Poshyachinda V
Institute of Health Research, Chulalongkorn University, Bangkok.
Bull Narc. 1993;45(1):77-90.
Opium has been produced and consumed since the nineteenth century in the areas of Asia currently referred to as the Golden Crescent and the Golden Triangle. In the 1970s and 1980s, most countries from Afghanistan to Japan experienced a heroin epidemic of varying degrees of severity. Opium and heroin abuse appeared to be more severe in countries and areas where those drugs were produced, an exception being Hong Kong, which has had a large population of heroin abusers for more than two decades. Drug injecting was far more common in countries of the Golden Triangle than in those of the Golden Crescent. In Myanmar and Thailand, for example, up to 90 per cent of chronic heroin abusers practised intravenous injection, which appeared to spread to heroin abusers in nearby territories such as the State of Manipur in India. Yunnan province in China, as well as Malaysia and Viet Nam. Amphetamine abuse was more frequent in Japan and the Republic of Korea for a number of years, while illicit production and consumption in the Philippines have recently shown significant increases. The injection of amphetamines was common only in the Republic of Korea. The prevalence of injecting among institutionalized methamphetamine abusers was reported at about 90 per cent. Most countries in Asia first reported cases of infection with the human immunodeficiency virus (HIV) in the mid-1980s. An extremely rapid spead of the epidemic and high prevalence, at rates of from 30 to 90 per cent, of HIV infection among the sample of intravenous heroin abusers were observed in a few countries with a high prevalence of intravenous injecting, such as India (in the State of Manipur), Myanmar and Thailand. The rest had either few reported cases or none at all, even though needle-sharing was found to be common. Great caution should be exercised in interpreting prevalence because of vast differences in methods of assessment. Given the vulnerability of intravenous drug abusers to rapid transmission of HIV infection, the prevention of drug injecting is of paramount importance in arresting the spread of the epidemic. Efforts to contain drug abuse, though difficult, are a principal means of achieving that end.
自19世纪以来，鸦片就在如今被称为“金新月”和“金三角”的亚洲地区生产和消费。在20世纪70年代和80年代，从阿富汗到日本的大多数国家都经历了程度不同的海洛因泛滥。在生产这些毒品的国家和地区，鸦片和海洛因滥用情况似乎更为严重，但香港是个例外，那里有大量海洛因滥用者已达二十多年。在金三角地区的国家，毒品注射远比金新月地区的国家普遍。例如，在缅甸和泰国，高达90%的慢性海洛因滥用者采用静脉注射，这种方式似乎传播到了印度曼尼普尔邦等附近地区、中国云南省以及马来西亚和越南的海洛因滥用者中。多年来，苯丙胺滥用在日本和大韩民国更为频繁，而菲律宾的非法生产和消费最近有显著增加。苯丙胺注射仅在大韩民国较为常见。据报告，在收容机构中的甲基苯丙胺滥用者中，注射率约为90%。亚洲大多数国家在20世纪80年代中期首次报告了人类免疫缺陷病毒（HIV）感染病例。在一些静脉注射盛行率较高的国家，如印度（曼尼普尔邦）、缅甸和泰国，观察到疫情极其迅速地蔓延，静脉注射海洛因滥用者样本中的HIV感染率高达30%至90%。其他国家要么报告的病例很少，要么根本没有病例报告，尽管发现共用针头的情况很普遍。由于评估方法存在巨大差异，在解释流行率时应极为谨慎。鉴于静脉吸毒者极易感染HIV，预防毒品注射对于遏制疫情蔓延至关重要。控制药物滥用的努力虽然困难，但却是实现这一目标的主要手段。
