ATS manufacture took place in almost all1.3. … · ATS manufacture took place in almost all ......

ATS manufacture took place in almost allregions. Production capacities in South-East Asiaexpanded rapidly, notably in the People’s Repub-lic of China, and in more recent years in Thai-land and Myanmar where a number of heroinmanufacture and trafficking organizationsdiversified their activities to include metham-phetamine. During the same period, clandestinemanufacture in Western Europe, notably in theNetherlands and in the UK, expanded fromsmall-scale kitchen laboratories to more estab-lished facilities. Parallel to this, ATS produc-tion capacities in the Baltic States, Bulgaria, theCzech Republic, Mexico, Poland, and USA alsoexpanded significantly.

While trafficking in most drugs is inter-regional,trafficking in ATS is largely intra-regional; i.e.production and consumption are usually withinthe same region, often within the same country.

Ecstasy is the exception to this. Most of theecstasy is still produced in Europe: often in theNetherlands, though there is also significantproduction in Germany and Belgium, and aspread of production to Eastern Europe. Pro-duction is also spreading, to Israel, South Africa,Australia, South America and Thailand.83 Orig-inally, ecstasy was almost exclusively destinedfor consumption within Europe, and Europecontinues to remain the principal area for traf-ficking and consumption. However, in thesecond half of the 1990s, there were hugeincreases in trafficking of ecstasy from Europeto North America, Australia/New Zealand,South Africa, and various Asian countries, aswell as from the Middle East to the Far East. In1999, the USA had the largest ecstasy seizuresworldwide; most of it was of European origin.84

Though the volumes were not large, an inter-regional pattern of ecstasy trafficking is emerging.

1 . 3 . C O N S U M P T I O N

1 . 3 . 1 . T H E G E O G R A P H I C A LS P R E A D O F D R U G A B U S E

Drug abuse is a global phenomenon. There ishardly any country in which it does not takeplace. While the extent and characteristics ofthe problem obviously differ from country tocountry, abuse trends, especially among youth,show same signs of convergence over the lastfew decades.

According to replies to UNDCP’s Annual ReportsQuestionnaire at least 134 countries and terri-tories were faced with a drug abuse problem(defined in the following section of this Chap-ter) in the 1990s. The overall number of coun-tries in which drug abuse takes place is higher.

Figure 28 shows that the most frequently men-tioned substances, reflecting the geographicspread of consumption, are still the plant-baseddrugs: cannabis (consumed in 96% of all coun-tries reporting a drug abuse problem), the opi-ates (87%) and the cocaine-type substances(81%). They are followed by the syntheticdrugs, i.e. by amphetamine-type stimulants(73%), benzodiazepines (69%) and variousvolatile substances or inhalants (69%) (Table 2shows these data by region). Three quarters ofall countries report abuse of heroin and twothirds abuse of cocaine. Both abuse of heroinand of cocaine are more widespread thanabuse of their respective intermediate products– opium/ morphine or coca leaf/coca pastewhich are usually consumed close to the areasof production.

The most widely consumed drug is cannabis. It isused either in the form of cannabis herb (mar-ijuana) or cannabis resin (hashish) in almostall countries across the globe.

By contrast, the abuse of the opiates is concen-trated in Asia and Europe, and of cocaine inthe Americas, and to a lesser extent in Europe.85

Abuse of synthetic drugs, notably ampheta-

55

CHAP__1 12.01.2001 0:28 Uhr Page 55

mine-type stimulants (ATS) and benzodi-azepines, is concentrated in Europe. Withinthe group of ATS, amphetamine and metham-phetamine are the most abused substancesworldwide, followed by the ecstasy substances.While methamphetamine is the dominant ATSin North America and East and South-EastAsia, amphetamine is the most widely abusedATS in Europe. Consumption of the varioussubstances of the ecstasy group is concentratedin Europe, though spreading to other regionsas well.

Barbiturates, which a couple of decades ago con-stituted a major problem, are now mentioned byless than half of all reporting countries, reflect-ing better controls to prevent diversion and ashift towards the use of the slightly less addic-tive benzodiazepines instead. Benzodiazepines

and barbiturates – in contrast to cannabis, opi-ates or cocaine-type substances – are usuallyobtained from licit sources, either through over-prescriptions or direct purchase in pharmaciesor parallel markets in countries lacking adequatecontrol systems.

