DRUG WORLD 8 - ANALYSIS OF DRUG MARKETS

 
ANALYSIS OF
DRUG MARKETS
Opiates, cocaine, cannabis,
synthetic drugs

                              3
WORLD
              2018

DRUG
REPORT
© United Nations, June 2018. All rights reserved worldwide.
ISBN: 978-92-1-148304-8
eISBN: 978-92-1-045058-4
United Nations publication, Sales No. E.18.XI.9

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PREFACE

Both the range of drugs and drug markets are              Drug treatment and health services continue to fall
expanding and diversifying as never before. The           short: the number of people suffering from drug use
findings of this year’s World Drug Report make clear      disorders who are receiving treatment has remained
that the international community needs to step up         low, just one in six. Some 450,000 people died in
its responses to cope with these challenges.              2015 as a result of drug use. Of those deaths,
                                                          167,750 were a direct result of drug use disorders,
We are facing a potential supply-driven expansion
                                                          in most cases involving opioids.
of drug markets, with production of opium and
manufacture of cocaine at the highest levels ever         These threats to health and well-being, as well as to
recorded. Markets for cocaine and methampheta-            security, safety and sustainable development,
mine are extending beyond their usual regions and,        demand an urgent response.
while drug trafficking online using the darknet con-
                                                          The outcome document of the special session of the
tinues to represent only a fraction of drug trafficking
                                                          General Assembly on the world drug problem held
as a whole, it continues to grow rapidly, despite
                                                          in 2016 contains more than 100 recommendations
successes in shutting down popular trading
                                                          on promoting evidence-based prevention, care and
platforms.
                                                          other measures to address both supply and demand.
Non-medical use of prescription drugs has reached
                                                          We need to do more to advance this consensus,
epidemic proportions in parts of the world. The
                                                          increasing support to countries that need it most
opioid crisis in North America is rightly getting
                                                          and improving international cooperation and law
attention, and the international community has
                                                          enforcement capacities to dismantle organized crimi-
taken action. In March 2018, the Commission on
                                                          nal groups and stop drug trafficking.
Narcotic Drugs scheduled six analogues of fentanyl,
including carfentanil, which are contributing to the      The United Nations Office on Drugs and Crime
deadly toll. This builds on the decision by the           (UNODC) continues to work closely with its
Commission at its sixtieth session, in 2017, to place     United Nations partners to assist countries in imple-
two precursor chemicals used in the manufacture           menting the recommendations contained in the
of fentanyl and an analogue under international           outcome document of the special session, in line
control.                                                  with the international drug control conventions,
                                                          human rights instruments and the 2030 Agenda for
However, as this World Drug Report shows, the prob-
                                                          Sustainable Development.
lems go far beyond the headlines. We need to raise
the alarm about addiction to tramadol, rates of           In close cooperation with the World Health Organi-
which are soaring in parts of Africa. Non-medical         zation, we are supporting the implementation of
use of this opioid painkiller, which is not under         the International Standards on Drug Use Prevention
international control, is also expanding in Asia. The     and the international standards for the treatment of
impact on vulnerable populations is cause for seri-       drug use disorders, as well as the guidelines on treat-
ous concern, putting pressure on already strained         ment and care for people with drug use disorders in
health-care systems.                                      contact with the criminal justice system.
At the same time, more new psychoactive substances        The World Drug Report 2018 highlights the impor-
are being synthesized and more are available than         tance of gender- and age-sensitive drug policies,
ever, with increasing reports of associated harm and      exploring the particular needs and challenges of
fatalities.                                               women and young people. Moreover, it looks into

                                                                                                                    1
WORLD DRUG REPORT 2018

                         increased drug use among older people, a develop-       Next year, the Commission on Narcotic Drugs will
                         ment requiring specific treatment and care.             host a high-level ministerial segment on the 2019
                                                                                 target date of the 2009 Political Declaration and
                         UNODC is also working on the ground to promote
                                                                                 Plan of Action on International Cooperation
                         balanced, comprehensive approaches. The Office
                                                                                 towards an Integrated and Balanced Strategy to
                         has further enhanced its integrated support to
                                                                                 Counter the World Drug Problem. Preparations are
                         Afghanistan and neighbouring regions to tackle
                                                                                 under way. I urge the international community to
                         record levels of opiate production and related secu-
                                                                                 take this opportunity to reinforce cooperation and
                         rity risks. We are supporting the Government of
                                                                                 agree upon effective solutions.
                         Colombia and the peace process with the Revolu-
                         tionary Armed Forces of Colombia (FARC) through
                         alternative development to provide licit livelihoods
                         free from coca cultivation.
                         Furthermore, our Office continues to support efforts
                         to improve the availability of controlled substances
                         for medical and scientific purposes, while prevent-
                         ing misuse and diversion – a critical challenge if we                                      Yury Fedotov
                         want to help countries in Africa and other regions                                    Executive Director
                         come to grips with the tramadol crisis.                       United Nations Office on Drugs and Crime

    2
CONTENTS

BOOKLET 1                    EXECUTIVE SUMMARY — CONCLUSIONS AND POLICY IMPLICATIONS

                             GLOBAL OVERVIEW OF DRUG DEMAND AND SUPPLY
BOOKLET 2                    Latest trends, cross-cutting issues

                             ANALYSIS OF DRUG MARKETS
BOOKLET 3                    Opioids, cocaine, cannabis, synthetic drugs
 PREFACE. . .......................................................................................................... 1
 EXPLANATORY NOTES...................................................................................... 5
 INTRODUCTION.. ............................................................................................. 11
 A. OPIOIDS���������������������������������������������������������������������������������������������������� 12
     The global area under opium poppy cultivation increased by more than
     a third in 2017, while global opium production increased by almost two thirds����������������������������������12
     Opiate seizures increased to record levels in 2016 and continue to be concentrated in Asia����������������14
     The global opiate market is on the increase again��������������������������������������������������������������������������������19
     The market for non-medical use of pharmaceutical opioids is expanding��������������������������������������������22
 B. COCAINE��������������������������������������������������������������������������������������������������� 29
     After the downward trend, coca bush cultivation is expanding dramatically����������������������������������������29
     Global cocaine manufacture reached a record level in 2016�����������������������������������������������������������������30
     At record levels in 2016, the largest quantity of cocaine seized was in the Americas and Western
     Europe, but seizure quantities are rising sharply in other regions���������������������������������������������������������31
     Cocaine continues to be trafficked primarily from South America to North America
     and Western and Central Europe, but trafficking routes to other subregions are proliferating�������������32
     Cocaine use is still concentrated in the Americas and Europe, and is on the increase��������������������������33
 C. CANNABIS������������������������������������������������������������������������������������������������� 38
     Cannabis production continues to affect all regions worldwide�����������������������������������������������������������38
     Global seizures of cannabis herb declined in 2016, while seizures of
     cannabis resin continued to rise�����������������������������������������������������������������������������������������������������������38
     Developments in measures regulating non-medical use of cannabis�����������������������������������������������������44
 D. SYNTHETIC DRUGS������������������������������������������������������������������������������������ 54
     Amphetamine-type stimulants�������������������������������������������������������������������������������������������������������������54
     New psychoactive substances���������������������������������������������������������������������������������������������������������������60
 GLOSSARY.. ..................................................................................................... 71
 REGIONAL GROUPINGS. . ................................................................................. 72
                             DRUGS AND AGE
BOOKLET 4                    Drugs and associated issues among young people and older people

                             WOMEN AND DRUGS
BOOKLET 5                    Drug use, drug supply and their consequences

                                                                                                                                                      3
WORLD DRUG REPORT 2018

                         Acknowledgements
                         The World Drug Report 2018 was prepared by the Research and Trend Analysis Branch, Division for
                         Policy Analysis and Public Affairs, United Nations Office on Drugs and Crime, under the supervision
                         of Jean-Luc Lemahieu, Director of the Division, and Angela Me, Chief of the Research and Trend
                         Analysis Branch.
                         General coordination and content overview           Editing
                         Chloé Carpentier                                    Jonathan Gibbons
                         Angela Me
                                                                             Graphic design and production
                         Analysis and drafting                               Anja Korenblik
                         Conor Crean                                         Suzanne Kunnen
                         Natascha Eichinger                                  Kristina Kuttnig
                         Susan Ifeagwu
                                                                             Coordination
                         Sabrina Levissianos
                                                                             Francesca Massanello
                         Kamran Niaz
                         Thomas Pietschmann                                  Data support
                         Martin Raithelhuber                                 Diana Camerini
                         Justice Tettey                                      Chung Kai Chan
                                                                             Sarika Dewan
                         Data management and estimates production
                                                                             Smriti Ganapathi
                         Enrico Bisogno
                         Coen Bussink                                        Administrative support
                         Hernan Epstein                                      Anja Held
                         Tun Nay Soe                                         Iulia Lazar
                         Andrea Oterová
                         Umidjon Rakhmonberdiev
                         Ali Saadeddin
                         Antoine Vella

                         Review and comments
                         The World Drug Report 2018 benefited from the expertise of and invaluable contributions from
                         UNODC colleagues in all divisions.

