Evolution Of Substance Abuse In Mauritius Criminology Essay

Evolution Of middle Ab procedure In Mauritius Criminology EssaySubstance holler is a multi-facetted enigma that plagues a whole society, irrespective of several(prenominal)(predicate) age categories and social classes. The consequences and the measuring stick of deterioration ca white plagued to the individual, the family and society ar diverse. Mauritius, while be a refined island of approximately 1.2 one million million million1inhabitants unless, far away from the leading powers of the global prudence, and niched at the heart of the Indian Ocean has not been sp bed from this issue. consort to the National medicine check shoot Masterplan 2004-20092, the age of initiation to internality clapperclaw in Mauritius starts from as early as 11 years because of peer or media influence. The precept of bone marrow abuse is merely not this simple. Sometimes, some people cut into in to the instinctive human behaviour which is trying to find the easiest cope from harsh rea lities and nuisances of daily life, and resort to substance abuse.Evolution of substance abuse in MauritiusSubstance abuse may fall in become an dreadful phenomenon of late, but medicines have been present in Mauritius for a far durable time. The use of doses has been recorded to have started with as early as during the French colonisation3with illicit rum production by slaves. With the arrival of bound labourers, Indians brought along with their culture and traditions, piece of tailnabis, while Chinese immigrants brought opium4. These do do medicinesss were well-nighly utilised in a socio-cultural circumstance, by adults with discover world a cause for serious concern. sixties brought with it the Hippie Culture5to Mauritanian shores as s considerably as red-hot gets of drugs such as LSD6, Mandrax7and different hallucinogens which became synonymous to new highs to youngsters.The seventies caused an altogether different trend of substance abuse, as the situation change d drastically from its socio-cultural to a more signifi finishtly worrying use. A rudimentary form of heroin8known as chocolate-brown Sugar was introduced in Mauritius. Brown Sugar was smuggled with the airport, harbour and with postal packets.The capital of The Netherlands Affair9that broke out in 1985 was the quintessence of the scope of the drugs bother in Mauritius. As an attempt to display its ordainingness to leave no precious stone unturned in the competitiveness against drug trafficking, legislation was amended10and closing penalty was introduced for proved traffickers. No drug trafficker have however been executed because of the thorny strengthive issues surrounding capital punishment. A choppy downward trend was observed in 1987 and continued until 1990 aft(prenominal) which indicators revealed a slight increase in illicit trafficking and consumption11.In 2003, the sportsmanlike Lady12 was a psychotropic drug opted by most drug users. Post 2005, Subutex13, wh ich is normally used as interference on those babelike on somnific pain killers, and opiates, soon became the most sought-after drug in Mauritius. Substance Abuse and RepercussionsSocial ConsequencesSignificant social consequences intromit the disintegration of the family unit, with the emotional and psychological well-being of family members being upset. Substance abuse and delinquency go hand in hand as sometimes dependency and withdrawal syndromes overcome reason and push addicts towards theft, violence and sympathetic such accomplishments to procure the financial means to obtain their required dosage. The 2009 gentleman medicine Report14shows that crook of drug- cogitate crimes has increased by 18% from 2006 to 2007. health ConsequencesSubstance abuse affects the personal health of drugs addicts themselves. Withdrawal and apathy ar a few of the psychological dysfunctions they might face. The impact of addiction can be far r to each oneing. Cardiovascular disease, str oke, cancer, and lung disease can all be caused by drug abuse15.Because of ace esteem leaf sharing behaviour16, a well-established norm among IDUs as has been shown by the IDUs Respondent Driven Sampling17, which is explained by the increased costs and low financial means of IDUs as well as law serve continuous stalking of IDUs in obstinance of drug paraphernalia, blood borne diseases such as help or Hepatitis18 ar easily transmitted, repercussions of which is catastrophic both for the IDU and society at large. IDUs who get bear on by such blood borne diseases ordain often through and through a domino effect, affect their sexual partners, while pregnant women who are IDUs footrace the risk of contaminating their unborn children with such. Injecting drug use is the cause for an change magnitude proportion of human immunodeficiency virus infections in many parts of the world, Mauritius included. It is estimated that between 11 and 21 million people worldwide inject drugs, and of those, between 0.8 and 6.6 million are infected with HIV19.Financial ImpactsHealth services that have to be give upd to drug addicts include treatment of diseases which may develop in drug addicts as a consequence of substance abuse, as well as costs of rehabilitation services, which is often overlooked by most