DRUG WORLD 8 - ANALYSIS OF DRUG MARKETS
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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 This publication may be reproduced in whole or in part and in any form for educational or non-profit purposes without special permission from the copyright holder, provided acknowledgement of the source is made. The United Nations Office on Drugs and Crime (UNODC) would appreciate receiving a copy of any publication that uses this publication as a source. Suggested citation: World Drug Report 2018 (United Nations publication, Sales No. E.18.XI.9). No use of this publication may be made for resale or any other commercial purpose whatsoever without prior permission in writing from UNODC. Applications for such permission, with a statement of purpose and intent of the reproduction, should be addressed to the Research and Trend Analysis Branch of UNODC. DISCLAIMER The content of this publication does not necessarily reflect the views or policies of UNODC or contributory organizations, nor does it imply any endorsement. Comments on the report are welcome and can be sent to: Division for Policy Analysis and Public Affairs United Nations Office on Drugs and Crime PO Box 500 1400 Vienna Austria Tel: (+43) 1 26060 0 Fax: (+43) 1 26060 5827 E-mail: wdr@un.org Website: https://www.unodc.org/wdr2018
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
1WORLD 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
2CONTENTS
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
3WORLD 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
4EXPLANATORY 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
5KEY 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
7WORLD 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
8KEY 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.
9WORLD 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.
10INTRODUCTION
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
11WORLD 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.
12ANALYSIS 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.).
13WORLD 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.
14ANALYSIS 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
15WORLD 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
16ANALYSIS 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).
17WORLD 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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