The World Drug Report 2023 comes as countries are struggling at the halfway point to revive stalled prog-
ress towards achieving the Sustainable Development Goals (SDGs). Crises and conflict continue to inflict
untold suffering and deprivation, with the number of people forcibly displaced globally hitting a new record high of 110 million. Peace, justice and human rights, which should be the birthright of all, remain out of reach for far too many.
The harms caused by drug trafficking and illicit drug economies are contributing to and compounding many of these threats, from instability and violence to envi-ronmental devastation. Illicit drug markets continue to expand in terms of harm as well as scope, from the grow-ing cocaine supply and drug sales on social media platforms to the relentless spread of synthetic drugs – cheap and easy to manufacture anywhere in the world, and in the case of fentanyl, deadly in the smallest of doses.
Drug use disorders are harming health, including mental health, safety and well-being. Stigma and discrimination make it less likely that people who use drugs will get the help they need. Fewer than 20 per cent of people with drug use disorders are in treatment, and access is highly unequal. Women account for almost half the people who use amphetamine-type stimulants, but only 27 per cent of those receiving treatment. Controlled drugs needed for palliative care and pain relief, namely pharmaceutical opioids, are denied to those who des-perately need them, with too little access in many countries – mainly low- and middle-income countries, where some 86 per cent of the world’s population lives.
Drug challenges pose difficult policy dilemmas that cannot be addressed by any one country or region alone. The United Nations Office on Drugs and Crime publishes the World Drug Report every year to provide a global perspective and overview of the world drug problem, offering impartial evidence with the aim of supporting dialogue and shared responses.
This edition of the World Drug Report highlights the rowing complexity of evolving drug threats. A special
chapter explores how illicit drug economies intersect with crimes that affect the environment and insecurity in the Amazon Basin, with impoverished rural popula-tions and Indigenous groups paying the price. Other sections of the report explore urgent challenges, includ-ing drug use in humanitarian settings, drugs in conflict situations and the changing dynamics of synthetic drug markets. The report also delves into new clinical trials involving psychedelics, medical use of cannabis and innovations in drug treatment and other services.
World drug problems may be global, but they do not affect all the world equally. It is the vulnerable, the poor and the excluded who pay the highest price, in the global South and in underdeveloped and underserved com-munities in all our countries, cities and villages. They suffer from the violence and insecurity fuelled by drug trafficking, as well as from insufficient access to and availability of controlled medicines. They are more likely to progress to drug use disorders and live with related diseases such as HIV, and are less likely to receive evi-dence-based treatment and services. Impoverished people with uncertain access to opportunities, resources and the rule of law are more easily entrapped in illicit
drug crop cultivation, production and trafficking.
Breaking these vicious cycles requires transformative action to achieve the SDGs and integrated, comprehen-sive approaches to security to tackle drug threats as part of prevention, peacekeeping and peacebuilding.
Most of all, ending the exclusion compels us to expand the circle of care and compassion, to embrace the people being left behind and left out because of mar-ginalization, discrimination and stigma.
Putting people first requires policymakers and service providers to actively protect the human rights of all by demolishing barriers to evidence-based, voluntary ser-vices across the continuum of care, dispelling gender, age and other biases and focusing on rehabilitation and reintegration instead of punishment.
Early prevention is crucial, and Governments must invest more in education to build resilience and give
young people the information they need to make healthy, smart choices about their lives. Thoughtful reg-
ulation that prioritizes public health can help to ensure access and availability where needed, while keeping commercial pressures in check and reducing the risks of diversion and non-medical use.
Stigma and discrimination can be deadly, depriving people of the help they need and deserve and keeping
problems in the dark until it is too late. Evidence can help shine a light on the challenges we can only face
together, and it is with this in mind that I am proud to present to you the World Drug Report 2023. By increas-ing understanding of shared drug challenges, we can foster greater compassion and commitment to global action to protect lives.