                         The Research and Trend Analysis Branch acknowledges the invaluable contributions and advice
                         provided by the World Drug Report Scientific Advisory Committee:
                         Jonathan Caulkins            Charles Parry                In memoriam
                         Paul Griffiths               Peter Reuter                 Brice de Ruyver
                         Marya Hynes                  Francisco Thoumi
                         Vicknasingam B. Kasinather Alison Ritter
                         Letizia Paoli

    4
EXPLANATORY NOTES

The boundaries and names shown and the designa-            All analysis contained in the World Drug Report is
tions used on maps do not imply official endorsement       based on the official data submitted by Member
or acceptance by the United Nations. A dotted line         States to the United Nations Office on Drugs and
represents approximately the line of control in            Crime through the annual report questionnaire
Jammu and Kashmir agreed upon by India and Paki-           unless indicated otherwise.
stan. The final status of Jammu and Kashmir has
                                                           The data on population used in the World Drug
not yet been agreed upon by the parties. Disputed
                                                           Report are taken from: World Population Prospects:
boundaries (China/India) are represented by cross-
                                                           The 2017 Revision (United Nations, Department of
hatch owing to the difficulty of showing sufficient
                                                           Economic and Social Affairs, Population Division).
detail.
                                                           References to dollars ($) are to United States dollars,
The designations employed and the presentation of
                                                           unless otherwise stated.
the material in the World Drug Report do not imply
the expression of any opinion whatsoever on the            References to tons are to metric tons, unless other-
part of the Secretariat of the United Nations con-         wise stated.
cerning the legal status of any country, territory, city   The following abbreviations have been used in the
or area, or of its authorities or concerning the delimi-   present booklet:
tation of its frontiers or boundaries.
                                                                  ATS amphetamine-type stimulants
Countries and areas are referred to by the names
that were in official use at the time the relevant data    EMCDDA European Monitoring Centre for
were collected.                                                   Drugs and Drug Addiction
                                                              Europol European Union Agency for Law
All references to Kosovo in the World Drug Report,
                                                                      Enforcement Cooperation
if any, should be understood to be in compliance
with Security Council resolution 1244 (1999).                    4-FA 4-fluoroamphetamine
Since there is some scientific and legal ambiguity            MDMA 3,4-methylenedioxymethamphetamine
about the distinctions between “drug use”, “drug             3-MMC 3-methylmethcathinone
misuse” and “drug abuse”, the neutral terms “drug
use” and “drug consumption” are used in the World                 NPS new psychoactive substances
Drug Report. The term “misuse” is used only to                 PWID people who inject drugs
denote the non-medical use of prescription drugs.
                                                            UNODC United Nations Office on Drugs
All uses of the word “drug” in the World Drug Report              and Crime
refer to substances controlled under the international         WHO World Health Organization
drug control conventions.
                                                            SAMHSA Substance Abuse and Mental Health
                                                                   Administration

                                                                                                                     5
KEY FINDINGS

Afghan opium poppy cultivation drives                     and Middle East, the non-medical use of tramadol,
record opiate production                                  a pharmaceutical opioid that is not under interna-
                                                          tional control, is emerging as a substance of
Total global opium production jumped by 65 per
                                                          concern.
cent from 2016 to 2017, to 10,500 tons, easily the
highest estimate recorded by UNODC since it               Non-medical use and trafficking of
started estimating global opium production at the         tramadol are becoming the main drug
beginning of the twenty-first century.                    threat in parts of Africa

A marked increase in opium poppy cultivation and          The focus of attention for global seizures of phar-
a gradual increase in opium poppy yields in Afghani-      maceutical opioids is now firmly on countries in
stan resulted in opium production in the country          West and Central Africa and North Africa, which
reaching 9,000 tons in 2017, an increase of 87 per        accounted for 87 per cent of the global total in 2016.
cent from the previous year. Among the drivers of         Countries in Asia, which had previously accounted
that increase were political instability, lack of gov-    for more than half of global seizures, reported just
ernment control and reduced economic                      7 per cent of the global total in 2016.
opportunities for rural communities, which may            The rise in seizures of pharmaceutical opioids in
have left the rural population vulnerable to the influ-   Africa is mostly due to the worldwide popularity of
ence of groups involved in the drug trade.                tramadol, an opioid used to treat moderate and
                                                          moderate-to-severe pain that is widely trafficked for
The surge in opium poppy cultivation in Afghani-
                                                          non-medical use in the region. Tramadol is smug-
stan meant that the total area under opium poppy
                                                          gled to various markets in West and Central Africa
cultivation worldwide increased by 37 per cent from
                                                          and North Africa, from where some of it is trafficked
2016 to 2017, to almost 420,000 ha. More than 75
                                                          onwards to countries in the Near and Middle East.
per cent of that area is in Afghanistan.
                                                          Countries in those subregions have reported the
Overall seizures of opiates rose by almost 50 per         rapid expansion of the non-medical use of tramadol,
cent from 2015 to 2016. The quantity of heroin            in particular among some vulnerable populations.
seized globally reached a record high of 91 tons in       The drug is not yet under international control and
2016. Most opiates were seized near the manufac-          is perceived by recreational users as a way of boost-
turing hubs in Afghanistan.                               ing energy and improving mood. However, tramadol
                                                          can produce physical dependence, with WHO stud-
Towards a multifaceted global opioid crisis
                                                          ies showing that this dependence may occur when
The non-medical use of pharmaceutical opioids is          it is used daily for more than a few weeks.
of increasing concern for both law enforcement            While some tramadol is diverted from licit channels,
authorities and public health professionals. Differ-      most of the tramadol seized worldwide in the period
ent pharmaceutical opioids are misused in different       2012–2016 appears to have originated in clandes-
regions. In North America, illicitly sourced fentanyl,    tine laboratories in Asia.
mixed with heroin or other drugs, is driving the
unprecedented number of overdose deaths. In               Non-medical use of pharmaceutical
Europe, the main opioid of concern remains heroin,        opioids reaches epidemic proportions
                                                          in North America
but the non-medical use of methadone, buprenor-
phine and fentanyl has also been reported. In             In 2015 and 2016, for the first time in half a cen-
countries in West and North Africa and the Near           tury, life expectancy in the United States of America