persons. The cost of non-generic antiretroviral treatment per person per annum may amount up to $ 150020, averaging to almost Rs 50, 000 based on current transmute rates.Financial consequences on the economy are grave, with the parallel running of a black economy with moolah obtained from the illicit traffic, as well as with the effects of drugs abuse of members of the regulate force which reduces productivity.Conventional Approaches to Substance abuseMauritius has ratified the United Nations Drug Control Conventions21. It has besides ratified the 2000 Convention on Trans-National Organized Crime22and is as well as signatory of both the African Union23and the SADC Drug Control Protocol. existing good frameworks that were used, and hush up are used to go steady drugs supply and fill decrement areThe Dangerous Drug exertion 200024The P revileacy prompt 198325The Financial word of honor and Anti Money Laundering portrayal 200226Drugs get hold of ReductionDrugs indigence reduction is one of the salute used to combat the substance abuse crisis at its core. Drug demand reduction refers to policies and programmes tell towards cut down the consumer demand for narcotic drug and psychotropic substances as cover by the three main International Drug Control Conventions, as mentioned above. The National Agency for Treatment and Rehabilitation of Substance Abusers (NATReSA) is a parastatal appeases under the aegis of the Ministry of Social Security, National Solidarity and Reform Institutions which was set up by an personation of Parliament in 199627and it is amenable for all demand reduction activities in the country. By conducting a n umber of ginmill activities in the community, schools and the workplace, NATReSA uses education as its main vehicular weapon to try to derogate the demand for drugs. It provides funding to a number of NGOs engaged in prevention, treatment and rehabilitation work. The National Prevention Unit set up by the NATReSa in 2002 has set up a submit Reduction interconnected Program, from which more than 25 regions have already benefitted money box date.Supply stance ReductionAs to supply side reduction, the law enforcement side is actively involved and a number of institutions operating under the aegis of different ministries are responsible for drug control activities.The Anti Drug import Unit (ADSU)28, the National Coast Guard and the Special Mobile staff office are special units of the Mauritius Police Force, working under the command of the Commissioner of Police involved in drug control. The Passport and Immigration Office to a fault operates under the supervision of the Commiss ioner of Police and has a role in the screen of passengers at the seaport and airport while Custom Investigation and Intelligence Unit plays a noteworthy role in the checking of containers and other baggage entering the country. The P ill-treatacy separate of the Ministry of Health and shade of Life is responsible for the issuing of licenses for the import of licit narcotic drugs and psychotropic substances.Finally, Mauritius Post Services work in close cooperation with the above units to exercise close control to guarantee that drugs do not enter the country through earn and postal softwares and the Forest Department aids through its field work in forests, mountains and state lands, and is instrumental in detecting cannabis cultivation.According to the 2010 World Drug Report29, Mauritius is the country with the highest opiates consumption prevalence in the African continent with an estimate of 1.9 %. This demonstrates clearly that conventional approaches to the Mauritian drug trouble have not met expectations in terms of efficiency in tackling it. Instead, new factors borne due to a rapidly changing society contributed to the description them inefficient opening up of airspaces which while increasing benefits from the tourism and belong industry has also increased the risks of drugs being brought into the country by foreigners, enlargement of the offshore sector through which large sums of money transits through Mauritius, sources of which remain confidential to the offshore companies and the open secret being that sometimes, part of these monies go into the black economy, financing drug transactions and poverty and prostitution which are key contributory factors as well to the expansion of the Mauritian drug market among others. The escalation of drug use became a cause for worry as the main vehicle for substance abuse being through snapshot, this implied a heightened risk of transmittal of blood borne diseases30among the IDU population and ther efore a greater number of HIV positive and hepatitis cases amongst others.An altogether new approach was hence adopted to counter this eventuality, known as the harm reduction approach. The harm reduction which consists of pauperizationle convince programs as well as repairer commutation therapy implied a completely different perspective, the core principle being admitting the populace of a substance abuse issue in a community, which often is stubbornly resisted by authorities, hence displaying the huge difficulty in the implementation of this system.Over the years, many observations have been do by journalists and Non- brass sectional Organisations (NGOs) representatives on