Alcoholic Beverage and Personal Communication Essay

Introduction The enjoy ment of a defraudsecrate of drug types, including alcoholic tipsiness, atomic recite 18 part of the traditions of galore(postnominal), if not all, communities in Fiji. The Fijian and Indo-Fijian communities bring on long traditions of psycho-active drug practice in the snarftext of ritual and ceremony. 1,2 It has been illustrious that seafargonrs, together with indentured labourers, brought cannabis or Indian hemp traditions to Fiji, with the scraping cane plantations providing fertile ground for cultivation. 2,3 Meanwhile, kava was widely cultivated and consumed by ethnic Fijians.The Indo-Fijian community slowly adopted kava crapulence rituals and piecemeal early(a)(a)s began to affix their intake. In increase, marihuana use emerged and spread with change magnitude popularity amongst youth, oddly males. 2-5 This literature review explores the original licit and outlaw(a) drug space in Fiji. It considers peer-reviewed articles ident i? ed using Pub Med, health Internet call on Access to Research Initiative (HINARI) searches and grey literature, including published and unpublished reports, and nett based resources (e.g. UNDOC, WHO).The review found that in that respect is limited entropy unattached to assist in understanding the current situation and associated harms in Fiji, exclusively notes much studies and reports conduct examined alcohol consumption patterns and associated genial problems when comp ard with studies on illegitimate drug use. 1, 5-15 alcoholic beverage use in Fiji check to the WHO Global positioning taradiddle on intoxicant, data from the 1993 home(a) Nutrition Survey specify that consumption of alcoholic home brew use is widespread in Fiji, as in different Paci? c nations.These bever hop ons usually contain up to three times the alcohol content of commercially produced beer and argon broadly drunk by boy career men. 16 After 1995, unrecorded alcohol consumption in Fiji wa s estimated to be 1. 0 litre of pure alcohol per capita for the population older than 15 years (estimated by a free radical of key alcohol experts). 17 Although there are no belatedly published statistics on the number of drinkers and abstainers, the said(prenominal) survey found quotidian drinkers to be 1. 4% among males and 0. 8% among females aged 12 years and over.18 Estimates from alcohol experts show that the proportion of adult males and females who had been abstaining (in the year prior to the survey) was 74% (males) and 98% (females). 17 Research shows that single insobriety sessions with a extravagantly rate of alcohol intake (common practice among Fijian youth) can event abrupt mood swings resulting in violence, accidents and ? ghts, exaggerated emotions, uncharacteristic behaviour, memory loss, stricken judgement, communicating problems, sleepiness, coma, stupor and death (at very heights intake) and suicide attempts. bacchanal drinking has alike been implicat ed in schizophrenic and other psychiatrical episodes. 19 165 REVIEW pacific wellness talks contact 201 1, VOL. 17, no 1 darn there is limited current discipline on the rate and consumption patterns of alcohol, cannabis and kava among immature wad,1,6,9 round(prenominal) studies2,3,8,11 were conducted to analyse the extent of tobacco and alcohol use among upstart people in Fiji in the 1990s and early 2000s.One of the studies4 found that alcohol is widely consumed in one form or another among young people, with about 2 in 5 of the young people surveyed having tasted it. The contri scarceion of young people classi? ed as current drinkers ranged from a amply of 26% among males to 9% among females. 4 Of attention was the high proportion of gorge drinkers about 3 in 5 young people describe having had 5 or more alcoholic drinks in one session. The understand4 indicated that the high prevalence among 13-15 year olds poses a serious concern, and highlights the unavoidablenes s for law enforcement and disturbance programs to create an environment that promotes responsible drinking.Interestingly, the study found that when compared to smoking, alcohol and kava use, the proportion of young people using cannabis was relatively low. 4 A follow up survey of 2147 students in 2004 by the topic marrow squash Abuse Advisory Council (NSAAC) found a general increase in substance use among secondary students (see table 1). Table 1 young person Substance Use in Fiji (Comparison of the results for Fiji in the 1999 Global Youth baccy Survey by UNICEF and WHO and 2004 follow up survey by NSAAC). Substance Tobacco Alcohol Kava Marijuana GYT Survey (1999) 32.3 40. 