2013 Suriname National Household Drug Prevalence Survey Report Provides an Overview of the Use of Substances Among the Population in Suriname

2013 SURINAME NATIONAL HOUSEHOLD

DRUG PREVALENCE SURVEY

Prepared By: Eva Stroo, MSc 2015

In collaboration with: Inter-American Drug Abuse Control Commission (CICAD) Organization of American States (OAS)

Suriname National Household Drug Survey 2013

Acknowledgements

This report is made possible by the Organization of American States (OAS), through the Executive Secretariat of the Inter-American Drug Abuse Control Commission (CICAD). Special thanks to Pernell Clarke and Tiffany Barry of CICAD for project management, training, monitoring and technical assistance during the implementation of this study. The Embassy of the USA in Suriname and the Bureau of International Narcotics and Law Enforcement Affairs (INL) of the US State Department provided financial support for this project.

Sincere gratitude to Gerold Dompig, CICAD’s Principal Representative to CICAD for his leadership in overseeing the completion of this project. Also many thanks to Tiffany Doerachman for practical support during the completion of the report.

Special thanks are extended to the Director and staff of the Suriname Statistical Bureau who not only selected the sample of households, but also trained the field personnel in relation to the mapping of districts and the identification of selected households. Also special acknowledgement to the field staff and data entry personnel, in particular Ms. Charity Linga, for their dedication and commitment to their tasks. Finally, thanks to the National Security Office in Suriname and the persons who coordinated this project at different stages for their contribution to this study.

Suriname National Household Drug Survey 2013

Table of Contents

Prologue ...... 5 Executive Summary ...... 6 1. Introduction ...... 7 1.1 Drug trade, drug related crime and drug use ...... 7 1.2 Treatment ...... 8 1.3 National Anti-Drug Council ...... 8 1.4 Household survey on drug use ...... 9 2. Methodology ...... 10 2.1 Sampling design ...... 10 2.2 Challenges ...... 11 3. Results ...... 12 3.1 Demographic Characteristics ...... 12 3.2 Substance use once in a lifetime, annual and last 30 days, overall and by gender ...... 16 3.3 Problems associated with alcohol use ...... 19 3.4 Problems associated with marijuana use ...... 22 3.5 Substance use by strata ...... 25 3.6 Substance use by work status ...... 29 3.7 Substance use by age group ...... 32 4. Conclusions ...... 34 4.1 Limitations ...... 35 5. Recommendations...... 36 References ...... 37 Appendices ...... 38 Appendix A, Questionnaire National Household Survey Suriname ...... 38

Suriname National Household Drug Survey 2013

List of Tables

Table 1. Gender ...... 12 Table 2. Strata ...... 12 Table 3. Age groups ...... 12 Table 4. Work Status ...... 13 Table 5. Head of the household ...... 13 Table 6. Education ...... 14 Table 7. Monthly income ...... 14 Table 8. Marital Status ...... 15 Table 9. Religion ...... 16 Table 10. Lifetime, past year and past month substance use, overall and by gender ...... 19 Table 11. Problems associated with alcohol use, overall, by gender and by age group ...... 20 Table 12. Various problems because of alcohol, overall, by gender and by age group ...... 21 Table 13. Problems associated with marijuana use, overall, by gender and by age group ...... 24 Table 14. Lifetime, past year, and past month prevalence of substance use by strata ...... 29 Table 15. Lifetime, past year, and past month prevalence of substance use by work status ...... 31 Table 16. Lifetime, past year, and past month prevalence of substance use by age group ...... 33

Suriname National Household Drug Survey 2013

List of Figures

Figure 1. The districts of Suriname ...... 10 Figure 2. Gender ...... 12 Figure 3. Strata ...... 12 Figure 4. Age groups ...... 12 Figure 5. Work status ...... 13 Figure 6. Head of the household ...... 13 Figure 7. Education ...... 14 Figure 8. Monthly income ...... 15 Figure 9. Marital status ...... 15 Figure 10. Religion ...... 16 Figure 11. Lifetime, past year and past month alcohol use, overall and by gender ...... 16 Figure 12. Lifetime, past year and past month tobacco use, overall and by gender ...... 16 Figure 13. Lifetime, past year and past month marijuana use, overall and by gender ...... 17 Figure 14. Lifetime, past year and past month cocaine use, overall and by gender ...... 17 Figure 15. Lifetime, past year and past month crack use, overall and by gender...... 17 Figure 16. Lifetime, past year and past month ecstasy use, overall and by gender ...... 18 Figure 17. Lifetime, past year and past month tranquilizer use, overall and by gender ...... 18 Figure 18. Lifetime, past year and past month stimulant use, overall and by gender ...... 18 Figure 19. Problems associated with alcohol use, overall and by gender ...... 21 Figure 20. Various problems because of alcohol, overall and by gender ...... 22 Figure 21. Problems associated with marijuana use, overall and by gender ...... 25 Figure 22. Lifetime, past year, and past month prevalence of substance use in Paramaribo ...... 26 Figure 23. Lifetime, past year, and past month prevalence of substance use in Wanica & Para ...... 26 Figure 24. Lifetime, past year, and past month prevalence of substance use in Nickerie, Coronie & Saramacca ...... 27 Figure 25. Lifetime, past year, and past month prevalence of substance use in Commewijne & Marowijne ...... 28 Figure 26. Lifetime, past year, and past month prevalence of substance use in Brokopondo & Sipaliwini...... 28 Figure 27. Lifetime, past year, and past month prevalence of tobacco use by work status ...... 30 Figure 28. Lifetime, past year, and past month prevalence of alcohol use by work status ...... 30 Figure 29. Lifetime, past year, and past month prevalence of marijuana use by work status ...... 31 Figure 30. Lifetime, past year, and past month prevalence of tobacco use by age group ...... 32 Figure 31. Lifetime, past year, and past month prevalence of alcohol use by age group ...... 32 Figure 32. Lifetime, past year, and past month prevalence of marijuana use by age group ...... 33

Suriname National Household Drug Survey 2013

Prologue

This report is made possible by an understanding between the General Secretariat of the OAS, through the Executive Secretariat of CICAD, and the Government of Suriname to conduct a general population (household) drug prevalence survey in Suriname. The purpose is to obtain the data necessary to determine the prevalence and incidence of drug use among the general population and to measure other indicators of drug use. The standardized methodology of the Inter-American Drug Use Data System (SIDUC) is used.

However, this survey started back in 2013 and due to several challenges, its completion was delayed. Despite the course of affairs, it is a pleasure to present the ‘Suriname National Household Drug Survey 2013’.

Hopefully the information made available through this report can be of use to local stakeholders and to the member states of CICAD for better understanding of the hemispheric situation. A scientific approach to the information on drugs and data gathering on a regular basis will contribute to the knowledge of drugs for good policy-making and effective program design, both nationally and internationally.

Suriname National Household Drug Survey 2013

Executive Summary

This 2013 Suriname National Household Drug Prevalence Survey report provides an overview of the use of substances among the population in Suriname. It was supported by the Organization of American States (OAS), through Executive Secretariat of the Inter-American Drug Abuse Control Commission (CICAD). The general objective of the survey was to determine the prevalence and incidence of drug use, and to measure other indicators of drug use.

The survey reported on rates of use of substances such as tobacco, alcohol, marijuana, cocaine, crack, ecstasy, tranquilizers and stimulants among persons in all 10 districts of Suriname, between 12 and 65 years of age. We also looked at other factors like age, district and work status for indicating drug use. 2507 respondents answered the standardized questionnaire provided by CICAD.

The first point that emerges from the information that is presented in this survey is that alcohol is the most commonly used substance, followed by tobacco, marijuana, tranquilizers, stimulants, crack, cocaine and ecstasy. When we look at prevalence rates by gender, males indicated more overall substance use than females surveyed.

An important issue is the use of alcohol. Of the respondents who admitted to using alcohol in the last month, 27.1% were found to be binge-drinkers (consuming 5 drinks or more in a single setting). Various problems associated with alcohol range from 1.5% of the respondents experiencing problems with police or other law enforcement to 3.3% of the respondents having problems with family or friends because of alcohol consumption. Various problems associated with marijuana range from 25.4% of the respondents experiencing problems (fights, accidents, low grades) because the use of marijuana once or more times to 88.1% of the respondents smoking marijuana alone once or more times. These marijuana associated problems were reported by persons who consumed marijuana in the past 12 months.

There are differences throughout the districts in the use of substances among the general population. Noteworthy is that the prevalence of lifetime use of marijuana differs from Nickerie, Coronie and Saramacca to Brokopondo and Sipaliwini, ranging from 3.8% to 14.9%. When we look at prevalence by work status, the use of tobacco, alcohol, marijuana and cocaine is highest in the category of persons who reported that they were working casually. The use of alcohol ranks second and third respectively in the groups ‘working part time’ and ‘working full time’. By age, the least substance use is reported in the age group 12 – 18, alcohol and marijuana are most used in the age groups 26 -34. Tobacco is the only substance that increases by age group. Cocaine is only reported in the age groups 35 – 44 and 45 – 65.

Recommendations of this survey for further policies are more scientific research and evidence-based prevention and treatment. This also needs to be adapted to age groups, district and work status.

Suriname National Household Drug Survey 2013

1. Introduction

The Republic of Suriname is a sovereign state located on the northeastern coast of South America and is the smallest country in this region with an area of just under 165,000 km². Suriname is situated between French Guyana to the east, Guyana to the west and Brazil to the south. The northern part, that borders the Atlantic coast, had been cultivated. Most of the population lives mainly in and around the capital Paramaribo. The Surinamese population is a mix of several ethnic groups with distinct cultures, norms and values. According to the General Bureau of Statistics Suriname (2014), Suriname had a population of approximately 565,000 inhabitants in 2013. The southern part of the country consists of tropical rainforest and savanna, covering about 80% of Suriname’s land surface.

The size of the labor force in 2011 was 145,697, of which 134,021 were employed and 11,676 were unemployed. Therefore the unemployment rate is 8% (ABS, 2011). The Situation Assessment and Analysis of Children’s Rights in Suriname 2010 identified the extreme disparities in education results between the coastal areas and the interior. The national net primary school attendance rate is 97% compared to 55% for the interior. Poor availability and quality of pre-schools and the sudden switch from local languages to Dutch are the main factors resulting in high repetition rates in first grade (19%) and poor net completion rates (51% completed 4 years of secondary school) in coastal areas, and in the interior (34% and 18% respectively). The national percentage for adult engagement in activities with children under five is 70%, while the percentage for the interior is only 44.7%. However in general, the upbringing is still quite traditional.

Due to its Dutch colonial history, Suriname had a long-standing relationship with The Netherlands. Full independence of Suriname was declared in 1975, but political disagreements followed whereby The Netherlands withdrew all support over the years. After independence many Surinamese emigrated to The Netherlands, and, despite the broken political ties, there are still a lot of personal ties between the population in Suriname and the Surinamese in The Netherlands. For example, the direct flight route from Suriname to The Netherlands is an effect of the ongoing bonds. The United Stated has had a positive relationship with Suriname since 1991 and provides funding for several programs. The Dutch influences are also still evident in the Surinamese society. Dutch is the official language of the country, but Sranan is the most widely spoken language in the streets and is often combined with Dutch, depending on the setting.

