabitants per day in 1992 the methylphenidate found in illicit markets is believed to

to 10.8 S-DDD per 1,000 inhabitants per day26 in 2011. be diverted from domestic distribution channels.

296. The use of methylphenidate for the treatment of 299. Many methods for the diversion of those ADHD has spread to a number of other countries. In 1992, preparations were identified. For example, methylphenidate the share of the United States in the total calculated use is among the substances most often obtained through of methylphenidate was 86 per cent; in 2011, that illegal Internet pharmacies. In several countries adolescents figure dropped to 69 per cent. Whereas in 1992 a total and young adults reported little difficulty in obtaining of 63 countries and territories reported use of preparations containing methylphenidate or amphetamines methylphenidate, in recent years over 100 Governments from friends or schoolmates. Furthermore, schools have have reported such use. In 2011, Canada and Iceland, for been broken into and medication supplies stolen. In some the second consecutive year, showed higher calculated per countries there were reports that methylphenidate could be capita consumption levels than the United States. Other obtained without a prescription, in contravention of the countries in Europe and Oceania27 that show very high provisions of the 1971 Convention. At least one criminal rates of per capita consumption of methylphenidate are also network was identified that was involved in falsifying among the countries with very high per capita orders for preparations containing methylphenidate.29 consumption levels of amphetamines.

300. The Board recognizes the usefulness of stimulants in 297. It should be noted that about half of the countries the treatment of ADHD when prescribed on the basis of and territories in the world do not report any use of the careful and appropriate diagnosis and proper treatment psychotropic substances that are typically used in the evaluation. Nevertheless, the Board has repeatedly treatment of ADHD. In particular, many countries where expressed its concern about the high level of consumption the population is much younger than in the countries of methylphenidate and the other substances used in the reporting high consumption levels of stimulants used treatment of ADHD, which has led to the widespread in ADHD, and that presumably would have a high rate diversion and abuse of pharmaceutical preparations of ADHD, hardly use such stimulants. containing those substances. The Board has requested the countries concerned to ensure that the control measures 298. The increase in the availability and use of the foreseen in the 1971 Convention are applied to the substances used to treat ADHD, in particular stimulants listed in Schedule II of that Convention and to methylphenidate, has been accompanied by frequent take additional measures, as necessary, to prevent both the reports of diversion and abuse of the pharmaceutical diversion from licit distribution channels and the abuse of preparations containing those substances from licit preparations containing that substance.30 The Board has distribution into illicit channels, in particular in countries also stressed on numerous occasions the importance of where consumption levels have been high. The education and training for health professionals on the preparations are typically abused by two groups:

rational use of psychoactive drugs, to prevent the abuse of (a) students and pupils who want to improve their prescription drugs. In this connection, the Board noted academic performance and who seem to ignore the health that the significant increase in the use of stimulants for risks involved in the use of such substances without ADHD treatment in many countries could be attributed to medical supervision, and (b) abusers of amphetamine-type possible overdiagnosis and overprescription.

stimulants who crush and subsequently snort, dissolve or inject the substances in question, such as methylphenidate, 301. Diversions of methylphenidate and other substances or mix them with street drugs to create what is called a used in the treatment of ADHD, direct advertising to the “speedball”. In the United States in the mid-1990s, the levels general public to promote their use and wide public of abuse of substances that are used to treat ADHD were dissemination of information about the misuse and abuse not less than the abuse levels of stimulants that were illicitly of such substances, as well as the sources where they can be manufactured.28 Whereas most other amphetamine-type obtained, have helped to create an illicit market for stimulants have been obtained from illicit manufacture, all preparations containing such substances. The Board is therefore concerned about the unabated increase in __________________ consumption of methylphenidate in a number of countries.

26 Since 2010, statistical data on consumption were reported by the United States. The reported data __________________ confirm excessively high consumption levels.

