World Drug Report 2021: Executive Summary Policy Implications

Drugs cost lives. In an age when the speed of information can often outstrip the speed of verification, the COVID-19 pandemic has taught us that it is crucial to cut through the noise and focus on facts, a lesson that we must heed in order to protect societies from the impact of drugs. Drug use killed almost half a million people in 2019, while drug use disorders resulted in 18 million years of healthy life lost, mostly due to opioids. Serious and often lethal illnesses are more common among drug users, particularly those who inject drugs, many of whom are living with HIV and Hepatitis C. The illicit drug trade also continues to hold back economic and social development, while disproportionately impacting the most vulnerable and marginalized, and it constitutes a fundamental threat to security and stability in some parts of the world. Despite the proven dangers, drug use persists and, in some contexts, proliferates. Over the past year, around 275 million people have used drugs, up by 22 per cent from 2010. By 2030, demographic factors project the number of people using drugs to rise by 11 per cent around the world, and as much as 40 per cent in Africa alone. There is often a substantial disconnect between real risks and public perception. In some parts of the world for example, cannabis products have almost quadrupled in potency, and yet the percentage of adolescents who perceive cannabis as harmful has dropped by as much as 40 per cent, despite the evidence linking regular use to health problems, particularly in young people, and despite the correlation between potency and harm. New psychoactive substances also continue to be a challenge, as markets witness the introduction of new drugs that are unpredictable and poorly understood. Regulatory and legislative steps have been successful in stemming the tide globally, but in low-income countries the problem is on the rise; between 2015 and 2019, South and Central America recorded a fivefold rise in the amount of new synthetic psychoactive substances seized, while seizures in Africa increased from minor to substantial amounts. Strong increases were also reported in South and Southwest Asia as well as the Near and Middle East. Meanwhile, the COVID-19 crisis has pushed more than 100 million people into extreme poverty, and has greatly exacerbated unemployment and inequalities, as the world lost 114 million jobs in 2020. In doing, so it has created conditions that leave more people susceptible to drug use and to engaging in illicit crop cultivation. Furthermore, disparities in access to essential controlled medicines around the world continue to deny relief to patients in severe pain. In 2019, four standard doses of controlled pain medication were available every day for every one million inhabitants in West and Central Africa, in comparison to 32,000 doses in North America. In parallel, drug traffickers have quickly recovered from the initial setback caused by lockdown restrictions and are operating at pre-pandemic levels once again. Access to drugs has also become simpler than ever with online sales, and major drug markets on the dark web are now worth some $315 million annually. Contactless drug transactions, such as through the mail, are also on the rise, a trend possibly accelerated by the pandemic. Communicating facts about drugs and promoting science-based interventions is an absolute necessity if we are to reduce demand and supply of drugs, while also facilitating access to controlled medicines for those in need. It is also the surest path to eliminating stigmatization and discrimination and providing adequate treatment, as seven in eight people who suffer from drug use disorders remain without appropriate care. At the UN Office on Drugs and Crime we are dedicated to pursuing and promoting fact-driven, human rights-based approaches to drug control and treatment. I am proud to present to you this World Drug Report, which embodies our commitment to raising awareness and combating misinformation. It is my hope that this report will inform policymakers, practitioners, and the general public on the facts of the world drug problem, and provide them with a powerful tool to share evidence and information, and in doing so help save and preserve lives

"Spice", "Kryptonite", "Black Mamba": An overview of brand names and marketing stragtegies of Novel Psychoactive Substances on the Web

Novel Psychoactive Substances (NPSs) are often sold online as “legal” and “safer” alternatives to International Controlled Drugs (ICDs) with captivating marketing strategies. Our aim was to review and summarize such strategies in terms of the appearance of the products, the brand names, and the latest trends in the illicit online marketplaces. Methods: Scientific data were searched in PsychInfo and Pubmed databases; results were integrated with an extensive monitoring of Internet (websites, online shops, chat rooms, fora, social networks) and media sources in nine languages (English, French, Farsi, Portuguese, Arabic, Russian, Spanish, and Chinese simplified/traditional) available from secure databases of the Global Public Health Intelligence Network. Results: Evolving strategies for the online diffusion and the retail of NPSs have been identified, including discounts and periodic offers on chosen products. Advertisements and new brand names have been designed to attract customers, especially young people. An increased number of retailers have been recorded as well as new Web platforms and privacy systems. Discussion: NPSs represent an unprecedented challenge in the field of public health with social, cultural, legal, and political implications.Web monitoring activities are essential for mapping the diffusion of NPSs and for supporting innovative Web-based prevention programmes.Peer reviewedSubmitted Versio

An international survey on the awareness, use, preference and health perception of Novel Psychoactive Substances (NPS)

