The true cost of drug addiction - book by Dr Patrick Dixon

The Truth about Drugs - book on drug addiction by Dr Patrick Dixon published by Hodder 1998 - 24 million requests in 12 months on this site

Impossible to price human suffering (Return to Index)

For millions of families whose every waking moment is dominated by the addiction of a close relative, you can never put a price on human suffering.How can you calculate the value of wasted cocaine years, a burned-out alcoholic brain, or of a life lost through an accidental heroin overdose?How do you assess the living nightmare of a young girl, forced to feed a crack habit by selling her body to crack dealers for unlimited sex? Such things are beyond price. And yet all these things have measurable costs to the whole of society, to the government for example, through added health bills, years of economic life lost, law and order and other things.

Drug use is too serious to ignore as a public health issue yet budgets for prevention and treatment are nothing like enough in most countries.But governments on tight budgets need to be persuaded that every dollar spent saves several dollars. The same applies to companies, institutions, non-profit bodies, churches - in fact every organisation that employs people.Prove addiction costs more money than prevention and care, and every employer becomes an agent of change, as part of a global movement to fight illegal drugs and alcohol abuse.

Drugs trafficking is now $400 billion a year, or 8% of all international trade according to the United Nations.That is more than the entire global trade in iron, steel and cars, or equal to all world trade in textiles.However there is one very big difference:this $400 billion cargo weighs just a few thousand tons compared to hundreds of millions of tons of lower value goods.This presents an impossible challenge for customs officials as we will see.

At any time around $5bn is sloshing around the international monetary system as dirty money, some of it filtering into legitimate business where "innocent" executives and shareholders also land up making their own profits.

Drugs trading is a world-class, highly profitable mega-industry, a huge mass-market retail operation.The markup from grower to retail seller can be as high as a hundredfold.For example a kilogram of heroin in Pakistan costing £850 from source would fetch £72,000 in London. No wonder the dealer on the street makes a decent profit too, typically.

Money from drugs dealing is often ploughed back into more drugs - for personal use.The dealer-user sells some and his profit margin is his own share.Many smaller user-dealers are selling at cost, or just enough above that to pay for their own habit and no more.

Further up the chain the deals are big, far larger than any user could use on personal addiction.Here there are warehouses, syndicates, co-operatives, large networks.Most profits from street use are therefore funnelled upwards with cuts at every level along the way, including slices for those who act as security for big deals and who guard or move drugs around.

User E may be selling small amounts on a non-profit basis to friends.Retailers D and E may be users themselves, so there may not be much distinction between a user and a dealer at the lower levels.

The quickest way to make a bigger profit is to buy and then dilute the stock, before selling it at the same or higher price by volume. The additives are often more dangerous than the drug itself - especially if injected.Non-sterile talcum powder is bad stuff to have in the blood stream. The UK average purity in 1995 was as follows:

· Heroin 43% - cut with lactose, glucose, mannitol, chalk dust, caffeine, quinine, procaine, boric acid, talcum powder, vitamin C

· Amphetamine - 10% - cut with caffeine, ephedrine, paracetamol, glucose, vitamin C, chalk powder, talcum powder

But then where does all the drug wealth go? The answer is that this cash-based economy spirits into thin air, as hard currency is converted again into goods:property, cars, small businesses, computers - or into deposits in offshore anonymous bank accounts.

UNDCP estimates that more than half of the world's offshore money transits are drug-related.Around $1.5 trillion of external assets are invested offshore (1993 figures) representing around 30% of the entire wealth of all the funds invested in industrialised nations in normal bank accounts.Offshore investment funds have more than $1 trillion of asserts under management.

Internationalisation of money laundering has been easier with recent integration of financial markets. Drug groups have also moved operations to countries where control is weakest, and legislation absent or ineffective.

The Internet is making things even harder.New technology already allows very large sums to be moved around secretly using encryption methods so secure that intelligence agencies can't crack them.Indeed entire drug operations from production to warehousing to transport and retail distribution can now be managed on-line, from any PC or mobile data-phone anywhere in the world, using public phone lines, with almost zero risk of interception.