                                                                                                                   7
WORLD DRUG REPORT 2018

                         declined for two consecutive years. A key factor was      The dramatic resurgence of coca bush cultivation
                         the increase in unintentional injuries, which includes    in Colombia — which had almost halved from 2000
                         overdose deaths.                                          to 2013 — came about for a number of reasons
                         In 2016, 63,632 people died from a drug overdose          related to market dynamics, the strategies of traf-
                         in the United States, the highest number on record        ficking organizations and expectations in some
                         and a 21 per cent increase from the previous year.        communities of receiving compensation for replac-
                         This was largely due to a rise in deaths associated       ing coca bush cultivation, as well as a reduction in
                         with pharmaceutical opioids, including fentanyl and       alternative development interventions and in eradi-
                         fentanyl analogues. This group of opioids, exclud-        cation. In 2006, more than 213,000 ha were
                         ing methadone, was implicated in 19,413 deaths in         eradicated. Ten years later, the figure was less than
                         the country, more than double the number in 2015.         18,000 ha.
                         Evidence suggests that Canada is also affected, with      The result has been a perceived decrease in the risk
                         a large number of overdose deaths involving fentanyl      of coca cultivation and a dramatic scaling-up of
                         and its analogues in 2016.                                manufacture. Colombia has seen massive rises in
                         Illicit fentanyl and its analogues are reportedly mixed   both the number of cocaine laboratories dismantled
                         into heroin and other drugs, such as cocaine and          and the amount of cocaine seized.
                         MDMA, or “ecstasy”, or sold as counterfeit prescrip-      Africa and Asia have emerged as cocaine
                         tion opioids. Users are often unaware of the contents     trafficking and consumption hubs
                         of the substance they are taking, which inevitably
                         leads to a great number of fatal overdoses.               Most indicators from North America suggest that
                                                                                   cocaine use rose between 2013 and 2016. In 2013,
                         Outside North America, the impact of fentanyl and
                                                                                   there were fewer than 5,000 cocaine-related deaths
                         its analogues is relatively low. In Europe, for exam-
                                                                                   in the United States, but by 2016 the figure was
                         ple, opiates such as heroin and morphine continue
                         to predominate, although some deaths involving            more than 10,000. Although many of those deaths
                         fentanyl analogues have started to emerge in the          also involved synthetic opioids and cannot be attrib-
                         region. A notable exception is Estonia, where fen-        uted exclusively to higher levels of cocaine
                         tanyl has long been regarded as the most frequently       consumption, the increase is nonetheless a strong
                         misused opioid. The downward trend in opiate use          indicator of increasing levels of harmful cocaine use.
                         since the late 1990s observed in Western and Cen-         The biggest growth in cocaine seizures in 2016 took
                         tral Europe appears to have come to an end in 2013.       place in Asia and Africa, reflecting the ongoing
                         In that subregion as whole, 12 countries reported         spread of cocaine trafficking and consumption to
                         stable trends in heroin use in 2016, two reported a       emerging markets. Although starting from a much
                         decline and three an increase.                            lower level than North America, the quantity of
                         A notable increase has been seen in                       cocaine seized in Asia tripled from 2015 to 2016;
                         cocaine manufacture                                       in South Asia, it increased tenfold. The quantity of
                                                                                   cocaine seized in Africa doubled in 2016, with coun-
                         Global cocaine manufacture in 2016 reached its
                                                                                   tries in North Africa seeing a sixfold increase and
                         highest level ever: an estimated 1,410 tons. After
                                                                                   accounting for 69 per cent of all the cocaine seized
                         falling during the period 2005–2013, global cocaine
                                                                                   in the region in 2016. This was in contrast to previ-
                         manufacture rose by 56 per cent during the period
                                                                                   ous years, when cocaine tended to be seized mainly
                         2013–2016. The increase from 2015 to 2016 was
                                                                                   in West and Central Africa.
                         25 per cent.
                                                                                   Cannabis remains the world’s most
                         Most of the world’s cocaine comes from Colombia,
                                                                                   commonly used drug
                         which boosted its manufacture by more than one
                         third from 2015 to 2016, to some 866 tons. The            Cannabis was the most commonly used drug in
                         total area under coca cultivation worldwide in 2016       2016, with 192 million people using it at least once
                         was 213,000 ha, almost 69 per cent of which was           in the past year. The global number of cannabis
                         in Colombia.                                              users continues to rise and appears to have increased

    8
KEY FINDINGS   3

by roughly 16 per cent in the decade ending 2016,        qualitative assessments, increases in consumption,
which is in line with the increase in the world          manufacturing capacity and in the amounts seized
population.                                              point to a growing market for methamphetamine
                                                         in East and South-East Asia and Oceania, where the
The quantities of cannabis herb seized globally
                                                         use of crystalline methamphetamine in particular
declined by 27 per cent, to 4,386 tons, in 2016.
                                                         has become a key concern.
The decline was particularly marked in North Amer-
ica, where the availability of medical cannabis in       Trafficking in amphetamine expands
many jurisdictions and the legalization of cannabis      beyond established markets
for recreational use in several states of the United     For many years, amphetamine dominated synthetic
States may have played a role.                           drug markets in the Near and Middle East and West-
Latest developments in recreational                      ern and Central Europe, but recent increases in the
cannabis regulations                                     quantities seized in North Africa and North America
                                                         point to growing activity in other subregions. While
Since 2017, the non-medical use of cannabis has
                                                         the reasons for the spike in the quantity of ampheta-
been allowed in eight state-level jurisdictions in the
                                                         mine seized in North Africa are not entirely clear,
United States, in addition to the District of Colum-
                                                         it may be related to the trafficking of amphetamine
bia. Colorado was one of the first states to adopt
                                                         destined for the large market in the neighbouring
measures to allow the non-medical use of cannabis
                                                         subregion of the Near and Middle East.
in the United States. Cannabis use has increased
significantly among the population aged 18–25 years      The synthetic drug market grows in com-
or older in Colorado since legalization, while it has    plexity and diversity
remained relatively stable among those aged 17–18        In recent years, hundreds of NPS have emerged,
years. However, there has been a significant increase    adding to the established synthetic drug market for
in cannabis-related emergency room visits, hospital      ATS. Grouped by their main pharmacological effect,
admissions and traffic deaths, as well as instances of   the largest portion of NPS reported since UNODC
people driving under the influence of cannabis in        began monitoring are stimulants, followed by can-
the State of Colorado.                                   nabinoid receptor agonists and classic hallucinogens.
In Uruguay, up to 480 grams per person per year of       A total of 803 NPS were reported in the period
cannabis can now be obtained through pharmacies,         2009-2017. The global NPS market remains widely
cannabis clubs or individual cultivation. Cannabis       diversified, but except for a few substances, NPS do
regulation in the country allows for the possession      not seem to have established themselves on drug
of cannabis products with a tetrahydrocannabinol         markets or replaced traditional drugs on a larger
content of up to 9 per cent and a minimum can-           scale.
nabidiol content of 3 per cent. In mid-2017, the         Use of new psychoactive substances leads
registration of those who choose to obtain cannabis      to an increase in related harm
for non-medical use through pharmacies began, as
did the sale of the drug through a network of 16         Although the overall quantity of NPS seized fell in
pharmacies.                                              2016, an increasing number of countries have been
                                                         reporting NPS seizures and concerns have been
Major markets for methamphetamine                        growing over the harm caused by the use of NPS.
continue to grow
                                                         In several countries, an increasing number of NPS
East and South-East Asia and North America remain        with opioid effects emerging on the market have
the two main subregions for methamphetamine traf-        been associated with fatalities. The injecting use of
ficking worldwide. In North America, the availability    stimulant NPS also remains a concern, in particular
of methamphetamine was reported to have increased        because of reported associated high-risk injecting
between 2013 and 2016, and, in 2016, the drug            practices. NPS use in prison and among people on
was reported to be the second greatest drug threat       probation remains an issue of concern in some coun-
in the United States after heroin. Based on              tries in Europe, North America and Oceania.

                                                                                                                  9
WORLD DRUG REPORT 2018

                         Kratom is emerging as a popular plant-
                         based new psychoactive substance
                         Kratom products are derived from the leaf of the
                         kratom tree, which is used in South-East Asia as a
                         traditional remedy for minor ailments and for non-
                         medical purposes. Few countries have placed kratom
                         under national legal control, making it relatively
                         easy to buy. There are now numerous products
                         around the world advertised as containing kratom,
                         which usually come mixed with other substances.
                         Some opioid users in the United States have reported
                         using kratom products for the self-management of
                         withdrawal symptoms. Some 500 tons of kratom
                         were seized during 2016, triple the amount of the
                         previous year, suggesting a boom in its popularity.

