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What is your assessment of current situation of drug crimes at sea? However, criminals also take advantage of the sea route for drug trafficking. In recent years, the Drug Crime Investigation Police Department has requested local police to coordinate with the Border Guard, Customs, and Coast Guard to investigate, discover, and seize many drug trafficking cases on sea route. Recently, due to pressure from drug crimes in the world and region, criminals have taken advantage of Vietnam's sea routes to illegally transport drugs through Vietnam to third countries for consumption. In the first months of , on the beaches of the Central and Southern provinces, people and authorities continuously discovered large amounts of drugs drifting on the coast mainly cocaine. In fact, the process of fighting drug crimes shows that cocaine is not consumed in the Southeast Asian market. The traffickers take advantage of the sea route to transport drugs through Vietnam for consumption in other countries. Could you analyze the characteristics of drugs drifting at sea? As mentioned above, the drugs drifting at sea are mainly cocaine packed into packages, weighing 1 kg, different from drugs traded in Southeast Asia and other countries in the region. Through a number of seizures, these drug packages were packed and attached with and positioning devices, proving that the drugs are released on the sea and will be picked up for consumption. This is a new method and trick of criminals. Currently, traffickers transport drugs by road and gather in Vietnam, especially overseas businesses involving foreigners, gather drugs into warehouses, then package, hide and mix them with exported goods plastic granules, animal feed, scrap It can be said that the drug crime situation on the sea route is complicated. The leader of the Ministry of Public Security has directed C04 and local police to actively take synchronous professional measures and coordinate with specialized drug prevention and combat authorities of the Border Guard, Customs, and Police to fight and prevent drug traffickers on the sea route. What are the specific difficulties and pressures of fighting drug crimes at sea? Our country's sea routes are very wide. On the sea route, there are many ships and boats from other countries passing through, in addition to fishing boats of people and traffickers mix and hide drugs in boats. The new trick is to use boats and disguise fishing boats to monitor and supervise competent authorities to alert drug traffickers to avoid areas where competent forces are conducting patrols. On the other hand, we are promoting the import and export of goods, with a very large amount of goods passing through the border gate, traffickers are taking advantage of this to mix drugs into imported and exported goods for transportation. This is an objective condition, but causes difficulties for the authorities. In addition, vehicles serving the fight against drug crimes at sea and technical equipment are limited. The force to prevent and combat drug crimes on the sea route is still thin and does not have much experience in fighting drug crimes at sea. However, under the direction of the Government and leaders of the Ministry of Public Security, C04 gradually coordinated with the authorities to fight and prevent drug criminals from taking advantage of sea routes for drug trafficking. Faced with the above situation, what do you recommend the people? In fact, in previous years there was a phenomenon of drugs drifting at sea and many people discovered them and handed them over to the authorities. However, there were also some people, due to lack of understanding and greed for profit, they arbitrarily hide them when they discover drugs. This is a particularly serious violation of criminal law. Therefore, it is recommended that people should raise their sense of responsibility and comply with the law. When detecting suspected drugs drifting ashore, they should quickly report to the authorities Police, Border Guard and the nearest local authorities, and do not hide or buy or sell drugs. I would like to emphasize that this is a violation of criminal law. C04 requests police at all levels to coordinate with local authorities to inform people to raise their sense of responsibility and vigilance against the actions of those who take advantage of drug trafficking. In , the authorities discovered 8 cases, arrested 7 suspects, and seized kg of cocaine, g of heroin, and g of synthetic drugs. Drugs drifting at sea mainly cocaine. Destroying a 'huge' drug trafficking network from Europe to Vietnam by air Quang Binh Customs Department seizes over 25, drug pills Customs seizes kg of drugs hidden on passenger car Major General Nguyen Ngoc Quang: Photo: C04 What is your assessment of current situation of drug crimes at sea? Thank you. Source: C Tags: Drug police sea border drug trafficking cocaine. Related News. Among them are especially dangerous wanted criminals hiding in Van Ho district, Son La province, Mai Chau district Hoa Binh and Dien Bien district Dien Bien who collude with domestic and foreign subjects for drug trafficking from the Golden Triangle area across the border into Vietnam and to third countries for consumption. Latest News. More News. However, toxic chemicals, including cyanide, are still openly sold on the market and on social networks. Ho Chi Minh City authorities have simultaneously inspected many chemical-related businesses in District 5 and discovered many violations. Thanks to that, security and order in the border area and border gates have been maintained, minimizing violations. Read More. Your care. Latest Most read. Destroying a 'huge' drug trafficking network from Europe to Vietnam by air. Quang Binh Customs Department seizes over 25, drug pills. Customs seizes kg of drugs hidden on passenger car.