It has never before been possible to be in constant touch with thousands of people involved in criminal activity, co-ordinating their every move with complete intelligence on the exact location of every one of them to within three metres anywhere on the surface of the earth. And all of this can run from a boat in the Mediterranean, or a train moving at eighty miles an hour in a tunnel under the Swiss Alps - at low cost and with ultra-high security.

Money laundering at current rates already has the power to undermine the integrity of the international banking system and destabilise entire nations.Let us take just 60% of that $2.5 trillion of offshore money - $2,500 billion.

Now we can understand why some suggested that the recent currency collapses of Thailand and other nations could have been influenced by the Drugs Factor.It is naïve just to point the finger at known speculators and general economic conditions, when the likelihood is that drug-related organisations controlling vast offshore funds also played a significant role.After all, they want a return on investment like anyone else, and are also playing the market.

However, an international drug syndicate may see things rather differently to the rest of the market.Changes in border restrictions, the arrest of most of a big network, closure of several large opium refineries,shift in global drug-taking habits - all these things could mean pulling currency out of one nation and placing it in another.Thus a drugs wild-card can be operating in addition to all the commonly understood market forces.

The market operates by trying to outguess what others are going to do next - buy or sell?Expect far greater attention to the Drugs Factor in future, to how drug-dealing owners of these vast offshore funds think and react.

What about the drugs economy inside a nation as a proportion of GDP? The UK heroin and cocaine trade alone is worth more than 0.2% of GDP,so the whole UK drugs economy must be at least 0.3%.The US is higher and Australia slightly less.Total figures for retail sales therefore could be (minimum):

Total social and health costs of dealing with the consequences of illegal use of drugs in the US has been estimated to be a further $66.9 billion a year.The total social and health costs to US society of dealing with alcohol and illegal drug abuse has been estimated as $167 billion. The US spends around $10 billion a year on supply reduction and $5.5 billion on demand reduction. What this means is that every man, woman and child pays almost $1,000 annually to cover the extra health care, law enforcement, car accidents, crime and lost productivity.

If you add the health and social costs of tobacco, the total becomes around $240 billion.

So then, the total costs of illegal drug purchases, and society costs comes to around $100 billion, or 1.5% of GDP.If you add the society costs of dealing with tobacco and alcohol abuse (not including purchase costs), then the total becomes more than $270 billion, or 4% of GDP - more than all America spends on schools or housing.

In addition America spends $40 billion on buying cigarettes. We also need to add a proportion of all alcohol sales, by those who are alcohol dependent, perhaps a further $30 billion.The total cost of illegal drug use, smoking and alcohol addiction then comes to at least $340 billion or 5% of US GDP.

Alcohol-related crime cost society $11.3 billion in 1990 - including direct crime costs, lost wages of victims, costs of prison.The number one substance abuse crime is drunk-driving - 1.4 million arrests in 1995 at a cost of $5.2 billion for arrests and prosecutions.Eight young people every day die in alcohol-related car accidents.7,800 drunk drivers aged 16 - 20 were fatally injured in 1996.The accidents they have are worse than the average with greater risks of injury.

40% of deaths from illegal drugs happen in the 30 -39 year age group - men more than women and blacks more than whites.AIDS is the fastest growing cause of drug-related deaths. 33% of all new AIDS cases in the US are among drug-injecting users and their sexual partners.

More than half a million visits to hospital emergency rooms a year are drug-related.Visits caused by heroin use rose from 34,000 in 1990 to 76,000 in 1995. Heroin-related admissions rose 124% from 1990 to 1995, cocaine admissions remained high and amphetamine admissions soared from 5,000 to 18,000 between 1991 and 1994.

One in twenty pregnant women uses illegal drugs during pregnancy - around 221,000 a year. Marijuana is used by 3% or 120,000, cocaine by 1% or 45,000.

Babies born to drug abusers can be drug dependent themselves at birth or have other problems.Pre-natal drug exposure can affect development in the womb, and many babies continue to face risks from further drug taking by their mothers. Mothers who are addicted may not be able to care for their children as well as they would have normally and multiple separations are common.