    10
INTRODUCTION

This booklet constitutes the third chapter of the      plant-based drugs and synthetic drugs in all regions.
World Drug Report 2018. This booklet presents a        The section on cannabis focuses on the evidence
global analysis of the markets for opioids, cocaine,   that has become available in the State of Colorado
cannabis and synthetic drugs, including ATS and        since it was among the first adopters of measures to
NPS. The market section examines recent develop-       allow non-medical use of cannabis in the United
ments in seizures made along major trafficking         States. The section also provides a brief update on
routes and in destination countries, as well as sig-   the status of implementation of the cannabis regu-
nificant developments in the consumption of            lation in Uruguay.

                                Number of past-year users in 2016

         192               34               34                19               21                18
        million          million          million           million          million           million
      cannabis      amphetamines and      opioids          opiates         “ecstasy”          cocaine
                  prescription stimulants

                  Number of countries reporting drug seizures, 2012-2016

        151               146              139              136              131                61
      cannabis          cocaine           opioids          opiates       amphetamines        synthetic
                                                                                               NPS

                                                                                                               11
WORLD DRUG REPORT 2018

                           A. OPIOIDS
                            Global cultivation                                                 37%   Global seizures                        10%          10%      579%
                            change from previous year                                                change from previous year              opium        heroin    morphine

                                           stimate
                                      te
                                               418,000 ha
                              en

                                                                             586,000 x
                           most rec

                                                              =                                              658
                                                                                                              tons
                                                                                                             opium
                                                                                                                                    91
                                                                                                                                   tons
                                                                                                                                   heroin
                                                                                                                                                   65
                                                                                                                                                  tons
                                                                                                                                              morphine
                                                                                            2017                                                                        2016
                            Global production                                                65%     Global number of users
                            change from previous year

                                                                                                                         rs
                                                                                                                  use
                                                                                 700 – 1,050

                                                                                                           id
                                                                                                                                                         34,3 million
                                                                                                         opio
                           10,500 tons                      9,100 – 9,400        tons
                                                                                                                              rs
                                                                tons             of heroin                               se
                             of opium                          processed

                                                                                                                   u
                                                                                 produced
                                                                                                                opiate
                                                               into heroin

                                                        1,100-1,400 tons                                                                                 19.4 million
                                                        consumed as opium

                                                                                            2017                                                                        2016
                         Note: All data refer to 2016 except cultivation and production, which refer to 2017 (preliminary).

                         The global area under opium poppy                                           Global opium production increased by 65 per cent
                         cultivation increased by more than                                          to 10,500 tons in 2017, the highest level since
                         a third in 2017, while global opium                                         UNODC started estimating global opium produc-
                         production increased by almost two                                          tion on an annual basis at the beginning of the
                         thirds                                                                      twenty-first century.1 The surge in global production
                                                                                                     primarily reflects an 87 per cent increase in opium
                         The total area under opium poppy cultivation
                                                                                                     production in Afghanistan to a record high of 9,000
                         worldwide is estimated to have increased by some                            tons, equivalent to 86 per cent of estimated global
                         37 per cent to almost 420,000 ha from 2016 to
                         2017, primarily reflecting an increase in the cultiva-                      1    Opium production estimates have existed since the proceed-
                         tion of opium poppy in Afghanistan. With 328,000                                 ings of the Shanghai Opium Commission in 1909. Such
                         ha under opium poppy cultivation, Afghanistan                                    estimates were, however, based on different methodologies
                                                                                                          (such as payment of taxes and other levies by opium farm-
                         accounted for more than three quarters of the esti-                              ers) and thus may not be fully comparable with the data
                         mated global area under illicit opium poppy                                      presented since UNODC started estimating global opium
                         cultivation in 2017, a record level.                                             production in 2000 (largely based on remote sensing and
                                                                                                          scientific yield surveys). The previous estimates included
                         By contrast, opium poppy cultivation in Myanmar,                                 16,600 tons of opium calculated for the year 1934, based on
                                                                                                          official reports by the League of Nations (UNODC, “A cen-
                         the country with the world’s second largest area                                 tury of international drug control” (2009)), and 41,600 tons
                         under opium poppy cultivation (accounting for 10                                 of opium for the period 1906/07, based on data reported by
                         per cent of the global estimated area in 2017),                                  the International Opium Commission (Report of the Inter-
                                                                                                          national Opium Commission, Shanghai, China, February 1 to
                         declined over the period 2015–2017 by some 25                                    February 26, 1909). For more details, see the online meth-
                         per cent to 41,000 ha, the lowest level since 2010.                              odological annex of this report.

    12
ANALYSIS OF DRUG MARKETS A. Opioids                 3

    Record increase in opium poppy cultivation in Afghanistan:
    future challenges
    The record level of opium poppy cultivation in Afghani-      Moreover, the transformation of opium into heroin is
    stan in 2017 is likely to create multiple challenges for     likely to bring increased trafficking of precursor sub-
    the country, neighbouring countries and the many other       stances, which will potentially be diverted from licit
    countries of transit and destination for Afghan opiates.     international markets and smuggled into Afghanistan
    Afghanistan is one of the least developed countries in       to supply manufacturers of heroin. More high-quality,
    the world, and the impact of illicit drug cultivation and    low-cost heroin will reach consumer markets across the
    production on economic, environmental and social devel-      world, with increased consumption and related harms
    opment continues to be multifaceted. Increased levels        being the likely consequence. Only a small share of the
    of opium poppy cultivation, opium production and illicit     revenues generated by the cultivation and trafficking of
    trafficking of opiates will exacerbate the harmful effects   Afghan opiates reaches Afghan drug trafficking groups.
    of the existing large-scale production of opiates and        Many more billions of dollars are made from trafficking
    are likely to fuel further instability and insurgency and    opiates into major consumer markets, mainly in Europe
    increase funding to terrorist groups in Afghanistan. The     and Asia. Addressing the opiate problem in Afghanistan
    expanding illicit economy, which in many provinces has       is therefore a shared responsibility.
    permeated rural societies and made many communities
    dependent on income from opium poppy cultivation, will       Source: UNODC and the Ministry of Counter-Narcotics of
    further constrain the development of the licit economy       Afghanistan, Afghanistan Opium Survey 2017: Cultivation
    and potentially fuel corruption.                             and Production (Vienna, 2017), p. 7.

opium production in 2017. The increase in produc-                manufacture to date has increased far less than
tion in Afghanistan was not only due to an increase              opium production.3
in the area under poppy cultivation but also to
                                                                 Of the 10,500 tons of opium produced worldwide
improving opium yields. There is no single reason
                                                                 in 2017, it is estimated that some 1,100–1,400 tons
for the massive increase in opium poppy cultivation
                                                                 remained unprocessed for consumption as opium,
in Afghanistan in 2017 as the drivers are multiple,
                                                                 while the rest was processed into heroin, resulting
complex and geographically diverse, and many ele-
                                                                 in an estimate of between 700 and 1,050 tons of
ments continue to influence farmers’ decisions
                                                                 heroin manufactured worldwide (expressed at export
regarding opium poppy cultivation. A combination
                                                                 purity), 550–900 tons of which were manufactured
of events may have exacerbated rule-of-law chal-
                                                                 in Afghanistan.
lenges, such as political instability, corruption, a lack
of government control and security. The shift in                 In contrast to the situation in Afghanistan, opium
strategy by the Afghan Government — focusing its                 production in Myanmar decreased over the period
efforts on countering anti-government elements in                2015–2017 by some 14 per cent to an estimated
densely populated areas — may have made the rural                550 tons, equivalent to 5 per cent of the global
population more vulnerable to the influence of                   opium production estimate. Despite this decline,
anti-government elements. A reduction in the                     the opium price fell by almost 30 per cent to $153
engagement of the international aid community                    per kg in Myanmar in 2017,4 and the quantity of
may also have hindered socioeconomic development                 opiates seized also decreased, suggesting a decrease
opportunities in rural areas.2                                   in demand for opiates produced in Myanmar. This
                                                                 may be linked to the massive expansion in the supply
As a result of the massive increase in opium produc-
tion in 2017, opium prices fell in Afghanistan by                3   Higher quality heroin prices were, in February 2018, still
47 per cent from December 2016 to December                           only 7 per cent lower than a year earlier. (Afghanistan,
2017. However, the price of high-quality Afghan                      Ministry of Counter-Narcotics and UNODC, “Afghanistan
                                                                     drug price monitoring monthly report” (February, 2018)).
heroin decreased by just 7 per cent over the same
                                                                 4   Also, only limited data on opium prices could be collected
period, which may be an indication that heroin                       by the opium survey field team in Myanmar in 2017, which
                                                                     may potentially impact on the findings (Myanmar, Central
2   Afghanistan, Ministry of Counter-Narcotics and UNODC,            Committee for Drug Abuse Control and UNODC, Myan-
    Afghanistan Opium Survey 2017 (Vienna, 2017).                    mar Opium Survey 2017, p. 16.).

