Extent and patterns of drug abuse among children in Malaysia

Sections

Abstract
Introduction
Method
Results
Extent of drug use
Type of drugs used
Acknowledgement

Details

Author: V. NAVARATNAM, L.B. AUN, C.P. SPENCER
Pages: 59 to 68
Creation Date: 1979/01/01

Extent and patterns of drug abuse among children in Malaysia [ 1]

V. NAVARATNAM
L.B. AUN
C.P. SPENCER
Universiti sains Malaysia, Penang, Malaysia

Abstract

A field survey, based on a representative sample of children aged 12 to 16 years was carried out in three different areas of Malaysia. The data derived from the study have revealed that 10.5 per cent of them used drugs for nonmedical reasons. Drug use was more common among boys (11.9 per cent) than girls (8.6 per cent). The highest frequency of drug use was found in the youngest group-12-year-old children (13.5 per cent). The use of barbiturate aad/or non. barbiturate sedatives (5.5 per cent) ranked first. This was followed in descending order by tranquillizers (4.5 per cent), stimulants/amphetamines (3.9 per cent), heroin (3.6 per cent), morphine and/or opium (3.2 per cent), the hallucinogens (3.1 per cent) and cannabis (2.7 per cent).

Introduction

Drug abuse in Malaysia is not a new phenomenon; however individuals who misuse and abuse drugs and related substances continue to vary in numbers, in motives and in kind, and in particular when comparisons are made with those who have been drug users in the past (Navaratnam and Williams, 1976). In recent years, Malaysia, like many other countries, has witnessed a considerable increase in drug abuse among young persons. Easy availability, peer influences, mood enhancement, low cost, the desire to escape from boredom, disquietude and stress, broken homes and inappropriate parental care are some of the contributory factors. In addition in the cities of both the industrialized and developing worlds, children are turning to drugs as a result of such deficiencies as lack of proper playgrounds and recreational facilities, lack of programmes to develop social and creative skills and lack of a home and social environment providing sufficiently for such needs as affection, understanding, encouragement, emotional support, friendship and a feeling of personal worth (Ling and Boutle, 1979). Studies have been carried out mainly in industrialized countries on the socio-pathological consequences of drug abuse in the young, but only a few have directed their attention to the drug-related problems of children below the age of 16 (O'Donnell et al., 1976; Abelson and Fishburn, 1976; Johnston et al., 1977). In this age group, there is an urgent need to obtain more knowledge on the characteristics and patterns of drug misuse and abuse, and in particular in a developing country like Malaysia whose geographical location near to the Golden Triangle places it in a position to interdict trafficking in illicit drugs through its borders but at the same time, raises the possibility of increased availability of these substances to drug users.

This survey was carried out with the financial assistance of the United Nations Fund for Drug Abuse Control. The project on this study has been executed by the National Drug Dependence Research Programme of the Government of Malaysia at the University of Science, Penang, Malaysia in collaboration with the United Nations Division of Narcotic Drugs,

The National Drug Dependence Research Programme, based at the University of Science, Penang, Malaysia, has already studied the patterns of drug use among several groups of the Malaysian population (Navaratnam and Spencer, 1978; Navaratnam, 1979). These studies permitted generalisations to be made about the likely characteristics of other similar populations within the country and provided a useful guide for the selection of social and attitudinal variables in this study.

The purpose of the studies reported here was to explore the extent and patterns of drug use among children of either sex under 16 years of age. It also examined the type of drugs mostly used and the frequency of use.

Method

The study was carried out in three areas of Malaysia during the period April/ December 1978. The survey included both male and female children from 12 to 16 years of age and was based on a representative sample, selected for each age group. Precaution was also taken to ensure the representativeness with respect to ethnicity and urban/rural location. The principal objective was to ascertain the extent and patterns of drug abuse among children.

A self-reporting questionnaire was used as a survey instrument. It was pretested with a population similar to that of the study sample. It was also validated against information available in the National Drug Abuse Reporting System. The questionnaire was, as appropriate, administered in English or Bahasa Malaysia. The anonymity and confidentiality of the survey was preserved. The questionnaire was introduced by a brief statement assuring anonymity and a further reminder of it was given where it was thought that the respondent might feel threatened by the questions concerning his/her actual experiences with drugs.