3 51. 9 12. 8 NSAAC (2004) 43 51 61 13 Signi? savings bank variations exist in the drinking habits of males and females in Fiji there are many more male drinkers than there are female drinkers. 11 Ordinarily males consume the bulk of the alcohol in the company of other males, usually during drinking session s with no special occasion, while well-nigh women drink alcohol during societal functions or in night club settings in the company of men and other women. While women occasionally participate in drinking sessions, typically it is an exclusively male activity.11,13 It is at these drinking parties where the most copious amounts of alcohol are accountly consumed. Thus, when males drink, they tend to drink larger amounts of alcohol in one sitting than women do. extramarital drug use in Fiji Border Security and medicine Control Limited data exist to aid in understanding illicit drug use and the associated harms across the Paci? c. In addition, there are no direction systems. 20 However, Fiji by virtue of its geographical position is faced with the twin problems of illicit drug traf? cking and increase use.21,22 These are further aggravated by the rapid coverional and social changes arising from urbanization. These developments create an atmosphere which exposes entire communiti es to greater find associated with drug use (Personal communication Fiji practice of law part, 2008). Minimal use of drugs such(prenominal)(prenominal) as heroin, morphine, cocain and hallucinogens occur, but this review found that Fiji is considered a transit area for smuggling. 20-23.Drugs such as heroin, methamphetamines and 166 PACIFIC HEALTH DIALOG march 201 1, VOL. 17, NO. 1 REVIEW cocaine are not ordinarily apply due to their high cost when compared to the average income. Raw cocaine has reportedly been found in Fiji and three Chinese men and a Fijian security guard were murdered in what was thought to be an organized crime execution linked to drugs. 22 National enforcement agencies involve responded to curb traf? cking as is re? ected by the large raptures of illicit drugs. 24,25 In spite of this response, a drug laboratory found in Fiji in 200625 supports the view that organized crime groups could escalate their activities in the Paci? c islands.21,25 A raid at an industrial estate in Suva, involving police from Australia and virgin Zealand and Fijian Customs Of? cer followed a major heroin seizure in 2000. 21,25 The lab identi? cation similarly suggests a transition of Fiji (and possibly other Paci? c Nations) from a transhipment point to a mathematical product base. According to the refreshing Zealand Police, to succeed in future operations similar to the Suva bust, interested agencies need to work towards having robust communication systems across organisations to keep them connected and cognizant on crime in the persona.21 It is reported that there are about 5000 vessels transiting in the Paci? c on any given day. 21,24 ample shipments may be unloaded from a mother ship to smaller vessels, and can subsequently go in hiding at the many small, uninhibited islets and atolls, waiting for the next step. 21 Fiji has novelly established a Transnational umbrage Unit (TCU) with the Fiji Islands taxation and Customs Authority (FIRCA) a s one of the key law enforcement agencies involved. This unit has been vigilant in promoting the cooperation amid border organizations in order to assist the TCU in keep backling the borders.24 The Unit also compiles data for intelligence risk assessments throughout the year. It supports a Case Management Intelligence System (CMIS), whereby relevant information from the Police Department, Immigration Department, Local Government Authorities, Financial Intelligence Unit, and other uprightness Enforcement Agencies24 are automatically linked in the system. A number of cases which the TCU have been investigating include a Tongan syndicate smuggling drugs from Fiji to Tonga.In a recent example of program cooperation a number of TCU surveillance targets were set abouted during a Police roadblock in Sigatoka (personal communication, FIRCA, 2008). Domestic Issues Cannabis is by far the most common and widespread illicit drug used in Fiji. 11 Like many other countries in the region, ane cdotic evidence suggests there has been a considerable increase in drug use among young people4 despite the relatively small increase suggested by the 2004 NSAAC study (see table 1). However, it is not clear if the devil studies they reported were direct comparable.Data collected by the St Giles infirmary and the Fijian Police Department support the view there has been an increase in use. Admissions data for St Giles Hospital reports on cannabis induced psychosis and other disorders. In 1987, ? ve young men were admitted to St Giles Hospital with cannabis related mental disorders. In 1988, the number locomote to ? fteen with many more unreported cases. 