Inadequately controlled supplies of those substances at sites x Stimulants such as methylphenidate and such as schools, private homes and illegal Internet phentermine pharmacies, as well as the continued lack of awareness on x Many sedatives and tranquillizers (certain the part of potential abusers about the health risks benzodiazepines and barbiturates, and GHB).

associated with the abuse of those stimulants, may lead to increased diversion and abuse. Diverted pharmaceutical preparations containing narcotic drugs and psychotropic substances are frequently abused in 302. The Board therefore reiterates that Governments the countries of diversion. However, they are also often should closely monitor the consumption levels of all smuggled from the countries where they were diverted to stimulants that are used in the treatment of ADHD and other countries and regions where they are abused, as ensure that they are prescribed in accordance with sound reported by a number of countries. For instance, diverted medical practice, as required under article 9, paragraph 2, preparations containing buprenorphine were smuggled of the 1971 Convention and in line with the rational use of from France into Mauritius, where the abuse of psychoactive drugs, as recommended by WHO. The buprenorphine is a significant concern. competent authorities of the countries concerned should 305. Governments are increasingly aware that further increase their vigilance with regard to the diversion pharmaceutical preparations continue to be diverted to of, trafficking in and abuse of stimulants in Schedule II feed the illicit market, yet knowledge about how those used for the treatment of ADHD. Where necessary — for drugs are being diverted remains limited. Of the example, at schools — safety measures for storage and 65 Governments that have returned the 2011 annual report distribution should be enforced. Health professionals questionnaire, 25 Governments indicated that they had prescribing substances for the treatment of ADHD and seized pharmaceutical preparations containing narcotic health authorities should advise the general public, drugs and psychotropic substances; however, only students and, in particular, parents of young patients of the 7 Governments could identify the source of supply or risks and consequences of the abuse of such substances.

methods of diversion. Lack of knowledge about the The Board calls further on all Governments to inform it of diversion methods makes it difficult to devise targeted any new development with regard to the diversion of, countermeasures. trafficking in and abuse of those substances.

306. On the basis of information available to the Board,

4. Diversion of pharmaceutical preparations the diversion of pharmaceutical preparations containing controlled substances continues to occur mainly in the

containing narcotic drugs or psychotropic

domestic supply chain. While such diversion appears to be

substances

a problem in many countries, it is most prominent in 303. Reported seizures of pharmaceutical preparations countries where either the national legislation or its containing controlled substances and the reports of implementation is weak. increasing abuse in many countries and regions (see 307. Diversion is often facilitated knowingly or paras. 281-302 above) prove that these preparations unknowingly in the health-care sector, for instance, continue to be readily available on the illicit market. Unlike through unethical practices of health-care professionals, the case of heroin, cocaine and amphetamine-type such as prescribing controlled substances in a manner that stimulants, which are well known to be clandestinely is not medically appropriate. The role of some manufactured, the illicit manufacture of pharmaceutical pharmaceutical companies is also important in this regard preparations containing controlled substances has rarely when they boost sales by offering incentives to medical been reported, indicating that their supply has been practitioners for promoting their products. Pharmacies are originating primarily from diversion from licit domestic another important source of diversion for pharmaceutical distribution channels.

preparations containing controlled substances.

304. The most commonly diverted pharmaceutical Preparations that require a prescription are obtained in preparations contain the following: many countries illicitly from pharmacies with or without prescriptions, sometimes owing to a lack of qualified x Strong analgesics such as fentanyl, hydrocodone, pharmacists in those pharmacies. For example, according morphine and oxycodone to a report of UNODC, in South Asia significant quantities x The substances buprenorphine and methadone of pharmaceutical preparations are diverted from licensed which are mainly diverted from substitution and unlicensed pharmacies both with and without treatment prescription.

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

308. Furthermore, pharmaceutical preparations hospitals and doctors’ offices was the primary method of containing controlled substances are often diverted by diversion for preparations containing fentanyl, patients. The sale of legitimate prescriptions to benzodiazepines and barbiturates such as phenobarbital. unauthorized persons, forgery of prescriptions, “doctor 312. Pharmaceutical preparations that are exempt from shopping” using false identification and obtaining drugs the prescription requirement under the international drug from friends are indicated by Governments as being the control treaties, such as cough syrup containing codeine, major methods of diversion. In some cases, drug abusers have often been targeted by traffickers, since they are easily misuse prescriptions from doctors by making repeated available in large quantities for abuse or use in the illicit purchases from multiple pharmacies using a single manufacture of other drugs. For instance, in the Russian prescription (“pharmacy shopping”). Federation, codeine preparations that were exempt from the prescription requirement were found to be used in the 309. In recent years, illegal Internet pharmacies and mail illicit manufacture of desomorphine, a substance that has and courier services have flourished as important channels been much abused in that country.