The overall ranking of drug abuse in geograph-ical terms (except for benzodiazepines and in-halants), is very similar to the ranking of countriesreporting seizures, indicating that countrieswith drug trafficking eventually face a drugabuse problem.

1 . 3 . 2 . M A I N P R O B L E M D R U G SThe definition of a problem drug relates to theextent to which use of a certain drug leads totreatment demandj, emergency room visits

56

Fig. 28: Countries and territories reporting an abuse problem in the 1990s – for most commonly mentioned substances as a percentage of all countries reporting on drug abuse (N=134)

Source: UNDCP, DELTA.

0 50 100

BarbituratesHallucinogens

InhalantsBenzodiazepines

EcstasyMethamphetamine

AmphetamineATS

Coca pasteCocaine

Coca-typeOpium

MorphineHeroin

OpiatesCannabis

Number of countries and territories

96%87%

76%52%51%

81%64%

22%

50%

24%69%

60%46%

69%

73%

34%

j) In order to establish a pattern, the relative proportions of treatment demand for each specific drug in each country or city for which datawas available, were calculated. These proportions were subsequently averaged to arrive at a regional average, which is the basis for the pre-sent discussion on problem drugs.

CHAP__1 12.01.2001 0:28 Uhr Page 56

(often due to overdose), drug related morbid-ity (including HIV/AIDS, hepatitis etc.), mor-tality and other drug-related social ills, such asdrug-related crime and violence. The termproblem drug does not relate to the size of thepopulation consuming it. Cannabis, for exam-ple, is the most widely consumed illegal sub-stance worldwide; it is not, however, the mainproblem drug in terms of the adverse healthand social consequences described above.(There are indications that it does play a roleas a ‘gateway drug’ to the use of other sub-stances. Most cannabis users do not, and willnot, move on to other drugs; but almost allavailable studies show that most users of otherdrugs, such as heroin or cocaine, have usedcannabis at some earlier stage in their drugcareers.) The main ‘problem drugs’ in the1990s were the opiates, primarily heroin, andcocaine (see Map 8).

E U R O P E A N D O C E A N I A

Opiates Opiates are the main problem drugs in Europe(both Western and Eastern), in most parts ofAsia and Oceania notably Australia. On average,opiates account for three quarters of all treat-ment demand in both Europe86 and Asia87 andtwo thirds in Australia. They are also responsi-ble for the large majority of drug-related mor-tality and morbidity cases.

Amphetamine-type stimulantsThe overall proportion of methamphetamineabusers in treatment in Asia (12%) exceeds theproportion of ATS abusers in treatment in Eu-rope (8%) and in North America (5%). Aus-tralia has a high share of treatment admissions(13%) for abuse of both amphetamine andmethamphetamine.

57

Table 2. Spread of drug abuse – Regional concentration of countries and territories reporting drugabuse in the 1990s

Regions Global (average)

EUROPE ASIA AMERICAS AFRICA OCEANIA ALL

Number of countries & 41 37 27 22 7 134territories reporting drug abuse to UNDCP, of whichCannabis 100% 95% 92% 95% 100% 96%Opiates 100% 100% 56% 86% 57% 87%* Heroin 88% 81% 42% 82% 29% 76%* Morphine 59% 62% 48% 36% 29% 51%* Opium 44% 81% 19% 36% 29% 51%Amphetamine-type 93% 62% 63% 59% 43% 73%stimulants (ATS)Benzodiazepines 76% 62% 69% 68% 14% 69%Inhalants 76% 62% 74% 64% 57% 69%(volatile substances)Cocaine 73% 32% 85% 64% 43% 64%Barbiturates 51% 43% 42% 36% 14% 46%

close to global average: blackabove global average (> 10%): redclearly below global average (< 30%): light blue

Source: UNDCP, DELTA (Replies to Annual Reports Questionnaires).

CHAP__1 12.01.2001 0:28 Uhr Page 57

58

9% 6%

73%

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7%7%3%

10%

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27%

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61%

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CHAP__1 12.01.2001 0:28 Uhr Page 58

59

In several countries of East Asia, notably Japan,the Philippines, and the Republic of Korea,methamphetamine is the main problem drug,accounting for 90% or more of treatment de-mand.88 Though opiates are the dominantproblem drug in South-East Asia, rapidly risinglevels of methamphetamine-related treatmentcases have been reported from this subregionin recent years, particularly from Thailand,89

where methamphetamine users already exceedthe number of heroin users.

