Drug abuse is when you take drugs that are not legal. It is also when you use alcohol, prescription medicine, and other legal substances too much or in the wrong way. Nonetheless, drug abuse differs from addiction. Many people with drug abuse problems are able to quit or can change their unhealthy behaviour. Addiction, on the other hand, is a disease. It means one cannot stop using even when their condition causes them harm.

According to the United Nations Office on Drugs and Crime (2019) in 2017, an estimated 271 million people worldwide aged 15–64 had used drugs at least once in the previous year (range: 201 million to 341 million). This corresponds to 5.5 per cent of the global population aged 15–64 (range: 4.1 to 6.9 per cent), representing one in every 18 people.

In 2009, the past-year prevalence of drug use globally was estimated to be lower, at 4.8 per cent. Between 2009 and 2017, the estimated number of past-year users of any drug globally changed from 210 million to 271 million, or by 30 per cent, in part as a result of global population growth (the global population aged 15–64 increased by 10 per cent). Data show a higher prevalence over time of the use of opioids in Africa, Asia, Europe and North America, and in the use of cannabis in North America, South America and Asia. It should be noted, however, that any comparison of estimates over time should be undertaken with caution, given the wide uncertainty intervals of the estimates.

Over the last decade, there has been a diversification of the substances available on the drug markets. In addition to traditional plant-based substances e.g. cannabis, cocaine and heroin, in the last decade has witnessed the expansion of a dynamic market for synthetic drugs and the non-medical use of prescription medicines. More potent drugs are available and the increasing number of substances, and their potential combinations, poses a greater risk. In recent years, hundreds of NPS have been synthesized. The majority are stimulants, followed by cannabinoids and an increasing number of opioids, with unpredictable and sometimes severe negative consequences, including death. The non-medical use of pharmaceutical opioids is of increasing concern.

In North America, the use of synthetic opioids such as fentanyl (and fentanyl analogues) resulted in the continued dramatic increase in opioid overdose deaths in 2017. In other sub-regions, such as West and Central Africa and North Africa, based on seizures, the market for the non-medical use of tramadol has grown considerably. The first large-scale national drug use survey conducted in Nigeria, in 2017, found a high prevalence of the non-medical use of prescription opioids (mainly tramadol), which was second only to the use of cannabis, with a past-year prevalence of 4.7 per cent.

Recent drug use surveys in Nigeria and India: enhancing understanding of the extent of drug use in Africa and Asia and globally

National drug use surveys that were conducted in India in 2018a and Nigeria in 2017b have considerably improved understanding of the extent of drug use in these two highly populated countries. Because of their large populations, Nigeria and India exert a considerable influence over regional, as well as global, estimates of drug use. Nigeria is the most populous country in Africa, accounting for 38 per cent of the population aged 15‒64 in West and Central Africa and 15 per cent of the population of Africa as a whole, while 86 per cent of the population in South Asia and 30 per cent of the population in Asia reside in India.

Survey findings from India have revealed a higher prevalence of the use of opioids and opiates in Asia than previously estimated for the region. At 1.0 per cent, the past-year prevalence of the use of opioids in Asia was higher in 2017 than in 2016, when it was 0.5 per cent, representing a change of 117 per cent in the number of past-year users from 13.6 million to 29.5 million. While, at 0.7 per cent, the prevalence of the use of opiates in Asia was also estimated to be higher in 2017 than in 2016, when it was 0.4 per cent, corresponding to a change in the number of past-year users from 11.2 million to 21.7 million. Likewise, in Africa, the past-year prevalence of the use of opioids was estimated to be higher in 2017 (0.9 per cent) than in 2016 (0.3 per cent), corresponding to a change in the number of past-year users from 2.2 million to 6.1 million, or of 178 per cent.

The updated global estimates of the use of opioids and opiates reflect new information from five countries, but the main changes from previous global estimates result from the new surveys conducted in Nigeria and India. Conversely, survey findings from India and Nigeria have led to lower regional estimates of the use of amphetamines in Africa and Asia, as well as globally.

In Africa, the past-year prevalence was estimated to be lower in 2017 (0.5 per cent) than in 2016 (0.9 per cent), resulting in fewer past-year users in 2017 (3.7 million) than in 2016 (6.0 million), while in Asia the prevalence was estimated at 0.5 per cent in 2017 and 0.6 per cent in 2016, a change in the number of past-year users from 17.5 million in 2016 to 14.1 million in 2017. As for opioids and opiates, while updated information on the use of amphetamines was available for five countries, most of the change in the global estimates are the result of the surveys conducted in Nigeria and India. Estimates for the past-year prevalence of cocaine use were also lower in Africa in 2017 (0.2 per cent) than in 2016 (0.5 per cent), with correspondingly fewer past-year users estimated in 2017 (1.3 million) compared with 2016 (3.2 million). Nigeria was the only country in Africa with new or updated information on the prevalence of the use of cocaine.