© 2017 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Deligianni, E, Corkery, JM, Schifano, F, Lione, LA. An international survey on the awareness, use, preference, and health perception of novel psychoactive substances (NPS). Hum Psychopharmacol Clin Exp. 2017; 32:e2581, which has been published in final form at https://doi.org/10.1002/hup.2581. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.ObjectiveThis survey investigated the level of public awareness, preference and motivation of NPS use as well as knowledge of potential associated health risks.Methods A Bristol Online Survey was advertised through social media and a drug forum ‘’Bluelight’’ between 7 January and 7 February 2015. ResultsResponses were received from 17 countries, mainly from Europe. Most responses (83%) came from University educated students. Two-thirds (65%) of the 168 respondents were aware of NPS. Awareness was significantly increased in those with bisexual/homosexual orientation (p0.05). Nearly half of the NPS users perceived NPS to carry either a low risk to health (20%) or did not know whether or not they posed a health risk (29%).ConclusionsThese survey data indicate that awareness of NPS and, importantly, perception of the potential health risks associated with NPS use is lacking. NPS awareness and use is higher in those in employment but is unaffected by the level of education. This highlights the need for targeted drugs education intervention by policy-makers in schools and universities.Peer reviewe

Anti-corruption Strategies in Afghanistan: An Alternative Approach

© 2016, © 2016 SAGE Publications. Afghanistan is one of the most corrupt countries in the world. This article provides a critical examination of Afghan anticorruption strategies based on formal anticorruption strategy, bureaucratic reform, and counter-narcotics. This article includes reference to some of the opinions of 70 semi-structured interviews conducted by the author in Kabul during May–June 2010 with anticorruption experts, rights-based organizations, civil society groups, ministries, and international and national organizations. The findings are that political interference from Afghan elites preserves corruption and deep roots of patron–client corruption—patronage networks and illicit drug trafficking interests with criminal groups for profitable gain—are difficult to combat with the existing anticorruption strategy. Hence, new approaches need to be attempted, such as, incorporating religion and ethics and empowering local leaders to combat corruption within a sixfold approach which involves (i) raising awareness, (ii) prevention, (iii) prosecution and sanctions, (iv) detection, (v) a collaborative counter-narcotics strategy, and (vi) linking religion

Novel psychoactive substance consumption is more represented in bipolar disorder than in psychotic disorders : A multicenter-observational study

© 2017 John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Acciavatti, T, Lupi, M, Santacroce, R, et al. Novel psychoactive substance consumption is more represented in bipolar disorder than in psychotic disorders: A multicenter‐observational study. Hum Psychopharmacol Clin Exp. 2017; 32:e2578. which has been published in final form at https://doi.org/10.1002/hup.2578. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.OBJECTIVE: Comorbidities between psychiatric diseases and use of traditional substances of abuse are common. Nevertheless, there are few data regarding the use of novel psychoactive substances (NPS) among psychiatric patients. Aim of this multicentre survey is to investigate the consumption of a number of psychoactive substances in a young psychiatric sample. METHODS: Between December 2013 and September 2015, a questionnaire was administered in 10 Italian psychiatric care facilities to a sample of 671 patients, aged 18-26 (mean age 22.24; SD 2.87). RESULTS: About 8.2% of the sample declared to have used NPS at least once, and 2.2% had consumed NPS in the previous 3 months. The three psychiatric diagnoses most frequently associated with NPS use were bipolar disorder (23.1%), personality disorders (11.8%), and schizophrenia and related disorders (11.6%). In univariate regression analysis, bipolar disorder was positively associated with NPS consumption, an association that did not reach statistical significance in the multivariate analysis. CONCLUSIONS: The use of NPS in a young psychiatric population appears to be frequent, and probably still underestimated. Bipolar disorder shows an association with NPS use. Careful and constant monitoring and an accurate evaluation of possible clinical effects related to NPS use are necessary.Peer reviewedFinal Accepted Versio

Compulsory detention, forced detoxification and enforced labour are not ethically acceptable or effective ways to treat addiction

Univ Queensland, Royal Brisbane & Womens Hosp Site, UQ Ctr Clin Res, Herston, Qld, AustraliaUniv Connecticut, Sch Med, Dept Community Med & Hlth Care, Farmington, CT 06030 USAKings Coll London, Inst Psychiat, Addict Dept, London SE5 8AF, EnglandUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilDeakin Univ, Sch Psychol, Geelong, Vic 3217, AustraliaUniv Uyo, Dept Psychol, Uyo 520003, NigeriaUniv Connecticut, Sch Med, Calhoun Cardiol Ctr, Farmington, CT 06030 USAIHPP, CAS, Muang, Nonthaburi, ThailandUCL, Dept Epidemiol & Publ Hlth, CRUK Hlth Behav Res Ctr, London, EnglandUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilWeb of Scienc

All at sea? Maritime dimensions of Europe's relations with Africa

The article examines three dimensions of Europe’s maritime relations with Africa: first, the notion that Europe’s strategic maritime frontiers are linked to Africa; second, the coherence or ‘actorness’ of the European Union’s (EU) anti-piracy force operating off the Horn of Africa; and third, the relationship between the EU’s own military and naval objectives and its wider regional policies in Africa. While the EU adopted a ‘Maritime Security Strategy’ in 2014, the article notes that, in practice, the EU’s strategy at sea has focused on two groups of ‘non-state actors’: the Africans who are ‘pirates’; and the migrants crossing the Mediterranean, who are the object of the EU’s Frontex patrols. As such, the initial question examined charts the somewhat fluid notion of the sea as a maritime frontier: where do Europe’s strategic interests in terms of its maritime frontiers lie? Is the EU’s anti-piracy mission defending them? Is this first-ever maritime mission a more tangible manifestation of EU’s common foreign and defence policy than some of the other shorter and smaller military and policing missions in Africa