In Europe, only the Czech Republic reportshigh levels of methamphetamine-related treat-ment, which accounts for almost half of alltreatment cases in Prague.90 Relatively high am-phetamine-related treatment demand has beenalso reported from Finland and Sweden.91

CannabisNine per cent of treatment in Asia is related tocannabis, a similar percentage as in Europe,but less than in Australia (13%), the Americas(16%) or Africa (61%). The latter proportionsreflect the strong demand for opiate treatmentrather than low levels of cannabis abuse. Highproportions for cannabis in treatment in Asiahave been reported by the Maldives, the coun-tries of central Asia, the Philippines, Nepal,South India; in Europe by Cyprus and withinthe EU by the Netherlands, notably the city ofAmsterdam (21%) where cannabis consump-tion is de facto decriminalized.92

CocaineCocaine is hardly mentioned at all in the admis-sion reports of Asian treatment centres and itsspread appears to be limited in Europe. Only3% of total treatment demand in Europe wasrelated to cocaine abuse. Within Europe, treat-ment demand is below 1% in Eastern Europe,but above 5% in the countries of the EuropeanUnion.93 In Amsterdam, cocaine accounts for32% of all treatment demand, reflecting its geo-graphic proximity to Rotterdam, one of the mainentry points of cocaine to Europe.94

A M E R I C A S

Cocaine-type substances, i.e. cocaine hydrochloride,crack-cocaine, and related cocaine-type prod-ucts such as basuco (an intermediate productin the cocaine manufacturing process) are, themain problem drugs in the Americas. They areresponsible for an average 61% of treatmentdemand and most drug-related crime and vio-lence. The next most frequently mentioned sub-stances in treatment centres are cannabis (16%)and inhalants (7%).95

South America, including Central America andthe CaribbeanThe proportion of cocaine and related productsis highest in the countries of South America whereabout two thirds of all treatment demand iscocaine-related. Most of the rest is accountedfor by tranquilizers and inhalants, which make upthe bulk of the relatively large category of ‘otherdrugs’, and by cannabis.

Cannabis abuse is spread all across the Americas,but its role as a problem drug is mainly con-centrated in Central America and the Carib-bean. Opiates, by contrast, are not very importantas a problem drug in this region; they are noteven mentioned in most treatment centres.96

North AmericaIn North America (Canada, Mexico, USA),cocaine is still the main problem drug, respon-sible for more than 40% of treatment cases onaverage. Though the USA now has the lowestproportion among all North American coun-tries, in absolute terms the total number ofpeople in treatment for cocaine abuse is still byfar the highest worldwide.97 But the numbersare falling: 222,000 people were treated forcocaine abuse in 1997 (29% of all treatmentcases, excluding alcohol), as compared to267,000 persons (43% of treatment cases) in1992.98 Three quarters of all cocaine abuserelated treatment in the USA is linked to crack-cocaine (see Table 3).

CHAP__1 12.01.2001 0:28 Uhr 9

Opiates account for slightly more than a quarterof all treatment demand in North America.This is a high proportion given the low levels ofheroin use among the general population. Thenumber of people in treatment for cocaineabuse, for example, was equivalent to 5% of theestimated number of annual cocaine users asrevealed in the national household survey ondrug abuse (or 12% for crack-cocaine users).The number of heroin treatment cases wasequivalent to 36% of the number of annualheroin users. The corresponding proportionsfor amphetamine-type stimulants and cannabiswere 4% and 1% respectively.

The overall proportion of cannabis in treatmentdemand is, nonetheless, fairly high in the USA(25% for the USA; 23% for North America as awhole). The high proportion is related to twoimportant factors: the higher levels of THC indomestically grown cannabis in the USA andCanada, which has made cannabis consumptionmore risky; and the fact that in some circum-stances cannabis users are required by law to seektreatment. The latter accounts for about half ofall cannabis related treatment in the USA.99

Amphetamines, mostly in the form of metham-phetamine (80% of all treatment for ATS is related

60

Drug category Estimated number of usersaccording to national house-

hold survey (annualprevalence) 1997

Treatment admissionsaccording to primary

substance of abuse1997

Annual treatment admissions per

1,000 users

Table 3. Relative risks of drug abuse – as revealed in US data on substance abuse and treatmentadmissions (1997)