                                                                                                                                  13
WORLD DRUG REPORT 2018

                                 Fig. 1                                   Opium poppy cultivation and production of opium, 2006–2017a
                                                                          11,000                                                                                                                 440,000
                                                                          10,000                                                                                                                 400,000
                                                                           9,000                                                                                                                 360,000

                                                                                                                                                                                                           Cultivation (hectares)
                                                      Production (tons)
                                                                           8,000                                                                                                                 320,000
                                                                           7,000                                                                                                                 280,000
                                                                           6,000                                                                                                                 240,000
                                                                           5,000                                                                                                                 200,000
                                                                           4,000                                                                                                                 160,000
                                                                           3,000                                                                                                                 120,000
                                                                           2,000                                                                                                                 80,000
                                                                           1,000                                                                                                                 40,000
                                                                               0                                                                                                                 0
                                                                                   2006

                                                                                          2007

                                                                                                 2008

                                                                                                         2009

                                                                                                                   2010

                                                                                                                              2011

                                                                                                                                                      2012

                                                                                                                                                             2013

                                                                                                                                                                    2014

                                                                                                                                                                            2015

                                                                                                                                                                                   2016

                                                                                                                                                                                          2017
                                                                                    Total area under cultivation           Production in Afghanistan
                                                                                    Production in Myanmar                  Production in the Lao People's Democratic Republic
                                                                                    Production in Mexico                   Production in other countries

                                 Source: UNODC, calculations are based on UNODC illicit crop monitoring surveys and the responses to the annual report questionnaire.
                                 a Data for 2017 are still preliminary. Mexico is not included in 2016/2017 due to the lack of data.

                                of even lower priced Afghan opiates in 2017.5 If                                                                        Another factor in the decline in the heroin price
                                confirmed, this would constitute a new phenomenon                                                                       could be a decrease in the demand for opiates
                                as there is no prior evidence of changes in Afghan                                                                      resulting from a switch to the use of ATS and other
                                opium production impacting on opium prices in                                                                           synthetic drugs in the subregion.
                                South-East Asia, or vice versa, as the two markets
                                                                                                                                                        While Canada is mainly supplied with heroin from
                                have mainly existed in isolation from each other.
                                                                                                                                                        South-West Asia,6 countries in Latin America
                                                                                                                                                        (mostly Mexico and, to a far lesser extent, Colombia
                                 Fig. 2                                   Global opium production and                                                   and Guatemala) account for most of the heroin
                                                                          quantities of opioids seized, 2006–2017                                       supply to the United States while also supplying the
                                                   10,000                                                             250
                                                                                                                                                        still small heroin markets of South America. How-
                         Opium production (tons)

                                                                                                                                                        ever, there are no opium production estimates for
                                                                                                                            Opioids seizures (tons)

                                                    8,000                                                             200                               Mexico for the years 2016 and 2017, as the meth-
                                                    6,000                                                             150                               odology for such estimates is currently under review.
                                                    4,000                                                             100                               Opiate seizures increased to record
                                                                                                                                                        levels in 2016 and continue to be
                                                    2,000                                                             50
                                                                                                                                                        concentrated in Asia
                                                                0                                                     0
                                                                                                                                                        The total quantity of heroin seized globally reached
                                                                          2016
                                                                          2017
                                                                          2012
                                                                          2013
                                                                          2014
                                                                          2015
                                                                          2008
                                                                          2009
                                                                          2010
                                                                          2011
                                                                          2006
                                                                          2007

                                                                                                                                                        a record high in 2016, while the quantities of opium
                                                                               Opium production                                                         and morphine seized reached the second highest
                                                                               Seizures of morphine
                                                                               Seizures of heroin                                                       level ever reported. The largest quantities of opiates
                                                                               Seizures of opium (in heroin equivalents)                                seized were of opium (658 tons), followed by sei-
                                                                               Pharmaceutical opioids                                                   zures of heroin (91 tons) and morphine (65 tons).
                                 Source: UNODC, responses to the annual report questionnaire;                                                           Overall seizures of opiates, expressed in heroin
                                 and government sources.                                                                                                equivalents, increased by almost 50 per cent from
                                 Note: A ratio of 10:1 was used to convert opium into heroin equiva-
                                 lents.
                                                                                                                                                        2015 to 2016, of which the quantity of heroin seized
                                                                                                                                                        exceeded that of opium and morphine.
                                5                    Myanmar, Central Committee for Drug Abuse Control and
                                                     UNODC, Myanmar Opium Survey 2017, p. 16.                                                           6    UNODC, responses to the annual report questionnaire.

    14
ANALYSIS OF DRUG MARKETS A. Opioids                         3

  Fig. 3       Countries reporting largest quantities of opiates seized, 2016
                              Opium                                                    Morphine                                                      Heroin
   Iran (Islamic                                528,928  Afghanistan                                     47,048                  Pakistan
   Republic of)                                                                                                                                                  23,172
                                                                                                                                                                 16,348
       Pakistan        64,608                            Iran (Islamic           10,903                                      Iran (Islamic                     21,098
                                                         Republic of)                                                        Republic of)                      16,116
   Afghanistan        49,665                                 Pakistan         6,596                                                  China             8,777
            India   4,903                                   Myanmar        472                                              United States            7,173
           China    3,104                                        China     97                                                      Turkey          5,585
  United States     1,7 76                                     Mexico      50                                                     Bahrain          5,438
     Uzbekistan     1,447                                         India    29                                                Afghanistan          4,588
      Myanmar       1,005                                   Colombia       28                                                         India    1,683
      Tajikistan    612                                 United States      12                                                  Azerbaijan     1,186
         Turkey     337                                            Italy   10                                                      France     1,080
                    293                                                                                                           Russian     966
  Turkmenistan                                                Sweden       4                                                   Federation
        Mexico      226                                       Canada       3                                                         Egypt    816
          Other     1,057                                       Other      4                                                        Other              9,277

                                                                              10,000

                                                                                       20,000

                                                                                                30,000

                                                                                                          40,000

                                                                                                                   50,000
                           200,000

                                      400,000

                                                                                                                                                     10,000

                                                                                                                                                                  20,000
                      Seizures (kilograms)                                     Seizures (kilograms)                                              Seizures (kilograms)

  Source: UNODC, responses to the annual report questionnaire; and government sources.