1.1 Drug trade, drug related crime and drug use An additional aspect of the ties with The Netherlands is that Suriname is one of the four countries that are responsible, as a transit country, for smuggling cocaine to The Netherlands. It involves not only those people who finance the transport and facilitate, but also those who are responsible for the cocaine after arrival and have involvement in the sales. Also, mainly because of its location, Suriname is a transit point for other countries (Gruter & Van de Mheen, 2005). An overall picture of drug crime in Suriname shows that crime is usually concentrated on the following illegal substances: cocaine, marijuana, hashish, synthetic drug types such as ecstasy and other party drugs or related substances of the aforesaid drug types. Suriname, as of old, is not a drug producing country. Marijuana is, however, cultivated on a regular basis, especially in rural areas and is used for local trade and use (National Drug Master Plan 2011-2015, 2011). Vice versa, there are relatively many Dutch people who are incarcerated in Suriname, of which two thirds were born in Suriname. 80% of Dutch people in detention abroad are incarcerated for a drugs related crime (Miedema & Stoltz, 2008). Most of the dirty money in The Netherlands comes from foreign criminality, and flows through The Netherlands to Suriname, The Netherlands Antilles, Turkey, Colombia and Spain for money laundering (Unger, 2008).

Suriname National Household Drug Survey 2013

In the nineties synthetic drugs such as a methamphetamine and methylenedioxymethamphetamine (MDMA, Ecstasy) were introduced to the market. In 2007 the most used illegal drug types were marijuana and ‘blaka jonko’ (mix of cocaine and marijuana for smoking), among legal drug types solvents and inhalants follow after alcohol. In the years 2008 until 2010, cannabis was frequently used in combination with other substances. In 2011 cheap cocaine also became available in Suriname causing youth to become dependent on this drug. In relation to drug use, there is a significant relation between the easy availability and access to these substances and illegal drug use (National Drug Master Plan 2011-2015, 2011).

1.2 Treatment The Psychiatric Center Suriname (PCS) is the only official mental health care treatment center in Suriname and has the most expertise on biological and psychological level of addiction. The PCS offers an outpatients’ clinic for the care and treatment of drug addicts consists of the following tasks: prevention activities, psychoeducation, ambulant counseling and treatment, and aftercare for patients who’ve been in the detox clinic. The detox clinic of PCS provides clients to detox with a stay up to eight weeks. In 2013 the PCS has treated 144 persons for addiction problems.

Over the years the non-Governmental organizations (NGOs) became increasingly significant and larger, and the most NGOs in the field of treatment and care start out from religious beliefs. Their activities span from information and prevention to shelter, treatment, follow-up care and re- integration. The PCS collaborates with the NGOs. Clients detoxified by the PCS will be able to move on more easily to NGO’s or vice versa for further treatment and coaching.

1.3 National Anti-Drug Council The National Anti-Drug Council (NAR) coordinates all national efforts for a strong approach of the drug problem. The council is not an executor but rather a facilitator and policy formulating institute. The pursuit is to decrease drug use, drug addiction, drug trafficking and drug-related crime. To achieve this goal, the focus is on the creation of a wide basis through involvement at the coordination, of relevant governmental institutions such as the Ministries of Health, Justice and Police, Education and Public Development as well as employers’ organizations, non-governmental organizations in the field of prevention, treatment and care.

The government has put the NAR in charge of the preparation of the National Drug Master Plan (NDMP). The national drug policy of Suriname is established within the National Drug Master Plan 2011-2015. The activities in this regard are therefore aimed at combating the supply, transit, trade and use of drugs. This policy is not static but dynamic and there is an integral and holistic approach that showed the problem comprised of multiple elements within the components of drug crime and drug abuse.

Because of the expiration, the NAR is creating a new NDMP for the coming five years. Suriname sought to be associated with the policies of CICAD because collaboration with other countries is necessary for exchanging knowledge and achieving international goals. CICAD has formulated regional policies and strategies with regard to drug control, and the NDMP was based on this Hemispheric Drug Strategy, Plan of Action 2011-2015 (CICAD/OAS). For the National Drug Master Plan 2016-2020, the renewed principles of the CICAD strategy that will be established in the upcoming months are essential.

Suriname National Household Drug Survey 2013

1.4 Household survey on drug use Drug use, drug trade and drug related crimes are internationally regarded as great threats for the development of a society. The diversity between sub regions of the OAS is important to understand and determine for an international policy against drugs. This survey is conducted in several member states of the OAS using the same basic questionnaire, sampling frameworks, and data-processing methods to study the extent and characteristics of drug use in the member states. The standardized methodologies ensure comparable results.

The protocol of the household survey on drug use (2011) describes the specific objectives as follows: o Determine the prevalence of psychoactive substance use: at least once in lifetime, over the past 12 months, over the past 30 days, and former use. o Determine the prevalence of psychoactive substance use on the basis of socio-demographic characteristics: gender, age, occupation, schooling, socio-economic level and place of residence. o Detect patterns of use of the various substances. o Describe aspects related to the use of substances: exposure to supply and use, risk perception, exposure to talks or courses on prevention, among others of interest.

This report will be published as official data by the National Anti-Drug Council in Suriname and the outcomes will be presented to key stakeholders for further policies.

Suriname National Household Drug Survey 2013

2. Methodology

The original standardized questionnaire of the household survey provided by CICAD has been reduced and adapted to 43 questions, to suit the situation in Suriname. Characteristics of respondents were collected and respondents were asked about the use of various types of drugs, age of first use and additional questions about the use and perception of drugs (see appendix A for the questionnaire).

The target population consists of persons in all 10 districts of Suriname. The ages of respondents ranged between 12 and 65 years of age. These males and females are from diverse socio-economic levels, living in the urban, rural and remote areas of the country. The fieldwork started on July 31st 2013 and finished on October 14th 2013 and was conducted by 33 field members (supervisors and interviewers), and guided by a coordinator.

2.1 Sampling design The General Bureau of Statistics Suriname (ABS) prepared the sampling frame, designed and selected the samples. It is fixed on 4000 household addresses, with an error margin of 10%. This is a systematic sampling where an Enumeration Area (EA) of 55 household addresses was selected. The EA’s are proportionally distributed across the districts. The 10 districts (figure 1) are divided into five strata.

Figure 1. The Districts of Suriname

Each stratum includes several EA’s and each EA contains 50 (+5 extra) households: Stratum 1: Paramaribo 35 EA’s Stratum 2: Wanica & Para 20 EA’s Stratum 3: Nickerie, Coronie & Saramacca 9 EA’s Stratum 4: Commewijne & Marowijne 7 EA’s Stratum 5: Brokopondo & Sipaliwini 9 EA’s

Suriname National Household Drug Survey 2013

All of the 80 EA’s were printed on cards, which were used by the fieldworkers to find the addresses. Those addresses were also listed (except in the case of the remote district of Sipaliwini, where only the villages were printed on the cards). Both the card and the list were used by the fieldworkers to gather the data. The house number was also on the list. But some houses did not have numbers at all. The ABS could not present an up-to-date list of households in the (5) EA’s for the remote district of Sipaliwini due to the lack of information about the households. As the area is remote, the houses in this district are not provided with house numbers and there are also no streets in most of the villages. With the help of the Government officials and locals, households were selected, bearing in mind that those selected households represent all the different parts of the villages. Efforts were made to proportionately distribute the number of household per village per EA. The interviewers returned 2507 completed forms. Of the remaining questionnaires 1943 that were prepared for the survey 288 were not used, 26 were not returned, and 1629 forms can’t be used for the survey due to different reasons. Therefore, overall response rate is 62.68%.

The overall experiences during the data collection were positive because the preparations were done in accordance with the District Commissionaires in the districts Nickerie, Coronie, Saramacca, Commewijne, Marowijne, Brokopondo, and Sipaliwini. The District Commissionaires brought the household survey team in contact with local representatives of the Government and members of the community. Those representatives and locals guided the fieldworkers through the EAs. The fieldworkers faced some challenges, especially in the remote areas. Nevertheless the data that is gathered is accountable.

The data was delivered in Excel and transferred to SPSS to produce the analysis.

2.2 Challenges A few bottlenecks incurred during the survey.

During the fieldwork, several households were not found, the addresses didn’t correspond with an actual house, and only 5 replacements were permitted per EA. There were also many refusals or unsuitable persons, for example, household members were older than 65 and the other household members were under 12 years of age.

While implementing the field work, the survey coordinator stepped out of the survey and further guidance was provided by the National Security Office in the Cabinet of the President of the Republic of Suriname. Nevertheless, the surveys in the hinterland were completed and the questionnaires were collected and booked.

The National Security Office of Suriname provided a report in 2015, but due to unfortunate circumstances the analyses of the existing database and the report had to be redone by a local consultant and collaboration with the first author could not take place.

Some results are not used in the report. For example, a few questions have an illogical translation or do not match previously created categories, which make some of the data unsuitable for analysis.

Suriname National Household Drug Survey 2013

3. Results

3.1 Demographic Characteristics The respondents consisted of 47.1% male and 52.7% female. Gender of 0.2 % of the population was unknown (Table 1).

Table 1. Gender Figure 2. Gender

Percent Male 47.1 Female 52.7 Missing 0.2 Male Female Missing

As seen in Table 2, the residential areas of the respondents were as followed: 38.6% live in Paramaribo, 23.3% have a domicile in Wanica and Para, 14.1% of the respondents have their home in Nickerie, Coronie and Saramacca. Commewijne and Marowijne represent 10.7% and Brokopondo and Sipaliwini accounted for 13.3% of the respondents.

Table 2. Strata Figure 3. Strata

Percent 1 Paramaribo 38.6 2 Wanica & Para 23.3 3 Nickerie, Coronie & Saramacca 14.1 4 Commewijne & Marowijne 10.7 Paramaribo 5 Brokopondo & Sipaliwini 13.3 Wanica & Para Nickerie, Coronie & Saramacca Commewijne & Marowijne Brokopondo & Sipaliwini

The respondents are divided into age groups. The age group 12-18 years old accounts for 14.5% of the respondents while the 19-25 age group accounts for 12.4%, 19.3% of the respondents fall into the age group 26-34 years old. The age group 35-44 years represents 22.1% and 31.3% of the respondents fall in the age group 45-65 years old (Table 3). The ages of 0.5% of the respondents are unknown.

Table 3. Age groups Figure 4. Age groups

Percent 12-18 14.5 19-25 12.4 26-34 19.3 35-44 22.1 45-65 31.3 12 - 18 years old 19 - 25 years old Missing 0.5 26 - 34 years old 35 - 44 years old 45 - 65 years old Missing

Suriname National Household Drug Survey 2013

Respondents were also asked for their work status. With a percentage of 44.4%, most of the respondents are working full time. 17% is a student, 13.3% homemaker and 6.6% of the respondents are working part time. In addition, the groups of ‘retired or receiving pension benefits’, ‘working casually’, ‘unemployed but looking for work’, ‘not working and not looking for work’ and ‘incapacity for work’ showed a percentage of, respectively, 5.2%, 4.6%, 4.6%, 2.4% and 1.4% of the surveyed population. The answers of 0.6% are missing (Table 4).

Table 4. Work Status

Percent Working full time 44.4 Working part time 6.6 Working casually 4.6 Unemployed, but looking for work 4.6 Student 17.0 Unemployed, not looking for work 2.4 Homemaker 13.3 Retired or receiving pension benefits 5.2 Disabled 1.4 Missing 0.6

Figure 5. Work status

Working full time Working part time

Working casually Unemployed, but looking for work Student Unemployed, not looking for work Homemaker Retired or receiving pension benefits Disabled Missing

Of the respondents, 43.9% is head of the household and 55.8% is not. Unknown is 0.2% (Table 5).

Table 5. Head of the household Figure 6. Head of the household

Percent Yes 43.9 No 55.8 Missing 0.2 Yes No Missing

Suriname National Household Drug Survey 2013

Of the respondents identified as head of the household, the most completed education is 4 years of secondary school with a percent of 37.4%. 28.4% completed 8 years of primary school and 16.4% completed 7 years of secondary education. Of the head of the households, 5.6% completed higher education and 3.2% finished university. 2.7% reported less than three years of primary education and 6.2% reported no schooling (Table 6).

