250 word response for each post minimum, 500 words total. 1 citation per post minimum.
1. (250 word response, 1 citation): According to the United Nations Office on Drugs and Crime (UNODC, 2011) report, transnational organized crime groups netted the better part of about US$68 billion; attributed mostly from the estimated 16.5 million people throughout the globe who use opium through illicit means (p. 5). The Afghan Taliban reaped about US$155 million through taxation, protection fees, and their own sales interests in 2009 alone. Those Afghans operating as traffickers brought in about US$2.2 billion, with the Afghan farmers bringing up the rear with about US$440 million.
Organized criminal envelopes understand the global desire for heroin which feeds about 12 to 13 million users on an annual basis. About 375 million tons of heroin are generated/required to feed the heroin habit for this many users. Twenty-eight hundred tons of raw opium is necessary to produce this amount of heroin annually (UNODC, 2011). Raw opium was also consumed at a rate of about 1,300 tons during 2009. The total amount of opium needed to supply the raw consumption and heroin production in 2009 was about 4,000 tons (p. 5). However, this total varies on an annual basis due to product seizures by law enforcement, disease affecting crop yields, new routes for transport being discovered, and new areas for cultivation are developed (NODC, 2011). To compensate for these expected and unexpected trends, large stockpiles of opium, morphine, and heroin are hidden in caches to be retrieved later when needed (p. 26).
Organized criminal entities are able to continue the opium, morphine, and heroin industries by taking advantage of border areas in countries such as “Iran, China, Pakistan, Uzbekistan, Tajikistan, and Turkmenistan” in which it is difficult for law enforcement seizure processes to take place due to weak state agencies, lack of police groups, corrupt public officials and citizenry, an abundance of crime in general, and an insufficient number of incorruptible border control stations (Kreutzmann, 2019, p. 152). In addition, due to the tremendous profits provided to organized criminal elements, an added value of around $28 billion “along the Balkan route to Western Europe alone,” disrupting the global opiate industry appears difficult, if not impossible (p. 153). And the difficulties are not restricted to Eastern and Western Europe, organized crime groups trafficking opium and its products have been established in Africa as well (UNODC, 2011, p. 71).
Nigerian organized crime groups, in combination with help from Tanzanian, Chinese, and Pakistanis participants, netted an estimated US$3.2 billion in 2009 (UNODC, 2011, p. 71). Africans are apparently using heroin as well, which is distressing due to the fact that out of about 33.4 million people globally known to be HIV positive, 22.4 million are African citizens, raising alarms that HIV too, as well as heroin abuse, will lead to furthering both catastrophes in this developing nation (p. 72). In one study performed in East Africa, out of over 300 heroin users, nearly half the number (44.9%) were known to have HIV. And it is not just the opium which is the problem, the major source of the preferred treatment agent to turn opium into heroin, the precursor chemical acetic anhydride, is illegally diverted and trafficked to areas such as Afghanistan for said processing (UNODC, 2011, p. 91).
Acetic anhydride is manufactured globally; in Asia, Europe, and the Americas (UNODC, 2011, p. 91). Organized crime groups take advantage of the same amenable conditions (weak states, lack of law enforcement, particularly at border crossings, and corruption) which allow for the trafficking of illicit products. Understanding that 85% of heroin world wide originates from Afghanistan, it is not surprising to note that tons of acetic anhydride (about 475 tons) makes its way to this country on an annual basis; in spite of more recent controls in an attempt to limit diversions of this useful chemical for illicit purposes (p. 91). Organized crime groups understand the need for this chemical, and where US$1 can purchase a liter of acetic anhydride in the legitimate course of business, the same liter will fetch over US$350 in Afghanistan; netting $165 million to the provider (p. 91).
2. (250 word response, 1 citation) Response: Baltimore, Maryland is a city with a serious problem regarding injection drug use (IDU) and human immunodeficiency virus (HIV) (Furr-Holden, Milam, Nesoff, Garoon, Smart, Duncan & Warren, 2016). These two activities relate to and perpetuate one another. Neighboring counties (“Anne Arundel . . . Carroll, Harford, Howard, and Queen Anne’s”) are included statistically with Baltimore proper; referred to as the Baltimore-Towson Metropolitan Statistical Area (p. 319). As of 2004, this large metropolitan area (also referred to as the Baltimore-Columbia-Towson area) has a population of about 2.8 million residents (City Populations, 2020); number derived from the U.S. Census Bureau. The Baltimore area has about 162 intravenous users per 10,000 residents, making them the second highest users of IDU in the nation (Furr-Holden et al, 2016, p. 319).