  As most seizures of opiates are made in, or close to,                                cent), while 6 per cent was seized in East and South-
  the main opium production areas, Asia, which is                                      East Asia.
  responsible for more than 90 per cent of global illicit                              Quantities of heroin and morphine seized
  opium production, accounted for 86 per cent of the                                   are on the increase in South-West Asia but
  total quantity of heroin and morphine seized in                                      on the decrease in South-East Asia, Europe
  2016. This is primarily a reflection of the increasing                               and the Americas
  concentration of opium production in Afghanistan
  and the consequent increase in seizures by neigh-                                    The quantity of heroin and morphine intercepted
  bouring countries.                                                                   in Asia more than doubled from 2015 to 2016 to
                                                                                       reach 135 tons. This reflected increases in the Near
  Similarly to the distribution of heroin and morphine                                 and Middle East/South-West Asia of more than 150
  seizures, overall, 90 per cent of the total quantity of                              per cent (mostly in countries neighbouring Afghani-
  opiates (including opium), expressed in heroin                                       stan), a consequence of marked increases in Afghan
  equivalent, was seized in Asia, the vast majority in                                 opiate production. By contrast, the quantities of
  the Near and Middle East/South-West Asia (83 per                                     heroin and morphine seized in East and South-East
                                                                                       Asia decreased by 6 per cent in that period, which
  Fig. 4       Distribution of global quantities of                                    can be linked to the decline in opiate production in
               heroin and morphine seized in 2016                                      Myanmar and thriving ATS trafficking in the
               (N= 156 tons)                                                           subregion.
                                                 Near and Middle East/
                                                 South-West Asia 76%                   In Europe, the quantity of heroin and morphine
                                                                                       seized fell by 32 per cent, to 11 tons, from 2015 to
                                                                                       2016, the smallest quantity seized since 1997,
Americas
  6%                        Asia                                                       reflecting a decrease of 11 per cent in West and
 Europe
                            86%
                                                              East and
                                                                                       Central Europe, a decrease of 31 per cent in South-
   7%                                                         South-East               Eastern Europe, and a decrease of 67 per cent in
 Africa                                                       Asia 7%                  Eastern Europe.
  1%
                                                       Other Asia
      Oceania                                             3%                           In 2016, the quantity of heroin and morphine seized
        0.2%
                                                                                       in the Americas decreased, for the first time in years,
  Source: UNODC, responses to the annual report questionnaire;                         by 22 per cent, mostly in North America (-25 per
  and government sources.                                                              cent). Nevertheless, almost 90 per cent of all heroin

                                                                                                                                                                           15
WORLD DRUG REPORT 2018

                         Fig. 5                        Quantities of heroin and morphine           per cent of the total quantity of heroin and mor-
                                                       seized, in kilograms, for selected regions, phine seized worldwide in 2016, with a further 4
                                                       2006–2016                                   per cent seized by countries in Western and Central
                                                       140,000                                     Europe. Most of the heroin and morphine seized
                                                       120,000                                     on the Balkan route was seized in the Islamic Repub-
                               Seizures in kilograms

                                                                                                   lic of Iran (32.0 tons), while smaller quantities were
                                                       100,000
                                                                                                   seized in Turkey (5.6 tons), the Balkan countries
                                                        80,000                                     (0.8 tons) and the countries of Western and Central
                                                        60,000                                     Europe (3.9 tons). Opiates are trafficked either along
                                                        40,000
                                                                                                   the eastern branch of the Balkan route from Turkey
                                                                                                   to Bulgaria and then onwards to Romania and Hun-
                                                        20,000
                                                                                                   gary, or along the western branch of the Balkan route
                                                            0                                      from Bulgaria to various western Balkan countries,
                                                                 2006
                                                                 2007
                                                                 2008
                                                                 2009
                                                                 2010
                                                                 2011
                                                                 2012
                                                                 2013
                                                                 2014
                                                                 2015
                                                                 2016
                                                                                                   and from there to countries in Western and Central
                                                                 Asia   Europe       Americas      Europe.
                         Source: UNODC, responses to the annual report questionnaire;              The analysis of all countries of origin, departure and
                         and other government sources.
                                                                                                   transit of seized heroin and morphine reported by
                         and morphine intercepted in the Americas was seized                       West and Central European countries in the annual
                         in North America, which is home to both the main                          report questionnaire over the period 2012–2016
                         heroin manufacturing country in the Americas                              revealed that 80 per cent of all heroin-related men-
                         (Mexico) and the main consumption country                                 tions were linked to countries along the Balkan route.
                         (United States). The decline in the quantity of                           A further 6 per cent were linked to Pakistan. While
                         heroin seized in North America has taken place in                         some heroin is trafficked directly from Pakistan by
                         the context of the rapidly growing market for syn-                        air or sea to Europe, large opiate shipments are also
                         thetic opioids, such as fentanyl and its analogues                        trafficked from Pakistan to the Islamic Republic of
                         smuggled into the United States, as reflected in the                      Iran for onward trafficking along the Balkan route.
                         doubling of the quantity of “pharmaceutical opioids”                      The Islamic Republic of Iran reported that 80 per
                         seized in North America in 2016. Overall, 25 per                          cent of the morphine and 85 per cent of the heroin
                         cent of fentanyl seizures in the United States also                       it seized in 2016 had been trafficked into the coun-
                         contained heroin in 2016 and were often sold as                           try via Pakistan, with the rest being smuggled directly
                         heroin.7                                                                  from Afghanistan. It should be highlighted, though,
                                                                                                   that significant amounts of Afghan opiates remain
                         The quantity of heroin seized in Africa increased by                      in the region for local consumption.
                         46 per cent from 2015 to 2016, but was still 85 per
                         cent lower than at its peak in 2014.                                      Much smaller amounts of heroin are trafficked along
                                                                                                   a sub-branch of the Balkan route that goes from the
                         The Balkan route continues to
                                                                                                   Islamic Republic of Iran to the countries of the
                         dominate the trafficking of opiates
                                                                                                   southern Caucasus (mainly Azerbaijan and Georgia)
                         originating in Afghanistan
                                                                                                   for shipment across the Black Sea to Ukraine and
                         The world’s principal heroin trafficking route con-                       then by land, partly through the Republic of Mol-
                         tinues to be the so-called Balkan route, along which                      dova, to Romania for onward trafficking along the
                         opiates are trafficked from Afghanistan to the Islamic                    eastern branch of the Balkan route to Western
                         Republic of Iran, Turkey, the Balkan countries and                        Europe. According to seizure data, opiate trafficking
                         then on to various destinations in West and Central                       along this sub-branch of the Balkan route increased
                         Europe. Excluding seizures made in Afghanistan,                           considerably for several years, with seizures of heroin
                         countries along the Balkan route accounted for 37                         and morphine rising from 121 kg in 2006 to 1.3
                                                                                                   tons in 2016. However, 2016 seizure data for this
                         7   United States, Department of Justice, Drug Enforcement
                             Administration, 2017 National Drug Threat Assessment                  route indicate diverging trends: heroin and mor-
                             (October 2017).                                                       phine seizures increased sharply in Azerbaijan and

    16
ANALYSIS OF DRUG MARKETS A. Opioids                3

        Fig. 6                                            Percentage distribution of quantities of           shipment to Europe or North America (mostly
                                                          heroin and morphine seized, by main                Canada). Overall, 9 per cent of mentions of coun-
                                                          trafficking routea                                 tries of origin, departure and transit of opiate seizures
                                           seized

                                                    100                                                      by reporting European countries were linked to
                                         seized

                                                     90
                                                                                                             opiate trafficking along the southern route over the
                                 morphine

                                                     80
                             andmorphine

                                                     70                                                      period 2012–2016. In 2016, two European coun-
                                                     60                                                      tries reported trafficking of heroin via the southern
                                                     50
                                                                                                             route: Belgium (10 kg, via Kenya) and Italy (65 kg,
                   (pcercentage)

                                                     40
                 (pcercentagte)
                      heroinand

                                                     30                                                      via the United Arab Emirates and via Qatar).
               globalheroin

                                                     20
                                                     10
                                                                                                             Heroin supply to the Russian Federation
                                                                                                             continues to transit Central Asia and
Proportionofofglobal

                                                     -
                                                          2006     2008     2010    2012     2014     2016   Transcaucasia
                                                                 Americas
                                                                 Americas
                                                                                                             Trafficking to the Russian Federation is carried out
Proportion