Figure 7. Education

Table 6. Education

Percent No schooling 6.2 Less than three years of primary education 2.7 Completed 8 years of primary education 28.6 Completed 4 years of secondary school 37.4 No schooling Completed 7 years of secondary school 16.4 Less than three years of primary education Higher education 5.6 University 3.2 Completed 8 years of primary education Completed 4 years of secondary school Completed 7 years of secondary school Higher education

University

The monthly incomes are divided in the followed 13 groups; less than SDR 500 (9.7%), between SRD 500 and SRD 750 (12.9%), between SRD 750 and SRD 1000 (15.2%), between SRD 1000 and SRD 1250 (11.2%), between SRD 1251 and SRD 1500 (10.9%), between SRD 1501 and SRD 1750 (10.5%), between SRD 1751 and SRD 2000 (9.9%), between SRD 2001 and SRD 2500 (8.8%), between SRD 2501 and SRD 3000 (4.0%), between SRD 3001 and SRD 4000 (3.3%), between SRD 4001 and SRD 5000 (1.3%), between SRD 5001 and SRD 6000 (0.8%) and more than 6000 (1.4%) (Table 7).

Table 7. Monthly income

Percent Less than SRD 500 9.7 Between SRD 500 and SRD 750 12.9 Between SRD 750 and SRD 1000 15.2 Between SRD 1000 and SRD 1250 11.2 Between SRD 1251 and SRD 1500 10.9 Between SRD 1501 and SRD 1750 10.5 Between SRD 1751 and SRD 2000 9.9 Between SRD 2001 and SRD 2500 8.8 Between SRD 2501 and SRD 3000 4.0 Between SRD 3001 and SRD 4000 3.3 Between SRD 4001 and SRD 5000 1.3 Between SRD 5001 and SRD 6000 0.8 More than SRD 6000 1.4

Suriname National Household Drug Survey 2013

Figure 8. Monthly income

Less than SRD 500 Between SRD 500 and SRD 750 Between SRD 750 and SRD 1000 Between SRD 1000 and SRD 1250

Between SRD 1251 and SRD 1500 Between SRD 1501 and SRD 1750 Between SRD 1751 and SRD 2000 Between SRD 2001 and SRD 2500 Between SRD 2501 and SRD 3000 Between SRD 3001 and SRD 4000

Between SRD 4001 and SRD 5000 Between SRD 5001 and SRD 6000 More than SRD 6000

Most of the respondents reported their marital status as single (51.4%), followed by married (27.4%) and living with a partner (12.8%). 3.9% of the respondents indicated to be divorced, 2.4% say they are a widow and 2.1% did not report their status (Table 8).

Table 8. Marital Status Figure 9. Marital status

Percent Single 51.4 Married 27.4 Living with a partner 12.8 Divorced 3.9 Widow/ widower 2.4 Missing 2.1 Single Married

Living with a partner Divorced Widow/ widower Missing

Table 9 shows the religious divisions amongst the participants. The most common religion is Protestant (32.2%), thereafter Hinduism (21.7%) and Catholic (19.7%). Followed by Islam (15%), Atheist (4.2%), other (3.5%) and Jewish (0.2%). 3.5% of the answers of the respondents on this topic is missing.

Suriname National Household Drug Survey 2013

Table 9. Religion Figure 10. Religion

Percent Catholic 19.7 Protestant 32.2 Hinduism 21.7 Islam 15.0 Jewish 0.2 Agnostic 0.0 Atheist, no religion 4.2 Other 3.5 Missing 3.5 Catholic Protestant Hinduism Islam Jewish Agnostic

Atheist, no religion Other Missing

3.2 Substance use once in a lifetime, annual and last 30 days, overall and by gender Alcohol is the most commonly used substance (table 10); 60.2% of the respondents reported lifetime use, 45.0% reported past year use and 30.1% indicated use in the past 30 days. More males use alcohol than females in their lifetime, in the past year, and in the last 30 days, with respectively 70.8%, 56.7% and 41.9% for males and 50.6%, 34.5% and 19.5% for females.

Figure 11. Lifetime, past year and past month alcohol use, overall and by gender

80 60 40 20 0 Lifetime Past year Past month

Overall Male Female

Tobacco is the second most used substance with 35% of the respondents using it at least once in their lifetime, 20.7% in the past year and 17.2% in the last 30 days. 53.3% of the male respondents used tobacco once in their lifetime, 34.3% in the past year and 29.2% in the last 30 days. Of the female respondents, 17.7% used tobacco once in a lifetime, 7.9% past year and 5.8% in the last 30 days.

Figure 12. Lifetime, past year and past month tobacco use, overall and by gender

60 40 20 0 Lifetime Past year Past month

Overall Male Female

Suriname National Household Drug Survey 2013

Thirdly, marijuana is used by 8.0% of the participants at least once in their lives, 3.4% in the past year and 2.3% in the last 30 days. 15.5% of the male respondents used marijuana at least once in their lives, 6.6% in the past year and 4.6% in the last 30 days. The females reported a lifetime prevalence of 1.2%, past year prevalence of 0.4% and past month prevalence of 0.2%.

Figure 13. Lifetime, past year and past month marijuana use, overall and by gender

20 15 10 5 0 Lifetime Past year Past month

Overall Male Female

0.4% of the respondents reported lifetime use of cocaine, 0.1% reported past year use and 0.1% indicated use in the past 30 days. 1.1% of the male respondents used cocaine at least once in their lives, 0.4% in the past year and 0.4% in the last 30 days. Females didn’t report the use of cocaine.

Figure 14. Lifetime, past year and past month cocaine use, overall and by gender

1.5 1 0.5 0 Lifetime Past year Past month

Overall Male Female

Crack is used with a use of 0.4% of the respondents at least once in their lifetime, 0.2% in the past year and 0.1% in the last 30 days. More males use crack than females in their lifetime, in the past year, and in the last 30 days, with respectively 1.0%, 0.5% and 0.3% for males and 0.2%, 0.1% and 0.1% for females.

Figure 15. Lifetime, past year and past month crack use, overall and by gender

1.5 1 0.5 0 Lifetime Past year Past month

Overall Male Female

0.4% of the respondents reported lifetime use of ecstasy, 0.1% reported past year use and 0.1% indicated use in the past 30 days. 0.6% of the male respondents used ecstasy once in their lifetime, 0.1% in the past year and 0.1% in the last 30 days. Of the female respondents, 0.4% used ecstasy once in a lifetime, 0.2% annual and 0.1% in the last 30 days.

Suriname National Household Drug Survey 2013

Figure 16. Lifetime, past year and past month ecstasy use, overall and by gender

0.8 0.6 0.4 0.2 0 Lifetime Past year Past month

Overall Male Female

Tranquilizers are used by 2.4% of the participants at least once in their lives, 1.2% in the past year and 0.7% in the last 30 days. 2.4% of the male respondents used tranquilizers at least once in their lives, 1.2% in the past year and 0.7% in the last 30 days. While lifetime prevalence for females for use of tranquilizers is reported at 2.3%, their past year and past month use exceeds or rivals that of their male counterparts with a past year prevalence of 1.1% and past month prevalence of 0.7%.

Figure 17. Lifetime, past year and past month tranquilizer use, overall and by gender

3 2 1 0 Lifetime Past year Past month

Overall Male Female

Stimulants are used by 0.7% of the participants at least once in their lives, 0.3% in the past year and 0.1% in the last 30 days. 1.2% of the male respondents used stimulants at least once in their lives, 0.6% in the past year and 0.3% in the last 30 days. The females reported a lifetime prevalence of 0.5%, past year prevalence of 0.1% and no past month prevalence.

Figure 18. Lifetime, past year and past month stimulant use, overall and by gender

1.5 1 0.5 0 Lifetime Past year Past month

Overall Male Female

Suriname National Household Drug Survey 2013

Table 10. Lifetime, past year and past month substance use, overall and by gender

Lifetime (%) Past year (%) Past 30 days (%) Tobacco Overall 35.0 20.7 17.1 Male 53.3 34.3 29.2 Female 17.7 7.9 5.8 Alcohol Overall 60.2 45.0 30.1 Male 70.8 56.7 41.9 Female 50.6 34.5 19.5 Marijuana Overall 8.0 3.4 2.3 Male 15.5 6.6 4.6 Female 1.2 0.4 0.2 Cocaine Overall 0.4 0.1 0.1 Male 1.1 0.4 0.4 Female 0.0 0.0 0.0 Crack Overall 0.4 0.2 0.1 Male 1.0 0.5 0.3 Female 0.2 0.1 0.1 Ecstasy Overall 0.4 0.1 0.1 Male 0.6 0.1 0.1 Female 0.4 0.2 0.1 Tranquilizers Overall 2.4 1.2 0.7 (e.g. Valium, Male 2.4 1.2 0.7 Librium, Xanax) Female 2.3 1.1 0.7 Stimulants Overall 0.7 0.3 0.1 (e.g. Dexedrine, Male 1.2 0.6 0.3 Cylert, Ritalin) Female 0.5 0.1 0.0

3.3 Problems associated with alcohol use Alcohol is the most commonly used substance; hence some additional questions regarding the characteristics of alcohol use by gender and age group are discussed (table 11). Of the respondents who admitted to consuming alcohol in the last 30 days, 27.1% were found to be binge drinkers- consuming 5 or more drinks in one sitting over the past two weeks. However, 72.9% stated that they had not consumed 5 drinks or more in a single setting over the past 2 weeks. As can be seen among the age groups the prevalence of binge drinking increases as the age group increases and a greater proportion of males are engaged in binge drinking.

Further, 11.3% of respondents admitted to having 6 or more drinks in a row within the past 12 months. While 88.7% of the respondents reported that they had not taken 6 or more drinks in a row in the past 12 months. Among the age groups, the prevalence fluctuates with no clear pattern, and more males engage in this behavior than females.

Of the respondents, 6.9% admitted that they had been unable to stop drinking once they started, 93.1% reported that they had not been unable to stop drinking. This is a DSM-V (Diagnostic and Statistical Manual of Mental Disorders) criterion for substance abuse. Among the age groups the prevalence of this criterion increases as the age groups increases, except the prevalence decreases in the highest age group. Males indicated more of this problem than the females surveyed.

3.4% of the respondents admitted alcohol intake alters the performance of normal activities. 96.6% stated alcohol intake never alters the performance of normal activities. This is also a DSM-V criterion

Suriname National Household Drug Survey 2013

for substance use disorder. Among the age groups, the prevalence fluctuates. A greater proportion of males are confrontated with this problem.

Of the respondents, 2.6% admitted to being unable to remember what happened the night before, 97.4% stated that they did not experience this problem. Among the age groups, the prevalence of this problem is higher in the lower age groups. Males indicated having this problem than the females surveyed. This is also a DSM-V criterion for substance use disorder.

