EXECUTIVE SUMMARY CONCLUSIONS AND POLICY ... - …

1 EXECUTIVE SUMMARY . CONCLUSIONS AND. POLICY IMPLICATIONS. 1. WORLD. 2018. DRUG. REPORT. United Nations, June 2018. All rights reserved worldwide. ISBN: 978-92-1-148304-8. eISBN: 978-92-1-045058-4. United Nations publication, Sales No. This publication may be reproduced in whole or in part and in any form for educational or non-profit purposes without special permission from the copyright holder, provided acknowledgement of the source is made. The United Nations Office on Drugs and Crime (UNODC) would appreciate receiving a copy of any publication that uses this publication as a source. Suggested citation: World Drug Report 2018 (United Nations publication, Sales No. ). No use of this publication may be made for resale or any other commercial purpose whatsoever without prior permission in writing from UNODC. Applications for such permission, with a statement of purpose and intent of the reproduction, should be addressed to the Research and Trend Analysis Branch of UNODC.

2 DISCLAIMER. The content of this publication does not necessarily reflect the views or policies of UNODC or contributory organizations, nor does it imply any endorsement. Comments on the report are welcome and can be sent to: Division for POLICY Analysis and Public Affairs United Nations Office on Drugs and Crime PO Box 500. 1400 Vienna Austria Tel: (+43) 1 26060 0. Fax: (+43) 1 26060 5827. E-mail: Website: PREFACE. Both the range of drugs and drug markets are Drug treatment and health services continue to fall expanding and diversifying as never before. The short: the number of people suffering from drug use findings of this year's World Drug Report make clear disorders who are receiving treatment has remained that the international community needs to step up low, just one in six. Some 450,000 people died in its responses to cope with these challenges. 2015 as a result of drug use. Of those deaths, 167,750 were a direct result of drug use disorders, We are facing a potential supply-driven expansion in most cases involving opioids.

3 Of drug markets, with production of opium and manufacture of cocaine at the highest levels ever These threats to health and well-being, as well as to recorded. Markets for cocaine and methampheta- security, safety and sustainable development, mine are extending beyond their usual regions and, demand an urgent response. while drug trafficking online using the darknet con- The outcome document of the special session of the tinues to represent only a fraction of drug trafficking General Assembly on the world drug problem held as a whole, it continues to grow rapidly, despite in 2016 contains more than 100 recommendations successes in shutting down popular trading on promoting evidence-based prevention, care and platforms. other measures to address both supply and demand. Non-medical use of prescription drugs has reached We need to do more to advance this consensus, epidemic proportions in parts of the world. The increasing support to countries that need it most opioid crisis in North America is rightly getting and improving international cooperation and law attention, and the international community has enforcement capacities to dismantle organized crimi- taken action.

4 In March 2018, the Commission on nal groups and stop drug trafficking. Narcotic Drugs scheduled six analogues of fentanyl, including carfentanil, which are contributing to the The United Nations Office on Drugs and Crime deadly toll. This builds on the decision by the (UNODC) continues to work closely with its Commission at its sixtieth session, in 2017, to place United Nations partners to assist countries in imple- two precursor chemicals used in the manufacture menting the recommendations contained in the of fentanyl and an analogue under international outcome document of the special session, in line control. with the international drug control conventions, human rights instruments and the 2030 Agenda for However, as this World Drug Report shows, the prob- Sustainable Development. lems go far beyond the headlines. We need to raise the alarm about addiction to tramadol, rates of In close cooperation with the World Health Organi- which are soaring in parts of Africa.

5 Non-medical zation, we are supporting the implementation of use of this opioid painkiller, which is not under the International Standards on Drug Use Prevention international control, is also expanding in Asia. The and the international standards for the treatment of impact on vulnerable populations is cause for seri- drug use disorders, as well as the guidelines on treat- ous concern, putting pressure on already strained ment and care for people with drug use disorders in health-care systems. contact with the criminal justice system. At the same time, more new psychoactive substances The World Drug Report 2018 highlights the impor- are being synthesized and more are available than tance of gender- and age-sensitive drug policies, ever, with increasing reports of associated harm and exploring the particular needs and challenges of fatalities. women and young people. Moreover, it looks into 1. WORLD DRUG REPORT 2018. increased drug use among older people, a develop- Next year, the Commission on Narcotic Drugs will ment requiring specific treatment and care.