                                                                 South-EastAsia
                                                                 South-East   Asiaand
                                                                                   andOceania
                                                                                       Oceania
                                                                 Northernroute
                                                                 Northern   route                            predominantly along the northern route via the
                                                                 Southernroute
                                                                 Southern   route                            countries of Central Asia, or via the countries of the
                                                                 Pakistan
                                                                 Pakistan
                                                                 Balkanroute
                                                                 Balkan  route
                                                                                                             Caucasus, to destination markets in the Russian
                                                                 Western
                                                                 West  and and  Central
                                                                           Central      Europe
                                                                                    Europe                   Federation and, to a very small extent, for traffick-
                                                                 Afghanistan
                                                                 Afghanistan                                 ing onwards to Belarus and Lithuania.8 In 2016,
                                                                 Seizuresinvolving
                                                                 Seizures involvingAfghan
                                                                                     Afghanopiates
                                                                                            opiates          the main transit countries for heroin seized in the
       Source : UNODC, responses to the annual report question-                                              Russian Federation continued to be countries in
       naire.
      a Balkan route: the Islamic Republic of Iran—South-Eastern
                                                                                                             Central Asia and Transcaucasia (notably Tajikistan,
      Europe—Western and Central Europe; the southern route: South                                           Kazakhstan and Azerbaijan), while Pakistan, which
      Asia—Gulf countries and other countries in the Near and Middle                                         had been mentioned as a transit country in 2015,
      East—Africa; northern route: Central Asia and Transcaucasia—East-
      ern Europe.                                                                                            was no longer a major country of transit.
                                                                                                             Despite indications of a decrease in heroin
      Georgia in 2016 but declined sharply in Ukraine
                                                                                                             trafficking in East and South-East Asia, the
      and Romania, which could be an indication of a                                                         subregion remains the main source of
      greater opiate supply through the countries of the                                                     heroin to Oceania
      Caucasus that goes undetected, or it could be an
      indication that increased law enforcement opera-                                                       Opiates produced in South-East Asia (mostly Myan-
      tions in the countries of the Caucasus have prevented                                                  mar) are trafficked to other markets in that subregion
      much of the onward trafficking to Ukraine and                                                          (mostly China and Thailand) and to Oceania
      Romania. Most of the heroin seized in Romania in                                                       (mostly Australia). Seizures made in those countries
      2016 had transited Turkey and Bulgaria, in contrast                                                    decreased by 15 per cent in 2016. In Australia, nearly
      to the situation reported in 2015, when most heroin                                                    all heroin quantities intercepted at the border in
      transited Ukraine.                                                                                     2015 originated in South-East Asia (98 per cent
                                                                                                             over the period January–June 2015), but trafficking
      Quantities of heroin trafficked directly to                                                            of heroin may be declining as suggested by seizures
      Western and Central Europe via the south-                                                              at the border which, in terms of both quantities and
      ern route may be on the decrease                                                                       cases, decreased from 2014/15 to 2015/16.9
      Some Afghan opiates are trafficked to Europe                                                           Heroin trafficking in the Americas is
      through the so-called southern route, which goes                                                       on the decrease, while the trafficking of
      from Afghanistan to Pakistan (and partly to the                                                        synthetic opioids is on the increase
      Islamic Republic of Iran) for subsequent shipment
      to the Gulf countries and East Africa and onward                                                       Most heroin (and morphine) trafficked in the Amer-
      trafficking to Europe, either directly by air or via                                                   icas is smuggled from Mexico to the United States,
      Southern or West Africa by air or sea. Alternatively,                                                  8   UNODC, annual report questionnaire data.
      drugs are trafficked along the southern route to India                                                 9   Australian Criminal Intelligence Commission, Illicit Drug
      and other countries in South Asia for subsequent                                                           Data Report 2015-16 (Canberra, 2017).

                                                                                                                                                                             17
WORLD DRUG REPORT 2018

18
     Map 1                Main heroin trafficking flows, 2012–2016

                                                                                                                                                                                                   RUSSIAN
                                                                                                                                                                                                 FEDERATION
                                                            CANADA
                                                                                                                                                                NETHERLANDS
                                                                                                                                                          WESTERN, CENTRAL AND
                                                             NORTH                                                                                        SOUTH EASTERN EUROPE                                               CENTRAL
                                                            AMERICA                                                                                                                                                            ASIA
                                                                                                                                                                                                      CA                           KAZAKHSTAN
                                                                                                                                                                                                           UC
                                                                                                                                                                                    BULGARIA                    AS         UZBEKISTAN                                                                                        CANADA
                                                          UNITED STATES                                                                                                           ALBANIA                            US                KYRGYZSTAN
                                                           OF AMERICA
                                                                                                                                                                                               TURKEY                     TURKMENISTAN   TAJIKISTAN
              PAKISTAN,                                                                                                                                                                                                                                      CHINA
                                                                                                                                                                                                                 ISLAMIC AFGHANISTAN
                INDIA                                                                                                                                                                                           REPUBLIC
                                                                                                                                                                                                                OF IRAN
                                                                                                                                                                                                                                       AN
                                                                                                                                                                                                                                    ST
                                                                                                                                                                                                                                 KI
                                                                                                                                                                                                        GULF AREA             PA
                                                                                                                                                                                                              &
                                                MEXICO                                                                                                                                                   MIDDLE EAST                                        MYANMAR
                                                                                                                                                                                                                                                INDIA                  LAO PDR

                                                                                                                                                                                                                                                                  THAILAND
                                                                                                                                                          WEST
                                                         GUATEMALA                                                                                       AFRICA
                                                                                                                                                                           NIGERIA
                                                                                                                                                                                                                                                                          SOUTH-EAST
                                                                                                                                                                                                                                                                             ASIA
                                                                       COLOMBIA
                   Most frequently mentioned                                                                                                                                                     KENYA

                   provenance/transit countries of seized                                                                                                                               TANZANIA
                   opiates produced in Latin America                                                                                                                                     (UNITED         EAST
                                                                                                                                                                                       REPUBLIC OF)     AFRICA

                   Most frequently mentioned
                   provenance/transit countries of seized
                                                                                                                                                                                                                                                                                                    OCEANIA
                   opiates produced in Myanmar/Lao
                   People’s Democratic Republic                                                     SOUTH
                                                                                                   AMERICA
                   Most frequently mentioned                                                                                                                                      SOUTHERN
                   provenance/transit countries of seized                                                                                                                          AFRICA
                   opiates produced in Afghanistan

           Global heroin trafficking flows by size of
           flows estimated on the basis of reported
           seizures, 2012-2016:

                                                                                                                                                                     Lorem ipsum

     Sources:   UNODC, responses
        Sources:UNODC,     responses       report
                                 to annualto  thequestionnaire and individual
                                                   annual report              drug seizure database.
                                                                         questionnaire        and individual drug seizure database.
         Notes: The size of the trafficking flow lines is based on the amount of heroin seized in a subregion and the number of mentions of countries from where the heroin has departed (including reports of ‘origin’ and transit”) to a specific subregion over the 2012-2016 period. A darker shade indicates that the
     Notes:   The
         country     size of
                  represents    the
                             more  thantrafficking
                                         50 percent of heroin
                                                         flowproduction
                                                                 lines is inbased
                                                                               the region.
                                                                                        onThethe    amount
                                                                                                trafficking  flowsof
                                                                                                                   areheroin    seized
                                                                                                                       determined on the basis
                                                                                                                                           in aof subregion        and the number
                                                                                                                                                   country of origin/departure,               of mentions
                                                                                                                                                                                transit and destination   of seized of   countries
                                                                                                                                                                                                                     drugs               from
                                                                                                                                                                                                                            as reported by       where
                                                                                                                                                                                                                                            Member   States inthe  heroin
                                                                                                                                                                                                                                                               the annual     has
                                                                                                                                                                                                                                                                          report     departed
                                                                                                                                                                                                                                                                                  questionnaire  and(including
                                                                                                                                                                                                                                                                                                     individual drug reports      of "origin"
                                                                                                                                                                                                                                                                                                                     seizure database:   as
     and such,
          "transit")
               they needtoto be
                              a considered     broadly indicative
                                specificassubregion            overof existing
                                                                        the period
                                                                               trafficking2012–2016.
                                                                                           routes while severalAsecondary
                                                                                                                  darkerflows    may not
                                                                                                                             shade        be reflected.
                                                                                                                                       indicates      that
                                                                                                                                                        Flow the     represent the
                                                                                                                                                             arrowscountry          direction of trafficking:
                                                                                                                                                                                 represents        more than  origins 50      arrows
                                                                                                                                                                                                                       of theper  centindicate
                                                                                                                                                                                                                                           of either
                                                                                                                                                                                                                                               heroin the area of manufacture
                                                                                                                                                                                                                                                           production              the one
                                                                                                                                                                                                                                                                             inorthe       of last provenance,
                                                                                                                                                                                                                                                                                       region.      The trafficking
                                                                                                                                                                                                                                                                                                                end points offlows     indicate
                                                                                                                                                                                                                                                                                                                               arrows are
         either the area of consumption or the one of next destination of trafficking.
     determined
         The boundaries
                      onshown
                           the on basis
                                     this map  country
                                           of do   not imply of  origin/departure,
                                                             official                         transit
                                                                      endorsement or acceptance     by theand    destination
                                                                                                            United Nations. Dashedof   seized
                                                                                                                                   lines representdrugs     as reported
                                                                                                                                                    undetermined   boundaries.byThe Member
                                                                                                                                                                                    dotted line represents     in the annual
                                                                                                                                                                                                   Statesapproximately        the Linereport
                                                                                                                                                                                                                                       of Controlquestionnaire
                                                                                                                                                                                                                                                  in Jammu and Kashmir  and    individual
                                                                                                                                                                                                                                                                           agreed              drug
                                                                                                                                                                                                                                                                                   upon by India  and Pakistan.
                                                                                                                                                                                                                                                                                                       seizureThedatabase:           as such,
                                                                                                                                                                                                                                                                                                                     final status of Jammu
     theyand  Kashmir
           need     tohas
                        benotconsidered
                               yet been agreedas upon   by the parties.
                                                    broadly             The final boundary
                                                                  indicative      of existingbetween trafficking        Sudan and
                                                                                                       the Republic ofroutes      the Republic
                                                                                                                                while           of South
                                                                                                                                          several         Sudan has not
                                                                                                                                                     secondary           yet been
                                                                                                                                                                      flows     maydetermined.
                                                                                                                                                                                        not be   A dispute   exists between
                                                                                                                                                                                                    reflected.        Flow the    Governments
                                                                                                                                                                                                                               arrows           of Argentina
                                                                                                                                                                                                                                           represent                the United Kingdom
                                                                                                                                                                                                                                                           theanddirection               of Great Britain
                                                                                                                                                                                                                                                                                of trafficking:           and Northern
                                                                                                                                                                                                                                                                                                       origins    of the Ireland concerning
                                                                                                                                                                                                                                                                                                                              arrows      indi-
         sovereignty over the Falkland Islands (Malvinas).
     cate either the area of manufacture or the one of last provenance, end points of arrows indicate either the area of consumption or the one of next destination of trafficking.
     The boundaries shown on this map do not imply official endorsement or acceptance by the United Nations. Dashed lines represent undetermined boundaries. The dotted line represents approximately the Line
     of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. The final boundary between the Republic of Sudan
     and the Republic of South Sudan has not yet been determined. A dispute exists between the Governments of Argentina and the United Kingdom of Great Britain and Northern
     Ireland concerning sovereignty over the Falkland Islands (Malvinas).
ANALYSIS OF DRUG MARKETS A. Opioids                                                                                                                                         3

with far smaller quantities smuggled from Colombia          Fig. 7                                     Estimated number of opiate users,
and Guatemala. Analysis of heroin samples in the                                                       trends in quantities of heroin seized
United States over the past decade shows the increas-                                                  and heroin and opium use perception
ing predominance of Mexico (90 per cent of samples                                                     indexes (2006=100)
analysed in 2015) as a source country of the drug,                                               30                                                                                                                                       300

                                                             Number of opiate users (millions)

                                                                                                                                                                                                                                                 Opiate use perception index (2006 = 0)
while the importance of countries in South America                                               25                                                                                                                                       200
(3 per cent) has declined markedly. South-West Asia                                              20                                                                                                                                       100
accounted for around 1 per cent of the samples ana-
lysed in 2015.10                                                                                 15                                                                                                                                       0

Based on quantities seized, heroin trafficking in the                                            10                                                                                                                                       -100

Americas, particularly trafficking to North America,                                             5                                                                                                                                        -200

                                                                                                      2006 16.5
                                                                                                                  2007 18.1
                                                                                                                              2008 17.4
                                                                                                                                          2009 16.2
                                                                                                                                                      2010 16.8
                                                                                                                                                                  2011 16.5
                                                                                                                                                                              2012 16.4
                                                                                                                                                                                          2013 16.5
                                                                                                                                                                                                      2014 17.3
                                                                                                                                                                                                                  2015 17.7
                                                                                                                                                                                                                              2016 19.4
showed a clear upward trend until 2015, ending                                                   0                                                                                                                                        -300
with a marked decline in 2016. This seems to have
gone in parallel with an expansion in the trafficking
of synthetic opioids in the region, as some organized                                                                  Estimated number of opiate users
                                                                                                                       Trends in quantities of heroin seized
crime groups from Mexico and, to a lesser extent,                                                                      Heroin use perception index
from the Dominican Republic that are involved in                                                                       Opium use perception index
heroin trafficking expanded their activities to the         Source: UNODC, elaboration based on annual report question-
trafficking of synthetic opioids, notably fentanyl.11       naire data.

The global opiate market is on the                          the prevalence of opiate use has been increasing,
increase again                                              with the increase being particularly marked in 2016.
The latest data on the number of annual opiate users        The 2016 increase was primarily the result of higher
suggest that there has been an expansion of the             opiate use estimates reported by Poland, reflecting
global opiate market, with 19.4 million users in            not only rising prevalence rates for heroin use (from
2016, or 0.4 per cent of the population aged 15–64          0.1 per cent of the population aged 15-64 in 2014
years. More than half of the estimated number of            to 1.1 per cent in 2016) but also high levels of
annual opiate users reside in Asia (58 per cent),           “kompot” use (1.7 per cent).12 Also known as
almost one fifth in Europe (17 per cent), and one           “Polish heroin”, “kompot” is a liquid preparation
seventh in the Americas (15 per cent). The highest          made from poppy straw, which is intended for
opiate prevalence rates were reported in the Near           injecting. In West and Central Europe as a whole,
and Middle East/South-West Asia (1.6 per cent),             12 countries reported stable trends in heroin use in
North America (0.8 per cent) and Europe (0.6 per            2016, two reported a decline and three an increase
cent). While both quantities of heroin seized and           (up from one in 2015).
the prevalence of opiate use are on the increase at         In parallel, there have been reports of rising drug-re-
global level, the heroin use perception index, based        lated deaths in various European countries in recent
on assessments by national experts, has remained            years, often linked to the use of opiates, although
relatively unchanged in the past few years.                 the ageing of drug-using cohorts may also have
Signs of increases in the opiate market in                  played a role. In England and Wales, for example,
West and Central Europe                                     opioid-related deaths rose by more than 58 per cent
                                                            over the period 2012–2016 to 2,593 cases, with
The downward trend in opiate use since the late             heroin- and morphine-related deaths doubling over
1990s observed in Western and Central Europe                that period.13 In Germany, where opiates are respon-
appears to have come to an end in 2013. Since then
                                                            12 UNODC, data from replies to UNODC annual report
10 United States, Department of Justice, Drug Enforcement      questionnaire.
   Administration, 2017 National Drug Threat Assessment     13 United Kingdom of Great Britain and Northern Ireland,
   (October 2017), p. 48.                                      Office for National Statistics, “Deaths related to drug poi-
11 Drug Enforcement Administration, 2017 National Drug         soning in England and Wales: 2016 registrations”, Statistical
   Threat Assessment.                                          Bulletin (Newport, 2 August 2017).

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