Abstract
Drug abuse has a long, but also different history in Germany and China. The Opium War largely influenced the history of China in 19th century; however, China was once recognized as a drug-free nation for 3 decades from the 1950s to the 1980s. Drug abuse has spread quickly since re-emerging as a national problem in China in the late 1980s. The number of registered drug abusers increased from 70 000 in 1990 to more than 1 million by the end of 2005. In past decades, illicit drug trafficking and production have swept most provinces in China, and drug abuse has caused many problems for both abusers and the community. One major drug-related problem is the spread of HIV, which has caused major social and economic damage in China. Germany, the largest developed European country, also faces the drug and addiction problem. Germany has about 150 000 heroin addicts, for whom HIV/AIDS has become a serious threat since the mid 1980s. To control the drug problem, the German Government adopted the “Action Plan on Drugs and Addiction” in 2003; the China Central Government approved a similar regulation in the antidrug campaign in 2005. Germany has experience in reducing drug-related harm. The methadone maintenance treatment (MMT) program has run for more than 20 years and the public has become more tolerant of addicts. In 2003, China began the MMT program for controlling the spread of HIV/AIDS. It is necessary for China to learn from developed countries to acquire success in its antidrug campaign. In this review, we will go over the differences and similarities in drug abuse between Germany and China. The differences are related to history, population and economics, drug policy context, drug laws, HIV/hepatitis C virus infection, the MMT program and so on. These 2 nations have drug abuse problems with different histories and currently use different approaches to handle illicit drug marketing and use. The legal penalties for illicit drug offences reflect the social differences of these 2 nations with respect to the seriousness of particular types of crimes. The characteristics of the MMT program may also influence patterns of drug abuse in these 2 nations and China should improve the MMT program based on the successful model in Europe, the USA, and Australia. We recommend more dialogue and collaboration between Germany and China.
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References
Liu XZ, Wang JL . An introduction to China's health care system. J Public Health Policy 1991; 12: 104–16.
Rakete G, Flüsmeier U . Ecstasy-Eine explorative Studie zum Konsum und Mißbrauch von Ecstasy. Wiener Zeitschrift für Suchtforschung, 1995.
Fang YX, Wang YB, Shi J, Liu ZM, Lu L . Recent trends in drug abuse in China. Acta Pharmacol Sin 2006; 27: 140–4.
Zhao C, Liu Z, Zhao D, Liu Y, Liang J, Tang Y, Liu Z, Zheng J . Drug abuse in China. Ann N Y Acad Sci 2004; 1025: 439–45.
Qian HZ, Schumacher JE, Chen HT, Ruan YH . Injection drug use and HIV/AIDS in China: Review of current situation, prevention and policy implications. Harm Reduct J 2006; 3: 4.
Chu TX, Levy JA . Injection drug use and HIV/AIDS transmission in China. Cell Res 2005; 15: 865–9.
Hao W, Xiao S, Liu T, Young D, Chen S, Zhang D . The second National Epidemiological Survey on illicit drug use at six high-prevalence areas in China: prevalence rates and use patterns. Addiction 2002; 97: 1305–15.
Annual report on drug control in China. Beijing, China National Narcotics Control Commission (CNNCC), 2002.
Kulsudjarit K . Drug problem in southeast and southwest Asia. Ann N Y Acad Sci 2004; 1025: 446–57.
Simon R, David SM, Farke W . Germany. New Developments, Trends and In-Depth Information on Selected Topics. 2005.
McCoy CB, Lai S, Metsch LR, Wang X, Li C, Yang M, et al. No pain no gain: establishing the Kunming, China, drug rehabilitation center. J Drug Issues 1997; 27: 73–85.
McCoy AW . The Politics of Heroin: CIA Complicity in the Global Drug Trade: Afghanistan, Southeast Asia, Central America, Colombia. Chicago, Lawrence Hill Books; 2003.
Bai YT . The anti-opium campaign movement in the early 1950s. CPC History 2001; 10: 38.
Baumler A . Modern China and Opium: a Reader. Ann Arbor, University of Michigan Press; 2001.
