Singapore Anti-Narcotics Association (SANA) Conference on Recovery and Desistance from Substance Abuse - Address by Mr K Shanmugam, Minister for Home Affairs and Minister for Law

Assoc Prof Muhammad Faishal Ibrahim, Minister of State, Ministry of Home Affairs & Ministry of National Development,

Mrs Gillian Koh-Tan, President of SANA,

Professor Cheong Hee Kiat, President of SUSS,

Ms Shie Yong Lee, Commissioner of Prisons,

Community Partners,

Ladies and gentlemen,

Introduction

1.   First, I think we ought to thank Gillian for the extremely heartfelt, warm, and powerful speech. You passionately put out what this was about. When we look at the drug situation, we divide it into people who are drug abusers and the others who are in the trade, who supply them, and traffic, and profit from their misery.

2.   Drug abusers, what this conference is going to focus on, for some years now, the way we have approached it is – they need help. It is an addiction problem, with surrounding issues, and really, we ought not to treat them as criminals. We ought to treat them as people who need help. Major legislative changes were made, I think three years ago or so, and we have embarked on a path where – if you are a drug abuser, even though technically it remains an offence, by and large, if you haven’t committed any other offence, that means you have taken drugs but you haven’t committed any other offence, and if it takes place in Singapore, or your urine test is positive, you are subjected to a different type of treatment. Sometimes, often, a rehabilitative approach without a criminal record, so that you can go on to lead your life, hopefully, after you have recovered.

3.   We have channelled a lot of resources into looking at how the rehabilitation process can take place. For that, we need to understand the broader issues as well as the issues specific to the individual, identify what solutions might work. It is both manpower and cost-intensive, and sometimes to be doing it at the individual level, it is not easy, but that is what the Central Narcotics Bureau (CNB) and Prisons together with partners like SANA do.

4.   Of course, we also want to look at the rehabilitation process as something that starts in prison, but continues outside, and that’s where there are stories of people who have successfully recovered. And, not just stories, people need bread to live. So, finding them jobs. But jobs alone are not enough [too], because the problem is not with getting jobs in Singapore, but very often, we find that it is with them keeping their jobs. So, how do you help them keep their jobs? We find that if they are able to keep their jobs and stay away from some of the things they do, for something like a year and a half, two years, then the process of recovery is much easier. But if they don’t, then it is a vicious cycle. And that is what we are trying to break – that vicious cycle. It requires community support, it requires family support. Community support comes in the form of charities; where people are religious, from religious organisations; from people here – a wide variety. The Government is fully committed to supporting each one of you, and we want to treat each drug abuser as a life that needs to be saved.

5.   I want to spend a little bit of time on the second part, on drug traffickers and the people who deal in drugs, who make money, and who profit from the misery of the drug abusers. So, drug abusers, our approach is very clear. We treat them as patients, we treat them as individuals. We want them to recover, and we give them every support to recover through Yellow Ribbon, through SANA, through others. The Government has put a lot of money and resources into this, and we are very happy that we are able to tap on so many volunteers here, and a lot of religious organisations have come forward. We thank them and community non-religious organisations. And NGOs too, we thank them.

6.   Traffickers. The reason we take a tough position is in the first place, we don't want people to get into this. We are dealing with downstream problems, but upstream, lives are being destroyed, families being affected, and the thousands of people who will get into drug abuse if we were not strict. Our task would become impossible. But, it's not just that our task becomes impossible. Their lives are ruined, their families’ lives are ruined, and you will see many more deaths.

Recent Global Trends in Drug Supply and Drug Abuse

7.   If you look at the 2022 World Drug Report, it says that in 2020, two years earlier, 284 million people worldwide had consumed drugs in the previous 12 months. That is about just under 6% of the world population. One in 18 persons.

8.   Deaths associated with drug abuse continue to rise. The WHO estimated that last year, about 500,000 deaths were linked to drug abuse.