The study investigated the general pattern of the non-medical use of drugs, though it was essentially interested in the use of illicit drugs. The use of alcohol and tobacco cigarettes was included in the survey but for the purpose of this paper these two items have been excluded from the analysis.

A drug user in this study is considered as any individual who had taken, without a medical reason, any one or more of the following drugs: cannabis, tranquillizers, barbiturate and/or non-barbiturate sedatives, amphetamine type substances, hallucinogens, heroin, morphine and opium. Drug use implied any use by an individual of an illicit drug or use of a licit drug without a medical reason, irrespective of whether such use was experimental, short-lived or a regular habit.

Although the above definitions allowed us to designate an individual as a drug user, it did not distinguish the experimental drug user from the drug dependent individual. The labelling of an individual as a drug dependent was again arbitrary and subjective. To diminish such a bias, the following rating scale was adopted: experimenter is an individual who used once to three times any of the above listed drugs for non-medical reasons; light user is anyone who used drugs once a week or continuously for at least 12 times; moderate user is

Extent and patterns of drug abuse among children in Malaysia 61 anyone who used a drug 2 to 3 times a week or continuously, at least 50 times; heavy user is anyone who used drugs at least 5 times a week or continuously, at least 100 times.

Taking into account the potency and purity of the locally available illicit drugs as well as existing clinical and pharmacological evidence on drug tolerance and drug dependency, we are of the opinion that persons who fall into the last category (i.e., the heavy users) may be considered as drug dependent.

Results

To facilitate the reader's understanding of the results presented in this paper, an overview of the availability of drugs on the illicit market in Malaysia is described below. The proximity of Malaysia to the Golden Triangle and recent advancements in communication have greatly contributed to an increased availability of drugs on the Malaysian illicit market and to place this country on the international trafficking network. The drugs predominantly available are opium, morphine and heroin. Cannabis (ganja) is also readily available. Psychotropic substances seem to reach the illicit market as a result of diversion from licit sources. These substances are also smuggled into Malaysia from neighbouring countries.

Extent of drug use

Of the total number (16580) of respondents 10.5 per cent are classified as drug users (table 1). The majority of children (89.5 per cent) have never experienced any drug and will hereafter be referred to as the non-drug users.

TABLE 1

Drug use by age

		Non-drug users		Drug users		Total number of respondents
Age	No.	Percentage distribution	No.	Percentage distribution	No	Percentage distribution
12 Years	4,671	31.5	732	42.1	5,403	32.6
	(86.5)		(13.5)
13 Years	4,171	28.1	462	26.6	4,633	27.9
	(90.0)		(l0.0)
14 Years	3,089	20.8	271	15.6	3,360	20.3
	(91.1)		(8.1)
15 Years	1,043	7	89	5.1	1,132	6.8
	(92.1)		(7.9)
16 Years	1,867	12.5	185	10.6	2,052	12.4
	(91.0)		(9.0)
Total	14,841	100	1,730	100	16,580	100

Figures in brackets are age-specific rates in percentages.

AGE

Table 1 shows the distribution by age. Drug use was most common among the youngest group -12-year-old (13.5 per cent). It then showed a decrease in 13-year (10 per cent), 14-year (8.1 per cent) and 15-year-old (7.9 per cent) groups respectively, but the number increased again among the 16-year-old (9 per cent). There appears to be no striking difference in the percentage distribution between the users and non-drug users.

SEX

Table 2 shows the variation by sex. It indicates that drug use occurred more frequently among boys (11.9 per cent) than girls (8.6 per cent). This pattern was found to be consistent in all represented age groups. Age-sex specific percentage rates show that the difference in drug use among boys and girls was more marked among the oldest and youngest children -16-, 15- and 12-year-old, than among the 13-and 14-year-old groups.

Both boys (15.0 per cent) and girls (11.7 per cent) in the 12-year age group were found to be considerably more involved in drug use than those in other age groups. Among the 15-year-old only 10.7 per cent of boys and 3.4 per cent of girls were drug users. In the 16-year-old group, there is a slight increase, namely, 11.8 per cent and 4.7 per cent of boys and girls respectively used drugs.

Type of drugs used

The variation of drug use by drug type is discussed in this section. It should be noted that those who had "ever used" a drug are not necessarily an indication of frequency of current usage. The frequency of drug use by substance ranked as follows: barbiturate and/or non-barbiturate sedatives (5.5 per cent), tranquillizers (4.5 per cent), stimulants/amphetamines (3.9 per cent), heroin (3.6 per cent), morphine and/or opium (3.2 per cent) and cannabis (2.7 per cent).