Table 11. Problems associated with alcohol use, overall, by gender and by age group

Overall Gender (%) Age group (%) (%) Male Female 12 - 18 19 - 25 26 - 34 35 - 44 45 - 65 Number of times Not once 72.9 65.2 87.3 84.6 74.1 73.6 75.4 67.9 taken 5 drinks or Just once 12.7 15.5 7.3 7.7 12.0 14.3 13.1 12.2 more over the 2 or 3 times 10.8 14.5 3.9 7.7 8.3 11.5 8.0 13.9 past 2 weeks Between 4 and 1.2 1.4 0.4 0 0 0 1.7 2.1 5 times More than 5 2.6 3.3 1.2 0 5.6 0.5 1.7 3.8 times Taken 6 or more Never 88.7 83.1 95.8 90.2 89.2 89.5 87.5 88.5 drinks one after Less than once 8.2 12.0 3.5 6.8 6.2 8.1 10.1 8.2 another a month Every month 1.5 2.3 0.5 3.0 2.1 1.2 1.8 0.8 Every week 1.4 2.2 0.3 0 2.1 1.2 0.6 2.1 Every day 0.2 0.4 0 0 0.5 0 0 0.4 Unable to stop Never 93.1 89.3 97.9 95.5 95.4 94.6 89.7 92.9 drinking once Less than once 4.5 7.0 1.4 1.5 3.0 4.8 6.2 4.6 started a month Every month 1.3 1.9 0.5 1.5 1.0 0 2.4 1.5 Every week 0.5 0.8 0.2 1.5 0.5 0 0.6 0.6 Every day 0.5 0.8 0.2 0 0 0.6 1.2 0.4 Alcohol intake Never 96.6 95.0 98.6 96.3 93.9 98.2 97.1 96.5 alters the Less than once 3.0 4.4 1.4 3.7 6.1 1.8 2.6 2.7 performance of a month normal activities Every month 0.2 0.4 0 0 0 0 0 0.6 Every week 0.1 0.2 0 0 0 0 0.3 0.2 Every day 0 0 0 0 0 0 0 0 Unable to Never 97.4 96.0 99.1 95.5 96.5 98.5 97.9 97.1 remember what Less than once 2.4 3.5 0.9 4.5 3.5 1.2 1.8 2.5 happened the a month night before Every month 0.1 0.2 0 0 0 0 0.3 0.2 Every week 0 0 0 0 0 0 0 0 Every day 0.1 0.2 0 0 0 0.3 0 0.3

Suriname National Household Drug Survey 2013

Figure 19. Problems associated with alcohol use, overall and by gender

120 100 80 60 40 20

Never Never Never Never

Not once Not

Justonce

Everyday Everyday Everyday Everyday

Everyweek Everyweek Everyweek Everyweek

2 2 or 3 times

Everymonth Everymonth Everymonth Everymonth

More than times 5 More

Between 4 and 4 Between times 5

Less than once a month a once Lessthan month a once Lessthan month a once Lessthan month a once Lessthan Number of times taken Taken 6 or more drinksUnable to stop drinking Alcohol intake alters Unable to remember 5 drinks or more over one after another once started the performance of what happened the the past 2 weeks normal activities night before

Overall Male Female

Table 12 shows the prevalence of various problems because of alcohol. Only 3% of respondents indicated that they had severe problems at home school or work because of alcohol, 2.5% were exposed to danger, 1.5% had problems with law enforcement, 3.3% had problems with family or friends, and 2% got into fights. A greater proportion of males admitted to experiencing these problems than females.

Table 12. Various problems because of alcohol, overall, by gender and by age group

Overall Gender (%) Age group (%) (%) Male Female 12 - 18 19 - 25 26 - 34 35 - 44 45 - 65 Severe problem at home, Yes 3.0 3.6 2.1 1.5 3.1 2.1 3.0 3.9 work or school because of No 97.0 96.4 97.9 98.5 96.9 97.9 97.0 96.1 alcohol Exposed to physical danger Yes 2.5 3.7 1.1 0.0 2.1 1.5 4.2 3.0 because of alcohol No 97.5 96.3 98.8 100.0 97.9 98.5 95.8 97.0 Problems with police or Yes 1.5 2.2 0.6 0.0 0.5 0.6 2.7 2.1 other law enforcement No 98.5 97.8 99.4 100.0 99.5 99.4 97.3 97.9 Problem with family or Yes 3.3 4.6 1.8 2.3 1.5 2.4 5.4 3.6 friends because of alcohol No 96.7 95.4 98.2 97.7 98.5 97.6 94.6 96.4 Involved in fist fights or Yes 2.0 2.6 1.2 0.8 1.0 1.5 3.3 2.1 assaulted someone under No 98.0 97.4 98.8 99.2 99.0 98.5 96.7 97.9 influence of alcohol

Suriname National Household Drug Survey 2013

Figure 20. Various problems because of alcohol, overall and by gender

5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Yes Yes Yes Yes Yes Severe problem at Exposed to physical Problems with Problem with family Involved in fist fights home, work or danger because of police or other law or friends because or assaulted school because of alcohol enforcement of alcohol someone under alcohol influence of alcohol

Overall Male Female

3.4 Problems associated with marijuana use Marijuana is the most commonly used illegal drug in Suriname. Therefore, additional questions regarding the experiences of the use of marijuana, by gender and age group are discussed (table 13). Only the respondents who stated the use of marijuana in the last 12 months were asked these questions.

Of the group that indicated use of marijuana in the last 12 months, 16.9% reported no use of marijuana before noon, 5.1% rarely, 27.1% sometimes, 42.4% fairly often and 8.5% very often. Males reported more use of marijuana than females before noon, with a percentages for never, rarely, sometimes, fairly often and very often of 14.3%, 5.4%, 28.6%, 42.9%, and 8.9% respectively for males. 33.3% of the females reported using marijuana fairly often before noon, 66.7% of the females in this group reported no use before noon.

Further, 11.9% of respondents stated that they never smoked marijuana alone, 3.4% did it rarely, 13.6% sometimes, 39.0% fairly often and 32.3% very often. More males stated that they smoked marijuana alone than females with, 3.6% of males stating that they have done it rarely, 14.3% sometimes, 39.3% fairly often, and 33.9% very often, 8.9% of males indicated that they have never smoked alone. 66.7% of females reported that they have never smoked alone and 33.3% have smoked alone fairly often.

Of the group that indicated use of marijuana in the last 12 months, 69.5% reported no memory loss as a result of smoking marijuana, 20.3% rarely lost their memory, 6.8% sometimes, 1.7% fairly often and 1.7% indicating that memory loss occurred very often. Females reported more memory loss as a result of smoking marijuana than males, 33.3% of them indicated that they sometimes experienced memory loss compared to 5.4% of males. 66.7% of females have never experienced memory loss,

Suriname National Household Drug Survey 2013 compared to 69.6% of males. Additionally, 21.4% of males indicated that they rarely experienced memory loss, with 1.8% indicating that memory loss occurred fairly often and very often. Of the respondents who reported use or marijuana in the last 12 months, 24.1% stated that no friends or family told them to reduce the use of marijuana, 5.2% rarely, 17.2% sometimes, 13.8% fairly often and 39.7% very often. More males stated they have been told to reduce the use of marijuana than females with 5.5% of males being told to do so rarely, 16.4% sometimes, 14.5% fairly often, and 41.8% very often. 33.3 % of females indicated that they have sometimes been told to reduce their use of marijuana and 66.7% of them reported that they have never been told to reduce to use of marijuana, this is compared to 21.8% of males who indicated that they have never been told to reduce their use of marijuana.

Further analysis of the group that indicated the use of marijuana in the last 12 months revealed that, 42.4% reported not trying to reduce the use of marijuana, 11.9% rarely, 15.3% sometimes, 18.6% fairly often and 11.9% very often. More Males reported trying to reduce use of marijuana than females, with a percentage for never, rarely, sometimes, fairly often and very often of 41.4%, 10.7%, 16.1%, 19.6% and 12.5% respectively for males. 33.3% of the females reported rarely, 66.7% of the females in the group using marijuana in the last 12 months reported not trying to reduce the use of marijuana.

Moreover, of the respondents who reported use or marijuana in the last 12 months, 74.6% stated that they never have problems (fights, accidents, low grades) because of use of marijuana, 16.9% reported rarely, 1.7% sometimes, 3.4% fairly often and 3.4% very often. More males stated that they have problems because of the use of marijuana 17.9% reported rarely, 1.8% sometimes, 3.6% fairly often, and 3.6% very often; with 73.2% indicating that they never have problems. No females reported problems because of use of marijuana.

Suriname National Household Drug Survey 2013

Table 13. Problems associated with marijuana use, overall, by gender and by age group

Overall Gender (%) Age group (%) (%) Male Female 12 - 18 19 - 25 26 - 34 35 – 44 45 - 65 Smoked Never 16.9 14.3 66.7 0 12.5 11.1 20.0 25.0 marijuana Rarely 5.1 5.4 0 0 0 5.6 6.7 6.3 before noon Sometimes 27.1 28.6 0 100.0 25.0 38.9 20.0 12.5 Fairly often 42.4 42.9 33.3 0 50.0 33.3 46.7 50.0 Very often 8.5 8.9 0 0 12.5 11.1 6.7 6.3

Smoked Never 11.9 8.9 66.7 0 12.5 16.7 6.7 12.5 marijuana Rarely 3.4 3.6 0 100.0 0 0 6.7 0 alone Sometimes 13.6 14.3 0 0 0 16.7 6.7 18.8 Fairly often 39.0 39.3 33.3 0 62.5 33.3 46.7 31.3 Very often 32.2 33.9 0 0 25.0 33.3 33.3 37.5 Memory loss as Never 69.5 69.6 66.7 100.0 62.5 72.2 73.3 62.5 a result of Rarely 20.3 21.4 0 0 12.5 16.7 13.3 37.5 smoking Sometimes 6.8 5.4 33.3 0 12.5 11.1 6.7 0 marijuana Fairly often 1.7 1.8 0 0 12.5 0 0 0 Very often 1.7 1.8 0 0 0 0 6.7 0 Ever told by Never 24.1 21.8 66.7 100.0 37.5 11.8 33.3 18.8 friends/family Rarely 5.2 5.5 0.0 0 12.5 0 6.7 6.3 to reduce use Sometimes 17.2 16.4 33.3 0 12.5 29.4 13.3 6.3 of marijuana Fairly often 13.8 14.5 0.0 0 0 23.5 13.3 12.5 Very often 39.7 41.8 0.0 0 37.5 35.3 33.3 56.3 Ever tried Never 42.4 41.4 66.7 100.0 62.5 50.0 33.3 31.3 reducing Rarely 11.9 10.7 33.3 0 25.0 11.1 6.7 6.3 marijuana use Sometimes 15.3 16.1 0 0 0 16.7 20.0 18.8 Fairly often 18.6 19.6 0 0 0 11.1 26.7 31.3 Very often 11.9 12.5 0 0 12.5 11.1 13.3 12.5 Problems Never 74.6 73.2 100.0 100.0 87.5 77.8 86.7 50.0 because use of Rarely 16.9 17.9 0 0 12.5 11.1 13.3 31.3 marijuana Sometimes 1.7 1.8 0 0 0 0 0 6.3 (fights, Fairly often 3.4 3.6 0 0 0 5.6 0 6.3 accidents, low Very often 3.4 3.6 0 0 0 5.6 0 6.3 grades)

Suriname National Household Drug Survey 2013

Figure 21. Problems associated with marijuana use, overall and by gender

120

100

Never Never Never Never Never Never

Rarely Rarely Rarely Rarely Rarely Rarely

Very often Very Very often Very often Very often Very often Very often Very

Sometimes Sometimes Sometimes Sometimes Sometimes Sometimes

Fairly often Fairly often Fairly often Fairly often Fairly often Fairly often Fairly Smoked marijuanaSmoked marijuana Memory loss as a Ever told by Ever tried Problems because before noon alone result of smoking friends/family to reducing use of marijuana marijuana reduce use of marijuana use (fights, accidents, marijuana low grades)

Overall Male Female

3.5 Substance use by strata Table 14 shows the lifetime, past year, and past month prevalence of substance use by strata.