US Opioid Crisis

9.   If you look at individual countries, just a few, in the US:

(a)   100,000 people died last year due to drug overdose. This doesn’t hit the headlines. People don’t seem to be shocked by this. I say that in the context of some of the activism surrounding death penalty, but this is the cost that countries pay.

(b)   Opioid abuse alone claims 187 lives per day, every single day, in the US, according to the CDC.

(c)   The Financial Times has reported that the opioid epidemic has shaved off one whole year from male life expectancy in the US. An American boy born today can expect to live four years less than a child born in another similarly wealthy country. Four years, but out of that four years, one year is due to opioid abuse.

10.   Nearly 80 new-born babies every day are diagnosed with neonatal abstinence syndrome. These are the real victims, not the drug traffickers.

11.   I was asked at an interview recently – maybe the US is different because they have specific factors like big pharma, poor regulation, which has led to the opioid crisis.

12.   But I think that's missing the woods for the trees. The key point is this: when drugs are freely available in society, regardless of the way in which they become available – whether it is because of soft drug laws, poor enforcement or regulation, or capture of the government by big pharma – the result is that there are more deaths, more families are destroyed, and society suffers tremendously. And often, who suffers the most? The lower socio-economic groups, they are the ones who suffer the most out of all of this.

Canada

13.   If you look at next to the US, in Canada – drug overdose has become an urgent public health issue in many Canadian cities.

14.   In 2021, about 21 people died every day from opioid overdose, which is close to three times the rate in 2016, when eight people died every day.

15.   Look at some of the other places.

Finland

16.   Finland has a population of 5.5 million, roughly the same if you include the foreign worker population in Singapore. Finland recorded 258 drug overdose deaths in 2020. Drug mortality, or deaths per capita, grew by 27% from 2009 to 2019.

New York City

17.   New York City has a land area of 778 square kilometres, roughly the same as Singapore. Of course, their population is much bigger. They reported more than 2,700 drug overdose deaths in 2021. 2,700 people, and that is reported.

18.   In contrast to many of these places, we don’t have a similar drug problem in Singapore. We have kept the rates of fatalities very low. We have kept the rate of crime that arises from drugs, and of course, crime from any situation, very low.

Recent Regional Trends in Drug Supply and Drug Abuse

19.   But the challenges are growing. In our region, drugs are becoming more accessible, and more abundant.

20.   In 2021, the UNODC reported a record amount of meth seized in East and Southeast Asia. Over one billion meth tablets were seized. In total, nearly 172 tonnes were seized – which is more than seven times what was seized 10 years ago.

21.   The UNODC said that our region is literally swimming in meth.

22.   And due to this huge supply, prices of methamphetamine have dropped, making it more accessible.

23.   Asia is also home to major heroin producers: Afghanistan and Myanmar. Afghanistan, Mexico, and Myanmar together accounted for 96% of the global opium production, which then is used to produce heroin. Of that, Afghanistan alone accounted for 85% of the global total. And from Afghanistan to Singapore, with us being a major shipping and air logistics hub, it doesn’t take very long.

24.   This is happening right at our doorstep. If we are not careful, if we are not strict, our country will be awash with drugs. It’s your children and mine who will be affected.

Trends Towards Liberalisation / Decriminalisation of Drug Use

25.   Against this backdrop, there are some countries around the world that are pushing to decriminalise drug use. Countries in Europe and Latin America.

26.   Often, it is because they have lost control of their domestic drug situation and have given up the fight against drugs.

27.   There is also a misplaced desire in some countries to capitalise on making money from the cannabis industry. The idea is that it is booming, so might as well tax it, and use the money. What studies have shown is that the amount you then spend on law enforcement, because of associated crime and the increased healthcare costs, far outweigh any money you make from the sale of cannabis.

28.   And it is sad, because the governments are effectively trying to make money by ruining people’s lives.

29.   Government policies in some countries, sad to say, have been significantly influenced by corporations with interests in pushing drugs. Pharma companies. They are very sophisticated. They fund pro-marijuana ballot measures, they fund politicians who can pass marijuana-friendly legislation.

