Youth are the most vulnerable to using drugs and are also more severely affected by substance use disorder in several regions

The number of people who suffer from drug use disorders has skyrocketed to 39.5 million, a 45 percent increase over 10 years, according to the UN Drug Report 2023.

Globally, over 296 million people used drugs in 2021, an increase of 23 percent over the previous decade, says the report launched by the UN Office on Drugs and Crime (UNODC) early this week.

New data puts the global estimate of people who injected drugs in 2021 at 13.2 million, 18 percent higher than previously estimated.

Youth are the most vulnerable to using drugs and are also more severely affected by substance use disorder in several regions. In Africa, 70 percent of people in treatment are under the age of 35.

The demand for treating drug-related disorders remains largely unmet, according to the report. Only one in five people suffering from drug-related disorders were in treatment for drug use in 2021, with widening disparities in access to treatment across regions.

The report highlights how social and economic inequalities drive – and are driven by – drug challenges and how the environmental devastation and human rights abuses caused by illicit drug economies. It also points out the rising dominance of synthetic drugs.

It features a special chapter on drug trafficking and crimes that affect the environment in the Amazon Basin. It also has sections on clinical trials involving psychedelics and medical use of cannabis, drug use in humanitarian settings, innovations in drug treatment and drugs and conflict.

The report makes a case for prioritization of public health, prevention, and access to treatment services, warning otherwise drug challenges will leave people behind. It calls for the need for law enforcement responses to keep pace with agile criminal business models and to pre-empt the proliferation of cheap synthetic drugs that are easy to bring to market.

“We are witnessing a continued rise in the number of people suffering from drug use disorders worldwide, while treatment is failing to reach all of those who need it,” Ghada Waly, Executive Director United Nations Office on Drugs and Crime says.

“We need to step up responses against drug trafficking rings that are exploiting conflicts and global crises to expand illicit drug cultivation and production, especially of synthetic drugs, fueling illicit markets and causing greater harm to people and communities,” Waly adds.

Table of Contents

Amazon Basin

As some 86 percent of the world’s population live in countries with too little access to pharmaceutical opioids (controlled under the 1961 Single Convention), the drug economy in the Amazon Basin is exacerbating additional criminal activities damaging the environment of the world’s largest rainforest.

“Indigenous peoples and other minorities are suffering the consequences of this crime convergence, including displacement, mercury poisoning, and exposure to violence, among others,” the report reads.

“Some impoverished and vulnerable populations, such as those in the tri-border area between Brazil, Colombia, and Peru, are trapped in rural areas with a high prevalence of drug-related crimes. Their remote locations make it exceedingly difficult for them to benefit from treatment services, resources, or the rule of law.”

War in Ukraine

While the war in Ukraine has disrupted traditional cocaine and heroin routes, there are signs that the conflict could trigger an expansion of the manufacture and trafficking of synthetic drugs, given the existing know-how and the large markets for synthetic drugs developing in the region.

The cheap, easy, and fast production of synthetic drugs has radically transformed many illicit drug markets, the report reveals.

“Criminals producing methamphetamine – the world’s dominant illegally manufactured synthetic drug – are attempting to evade law enforcement and regulatory responses through new synthesis routes, bases of operation, and non-controlled precursors,” the report says.

“Fentanyl has drastically altered the opioid market in North America with dire consequences. In 2021, the majority of the approximately 90,000 opioid-related overdose deaths in North America involved illegally manufactured fentanyls,” the report adds.

Waly explains: “Illicit drug markets continue to expand in terms of harm as well as scope, from the growing cocaine supply and drug sales on social media platforms to the relentless spread of synthetic drugs – cheap and easy to manufacture anywhere in the world, and in the case of fentanyl, deadly in the smallest of doses.”

The United Nations Office on Drugs and Crime publishes the World Drug Report every year to provide a global perspective and overview of the world drug problem, offering impartial evidence with the aim of supporting dialogue and shared responses. This edition of the World Drug Report highlights the growing complexity of evolving drug threats.

This year’s report also explores urgent challenges, including drug use in humanitarian settings and drugs in conflict situations. The report also delves into new clinical trials involving psychedelics, medical use of cannabis, and innovations in drug treatment and other services.

“World drug problems may be global, but they do not affect all the world equally. It is the vulnerable, the poor and the excluded who pay the highest price, in the global South and in underdeveloped and underserved communities in all our countries, cities, and villages. They suffer from the violence and insecurity fueled by drug trafficking, as well as from insufficient access to and availability of controlled medicines,” Waly says.

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