It was reported in the newspaper that the Northern Hospital received 126 drug abuse cases last year, and 44% of the patients were found to have hyperactive bladders. Four were seriously ill, and among them a 14-year-old boy suffered severe reduction of urinary bladder capacity to just 90 ml, i.e., less than a tiny Yakult drink. The shrunk bladder is caused by cystitis, a condition commonly seen after prolonged abuse of ketamine, a psychoactive drug. Patients are toilet-bound and life becomes a nightmare. Fortunately, some patients were able to recover part of their bladder function when they stopped abusing drugs.

These stories are all too familiar to Prof. Cheung Yuet-wah, chairman of the Department of Sociology, CUHK, whose research interests are in crime and deviance, substance abuse, and medical sociology, including alcoholism and drug abuse. He had just finished a research project on adolescent abuse of psychoactive drugs in Hong Kong sponsored by the Beat Drugs Fund. The research employed a longitudinal research design to survey more than 700 young drug abusers. Each of them was interviewed once every six months, and altogether six rounds of interviews were conducted from 2009 to 2011. Also, focus groups comprising young drug abusers were formed to collect in-depth information on their drug taking habits. Professor Cheung remembered a 28-year-old long-term ketamine abuser who used to describe his experience in great detail. Now regretful of his behaviour, he volunteered to share his story with secondary school students. His greatest trouble is he needs to go to toilet every 10 minutes or so. That means going out or taking the bus or MTR, etc., is not possible at all.

In the past 15 years, Professor Cheung has conducted extensive research on substance abuse and drug policy in Hong Kong. ‘The stomach will get into trouble first, followed by the heart, liver, kidneys and bladder. If parents found their children suffer from stomach-aches for no obvious reason, this could be a sign. If this is accompanied by frequent urges to urinate, it’s something worth noticing,’ he said.

From the end of WWII to the 1990s, the main drug problem in Hong Kong was heroin. From the mid-1990s onwards, the types of drugs abused diversified, and an upsurge in psychoactive drug abuse was recorded, said Professor Cheung. Besides trying to curb the supply and consumption of psychoactive drugs, the government also stressed prevention and rehabilitation. During that time, more research on drug abuse was conducted. ‘By the end of the 20th century, drug abuse among young people worsened and it became a global issue, especially in Europe. In 1998, a British sociologist Howard Parker in his research used ‘normalization of recreational drug use’ to describe this stunning phenomenon. Drug-taking in discos and parties is common, and more young people see it as a way to spend their leisure time. The same is occurring in Hong Kong now.’

Findings from Professor Cheung’s research reveal that drug abuse in Hong Kong is not limited to marginal youths or those who do poorly in school, but also found in ordinary students or young people with decent jobs. The biggest worry is young people tend to think taking psychoactive drugs is a bad hobby, just like smoking, Internet surfing, playing online games and gambling. ‘They do not see taking psychoactive drugs as “drug abuse”, and thus become insensitive to the danger. Ketamine is now the most popular drug, and ketamine users look normal just like anyone else. Semantically, “drug abuse” is less severe than “drug addiction”. Therefore, the government now uses “drug addiction” more often in public campaigns, to remind young people not to overlook the serious consequences of drug abuse.’

Young abusers always tell Professor Cheung that it is easy to take drugs at home without parents knowing. Taking drugs in school toilets and classrooms during breaks are also easy. Professor Cheung said we have entered a new drug era. Since the conventional treatment programmes are mainly targeted at heroin addicts, if we use them to treat psychoactive drug abusers, detailed investigation and assessment are urgently required. Besides, as young abusers grow older, they would take up different roles and cultivate different lifestyles, and might not participate in doping parties as often as they usually did. What would happen if they move on and face the next stage in life? Would ketamine abusers later shift to heroin? This requires more research and monitoring.

‘Society has changed a lot in the past decade and competition is growing fierce. Young people feel helpless and lack direction. Some numb their senses through drug abuse in order to cope with harsh reality,’ observed Professor Cheung, who is the current president of the Hong Kong Sociological Association and a founding member of the Asian Criminological Society. ‘Drug abuse is a youth problem, as well as a social problem. The society is our own making, and so is the kind of youth problem we have. In order to prevent young people from abusing illicit drugs or indulge in other risky behaviour, we need to do more research to understand adolescents’ subculture and penetrate into the core of the problem,’ he commented.