30.   They also partner think-tanks, civil society organisations, academics, and celebrities, to systematically shape public opinion, against credible scientific findings.

31.   Here in Asia, there are also countries that have taken some steps to make drugs more easily accessible, and I think it is useful to study their experience.

Thailand

32.   The most recent example is Thailand. It has removed cannabis from its list of controlled drugs. Within one week of decriminalisation, cannabis was everywhere: cookies, drinks, even toothpaste. Because it was a market that was predicted to be worth several billion dollars a year.

33.   Recreational use of cannabis has taken off.

34.   In the two months after the change in law, there are reports of teenagers hallucinating and harming themselves after smoking cannabis. At least one death. A three-year-old girl who ate part of a cookie containing cannabis.

35.   What has been the response? Different government agencies have now rushed to impose stopgap measures, after opening up. Now, they are trying to prevent the situation from getting out of control.

36.   So, for example, Bangkok has banned the sale of cannabis in and outside schools. Education Ministry has imposed a ban on cannabis use in all schools across the country.

37.   The Public Health Ministry imposed a ban on smoking cannabis in public places, and on the sale of cannabis to minors, pregnant women, and breastfeeding women. But just take a step back. Does it make sense? It’s free, it’s in cookies, it’s in canned drinks, it’s in toothpaste. It is available everywhere, and then you impose a ban to say children cannot have it? How do you enforce it? How do you prevent pregnant women from getting it? How do you prevent children from getting it? It is not available in schools, but it is available a little bit away from schools, and it is not illegal. So, what do these measures mean and what impact do these measures have?

38.   A few weeks ago, there was a Bill, to coordinate the regulation of cannabis use that was withdrawn from the Thai House of Representatives, because there was criticism that it did not criminalise recreational use. So, they put in legislation, they took it back without passing it. But in any event, even if you criminalise, once you have made it available in all the shops, how do you criminalise? How do you charge people for recreational use? How do you prove recreational use?

39.   Even if the Bill is passed, it is going to be impossible to regulate and enforce. One Thai MP put it memorably: “Once you release the tiger to the jungle, it’s hard to make it come back”. I think it is hard to make it voluntarily come back, but I think the drug situation is far worse than a tiger released into the jungle.

40.   And I don’t think this is what Singaporeans want for our country.

San Francisco

41.   If you look at another place, San Francisco. Decriminalised drug possession eight years ago in 2014. Since then, people have been dealing, using, and overdosing on drugs openly in the streets.

42.   In 2021, the mayor of San Francisco declared a state of emergency in the city’s Tenderloin neighbourhood, because of the alarming rise in drug use, crime, homelessness. But all of this was entirely predictable.

43.   In 2020, San Francisco had more than 700 drug deaths. That is, to put it in context, three times the number of people in San Francisco who died of COVID-19. COVID-19 was on the front-page every day. Drug deaths in San Francisco are not on the front-page, but they kill three times as many. And countless more homeless and crime.

Oregon

44.   If you look at Oregon, recreational cannabis was legalised in 2015. Since then, the state has been producing twice as much cannabis as what its people are consuming.

45.   So, there are more than six years’ worth of excess supply sitting on shelves and at farms.

46.   In the three years after decriminalisation, the rate of visits to emergency departments in hospitals linked to cannabis use increased by 80%.

Singapore’s Approach

47.   In Singapore, we base our policies on evidence, science, and common sense. Science clearly shows that cannabis use is harmful, both in the short- and long-term.

48.   I asked IMH to do a literature review in 2015 – we’ll update it – and they looked at a comprehensive review of the literature that had been published on the use of cannabis. And it was clear from all over the world, research papers done by scientists, that cannabis consumption is associated with irreversible brain damage, shrinkage of the brain, as well as serious mental and psychiatric illnesses.