USE OF CANNABIS

Of the total number of respondents, 446 or 2.7 per cent of children were users of cannabis (ganja). Among those classified as drug users in this study, there were 25.6 per cent of children who admitted to having experienced the use of cannabis. With respect to the age groups of the surveyed population, it was found that cannabis was used by 2.9 per cent of 12-year-old children, 2.3 per cent of 13-year-old and only 1.5 per cent of 14-year-old. A considerable increase in the use of cannabis was found among 15-year-old (3.7 per cent) and 16-yearold (4.7 per cent); however, the percentage of experimenters (approximately two thirds of cannabis users) was higher in these two groups than in the 12-, 13- and 14-year-old groups. It should also be noted that 5.4 per cent of respondents indicated that though they had not tried cannabis they would have liked to, if the opportunity arose.

This survey also revealed that 46.4 per cent of those who reported "ever tried" cannabis had only had one or two experiences with it; 18.2 per cent tried it less than 10 times; 9.4 per cent used it 10-50 times and 4.5 per cent 51-100 times, while 21.5 per cent of respondents lost count of the number of times they used cannabis.

TABLE 2

Drug use by sex and age.

(N.D.U. = Non-Drug Users; D.U. = Drug Users

	> 12 years		> 13 years		> 14 years		> 15 years		> 16 years
Sex	N.D.U	D.U.	N.D.U	D.U.	N.D.U	D.U.	N.D.U	D.U.	N.D.U	D.U.	Total
Male	2575	455	2 394	285	1763	177	620	74	1089	146	9578
	(55.1)	(62.2)	(57.4)	(61.7)	(57.1)	(65.3)	(59.4)	(83.1)	(58.3)	(78.9)	(57.8)
		(15.0)		(10.6)		(9.1)		(10.7)		(11.8)
Female	2084	276	1786	175	1317	93	423	15	778	38	6967
	(44.6)	(37.7)	(42.4)	(37.9)	(42.6)	(34.3)	(40.6)	(16.9)	(41.7)	(20.5)	(42.0)
		(11.7)		(8.9)		(6.6)		(3.4)		(4.7)
No information	12	1	9	2	9	1				1	35
	(0.3)	(0.1)	(0.2)	(0.4)	(0.3)	(0.4)	-	-	-	(0.5)	(0.2)
Total	4671	732	4171	462	3089	271	1043	89	1867	185
	(100.0)	(100.0)	(100.0)	(100.0)	(100.0)	(100.0)	100.0)	(100.0)	(100.0)	(100.0)
	(86.5)	(13.5)	(90.0)	(10.0)	(91.1)	(8.9)	(92.1)	(7.9)	(91.0)	(9.0)	16580
Grand total	5403		4633		3360		1132		2052
											(100.0)

Figures appearing in the first set of parentheses below the absolute numbers are percentage distributions, while those in a subsequent set are age sex-specific Percentage rates.

TABLE 3

Use of cannabis (ganja)*

	Numbers of users
Frequency of usage	12 years	13 years	14 years	15 years	16 years	Total
Once or twice	48	44	24	27	64	207
	(31.2)	(42.3)	(49.0)	(64.2)	(66.0)	(46.4)
	(0.9)	(0.9)	(0.7)	(2.3)	(3.1)
Less than 10 times	25	16	9	11	2 0	81
	(16.2)	(15.5)	(18.4)	(26.2)	(20.6)	(18.2)
	(0.5)	(0.3)	(0.3)	(1.0)	(1.0)
10-50 times	24	93	1	5	42
	(15.5)	(8.6)	(6.1)	(2.4)	(5.2)	(9.4)
	(0.4)	(0.2)	(0.1)	(0.1)	(0.2)
51-100 times	12	5	1	1	1	20
	(7.7)	(4.8)	(2.0)	(2.4)	(1.0)	(4.5)
	(0.2)	(0.1)	(0.03)	(0.1)	(0.1)
Lost count of numbers of times	45	30	12	2	7	96
	(29.2)	(28.8)	(24.5)	(4.8)	(7.7)	(21.5)
	(0.8)	(0.7)	(0.4)	(0.2)	(0.3)
Total	154	104	49	42	97	446
	(100.0)	(100.0)	(100.0)	(100.0)	(100.0)	(100.0)
	(2.8)	(2.2)	(1.5)	(3.7)	(4.7)

Figures appearing in the first set of parentheses below the absolute numbers are percentage distributions, those in a subsequent set are age-specific percentage rates..