the structural changes of the drug situation in Mauritius, the worrying dimensions of the issue of substance abuse and its relations with transmission of blood borne diseases. aggrieve reduction however, being a relatively new concept in Mauritius dating only back to 2006, remains a rather unexplored pa th.Hence, the purpose of this oration would be to bring focus on molest swap Programs (NEPs) as they are carried out in the Mauritian place setting. While running through a general overview of the harm reduction approach, the rationale behind it leave alone be examined along with implementation timeline of NEP in Mauritius. Policy aspects lead be reviewed and an analysis of the legal backdrop of NEPs in Mauritius go out be presented, which will consist of a study salient features of the existing laws and NEPs and eventually the NEP particularised framework which is the HIV/AIDS Act 06. NEP in prisons, being a delicate and debatable issue, will be considered and the prospect of such in Mauritian prisons discussed. The dissertation will be concluded by evaluating the Mauritian NEP, and proposing recommendations of possible ways to gear more towards efficiency and best coiffure with regards to Mauritian laws and spur exchange.Preliminary Chapter Understanding disparage Reduc tionThe introductory ConceptHarm reduction refers to policies, programmes and practices utilised and applied with the objective of fall risks associated with the use of drugs by substance abusers31. Subdivided into needle exchange programs and methathrough substitution therapies, harm reduction is viewed as a far-reaching innovative approach to the problem of substance abuse and its related risks. The salient feature of this novel method is the radical shift in focus to the prevention of harm caused by substance abuse, rather than on the prevention of drug use itself. This entails recognising the existence of a substance abuse problem in society which in turn indicates the inability or sometimes even failure of interested authorities in tackling the drug problem.This approach was often discussed in Mauritius after recognition of the threat of HIV as well as other blood borne diseases which were spreading through injecting drug use. (RSA())32. Stakeholders including the National AI DS secretariate33agreed that harm reduction does not undermine but or else complements approaches seeking to prevent or decrease drug consumption. It is based on the recognition that many people throughout the world continue to use drugs despite the best of efforts to prevent drug use.Rationale Behind Harm ReductionHarm Reduction and Human RightsThe harm reduction approach to drugs is based on a strong pledge to public health and human rights. Harm reduction interventions have found support among numerous United Nations (UN)34human rights mechanisms, specifically in linguistic context of HIV prevention and the right to attain the highest achievable standard of healthInternational engagement on Economic, Social and cultural Rights35(ICESCR) And Harm Reduction.The Committee on the Economic, Social, and Cultural Rights36(CESCR) has recommended37many times that States Parties scale up their harm reduction programmes in order to meet their obligations under Article 1238of the ICESCR. In its last Observations on Ukraine (2007), the Committee stated that it was gravely concerned atthe check access by drug users to substitution therapy, and recommended that the state party murder drug substitution therapy and other HIV prevention services more accessible for drug users39.In 2009, the UN Human Rights Council40adopted a final result on human rights and HIV/AIDS that unequivocally provided support to harm reduction programs, including needle exchange. The resolution reflected onetime(prenominal) Commitments41made at the every twenty-four hour period Assembly42in 2001 and again in 2006. In 2010, the UN Commission on Narcotic Drugs43adopted a resolution more than ever, backing the far-reaching package of interventions for HIV prevention treatment and among injecting drug users. Both ECOSOC and the UNAIDS Programme Co-ordinating Board(will be explained in footnote) have also endorsed these interventions.Article 15.1.b ((will be laid out in footnote) guarantees the right of everyone to benefit from scientific progress and its applications. In the context of injecting driven HIV, this implies a right to benefit from demonstration based programs that can prevent, treat and control HIV/AIDS and other drug related potential diseases. Harm reduction methods have been backed by wide scientific evidence base indicative of their effectiveness at reducing injecting-related risks.Research Based RationaleSupply reduction has been used in Mauritius now, since many years and although being an expensive method to combat substance abuse, drug trafficking crimes and substance abuse is still well present in the Mauritian society.2002, 2003 to 2004 modality of transmission of HIV and blood borne infections steadily shifted from straight activities to injecting drug use.