[Chatham House Roundtable] "Korea's Drug Prevention Costs at 2% of US Level... Stable Market to Form Within 1-2 Years"

Establish a Control Tower for Consistent Response
Very Vulnerable Treatment, Prevention Budget Too Low
Light Punishments Are a Problem, Stronger Penalties Needed

Editor's NoteDrug crimes are becoming increasingly serious. Since the 'drug beverage' incident in the Daechi-dong academy district last April, and the emergence of drug-related suspicions involving celebrities, the 'shockwave' has been growing day by day. The number of drug offenders arrested has exceeded 20,000 for the first time in 30 years since statistics began. On the 23rd, Asia Economy held a Chatham House roundtable at the Asia Media Tower in Jung-gu, Seoul, to diagnose the drug problem and seek solutions. Chatham House is the nickname for the Royal Institute of International Affairs (RIIA), a top-level research institution in the field of diplomacy and security in the UK. Participants in this roundtable included Professor Kim Dae-jin of the Department of Psychiatry at Seoul St. Mary's Hospital, Andong-hyun, head of the Drug Crime Investigation Unit at Seoul Metropolitan Police Agency, Lee Han-duk, head of the Addiction Rehabilitation Team at the Korea Anti-Drug Movement Headquarters, and Lee Ho-seok, lawyer at Taeha Law Firm (in alphabetical order). The roundtable followed the 'Chatham House Rule,' where the list of participants is disclosed but each speaker's remarks are anonymized.

At the Asia Economic Chatham House roundtable held on the 23rd at the Asia Media Tower in Jung-gu, Seoul, participants are sharing their opinions on drug issues. From the bottom left clockwise: Lee Han-deok, Head of Addiction Rehabilitation Team at the Korea Drug Eradication Movement Headquarters; Kim Dae-jin, Professor of Psychiatry at Seoul St. Mary's Hospital; Lee Ho-seok, Lawyer at Taeha Law Firm; and Ahn Dong-hyun, Head of the Drug Crime Investigation Unit at Seoul Metropolitan Police Agency. Photo by Yoon Dong-joo doso7@

▶Moderator = So Jong-seop, Managing Editor of Politics and Society

The level of drug risk in our country has risen considerably. I wonder whether this is the manifestation of an underlying problem or if a specific trigger caused it to grow rapidly. What is your view?

It has been internalized continuously, with a gradual increasing trend. Various causes are influencing this. Overseas smuggling, difficulties in crackdowns, and criminal organizations exploiting SNS and international courier services are creating easier access routes to drugs. Until now, Korea had relatively high drug prices due to effective crackdowns compared to other countries, but drug organizations seem to have judged that they could profit by pioneering the market.

Drugs have increased gradually. Although recent incidents have highlighted the seriousness, signals of increasing risk have been ongoing. The main cause is seen from the perspective of accessibility. In the past, access was difficult, but nowadays, environments like Telegram and the dark web make it easier for younger generations than middle-aged people to obtain drugs, which I think is the problem.

What do you think are the specific causes that have led to drugs spreading to this extent?

The development of social networking services (SNS) is the first, and the use of virtual currency is the second. The combination of these two has diversified the groups accessing drugs, which used to be limited to the wealthy or those with easy access to information. The expansion of overseas experience and the entry of foreigners who bring their drug experiences from their home countries also play a role. These factors collectively have created a culture that downplays the seriousness of drugs.

Purchase histories and information have all become IT-based and blockchain-based, enabling anonymity. Tracking has become difficult and sophisticated. In the past, people took risks to obtain drugs, but now they don't have to take such risks. A recent concern is that the age of users is continuously lowering. It has definitely dropped to middle school students, and there are signals that 5th and 6th graders in elementary school are also at risk. Drugs are distributed under the guise of improving intelligence and concentration rather than as drugs.

Drug distribution methods and types are also diversifying. It seems that a domestic drug market is effectively forming.