In stratum 1 (Paramaribo) the most used substance is alcohol with 59.1% of the surveyed population reported lifetime use, 44.6% past year use, and 31.2% past month use. Tobacco is the second most used substance with 38.1% of the respondents reporting lifetime use, 20.9% past year use, and 16.1% past month use. 8.5% of the respondents reported using marijuana at least once in their lifetime, 2.9% reported past year use, and 1.6% reported past month use. The prevalence of all other drugs was indicated for lifetime, past year and past month use of respectively 0.5%, 0.3%, 0.3% for cocaine, 0.9%, 0.4%, 0.3% for crack, 4.3%, 1.8%, 1.2% for tranquilizers and 1.5%, 0.6%, 0.2% for stimulants. 0.7% of the respondents reported lifetime use of ecstasy.

Suriname National Household Drug Survey 2013

Figure 22. Lifetime, past year, and past month prevalence of substance use in Paramaribo

Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime

Past year Past year Past year Past year Past year Past year Past year Past year Past

Past month Past Past month Past month Past month Past month Past month Past month Past month Past Tobacco Alcohol Marijuana Cocaine Crack Ecstasy Tranquilizers Stimulants

In stratum 2 (Wanica & Para) the most used substance is also alcohol with 56.2% of the surveyed population reported lifetime use, 42.3% past year use, and 26.4% past month use. Tobacco is the second most used substance with 30.7% of the respondents reporting lifetime use, 18.9% past year use, and 16.7% past month use. 5.0% of the respondents reported using marijuana at least once in their lifetime, 1.2% reported past year use, and 0.3% reported past month use. The prevalence of all other drugs was indicated for lifetime, past year and past month use of respectively 0.2%, 0.2% 0.2% for crack, 2.3%, 1.4%, 0.7% for tranquilizers and 0.4%, 0.2%, 0.0% for ecstasy. 0.2% and 0.3% of the respondents stated lifetime use of respectively cocaine and stimulants.

Figure 23. Lifetime, past year, and past month prevalence of substance use in Wanica & Para

Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime

Past year Past year Past year Past year Past year Past year Past year Past year Past

Past month Past Past month Past month Past month Past month Past month Past month Past month Past Tobacco Alcohol Marijuana Cocaine Crack Ecstasy Tranquilizers Stimulants

Suriname National Household Drug Survey 2013

In stratum 3 (Nickerie, Coronie and Saramacca) the most used substance is alcohol with 61.5% of the surveyed population reporting lifetime use, 40.2% past year use, and 26.8% past month use. Tobacco is the second most used substance with 32.9% of the respondents reporting lifetime use, 20.2% past year use, and 17.0% past month use. 3.8% of the respondents reported using marijuana at least once in their lifetime, 1.3% reported past year use, and 1.2% reported past month use. The prevalence of all other drugs was indicated for lifetime, past year and past month use of respectively 0.6%, 0.3%, 0.3% for crack, 0.6%, 0.3%, 0.3% for ecstasy and 0.9%, 0.6%, 0.3% for tranquilizers. 0.3% of the respondents reported lifetime use of both cocaine and stimulants.

Figure 24. Lifetime, past year, and past month prevalence of substance use in Nickerie, Coronie & Saramacca

Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime

Past year Past Past year Past year Past year Past year Past year Past year Past year Past

Past month Past Past month Past month Past month Past month Past month Past month Past month Past Tobacco Alcohol Marijuana Cocaine Crack Ecstasy Tranquilizers Stimulants

In stratum 4 (Commewijne and Marowijne) the most used substance is alcohol with 58.4% of the surveyed population reporting lifetime use, 43.6% past year use, and 26.2% past month use. Tobacco is the second most used substance with 34.6% of the respondents reporting lifetime use, 20.7% past year use, and 17.8% past month use. 8.7% of the respondents reported using marijuana at least once in their lifetime, 4.5% reported past year use, and 3.4% reported past month use. The prevalence of all other drugs was indicated for lifetime, past year and past month use of respectively 0.4%, 0.4%, 0.4% for both ecstasy and stimulant and 0.4%, 0.4%, 0% for tranquilizers. 1.5% and 0.4% of the respondents reported lifetime use of respectively cocaine and crack.

Suriname National Household Drug Survey 2013

Figure 25. Lifetime, past year, and past month prevalence of substance use in Commewijne & Marowijne

Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime

Pastyear Pastyear Pastyear Pastyear Pastyear Pastyear Pastyear Pastyear

Past month Past Past month Past month Past month Past month Past month Past month Past month Past Tobacco Alcohol Marijuana Cocaine Crack Ecstasy Tranquilizers Stimulants

In stratum 5 (Brokopondo and Sipaliwini) the most used substance is also alcohol with 70.7% of the surveyed population reported lifetime use, 58.0% past year use, and 40.5% past month use. Tobacco is the second most used substance with 36.5% of the respondents reporting lifetime use, 24.7% past year use, and 20.7% past month use. 14.9% of the respondents reported using marijuana at least once in their lifetime, 9.2% reported past year use, and 7.7% reported past month use. The prevalence of all other drugs was indicated for lifetime, past year and past month use of respectively 0.3%, 0.3%, and 0.3% for both cocaine and tranquilizers. None of the respondents reported use of crack, ecstasy and stimulants.

Figure 26. Lifetime, past year, and past month prevalence of substance use in Brokopondo & Sipaliwini

80 70 60 50 40 30 20 10

Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime Lifetime

Past year Past year Past year Past year Past year Past year Past year Past year Past

Past month Past month Past month Past month Past month Past month Past month Past month Past Tobacco Alcohol Marijuana Cocaine Crack Ecstasy Tranquilizers Stimulants

Suriname National Household Drug Survey 2013

Table 14. Lifetime, past year, and past month prevalence of substance use by strata

Lifetime Past year Past month (%) (%) (%) District Tobacco Paramaribo 38.1 20.9 16.1 Wanica & Para 30.7 18.9 16.7 Nickerie, Coronie & Saramacca 32.9 20.2 17.0 Commewijne & Marowijne 34.6 20.7 17.8 Brokopondo & Sipaliwini 36.5 24.7 20.7 Alcohol Paramaribo 59.1 44.6 31.2 Wanica & Para 56.2 42.3 26.4 Nickerie, Coronie & Saramacca 61.5 40.2 26.8 Commewijne & Marowijne 58.4 43.6 26.2 Brokopondo & Sipaliwini 70.7 58.0 40.5 Marijuana Paramaribo 8.5 2.9 1.6 Wanica & Para 5.0 1.2 0.3 Nickerie, Coronie & Saramacca 3.8 1.3 1.2 Commewijne & Marowijne 8.7 4.5 3.4 Brokopondo & Sipaliwini 14.9 9.2 7.7 Cocaine Paramaribo 0.5 0.3 0.3 Wanica & Para 0.2 0.0 0.0 Nickerie, Coronie & Saramacca 0.3 0.0 0.0 Commewijne & Marowijne 1.5 0.0 0.0 Brokopondo & Sipaliwini 0.3 0.3 0.3 Crack Paramaribo 0.9 0.4 0.2 Wanica & Para 0.2 0.2 0.2 Nickerie, Coronie & Saramacca 0.6 0.3 0.3 Commewijne & Marowijne 0.4 0.0 0.0 Brokopondo & Sipaliwini 0.0 0.0 0.0 Ecstasy Paramaribo 0.7 0.0 0.0 Wanica & Para 0.4 0.2 0.0 Nickerie, Coronie & Saramacca 0.6 0.3 0.3 Commewijne & Marowijne 0.4 0.4 0.4 Brokopondo & Sipaliwini 0.0 0.0 0.0 Tranquilizers Paramaribo 4.3 1.8 1.2 Wanica & Para 2.3 1.4 0.7 Nickerie, Coronie & Saramacca 0.9 0.6 0.3 Commewijne & Marowijne 0.4 0.4 0.0 Brokopondo & Sipaliwini 0.3 0.3 0.3 Stimulants Paramaribo 1.5 0.6 0.2 Wanica & Para 0.3 0.0 0.0 Nickerie, Coronie & Saramacca 0.3 0.0 0.0 Commewijne & Marowijne 0.4 0.4 0.4 Brokopondo & Sipaliwini 0.0 0.0 0.0

3.6 Substance use by work status Table 15 shows that current users of tobacco (those who reported consuming in the past 30 days) were mostly casually employed (39%), working part time (28.1%), or working full time (22.4%). 24.4% of persons who were unable to work due to a disability were also current smokers. Generally, persons who were not employed (homemaker, students, unemployed) reported lower levels of past month use.

Suriname National Household Drug Survey 2013

Figure 27. Lifetime, past year, and past month prevalence of tobacco use by work status

60 50 40 30 20 10 0

Lifetime Past year Past month

Of the respondents who reported the use of alcohol in the last 30 days, 45.9% were casually employed, 42.5% working part time and 39.0% working fulltime. 28.4% of respondents who were unemployed, but looking for work, and 27.0% of the persons who were unemployed, not looking for work, were also current users of alcohol. Respondents who were mainly not employed (homemaker, retired, disabled, student) stated lower levels of current use of alcohol.

Figure 28. Lifetime, past year, and past month prevalence of alcohol use by work status

90 80 70 60 50 40 30 20 10 0

Lifetime Past year Past month

Users of marijuana in the past month were mostly casually employed (12.3%), working part time (4.9%), or unemployed but looking for work (4.9%). 3.3% of the respondents were unemployed, not looking for work, and 2.8% were working fulltime.

Suriname National Household Drug Survey 2013

Figure 29. Lifetime, past year, and past month prevalence of marijuana use by work status

35 30

25 20 15 10 5 0

Lifetime Past year Past month Table 15. Lifetime, past year, and past month prevalence of substance use by work status

Lifetime Past year Past month prevalence (%) prevalence (%) prevalence (%) Work status Tobacco Full time 45.6 27.4 22.4 Part time 48.2 31.7 28.1 Working casually 53.9 44.2 39.0 Unemployed, but 38.6 20.7 18.2 looking for work Student 10.4 3.5 1.8 Unemployed, not 27.9 18.1 16.4 looking for work Homemaker 13.7 7.3 5.8 Retired 45.0 19.8 15.2 Disabled 45.7 27.4 24.4 Alcohol Full time 68.9 55.7 39.0 Part time 70.3 55.4 42.5 Working casually 81.7 64.1 45.9 Unemployed, but 61.7 44.7 28.4 looking for work Student 40.9 26.7 14.6 Unemployed, not 54.1 35.5 27.0 looking for work Homemaker 46.4 28.3 15.3 Retired 55.4 37.2 22.5 Disabled 50.0 26.5 10.6 Marijuana Full time 11.1 4.4 2.8 Part time 12.2 5.5 4.9 Working casually 29.9 17.9 12.3 Unemployed, but 10.7 4.9 4.9 looking for work Student 0.5 0.0 0.0 Unemployed, not 9.8 6.5 3.3 looking for work Homemaker 0.6 0.3 0.0 Retired 4.7 0.0 0.0 Disabled 5.7 0.0 0.0

Suriname National Household Drug Survey 2013

3.7 Substance use by age group Table 16 shows that tobacco use generally increases as age increases. 1% of the respondents in the 12 to 18 age category smoked cigarettes in the past month, but this rate rises steadily with each increasing age category to 23.2% for the 45 – 65 age group.

Figure 30. Lifetime, past year, and past month prevalence of tobacco use by age group

50 45 40 35 30 25 20 15 10 5 0 12 - 18 years old 19 - 25 years old 26 - 34 years old 35 - 44 years old 45 - 65 years old

Lifetime Past year Part month

Current alcohol users are most common in the 26 – 34 age group (38.1%). 12.0% of the respondents in the 12 – 18 age group and 33.2% in the 19 – 25 age group reported use of alcohol past month. 31.3% of respondents in the two highest age groups reported use of alcohol in the last 30 days.

