Executive summary

The booklet provides the summary of the six subsequent booklets of the World Drug Report 2020 by reviewing their key findings and highlighting policy implications based on their conclusions. The main findings in 2020 were:

Effects of covid-19 on drug markets

Impact could be like the 2008 economic crisis

The effect of COVID-10 pandemic on drug markets is unknown and hard to predict but it could be far reaching. Some producers could be forced to seek out new ways to manufacture drugs as restrictions on movement constrict access to precursors and essential chemicals.

Following the economic crisis of 2008, some users began seeking out cheaper synthetic substances, and patterns of use shifted towards injecting drugs. Meanwhile, Governments reduced drug-related budgets.

The biggest immediate impact on drug trafficking can be expected in countries where large quantities are smuggled on commercial airliner flights.

In the longer run, the economic downturn and associated lockdowns have the potential to disrupt drug markets. Rising unemployment and lack of opportunities will make it more likely that poor and disadvantaged people engage in harmful patterns of drug use, suffer drug use disorders and turn to illicit activities linked to drugs – either production or transport.

Expansion and complexity: market growth

Patterns of population growth partially explain the market expansion

Drug use around the world has been on the rise, in terms of both overall numbers and the proportion of the world’s population that uses drugs. In 2009, the estimated 210 million users represented 4.8 per cent of global population aged 15‒64, compared with the estimated 269 million users in 2018, or 5.3 per cent of the population.

Urbanization is a driving factor in current and future drug markets

Drug use is higher in urban areas than in rural areas, in both developed and developing countries. The mass movement of people from the countryside to towns and cities – more than half the world’s population now live in urban areas compared with 34 per cent in 1960 – partially explains the overall rise in drug use.

Increasing wealth is linked to rising drug use, but the poorest suffer the largest burden of disorders

Worldwide, drug use is more widespread in developed countries than in developing countries. Drugs such as cocaine are even more firmly associated with the wealthier parts of the world.

Emergence of substances not under international control stabilizes, but new potentially harmful opioids are on the increase

Drug markets are becoming increasingly complex. Plant-based substances such as cannabis, cocaine and heroin have been joined by hundreds of synthetic drugs, many not under international control. There has also been a rapid rise in the non-medical use of pharmaceutical drugs.

Rapid market changes

Synthetics replace opiates in Central Asia and the Russian Federation and methamphetamine market grows in Afghanistan and Iraq
Policy changes and changing trends Cannabis use on the rise in most jurisdictions where non-medical use legalized.

Canada, Uruguay and 11 jurisdictions in the United States allow the manufacture and sale of cannabis products for non-medical use. In most of those jurisdictions, cannabis use has risen since its legalization.

 

Disadvantaged face harm from legal and illicit drug markets:

Pharmaceutical opioids for pain management and palliative care are available mostly in high-income countries

Medicines for pain relief are unequally distributed across regions. More than 90 per cent of all pharmaceutical opioids available for medical consumption were in high-income countries in 2018

Poorer people face a greater risk of drug use disorders

Some 35.6 million people suffered from drug use disorders in 2018. Poverty, limited education and social marginalization may increase the risk of drug use disorders and exacerbate the consequences.
The relationship between drugs and violence is complex. It is difficult to pin down all the causal relationships between the use of psychoactive substances and violence. The limited data at the global level show that intoxication may be a significant factor in homicide.

Latest trends

Drug use

Cannabis the most used substance, opioids the most harmful. An estimated 192 million people used cannabis in 2018, making it the most used drug globally. In comparison, 58 million people used opioids in 2018. accounted for 66 per cent of the estimated 167,000 deaths related to drug use disorders in 2017 and 50 per cent of the 42 millions years (or 21 million years) lost due to disability or early death, attributed to drug use. More than 11 million people inject drugs, while 1.4 million PWID are living with HIV, 5.5 million with hepatitis C and 1.2 million are living with both hepatitis C and HIV.

Non-medical use of synthetic opioids fuels public health crises In West, Central and North Africa, the opioid crisis is fuelled by tramadol; in North America, by fentanyls.

The stimulant scene is dominated by cocaine and methamphetamine, and use of both substances is rising in their main markets. Some 19 million people used cocaine in 2018, while roughly 27 million people used amphetamines that same year, methamphetamine being the most used ATS in South-East Asia.

Supply chains

Supply of plant-based drugs still at a high level despite some decreases The area under opium poppy cultivation (240,800 hectare) shrank for a second year in a row in 2019, led by declines in Afghanistan and Myanmar. The quantities of opiates seized (704 tons) in 2018 also fell markedly from the previous year.

Coca bush cultivation continues at a historically very high level (244,200 hectare) . The area under coca cultivation remained stable from 2017 to 2018. However, estimated global manufacture of cocaine once more reached an all-time high (1723 tons), and global seizures increased marginally (1,131 tons).

Quantities of seized methamphetamine, the ATS with the largest market globally, reached a new record high, at 228 ton-equivalents, in 2018.

Traffickers show resilience by changing routes and production practices Heroin, cocaine and methamphetamine traffickers have varied routes and continue to develop new trading patterns.