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Official websites use. Share sensitive information only on official, secure websites. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. People who inject drugs PWID are a dominant risk group afflicted by blood-borne viruses, mental health disorders, and social precariousness. Risk reduction interventions are administered to PWID regardless of their characteristics or specific risks. The objective of this cross-sectional analysis was to empirically identify profiles of PWID regarding their drug use, risk behaviors, and mental health in order to tailor adapted interventions taking into account limited access to comprehensive care in middle-income countries. PWID were recruited using respondent-driven sampling. PWID with urine testing positive for heroin or methamphetamine and manifesting recent skin injection marks were enrolled. Classification of participants was based on drug use, injection, risky sexual behavior, and mental health data. This was subjected to multiple correspondence analysis followed by hierarchical cluster analysis combined with K -means methodology. From October to January , participants were recruited of which were eligible and enrolled. HCV prevalence was The cluster analysis identified five distinct profiles: profile 1: recent injection practices and high alcohol consumption, profile 2: at-risk injection and sexual behaviors with precarious situations, profile 3: no sexual activity and older age, profile 4: frequent injections with high methamphetamine use, and profile 5: stable partnerships and less frequent injections. Our study has identified profiles of PWID at particularly high risks, and they should thus be targeted for interventions tailored to their specific risks. Vietnam is particularly concerned with illicit drug use since the economic reform promoted liberalization of the economic market in Doi Moi \[ 1 \]. Drug supply was also facilitated by its close proximity to the Golden Triangle \[ 2 \]. Since , the political response to drug use was to send PWID to rehabilitation centers without any addiction care \[ 4 \]. Several preventive or medical interventions have been implemented since the early s. Subsequently, in , Haiphong pioneered methadone clinics \[ 5 \]; there were 13 in the city in In contrast, HCV has been neglected in Vietnam. Mental health disorders among PWID are often associated with the severity of substance use disorder and higher risk practices \[ 9 — 11 \]. However, promising mental health community-based interventions have been described elsewhere, including group interpersonal psychotherapy, counseling sessions at home, and community reentry programs \[ 12 — 14 \]. This may not address the wide diversity of PWID \[ 15 \] as well as the different settings, particularly in middle-income countries where access to specialized care addiction treatment, psychiatric care, and harm reduction settings is limited. HCV control mainly based on harm reduction towards safer injection practices stands as a good example, but this concern also applies to all other interventions implemented for PWID. Since these interventions are mainly led by peers within small groups of PWID, an approach tailored to the specific risks may make a difference \[ 16 \]. In order to have information on risk reduction activities, knowledge of the different profiles of PWID is crucial. The objective of this study was therefore to identify and describe the various profiles of PWID regarding their drug use, risk behaviors, and mental health in order to tailor adapted community-based interventions in Haiphong, Vietnam. RDS, first described by Heckathorn, is the most suitable method for recruiting a representative sample of hard-to-reach populations \[ 17 — 19 \]. It is registered under www. Given that our target population was PWID at high risk i. Only eligible PWID having signed an informed consent form after being informed about the study were enrolled. Twenty seeds 10 individuals from each site were selected to initiate the RDS. These included PWID recently, PWID for a long time, sex workers who inject drugs, and men who have sex with men who inject drugs from various districts. Each coupon was valid for one week. One month after recruitment, the number of participants recruited per day decreased below the initial target. In order to improve cohort size, we added five new seeds and temporarily increased the number of coupons up to 10 for the very few participants describing a very large network. This strategy was actually not very successful and was discontinued, with only 33 participants recruiting more than four other PWID. Coupon validity was extended to two weeks. A fingerprint machine allowed unique identification of participants and avoided repeated enrollments. A standardized questionnaire was administered by a trained research assistant to collect information on demographic characteristics, drug use with injection practices, sexual behaviors, contact with drug treatment services, and medical history. Drug use and sexual behaviors were documented for the prior six months. At-risk alcohol consumption was defined as a score of 4 and above for men and 3 and above for women. Binge drinking was defined as consumption of 5 or more drinks on one occasion at least once per month. All seeds were included in the analysis. We first conducted a multiple correspondence analysis MCA to reduce the dimensions of the data set using active variables reflecting drug use, risk behaviors, and mental health Table 1. Briefly, active variables included items related to heroin and other drug use, injection and risky sexual behaviors, methadone use, and