Only one in six people who are dependent on drugs on treatment
Only one in six of the 29 million people who are dependent on drugs are accessing the vital treatment and support services they need, according to new data released by United Nations Office on Drugs and Crime (UNODC).
The World Drug Report 2016, launched in advance of the International Day Against Drug Abuse and Illicit Trafficking (26 June), looks at the global state of drug markets, trafficking and the health impacts of taking drugs on users and those around them.
The report estimates 5% of the world population used drugs in 2014, some quarter of a billion people. Whilst this number has stayed stable over the past four years, the number of people dependent on drugs has increased.
Yury Fedotov, the Executive Director of the UNODC, said: “the report shows a rise in the number of problem drug users from 27 to 29 million people aged 15-64; the disastrous resurgence of heroin in some regions; the use of the "Darknet" for drug trafficking; the appalling loss of life due to overdoses, and the disproportionate impact illicit drugs have on women, among many others challenges.”
Health outcomes for people who use drugs are generally poor, but people who inject drugs are particularly vulnerable to harm, through unsafe injecting, risk of overdose, and a lack of access to healthcare. These issues are exacerbated by the HIV and viral hepatitis epidemics – around one in seven (14%) people who inject drugs are living with HIV, and one in two (52%) are living with hepatitis C.
The report names needle and syringe exchange programmes, opioid substitution treatment and treatment for HIV and hepatitis among the evidence-informed and effective interventions that people who use drugs desperately need. Compulsory confinement in drug treatment centres does not work and only makes the lives of already vulnerable drug users harder, says the report.
Prisoners in particular are highly vulnerable to infectious diseases. Estimates show that 23% of prisoners will have used drugs during their incarceration, with high levels of injecting drug use as well. Many prisoners start taking drugs whilst in prison, but also a high number of people arrive in prison as a result of drug use. Across several countries, studies show that between 56% and 90% of people who inject drugs have been incarcerated at some stage in their life.
Drug use arising from stimulants such as cocaine and amphetamines, whether injected or not, is also an increasing concern due to the differing environments under which these types of drugs are consumed. Whilst opioids such as heroin are generally taken either alone, or with one other person, stimulants are used in a social environment. Under these circumstances, inhibitions are lowered and the likelihood of engaging in high-risk behaviours, such as condomless sex with casual partners and selling sex, are greater.
Moreover, drug users who inject stimulants have been found to have a higher HIV prevalence than those who inject opioids. Many stimulants have a shorter duration of action and thus require more frequent injecting, this and the environment under which these drugs are taken heightens the risk of sharing equipment. For example, those who inject cocaine have a 3.6 times higher risk of getting HIV compared to those who do not inject.
Globally, 12 million people inject drugs, although just under half are living in three countries – Russia, the United States and China. Eastern and South-Eastern Europe (1.27%), Central Asia (0.72%) and North America (0.65%) all have a high prevalence of people who inject drugs.