for diversion, because shipments are difficult to track and the sheer volume of international mail makes it impossible 313. The Board is aware that some Governments have to screen every package. Benzodiazepines appear to be the implemented targeted measures to address the specific substances under international control that are most challenges posed by the diversion of pharmaceutical commonly ordered from illegal Internet pharmacies. There preparations containing controlled substances in their is another related concern: the majority of the drugs country, or are planning to do so. For example, in the supplied by illegal Internet pharmacies may be counterfeit. United States, prescription drug monitoring programmes have been established in 35 states to track controlled 310. Since 2009, the Board has been collecting substances prescribed by authorized practitioners and information on the smuggling of internationally controlled dispensed by pharmacies. In India, where pharmacies were substances by mail in response to the request by the found to be frequent points of diversion of pharmaceutical Commission on Narcotic Drugs (resolution 50/11). To preparations destined to feed the illicit market in the enable the Board to fully assess trends relevant to this issue, subregion of South Asia, a programme to monitor the Governments are requested annually to provide the Board distribution of pharmaceutical preparations to vulnerable with information on all seizures of pharmaceutical areas close to international borders, as well as an online products containing internationally controlled substances prescription monitoring system is planned. In Australia and sent through the mail, whether ordered via the Internet or China, law enforcement actions against illegal Internet not, and add information regarding the use of the Internet pharmacies have been intensified, leading to the in the relevant transactions, if possible. The Board notes dismantling of a number of illegal online pharmacies and that, while the number of responses received has increased significant seizures of diverted preparations containing since 2009, several countries with major experience in the controlled substances. In June 2012, the Russian Federation control of narcotic drugs and psychotropic substances introduced a prescription requirement for the purchase of smuggled by mail did not submit data to the Board, which any codeine preparation in order to reduce the diversion of makes a full analysis of trends difficult. The Board such preparations.

therefore reminds all Governments, pursuant to Commission on Narcotic Drugs resolution 50/11, to submit 314. The Board believes that preventing the diversion of to the Board the form entitled “Notification on seizures of pharmaceutical preparations containing controlled internationally controlled licit substances smuggled substances requires a combination of actions to respond to through the mail, including those ordered via the specific methods of diversion, as shown in the examples

Internet”,31 which is sent every year to all Governments. above. Strengthening regulatory control measures and building up the capacity of law enforcement authorities so 311. Theft from hospitals and warehouses has also been a that they are fully aware of the problems associated with method of diversion in many countries. For instance, in the diversion of prescription drugs, are essential. Where Canada between 2009 and 2011, over 3 million tablets were appropriate, Governments should introduce or expand diverted, with over 70 per cent having been stolen. Most of programmes to monitor the movement of prescription the stolen tablets contained opioids such as oxycodone, drugs. New legislation might have to be adopted. For hydromorphone and morphine, substances with a high example, the sale of internationally controlled substances potential for abuse. In the Russian Federation, theft from by Internet pharmacies should be prohibited. It is equally __________________ important for Governments that experience problems of diversion of pharmaceutical preparations to carry out 31 Available from www.incb.org/incb/en/narcotic-drugs/Yellowlist_Forms/forms.html. studies of the domestic supply chain, from manufacture or

import of the preparations containing controlled upon all Governments to implement those resolutions substances to the point of their retail distribution, in order without delay. In 2008, the Board sent a questionnaire to all to ascertain the points that are most vulnerable to Governments requesting information on the specific legal exploitation by traffickers. In addition, the origin of seized or administrative measures adopted pursuant to preparations should be investigated by law enforcement Commission resolution 49/6, including, in particular, authorities to identify their sources and points of diversion. information on measures to control imports and exports In this connection, the sharing of information and of ketamine. The Board received information from cooperation between the law enforcement authorities of the 104 countries and territories. Of those, over 50 per cent countries concerned is needed to investigate the smuggling reported that ketamine had already been placed on of diverted pharmaceutical preparations.

the list of substances controlled under national 315. Furthermore, measures are needed to reduce the legislation, pursuant to Commission on Narcotic Drugs abuse of diverted pharmaceutical preparations (see resolution 49/6. With regard to the control of licit paras. 281-291 above), since without such abuse there international trade in ketamine, 59 countries and territories would be no diversion of those preparations. In this informed the Board that they required import and export connection, awareness-raising programmes should be authorizations for ketamine. conducted for the health-care professions, targeting the 319. The Board has published, on a secure page of its legal and ethical aspects of prescribing and dispensing website, information on the requirements for import and preparations containing controlled substances. Last but not export authorizations for ketamine in individual countries, least, Governments should make every effort to ensure that measures to strengthen control of the supply and with a view to assisting trading countries in rapidly distribution of controlled substances should never verifying the legitimacy of individual trade transactions jeopardize the availability of those substances for medical involving that substance without unduly delaying licit treatment. trade. The Board calls upon the competent authorities of exporting and importing countries to consult that information before authorizing imports or exports of