26 The 2005 hospital data revealed that a total of 612 patients were seen at outpatients department diagnosed with a substance abuse disorder.These include 386 (63%) patients for marijuana, 59 (10%) alcohol, 99 (16%) kava and 99 (16%) tobacco use issues. In 2006, 272 admissions to St Giles Hospital were reported as drug related, co nsisting of 66% Fijians, 20% Indo-Fijian and 14% belong to other ethnic groups. It is probable that the political troubles in 2006 force on the number of admissions, but no data were available to con? rm or reject this view. Police arrest data report self-command (see Table 2).8,13,26 Statistics provided by Fiji Police showed 259 drugrelated crimes were committed in 2008. There was a 21 per cent drop from 2007 which had 329 drug-related 167 REVIEW PACIFIC HEALTH DIALOG border 201 1, VOL. 17, NO. 1 crimes. 27 There are also reports of increasing cannabis cultivation as a form of inter-seasonal hard cash crop substitution among farmers. It is estimated that Fiji has between 500 to 1000 cannabis producers, some of them citing the countrys worsening economy as the motivator for production (personal communication, Police Drug Unit, November 2008).For generations, the villagers of Navosa have travelled for hours across rugged terrain to cause a road to the market to sell their produc e with no countenance their produce will be sold. Facing the same hardships as their ancestors, many of these villagers report having no choice but to resort to marijuana exploitation because The product is lighter, it has a steady market and is sparingally viable (Personal communication with growers, December, 2008). Production is predominantly for local consumption. Table 2 Recent Crime Data ( Drug offences recorded by the Fiji Police Forces from 2000 to 2006).Year Drug offences 2001 433 2002 417 2003 417 2004 312 2005 312 2006 333 The Save the Children stemma in Fiji reports that the continuing political and economic instability in the country has also led to a lot more children running(a) as drug traf? ckers or prostitutes. 28 Concern over the increasing number of children involved in drug traf? cking was sparked by the recent arrest of three school children caught selling drugs in an amusement centre in Labasa. The Fiji Womens Crisis tenderness reported an increase in you ng Indo-Fijian girls working as prostitutes in urban centres.Furthermore, the National Manager for Save the Children Fund in Fiji, says there is a growing trend among poor families to blame their children out onto the streets. 28 Drug and alcohol legislation and policy According to the literature, there is no regional-based illicit drug policy for the Paci? c and fewer treatment programs. 20,29 Information from the Paci? c Island assembly Secretariat (PIFS) indicates that Fijis extracurricular Drugs Control Act is an adaptation of the Regional Model Law on the Control of Illicit Drugs which was developed by the Secretariat.There was no schematic committee, but it was endorsed by a Cabinet sub-Committee on legislation which was chaired by the then Attorney- prevalent. Both the Fijian Government and PIFS are advocating for a regional legislative framework to respond to the increase in illicit drugs in the region (personal communication, PIFS, 2008). Amphetamines are a key drug of concern with the regions geographical vulnerability highlighted as a key gene in the rationale for this approach. At the time of writing, Kiribati and Fiji are the however two PIFS member countries to have adapted and enacted the model law.Furthermore, a Code of commit has been developed by PIFS to assist stakeholders such as law enforcement agencies and pharmacies to classify, point and dispose of illicit drugs (personal communication, PIFS, 2008). It may be adapted by Forum member countries with modi? cations to suit national legal and administrative arrangements. Legislative control on the consumption and sale of alcohol to minors has not been widely and effectively implemented. While minors are legally barred from go through alcohol, the sale of alcohol beverages to under-age drinkers is common throughout the country.11 For the minor who is unavailing to gain access to commercial alcohol beverages, homebrew is an easily obtained alternative. anecdotical evidence suggests that minors make up a large and undiscovered percentage of consumers of alcohol beverages. 