Drug abuse by mothers brings a higher risk of miscarriage, stillbirth or death shortly after birth up to the first year of life.One large study found infant mortality rates up by around 50% in drug abusing mothers (14.9 per million) looking at a population on Medicaid (low income).Cot deaths were 2.5 times as common.

One in 144 of the entire American adult population is in prison today for a crime in which drugs and / or alcohol was involved - 1.4 million people out of a total off 1.9 million.Taxpayers are spending $30 billion a year keeping them in gaol.Companies are spending $90 billion a year on private security, mostly to keep those out of gaol away from their property.

Drug-related crime cost the American people $46 billion in 1990 - including direct crime costs, lost wages of victims, costs of prison, losses to the economy of those engaged in crime rather than legal employment.

10% of federal prisoners and 17% of state prison inmates say they committed crimes to pay for drugs.One in ten murderers in New York State say that their Marijuana use in the hours before the killing was a significant factor in what happened.

80% of those in US prisons are high on drugs or alcohol when arrested, steal to buy drugs or have a history of drug and alcohol abuse.One in ten prisoners use drugs in gaol, usually marijuana.Since 1996, prisoners have been required to test drug-free to win parole.

Despite the disturbing level of addiction and abuse among those in prison, investment in treatment programmes is innadequate. The number of inmates needing drug treatment has increased by around 50,000 every year to 840,000 by 1996, while the numbers in drug treatment programs has been almost unchanged.Just 13% were receiving help of the 70% - 85% of inmates needing it.What is going on?We know that almost all of these offenders will return almost immediately to previous patterns of addiction and drug-related crime, even after months or years of enforced abstinence in prison.

This is a very expensive national network of long stay facilities, every one of which should become a huge rehab project.After all, only 20% of prisoners would not qualify to be offered the treatment package.

As we have seen, money laundering undermines society - drug dealing generates 10 billion dollars a year. 60% of cases investigated by the Inland Revenue Service in 1996/7 were drug-related.

A key control strategy is to restrict supply with seizures at borders and points of entry such as airports, but this is costly.Customs posts are completely overwhelmed by the global revolution in low cost travel. Every year 60 million people enter the US on more than 675,000 commercial and private flights, another 6 million by sea and 370,000 by land.116 million vehicles travel across Mexican and Canadian borders. 90,000 merchant and passenger ships dock each year, carrying 9 million shipping containers, 400 million tons of cargo.And a further 157,000 smaller vessels visit ports.

Mexico's border alone is an impossible problem with 84 million car crossings,plus 2.8 million trucks, 232 million drivers and passengers.All pass through 38 ports of entry scattered along a 2,000 mile frontier.Drug-runners just cut across wherever they will, terrifying ranchers and those living in rural areas - if they bother.The risks of arrest at an official border crossing are minimal.

The US government threw almost 2,000 extra people at the problem in 1997, together with new detection technologies, sensors, infrared sighting devices, but all with limited success - how can you hope to succeed against such traffic flows?

The same is true of any busy international airport. The volumes of baggage and the speed requirements for loading and unloading are impossible to overcome.And with a kilogram of heroin worth $250,000, a single suitcase can contain over $5 million, while a person can hide $100,000 of heroin on or inside his or her body with little difficulty.

Then there are the sea ports. North Atlantic sea trade has grown to 1.3 million containers a year.

Even if there is a major crack-down on one route, traffickers rapidly move to a softer option.There is always going to be a way. The fact is that many countries are awash with drugs, which is why purity is rising as prices are falling.There is far more to go round than needed. The markets are becoming flooded, while the level of seizures is too small to affect street prices for long - the only real test of effectiveness.

So what about the costs of drug abuse in Britain?We have already seen that the total UK drugs economy is worth around 0.3% of GDP or £2 billion a year.In addition at least £3 billion is spent dealing with the social and health costs and there are more than £6 billion of other costs to society.That makes a total of more than £10 billion, or around 1.5% of British GDP - a significant drain on the nation.If you add on the costs to society and smoking, the total could be more than £30 billion a year, or 4% GDP.Let us look at some of those costs.