It is already at a serious level. Looking at the US, when cocaine prices dropped and it spread to the poor, authorities were passive. The same applies to fentanyl, which is currently serious in the US. Once the market expands, blocking supply becomes almost impossible. Market suppression must be enforced, but now it has reached a level where it cannot be delayed any longer. Although the exact hidden offender rate is unknown, the consensus is that it is in the hundreds of thousands. I estimate the hidden offender rate to be about 30 times. Multiplying the number of arrested offenders by 30 gives an estimate of the actual number of drug users.

I believe we have not crossed the irreversible point yet. It is still possible to catch them. Unlike the US, where drug users walk the streets like zombies, Korea does not have that. However, the lowering age of drug users and the normalization of drugs are serious issues. Given the high dependency and addiction, how can someone who starts young endure the rest of their life? Previously, drug users were mostly wealthy, overseas-educated, or entertainment industry workers, but now about half are ordinary office workers.

It is right to strongly block illegal inflows from overseas. Supply suppression policies should be the foundation, and under that, demand suppression policies should operate smoothly. If we cannot block external inflows, all remedies are ineffective. However, the lack of interest in treatment and prevention is also a big problem.

The US spends nearly 1.5 to 2 trillion won on drug research and prevention alone. The leading cause of death among Americans in their 40s is not cancer but sudden death from fentanyl overdose. Despite such spending, the wildfire is so large that pouring water does not extinguish it. Considering Korea's scale, we should spend at least 10% of that, but currently, we probably spend about 10 billion won. In Korea, the Ministry of Health and Welfare, the Ministry of Food and Drug Safety, the prosecution, and the police each make separate drug response plans. Instead of this fragmented approach, a control tower should be established under the Prime Minister's Office to consolidate budgets from various ministries and create a consistent response roadmap. Without a comprehensive roadmap, after a year or two, it will be difficult to do anything. If the number of addicts increases and the drug market stabilizes, no matter how much water is poured, the fire will not go out. I think Korea has reached some critical point.

The discussion naturally leads to legal and institutional issues. What do you think are the problems or gaps in drug problem responses?

Drug investigations have all the difficulties. Like voice phishing, they have overseas bases. We need to cut off the head, but often only the domestic distribution network is disrupted. Disrupted organizations recover over time. There is no cooperation with dark web or Telegram used for distribution, and transactions use virtual assets. Prisons act as military academies. Kingpins serve relatively short sentences and build networks inside prisons.

Drugs are not covered by insurance codes. While 100 billion won is spent annually on free smoking cessation treatments, drugs receive no support or insurance benefits, making treatment environments difficult.

Recently, government drug management measures included applying insurance benefits to drug treatment. This is highly anticipated.

There is much talk about treatment, but currently, there is no treatment method for detainees awaiting trial on drug charges. Those detained in detention centers cannot receive treatment and think about what drugs to use once released. Indiscriminate prescribing of narcotics by hospitals and clinics is also a problem. Drug offenders share information about which hospitals or clinics have been breached. Unless a doctor's prescription is clearly unreasonable, non-experts cannot know. Although legally difficult, the medical community should create more detailed guidelines. Drug disposal in hospitals only requires reporting with proper paperwork, but currently, it relies on professional ethics.

The police, prosecution, and courts operate drug response programs, but there is no inter-system linkage. Drug addiction is a chronic disease requiring continuous recovery management. Without this, offenders reoffend and return to prison. The Correctional Headquarters and the Ministry of Food and Drug Safety are conducting pilot projects to enable drug offenders to receive treatment, but cases are few and need verification.

Drugs can become new narcotics by changing molecular structures. To respond to these new drugs, there is a temporary narcotics designation system, but it is hard for the system to keep up. It needs to be faster. Usually, it takes several months to designate new drugs. Since new drugs are easy to create, complicated administrative procedures make it impossible to keep up.

You mentioned that technology development is hard to keep up with. Are there institutional shortcomings in blocking drug distribution?

Strictly speaking, it is due to manpower shortage. Drug organizations promote through SNS, but the personnel deleting these promotions cannot keep up with those promoting and distributing. So-called 'named' figures advertise, and when caught, rumors spread, and they go underground.

