World Drug Report 2023 – Part 1 – Asrar Qureshi’s Blog Post #885

World Drug Report 2023 – Part 1 – Asrar Qureshi’s Blog Post #885

Dear Colleagues!  This is Asrar Qureshi’s Blog Post #885 for Pharma Veterans. Pharma Veterans  aims to share knowledge and wisdom from Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on  WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

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We are now talking about DRUGS, the illicit compounds of various types and abused medicines. 

This is the latest information from UNODC - United Nations Office on Drugs and Crime. They have published World Drug Report 2023 (link at the end) which shows where the world is vis-à-vis drugs and crime; illicit drugs or abused medicines are a crime by itself and leads to more crimes. This report such important information that it should be shared in detail and shared publicly to raise awareness. I shall reproduce here the highlights of the report in summarized way and shall try to keep the essence of the report intact.

Several key messages have been presented and addressed in this report and I shall present and discuss each of these messages here.

Key Message #1 – One in every 17 people worldwide had used a drug in 2021, 23% more than a decade earlier.

Drug use continues to stay high, rather increase. Among people aged 15 – 64 years, the estimated number grew from 240 million to 296 million; it represents 5.8% of the above population. It should be noted that this age bracket represents most people who are working and earning and have the responsibility of families and households.

Cannabis continues to be the most used drug, with an estimated 219 million users (4.3% of adult population). Use of the drug is constantly on the rise; although globally cannabis users are mostly men, about 70%, the gender divide is reducing in reducing in some regions, for example, women account for 42% of cannabis users in North America.

It is estimated that 36 million had used amphetamines in 2021, 22 million had used cocaine, and 20 million had used ‘ecstasy’ type substance. The proportion of female users in higher in the case of amphetamine-type stimulants – 45% of users are women, and non-medical use of pharmaceuticals – 45% to 49%. The highest share of men is found in users of opiates – 75%, and cocaine – 73%.

Opioids continue to be the group of substances with the highest contribution to severe drug-related harm, including fatal overdoses. An estimated 60 million people engaged in non-medical opioid use, 31.5 million of whom used opiates – mainly heroin.

Key Message #2 - Opioids continue to be the main drug that impacts the global burden of disease whereas cannabis is reported by a large share of countries as the drug of most concern for drug use disorders.

Different drugs pose different burdens on health and health-care systems. Most drug use disorders are related to cannabis and opioids, which are also the drugs that lead most people to seek drug treatment, but opioids remain the most lethal drug. 

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

There are clear regional differences in the primary drug reported by people entering drug treatment: in most of Europe and most of the subregions of Asia, opioids are the most frequent primary drug of people in drug treatment, whereas in Latin America it is cocaine, in parts of Africa it is cannabis, and in East and South-East Asia it is methamphetamine. 

Opioids remain the leading cause of deaths in fatal overdoses. Opioids accounted for nearly 70 per cent of the 128,000 deaths attributed to drug use disorders in 2019. Opioid use disorders also accounted for nearly 13million healthy years of healthy life years lost owing to premature death and disability in 2019.

Key Message #3 - New data put the global estimate of people who injected drugs in 2021 at 13.2 million, 18 per cent higher than in 2020.

An estimated 13.2 million people were injecting drugs in 2021. This estimate is 18 per cent higher than in 2020 (11.2 million). This increase is due to newly available estimates in the United States of America and in some other countries. Eastern Europe (1.3 per cent of the adult population) and North America (1.0 per cent) remain the two subregions with the highest estimated prevalence of people who inject drugs, and, in absolute terms, North America now has the highest number of individuals that report injecting drugs, ahead of East and South-East Asia. 

The risk of acquiring HIV is 35 times higher for those who inject drugs than for those who do not inject drugs. The joint UNODC, WHO, UNAIDS and World Bank global estimate for people who inject drugs living with HIV is nearly 12 per cent, so 1.6 million people (1 in every 8 people) injecting drugs is living with HIV. South-West Asia (29.3 per cent) and Eastern Europe (25.4 per cent) are the two subregions with the highest prevalence of HIV among people who inject drugs. 

Injecting drug use continues to be an important facilitating driver of the global epidemic of hepatitis C, with WHO estimating that 23 per cent of new hepatitis C infections are attributable to unsafe drug injection. Based on the joint UNODC, WHO, UNAIDS and World Bank global estimates, every second person injecting drugs is living with hepatitis C (an estimated 6.6 million people). Overall, liver diseases attributed to hepatitis C account for more than half the deaths attributed to the use of drugs. In the decade 2010–2019 there was a 13 per cent increase in the number of healthy years of life lost due to disability and premature death caused by liver disease attributed to hepatitis C among people who use and inject drugs. 

As is the case with the use of drugs, there are more men than women injecting drugs. Men are 5 times more likely than women to inject drugs (based on limited data from 18 countries), whereas women who inject drugs are 1.2 times more likely than men to be living with HIV (based on data from 58 countries). Women who inject drugs are likely to have a male intimate partner who initiated them into drug use; they are also likely to ask their male partner to inject them. As a result, women are more likely to be exposed to higher risk for sexual transmission of infections, also through sex work and their increased vulnerability to abuse from law enforcement officers and intimate partners, and to be the victim of physical assault or rape.

This is an important report and must be seen in detail. More excerpts shall follow.

To be Concluded…

Reference:

https://www.unodc.org/res/WDR-2023/WDR23_Exsum_fin_DP.pdf