World Drug Report 2017
World Drug Report2017Pre-briefing to theMember StatesVienna, 16 June 2017
Drug useGlobal trends in estimated number ofdrug users and people with drug userdisorders, 2006-2015Global trends in the estimated prevalenceof drug use and prevalence of people withdrug use problems, 2006-2015
12 million people inject drugs
Hepatitis C accounts for a great harmBurden of disease from hepatitis Cand HIV from injecting drug use, 2013
Health related harmNumber of deaths and “healthy” years of life lost (DALYs)attributable to drug use, 2015
Tuberculosis and drug useHigh-risk factors for acquiring andprogressing to active tuberculosis (TB)among people who use drugs8% in people who inject drugs vs0.2% in the general populationFrequent co-morbidity in drug usersMore barriers to access prevention andtreatment for TB
A minimum of 190,000 drug related deathsMostly overdoses, mostly opioid-relatedDrug-related deathsRegional variation in drug-relateddeaths, 2015Sources: United States, National Institute on Drug Abuse, National Center on Health Statistics, Centersfor Disease Control and Prevention Wide-ranging Online Data for EpidemiologicResearch; and United Kingdom of Great Britain and Northern Ireland, Office for National Statistics,“Deaths related to drug poisoning in England and Wales: 2015 registrations”, Statistical Bulletin(Newport, 9 September 2016).
Heroin and synthetic opioidsThe opioid market is becoming more diversifiedMisuse of pharmaceutical drugsPrescription forgery, diversion, illicit manufacture, counterfeit medicinesResearch opioids on the market (NPS)Number of samples submitted to and analysed bylaboratories, by type of drug identified, United States
Cultivation and productioncoca/cocaine, opium/heroinTotal area under opium poppy andcoca bush cultivationGlobal potential opium production andcocaine (100 % pure) manufacture
Opiates trafficking: new Caucasus branchMain opiate trafficking flows, 2011-2015
Most opiates trafficking along the Balkan routePercentage distribution of quantities of heroin and morphine seized,by main trafficking routea
Cocaine trafficking: expanding eastwardsMain cocaine trafficking flows, 2011-2015
Cocaine market in expansion in North AmericaQuantities of cocaineseized in North Americaandannual prevalence ofcocaine use in the UnitedStates and Canada
Cocaine market: signs of expansion in EuropeQuantities of cocaine seized inEurope and annual prevalence ofcocaine use in the European UnionBenzoylecgonine (cocaine metabolite) found inwastewater per 1,000 inhabitants in Europe(based on data from 80 European cities)
Cannabis herb dominates seizuresGlobal quantities of cannabis resin and herb seized
Cannabis use: diverging trendsAnnual cannabis prevalence:United States, European Union,Australia, global levelCannabis prevalence among15-16 year-old, Europe
Regulations of recreational cannabis useJurisdictions in the United States allowing recreational use, medical use ofcannabis and with no access to cannabis, May 2017
Regulations of recreational cannabis use, USCannabis use patterns, riskperception, availability,medical cannabisCannabis useinitiation in thepast yearCannabis usedisorders in dailyor near-dailyusers
Expanding market: Amphetamine-type stimulants (ATS)ATS seized worldwide Total ATS seizures: highestever Amphetamine andmethamphetamine constituteconsiderable share of burdenof disease, rank second onlyafter opioids Users of amphetaminesincreased, reaching 37 millionglobally Methamphetamine seizuresup, East and South-East Asiaovertaking North America “Ecstasy” seizures stable butgreater variety of products onthe market
Methamphetamine: interregional trafficking flowsExpanding market in East/South-East Asia, Oceania, concerns about growing use inNorth America, South-West Asia and parts of Europe. Rising treatment demand in someregions.
Amphetamine: trafficking spreading beyondAmphetamine seized worldwidetraditional regions Amphetamine seizures up inMiddle East and CentralAmerica In the Near and Middle East,sold as “captagon” tablet Trafficking of amphetamineaffecting more regions astransit or origin Central America emergingas origin of amphetamine
Expanding market: New psychoactive substancesNo. of different NPS reported each year Between 2009-2016, 739different NPS reported In 2015 alone, almost 500 NPSwere on the market worldwide Core group of about 80persistent NPS Innovation continues but atslower pace NPS with stimulant propertiesexpand in number Recent emergence of NPSmimicking medicines (fentanylanalogues, benzodiazepinederivatives) with high potentialto cause harmUNODC, early warning advisory on new psychoactive substances.
NPS useProportion of NPS by effect Overall size of market for NPS stillrelatively small Many NPS users unaware of contentof NPS products and dosage ofsubstances contained Injecting use of NPS with stimulanteffect among high-risk groups furtheraggravating health risks (e.g. HIV) Easy availability and low price makethem highly attractive for somegroups Identification of NPS in the laboratorystill a challenge due to their highnumberSource: UNODC, early warning advisory on new psychoactive substances. Based on the analysis of 717 NPS.Note: The analysis of the pharmacological effects comprises NPS registered up to December 2016. Plant-basedsubstances were excluded from the analysis as they usually contain a large number of different substances some ofwhich may not have been known and whose effects and interactions are not fully understood.