Smoking is estimated to kill around 120,000 a year in Britain, shortening life on average by at least ten years.That's 1.2 million years of life lost.Normal government Actuarial calculations would be that for every year of life lost, the economy shrinks by the wage of the person who is not now earning.The average annual salary is around £17,500.Therefore if just twenty smokers have to stop work five years before retirement because of smoking-related ill health or early death, the loss is around £1.9 million.The numbers soon start to climb.

Most smoking ill health and most of the 120,000 smoking deaths a year are among those retired.But if we take a figure of20,000 people, who are unable to work for an average of five years each (mainly because ofdeaths before retirement), then the economic cost would be almost £2 billion a year.

The cost of caring for those with tobacco-related illness is around £1.6 billion - a significant proportion of the £35 billion a year spent on health. Against that many smokers argue that tax revenues on cigarettes more than compensate for the extra workload. Similar arguments have been made in the US.They also argue that people who die from smoking aged 70 are less a drain on the state than those who live till they are 90.

We can dispute the exact figures but the fact is clear:smoking robs people of health and life, and both of these are devastatingly high costs to the individuals, to their families and friends, as well as to society.

Alcohol abuse dominates law and order enforcement in many areas, and wrecks millions of people's lives.Alcohol abuse alone is far more disruptive than all the rest of substance abuse combined.

Alcohol kills 31,000 a year - 28,000 deaths a year are alcohol-related (and a further 3,000 are deaths where alcohol is listed as a cause on a death certificate).The 28,000 include suicides, accidents, cancers and strokes. Alcohol-related accidents at home - for example falling downstairs, and head injuries are the most frequent result.

While deaths from alcoholic liver damage are usually in older people, deaths which are alcohol-related are spread across the age groups more evenly.If we say that the average alcohol-linked death results in a loss of five working years, then the cost to society in Actuarial terms each year based on lost earnings could be more than £2.5 billion.

Alcohol-related health costs in Britain have been estimated by Alcohol Concern to be around £150 million a year,or 4.3% of total health spending.

· Drinking excessively is a common cause of high blood pressure, strokes and obesity

· Alcohol is a factor in around 15% of all road deaths, 26% of drownings and 39% of deaths in fires.

· 4,500 people are admitted because of mental health problems every year because of alcohol

There are many links between alcohol and crime: alcohol-defined crimes such as drink-driving, public drunkenness and others, disinhibition, links to violence and so-called "Dutch courage" and crime to pay for drink.

Drink-driving accidents have fallen 40% in ten years to around 10,000 a year in the UK despite a 30% increase in motoring.However, these crashes still kill eleven people a week.The annual cost of drink-related traffic crime has been estimated to be £50 million.

Drink kills pedestrians and cyclists too.15% ofall those injured in road traffic accidents have been drinking in the four hours previously.

Just one example of large-scale alcohol-related injury is facial cuts.As a casualty officer I have seen entire emergency departments grind to a halt as ten or more drunken lads stagger in with bleeding faces, each of which will need perhaps half an hour to an hour of a doctor or nurse's time to stitch back together again.Every Saturday night the same thing happened, around 2.30 in the morning as the local night club crowds began to leave.

Half a million people in Britain suffer facial injuries each year, severe enough to need medical help, 125,000 of them in assaults. Half of all facial injuries in the 15 - 25 year age group happen after victim or aggressor have been drinking, and usually take place in bars, clubs or in the streets. Alcohol increases aggression in some and vulnerability in others, a dangerous combination.

Outside the home, four times as many men than women are facially injured, but this is reversed at home.Almost half of all facial injuries in women occur in women and half of these are linked to drinking.

There would be a dramatic fall in all the offences listed above if the nation were very moderate in drinking, instead of the reality where as we have seen, 6% of men are drinking more than 50 units a week.

· One in five of all people arrested and brought to Charing Cross police station in 1994 were charged with drunkenness.

· Half of all incidents of disorderly behaviour in urban areas happen just after pubs close, mainly on Friday and Saturday nights, usually young men

· Fear of alcohol-related crime discourages large numbers of older people from walking around city centres in the late evening, especially at weekends

· 30% of those on probation have severe alcohol problems, and 70% of those were inebriated when they committed their last offence.

· Almost half of those on remand have a significant problem with alcohol, together with one in five convicted prisoners - one in ten are alcohol dependent.