Heroin* 597,000 217,868 365Crack-cocaine 1,375,000 163,211 119Methamphetamine** 802,364 53,006 66Cocaine (all)* 4,169,000 222,001 53Amphetamine-type 1,687,000 67,137 40stimulants***Cannabis 19,446,000 191,724 10All drugs (incl. others) 24,189,000 764,142 32

Memo: Alcohol (incl. use of drugs) 138,500,000 713,739 5Alcohol (excl. use of drugs) 138,500,000 401,961 3

* Broader US estimates provided by ONDCP, which aim at including marginalized groups not living in households, sawthe number of hardcore heroin users at 935,000 in 1997; this would lower the ratio to 233 treatment admissions per1,000 heroin users; the comparable ONDCP’s estimate on the number of hard-core cocaine users was 3,503,000, equiva-lent to 63 treatment admissions per 1,000 cocaine users (‘hardcore’ being defined as weekly users). If hardcore andoccasional users are taken together, the respective ratios of treatment admissions per 1,000 users would be 142 forheroin and 32 for cocaine.

** Estimate for annual prevalence based on available life-time prevalence data and relationship between life-time andannual prevalence for the broader group of ATS.

*** ATS excluding ecstasy.

Sources: SAMHSA, US National Household Survey (1998); SAMHSA, Treatment Episode Data Set (TEDS), 1992-97;ONDCP, The National Drug Control Strategy : 2000, Annual Report.

CHAP__1 12.01.2001 0:28 Uhr 0

61

to methamphetamine abuse) account for 9% ofall treatment in the USA100 – i.e. a slightly higherproportion than ATS in Europe (8%), though ifthe unweighted average for the three NorthAmerican countries is calculated, the proportionfalls to 5%, due to the low level of methampheta-mine-related treatment cases in Mexico.101

A F R I C A

CannabisOnly in Africa and a few countries of CentralAmerica does cannabis appear as the mainproblem drug in treatment demand. However,even in these countries where treatment demandis high, cannabis-related mortality and crimeare low. On average, some 60% of treatmentdemand in Africa in the late 1990s was relatedto long-term abuse of cannabis. This statement,however, needs to be qualified. Currently avail-able data for many countries in Africa are notvery robust. The number of people who haveactually been treated in hospitals and special-ized treatment facilities is very small. This is notnecessarily a reflection of low levels of drugabuse but of a poor treatment infrastructureand, in many cases, the social stigma attached tothe use of such facilities. People are often treatedoutside the formal system and consequently donot register in the data set.

Other drugs in AfricaTreatment data do show that various psycho-tropic substances (mostly in Western Africa) butalso opiates and in more recent years cocaine,have made inroads into Africa, and their abuseis growing.

In Egypt, for instance, despite a tradition ofcannabis consumption and abuse, with hashishhaving been the main problem drug until the1970s, opiates emerged in the 1990s as the mainproblem drug (45% of all cases in treatmentcentres in 1999), followed by benzodiazepines(32%).102 Opiates are also showing up in treat-ment demand in several countries along theeastern coast of Africa, down to South Africa.

Cocaine abuse is manifested in treatmentdemand in Western Africa and increasingly insome of the countries of Southern Africa. In theRepublic of South Africa it accounts for 15% ofall treatment demand, as compared to 3% forabuse of opiates.103 The main problem drug-combination in South Africa, however, is a mix-ture of methaqualone (known as Mandrax) andcannabis, which is also found in some of the otherAfrican countries along the Indian Ocean.104 Inthe horn of Africa, large-scale khat consump-tion is reflected in treatment demand.105

1 . 3 . 3 . T R E N D S I N D R U G A B U S E

Once a drug abuse problem is identified, itsdevelopment and dynamics have to be charted.k

Drug abuse continued spreading in the 1990sparticularly in countries located along themain trafficking routes. The overall spread,however, was less dramatic than in the 1980s. In1997/98 less than half the countries reportingon drug abuse trends saw an increase in drugabuse, a third saw a stabilization and more thana quarter experienced a decline.l Among thecountries reporting an increase, less than halfexperienced a strong increase (see Figure 29).

