Asia Pacific Forum Against Drugs - World Federation Against Drugs 2019 - Speech by Mrs Josephine Teo, Minister for Manpower and Second Minister for Home Affairs

Mr Esbjörn Hörnberg,
International President, World Federation Against Drugs (WFAD)

Dr Chew Tuan Chiong,
Vice Chairman, National Council Against Drug Abuse (NCADA)

Mr Ng Ser Song,
Director, Central Narcotics Bureau

Colleagues and Friends,

Introduction

1. Thank you for inviting me to join you for this important get-together. I also want to thank Esbjörn and Tuan Chiong for their very thoughtful reflections on the situation today.

2. Now, as many of you know, the Singapore National Council Against Drug Abuse, or NCADA, started the Asia-Pacific Forum Against Drugs (APFAD) in 2015.

3. This year’s APFAD is a joint conference with the World Federation Against Drugs (WFAD), and of course, I want to thank both WFAD and NCADA for getting it organised. There is no doubt in my mind that discussions at this conference will benefit governments and organisations in this region, who are working hard in our common fight against illicit drugs.

Global Drug Situation

4. As you have heard from the two previous speakers, the global drug situation is very worrying. According to the World Drug Report published in 2019, this year, one in every 18 people in the world had used drugs at least once in the previous year. Not in their lives - in the previous year. Compared to a decade ago, this increase is more than 30 per cent.  It is a 30 per cent increase over just ten years. This is a sobering fact.

5. Drug abuse is harmful.  For individuals, there is a heightened risk of health disorders, HIV infections and even premature death due to overdose. The Global Burden of Disease Study 2017 estimated that there were close to 600,000 drug-related deaths that year. This was in 2017. The study also measured the years of “healthy” life lost – a combination of years of life lost due to premature death and years of life lived with disability, as a result of drug use. The number they came to was an alarming 42 million years lost in 2017 alone. However we feel about the methodology, it’s just a very interesting metric to reflect upon, if you add lives lost, lives lived in disability just due to drugs – 42 million years. That is astounding.

6. Drug abuse affects not only the individual, but the families as well. You and I are very well-persuaded of it. One of the things that we found troubling in Singapore was a local study indicating that children of drug abusers were more likely to be exposed to risks such as anti-social activities at home, and anti-social peers. This is not so unintuitive, if you can believe it. This is because these children were less likely to receive adequate parental supervision. But what was even more sobering was the fact that from this study, we found that one in five drug abusers who are parents, also have children who later in life had brushes with the law.

7. Drug abuse therefore has a wider impact on society. An earlier study in Singapore had found that one in three drug abusers had committed other criminal offences, with the most common being theft, violence against persons, disorderly behaviour and driving under influence, among others.

8. These harms to lives and societies are caused not just by illegal drugs like heroin and methamphetamine. In recent years, societies have seen lives destroyed through addiction to legalised drugs.

Opioid Crisis in the United States

9. Many of us have heard about the opioid crisis in North America. It was caused by over-prescription in the late 1990s of drugs containing opiates. Knowingly or unknowingly, casual users became addicted. Purdue Pharma, the manufacturer of OxyContin, one of the widely-abused opiates, is currently facing more than 2,600 federal and state lawsuits in the US, and stands accused of using deceptive marketing practices.

10. According to court documents, Purdue already knew about the significant abuse of OxyContin in the first years after the drug hit the market. However, it concealed that information and continued to market OxyContin as being less addictive and less liable to abuse. It took more than a decade for the company to plead guilty to criminal charges of misbranding OxyContin. It was made to pay more than US$600 million in fines. It’s a hefty bill but can we really put a price tag to the thousands of lives destroyed?

11. Sadly, even after the conviction and fine, Purdue continued its aggressive marketing and made billions of dollars more from continued sales of OxyContin all the way till 2016.  The easy money was too good to resist.

12. The opioid crisis has led to many deaths. In 2017 alone, more than 47,000 opioid overdose deaths were recorded in the US. In Canada, there were nearly 4,000 opioid-related deaths in that same year.

13. No amount of compensation derived from the ongoing lawsuits will be able to make good the consequences of Purdue’s irresponsible actions.

