The non-medical use of prescription drugs is becoming a major threat to public health and law enforcement worldwide with opioids causing the most harm and accounting for 76 per cent of deaths where drug use disorders were implicated, according to the latest World Drug Report, released today by the United Nations Office on Drugs and Crime (UNODC).
Fentanyl and its analogues remain a problem in North America, while tramadol - an opioid used to treat moderate and moderate-to-severe pain - has become a growing concern in parts of Africa and Asia. Accessibility of fentanyl and tramadol for medical use is vital for treating pain, but traffickers manufacture them illicitly and promote them in illegal markets causing considerable harm to health.
The global seizure of pharmaceutical opioids in 2016 was 87 tons, roughly the same as the quantities of heroin seized that year. Seizures of pharmaceutical opioids - mainly tramadol in West and Central Africa, and North Africa accounted for 87 per cent of the global total in 2016. Countries in Asia, which had previously accounted for more than half of global seizures, reported just 7 per cent of the global total in 2016.
Global cocaine manufacture in 2016 reached the highest level ever reported, with an estimated 1,410 tons being produced. Most of the world's cocaine comes from Colombia while the Report also showed that Africa and Asia are emerging as cocaine trafficking and consumption hubs.
From 2016-2017, global opium production jumped by 65 per cent to 10,500 tons, the highest estimate recorded by UNODC since it started monitoring global opium production at the start of the twenty-first century. A marked increase in opium poppy cultivation and gradually improving yields in Afghanistan resulted in opium production there last year reaching 9,000 tons.
"The findings of this year's World Drug Report show that drug markets are expanding, with cocaine and opium production hitting absolute record highs, presenting multiple challenges on multiple fronts," said UNODC Executive Director Yury Fedotov. He highlighted that "UNODC is committed to working with countries to seek balanced, integrated solutions to drug challenges and achieve progress towards the Sustainable Development Goals."
"The World Drug Report represents a key pillar of our support, along with assistance to translate international obligations into action and capacity building on the ground to enable effective responses, and protect the health and welfare of humankind," Mr. Fedotov said.
Cannabis was the most widely consumed drug in 2016, with 192 million people using it at least once during the previous year. The global number of cannabis users continues to rise and appears to have increased by roughly 16 per cent in the decade to 2016, reflecting a similar increase in the world population.
Drugs such as heroin and cocaine that have been available for a long time increasingly coexist with new psychoactive substances (NPS) and prescription drugs. A growing stream of pharmaceutical preparations of unclear origin destined for non-medical use, together with poly drug use and poly drug trafficking, is adding unprecedented levels of complexity to the drug problem.
Vulnerability of various age and gender groups
The number of people worldwide using drugs at least once a year remained stable in 2016 with around 275 million people, or roughly 5.6 per cent of the global population aged 15-64 years.
Looking at vulnerabilities of various age groups, the Report finds that drug use and the associated harm are the highest among young people compared to older people. Most research suggests that early (12-14 years) to late (15-17 years) adolescence is a critical risk period for the initiation of substance use and may peak among young people (aged 18-25 years).
Cannabis is a common drug of choice for young people. However, drug use among young people differs from country to country and depends on the social and economic circumstances of those involved. There are two extreme typologies of drug use among young people: club drugs in nightlife and recreational settings among affluent youth; and use of inhalants among street children to cope with their difficult circumstances.
Drug use among the older generation (aged 40 years and older) has been increasing at a faster rate than among those who are younger. This, although there is only limited data available, requires attention, the Report finds. People who went through adolescence at a time when drugs were popular and widely available are more likely to have tried drugs and, possibly, to have continued using them.
Older drug users may often have multiple physical and mental health problems, making effective drug treatment more challenging, yet little attention has been paid to drug use disorders among older people.
Globally, deaths directly caused by the use of drugs increased by 60 per cent from 2000 to 2015. People over the age of 50 accounted for 27 per cent of these deaths in 2000, but this had risen to 39 per cent in 2015. About three quarters of deaths from drug use disorders among those aged 50 and older are among the ageing cohort of opioid users.
The majority of people who use drugs are men, but women have specific drug use patterns, the Report finds. The prevalence of non-medical use of opioids and tranquillizers by women remains at a comparable level to that of men, if not actually higher. While women may typically begin using substances later than men, once they have initiated substance use, women tend to increase their rate of consumption of alcohol, cannabis, cocaine and opioids more rapidly than men as well as rapidly develop drug use disorders.
Women with substance use disorders are reported to have high rates of post-traumatic stress disorder and may also have experienced childhood adversity such as physical neglect, abuse or sexual abuse. Women continue to account for only one in five people in treatment. The proportion of females in treatment tends to be higher for tranquillizers and sedatives than for other substances. Drug use treatment and HIV prevention, treatment and care should be tailored to the specific needs of women.
The 2018 World Drug Report provides a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine-type stimulants and new psychoactive substances (NPS), as well as their impact on health. It highlights the different drug use patterns and vulnerabilities of particular age and gender groups, and highlights the shift in the global drug market.