mental health. The Benzecri adjustment was applied to calculate the contribution of the selected axes to the total inertia \[ 22 \]. The MCA output was then used to perform the cluster analysis in order to identify subgroups clusters of participants with specific risk profiles. The clustering was based on a mixed method combining a hierarchical cluster analysis HCA , to determine the optimal number of subgroups, and the K -means method, to define the clusters by assigning each participant to one of the subgroups \[ 23 \] see supplementary data, Table S2 and Figures S1 and S2. Drug use, risk behaviors, and mental health characteristics active variables in study participants. The profiles were then characterized by describing the distribution of active variables, as well as other variables that were not used for the cluster analysis, such as sociodemographic variables. The stability of the classification was checked by modifying the number of axes of the MCA. Among the coupons issued, coupons were returned Each seed recruited between zero and three participants, and there were 16 waves of recruitment. We encountered some challenges during participant recruitment. In all, participants were enrolled and analyzed. The participant flowchart is presented in Figure 1 and the recruitment network in Figure 2. Squares and triangles represent participants who were recruited at Friendship Arms office or Light House office, respectively. HCV-seropositive participants are shown in orange and seronegative ones in green. Large data points represent the seeds. The homophily was 0. The unweighted prevalence was Therefore, we conducted further analyses considering samples as a representative of the population of interest without accounting for the design effect. Participants had a mean age of 39 years and were predominantly male The participant characteristics are shown in Table 1. They were defined as follows: sexual activity, risky injection and sexual behavior, injection frequency and methadone use, alcohol consumption, drug use, duration of injection, and overdose. We identified five subgroups from the HCA and used them to carry out the K -means analyses. This profile consists of PWID who started to inject more recently but injected less frequently than other profiles. They were predominantly males, and all presented hazardous alcohol consumption, such as frequent binge drinking. PWID from this profile tended to inject with an already used syringe, shared water, and had the highest overdose rate. They reported risky sexual behaviors with primary or casual partners more frequently than the other profiles. The psychological assessment score reflected a probable mental health disorder. They had the most precarious situations. Indeed, they were the youngest PWID with the most illegal sources of income, the highest proportion of homelessness, and lack of ID card. These PWID were the oldest, being more frequently single and without sexual activity. They injected heroin safely and moderately every day, with less use of methamphetamine and methadone. These PWID had the highest frequency of injection three-four times a day. This profile had the highest proportion of women, methamphetamine uses, and other drug uses. These PWID did however practice safe injection and had safe sexual behaviors. These PWID injected less than those in the other profiles. They used less methamphetamine, and they exhibited less sexual and injection risk behaviors. They had the highest level of education and lived in partnerships with almost no casual partners. Varying the number of axes before HCA up to 12 and the number of classes selected for the K -means from four to six did not improve the characterization of the profiles data not shown. We identified five profiles of PWID in Haiphong City exhibiting different levels of drug use, drug- or sex-related risk behaviors, and mental health disorders. Among the profiles, three profiles 1, 2, and 4 demonstrate behaviors commonly associated with transmission of blood-borne viruses, either through unsafe injection practices, unsafe sex, high stimulant methamphetamine consumption, or at-risk alcohol consumption. It should be noted that this latter group reported the lowest rate of HCV awareness and testing. Furthermore, these PWID were the youngest and the most at risk with respect to several aspects social precariousness, former history of overdosing, mental health condition, and at-risk sexual behavior. They also reported the highest rate of street methadone use. CBO members indicated that the use of street methadone was a way to cope with heroin shortage. Outreach interventions targeting awareness on transmission of blood-borne viruses, rapid on-site testing, free injection solution provisions, and facilitation of free access to methadone treatment would likely be adapted to this subpopulation. PWID in profile 1 were all at-risk drinkers. Although it was not demonstrated by our data, possibly due to underreporting, alcohol use is known to be associated with disinhibited behaviors and risk-taking practices \[ 24 , 25 \]. Alcohol use should be systematically assessed among PWID, and brief intervention should be offered to all at-risk drinkers \[ 26 \]. Nevertheless, in our study, very few PWID were injecting methamphetamines; it was almost exclusively smoked. Indeed, risks could then rather be related to inappropriate practices when injecting heroin during methamphetamine rush, unsafe sex, and also HCV transmission when sharing pipes with lip burns. These PWID were more often female, injecting more frequently, and more often polydrug users. Most women who inject drugs are sex workers, and CBO members reported that