Most users did not provide information on their age when they started using cannabis. However, among those who did provide such information it was evident that the majority of the 12-year-olds commenced using cannabis when they were 10 years old or younger, while many of the respondents from the other age groups indicated that they started using it at the reported year or the preceding year.

USE OF TRANQUILLIZERS

Of the total number of respondents, 740 individuals (4.5 per cent), used these substances (table 4). It would appear that the younger respondents showed greater experience with tranquillizers; 6.7 per cent of the 12-year-old group used them whereas such use was noted only in 1.2 per cent of the 15-year-old and 1.9 per cent of the 16-year-old.

Approximately one half of the users of tranquillizers in the 12-, 13- and 14-year-old groups were classified as experimenters in contrast to the majority of experimenters among the 15- and 16-year-old.

TABLE 4 Use of tranquillizers a

Frequency of use	12 years	13 years	14 years	15 years	16 years	Total
Rarely (experimenters)	183	98	55	12	29	377
	(3.4)	(2.1)	(1.6)	(1.1)	(1.4)	(2.0)
Quite often (light to moderate users)	94	64	26	-	4	123188
	(1.7)	(1.4)	(0.8)	(0.2)	(1.0)
Very often (heavy users)	84	54	29	2	6	175
	(1.6)	(1.2)	(0.9)	(0.2)	(0.3)	(1.0)
Total	361	216	110	14	39	740
	(6.7)	(4.7)	(3.3)	(1.2)	(1.9)	(4.5)

Figures appearing in parentheses are age-specific percentage rates.

USE OF BARBITURATE AND/OR NON-BARBITURATE SEDATIVES

There were 914 respondents or 5.5 per cent who used barbiturates and/or non-barbiturate sedatives. The majority of them (502) were experimenters. As with tranquillizers, the use of sedatives quite often (light or moderate users) and very often (heavy users) was more frequent among the younger respondents, 12-, 13- and 14-year-old, than among the 15- and 16-year-old (table 5).

USE OF STIMULANTS/AMPHETAMINES

Table 6 shows that 636 (3.9 per cent) respondents were involved with stimulants. Of these, 268 (42.1 per cent) used these substances rarely (experimenters). In contrast 176 (27.1 per cent) of respondents (classified as light to moderate users) used them quite often, and 192 (30.2 per cent) were heavy users and used them often.

TABLE 5

Use of barbiturate and/or non-barbiturate sedatives.

Frequency of use	12 years	13 years	14 years	14 years	16 years	Total
Rarely (experimenters)	228	131	74	25	44	502
	(4.2)	(2.8)	(2.2)	(2.2)	(2.1)	(3.0)
Quite often (light to moderate users)	87	69	36	4	12	208
	(1.6)	(1.5)	(1.1)	(0.3)	(0.6)	(1.3)
Very often (heavy users)	93	69	37	2	3	204
	(1.7)	(1.5)	(1.1)	(0.2)	(0.2)	(1.2)
Total	408	269	147	31	59	914
	(7.5)	(5.8)	(4.4)	(2.7)	(2.9)	(5.5)

Figures appearing in parentheses are age-specific percentage rates.

TABLE 6

Use of stimulants/amphetamines

Frequency of use	12 years	13 years	14 years	15 years	16 years	Total
Rarely (experimenters)	113	80	40	10	25	268
	(2.1)	(1.7)	(1.2)	(0.9)	(1.2)	(1.6)
Quite often (light to moderate users)	87	54	27	2	6	176
	(1.6)	(1.2)	(0.8)	(0.2)	(0.3)	(1.1)
Very often (heavy users)	105	55	28	1	3	192
	(1.9)	(1.2)	(0.8)	(0.1)	(0.2)	(1.2)
Total	305	189	95	13	34	636
	(5.6)	(4.1)	(2.8)	(1.2)	(1.7)	(3.9)

Figures appearing in parentheses are age-specific percentage rates.

Younger respondents, 12-, 13- and 14-year-old, were significantly more involved with stimulants than those from the 15- and 16-year age groups. There were 305 (5.6 per cent) in the 12-year age group and among them approximately one third were heavy users. Among the 15- and 16-year-old it was found that the percentages of users were 1.2 per cent and 1.7 per cent respectively.

