23 June 2016 - Around five per cent of the adult population, or nearly 250 million people between the ages of 15 and 64, used at least one drug in 2014, according to the latest World Drug Report released today by the United Nations Office on Drugs and Crime (UNODC). Although substantial, this figure has not grown over the past four years in proportion to the global population. The report, however, suggests that the number of people classified as suffering from drug use disorders has increased disproportionally for the first time in six years. There are now over 29 million people within this category (compared to the previous figure of 27 million). Additionally, around 12 million people inject drugs with 14 per cent of these living with HIV. The overall impact of drug use in terms of health consequences continues to be devastating.
This report comes soon after April's UN General Assembly special session on the world drug problem (UNGASS), a landmark moment in global drug policy which resulted in a series of concrete operational recommendations. Collectively, these look to promote long-term, sustainable, development-oriented and balanced drug control policies and programmes. As UNODC Executive Director Yury Fedotov notes, it is critical that the international community come together to ensure the commitments adopted at the UNGASS are met - and the World Drug Report offers an important tool to assist with this task. "By providing a comprehensive overview of major developments in drug markets, trafficking routes and the health impact of drug use, the 2016 World Drug Report highlights support for the comprehensive, balanced and integrated rights-based approaches as reflected in the outcome document which emerged from the UNGASS."
Drug use and its health consequences
While drug-related mortality has remained stable around the world, in 2014 there were still around 207,000 deaths reported: an unacceptably high number of deaths which are preventable if adequate interventions are in place.
Heroin use, and related overdose deaths, appear to have increased sharply over the last two years in some countries in North America and Western and Central Europe. Underlining the significance of this, Mr. Fedotov noted that while the challenges posed by new psychoactive substances remain a serious concern, "heroin continues to be the drug that kills the most people and this resurgence must be addressed urgently." Overall, opioids continue to pose the highest potential harm and health consequences among major drugs.
Cannabis, meanwhile, remains the most commonly used drug at the global level, with an estimated 183 million people having used it in 2014. By analysing trends over several years, the report shows that with changing social norms towards cannabis - predominantly in the west - cannabis use has climbed in parallel with higher acceptability towards the drug. In many regions, more people have entered treatment for cannabis use disorders over the past decade.
The report also includes new findings related to people who inject drugs (PWID). For example, the link between the use of stimulants (among them new psychoactive substances which are not under international control) and engaging in risky injecting and sexual behaviours which can result in a higher risk of HIV infection, is looked at. Additional findings point to high levels of drug use in prison, including the use of opiates and injecting drug use. Prisons therefore remain a high-risk environment for infectious diseases, and the prevalence of HIV, hepatitis and tuberculosis among persons held in prison can be substantially higher than among the general population. The risk from overdose continues to be high among ex-prisoners particularly shortly after their release from prison.
The report notes that men are three times more likely than women to use cannabis, cocaine or amphetamines, whereas women are more likely than men to engage in the non-medical use of opioids and tranquilizers. Gender disparities can be attributed to the opportunity of drug use in a social environment, rather than gender being a factor determining drug use. Despite the fact that more men use drugs than women, the impact of drug use is greater on women than it is on men, because women tend to lack access to the continuum of care for drug use dependence. Within the family context, female partners and children of drug users are also more likely to be the victims of drug-related violence.
The world drug problem and sustainable development
With 2016 marking the first year of the adoption of the new Sustainable Development Goals (SDGs), the report provides a special focus on the world drug problem within this context. In analysing these linkages the SDGs have been divided in five broad areas: social development; economic development; environmental sustainability; peaceful, just and inclusive societies; and partnerships.
The report highlights a strong link between poverty and several aspects of the drug problem. Indeed, the brunt of the drug use problem is borne by people who are poor in relation to the societies in which they live, as can be seen in stark terms in wealthier countries. The strong association between social and economic disadvantage and drug use disorders can be seen when analysing different aspects of marginalization and social exclusion, such as unemployment and low levels of education.
The report also sheds some light on the varied ways in which the world drug problem results in different manifestations of violence. While the intensity of drug-related violence is greatest when associated with drug trafficking and production, these do not necessarily produce violence, as illustrated by the low levels of homicide in transit countries affected by the opiate trafficking routes in Asia. The drug trade is generally seen to flourish where State presence is weak, where the rule of law is unevenly applied, and where opportunities for corruption exist.
The report analyses the influence of the criminal justice system on drug trafficking and drug markets, as well as on drug use and people who use drugs. For example, it notes that globally 30 per cent of the prison population is made up of un-sentenced or pre-trial prisoners. Among the convicted prisoners, 18 per cent are in prison for drug-related offences. The excessive use of imprisonment for drug-related offences of a minor nature is ineffective in reducing recidivism and overburdens criminal justice systems, preventing them from efficiently coping with more serious crimes. Provision of evidence-based treatment and care services to drug-using offenders, as an alternative to incarceration, has been shown to substantially increase recovery and reduce recidivism.
The 2016 World Drug Report provides a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine-type stimulants and new psychoactive substances, as well as their impact on health. It also reviews the scientific evidence on polydrug use, treatment demand for cannabis and developments since the legalization of cannabis for recreational use in some parts of the world. Additionally, the mechanisms of the interaction between the world drug problem and all aspects of sustainable development through the lens of the Sustainable Development Goals are brought into view through a thorough analysis.