Figure 31. Lifetime, past year, and past month prevalence of alcohol use by age group

0 12 - 18 years old 19 - 25 years old 26 - 34 years old 35 - 44 years old 45 - 65 years old

Lifetime Past year Part month

Use of marijuana is also most common in the 26 – 35 age group (3.5%). The use decreases in the lower and higher age groups to 0.3% for the 12 – 18 age group and 2.1% for the 45 – 65 age group in the past month.

Suriname National Household Drug Survey 2013

Figure 32. Lifetime, past year, and past month prevalence of marijuana use by age group

0 12 - 18 years old 19 - 25 years old 26 - 34 years old 35 - 44 years old 45 - 65 years old

Lifetime Past year Part month

Table 16. Lifetime, past year, and past month prevalence of substance use by age group

Lifetime Past year Past month prevalence (%) prevalence (%) prevalence (%) Age group Tobacco 12 - 18 9.6 2.3 1.0 19 - 25 27.5 15.7 11.5 26 - 34 33.7 19.9 16.5 35 - 44 41.6 26.4 22.4 45 - 65 45.8 27.6 23.2 Alcohol 12 - 18 39.1 24.8 12.0 19 - 25 63.6 48.3 33.2 26 - 34 69.1 54.8 38.1 35 - 44 61.4 47.6 31.3 45 - 65 62.2 45.3 31.3 Marijuana 12 - 18 0.3 0.3 0.3 19 - 25 8.5 4.4 2.8 26 - 34 10.0 5.0 3.5 35 - 44 8.4 3.4 2.2 45 - 65 9.4 3.1 2.1

Suriname National Household Drug Survey 2013

4. Conclusions

This national household survey is a contribution towards furthering our understanding of the use of drugs in Suriname.

The most commonly used substance is alcohol, followed by tobacco, marijuana, tranquilizers, stimulants, crack, cocaine and ecstasy. The types of substances used can partly be explained by their accessibility in Suriname.

Alcohol prevalence among males was higher than the national average and among females it was below the average. The same applies to experiencing problems because of the use of alcohol. Overall problems because of the use of alcohol are most common in the age groups 35 – 44 and 45 – 65 years old.

Interestingly, the relatively high scores on the questions of the experiences in the use of marijuana could indicate that if the respondents are using marijuana, the use seems to increases quickly to problematic use. Males indicated more use of marijuana than the females surveyed. Problems experienced because of the use of marijuana like fights, accidents and low grades are only reported by males and no females indicated these kinds of problems. The older the age group, the more they tried to reduce the use of marijuana overall.

An important finding in this survey is related to strata. The highest lifetime, past year and past month use of alcohol, marijuana and tobacco by far is found in Brokopondo and Sipaliwini. This can be partly explained by the under education in the hinterland. For marijuana, past month use is more than double the prevalence reported in the other strata. The second stratum with a high prevalence of marijuana and a big difference compared to other strata is Commewijne and Marowijne. This can partly be explained that the use of marijuana is part of the culture of the tribes in the designated areas. For alcohol, the second stratum with a difference towards other strata is the use in Paramaribo, the other three are approximately the same. Tranquilizers are most common in Paramaribo and less in other strata.

By work status, the use of tobacco, alcohol, marijuana and cocaine is highest in the category working casually. This can possibly be explained through instability in life for different reasons. In Suriname, part of the culture is having more different temporary sources of income, which gives instability. The use of alcohol ranks second and third respectively in the groups ‘working part time’ and ‘working full time’. Therefore, it can’t be said that work is a protective factor, and maybe an income provides for the use of alcohol. The respondents in the unemployed group not looking for work also stated a relatively high score on the use of alcohol, tobacco and marijuana.

The survey also revealed the lifetime, past year and past month prevalence of use in different age groups. In the age group 12 – 18, the least substance use is reported. 12% of the respondents in this group reported use of alcohol in the last 30 days, the rest of the substances are reported by only 1% or less of the surveyed population in this group. Tobacco is the only substance that increases by age group. Alcohol and marijuana are most used in the last 30 days in the age group 26 – 34. Cocaine is only reported in the age groups 35 – 44 and 45 – 65.

Suriname National Household Drug Survey 2013

4.1 Limitations All the information on drug intake was based on self-reports from the respondents, and even though anonymity was maintained, under reporting is a possibility. Also, talking about the use of drugs is still very much a taboo in Suriname.

Suriname National Household Drug Survey 2013

5. Recommendations

The conclusions of this survey can be used for prevention, treatment and further research.

 Scientific research - Continuous overall scientific research on drugs is very important to conduct further policies and evidence-based treatment. Scientific surveys should be developed and implemented by research experts - More in-depth research is needed to ascertain the risk factors of drug use, which also can be the basis of treatment

 Prevention - Developing more evidence-based prevention programs - Increase the general awareness and knowledge of drugs, drugs use and consequences at several levels as policy, schools, families and individual levels - Prevention has to be adjusted (amount and content) by age group, district and work status

 Treatment - Creating and adapting more evidence-based treatment through scientific research - Treatment has to be more accessible - Treatment has to be adapted to the age groups and their experienced problems, districts and work status

Suriname National Household Drug Survey 2013

References

Gruter, P., & Van de Mheen, D. (2005). Cocainehandel in Nederland. Rotterdam: Instituut voor Onderzoek naar Leefwijzen en Verslaving.

Miedema, F., & Stoltz, S. (2008). Vast(gelopen) in den Vreemde. Een onderzoek naar het hoge aantal Nederlanders in buitenlandse detentie. Nijmegen: Wetenschappelijk Onderzoek en Documalestatie Centrum van het Ministerie van Justitie.

Suriname, T. G. (2011). Labor Statistics. Retrieved October 2015, from http://www.statistics- suriname.org/index.php/statistieken/database/151-arbeidsstatistieken

The General Bureau of Statistics Suriname. (2014). Evaluation Report Census 8. Paramaribo. Retrieved from http://statistics- suriname.org/index.php/statistieken/downloads/category/30-censusstatistieken-2012

Unger, B. (2008). Effectiviteit van antiwitwas beleid in Nederland. Economisch Statistische Berichten, 45-50.

UNICEF. (2010). Situation Assessmalest and Analysis of Children’s Rights in Suriname. Paramaribo.

Suriname National Household Drug Survey 2013

Appendices

Appendix A, Questionnaire National Household Survey Suriname

INTER-AMERICAN UNIFORM DRUG USE DATA SYSTEM – SIDUC OAS/CICAD/OID

II. STANDAARD VRAGENLIJST MODULE 1: VOORPAGINA GEOGRAFISCHE INFORMATIE Land Regio District Landnummer Huishoudnummer Nummer Aselect Vragenlijst Letter

Goedemorgen/Goedemiddag We zijn bezig met een onderzoek naar issues die te maken hebben met de drugsproblemales in een aantal huishoudens over het geheel land. Het doel van dit onderzoek is het verzamelen van informatie, om zo goed mogelijk, oplossingen te kunnen vinden voor een aantal drugsproblemales in ons land. Uw medewerking aan dit onderzoek zal zeer nuttig zijn. Uw antwoorden zijn absoluut geheim. Ze worden als statistieken verwerkt en blijven anoniem. INFORMATIE OP HET VELD Datum en tijd van het Code enquêteur Resultaat Paraaf enquêteur bezoek

Controle Code supervisor Resultaat Paraaf supervisor

Algemeen supervisor

TABEL VOOR ASELECT RESPONDENT a) Schrijf de initialen van alle huishoudleden op. Begint u met het noemen van het oudste huishoudlid. b) Geef elk huishoud lid tussen de leeftijd van 12 en 65 jaar een nummer en plaats het onder de kolom ‘Nummer’.

Suriname National Household Drug Survey 2013

Initialen Leeftijd Nummer A B C D E F G H I J K L M N O P Q R

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2

1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 3

1 1 1 2 2 1 2 2 2 3 3 3 4 3 3 4 4 4

1 1 1 2 2 3 2 2 3 3 4 4 3 4 4 5 5 5

1 2 1 2 2 2 3 3 3 4 4 4 5 5 5 6 5 6

1 1 2 1 2 3 4 3 4 4 5 4 5 6 7 6 7 7

1 1 2 2 3 4 4 3 4 5 6 5 5 6 7 7 8 8

1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9

1 1 2 2 3 3 4 5 4 6 7 6 8 8 9 9 10 10

1 2 3 4 2 4 5 5 6 6 7 7 8 10 8 9 10 11

1 2 3 4 2 4 5 6 5 7 8 7 9 10 9 11 10 12

GESELECTEERD PERSOON

Geslacht respondent Leeftijd respondent 1. Man Jaar

2. Vrouw

2: ALGEMALESE INFORMATIE 1. Heeft u momenteel een baan en wat is de 2.Welk van de volgende omschrijvingen weergeven status hiervan? uw huidige baan het best? 1.Full-time job Schrijf het antwoord aan de zijkant en later aankruisen.

2. Part-time job 1. Leden van de Uitvoerende of 3. Ik heb af en toe werk Wetgevende Macht of

Staflid op een Ministerie of de Private Sector.Officieren van de *4.Werkloos, maar zoekt werk gewapende macht, eigenaren van *5.Student commerciële bedrijven

Suriname National Household Drug Survey 2013

*6.Werkt niet en zoekt geen werk die uit 26 of meer werknemers bestaan of *7.Huisman/huisvrouw landbouwers die over meer dan 100 hectaren *8.Gepensioneerd, ontvangt AOV grond beschikken.

*9.Rentenier 2. Professionals, wetenschappers, *10. Arbeidsongeschikt universiteitsprofessoren, onderofficieren, *00.Weet niet/Geen antwoord eigenaren van commerciële bedrijven die uit 6-25werknemers bestaan of landbouwers *GA NAAR VRAAG #3 die over 50-100 hectaren grond beschikken.

3.Technische experten/ onderwijzers/eigenaren

van commerciële bedrijven die uit 2-5 3.Welk van de volgende situaties zou u hanteren werknemers bestaan/ om uw inkomen voor de huishouding het best te administratief personeel omschrijven? (LEES GOED EN KIES) of landbouwers die over 1.Mijn inkomen is het enige 25-50 hectaren grond inkomen dat gebruikt wordt beschikken. voor de huishouding 4. Kantoor medewerkers 2.Mijn inkomen is het in de volgende sectoren: belangrijkste inkomen, maar er industrie, handel, zijn andere inkomsten voor de dienstverlenend huishouding bedrijven, 3.Ik zorg slechts voor de helft overheidsinstellingen etc. van de inkomsten voor de 5. Klein huishouding handelaren/winkeliers of landbouwers die over 4.Ik draag bij, maar mijn minder dan 25 hectaren inkomen is niet het belangrijkste grond beschikken. inkomen voor de huishouding. 6. Ambachtslieden 5.Ik draag niets bij voor de (schoenmakers, huishouding. loodgieter, kappers/kapsters, etc.)

7. Ervaren hand arbeiders/machine operators in bedrijven, dienstverlenende bedrijven of landbouwactiviteiten. 8. Arbeiders/ studenten/ handlangers 9.Manschappen en veiligheidspersoneel 10. Hulp in de

Suriname National Household Drug Survey 2013

huishouding/ straatventers.

11. Gepensioneerden met minimum inkomen, uitkering voor mensen met een beperking, ouderen etc. 00. Weet niet/Geen antwoord.