McCoy CB, McCoy HV, Lai S, Yu Z, Wang X, Meng J . Reawakening the dragon changing patterns of opiate use in Asia, with particular emphasis on China's Yunnan province. Subst Use Misuse 2001; 36: 49–69.
Jiang ZN : Heroin addiction and contemporary treatments. Beijing: Science Press; 1995.
Lowinger P . The solution to narcotic addiction in the People's Republic of China. Am J Drug Alcohol Abuse 1977; 4: 165–78.
Naik TN, Sarkar S, Singh HL, Bhunia SC, Singh YI, Singh PK, et al. Intravenous drug users — a new high-risk group for HIV infection in India. Aids 1991; 5: 117–8.
Drug use and HIV vulnerability: Policy research study in Asia. Bangkok UNAIDS Asia Pacific Inventory Team, 2000.
Shi J, Liu YL, Fang YX, Xu GZ, Zhai HF, Lu L . Traditional Chinese medicine in treatment of opiate addiction. Acta Pharmacol Sin 2006; 27: 1303–8.
Hao W, Su Z, Xiao S, Fan C, Chen H, Liu T, Young D . Longitudinal surveys of prevalence rates and use patterns of illicit drugs at selected high-prevalence areas in China from 1993 to 2000. Addiction 2004; 99: 1176–80.
Zhou Y, Li XL . Demographic characteristics and illegal drug use patterns among attendees of drug cessation programs in China. Subst Use Misuse 1999; 34: 907.
Liu ZM, Lu, XX, Mu Y, Lian Z, Zhou WH . Epidemiological features of drug abusers in China. Chin J Drug Abuse Prevent Treat 2002; 8: 27–30.
Xue LY, Wang, ZC, Du YJ, Fei H . Retrospective investigation of the epidemiology and characteristics of drug abuse in Shanghai. Chin J Drug Depend 2002; 11: 47.
Lou JL, Shi JH, Yang HH, Li F, Zheng PK, et al. A survey of substance abuse among 2207 drug users in Yunnan. Chin J Drug Abuse Prevent Treat 2003; 9: 5.
Krollpfeiffer K . Auf der Suche nach ecstatischer Erfahrung. Berlin, On the search for ecstatic experience, 1995.
Gouzoulis-Mayfrank EHL, Kovar KA . Die Entaktogene: Ecstasy “(MDMA), Eve” (MDE) und andere ring-substituierte Methamphetaminderivate. Eine neue Stoffklasse unter den illegalen Designer-Drogen?. Nervenarzt 1996; 67: 369.
Wilkinson DA, Leigh GM, Cordingley J, Martin GW, Lei H . Dimensions of multiple drug use and a typology of drug users. J Addict 1987; 82: 15.
Lyttle T, Montagne M . Drugs, music and ideology: a social-pharmacological interpretation of the ‘acid-house-movement’. Int J Addict 1992; 27: 1159.
Griffiths PVL . The use of amphetamines, ecstasy and LSD in the European Community: a review of data on consumption patterns and current epidemiological literature. In: The EMCDDA by the National Addiction Centre (NAC). London, 1997.
Henderson S . Women, sexuality and ecstasy use - the final report. Lifeline publication. 1993.
Saunders N . Ecstasy. Ricco Bilgen, Zurich, 1994.
Tossmann HP . Ecstasy-konsummuster, konsumkontexte und komplikationen. Ergebnisse der Ecstasy-Infoline. Suchtmed 1997; 2: 9.
Tossmann HP, Heckmann WT . Drogenkonsum Jugendlicher in der Techno-Party-Szene. 1997.
Lewis R, Sherval J . Demand reduction activities related to “new synthetic drugs”: MDMA (ecstasy), other amphetamines and LSD in European Member States., in Report prepared for the EMCDDA by the Centre for HIV/AIDS and Drug Studies (CHADS). Edinburgh, 1997.
Tossmann H P, Heckmann WT . Drogenprävention für die Techno-Party-Szene. 1997.
Center Nioddandas: Report of drug surveillance. Beijing, National Institute on Drug Dependence, 2003.
Center Nioddandas: Report of drug surveillance. Beijing, National Institute on Drug Dependence, 2004.