In comparison with alcohol and tobacco, the total impact on Britain of illegal drug use is slight. However the links to property crime are huge.

A Department of Health survey of 1,100 addicts found that they had committed more than 70,000 separate crimes in three months before entering treatment. 20% of all criminals use heroin and heroin users are stealing £1.3 billion a year in property to pay for their habit.

The 20% using heroin are responsible for 80% of all property crime, more than 800,000 burglaries, more than 1.9 million other reported thefts, not including stolen vehicles. In Lancashire for example that amounts to a loss of £147 in every household every year. It is possible that the crime wave may decline in the short term with lower heroin prices, but lower prices will increase consumption and the number of users. Heroin for the price of beer can only make the problem of addiction worse.

A significant part of the legal system is needed just to deal with drug-related crime.That is a proportion of total costs of £14 billion a year, including £7 billion on policing, remand and borstals, £1 billion on legal aid and £0.3 billion on probation costs, £1.5 billion on prisons - around 6% of all government spending.

Four out of ten men in prison are there because of drugs. (Return to Index)

One in a thousand of all adults in England and Wales is in prison at any time, rising rapidly (10% from 1995 to 1996) and the greatest increases are among those with drugs offences - from 8 - 13%from 1995 to 1996 alone.

15% of men in prison have been gaoled for drugs offences, 14% for burglary and 14% for robbery.However, as we have see, 80% of burglaries and robberies are to pay for drugs.So around four out of ten men in prison are there because of illegal drugs - trading, buying, selling or stealing.This fits with another finding that 40-70% of convicted prisoners report using drugs shortly before being arrested. One in three women prisoners are inside for drugs offences, with more there for drug-related theft or burglary or prostitution.

12% of male and 24% of female prisoners are addicted to drugs or alcohol when taken into custody. 10% of prisoners say they were injecting before entering. Between February 1995 and January 1996, a pilot scheme for compulsory testing of prisoners (urine samples) found that 1435 out of 3785 were positive for drugs (38%) of which 81% were for Marijuana, 9% for heroin. That suggests that around 3% inject heroin in prison, often in situations where they are likely to share needles.But providing needles in prisons is almost impossible without jeopardising safety and security.Bloody needles and syringes become highly feared offensive weapons when others suspect the blood is HIV infected.

Clearly this level of drug consumption requires money, favours, and extensive outside and inside help. High levels of drug-taking destabilise prison life and subvert every level of day to day activity.On the other hand, aggressive clamp-downs can also trigger unrest.Many prisons are controlled by a small number of well organised and aggressive drug barons who rule for favours.

One direct result of soaring property crime from drug addiction has been a boom in private security firms. As we have seen, in the US the bill for private security is now $90 billion compared to $40 billion for the police while there are two security guards in Britain for every police officer.80% of this effort in Britain is to prevent drug-related crime.

Emergency admissions to hospital wards are common in British drug users.Every year thousands are admitted:

The bill for care and prevention of HIV/AIDS is in excess of £210 million.Those with AIDS through the use of drugs constitute around 6% of the total.Other sex diseases are also more likely to spread among drug users who may be too intoxicated to care about risks.

Hepatitis C has spread rapidly through needle sharing - indeed it is the commonest route of transmission.60% of drug injectors attending UK drug services are now carrying Hepatitis C.Up to 400,000 people in the UK may have been infected through sharing injecting equipment. Hepatitis C is a major problem world-wide.In most developed countries with incidence is around 1-2%, and is predominantly blood borne.

85% of those infected develop chronic infection, usually chronic hepatitis.Of these one in five develop cirrhosis eventually.In the US hepatitis C already kills 8-10,000 people a year.

Each drug user that dies at a young age is a loss economically to society.Actuary tables for loss of earnings for someone dying aged 35 are around £400,000.

Drug abuse costs the State heavily in social welfare support. There is very little data on the social situations of those using illegal drugs, however theYorkshire Substance Abuse Database reported the flowing in 1996:

There are other social costs, for example rehabilitation and child protection. Under community care regulations, social services are responsible for funding residential rehab placements for addicts.They are also responsible for child protection.Although the 1989 Children's Act stresses the need to try and keep families together, many women are scared of coming forward for help in case they lose their children or a baby yet to be born. We also need to add a proportion of the cost of citizens advice centres, child therapy, family support agencies and the rest.