k) Trend data should ideally be based on sound epidemiological studies. International standard-setting for such work, however, has only developedgradually. In the ‘Declaration on the guiding principles of drug demand reduction’, passed at the Special Session of the General Assembly in June1998, it was categorically established for the first time that programmes had to be based ‘on a regular assessment of the nature and magnitudeof drug use and abuse and drug-related problems in the population’ and that this was ‘imperative for the identification of any emergingtrends’ (see Chapter II in the present Report). Though a number of countries have started to develop comprehensive drug monitoring systems,most countries still lack them. In the absence of consistent and comprehensive epidemiological surveys, the available trend data reflect obser-vations by professionals in treatment institutions or health authorities. While one cannot exclude bias in individual expert opinions, there isno evidence of any systematic bias.

l) In the UNDCP Annual Reports Questionnaire, countries note their perception of abuse trends for different drug categories. Assuming thatin a particular country, the abuse of some drugs increases, of others it remains stable, and of others it declines, the distribution would be equal:33.3% each for increase, stable and decline. Any deviation from this pattern is measured and reflected in these trend data.

CHAP__1 12.01.2001 0:28 Uhr Page 61

Fig. 29: Drug abuse trends* in 1997/98: all drugs


Some decline 18%Large decline 9%

* Number of countries reporting increase/stable/ decrease; N=96

Stable 33%Some increase 24%Large increase 16%

Fig. 30: Drug abuse trends* in 1992-98: all drugs

* Countries and territories reporting increase/stable/decline in drug abuse as a proportion of all countries and territories reporting trends.

Dist

ribut

ion

38%

33%

29%

34% 32%

46%41%

20%27%

increase stable decrease


1992 1995 1998

Fig. 31: Substance abuse trends*: selected drugs (1992/1998)

* Number of countries reporting increase or decrease in abuse of specific drugs as a percentage of all countries reporting (N=52 in 1992; N=70 in 1998).

Source: UNDCP, DELTA.40% 20% 20% 40% 60%0%

13%

decrease increase

Cannabis 1998

1992

ATS 1998

1992

Heroin 1998

1992

Cocaine 1998

1992

Benzodiazepines 1998

1992

1992

1992

Opium 1998

Barbiturates 1998

14%

13%

3%

7%

11%

4%

57%

49%

47%

33%

24%

16%

3%

62

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63

Drug abuse at the global level was still expand-ing in the early 1990s, but this expansion lostmomentum in the second half of the decade.Between 1995 and 1998 the number of coun-tries reporting an increase in drug abuse fellwhile the number of countries reporting adecline in drug abuse rose. The fact that someof the stabilization or decline in drug abuse wasreported in the main consumer countries makesit unlikely that overall abuse, in terms of abso-lute numbers, is expanding even though it maycontinue spreading in geographic terms.

For all of the major drug types, the number ofcountries and territories reporting an increase inabuse continues to outnumber those reporting adecline (see Figure 30). The strongest overallspread of drug abuse in the 1990s was for theamphetamine-type stimulants (ATS) and cannabis(see Figure 31). The most ‘dynamic’ drugs werethe ATS. The number of countries and territoriesreporting an increase in ATS abuse almosttripled between 1992 and 1998 (see Figure 31).

More than half of all countries reported in-creases in cannabis use in 1998. The ongoingspread of cannabis consumption is problematicfor the medium term. In many countries, thelevel of cannabis consumption correlates posi-tively with the level of consumption of majorproblem drugs. Thus, with cannabis consump-tion spreading, one might expect the con-sumption of problem drugs to escalate once aproportion of the cannabis users ‘advances’ toother drugs.

Increases in the abuse of other drugs, includ-ing heroin and cocaine, were by far less signif-icant in the 1990s. While half of all countries in1998 saw an increase in ATS, only one third re-ported an increase in cocaine abuse. Althoughthere was a spread in cocaine abuse, the numberof countries reporting an increase stagnatedover the 1992-98 period. It is also interesting tonote that throughout the 1990s more countriesreported an increase in heroin than in cocaineabuse – which conforms to the productiontrends of opium and coca leaf.