Hanson GR, Rau KS, Fleckenstein AE . The methamphetamine experience: a NIDA partnership. Neuropharmacology 2004; 47 Suppl 1: 92–100.
Morton J . Ecstasy: pharmacology and neurotoxicity. Curr Opin Pharmacol 2005; 5: 79–86.
Parrott AC . MDMA (3,4-Methylenedioxymethamphetamine) or ecstasy: the neuropsychobiological implications of taking it at dances and raves. Neuropsychobiology 2004; 50: 329–35.
Beyrer C, Razak MH, Lisam K, Chen J, Lui W, Yu XF . Overland heroin trafficking routes and HIV-1 spread in south and southeast Asia. Aids 2000; 14: 75–83.
Chung H, Park M, Hahn E, Choi H, Choi H, Lim M . Recent trends of drug abuse and drug-associated deaths in Korea. Ann N Y Acad Sci 2004; 1025: 458–64.
National Anti-drug Committee, in Anti-drug forum, 2004.
Backmund MR, Reimer J, Meyer K, Gerlach T, Zachoval R . Hepatitis C virus infection and injection drug users. Prevention, risk factors and treatment. Clin Infect Dis 2005; 40 ( Suppl S): S330.
Gölz J, Rockstroh J . Compliance in der HIV-Therapie. 2001.
Gölz J, Klausen G, Schleehauf D . Therapie der chronischen Hepatitis C bei HIV/HCV-koinfizierten Drogenabhängigen. Suchtthera-pie 2006; 7: 2.
Schäfer M, Heinz A, Backmund M . Treatment of chronic hepatitis C in patients with addiction: time to change the rules. Addiction 2004; 99: 9.
Mauss S, Berger F, Goelz J, Jacob B, Schmutz G . A prospective controlled study of interferon-based therapy of chronic hepatitis C in patients on methadone maintenance. Hepatology 2004; 40: 120–4.
Annual report of China-UK HIV/AIDS Prevention and Care Project. Beijing, China-UK Workshop on HIV/AIDS in China, 2004.
Kaufman J, Jing J . China and AIDS: the time to act is now. Science 2002; 296.
Yang H, Li X, Stanton B, Liu H, Liu H, Wang N, et al. Heterosexual transmission of HIV in China: a systematic review of behavioral studies in the past two decades. Sex Transm Dis 2005; 32: 270–80.
Zeng Y . HIV infection and AIDS in China. Arch AIDS Res 1992; 6: 1–5.
Kerr C . Sexual transmission propels China's HIV epidemic. Lancet Infect Dis 2005; 5: 474.
Lau JT, Feng T, Lin X, Wang Q, Tsui HY . Needle sharing and sex-related risk behaviours among drug users in Shenzhen, a city in Guangdong, southern China. AIDS Care 2005; 17: 166–81.
Ruan Y, Qin G, Liu S, Qian H, Zhang L, Zhou F, et al. HIV incidence and factors contributed to retention in a 12-month follow-up study of injection drug users in Sichuan Province, China. J Acquir Immune Defic Syndr 2005; 39: 459–63.
Aceijas C, Stimson GV, Hickman M, Rhodes T . Global overview of injecting drug use and HIV infection among injecting drug users. Aids 2004; 18: 2295–303.
Sun Z, Ming L, Zhu X, Lu J . Prevention and control of hepatitis B in China. J Med Virol 2002; 67: 447–50.
Gerlach R, Caplehorn JRM . Attitudes and beliefs of doctors prescribing methadone to addicts in the Westfalen-Lippe region of Germany. Drug Alcohol Rev 1999; 18: 163.
Degkwitz PC, Krausz M . Five years of methaone prescription in Germany, in AIDS and drug addiction in the European Commuity. Proceedings of a Seminar on AIDS and drug addiction in twelve European Comunities Member States, EMCDDA, 1993.
Verthein U, Raschke P, Kalke J . ‘Methadone Therapy in Hamburg’. Eur Addict Res 1995; 1: 7.
Michels II, Stoever H, Gerlach R . Substitution treatment for opioid dependent in Germany. Chin J Drug Depen 2006.