168 PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 REVIEW Sexually Transmitted Infections Sexually Transmitted Infections, including HIV, are emerging public health problems in Fiji. 13 A recent WHO report indicated that the rise in the number of HIV cases, in addition to increasing number of patients accessing STI clinics, in an ongoing concern.In 2006, MOH statistics indicated30 that Fijians comprised 83% of con? rmed HIV diagnoses, Indo-Fijian 13% and others 4%. Since 2004, Fijian males had replaced females as having the highest number of cases. Overall, males comprised 59% and hetero bring upual transmission accounted for 85% of all cases. By the end of 2004 a total of 182 HIV infections had been reported in Fiji13 and the number of current cases reported each year has change magnitude for the last ? ve years. In Fiji, reported cases of lues and gonorrhea have ? uctuated between 19 98 and 2004. In 2004 there were 852 reports of syphilis and 1182 gonorrhea.The number of cases reported for 2008 were 1004 for syphilis, 1064 gonorrhea and 283 HIV cases. 27 Recent statistics from Fijis Health Ministry on Sexually Transmitted Infections are a cause for concern with the high rate of STIs among people aged 20 to 29 increasing the risk for HIV infection. 31,32 Fijis Director of Public Health notes that statistics pull together over the past eight years by the Ministry show that clack and syphilis are the most frequently reported STIs in the country, which highlights the central concern of unsafe internal behaviour among young people and the same high-risk behaviour for the transmission of HIV. He also said that sex is serious business and that anyone, especially young people, who participates does so at their risk, in view of the sad consequences of infection from so many STIs including HIV, pelvic in? ammatory disease and infertility. 32 Risk/Protective Factors Som e religious groups in Fiji, such as Islam, strictly forbid the use of alcohol. Christian denominations such as the Assemblies of God, Jehovahs Witnesses and the Seventh Day Adventist Mission also prohibit the consumption of alcohol. Individual members of these religious groups vary in the compass point to which they adhere to these principles.Any negative effects of combining tobacco or alcohol with kava use are currently conjecture, with relatively unretentive work done to explore the nature of the relationship between these substances in the Paci? c. 1,6,9,26,33 However, anecdotal evidence suggests an inter-relationship exists with social and health consequences. 1, 4-6, 9, 13, 26, 33, 34 Reports of kava drinking followed by a beer chaser, known as washdown, are not special and suggests the need for further exploration of potentially harmful consumption patterns. extravagant drinking, drinking too frequently and too much, often re?ects the drinking pro? le of the majority of y oung people in countries like Fiji. 5, 11, 14 Excessive drinking is reported as a signi? cant contributor to motor vehicle accidents, violence and aggressive behaviour, unwanted pregnancy, sexually transmitted infections, and criminal activities. 3, 14, 15, 18, 26 It has been suggested that the alcohol consumption pattern of young Indigenous Fijian males follows the traditional kava ritual of drinking until there is nothing left in the kava bowl. In many instances, young people often end their kava drinking session by consuming alcohol (wash down).3, 5 It is reported that most youths drink excessively to manage their problems, but it may result in new problems like unsafe sex, crime and violence and even suicide. 5, 14, 15, 34, 35 A study in Fiji10, 11 revealed that alcohol was a factor in 58% of all homicide between 1982 and 1992 and approximately 80% of the crime in the country is alcohol-related. 10, 18 169 REVIEW PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO.1 Furthermore, the effects of alcohol on the physical, mental and social health of Fijis citizens have in recent years been the hooked of considerable concern amongst health-care professionals and social scientists, as well as the median(a) citizens. 