polydrug use with clients was a common practice among sex workers. These findings are consistent with a study conducted in Tijuana, Mexico, where stimulant smoking was associated with polydrug use and transactional sex \[ 15 \]. In contrast with our study, highlighting that unsafe sex was not frequent in this profile, it was associated with high-risk sexual behavior in the Mexican setting. Interventions should probably target information on methamphetamine use, prevention of psychiatric disorders related to methamphetamine use, and prevention of transition to methamphetamine injection. The other two profiles profiles 3 and 5 exhibit lower risk profiles. It should be noticed that among PWID in profile 5, very few reported sexual intercourse with casual partners, but they had the highest rate of unprotected sex with their primary partner. Screening and awareness for the primary partner should be proposed. Our study presents some limitations. We cannot exclude a selection bias due to police enforcement that changed the drug scene, reducing contacts between PWID due to the elimination of many drug purchasing hotspots. Therefore, the most precarious PWID may be underrepresented in this study. A desirability bias is always possible during a face-to-face interview. Indeed, questions on injection practice, drug use, and sexual behaviors are very sensitive as they are designed to elicit very personal information. Some participants may have underreported certain behaviors because they felt embarrassed or guilty regarding these behaviors. Finally, some HCV infection risk factors were not evaluated, including tattoos, blood transfusion, or surgery history \[ 27 , 28 \]. One of the strengths of our study is that it describes a hard-to-reach population having never before been characterized in terms of risk profiles. We were able to enroll a large sample size, about the third of the total population of active PWID, likely being representative of the target population, given that the RDS assumptions were met \[ 29 \]. Finally, we adopted a cluster analysis which is likely the most appropriate approach to define various profiles of a marginalized population \[ 30 \]. However, in this setting, additional interventions are required to tackle HCV transmission, which remains highly prevalent and incident. HCV routes of transmission are not well known by PWID, in particular transmission via water or other dilution liquids, i. These practices should be targeted by preventive interventions. The risk of HCV transmission with methamphetamine use is also possible. Indeed, formation of microlesions by lip burns during smoking can transmit HCV if smoking material is shared \[ 31 \]. Again, these risk behaviors should be targeted by dedicated prevention activities, such as the availability of safer methamphetamine kits which include glass stems and rubber mouthpieces \[ 32 \]. Focusing prevention on sharing drug use material and a good knowledge of the disease are necessary to effectively manage and control HCV spread among PWID. During peer-led interventions, a quick assessment could be done to identify to which profile the individual belongs in order to then deliver interventions tailored to his or her profile-specific risks. For low-risk profiles, minimal general information on HCV infection could be provided, but the risk level should be maintained over time through continuous counseling. This would be via reducing the HCV viral load at the population level, i. Although the cost of these treatments was prohibitive until recently, several initiatives are underway to open their access in resource-limited countries. Our findings cannot be generalized to all PWID. Although we had to marginally modify some of the RDS rules, the decent representativeness of our sample led us to obtain robust estimations of the target population. Our results could therefore be of interest for other urban settings in Asia. Our study showed that the PWID population in large cities, such as Haiphong, is made of distinct profiles of individuals with varying levels of infection risk. Given that resources are limited, particularly the availability of peers, the knowledge of these profiles is crucial to target those with the highest risk and to subsequently tailor their interventions. The funding agencies had no role in designing the research, the data analyses, and the preparation of the report. Table S1 provides a description of weighted and unweighted estimates of the main characteristics of the study population. Table S2 and Figures S1 and S2 provide additional information on the cluster analysis. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Biomed Res Int. Find articles by Adeline Riondel. Find articles by Duong Thi Huong. Find articles by Laurent Michel. Find articles by Marianne Peries. Find articles by Khuat Thi Hai Oanh. Find articles by Pham Minh Khue. Find articles by Nham Thi Tuyet Thanh. Find articles by Hoang Thi Giang. Find articles by Roselyne Vallo. Find articles by Amandine Cournil. Find articles by Delphine Rapoud. Find articles by Catherine Quillet. Find articles by Didier Laureillard. Find articles by Vu Hai Vinh. Find articles by Jean-Pierre Moles. Find articles by Jonathan Feelemyer. Find articles by Ted Hammett. Find articles by Don Des Jarlais. Find articles by Nicolas Nagot. Open in a new tab. Supplementary Materials Table S1 provides a description of weighted and unweighted estimates of the main characteristics of the study population. Click here for additional data file. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Overdose associated with a loss of consciousness a.

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