We just have not done enough.

• Author: Navaratnam, Vis
• Position: International efforts to control illegal drugs

It's been nearly thirty years since I was introduced to the field of drug dependency. In 1970, I became involved in research in the neuropsychopharmacology of benzodiazepines. Since then, my interest and work have spread to include issues related to the epidemiology, treatment and rehabilitation, prevention, policy development and evaluation at local, national, regional and international levels. My first attempt to review the efforts in the field of drug abuse was described in the book "Drug Abuse in East Asia" in 1981.

Now, 25 plus years since my initiation into the field, I feel it is time, with the international community, to look again at our global efforts and analyze them, specifically to address some of the following questions: What did we do right? What would we repeat? What have we learnt? And what can others learn from our experiences?

I believe we need to stimulate a process of review at all levels which might hopefully lead to the development of more practical, focused and cost-effective programmes and policies in the field of drug abuse control.

My own review has led me to conclude the following: the abuse of licit and illicit drugs represents a major security, social and public health problem, which remains a significant societal concern in most countries. The concern stems from the costs to society caused by the problem. These costs include: premature death of productive individuals due to drug-related illnesses; accidents; economic costs related to lost productivity; health care; and crime prevention. Furthermore, many infectious and social ills plaguing a number of countries - the HIV/AIDS epidemic, increased levels of violence, petty crimes - in many instances are linked to the abuse of drugs. In addition, it has been clearly demonstrated that the consequences of drug abuse have had an impact on people within every economic, racial, religious and political group.

The international community has responded by enacting a multitude of treaties, declarations and laws, and by developing policies and introducing programmes to redress the situation. Yet, despite all these international efforts, we have to acknowledge that producer countries as a whole produce more than ever, and consumer countries consume more than ever, without any real change having been induced by the policies and programmes being implemented on this larger scale, and despite the financial investments being made on an even larger scale.

Why has this happened...