USE OF MORPHINE AND/OR OPIUM

The figures representing morphine use and opium use are combined in table 7. It shows that 538 (3.2 per cent) respondents used these substances. Of these 181 (33.6 per cent) were heavy users, 151 (28.1 per cent) were light to moderate users and 206 (38.3 per cent) experimenters. The distribution of users by age is similar to that presented in previous tables. The usage of these substances was more common among younger 12-, 13- and 14-year-old, than among the 15- and 16-year-old respondents.

TABLE 7

Use of morphine and/or opium a

Frequency of use	12 years	13 years	14 years	15 years	16 years	Total
Rarely (experimenters)	89	55	36	6	20	206
	(1.7)	(1.2)	(1.1)	(0.5)	(1.0)	(1.2)
Quite often (light to moderate users)	76	53	21	1	-	151
	(1.4)	(1.1)	(0.6)	(0.1)		(0.9)
Very often (heavy users)	88	63	28	2	-	181
	(1.6)	(1.4)	(0.8)	(0.2)		(1.1)
Total	253	171	85	9	20	538
	(4.7)	(3.7)	(2.5)	(0.8)	(1.0)	(3.2)

Figures appearing in parentheses are age-specific percentage rates.

In the group of respondents who were classified as users of any drug, there were 44 per cent of the 12, 13 and 14 age groups and 10 per cent of the 15- and 16-year-old who claimed to have any experience with morphine or opium, with 12 per cent of the younger drug users claiming that they had very often used one of the two drugs.

The availability of opium pills in Malaysia may contribute to the possible explanation of the higher frequency of opium/morphine use by the younger population. These pills which have the appearance of Candy, are chewed by curious young persons to gain an euphoric effect.

USE OF HEROIN

Table 8 shows that 593 or 3.6 per cent of respondents used heroin. Among them 254 (42.8 per cent) were classified as experimenters while 177 (29.8 per cent) were heavy users and 162 (27.3 per cent) light to moderate users. The age-specific percentage rate was 4.7 in the 12-year-old group, 3.9 in the 13-year, 2.8 in the 14-year and 1.9 in the 15- and 16-year age groups.

In the group of respondents classified as drug users, 47 per cent of the 12-, 13- and 14-year-old and 22 per cent of the 15/16-year-old reported having experienced heroin; 3.6 per cent of the older non-drug users and 13.5 per cent of the older drug users, who were not involved with heroin, expressed interest in trying it.

USE OF HALLUCINOGENS

Only data from younger respondents, 12-, 13- and 14-year-old, were analysed with regard to the frequency of use of hallucinogens (table 9). Among them 601 individuals used these substances. The age-specific percentage rate of use for this group was 4.5. As with other drugs, the youngest respondents were more involved with hallucinogens; 6 per cent of the 12-year-old, 3.7 per cent of the 13-year-old and 3.1 per cent of the 14-year-old group used these substances.

TABLE 8 Use of heroin a

Frequency of use	12 years	13 years	14 years	15 years	16 years	Total
Rarely (experimenters)	104	70	34	16	30	254
	(1.9)	(1.5)	(1.0)	(1.4)	(1.5)	(1.5)
Quite often (light to moderate users)	70	54	34	1	3	162
	(1.3)	(1.2)	(1.0)	(0.1)	(0.2)	(1.0)
Very often (heavy users)	83	58	26	5	5	177
	(1.5)	(1.2)	(0.8)	(0.4)	(0.2)	(1.1)
Total	254	182	94	22	38	593
	(4.7)	(3.9)	(2.8)	(1.9)	(1.9)	(3.6)

Figures in parentheses are age-specific percentage rates.

TABLE 9

Use of hallucinogens

Frequency of use	12 years	13 years	14 years
Rarely (experimenters)	119	57	38
	(2.2)	(1.2)	(1.1)
Quite often (light to moderate users)	103	45	35
	(1.9)	(1.0)	(1.0)
Very often (heavy users)	101	71	32
	(1.9)	(1.5)	(1.0)
Total	323	173	105
	(6.0)	(3.7)	(3.1)

Figures in brackets are age-specific percentage rates.

Acknowledgement

The authors wish to acknowledge the help provided by Dr G.M. Ling and Dr M. Kilibarda of UNDND in preparing this publication.

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