4.Bent u het hoofd van het gezin? 5.Wat is het hoogste niveau aan scholing die u heeft voltooid? Kruis het afgerond leerjaar aan. 1.Ja 2.Nee (ga naar # 6) Wijs Kaart # 1 aan

1. Geen scholing 2. Kleuter Onderwijs (KO) 3. Gewone Lager Onderwijs (GLO) 4. Voortgezet Onderwijs op Junioren niveau (VOJ) 5. Voortgezet Onderwijs op Senioren niveau (VOS) 6.HBO 7. Universiteit

6.Hoeveel bedraagt uw maandelijks inkomen 7. Wat is uw huidige burgerlijke ongeveer? Probeer een volwassen persoon erbij staat/samenwoningsverband? te betrekken voor de beantwoording van deze vraag, indien de respondent minderjarig is. 1.Ongehuwd

Wijs kaart # 2 aan. 2.Gehuwd

1.Minder dan SRD 500 3.Woont samen met partner 2.Tussen SRD 500 - SRD 750 (concubinaat) 3.Tussen SRD 750 - SRD 1000 4.Tussen SRD 1000 - SRD 1250 4.Gescheiden 5.Tussen SRD 1251 - SRD 1500 6.Tussen SRD 1500 - SRD 1750 5.Weduwnaar/weduwe 7.Tussen SRD 1751 - SRD 2000 8.Tussen SRD 2001 - SRD 2500 0.Weet niet/ Geen antwoord

9.Tussen SRD 2501 - SRD 3000 10.Tussen SRD 3001 - SRD 4000 11.Tussen SRD 4001 - SRD 5000 12.Tussen SRD 5001 - SRD 6000 13.Meer dan SRD 6000 00.Weet niet/geen antwoord

Suriname National Household Drug Survey 2013

8. Tot welke etnische groep rekent u zichzelf? 9.Tot welke geloofsovertuiging/religie rekent u uzelf? 1. Surinamer 2. Inheems/Indiaan 1.Rooms Katholiek 3. Marron/Boslandcreool 2.Protestants ( Evangelische Broeder 4. Creool Gemeente, Volle Evangelie, Hervormd en 5. Afrosurinamer Overig Christen etc.) 6. Hindoestaan 7. Javaan 3.Hindoeïsme 8. Chinees 4.Islam/Moslim 9. Kaukasisch/Blank 10. Gemengd 5.Jodendom 11. Overige 6.Agnostisch 00.Weet niet/Geen antwoord

7. Atheïst/geen religie

8. Anders

0.Weet niet/Geen antwoord

MODULE 3: DRUGS TABAK. Bij alle vragen wordt met tabak bedoeld: filter en non-filter sigaretten, sigaren, pijproken etc. 10a. Heeft u ten minste één keer in uw leven 10b. Wanneer heeft u voor het eerst gerookt? gerookt? 1.Ja 2.Nee (Ga naar #11a) 1. In de afgelopen 30 dagen 0.Weet niet/Geen 2. Langer dan een maand antwoord geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden 0. Weet niet/Geen antwoord

10c.Hoe oud was u toen u voor het eerst rookte? 10d. Heeft u in de afgelopen 12 maanden gerookt?

Jaar 1.Ja 2.Nee (Ga naar 0.Weet niet/Geen #11a) antwoord

10e. Heeft u in de afgelopen 30 dagen gerookt? 10f. Hoeveel sigaretten of ander tabak soort heeft u per dag gerookt de afgelopen 30

Suriname National Household Drug Survey 2013

1.Ja dagen? 2.Nee (Ga naar #11a) 0.Weet niet/Geen Aantal sigaretten per dag antwoord 0. Weet niet/Geen antwoord

10g. Hoeveel van de afgelopen 30 dagen heeft u 10h. Hoeveel jaren heeft u dagelijks sigaretten één of ander sigaret of een ander tabak soort of een ander tabak soort gerookt? gerookt? Aantal jaren Aantal dagen 0. Weet niet /Geen antwoord

ALCOHOL. Bij alle vragen, tenzij anders vermeld, wordt met alcohol bedoeld: bier, sterke dranken zoals whisky, wijn, pisco, rum, vodka, tequila, brandy (schnapps, moonshine, aguardiente) etc. 11b. Wanneer heeft u voor het eerst een 11a. Heeft u ooit in uw leven een alcoholische alcoholische drank gebruikt? drank gebruikt? 1. In de afgelopen 30 dagen 1. JA 2. Langer dan een maand maar 2. NEE (Ga naar # korter dan een jaar geleden 0. Weet niet/Geen 27) 3. Langer dan een jaar geleden antwoord 0. Weet niet/Geen antwoord

11c. Hoe oud was u toen u voor het eerst een 11d. Heeft u één of ander alcoholische drank alcoholische drank gebruikte? gebruikt in de afgelopen 12 maanden? (Laat momalesten die uw ouders u een slokje gaven om te proeven buiten beschouwing) 1. JA 2. NEE (Ga naar # Jaar (afgerond) 0. Weet niet/Geen 12) antwoord

11e. Heeft u één of ander alcoholsoort gebruikt 11f. Hoeveel van de afgelopen 30 dagen in de afgelopen 30 dagen? heeft u één of ander alcoholsoort gebruikt?

Aantal dagen

1. JA 2. NEE (Ga naar # 0. Weet niet/Geen 12) antwoord

11g. Welk alcoholische drank heeft u gebruikt en hoe vaak heeft u dat gedaan in de afgelopen 30 dagen? (Kruis 1 keer bij elk alcoholische drank aan hoe vaak) 1. Elke dag 2. In het weekend 3. Een aantal keren in de week

Suriname National Household Drug Survey 2013 a) Bier b) Wijn c) Sterke drank (whisky, vodka, pisco, rum,tequila, brandy bijv. schnapps,moonshine, aguardiente etc.)

11h. In de afgelopen 2 weken, hoeveel keren 11i. Gelet op de afgelopen maand, hoeveel geld heeft u 5 dranken of meer gebruikt? heeft u in totaal aan alcoholische dranken besteed?

1. Niet eens 1 keer 1. Geen 2. Maar 1 keer 2. Minder dan SRD 50 3. 2 tot 3 keren 3. Tussen SRD50 en SRD100 4. Tussen 4 en 5 keren 4. Tussen SRD100 en SRD300 5. Meer dan 5 keren 5. Meer dan SRD 300

0. Weet niet/Geen antwoord

12. Hoe vaak drinkt u 0.Nooit 1. Eén keer 2. 2-4 keren 3.5 tot 10 4. 11 keren alcohol? per maand of per maand keren per of meer helemaal niet maand per maand 13. Hoeveel drankjes nuttigt 0 1 2 3 4 u op feestdagen? 0-2 3-4 5-6 7-8 9 of meer Maak gebruik van het schema hieronder om het aantal drankjes dat u op zo’n dag nuttigt in te kunnen schatten

1 drank 1 ½ drank 6 dranken 18 dranken - één fles of een kan Halve liter bier Eén fles wijn (750 cc.) Eén fles sterke drank bier (333 cc.) (750 cc.) - één glaswijn (140 3 dranken 8 dranken cc.) Eén liter bier Eén liter wijn - één shot of sterke drank (40 cc.) (pisco, rum, vodka, whisky)gemixed of een enkel drank

14. Hoe vaak gebruikt 0 1 2 3 4 u 6 of meer drankjes Nooit Ten minste 1 Elke maand Elke week Elke dag of bijna achterelkaar? keer per elke dag

Suriname National Household Drug Survey 2013

maand 15. In de afgelopen 12 0 1 2 3 4 maanden, hoe vaak Nooit Ten minste 1 Elke maand Elke week Elke dag of bijna heeft u geprobeerd om keer per elke dag zelfstandig te stoppen maand met drinken en hierin gefaald? 16. Hoe vaak, in de 0 1 2 3 4 afgelopen 12 Nooit Ten minste 1 Elke maand Elke week Elke dag of bijna maanden, heeft keer per elke dag alcoholgebruik invloed maand gehad op uw deelname aan normale activiteiten?

17. Hoe vaak, in de 0 1 2 3 4 afgelopen 12 Nooit Ten minste 1 Elke maand Elke week Elke dag of bijna maanden, vond u het keer per elke dag nodig om in de maand ochtenduren alcohol te gebruiken om te kunnen herstellen van overmatig alcoholgebruik van de dag ervoor?

18. Hoe vaak, in de 0 1 2 3 4 afgelopen 12 Nooit Ten minste Elke maand Elke week Elke dag of maanden, heeft u 1 keer per bijna elke spijt of maand dag schuldgevoelens gehad na het gebruiken van alcohol? 19.Hoe vaak, in de 0 1 2 3 4 afgelopen 12 Nooit Ten minste Elke maand Elke week Elke dag of maanden, was u niet 1 keer per bijna elke in staat om dingen maand dag die een avond van te voren waren gebeurd, te herinneren omdat u alcohol had gebruikt? 20. Bent u of is 0 2 4 iemand gewond Nee Ja, maar niet Ja, het geraakt omdat u het afgelopen alcohol had gebruikt? afgelopen jaar jaar 21. Heeft een 0 2 4 familielid, vriend, Nee Ja, maar niet Ja, het

Suriname National Household Drug Survey 2013 arts of ander het afgelopen gezondheidswerker afgelopen jaar zijn/haar jaar bezorgdheid geuit over uw alcoholgebruik en u geadviseerd om ermee te stoppen?

GELET OP DE AFGELOPEN 12 MAANDEN 22. Heeft u enig ernstig probleem gehad thuis, aan het werk 1. 2. 0. Weet of op school vanwege alcoholmisbruik? Problemen zoals het JA NEE niet/ Geen verwaarlozen van uw kinderen, afwezig zijn op het werk of antwoord spijbelen, slechte prestatie aan het werk of op school of uw baan verloren? 23. Is er een moment geweest waarbij u werd blootgesteld aan één of ander vorm van gevaar vanwege alcoholmisbruik? Zeg maar een auto-ongeluk of een soort gelijk ongeval etc. 24.Heeft u ooit iets onder invloed van alcohol gedaan en bent u hierdoor in aanraking gekomen met de politie? Bijvoorbeeld het besturen van een motorvoertuig onder invloed van alcohol, het aanbrengen van graffiti op muren, vernietigen van een staatseigendom, of op zodanig wijze bezig zijn dat uw buren last ondervinden van uw doen en laten, stelen etc. 25. Heeft u problemen gehad met uw familieleden of vrienden vanwege alcoholgebruik? Bijvoorbeeld woede/agressiviteit of een gesprek dat uit de hand is gelopen en hierdoor geen contact meer heeft met het desbetreffend familielid of die ene vriend. 26. Bent u betrokken geweest in een vechtpartij of heeft u iemand mishandeld onder invloed van alcohol?

27. Heeft u ooit in uw leven één van de volgende middelen gebruikt? 28.Hoe oud was u KRUIS BIJ ELK MIDDEL AAN WAT RELEVANT IS toen u het voor het NEE JA eerst uitprobeerde? a) Kalmeringsmiddelen zonder medisch voorschrift Jaar

b) Amfetamine soorten Jaar

c) Snuifbare middelen (bijv. oplosbare middelen zoals verf Jaar

lijm, benzine) d) Marihuana Jaar

e) Cocaïne pasta Jaar

Suriname National Household Drug Survey 2013

f) Heroïne Jaar

g) Opium Jaar

h) Morfine Jaar

i) Hallucinogenen Jaar

j) Hasjiesj Jaar

k) Crack Jaar

l) MDMA (Ecstasy, Adam, X-TC) Jaar

m) Blacka djonko Jaar

n) Anders………………. Jaar

MARIHUANA 29a. Wanneer heeft u voor het eerst marihuana 29b. Heeft u tenminste één keer marihuana uitgeprobeerd? gebruikt in de afgelopen 12 maanden?