Opiates Abuse trend data for the opiates (heroin, mor-phine, opium) for the late 1990s (1998 or pre-vious years) reveal the following patterns (seeMap 9):

• an increase, in drug transit countries, notablyCentral Asia and East European countries alongthe Balkan route, Southern and Eastern Africa,and in some of the countries of NorthernAfrica; by contrast, there were signs of declinein some of the Western African countries,after having grown rapidly in previous years;

• a stabilization or decline in the main con-sumer markets of Western Europe (except forthe UK, and – though starting from lowlevels – some Nordic countries), in somecountries of central Europe, and in the USA,following a period of strong increases in pre-vious years; increases in opiate abuse, how-ever, continued in both Canada and Mexico;

• an increase in South America, particularly Colom-bia, linked to the increase in the domestic pro-duction of opium and heroin, some of itsneighbouring countries (Venezuela and Ecua-dor), and Argentina; in Brazil, Bolivia and Para-guay, by contrast, opiate abuse remained stable;

• increases in practically all countries of Asia,with the exception of Myanmar, which re-ported a decline in 1998; and

• an increase in Australia.

Compared to the first half the 1990s (1994 or pre-vious years), the most striking features appearto be:

• declining levels of abuse in Western Europe;• the apparent end of the ‘heroin chic’ in the

USA, which had started in the first half of thedecade and was related to the emergence ofhigh quality heroin on the US market; and

• the increasing abuse problem in drug tran-sit countries.

Cocaine-type drugsAbuse trend data for cocaine in the late 1990s(1998 or previous years) reveal the followingtendencies (see Map 10):

CHAP__1 12.01.2001 0:28 Uhr Page 63

64

Some increaseLarge increase

Strong declineNot available

Some declineStable

1994

1994

19941993

1993

1994

1992

1994

1994

1993

1993

1993

1994

1994

1994

1994

1993

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1994

1992

1994

1994

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1994

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19981998

1994

1994 1994

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1994 1994

19941994

19931992

19931993

1993

19921993

1993

1994

19941994

1994

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1994

19941994

19941994

199419941994

1993

1994

1994



Some declineStable

19981996

1998

1998

1998

1998

19981998

1997

1998

1998

1998

1997

1997

1998

1998

1998

1998

1998

19981998

1996

1996

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1996

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1997

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19981998

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19981998

1998

199819981998

1998 1998

1998

1997

1996

19971998

1998

1998

1997

1997

1996

1998

1996

1996

19961996

1998

1997

1998

1998

1998

1996

1997

Map 9. Changes in abuse of heroin and other opiates, 1994 ( or latest year available)

Changes in abuse of heroin and other opiates, 1998 (or latest year available)

Sources: UNDCP Annual Reports Questionnaires data; Asian Multicity Epidemiology Workgroup; Bundeskriminalamt (BKA) and other LawEnforcement Reports; Comisión Interamericana para el Control del Abuso de Drogas (CICAD); Council of Europe (Pompidou Group);PHARE, Summary Reports on the Drug Situation in Central and Eastern European Countries; SACENDU (South African Community Epidemiology Network; United States Department of State, International Narcotics Control Strategy Report. Note: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations.

CHAP__1 12.01.2001 0:28 Uhr Page 64

65

• a decline in cocaine consumption in the USA,the world’s largest cocaine market;

• increases in cocaine consumption in SouthAmerica, Central America, Europe (primar-ily Western Europe), Southern Africa andAustralia; and

• very limited abuse in Asia.

Compared to the mid-1990s, the most strikingfeatures appear to be:

• the intensification of abuse throughout LatinAmerica, Western Europe and Australia; and

• the emergence of a cocaine abuse problemin the countries of Southern Africa, afterthey became trafficking transit countries;Western Africa showed mixed results withcocaine abuse apparently shifting to coun-tries where it did not exist before, anddeclining in others.

CannabisThe following trends can be observed forcannabis abuse in the 1990s (see Map 11):

• stable consumption in North America, theworld’s largest market for marijuana;

• decline in cannabis abuse in most Asiancountries, except for Kazakhstan and a fewcountries in East and South-East Asia;

• increase in cannabis abuse in Europe, bothEastern and Western (except for a few coun-tries, including the UK and Ireland, whichalready have the highest levels of cannabisconsumption in Europe);

• increases in cannabis abuse in both SouthAmerica and Central America;

• increases in several countries of SouthernAfrica, Central Africa, Northern and West-ern Africa ;

• increases in most countries in the Oceaniaregion.