Blocking SNS promotional materials takes time, and content is continuously altered, making crackdowns difficult. It may even be impossible. I also want to point out the issue of foreign workers entering the country. Some drugs legal in their countries are illegal here. Mandatory preventive education should inform them of our system, and comprehensive drug prevention education should be conducted.

Analyzing and responding to drug realities is as important as prevention and treatment of addicts. How do you view Korea's current drug addiction treatment system?

It is very, very vulnerable. It is practically being managed by endurance. There are no drug treatment medications in Korea. The US FDA-approved drugs are not available here. Management is difficult, and pharmaceutical companies have no incentive to import them. Inpatient treatment wards have collapsed. No one wants to treat drug patients. Only about ten doctors can properly treat drug patients. General psychiatrists find it difficult. In the US, 1-2 years of specialized training is required, but there are no incentives.

We cannot make drug treatment hospitals like 'KAP Hospitals' (alcohol addiction treatment hospitals established with initial support from liquor companies), so the state must take responsibility. The US is the worst, Russia regulates but does not treat, worsening the situation. China strictly controls internal distribution, even imposing the death penalty, so cases decrease. Japan is increasing slightly. Some countries give revolutionary support; Portugal does not punish but only treats, which does not fit our standards. Switzerland is worth referencing. They use a four-pronged model of prevention, treatment, harm reduction, and strong law enforcement, reducing cases by nearly 50%. Benchmarking the Swiss model might be a good idea.

There are 24 designated treatment institutions, but only a few handle most cases; others see only a few patients annually. Hospitals are the last refuge for drug addicts, but there is nowhere to send them now. Even if matched with clinics that do not admit patients, some patients are difficult for doctors. Continuous treatment is necessary for recovery. Recovering addicts are effective in this process. People with similar addiction experiences quickly break down barriers. Managing these recovering addicts to provide help is a very difficult task.

Does Korea conduct nationwide surveys on drug use?

The law mandates surveys every five years. The Ministry of Food and Drug Safety and the Ministry of Health and Welfare conduct them, but they target people with addiction problems, not the general public. Recently, a media outlet surveyed 5,000 adult men and women, finding a lifetime prevalence of just over 3%. The Supreme Prosecutors' Office publishes a drug white paper, but it only shows arrest numbers. Previously, the hidden offender rate was said to be 10 times; some studies estimate 28%. This means over one million people have drug experience, implying almost every household has a drug problem. Experts say that once prevalence exceeds 1%, all remedies become ineffective. This is a very critical time. Without full effort, the drug problem will persist, as is currently the case in the US.

How should our society respond to the drug problem going forward?

The drug problem involves many IT aspects. Distribution and treatment are moving digitally. AI-based monitoring of ten biometric signals from patients' wrists is possible. Drug use causes sudden changes in biometric patterns. A smartwatch alone can predict drug use. Digital therapeutics via smartphones are also possible. Drug offenders under probation could be required to complete such programs daily, combined with offline treatment. Since intelligent treatment is possible, the government should open research and development and gather wisdom.

Currently, there is no prevention and treatment is late. Drug offenders know investigation techniques and drug analysis methods, how to get caught or avoid it. But they lack awareness of how drugs affect their health. They should be able to receive hospital treatment immediately, but hospitals refuse. When treated, simple drug users sometimes receive leniency, which is not entirely bad as it shows willingness to quit. A system allowing treatment from the moment of police booking and case registration is needed.

First, many drug offenders must be caught. Criminals distributing drugs for profit through smuggling and supply must be arrested without exception. These dealers should receive heavy sentences, but last year, 84.3% of first trials resulted in less than three years imprisonment. Punishments are too lenient. Strict responses are needed for drug suppliers. Simple users, though criminals, should be linked to rehabilitation and treatment to quit. Budgets for this must increase significantly. Nowadays, many drug offenders are ordinary people. Although they violate the law, they should be recognized as treatment candidates.

Drug suppliers should be severely punished, and users should be actively treated based on law. Without prevention and rehabilitation support, the situation will worsen.