6 Host a high-level ministerial segment on the 2019. target date of the 2009 Political Declaration and UNODC is also working on the ground to promote Plan of Action on International Cooperation balanced, comprehensive approaches. The Office towards an Integrated and Balanced Strategy to has further enhanced its integrated support to Counter the World Drug Problem. Preparations are Afghanistan and neighbouring regions to tackle under way. I urge the international community to record levels of opiate production and related secu- take this opportunity to reinforce cooperation and rity risks. We are supporting the Government of agree upon effective solutions. Colombia and the peace process with the Revolu- tionary Armed Forces of Colombia (FARC) through alternative development to provide licit livelihoods free from coca cultivation. Furthermore, our Office continues to support efforts to improve the availability of controlled substances for medical and scientific purposes, while prevent- ing misuse and diversion a critical challenge if we Yury Fedotov want to help countries in Africa and other regions EXECUTIVE Director come to grips with the tramadol crisis.

7 United Nations Office on Drugs and Crime 2. CONTENTS. BOOKLET 1 EXECUTIVE SUMMARY CONCLUSIONS AND POLICY IMPLICATIONS. 1. EXPLANATORY NOTES.. 5. EXECUTIVE 7. Latest trends 8. Market developments 10. Vulnerabilities of particular groups 15. CONCLUSIONS AND POLICY 23. 29. REGIONAL 31. GLOBAL OVERVIEW OF DRUG DEMAND AND SUPPLY. BOOKLET 2 Latest trends, cross-cutting issues ANALYSIS OF DRUG MARKETS. BOOKLET 3 Opioids, cocaine, cannabis, synthetic drugs DRUGS AND AGE. BOOKLET 4 Drugs and associated issues among young people and older people WOMEN AND DRUGS. BOOKLET 5 Drug use, drug supply and their consequences 3. WORLD DRUG REPORT 2018. Acknowledgements The World Drug Report 2018 was prepared by the Research and Trend Analysis Branch, Division for POLICY Analysis and Public Affairs, United Nations Office on Drugs and Crime, under the supervision of Jean-Luc Lemahieu, Director of the Division, and Angela Me, Chief of the Research and Trend Analysis Branch.

8 General coordination and content overview Jesus Maria Garcia Calleja (WHO). Chlo Carpentier Riku Lehtovuori Angela Me Tun Nay Soe Andrea Oterov . Analysis and drafting Umidjon Rakhmonberdiev Pablo Carvacho Ali Saadeddin Conor Crean Keith Sabin (UNAIDS). Philip Davis Antoine Vella Catalina Droppelmann Diana Fishbein Editing Natascha Eichinger Joseph Boyle Susan Ifeagwu Jonathan Gibbons Theodore Leggett Graphic design and production Sabrina Levissianos Anja Korenblik Kamran Niaz Suzanne Kunnen Jos Luis Pardo Veiras Kristina Kuttnig Thomas Pietschmann Fifa Rahman Coordination Martin Raithelhuber Francesca Massanello Alejandra S nchez Inzunza Data support Claudia Stoicescu Diana Camerini Justice Tettey Chung Kai Chan Amalia Vald s Sarika Dewan Data management and estimates production Smriti Ganapathi Enrico Bisogno Administrative support Coen Bussink Anja Held Hernan Epstein Iulia Lazar Review and comments The World Drug Report 2018 benefited from the expertise of and invaluable contributions from UNODC colleagues in all divisions.

9 The Research and Trend Analysis Branch acknowledges the invaluable contributions and advice provided by the World Drug Report Scientific Advisory Committee: Paul Griffiths Charles Parry In memoriam Marya Hynes Peter Reuter Brice de Ruyver Vicknasingam B. Kasinather Francisco Thoumi Letizia Paoli Alison Ritter The research and production of the joint UNODC/UNAIDS/WHO/World Bank estimates of the number of people who inject drugs were partly funded by the HIV/AIDS Section of the Drug Prevention and Health Branch of the Division for Operations of UNODC. The research for booklets 4 and 5 was made possible by the generous contribution of Germany (German Agency for International Cooperation (GIZ)). 4. EXPLANATORY NOTES. The boundaries and names shown and the designa- All analysis contained in the World Drug Report is tions used on maps do not imply official endorsement based on the official data submitted by Member or acceptance by the United Nations.

10 A dotted line States to the United Nations Office on Drugs and represents approximately the line of control in Crime through the annual report questionnaire Jammu and Kashmir agreed upon by India and Paki- unless indicated otherwise. stan. The final status of Jammu and Kashmir has The data on population used in the World Drug not yet been agreed upon by the parties. Disputed Report are taken from: World Population Prospects: boundaries (China/India) are represented by cross- The 2017 Revision (United Nations, Department of hatch owing to the difficulty of showing sufficient Economic and Social Affairs, Population Division). detail. References to dollars ($) are to United States dollars, The designations employed and the presentation of unless otherwise stated. the material in the World Drug Report do not imply the expression of any opinion whatsoever on the References to tons are to metric tons, unless other- part of the Secretariat of the United Nations con- wise stated.