As we have seen, drug addiction at school causes loss of concentration, delinquency and encourages truancy - all of which cost money in terms of wasted education.Suspensions, expulsions and other disciplinary measures distract teachers from what they are called to do which is teach.Drug-using pupils can also be a continuously disruptive influence in class.

It may seem a little strange to count the benefits to the economy from drug addiction, but unless we address these as a central issue, the problem of addiction will continue to grow.The truth is that addiction in some ways can be very good news to many governments, including Britain, creating millions ofjobs and helping exports.For example, a million jobs in Britain alone depend on the alcohol industry.

How many jobs would be lost if alcohol consumption falls?This is the main reason why alcohol has become cheaper in real terms over the last twenty years.The problem has been made worse by European partners such as the French who have insisted on standard taxes on alcohol throughout the EC - low ones to protect their own wine-making economy.

Every measure designed to restrict sales of abused substances directly affects the economy.Interests may be wealthy, powerful and organised, as in the case of the tobacco industry.After all, we are talking about a significant element of GDP.

Then there are emerging economies like Afghanistan or Myanmar where drugs trade is absolutely vital to foreign currency earnings. Mexico, Colombia and many others have a huge disincentive to attacking production and export of one of their main cash crops.

In many countries democratic government is being undermined by the drugs trade.A recent EU commission found evidence of this several Caribbean countries in 1996.

Mexico is so hooked on drugs money that the profits from illegal trade would make the difference between boom and bust.Mexican gangs have overtaken Colombians as the most powerful drug cartels in America.They supply around 770 tons a year of cocaine, 6.6 tons of heroin and 7,700 tons of Marijuana - 70% of all drugs entering the US. Drug cartels are hiring former US military officers at up to $500,000 a year for expertise on such things as burst transmissions, bug interception and detection and intelligence on highly classified drugs operations.

It's not just producing nations who benefit.Every country through which drugs pass, and whose citizens take profits en route, benefits economically from the trade.Of course at the same time, they acquire a drugs problem of their own.

The end of the Cold War has opened up new routes and markets, as part of the unstoppable forces of globalisation. For example, the abolition of apartheid in South Africa has helped grow the local market for heroin, cocaine, Marijuana and mandrax.

Most opium destined for Europe comes from the "Golden Crescent" of South West Asia: Southern Afghanistan, Northern Pakistan and Eastern Iran.In 1994 Afghanistan overtook Burma as the world's largest producer, with a crop of 3,400 tons.

Opium is by far the most valuable cash crop that Afghan farmers can grow.Lack of central government control and political strife have allowed unhindered growth of opium cultivation and heroin refining.

Most of the Afghan and Pakistani opium is refined in Pakistan into around 350 tons a year of heroin.While some is consumed in Pakistan, 20% goes to the US and most of the rest to Europe.Around 4 tons of heroin is made in Lebanon a year, from imported base.

North American, Australian and Japanese markets are fed from the South East Asian "Golden Triangle" - highlands stretching from North and East Burma tothe North of Laos and Thailand.Total production of opium here is around 2,500 tons a year.

Burma alone accounts for 90% of the region's opium production, Laos 9% and Thailand 1%.This opium is equivalent to 250 tons of pure heroin.Much of the refining takes place on the Thai-Burmese border.

Secondary producers for the American market are Mexico, Guatemala and Colombia, where cocaine syndicates are diversifying into heroin.Crop eradication programmes in these countries have destroyed large areas of cultivation.

Every driver, every supplier of a lorry, every packer, every distributor and every courier benefits along the trafficking chain; every airline who carries a courier, every shipping company handling a container of Marijuana; banks, finance houses, industries owned by money laundering operations - all become involved in profit sharing whether they realise it or not.

Most South West Asian heroin bound for Europe travels overland from the Afghanistan-Pakistan border in heavily armed convoys of trucks to Iran, where it is transferred into container lorries to go across Turkey and Central Europe.