Cannabis Legalisation

14. This brings me to the worrying development of the push for cannabis legalisation in many countries. One commonly cited excuse why cannabis should be legalised is its purported medical properties. In recent years, cannabis has been portrayed as a “miracle drug” which can cure many ailments and diseases.

15. However, there is a lot of confusion and misperception of “medical cannabis”. According to the International Narcotics Control Board (INCB), “medical cannabis” should refer only to cannabinoids that have had their safety and effectiveness evaluated in controlled clinical trials and have been licensed for use as medicines.

16. There is published research, using controlled clinical trials, on the potential uses of cannabinoids to manage some medical conditions such as seizures and epilepsy. For such potential pharmaceutical products, we can allow them to be sold by prescription, after experts have assessed their safety, quality and efficacy based on scientific evidence from clinical studies and data on the manufacturing process, as we do for other medicines.

17. What we are concerned about, is parties claiming that unprocessed or raw cannabis is “medical cannabis”. There is no scientific evidence of the safety and efficacy of raw cannabis use.

18. The question, of course, is why this misuse is so prevalent. Why is this idea gaining traction? The answer is very simple. There are big companies, big money and investors behind it, pushing the message that such drugs have “medical purposes”. They are also marketing cannabis as a hip and harmless life-style product, choosing to turn a blind eye to its harmful effects.

19. What is buried under this proliferation of misinformation is that: one, cannabis is harmful and addictive; and two, there are actually no studies which have validated the claims of unprocessed or raw cannabis being able to treat any medical conditions.

20. Recently, the US Surgeon General issued an advisory on the harms of cannabis on brain development. He stated that “frequent cannabis use during adolescence is associated with changes in the areas of the brain involved in attention, memory, decision-making, and motivation”. In short, cannabis impairs learning in adolescents, and its use is linked to decline in IQ and an increased risk of early onset of psychotic disorders. Similarly, a research published in the Lancet Psychiatric Journal showed a significant link between cannabis use and psychosis and schizophrenia.

21. But there is big money to be made. So despite these known harms, some companies are pushing for liberalisation of cannabis regulation and this is happening in many countries.

22. The cannabis market is projected to grow into a multi-billion dollar industry with forecasts of US$75 billion in global sales by 2030. That is not so far away. Big businesses are rushing in. Constellation Brands, parent company of Corona beer, invested US$3.8 billion into a Canadian cannabis grower, a company known as Canopy Growth Corp. Heineken-owned brewery, Lagunitas, has launched cannabis-infused sparkling water. Nobody wants to miss this lucrative boat, regardless of the high cost it will impose on individuals and society.

23. These potential monetary gains have also become a point of political interest in the US. Some US politicians have become vocal about their support for cannabis legalisation.

24. A former Speaker of the House, who was against legalising cannabis during his term in office, currently sits on the board of Acreage Holdings, a cannabis investment firm. This former Speaker has now become a lobbyist to persuade the US government to legalise cannabis. It is not hard to guess what might have changed his mind.

25. In fact, the current Congress is reported to be the most cannabis-friendly Congress in history – no fewer than 60 cannabis-focused bills have been filed. They all have the aim of freeing cannabis businesses from the risk of breaking laws.

26. If they succeed, the drug situation could become even more grim. The latest World Drug Report pointed out that cannabis legalisation in some countries or states has led to an increase in the prevalence of cannabis use. Already, almost 12 million, or more than a third of young Americans, reported cannabis use in 2018 – this is the highest level of cannabis use since 2002. With legalisation, these numbers will rise.

27. As it is, there is and there has been a more varied range of cannabis products, including edibles like cannabis-infused gummy bears – they really look harmless. The potency of these products and the lack of control and regulation jeopardises the health of its consumers including innocent children. It has been reported that cannabis edibles have led to more emergency room visits each year and patients were more likely to suffer adverse effects including psychiatric symptoms and heart problems.  There is also the risk that cannabis is a “gateway” to the use of other drugs.

28. In Colorado, since legalisation, traffic deaths involving drivers who tested positive for cannabis more than doubled from 2013 to 2017 – that is a matter of four years. There was also a significant increase in organised crimes linked to cannabis, from 31 cases in 2012 to 119 in 2017.