In response to the correlation between IDU and HIV, financial support for the Baltimore Substance Abuse System (bSAS) has increased through funding via the federal, city, and state government institutions (Furr-Holden et al, 2016). The bSAS has funded needle exchange programs (NEPs) in 16 different locations to help with the comorbidity problem of IDU and HIV in the Baltimore area; focusing on data accumulated through self-reporting surveys for the city’s zip codes to determine areas most in need. It should be noted that when these problems of comorbidity occur in many people in a population, it is often referred to as a syndemic problem; that relating to groups associated by persons, places, and time.
The syndemic problem of IDU and HIV in Baltimore has been observed from a geographic perspective, the spatial distribution of where IDU and HIV has, and is still, occurring (Furr-Holden et al, 2016). The bSAS partnered up with Johns Hopkins Bloomberg School of Public Health research. Together, they formed the “syndemic triangle” tool with which they hoped to better understand the spatial developments of IDU, HIV, and other health related problems relating to substance abuse, and determine what actions should be taken to better assist the community (p. 321). Monthly meetings were held which included staff, directors, providers of treatment, long-term recovery recipients, and other members of the community. Lastly, the Furr-Holden et al (2016) study’s aim was to present information on how the syndemic triangle tool helped, if at all, in Baltimore, what the empirical results have been using the tool, how policies might be improved, and understand how useful the tool might be to other cities (p. 321).
The bSAS study results showed what areas of Baltimore had unmet medical needs, and a currently functioning treatment organization was contracted to meet those needs (Furr-Holden et al, 2016, p. 323). Unfortunately, following postings of where new treatment centers would be located caused a stir among the residents of said area, and with the aid of zoning laws, halted the establishing of the prospective treatment centers. The U.S. Department of Justice filed a lawsuit claiming discrimination in 2009 against the city of Baltimore, following which the nonprofit organization of treatment providers, the Baltimore City Substance Abuse Directorate, filed a lawsuit of their own against the city. In 2012, the U.S. District Court for the District of Maryland said the ordinance requirement was “overbroad and discriminatory” with regards to how many people could be housed in a treatment center; ordinance against treatment center with 17 or more people okay, but discriminatory against treatment centers with 16 or fewer.
In spite of the fact that the syndemic treatment tool appeared to work well in seeing who needs current immediate needs which have not been met, other legal entanglements, such as ordinance laws on what can be placed with how many, can inhibit much needed medical services in areas most in need. Tools used for such use in policy decisions also have to take into account who are actually intravenous drug users, whether or not they are HIV positive, and are they “sellers, buyers, visitors, and other outsiders,” (Furr-Holden et al, 2016, p. 324). A separate report stated that 92% of IV drug users only do this “in their own homes,” while yet another report stated that 86% shoot up in a friends residence (p. 324). In conclusion, it appears that further research is needed.
Furr-Holden, C., Milam, Adam J, MD,PhD., M.H.S., Nesoff, E. D., M.P.H., Garoon, Joshua,PhD., M.P.H., Smart, Mieka J,DrP.H., M.H.S., Duncan, Alexandra,DrP.H., M.P.H., & Warren, Gregory C,M.A., M.B.A. (2016). Triangulating syndemic services and drug treatment policy: Improving drug treatment portal locations in baltimore city. Progress in Community Health Partnerships, 10(2), 319-327. Retrieved from https://search-proquest-com.ezproxy2.apus.edu/docv…
Kreutzmann, H. (2019, Spring). Afghan poppy production for the world: Dynamics and entanglements. The Brown Journal of World Affairs, 25, 145-155. Retrieved from https://search-proquest-com.ezproxy2.apus.edu/docv…
United Nations Office on Drugs and Crime (UNODC). (2011). http://www.unodc.org/documents/data-and-analysis/Studies/Global_Afghan_Opium_Trade_2011-web.pdf
City Populations. (2020). Baltimore-Columbia-Towson. https://citypopulation.de/en/usa/metro/12580__balt…