The traditional route via Bosnia has been disrupted by fighting, replaced by Bulgaria, Romania and Hungary, and increasingly through Albania to Italian ports.A second route is via the former Soviet Asian Republics.Other routes include India then air or sea to Europe, or sea via the Gulf or Africa via air to Europe (couriers usually West Africa, often Nigerian).

Most South East Asian heroin travels overland to Thai ports and then in shipping containers to North America and Australia.Other routes link Hong Kong, Southern China, Vietnam and Cambodia.

Cocaine is mainly produced in the Andean region of South America. 56% of Coca leaf production is in Peru, 20% Bolivia and 11% Columbia. Total global production is around 750 - 900 tons a year, mostly destined for North America and Europe.

Cocaine bound for Europe is exported mainly through Venezuela, Ecuador and Brazil and unloaded at Rotterdam in the Netherlands, Mediterranean ports such as Genoa and Barcelona and in the Baltic states. Small ships are also used.

The North American traffic is mainly via small aircraft up the Pacific coast, with other small flights to dropping points in the Caribbean, where cargo is picked up by small boats.However traffickers are increasingly brazen, as seen with multi-ton shipments of cocaine on commercial-sized planes from Columbia to large airfields in Mexico.

Most European Marijuana comes from Morocco, where production dominates the Northern Rif Region economy.The annual crop is around 350,000 tons of raw plant (kif), equivalent to 35,000 tons of herbal Marijuana.Most kif is turned into resin and hashish oil or consumed locally.

Other routes are Lebanon, less since crop eradication was introduced, and Pakistan. US Marijuana is grown in-country and in neighbouring nations such as Mexico. Moroccan Marijuana reaches Europe mainly via the straits of Gibraltar to Spain.A second route is via Morocco to Spain or North Europe.

Synthetic drugs can be made anywhere no unlike crops such as Marijuana do not need long-distance routing.This allows greater profit margins. Synthetic drugs such as LSD, Ecstasy, amphetamines and other s are manly made where they are consumed.Exceptions are Poland which is a big exporter of Ecstasy and other synthetics to Western Europe, and India which supplies Southern Africa with mandrax

Central Asian states have seen growth in heroin and opium production and trafficking since the collapse of the Soviet Union. The climate is ideal for both opium and Marijuana. Opium poppies are wild flowers in Kazakhstan and Uzbekistan, while a potent variety of Marijuana grows as a weed in Kazakhstn and Kyrgyzstan.Most wild plants are never harvested, but cultivation is becoming more commercialised.

Extra controls in Thailand and opening of trade in Vietnam has resulted in a shift of routes.China is also seeing an increasing problem, especially in Yunnan, Guangxi and Guangdong, which lie on he route between the Golden Triangle and Hong Kong.A sever Chines crackdown has failed to stem the flow.

Columbia and Bolivia governments have publicly announced their own ambitious eradication plans for coca production. Columbia aims to rid the country of all cocaine production within a few years.However, as we have seen, the economic pressures from lost production make the promises hard to fulfil.

Cocaine exports are of major importance to Columbian foreign exchange earnings, and contribute directly to the standard of living of the Columbian people - or some of them.In addition, the country has 600,000 cocaine addicts of its own.The problem of addiction in producing countries is a major hurdle to overcome, since local people are committed to making and selling in order to supply not only income but their own dependency.

This is also a factor in Pakistan which had 5,000 heroin addicts in 1980 but over a million by 1990 and three million by 1994. This is in part a direct result of the overflow from opium factories based on Pakistan soil near borders.Transit countries are also hard hit by addiction as payment tends to be in drugs rather than currency, and those addicted are willing to take huge personal risks for a generous supply.

In summary then, addiction is costing wealthy nations a fortune and earning poor nations another fortune with vast profits creamed off by criminals along the way who are growing in power and global influence.The drugs epidemic of the mid to late twentieth century has hardly begun.We can hardly conceive what the impact could be in the early third millennium, with widespread addiction at every level of society.

But before we look at individual drugs and how they act, and then at prevention and cure of addiction, we need to ask some fundamental questions about pleasure seeking, fulfilment and the kind of world we want to live in.Are we all addicted to pleasure?