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UNODC – United Nations Office on Drugs and Crime has published World Drug Report 2023 (link at the end) which shows where the world is vis-à-vis drugs and crime. I am reproducing here the highlights of the report in summarized way.
Key Message #9 – Forcibly displaced populations suffer an elevated vulnerability to mental health and substance use disorders.
By mid-2022, the number of people who had been forcibly displaced worldwide had exceeded 100 million, which was more than double the nearly 43 million who were forcibly displaced a decade earlier.
People who are forcibly displaced are among marginalized groups who suffer acute physical and psychological trauma, and elevated levels of socioeconomic vulnerability. As a result, they are likely to suffer elevated levels of social and mental health problems, as well as an increased vulnerability to substance use disorders. Anxiety, depression and post-traumatic stress disorder are common among displaced people. Among displaced populations, the initiation of, or transition to, harmful use of substances is complex though it is not entirely different from general population, however, availability and accessibility of mental health services, including drug treatment services, remain a challenge for displaced people, who may face stigma and discrimination when accessing local services.
Key Message #10 – The other opioid crisis – the non-medical use of tramadol – continues to affect countries in parts of Africa and Asia
Tramadol is a synthetic opioid used in pain management of moderate and severe pain, although it also has a mood enhancement effect. Administration of higher than therapeutic doses of tramadol leads to a similar dependence profile to that of morphine and other opioids.
Numerous countries in North, West and Central Africa, in the Near and Middle East and in South-West Asia have reported evidence of non-medical use of the drug. Significant misuse in some countries in other regions also occurs. The gender divide in the non-medical use of tramadol may be narrower than that for other drugs.
Although the drug can be diverted from the legal supply chain, seizures in the above-mentioned regions suggest that the tramadol used in the non-medical market is often a falsified product of higher dosage than the pharmaceutical product, sourced from abroad.
The problematic non-medical use of tramadol is visible in the high proportion of people entering drug treatment for tramadol use disorders in Egypt, Iraq, Nigeria and the United Arab Emirates. Significant numbers have also been reported in other countries, including Liberia, the Niger and Sierra Leone, indicating in some cases recent sharp increases in the demand for treatment for tramadol use disorders.
Pakistan has a huge consumption of Tramadol in both forms: Tramadol alone, and in combination with Paracetamol. Millions of packs of these drugs are sold legally on the pharmacies.
Key Message #11 – Number of substances on the drugs market is increasing.
Cannabis-based Substances
Cannabis continues to be the most used drug worldwide. Products for its non-medical use have diversified over the last two decades, in particular in geographical locations which have legalized cannabis supply for non-medical use.
Over the last few years, but mainly since 2020, there has been a new trend of synthesis of cannabinoids mainly from a non-psychoactive substance occurring in the cannabis plant, namely cannabidiol (CBD). These cannabinoids, possibly developed to evade drug laws, have been sold in various forms for non-medical use.
By 2011, a new strain of cannabis that was reported to be genetically modified and to contain high levels of THC had appeared in Colombia under the name of “creepy”, and has since appeared in other countries in South America under similar names. Data remain scarce, however, preventing full understanding of the THC content and harm that this type of cannabis product may pose to health.
Synthetic Compounds
Without the need for plant-based inputs that require large tracts of land in territories with weak rule of law, synthetic drugs only require cheap chemical inputs that can be easily sourced. Illegal manufacture of synthetic drugs is expanding in low- and middle-income countries, including in countries with strong rule of law. A growing number of laboratories have been detected in Central Asia, South-East Asia, the Near and Middle East, Africa, Europe and North America, producing a range of stimulants, depressants and other novel dissociatives.