0. Ik heb nog nooit marihuana 1.JA gebruikt (Ga naar # 30a) 2.NEE (Ga naar # 30a)

1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden

29c. Hoe vaak heeft u marihuana gebruikt? 29d. Heeft u marihuana gebruikt in de 1. Slechts 1 keer afgelopen 30 dagen? 2. Meerdere keren in de afgelopen 12 maanden 1.JA 3. Meerdere keren per maand 2.NEE (Ga naar # 30a)

4. Meerdere keren per week 5. Elke dag

29e. Hoeveel van de afgelopen 30 dagen heeft 29f. Hoeveel marihuana ballen rookt u u marihuana gerookt? maandelijks?

Aantal dagen (0 t/m 30) Aantal marihuana ballen

29g. Hoeveel denkt u dat een marihuana bal 29h. Hoeveel heeft u aan marihuana besteed kost? de afgelopen 30 dagen? SRD SRD

Suriname National Household Drug Survey 2013

29i.IN DE AFGELOPEN 12 Nooit Zelden Soms Vaak Heel vaak MAANDEN, hoe vaak is het volgende u overkomen? a) Heeft u marihuana gerookt vóór de middag? b) Heeft u marihuana gerookt toen u alleen was? c) Heeft u geheugenproblemen gehad toen u marihuana rookte? d) Hebben uw vrienden of familieleden u gezegd om te stoppen of het gebruik van marihuana te verminderen? e) Heeft u geprobeerd om uw marihuana gebruik te verminderen zonder erin te slagen? f) Heeft u één of ander probleem gehad vanwege het gebruik van marihuana (gevecht, ongeval, slechte resultaat op school, enz.)?

COCAÏNE

30a. Wanneer heeft u voor het eerst cocaïne 30b. Heeft u tenminste één keer cocaïne uitgeprobeerd? gebruikt in de afgelopen 12 maanden?

0. Ik heb nooit cocaïne gebruikt (Ga naar # 36a) 1.JA 1. In de afgelopen 30 dagen 2. NEE (Ga naar # 36a) 2.Langer dan een maand geleden, maar minder dan een jaar geleden 3.Langer dan een jaar geleden

30c. Hoe vaak heeft u cocaïne gebruikt? 30d. Heeft u ten minste één keer cocaïne 1. Slechts 1 keer gebruikt in de afgelopen 30 dagen? 2. Meerdere keren in de afgelopen 12 maanden 1.JA 3. Meerdere keren per maand 2.NEE (Ga naar # 36a)

4. Meerdere keren per week 5. Elke dag

Suriname National Household Drug Survey 2013

30e. Hoeveel van de afgelopen 30 dagen, 30f. Hoeveel pitten cocaïne rookt u hoeveel dagen heeft u cocaïne gerookt? maandelijks?

Aantal dagen (0 t/m 30) Aantal pitten cocaïne

30g. Hoeveel denkt u dat een pit cocaïne kost? 30h. Hoeveel heeft u aan cocaïne besteed de SRD afgelopen 30 dagen? SRD

31. Heeft u thuis, op school of op het werk enig ernstig probleem 1. 2. 0. Weet gehad vanwege het gebruiken van cocaïne? Problemen zoals het JA NEE niet/Geen verwaarlozen van uw kinderen, afwezig zijn op het werk of antwoord spijbelen, slecht gepresteerd aan het werk of op school of uw baan verloren? 32. Is er een moment geweest waarbij u werd blootgesteld aan één of ander vorm van gevaar vanwege cocaïne gebruik? Zeg maar een auto-ongeluk of één of ander ongeval. 33. Heeft u ooit iets onder invloed van cocaïne gedaan en bent u hierdoor in aanraking gekomen met de politie? Bijvoorbeeld het besturen van een motorvoertuig onder invloed van alcohol, het aanbrengen van graffiti op muren, vernietigen van staatseigendom, op zodanig wijze bezig zijn dat uw buren last ondervinden van uw doen en laten, stelen etc. 34. Heeft u problemen gehad met uw familieleden of vrienden vanwege cocaïne gebruik? Bijvoorbeeld woede/agressiviteit of een gesprek dat uit de hand is gelopen en hierdoor geen contact meer hebt met het desbetreffend familielid of die ene vriend. 35. Bent u betrokken geweest in een vechtpartij of iemand mishandeld onder invloed van cocaïne?

CRACK (assisie) 36a. Wanneer heeft u crack voor het eerst 36b. Heeft u tenminste één keer crack gebruikt uitgeprobeerd? in de afgelopen 12 maanden?

0. Ik heb nog nooit crack gebruikt 1.JA (Ga naar # 37a) 2.NEE (Ga naar # 37a)

1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden

3. Langer dan een jaar geleden

Suriname National Household Drug Survey 2013

36c. Hoe vaak heeft u crack gebruikt? 36d. Heeft u tenminste één keer crack gebruikt 1. Slechts 1 keer in de afgelopen 30 dagen? 2. Meerdere keren in de afgelopen 12 maanden 1.JA 3. Meerdere keren per maand 2.NEE (Ga naar # 37a)

4. Meerdere keren per week 5. Elke dag

36g. Hoeveel denkt u dat een “zak” crack (van 36h. Hoeveel heeft u aan crack besteed de 1gr) kost? afgelopen 30 dagen? SRD SRD

ECSTASY 37a. Wanneer heeft u voor het eerst ecstasy 37b. Heeft u tenminste één keer ecstasy uitgeprobeerd? gebruikt in de afgelopen 12 maanden?

0. Ik heb nog nooit ecstasy gebruikt 1.JA (Ga naar # 38a) 2.NEE (Ga naar # 38a)

1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden

37c. Hoe vaak heeft u ecstasy gebruikt? 37d. Heeft u eens ecstasy gebruikt in de afgelopen 30 dagen? 1. Slechts 1 keer 2. Meerdere keren in de afgelopen 1.JA 12 maanden 2.NEE (Ga naar # 38a)

3. Meerdere keren per maand 4. Meerdere keren per week 5. Elke dag

37e. Hoeveel van de afgelopen 30 dagen heeft 37f. Hoeveel ecstasy tabletten gebruikt u u ecstasy gebruikt? maandelijks?

Aantal dagen (0 t/m 30) Aantal ecstasy tabletten

37g. Hoeveel denkt u dat een ecstasy tablet 37h. Hoeveel heeft u aan ecstasy besteed de kost? afgelopen 30 dagen? SRD SRD

DE LANDEN KUNNEN ANDERE DRUGSSOORTEN NOTEREN OM DE OMVANG EN HET GEBRUIK DAARVAN TE METEN 38a. Wanneer heeft u voor het eerst XXX 38b. Heeft u tenminste één keer XXX gebruikt

Suriname National Household Drug Survey 2013 gebruikt? in de afgelopen 12 maanden?

0. Ik heb nog nooit XXX gebruikt (Ga 1.JA naar 2.NEE (Ga naar # 39a)

# 39a) 1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden

38c. Hoe vaak heeft u XXX gebruikt? 38d. Heeft u XXX gebruikt in de afgelopen 30 1. Slechts 1 keer dagen? 2. Meerdere keren in de afgelopen 12 maanden 1.JA 3. Meerdere keren per maand 2.NEE (Ga naar 39a)

4. Meerdere keren per week 5. Elke dag

KALMERERINGSMIDDELEN. Denk bijvoorbeeld aan Alprazolam, Diazepam (Valium), Flunitrazepam (Rohypnol), chloordiazepoxide (Librium) etc. om de vragen over kalmeringsmiddelen te kunnen beantwoorden. 39a. Wanneer heeft u voor het eerst kalmeringsmiddelen zonder voorschrift gebruikt?

0. Ik heb nog nooit kalmeringsmiddelen gebruikt (Ga naar# 40a) 1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden

39b. Heeft u kalmeringsmiddelen gebruikt in de 39c. Heeft u kalmeringsmiddelen gebruikt in de afgelopen 12 maanden? afgelopen 30 dagen? 1.JA 2.NEE (Ga naar # 40a) 1.JA

2.NEE (Ga naar # 40a)

39d. Hoeveel van de afgelopen 30 dagen heeft u 39e. Vanwaar haalde u de kalmeringsmiddelen? kalmeringsmiddelen gebruikt? 1.Van een paramedicus 2.Op straat Aantal dagen (0 t/m 30) 3.Thuis 4.Van een vriend 5.Van de drugstore 6.Anders

OPPEPMIDDELEN. Denk aan de oppepmidelen of stimulerende middelen zoals methylfenidaat (Ritalin), Fenmetrazine (Preludin of Adepsin), Amfetamine (Adderall), Dextroamphetamine(Dexedrine, Dextrostat), Pemolinum (Cylert) om de vragen te kunnen beantwoorden. 40a. Wanneer heeft u voor het eerst oppepmiddelen zonder voorschrift gebruikt?

0. Ik heb nog nooit stimulerende middelen gebruikt (Ga naar # 41)

Suriname National Household Drug Survey 2013

1. In de afgelopen 30 dagen 2. Langer dan een maand geleden, maar korter dan een jaar geleden 3. Langer dan een jaar geleden

40b. Heeft u oppepmiddelen gebruikt in de 40c. Heeft u oppepmiddelen gebruikt in de afgelopen 12 maanden dagen? afgelopen 30 dagen?

1.JA 1.JA 2.NEE (Ga naar # 41) 2.NEE (Ga naar # 41)

40d.Hoeveel van de afgelopen 30 dagen heeft u 40e. Vanwaar haalde u de oppepmiddelen? oppepmiddelen gebruikt? 1.Van een paramedicus 2.Op straat Aantal dagen (0 t/m 30) 3.Thuis 4.Van een vriend 5.Van de drugstore 6.Anders

MODULE 4: DRUGS EN DRUGSGERELATEERDE PROBLEMALES 41. Hoe gevaarlijk denkt u dat het 1.Niet 2.Een 3.Gewoon 4.Zeer 5.Ik weet volgende kan zijn. gevaarlijk beetje gevaarlijk gevaarlijk niet hoe Kruis bij elk punt slechts 1 keer aan gevaarlijk gevaarlijk het kan zijn 1. Soms sigaretten roken 2. Vaak sigaretten roken 3. Soms alcoholische dranken gebruiken 4. Vaak alcoholische dranken gebruiken 5. Dronken worden 6. Soms kalmeringsmiddelen/ stimulerende middelen zonder voorschrift gebruiken

7. Vaak kalmeringsmiddelen/ stimulerende middelen zonder voorschrift gebruiken

8. Soms oplosbare middelen inhaleren 9. Vaak oplosbare middelen inhaleren 10. Soms marihuana roken 11. Vaker marihuana roken 12. Soms cocaïne gebruiken 13. Vaak cocaïne gebruiken 14. Soms rook afkomstig van drugs/tabak inademen (Meeroken) 15. Vaak rook afkomstig van drugs/tabak inademen

Suriname National Household Drug Survey 2013

(Meeroken) 16. Soms ecstasy gebruiken 17. Vaak ecstasy gebruiken 18. Soms crack gebruiken 19. Vaak crack gebruiken

42. Bent u ooit nieuwsgierig geweest om één of 43. Als u de gelegenheid had, zou u een illegale ander illegale drugs uit te proberen? drugs uitproberen? (Bijvoorbeeld marihuana, cocaïne, crack, ecstasy (Bijvoorbeeld marihuana, cocaïne, crack, ecstasy etc.) etc.)

1.JA 1.JA 2.NEE 2.NEE 3.Misschien 3.Misschien 0.Weet niet/Geen antwoord 0.Weet niet/Geen antwoord