2, 3, 8, 10, 11, 23, 26, 33 At present there is suf? cient evidence from a flesh of research ? ndings1, 6, 10, 11, 34 to suggest that the heavy consumption of alcohol contributes other health problems in Fiji, such as diabetes, heart problems, obesity and hypertension. Among the social consequences of excessive alcohol consumption in the country,10, 11 violent crime, house servant violence, and road fatalities have been identi? ed as the most serious.8, 23, 34 While alcohol and home brew drinking are more common, marijuana cultivation, sales and distribution has become pervasive in some Paci? c Island countries. It has been seen as a good source of income. A further emerging substance abuse issue is glue snif? ng among school age children, mostly in th eir early teens. In addition, unemployment in youths is a major problem in the Paci? c. In Fiji it has been estimated that out of nearly 10,000 youths seeking employment, only 1500 can be employed. 2, 3, 13 Studies and observations in some urban areas of Paci?c countries point to an increasing numbers of people between the ages of 15-19 engaging in commercial sex worker with some aged even younger. 2, 3, 11, 15, 35, 36 Conclusions There is a range of evidence and data suggesting the potential for increased risk of HIV infection associated with substance use in Fiji, but there is a need to explore this issue further with social behavioural and qualitative research. While harmful substance use patterns and sexual health risk factors are increasingly reported, there is little current analysis regarding the interaction of the two.Of particular concern is the current environment of speedily changing substance use patterns with little in the way of morphological responses to protect the people of Fiji from the range of social and health-related harms. In addition, dif? cult economic conditions and the tangible bene? ts of cannabis growing and distribution (and potential for amphetamine production) supply urgency to the need to investigate these issues further and to develop viable interventions that are informed by robust data and research information. References 1. Goundar R, Kava consumption and its health effects.Journal of Community Health and Clinical Medicine for the Paci? c 2006. 13(3) p. 131-5. 2. Plange, N. K. , social Aspects of Drug and Alcohol Abuse An overview of the situation in Fiji. Fiji medical examination Journal, 1991. 17(3) p. 5-12. 3. Plange, N. K. , Alcoholism and Crime among Urban Youth in Fiji. 1991, University of the South Paci? c. 4. UNICEF. , Substance use among adolescents in Fiji A surveillance Report from the Fiji Global Tobacco Survey. 1999. 5. Rokosawa, M. Alcohol problems in Fiji. 1986 cited. 6. Moulds RFW, M. J. , Kava herbal pa nacea or colorful poison?For Debate. Medical Journal of Australia, 2003(178) p. 451-3. 7. Morrison F, H. F. , Gaylord J, Leigh B, Rainey D. , Adolescent drinking and sex ? ndings from a daily diary study. Perspective on Sexual Reproductive Health, 2003. 35(4) p. 162-8. 8. Adinkrah, M. , Homicide-Suicides in Fiji Offence patterns, situational factors & socio-cultural contexts. Suicide and Life Threatening Behavior, 2003. 33 p. 65-73. 170 PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 REVIEW 9. Kava, R. , The unbecoming effects of Kava. Paci? c Health Dialog, 2001. 8 p. 115-18. 10. Adinkrah, M., Violent encounters A study of homicide patterns in Fiji society.1996, Fiji Council of Social Services. Suva, Fiji. 11. Adinkrah, M. , Crime, deviance & delinquency in Fiji. 1995, Suva, Fiji Fiji Council of Social Services. 12. Plange, N. K. , Social aspects of drug and alcohol abuse An overview of the situation in Fiji. Fiji Medical Journal, 1991. 17(3) p. 4-12. 13. 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Illicit Drugs Control Bill Draft. Fiji Paci? c Islands Forum Secretariat. 2002. 30.Minis try of Health, Annual Report Shaping Fijis Health.2007. 31. http//www. health. gov. fj/index. html. 2008. 32. http//www. stats? ji. gov. fj/Social/health_cdeath. htm. 2008 cited. 33. Council out to Fight Drug Abuse, in The Fiji Times. 34. Caswell, S. , Alcohol in Oceania. 1986, Alcohol Research Unit, Dept of Community Health and General Practice, School of Medicine, University of Auckland, New Zealand. p. 25. 35. Kippax D, O. M. J. , Alcohol-Related Problems in Fiji. 1986, Suva Suva. 36. Ali, S. , Family Life Education. 1986, Ministry of Education. p. 36-39. 171 REVIEW PACIFIC HEALTH DIALOG MARCH 201 1, VOL. 17, NO. 1 172.