Synthetic drugs offer criminals several advantages, namely lower operational costs, fewer production impediments, and reduced risks of detection, interdiction and prosecution because they can be produced closer to destination. Synthesis of drugs offers additional flexibility in terms of having no fixed geography and much shorter production times. Interdiction of drugs may be less effective, as illegal manufacture can be relocated and product quickly replaced. Consumers face growing challenges from synthetic drugs owing to the unknown pharmacology and harms of the drugs, lack of pharmacological treatments, therapies or antagonists, and an increasingly dangerous mix in retail markets, as shown by the growing numbers of tranquilizers, including novel benzodiazepines, found in the drug supply.
Ketamine
Non-medical use of ketamine (a dissociative anaesthetic not under international control but used in medicine) is not new and, at one point, it was one of the most used drugs in some countries in East and South-East Asia.
Recently, illicit ketamine manufacture has diversified geographically and trafficking has spread beyond a handful of countries in East and South-East Asia. The non-medical use of the drug has also recently increased in parts of the world beyond the subregion to Western Europe, the Middle East and a few other countries in South Asia, North Africa and Oceania. Traffickers have begun exploring new ways to promote ketamine on the illicit market, with the appearance of ketamine-containing mixtures with other ingredients that are often unknown to users.
New Psychoactive Substances – NPS
After several years of stabilization, the number of new psychoactive substances on the global market increased in 2021. Of the 618 substances reported to be on the global market in 2021, 87 were newly identified. The number of opioid new psychoactive substances on the market has, however, stabilized, and the number of fentanyl analogues have even declined slightly, following year-on-year increases.
The cumulative number of new psychoactive substances identified over the last 15 years reached 1,165 substances in 2021 and, according to preliminary data, 1,184 substances in 2022. The use of new psychoactive substances continues to be lower than that of traditional drugs but it can be high in niche markets of specific population groups, although data are largely available only in high-income countries. T
The use of new psychoactive substances has become significant in particular in Central Asia and Eastern Europe, as well as in some other regions.
Captagon
The market for “captagon”, an illicitly manufactured substance mostly containing various concentrations of amphetamine, continues to grow in the Near and Middle East. Assuming that all amphetamine seizures reported in the subregion are of “captagon”, seizures doubled from 2020, reaching a record high of 86 tons in 2021.
The main departing area for “captagon” shipments continues to be in the Levant (the Syrian Arab Republic and Lebanon), with destinations in the Gulf countries reached either directly by land or sea, or indirectly with shipments through other regions, such as Southern Europe. In addition, some seizures point to new destinations in North and West Africa, but more information is needed to understand whether these are new established routes.
In parallel to “captagon” trafficking, a methamphetamine market seems to be developing in the Near and Middle East, as shown by a rise in seizures of the drug.
New Mixed Combinations
New combinations, mostly mixtures of controlled drugs, which can also contain prescription medicines, veterinary medicines, alcohol, soft drinks, food colorants and aromas or even substances (such as volatiles, poisons, or fuel) which are meant for industrial use, are increasingly being reported on the drug market in all regions. Although some of these mixtures have long traditions (such as nyaope in South Africa), others are relatively new, such as “tuci”, which seems to be spreading fast in South America and seems to have reached North American and European drug markets over the past few years. Similarly, “happy water” and ”k-powdered milk” are new mixtures that have recently appeared in East and South-East Asia.
Sum Up
The excerpts I have shared from the UNODC report show that the illicit drugs trade is not just increasing, it is flourishing all over the world. There are several reasons for this. People are under enormous pressure particularly after COVID19 and they are seeking relief whatever way it comes. Many regions are embroiled in active conflicts and the warring factions resort to drug trade to finance their activities. The power centers like USA, UK, Europe, and their allies like Australia and Canada favor continuation of conflicts as it keeps their arms industries running. Many countries have weak governance structure and cannot control production and trade of such substances. The amount of money involved in this trade is staggeringly high and no one, not even governments want to lose that money. Apparently, there will be no respite from this evil after claims of massive seizures of huge amounts. If the G20 countries clean up their act, and rather than bombing innocent citizens, make targeted attacks on drug trade, their own population and others can be saved. However, they will never do it for reasons well understood.
Concluded.
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