(annexed charts)The 2009 Injecting Drug User HIV surveillance survey was enforced by the AIDS Unit of the Mauritius Ministry of Health and Quality of Life (MOHQL). HIV prevalence is 47.4%. Hepatitis C prevalence is 97.3%. (Results of the survey will be annexed as table)Currently, injecting drug use comprises the bulk of HIV infections in Mauritius. Whereas in 2002 injecting drug use accounted for 14% of all new HIV infections in Mauritius, this luck increased dramatically to 92% in 2005.44Although HIV prevalence among Injecting Drug Users appears to have decreased gradually to 73% in 2008, this percentage is still cause for worry. The use of non- sterilized needles and syringes and other injecting drug equipment is an extremely efficient mode of HIV transmission and remains a key factor exacerbate the HIV epidemic among drug users worldwide.Estimation of population size of IDUs in 2009 has been rounded off at 10000.High-risk injection drug use practices 61.2% of Injecting Drug Users reported injecting 2 to three times a day and 29.3% reported injecting with a previously used needle in the past monthThe Implementation of Harm Reduction In MauritiusHarm reduction imp lemented in Mauritius under two programs Methadone refilling Therapy and The plague trade ProgramMethadone Substitution Therapy (MST)Methadone hydrochloride is an opioid (will be explained in footnote). Methadone is now primarily used today for the treatment of narcotic addiction. Methadones effects can last up to 24 hours, thereby minded(p) only once a day in heroin detoxification and upkeep programs for the treatment of people dependent on heroin and other opioids. (sources will be provided in footnote) Methadone is unremarkably available as a liquid and drunk with fruit juice.MST works by reducing cravings and barricade highs from heroin. It does not provide the euphoric rush. The drug user under MST will no longer experience extreme highs and lows that results from the level of heroin in the blood. (source will provided in footnote). Ultimately, the patient remains physically dependent on the opioid, but is freed from the uncontrolled, compulsive, and disruptive behavior seen in heroin addicts. National Detoxification plaza For MST found at Cit Barkly. Program may be residential (15 days) or day-care. Drug users are induced on methadone under medical examination supervision and doses consequently adjusted.16 methadone dispensing points from which drug users, after having bypast through initial induction receive their daily doses of methadone. plague Exchange ProgramForms part of harm reduction strategy and is funded by the governing body through the Ministry of Health and Quality of Life and partially by external organisations such as the Global Fund.NGOs and Government through Ministry Of Health and Quality of life both carry out NEPs.The program offers a large package of services which include exchange of used needles, HIV instruction and testing, formulation of condoms and alcohol swabs and referrals for rehabilitation services (where requested) as well as other HIV-related services.The Mauritian Needle Exchange ProgramImplementation of Ne edle Exchange Program In MauritiusHaving recognised injecting drug use as the main vehicle of blood borne transmission, the aim behind carrying out needle exchange programs is to transmissionof HIVand otherviralinfections(HepatitisBC)which travels through contaminated syringes and equipments.NEP protects the IDU, by ensuring provision of safe, clean and sterile injecting equipment, eliminating risk of transmission of HIV and blood borne infections through sharing.NEP protects not only the IDU but also IDUs sexual partner.Needle exchange started in 2006 by two NGOs- Ki Nu t and Prevention Information et Lutte contre le Sida (PILS) on two sites Batterie Cass and Baie Du Tombeau (source will be cited in footnote)Adoption of HIV/AIDS Act in 2006 which provided legal framework for NEP following which November 2007 saw government through the Ministry of Health And Quality of Life endorse NEP in Mauritius through the authorized launching of the NEP in Mauritius.A third NGO started NEP on a new site at Tranquebar in November 2007In 2008, MOHQL called for tenders for new NGOS automatic to participate in NEP, with only one response and in February 2008 Idriss Goomany boil down (IGC) started Needle Exchange on a new site in Plaine VerteMarch 2008 saw some of the non-governmental organisations undertaking needle exchange till date regroup themselves under the aegis of one central organisation Collectif Urgence Toxida (CUT). CUT consists of Ki Nu Et, PILS and Rapid IGC joined CUT for a extra time period only. In April 2008 two new sites for needle exchange were put into operation by CUT.May 2008 official kick off of government run NEP It is worth noting that Mauritius has pioneered government run needle exchange in Sub-Saharan AfricaAs of date- 35 sites officially operating for Government run NEP and 17 sites for NGOs run NEPOperation of the Mauritian Needle Exchange ProgramTwo principal methods of operation, NGO run NEP and Government melt down NEPNGOs street bas ed needle exchange. Usually, two members of the NGO visit a fixed spot in the locality the site, a certain number times per week (depending on the NGO in question) and have a number of syringes with them and an empty gallon. IDUs come to see them , bringing with them the used syringes which are disposed in the gallon and are given new sterile syringes by the members. IDUs are