5. Substances not under international control

ketamine. Moreover, the Board reiterates its requests to all 316. In recent years, the Board has repeatedly drawn the Governments that have not yet done so to furnish it with attention of Governments to the reports of abuse of and updated information on their national regulatory control international trafficking in ketamine, a substance currently measures for ketamine that are applied in their countries not under international control. The Board has noted with pursuant to Commission on Narcotic Drugs concern that diversion or trafficking of ketamine has been resolutions 49/6 and 50/3. noted in all regions of the world and that the abuse of 320. In recent sessions of the Commission on Narcotic ketamine has become a health risk in a number of Drugs, a number of Governments have commented on the countries. Widespread abuse of ketamine, particularly health risks and other problems associated with abuse and among youth, continues to be reported by countries in East diversion of ketamine as experienced in their countries.

and South-East Asia, as well as in the Americas.

Those countries expressed their disappointment with the fact that the substance was not under international control 317. The international community shares those concerns and called for urgent international action to counter the of the Board. The Commission on Narcotic Drugs, at its abuse of and trafficking in ketamine. Welcoming the forty-ninth session, in March 2006, adopted national controls applied in many countries in accordance resolution 49/6, entitled “Listing of ketamine as a with the above Commission resolutions, those controlled substance”, in which the Commission called Governments stressed the need for concerted action by all upon Member States to consider controlling the use of Governments, which would best be achieved when ketamine by placing it on the list of substances controlled ketamine was controlled under the international drug under their national legislation, where the domestic control treaties.

situation so required. In March 2007, the Commission took further action in its resolution 50/3, encouraging Member 321. The Board notes that ketamine has been illicitly States to consider adopting a system of precautionary manufactured in some countries, in addition to being diverted from licit channels, and has been subsequently measures for use by their government agencies to facilitate trafficked between countries and regions, to satisfy the the timely detection of the diversion of ketamine.

growing illicit demand for the substance. The Board shares 318. The Board notes the adoption of the above the opinion of the Governments concerned that national resolutions of the Commission on Narcotic Drugs and calls control measures alone may not be sufficient to enable law

REPORT OF THE INTERNATIONAL NARCOTICS CONTROL BOARD

enforcement cooperation between the countries involved, necessary to address that problem and to furnish pertinent the concerted investigation of such crimes or the information on the extent and nature of the abuse of and prosecution of the criminals behind them, to name a few of trafficking in tramadol to the Board and WHO. the actions that need to be taken in this regard.

6. Plant materials not under international

322. The Board therefore recommends that Governments that do not apply control measures to ketamine remain control containing psychoactive substances vigilant, in view of the risk that ketamine might be diverted 328. The utilization of plant-based preparations that are or abused in the country. The Board further encourages not under international control and which contain natural Governments to inform the Board and UNODC of cases of psychoactive ingredients is often part of traditional diversion or attempted diversion of ketamine that they may indigenous rituals, traditional medicine and religious uncover and to collect epidemiological data on the abuse of ceremonies. Examples of the plants or parts of plants from the substance, and reminds Governments that experience which such preparations are concocted include khat (Catha difficulties with the diversion and abuse of ketamine edulis) from East Africa and the Arabian peninsula; to provide the relevant information to INCB, UNODC ayahuasca, a preparation made from plants indigenous and WHO.

to the Amazon basin of South America, most importantly 323. Another development of concern is the increasing a jungle vine (Banisteriopsis capii) and another abuse of tramadol, a synthetic opioid not under tryptamine-rich plant (Psychotria viridis), containing a international control, which has become a serious problem number of psychoactive alkaloids, including DMT; the in a number of countries in Africa, notably Egypt. Abuse of peyote cactus (Lophophora williamsii), containing tramadol has also been reported by Jordan, Lebanon, Libya, mescaline; magic mushrooms (Psilocybe), which contain Mauritius, Saudi Arabia and Togo. psilocybine and psilocine; Ephedra, containing ephedrine; “kratom” (Mitragyna speciosa), a plant indigenous to 324. In response to that emerging threat and concerned by South-East Asia containing mitragynine; Salvia divinorum, the increasing abuse of tramadol preparations in the a plant originating in Mexico that contains the country, the Government of Egypt placed that substance, as hallucinogen salvinorin A; and iboga (Tabernanthe iboga), well as its salts and derivatives and preparations containing native to western Central Africa, containing the tramadol, under national control in 2012. Tramadol is also hallucinogen ibogaine.

