World Drug Report 2022

As it does each year, the United Nations Organization on Drugs and Crime (UNODC) released its World Drug Report, an impressive document that analyses the developments and trends in the global drug market in great detail – image: UNODC, all rights reserved

The Editor – Consisting of five separate booklets, the World Drug Report 2022 provides an in-depth analysis of world drug markets and examines for the first time in such detail the nexus between drugs and the environment within the bigger picture of the Sustainable Development Goals, climate change and environmental sustainability.

The UNODC report aims not only to foster greater international cooperation to counter the impact of the world drug problem on health, governance and security, but also to assist Member States in anticipating and addressing the threats posed by illicit drug markets and mitigating their consequences.

Until October, Dianova will be publishing a series of articles dedicated to some of the issues addressed in  the World Drug Report 2022, including the environmental consequences of drugs and how illicit markets thrive in conflict situations. Lastly, a special article will delve deeper into a topic that has not been addressed in the report: the human rights violations resulting from overly repressive drug policies, in stark contrast with the recent statement by several UN human rights experts on this topic.

Some of the topics of the report

Note: the links that follow give access to more information located below. For additional details, please download the UNODC World Drug Report 2022

• The report reviews the current trends in the world’s drug markets, highlighting how the market for cocaine is “booming” and analysing drug trafficking via the Internet.
• It provides a detailed analysis of the gender gap in drug use and treatment, and of the impact of the COVID-19 pandemic on women who use drugs.
• The report also looks at the global supply and use of opioids and at the availability of pharmaceutical opioids for medical consumption worldwide.
• The report examines the wide-ranging impact of cannabis legalisation on public health and safety, market dynamics, commercial interests and criminal justice responses, and suggests possible responses.

Current trends

In 2020, an estimated 284 million people aged 15-64 had used a drug in the last 12 months (5.6 per cent of the age group), a 26 per cent increase compared to 2010, attributable in part to global population growth. The report also sheds lights on the devastating number of direct and indirect drug-related deaths, with an estimated 494,000 deaths in 2019 alone, and an overall increase of 17.5 per cent between 2009 and 2019.

Global estimates in the number of drug users in millions – Image: World Drug Report 2022, UNODC, all rights reserved

Cannabis remains the most widely used drug worldwide: in 2020 it was used by 209 million people (15-64 years), or 4 per cent of the world’s population in this age group. It should be noted that past year prevalence of use has increased by 8 per cent since 2010, while the number of users has increased by 23 per cent since that date, partly due to population growth.

The use of amphetamine-type stimulants affected 34 million people in 2020 (15-64 years), or 0.7 per cent of the global population in this age group. The global estimate of use is similar to that in 2010 (33 million), but these figures are likely to be underestimated due to a lack of data from various Asian countries where use is high, even though seizure figures and other factors suggest an expansion of use over the last decade.

The COVID-19 pandemic seems to have temporarily halted the increase in cocaine and ecstasy use, apparently due to the mandatory closure of bars and other recreational venues.

Despite this pause in 2020, various indicators show that cocaine use has resumed its long-term increase in 2021. In 2020, an estimated 21.5 million people dad used the drug at least once in the last year. In addition, global cocaine production reached a new record that same year with 1,982 metric tons of pure cocaine, an 11% increase over the previous year.

Global cultivation, production, seizures and number of users of cocaine – Image: UNODC, WDR 2022, all rights reserved

Lastly, the report notes that despite the numerous advantages of using online platforms for both traffickers and people who use drugs (higher levels of anonymity and reduced risks of detection), the Internet has not dramatically changed drug supply chains so far, and online platforms overall account for only a small portion of the global drug market.

Gender gap and impact of the pandemic

Drug use remains unevenly distributed in the population, however, besides regional and national differences, the most obvious factors are sex and age. Still, while drugs are in general used predominantly by men, women account for more than 40% of people who use amphetamine-type stimulants and engage in non-medical use of pharmaceutical stimulants, opioids and sedatives and tranquillisers.

In most regions, women are under-represented in drug treatment programmes with evidence suggesting numerous additional barriers to access (fear of legal sanctions, increased social stigma, lack of childcare facilities, fear of losing custody, etc.). These inequalities in treatment are a global problem and are particularly relevant for women who use amphetamine-type stimulants: these women represent only one in five people in treatment for this type of substance use disorders, while one in two people who use these drugs is a woman.