assigned a code when they visit the sites. It should be noted that this is not for identification purposes of the IDUs but rather for monitoring and reporting purposes (Number of syringes per IDUs, number of IDUs visiting each sites). Disposal of the needles is made after full stop of sites for the day, by dropping them off at regional hospitals, where they are burned in the incinerators.MOHQL Mobile NEP through two operational caravans. Two authorize health care assistants and one qualified nurse per caravan (identified by Ministry issed identification cards). Each caravan visit three sites daily, spendin g an total of one hour and a half to two hours on each site. Work in collaboration with peer leaders amongst IDUs who help quicken smooth interacting between IDU crowds and the government staff.The Needle Exchange Program in Mauritius and Other Policy MeasuresNeedle Exchange And Demand ReductionDemand reduction, focuses on detoxification and management of withdrawal syndromes with the aim of long term abstinence. However, the results yielded are not the expected ones as detoxification succeeds in removing people from the drug burst in the short term but the relapse rates usually approach 100 per cent (Fact Sheet Supply Demand And Harm Reduction, Burnet Institute Centre For Harm Reduction).Needle Exchange And Methadone Substitution TherapyContrasting costs of providing needle and costs of providing methadoneReturn rate of syringes and treatment follow-up statistics and relapse rates for MSTEfficiency of both harm reducting programs in the sense that they would still cost less even than provision of antiretroviral treatment to an HIV positive person (provision of non-generic anti-retroviral may approximate $15000)The Needle Exchange Program and Its Framework In MauritiusAdoption of the HIV/AIDS Act 2006Needle exchange was carried out by NGOs even earlier the HIV/AIDS Act came into effect. As such, they faced a legal impediment in the sense that the practice of needle exchange was incompatible with the provisions of existing laws which is the Dangerous Drugs Act at its section 34(c) which made self-control of injecting equipment and drug paraphernalia a criminal offence.Following several committees of various stakeholders including the MOHQL itself, police officers, specially members of the ADSU and NGOs , it was agreed that there was a need for a framework to regulate the situation of NEPs. HIV/AIDS Act 2006 was then adopted in 2006 with general consensus by members of parliaments (comments of few members from Hansard will be included here and lengthier wo rks will be attached) and came into effect in August 2007.Aims of HIV/AIDS Act 06 according to the act itself is to provide for measures for the prevention and containment of HIV and AIDS abstract of this aim was a framework really required to provide for prevention measures which are done principally through education, information and sensitization, and containment which is already handled through supply-side reduction. This tends to lead to the shutdown that the true motive behind the HIV/AIDS Act was to provide a legal framework for the NEPPossession of Syringes and Needles and the HIV/AIDS Act 06Article 2 of the International Convenant on Economic, Social and Cultural Rights also requires legislative reform in order to create a legal and policy environment conducive to the scale up of these services and the remotion of barriers to access and coverage to improve accessibility. Hence in line with this, scratch 16 of the HIV/AIDS Act deals with the Possession of syringes and nee dles in the context of NEP. It in fact through very explicit terms decriminalizes its self-possession in the circumstance of the NEP.This was crucial because possession of a used needle and syringe may be used as circumstantial evidence to lay other drug-related charges. For this reason some clients may be slow to return used equipment to NEP site.fear of being arrested while in possession of drugs and/or injection equipment can lead IDUs to rush injections, skip safer injection techniques (e.g., hand and skin cleaning) and to feel so anxious that they cannot inject with accuracy. completely of these consequences can increase the risk of injection-related problems such as infections and skin and soft-tissue hurtHowever variance 34 (c) has still not yet been repealed. Questionned by NGOs as to whether this is a best practice.Needle Exchange Health and guard Under the HIV/AIDS Act 06Handling of used syringes by personnel involved under the NEP compliance with Occupational Heal th and prophylactic Act Applicable only for Govt. Run NEPsSection 10 put on the line Assessment By Employment (Will be showed in footnote) Is this carried out?Section 35 Cleanliness (Will be showed in footnote)Analysis of whether the caravans meet up with these requirementsSection 37 Ventilation and Temperature (Will be showed in footnote)Analysis of whether the caravans meet up with these requirementsSection 39 Sanitary Conveniences (Will be showed in footnote)Analysis of whether the caravans meet up with these requirementsSection 40 Supply of drinking water (Will be showed in footnote)Analysis of whether the caravans meet up with these requirementsSection 41 Washing Facilities (Will be showed in footnote)