under national control in other countries, such as Jordan

and Saudi Arabia. 329. The Board pointed out some of the problems related to the use of those plant materials outside their original 325. According to information available to the Board, socioeconomic context in its annual report for 2010 tramadol seems to be diverted mainly from international (paras. 284-287). Since then, increasing interest in the use trade. For instance, Egyptian authorities seized in the of such plant materials for recreational purposes has been country’s main seaports about 120 million tablets noted, possibly encouraged by a lack of clarity with regard containing tramadol in 2011 and about 320 million tablets to the control status of the plants at the national or the in the first quarter of 2012. The preparations were international level. At present, no plants, including the ones reportedly smuggled into Egypt mainly from China and containing psychoactive ingredients, are controlled under India. Increasing amounts of seizures of preparations the 1971 Convention, although the active ingredients they containing tramadol are also reported by Saudi Arabia.

contain are sometimes subject to international control. For 326. In West Africa, a series of large seizures of tramadol example, cathine and DMT are psychotropic substances preparations, totalling more than 132 tons of such included in Schedule I of the 1971 Convention, while the preparations, were effected between February and plants and plant-based preparations that contain them, October 2012. The preparations had been concealed in sea namely khat and ayahuasca, respectively, are not subject to containers coming from India and were intercepted by the any restrictions or control measures. This situation is law enforcement authorities of Benin, Ghana, Senegal seemingly exploited by drug trafficking networks and and Togo. online retailers, resulting in increased trade, use and abuse of these plant materials in many countries.

327. The Board is concerned about the growing abuse of tramadol in some African and West Asian countries and the 330. The easy availability of those plant materials through increasing amount of trafficking in tramadol preparations the Internet is evidenced in the 2011 EMCDDA survey on to Africa, as evidenced by recent large seizures of such the online availability of new psychoactive substances in preparations in North and West Africa. The Board calls on the European Union. According to that survey, the most countries in Africa and West Asia to take the measures commonly sold new psychoactive substances based on

natural products in Europe include “kratom”, Salvia 333. In view of the health risks associated with those divinorum, ayahuasca and hallucinogenic mushrooms. materials, a growing number of Governments have placed such material or preparations under national control, or are 331. Furthermore, the Board notes the increasing popularity of practices that purportedly have spiritual considering doing so, and are taking other measures to connotations, such as “spiritual tourism”, under the cover of prevent negative health consequences of such use. For which the plant-based psychoactive materials are example, in 2009 Salvia divinorum emerged in Canada as a consumed. Several centres around the world offer substance of concern; in 2010, an estimated 1.6 per cent of “initiatory journeys” with the presence and assistance of a Canadians aged 15 years and over had used the substance in shaman. Some online travel agencies offer “initiatory their lifetime and 0.3 per cent reported having used it in the journeys” “supervised” by shamans, although such events past year. Although Salvia divinorum is not currently are usually totally outside the sociocultural context that scheduled under the Controlled Drugs and Substances Act, they claim to represent. Shamanic practices during such Health Canada has proposed to include it as a controlled initiatory journeys, such as trance, ecstasies, hallucination substance under that Act. In the United States, the substance and divination, are reached mainly through the ingestion of has been placed on the Drug Enforcement Administration’s preparations made out of plant materials containing the “Drugs and Chemicals of Concern” list. In addition, several psychoactive substances mentioned above.

states in the United States have banned the substance.

332. The Board notes with concern that the use of those 334. The Board reiterates its recommendation to the substances has been associated with various serious health risks (both physical and psychological) and even with Governments of countries where the misuse and trafficking death. The Board therefore wishes to draw the attention of of such plant materials may occur to remain vigilant and Governments to the fact that the use of such plant materials recommends that appropriate action be taken at the for whatever purpose could be unsafe practice. national level where the situation so requires.