Drug problem 'not just a public health issue'

Cannabis seized by the Central Narcotics Bureau.
Cannabis seized by the Central Narcotics Bureau. PHOTO: LIANHE ZAOBAO

Singapore's uncompromising stance against drugs is the reason it has stayed relatively drug-free, with arrested drug abusers comprising less than 0.1 per cent of the country's population.

Senior Minister of State for Home Affairs Desmond Lee said this on Monday at a meeting of international delegates, at the United Nations Commission on Narcotic Drugs (CND) in Vienna, Austria.

The event is a preparatory meeting for the upcoming UN General Assembly Special Session on the world's drug problem next month, when members will set goals for global drug control in the next decade.

Mr Lee rejected calls that the drug problem be framed purely as a "public health issue", pointing out that there were also public security concerns. If drug abuse takes root, "the wider community pays a hefty price in terms of crime," he said, adding that Singapore would persevere in its stance, despite some countries moving towards a liberal "harm reduction" approach to drugs.

"The harm reduction approach, with programmes such as needle exchange or opiate substitution, is not relevant in our context... We also do not support calls for drug decriminalisation or legalisation. This is not applicable to societies that are relatively drug-free," he said.

He also rejected legalising cannabis for medical or recreational use.

He referenced two recent studies done by Singapore experts that, he said, supported Singapore's "harm prevention" approach.

Commissioned by the Ministry of Home Affairs last year, the studies were done by researchers from the Duke-NUS Medical School and Institute of Mental Health (IMH). The first study compared Singapore's approach to "harm reduction" policies in 11 other countries - such as Australia, Canada and Thailand.

Adjunct Professor Stella Quah from the Duke-NUS Medical School helmed the study and said harm reduction was focused on reducing the transmission of HIV through needle-exchange programmes.

"(Harm reduction) started as a desperate measure way back in the 1980s; doctors in the United States noted that HIV and Aids infections were spreading most rapidly... particularly (among) those who inject drugs," said Prof Quah, speaking at a media briefing last week.

"In their opinion, it was not possible to convince drug addicts to stop their addiction; they thought it was more practical to give them clean needles instead." But the approach has had little impact on stemming the spread of diseases such as Aids and hepatitis C, she noted.

The second study, a literature review of over 500 academic papers on medical cannabis, pointed out that its benefits were not clear.

Dr Jimmy Lee, a consultant at IMH's department of general psychiatry who chaired the study, said despite claims that cannabis works for certain conditions - such as chemotherapy-induced nausea - there were proven alternatives, and there was no reason for cannabis to be a "first-line treatment".

He added that while there was some medical evidence in favour of its use, more robust studies needed to be done. "Any potential benefit has to be weighed against the known negative effects," he said.

Abusers risked irreversible brain damage and psychiatric disorders.

But one of the chemicals in cannabis, cannabidiol - which is neither addictive nor psychoactive - appears to have beneficial effects on anxiety and psychotic symptoms, and was a promising area of research.

The abuse of cannabis, or marijuana, is a growing problem among young drug users here. Among first-time drug abusers, cannabis is the second-most abused drug, after methamphetamine, or Ice, according to latest Central Narcotics Bureau statistics.

Dr Thomas Lee, an addictions specialist at The Resilienz Clinic, said there was "insufficient empirical data" on cannabis' medical benefits. "Conversely there is ample research evidence to show cannabis is harmful to all aspects of health," he said.

In his speech on Monday, Mr Lee said: "We believe in harm prevention... We want a drug-free society, not a drug-tolerant one."

A version of this article appeared in the print edition of The Straits Times on March 16, 2016, with the headline 'Drug problem 'not just a public health issue''. Print Edition | Subscribe