Verthein U, Kalke J, Raschke P . ‘Substitution treatment with methadone in Germany: politics, programmes and results’. Int J Drug Policy 1998; 9: 8.
Scherbaum N, Kluwig J, Specka M, Krause D, Merget B, Finkenbeiner T, et al. Group psychotherpy for opiate addicts in methadone maintenance treatment. A controlled trial. Eur Ad Res 2005; 11: 9.
Brack JBK . Erfahrungen mit dem Einsatz von Buprenorphin in der qualifizierten stationaeren Entzugsbehandlung Opiatab-haengiger. Suchtmed 2004; 6: 241–8.
Krausz M, Verthein U, Degkwitz P, Haasen C, Raschke P . Maintenance treatment of opiate addicts in Germany with medications containing codeine - results of a follow-up study'. Addiction 1998; 93: 1161.
Stöver H . Drug substitution treatment and needle exchange programs in German and European prisons. J Drug Issues 2002; 2: 23.
Stöver H . An overview study: Assistance to drug users in European Union Prisons. Lisbon, European Monitoring Centre for Drugs Drug Addict 2001.
Stöver H, Hennebel L, Casselmann J . Substitution treatment in European prisons, in a study of policies and practices of substitution treatment in prisons in 18 European countries. London/Oldenburg, 2004.
Stöver H, Casselmann J, Hennebel L . Substitution treatment in European prisons: A study of policies and practices in 18 European countries. Int J Prisoner Health 2006; 2: 10.
Scherbaum N, Kluwig J, Specka M, Krause D, Merget B, Finkbeiner T, Gastpar M . Group psychotherapy for opiate addicts in methadone maintenance treatment — a controlled trial. Eur Addict Res 2005; 11: 163–71.
Sigmon SC, Stitzer ML . Use of a low-cost incentive intervention to improve counseling attendance among methadone-maintained patients. J Subst Abuse Treat 2005; 29: 253–8.
1000 clinics offering methadone maintenance treatment to be opened, in People's Daily Online, 2004.
Newman RG . ‘Another Wall That Crumbled - Methadone Maintenance Treatment in Germany’. Am J Drug Alcohol Abuse 1995; 21: 27–35.
Gerlach R . Drug substitution treatment in Germany: a critical overview of its history, legislation and current practice. J Drug Issues 2002; 2: 503–22.
Newman RG . ‘ Is there a Role for Methadone in Germany?’ AIDS Public Policy J 1988; 3: 23–9.
Rosenberg H, Melville J, McLean PC . Acceptability and availability of pharmacological interventions for substance misuse by British NHS treatment services. Addiction 2002; 97: 59–65.
Simpson DD . The relation of time spent in drug abuse treatment to posttreatment outcome. Am J Psychiatry 1979; 136: 1449–53.
Carroll KM, Ball SA, Nich C, Martino S, Frankforter TL, Farentinos C, et al. Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend 2006; 81: 301–12.
Schroeder JR, Epstein DH, Umbricht A, Preston KL . Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence. Addict Behav 2006; 31: 868–79.
Thompson D . The “People's War” against drug and HIV/AIDS, 2005.
Poehlke T, Flenker I, Schlüter HJ, Busch H . Suchtmedizinische Versorgung. Berlin, Provision of Addiction Medicine, 2000.
Heather N . Treating addictive behaviors: process of change. New York: Plenum Press; 1998.
Bühringer G . Allocating treatment options to patients profils: clinical art or science?. Addiction 2006; 101: 646–52.
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This work was supported in part by grants from the Intramural Research Program of the National Institute of Drug Abuse, National Institute of Health, USA, the 985 Talent Program of Peking University (No 985-2-046-121 and 985-2-027-39), the New Century Talent Scientist Grant of the Ministry of Education, the National Basic Research Program of China (No 20003CB 515400), and the National Natural Science Foundation of China (No 30570576, 30670713, and 30611120528).
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Michels, I., Fang, Yx., Zhao, D. et al. Comparison of drug abuse in Germany and China. Acta Pharmacol Sin 28, 1505–1518 (2007). https://doi.org/10.1111/j.1745-7254.2007.00633.x
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DOI: https://doi.org/10.1111/j.1745-7254.2007.00633.x
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