29. The experience in other states has not been positive either. Cannabis dispensaries in the city of Los Angeles were found to be significant crime attractors, especially homicides and robberies. In 2014, the placement of a cannabis dispensary was associated with a 250 per cent increase in homicides and almost 50 per cent increase in robberies.

30. The phenomenal growth of the commercial cannabis industry in spite of its known and clear harms is why we need to push back. We need to counter the wave of misinformation campaigns sponsored by the industry. We need to mobilise the community for this.

Importance of NGOs in Partnering the Government and Sustaining Community Action

31. It is apt therefore that the theme for this year’s conference is “Prevention through Partnerships and Community Action – for a World Without Drugs”. There are two parts to this. First, developing and executing good prevention strategies and campaigns and second, garnering community support and involvement.

32. Anti-drug efforts have become more challenging due to the significant shifts in global perceptions towards drugs and drug abuse. Youths in Singapore too, have more liberal views towards cannabis than older Singaporeans.

33. As such, we have been stepping up on our preventive education efforts, to ensure that our people have access to accurate information about drugs, and to debunk the myths. In this, we work with non-governmental organisations (NGOs) and civil society organisations.

34. One good example is the upcoming NCADA Media Campaign, which you will be hearing more about later. NCADA will be partnering schools, media outlets and the community to push out content which will bust myths about drugs being okay and spur conversations on the harms and consequences of drug abuse.

35. We also need to come together at the international level, and make ourselves heard. The Singapore Anti-Narcotics Association (SANA) participated at the Commission on Narcotic Drugs (CND) meeting in March this year and co-organised a side event with NGOs from other countries, namely WFAD, Smart Approaches to Marijuana (SAM), Fourth Wave Foundation (FWF) and San Patrignano Foundation. The event focused on “Community Action in Empowering Recovery”. Its objective was to facilitate cross-regional discussion among NGOs on measures to promote prevention and recovery, with a focus on community mobilisation.

36. Another issue on which we should work on together is the recommendations to liberalise controls on cannabis and cannabis-related substances made by the World Health Organisation’s Expert Committee on Drug Dependence (WHO ECDD).

37. To give this committee the benefit of the doubt, perhaps the recommendations were made innocently on the premise of reducing barriers to access to cannabis for medical and scientific research purposes. But in the first place, such barriers already do not exist within the current control framework.  One must question why further liberalisation is thought to be needed, especially on the therapeutic front. The evidence for the therapeutic use of cannabis is not robust enough to warrant a loosening in controls. If we do, we will be sending the wrong message to our people, especially our youths.

38. In short, we need to think hard about the potential adverse impact if we agree to the ECDD’s recommendations. As the people closest to the ground, you may want to take coordinated action to let your policy makers know of the harms which you are seeing with cannabis use and why it should continue to be controlled under the strictest of regimes and not relaxed.

Conclusion

39. These rapid developments in the drug scene globally underline the importance for anti-drug practitioners to come together to discuss the challenges we face, brainstorm for solutions, and share best practices and knowledge.

40. The WFAD is a key platform for such knowledge sharing and network building. Apart from the biennial World Forum Against Drugs, the WFAD also supports many regional programmes in Africa and Asia. The Asian Regional Forum Against Drugs held in Cochin, India two months ago is an example. The joint conference between WFAD and FWF gathered civil society organisations and country representatives in Asia to share best practices and strengthen capacity in advocacy work.

41. On our part, Singapore is committed to also step up efforts. In September this year, the Central Narcotics Bureau co-organised a workshop with the United Nations Office on Drugs and Crime (UNODC) on drug prevention for officials from 18 countries in ASEAN, South Asia and the Pacific Islands. We shared with the participants various evidence-based preventive drug education programmes and different approaches to evaluate their effectiveness.

42. Similarly, this conference has put together an impressive list of experts and speakers, and I hope that their sharing will be beneficial to all the participants. Together, I believe we can build a stronger global community and work towards a drug-free world for our children.

43. I wish you a fruitful conference. Thank you very much.