Cannabis use around the world continues to eclipse other drugs––and is increasing. Opioids, meanwhile, continue to cause the most harm.

Those are just some of the takeaways from the United Nations’ annual “World Drug Report” for 2023.

“Drug use continues to be high worldwide. In 2021, 1 in every 17 people aged 15–64 in the world had used a drug in the past 12 months. The estimated number of users grew from 240 million in 2011 to 296 million in 2021 (5.8 per cent of the global population aged 15–64). This is a 23 per cent increase, partly due to population growth,” the report’s “executive summary” said. 

According to the report, cannabis “continues to be the most used drug, with an estimated 219 million users (4.3 per cent of the global adult population) in 2021.” 

That number is also trending upward––perhaps a byproduct of legalization in the United States and elsewhere. But the report also showed a gender divide when it comes to pot use.

“Use of the drug is increasing and although globally cannabis users are mostly men (about 70 per cent), the gender divide is reducing in some subregions; women account for 42 per cent of cannabis users in North America,” the report said.

Opioids, meanwhile, “continue to be the group of substances with the highest contribution to severe drug-related harm, including fatal overdoses,” according to the report. 

That will come as little surprise to those in the United States, which has been mired in an opioid epidemic for more than two decades. According to the Centers for Disease Control and Prevention, the number of people in the U.S. who died from a drug overdose in 2021 “was over six times the number in 1999” and the “number of drug overdose deaths increased more than 16% from 2020 to 2021.”

Among the nearly 107,000 drug overdose deaths in the United States in 2021, more than 75% involved an opioid, according to the CDC.

The CDC says that the “rise in opioid overdose deaths can be outlined in three distinct waves.”

“The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999. The second wave began in 2010, with rapid increases in overdose deaths involving heroin. The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl. The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine,” according to the CDC.

The UN’s report said that an “estimated 60 million people engaged in non-medical opioid use in 2021, 31.5 million of whom used opiates (mainly heroin).” Opioids remain “the leading cause of deaths in fatal overdoses,” the repot said, accounting “for nearly 70 per cent of the 128,000 deaths attributed to drug use disorders in 2019.” 

“Opioid use disorders also accounted for the majority (71 per cent of the 18 million healthy years of life lost owing to premature death and disability in 2019,” the UN report said.

According to the report, “most drug use disorders are related to cannabis and opioids, which are also the drugs that lead most people to seek drug treatment, but opioids remain the most lethal drug.”

“Among all countries that ranked the drugs leading to drug use disorders, the majority (46 per cent of countries) reported cannabis in first place, 31 per cent of countries reported opioids in first place, mainly heroin, whereas amphetamine-type stimulants, in particular methamphetamine, were reported in first place by 13 per cent of countries. The ranking in each country is determined mainly by two factors: prevalence of use and dependence potential,” the report said.

The UN report also provided a regional breakdown of drug use.

“There are clear regional differences in the primary drug reported by people entering drug treatment: in most of Europe and most of the subregions of Asia, opioids are the most frequent primary drug of people in drug treatment, whereas in Latin America it is cocaine, in parts of Africa it is cannabis, and in East and South-East Asia it is Methamphetamine,” the report said.

The report also identified an uptick in intravenous drug use.

“An estimated 13.2 million people were injecting drugs in 2021,” the report said. “This estimate is 18 per cent higher than in 2020 (11.2 million). This increase is due to newly available estimates in the United States of America and in some other countries. Eastern Europe (1.3 per cent of the adult population) and North America (1.0 per cent) remain the two subregions with the highest estimated prevalence of people who inject drugs, and, in absolute terms, North America now has the highest number of individuals that report injecting drugs, ahead of East and South-East Asia.”

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