Synthetic cannabinoids: not just a kind of cannabisSynthetic cannabinoids seizuresworldwide Source: UNODC, responses to annual report questionnaire, 2010-2015.Note: Contains seizures in the form of herbal material, as well as powder and liquids.Some synthetic cannabinoids aremuch more potent and toxicthan THCIntoxications, includinghospitalisations and fatalities,reportedMany new substances in manydifferent compositionsIn addition to herbal materialalso used as liquid, blotter,powder, tabletProblematic use in prisons andby vulnerable population groups(e.g. homeless)Use among some user groupsdeclining (e.g. US 12 graders)
Synthetic opioids (NPS)Annual number of synthetic opioids(NPS) reported to UNODC, 2012-2016Source: UNODC early warning advisory on new psychoactive substances. Includesonly synthetic opioids reported as NPS (i.e., with no current approved medical use).Data for 2016 are preliminary. Mainly sold as or mixedwith heroin or fakeprescription medicines Highly potent, difficult todose, difficult to detect Pose a threat to publichealth because of thevariable quantity andpotency (up to 10,000times that of morphine)
Booklet 4: Conclusions and policy implications The synthetic drugs market has never been socomplex and widely spread NPS proliferating at unprecedented rate:prioritization, early warning, and healthresponses are key Evolution of synthetic drugs requires improvedforensic capacity and new approaches to datacollection
Drugs and organized crimeEuropean UnionChanging business models fordrug trafficking and organizedcrimeBranching out to seize new crimeopportunitiesContinued importance of drugsStructural transformationsTechnological changes
Drugs on the darknetAnnual drug users obtainingdrugs over the darknet in thepast 12 monthsNumber of transactions and their market shareon the darknet
Drugs and illicit financial flowsMeasurement conceptsDrugs account for between afifth and a third of the incomeof transnational organizedcrime60-70% of global drugproceeds may be launderedA third of drug proceeds mayresult in illicit financial flows
Drugs and illicit financial flowsEstimated drug expenditure by householdsin 21 European Union countriesImpact of drug proceeds and illicitfinancial flows may be small in themajority of countriesbut may be substantial for somedrug producing developingcountriesDrug proceeds damage economiesin the long term
Drugs and corruptionCorruption facilitates illicit drugmarkets, which fuel corruptionCorruption exist all along thedrug supply chainHigh-level vs low-levelcorruptionCorruption and violence
Drugs and terrorism, insurgencyEntities placed under the consolidated UN Security Council Sanctions listInsurgent groups and other non-State armed groupsThe Taliban involvement in the illicit drug (opiates) trade inAfghanistan is well documentedAlso evidence of the involvement of the FARC in Colombia inthe coca/cocaine illicit trade, before the Peace Agreement of2016But evidence implicating other groups is comparatively thinIncome from drugs is key for some groupsOnly one revenue stream of many for most terrorist groups
Drugs and terrorism, insurgencyEntities placed under the consolidated UN Security Council Sanctions listInsurgent groups and other non-State armed groupsArea under control of insurgent groups andarea under opium poppy cultivation in Afghanistan, 2016Taliban’s involvement in thedrug trade26-85% of area under opiumpoppy cultivation under someinfluence of Taliban 150 million in tax income fromthe opiate trade (2016)Half of Taliban’s income isgenerated from drugs
Data coverageWide range of UNODC and external sources used in the ReportShortcomings in Member States reporting to UNODC (Africa, Oceania, Asia)
Thank you forlisteningVienna, 16 June 2017
World Drug Report 2017 Pre-briefing to the Member States Vienna, 16 June 2017 . Global trends in estimated number of drug users and people with drug user disorders, 2006-2015 Global trends in the estimated prevalence of drug use a
member requests a refill of the drug, at which time the member will receive a 60-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug.
If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug. Other changes. We may make other changes that affect members currently taking a drug. For
(drug-drug interaction), food, beverages, dietary supplements the person is consuming (drug-nutrient/food interaction) or another disease the person has (drug-disease interaction). A drug interaction is a situation in which a substance affects the activity of a drug, i.e.
the construction of drugs, drug users, drug producers and drug traffickers as ‘the antagonistic drug Other’ (Herschinger, 2011) or existential threat. Initially the ‘Other’ was seen to be drug users, however gradually drug trafficking organisations (DTOs) and then ‘narco-terrorists’ became seen as the most dangerous drug ‘Other .
Free drug (a) Tumor Drug-loaded NPs (b) F : Schematic contrast of drug biodistribution a er injection of free drug (a) and drug-loaded NPs (b). self-assembly), targeted drug delivery processes, and the current state of NP computational modeling. Directions for future research are also discussed. 2. Self-Assembled Nanoparticles as Delivery Vehicles
Drug- Drug Interactions Need to understand: The disposition or handling of each drug The therapeutic window of each drug . ARV Co-Med TOXICITY . TFV HIV FDA Center for Drug Evaluation and Research. Clinical Pharmacology & Biopharm Rev 2014 Gupta SK, et al. IAS 2015. Vancouver, CA; #TUAB0103.
potential for a drug to be a substrate, inhibitor, or inducer of that process, we can predict the potential for drug interactions. In Vitro models/Tools Reza Fassihi Ph.D. 20 The integration of in vitro and in vivo (both animal and human) data can identify the role of transporters in drug‐drug interactions.
Spring Awakening [1891/1906]. Translated by Jonathan Franzen. Faber & Faber 2007. [on loan from NYU Berlin] o Oskar Kokoschka. Murderer, Hope of Women In: Plays and Poems [1907/1910. ]. Translated by Michael Mitchell. Ariadne Press 2001. pp. 21 – 28. [course reader] o David F. Kuhns. German Expressionist Theatre: The Actor and the Stage .