Even though almost one in two amphetamines users is a woman, less than one in five persons in treatment for amphetamines is a woman – Image: UNODC, WDR 2022, all rights reserved

Women who use drugs may be disproportionately affected by the pandemic due to specific background vulnerabilities and socio-economic factors, including: lower incomes and savings, even in high-income countries, less job security and over-representation in sectors vulnerable to lockdowns.

In addition, women are responsible for most single-parent households and have had to cope with the additional responsibilities associated with school closures. Intensification of women’s unpaid care and domestic workloads during the pandemic has been reported, adding to multifactorial stress.

Finally, it should be noted that many countries have reported spikes in domestic violence during lockdowns, especially in the presence of drug use.

The global opioid market

Opioid use remains at a high level, with a slight increase since 2017. For the year 2020, an estimated 61.3 million people worldwide used opioids in the past year. This figure includes people who use opiates (mainly heroin and opium) and those who use opioid pharmaceuticals for non-medical purposes.

The availability of pharmaceuticals opioids for medical purposes more than doubled between 2000 and 2010 before declining by 15% between 2012 and 2019. This overall decline was primarily driven by declines in the USA, where state and federal government agencies tightened prescribing policy guidelines and monitoring.

The availability of pharmaceutical opioids continues to be highly unequal worldwide: the largest amounts available per capita continue to be concentrated in North America, and, to a lesser extent, in Central and Western Europe, Australia and New Zealand. Only 7 per cent of pharmaceutical opioids for medical purposes are available for consumption in low- and middle-income countries, even though those countries account for 84 per cent of the world’s population.

North America has 7,500 times more doses of pain medication than central Africa – Image: UNODC WDR 2022, all rights reserved

The impact of cannabis legalisation

As of January 2022, legal provisions allowing the production and sale of cannabis for non-medical purposes have been approved in Canada, Uruguay and 21 jurisdictions in the United States (18 states, 2 territories and the District of Columbia). Canada and most of the US jurisdictions concerned allow production and sale by commercial entities, while the retail market is still partially regulated and controlled by the Uruguayan state.

These countries and jurisdictions have taken the decision to legalise the production and sale of cannabis to meet a number of concerns and aspirations, including: establishing a regulated market to ensure product quality and prevent the use of hazardous contaminants in production; preventing organized crime groups from generating profits from the illicit trade; addressing criminal justice responses that have resulted in some countries (e.g. the US) in the arrest of tens of thousands of people, often from ethnic minorities; reducing law enforcement costs; generating revenue and investing part of it in prevention, etc.

However, as the report notes: any attempt to assess the impact of cannabis legalisation would also have to include a thorough analysis of whether or not the concerns and aspirations described above have been addressed, which will necessarily take several years.

Moreover, cannabis legalisation may have favourable effects in some areas and unfavourable effects in others. Given the polarisation of views on this issue, advocates are often selective in how they combine or aggregate different indicators to focus exclusively on outcomes that favour their pre-existing conclusions.

Early indicators suggest, however, that cannabis legalisation has had a significant impact on public health and safety, market dynamics, commercial interests and criminal justice responses:

• Cannabis legalisation appears to have accelerated the upward trends in reported daily use of the drug, with a pronounced increase in the frequent use of high-potency products. In contrast, the prevalence of cannabis use among teenagers has not changed significantly.
• The proportion of people with psychiatric disorders and suicides associated with regular cannabis use has increased, as has the number of hospitalisations due to cannabis-related disorders.
• Cannabis products have diversified and average THC levels have continued to increase, reaching 60% in some markets.
• The growing influence and investment of large corporations, including those in the alcohol and tobacco sectors, is evident in the legal cannabis industry. Tax revenues from the legalised market have continued to rise. While the illegal cannabis market is shrinking in some jurisdictions, it continues to exist alongside legal markets.
• Legalisation has led to a significant reduction in the number and rates of arrests of people for cannabis-related offences, however, since possession of cannabis remains a criminal offence for minors, legalisation has not led to substantial reduction in youth arrest rates.

To address these consequences, the report suggests that the impact of cannabis legalisation in these areas should continue to be monitored and that investment should be made in research into the health consequences of the use of products with high THC content, especially on young people, women and pregnant women. Misperceptions about the risks of cannabis use should also be addressed through evidence-based prevention messages, particularly targeting young people.

We need to draw from the experience and lessons learned from the tobacco, alcohol and ultra-processed food industries, as well as the pharmaceutical industry and documented cases where the pursuit of commercial interests has targeted vulnerable or disadvantaged groups, and competed with public health concerns.