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Worldwide drug use up over last 10 years

One in every 17 people worldwide had used a drug in 2021, an increase of 23 per cent from a decade ago. Most drug use disorders are related to cannabis and opioids, but the latter remains the most lethal drug, according to the World Drug Report 2023 by the United Nations Office on Drugs and Crime (UNODC).

New data estimates 13.2 million people globally injected drugs in 2021. Overall, more than 296 million used drugs in 2021, an increase of 23 per cent over the previous decade.
Meanwhile, the number of people suffering from drug use disorders has almost doubled over 10 years, reaching 39.5 million.

“Drug use disorders are harming health, including mental health, safety and well-being,” said UNODC Executive Director Ghada Waly in the report’s preface. “Stigma and discrimination make it less likely that people who use drugs will get the help they need. Fewer than 20 per cent of people with drug use disorders are in treatment, and access is highly unequal.”

Cannabis is the most used drug in 2021, with an estimated 219 million users. Globally, men make up a majority of cannabis users at about 70 per cent but the gap is smaller in some subregions, such as in North America where women account for 42 per cent. Meanwhile, an estimated 36 million people used amphetamines in 2021, while 22 million used cocaine and 20 million used ecstasy-type substances.

Drug overdoses account for a quarter of drug-related deaths. Opioids remain as the leading cause of deaths in fatal overdoses, accounting for nearly 70 per cent of deaths attributed to drug use disorders in 2019. Meanwhile, liver diseases attributed to hepatitis C are a main cause of drug-related deaths.


Among all countries that ranked the drugs leading to drug use disorders, the majority (46 per cent of countries) reported cannabis in first place. Opioids – mainly heroin – was reported in first place by 31 per cent of countries, whereas amphetamine-type stimulants, in particular methamphetamine, were reported in first place by 13 per cent of countries.

Ranking is mainly determined by prevalence of use and dependence potential. The primary drug reported for treatment among users varies depending on the regions.

In most of Europe and most of the subregions of Asia, opioids are the most common drug for treatment. In Latin America it is cocaine, in parts of Africa it is cannabis, and in East and Southeast Asia it is methamphetamine. According to the report, the demand for treating drug-related disorders is largely unmet.

Only one in five people were in treatment for drug use in 2021, with widening disparities in access to treatment across regions.

Women are also underrepresented in drug treatment, particularly for amphetamine-type stimulants.

Despite making up half of amphetamine-type stimulants userbase, only one in four people in treatment is a woman. The cheap and easy production of synthetics drugs has also led to the growth of illicit drug markets.

Unlike plant-based inputs that require large tracts of land in territories with weak rule of law, synthetic drugs only require cheap chemical inputs that can be easily sourced.

In addition to having lower operational costs and less production impediments, production of synthetic drugs also has reduced risks of detection, interdiction and prosecution because they can be produced closer to destination.

Illegal production of synthetic drugs is gaining traction in low- and middle-income countries, with a growing number of laboratories detected in Central Asia, Southeast Asia, the Near and Middle East, Africa, Europe and North America.

Fentanyl in particular has had a significant impact on the opioid crisis in North America. In 2021, the majority of opioid related overdose deaths in North America involved illegally manufactured fentanyls. Canada has also experienced an increasing trend in drug overdose deaths related to the proliferation of synthetic opioids, mainly fentanyl.

In the first half of 2021, fentanyl was found in 86 per cent of the samples from people who had died as a result of opioid overdose.

The report also highlights that young people are the most vulnerable group to using drugs.

Globally in 2021, those aged between 15 and 16 had an annual prevalence of cannabis use of 5.34 per cent, compared with 4.3 per cent for adults. Drug use is also particularly harmful to young people and can have long-term negative effects while the adolescent brain is still developing.

In some regions, young people are more severely affected by substance use disorder. In Africa, 70 per cent of people receiving drug treatment are below the age of 35.

The year 2023 marks the midpoint of the work towards achieving the Sustainable Development Goals (SDGs). The global drug phenomenon continues to challenge both the implementation of SDG targets and efforts to promote peace, security and human rights. – Aqilah Rahman