49.   Likewise, a 2019 study published in the Lancet Psychiatric Journal found a link between cannabis use, and psychosis and schizophrenia. A 2019 WHO report said in children, it could cause respiratory depression, tachycardia, even coma. These are serious effects.

50.   On the other hand, there is no scientific evidence that I have come across, showing the safety and efficacy of raw cannabis use, or its ability to treat medical conditions.

51.   If a doctor tells me, and doctors do say in Singapore, they need to use cannabis, we allow. If doctors prescribe it under certain conditions for a patient, we will approve – opium, cannabis. But that should be a choice of doctors, not pharma companies selling through shops.

Harms of Drugs to Families and Children

52.   Drugs harm the abusers, and also those around them.

53.   Drug habits strain family relationships, and create financial, psychological, and emotional difficulties for family members.

54.    A recent study by the Singapore Prison Service found that one in five drug-abusing parents had a child who ended up either imprisoned, sent to a juvenile home, or was put on probation. So, you see the cycle. One in five. And the other four, doesn’t mean that they have better lives either. It’s a broken life, and often, they are from poorer families, disadvantaged backgrounds.

55.   So, our CNB officers often see the effects on families first hand when they come across sad cases of drug abusing parents who are unable to care for their children, because they are drug crazed. Thankfully, it is not as serious here, as in other countries, because we keep the situation under control. But you ask yourself whether the children in these situations deserve this.

56.   And just in the last few days, we have seen reports of:

(a)   A man who killed his grandmother and mother under the influence of LSD. We don’t see activists holding candlelight vigils for either the grandmother or mother. Their lives matter too.

(b)   And a man who assaulted cabin crew and made a bomb threat on an SIA plane, suspected to be taking drugs. The plane had to be escorted down by fighter jets.

57.   So, we are very tough on the upstream consequences. We are very tough on people who make a cynical calculation to make money out of selling drugs.

58.   At the same time, you can see the tremendous value in the work that you do with drug abusers. And with drug abusers, I think we need to show them sympathy, compassion, kindness, and try and give them a better life. They are in that situation, there are many reasons why they’ve gotten in – sometimes, it’s familial, sometimes its circumstantial. But whatever it is, they’ve taken a wrong turn, we’ll try and help them. We don’t stigmatise them, and we try and keep their confidentiality, move them ahead, find them a job, support them through life, and hopefully, they are able to achieve their full potential.

Conclusion

59.   So, ex-abusers who have successfully turned away from drugs show the effectiveness of our approach through the efforts of Prisons, Yellow Ribbon, community partners like SANA, and volunteers like you.

60.   And this approach proves to other abusers that it is possible to turn away from a life of drugs.

61.   One such role model is Hannah, who got involved in drugs as a teenager. Her family environment was neither stable nor nurturing, and the place where she found acceptance was at nightclubs where she worked, and she came across drugs.

62.   First admitted to prison at 16 years old for drug consumption. Tried to stop, after the birth of her first child, but could not succeed.

63.   During one of her admissions, a prison volunteer who had been drug-free for 20 years, shared her story, and that inspired Hannah to commit to turn away from drugs.

64.   There was strong support from her husband, family, friends, and through her faith, she has been drug-free for the past 10 years.

65.   And today, Hannah runs a women’s support group for disadvantaged women, and she volunteers at a charity organisation that offers shelter to women offenders.

66.   She is just one of many success stories, but very inspiring. She got help, she turned her life around, and she’s doing a lot to help other women.

67.   While the global situation is challenging and will not get easier, in Singapore, our streets are safe, our families are protected, and as I often say to my audiences, you can send your 10-year-old child on public transport and not worry whether the child will come back. It’s not something that you can do in many places around the world. And because of the collective efforts of our agencies, community partners like SANA, practitioners, volunteers, our streets and our country are safe.

68.   So, thank you very much for your hard work, and I wish all of you a fruitful conference as we continue to work together in this very important effort.

69.   Thank you.