The most striking changes compared to themid-1990s were the decline in cannabis con-sumption in much of Asia, and the increase inEurope.

Amphetamine-type stimulantsConsumption of amphetamine-type stimulants(ATS) increased throughout the 1990s, notablyin Europe (both amphetamine and ecstasy),and if methamphetamine is considered, in Eastand South-East Asia and North America. Thoughstill most frequent in Europe, ‘ecstasy’ abuse hasincreased across all continents.

The years 1994 and 1998 have been chosen asthe basis for comparison of drug abuse trendsbecause the two years, on the whole, are typicalyears for the first and the second half of thedecade, for opiates, cocaine and cannabis (seeMaps 9, 10 and 11). They are, however, less rep-resentative, when it comes to consumption ofamphetamine-type stimulants. The increase inATS use was most pronounced after 1994 andprior to 1998. Almost all countries reportedincreases in ATS abuse over the 1995-97 period(see Map 12).

By 1998, a number of countries in Europe, NorthAmerica and East and South-East Asia, includ-ing the USA, the UK, Spain and Japan, saw sta-bilization or decline in ATS abuse for the firsttime in years. Nonetheless, overall abuse con-tinued increasing in the late 1990s, in South-EastAsia (particularly Thailand), and some Euro-pean countries, including the Nordic countriesand countries such as France or Italy which hadstarted out from lower levels.

A mixed picture emerges for countries in LatinAmerica in the late 1990s. While Mexico, Colom-bia and Brazil reported rising ATS consump-tion, there was a decline in the south of thecontinent in Chile and Argentina. This is linkedto better controls of licit ATS, which are still themain source of supply in this part of the world.However, there have been some signs that con-sumption could shift from ATS to cocaine asthe latter becomes more easily available.

ATS abuse is fairly widespread in Africa, but, incontrast to other regions, there are no indica-tions of an increase. ATS in Africa, like in SouthAmerica, are still mostly licit medicines that

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66



Some declineStable

1996

199719971998

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Some declineStable

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Map 10. Changes in abuse of cocaine, 1994 (or the previous year(s))

Changes in abuse of cocaine, 1998 (or latest year available)

Sources: UNDCP Annual Reports Questionnaires data; Asian Multicity Epidemiology Workgroup; Bundeskriminalamt (BKA) and other LawEnforcement Reports; Comisión Interamericana para el Control del Abuso de Drogas (CICAD); Council of Europe (Pompidou Group); PHARE,Summary Reports on the Drug Situation in Central and Eastern European Countries; SACENDU (South African Community EpidemiologyNetwork; United States Department of State, International Narcotics Control Strategy Report. Note: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations.

CHAP__1 12.01.2001 0:32 Uhr Page 66

67



Some declineStable

1998

19981998

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19981998

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Some declineStable

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19941994 1994

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1994 19931994

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19931994

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199319941994

19921994

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1994

Map 11. Changes in abuse of cannabis, 1994 (or the previous year(s))


Changes in abuse of cannabis, 1998 (or latest year available)

CHAP__1 12.01.2001 0:32 Uhr Page 67


Map 12. Changes in abuse of amphetamine-type stimulants, 1994 (or the previous year(s))

Changes in abuse of amphetamine-type stimulants, 1998 (or latest year available)

68

CHAP__1 12.01.2001 0:32 Uhr Page 68

69

have been diverted into illicit channels. Bettercontrols of licit manufacture and trade at theglobal level limited diversion into illicit chan-nels during the 1990s.

1 . 3 . 4 . T H E E X T E N T O F D R U G A B U S E

Assessing the extent of drug abuse (the numberof drug abusers) is a particularly difficultundertaking because it involves measuring thesize of a hidden population. Margins of errorare thus considerable, and tend to multiply asthe scale of estimation is raised, from local tocountry, regional and global levels.

110 countries provided UNDCP with estimateson the level of drug abuse in the 1990s (79 coun-tries in 1997/98). These estimates are very het-erogeneous, in terms of quality and reliability.They are, in general, difficult to compare.Detailed information is available from countriesin North America, a number of countries inEurope (mostly Western Europe), some countriesin South and Central America, a few countriesin the Oceania region, and a limited number ofcountries in Asia and in Africa. For several othercountries, available qualitative information onthe drug abuse situation allows for making some‘guesstimates’.m In the case of complete datagaps for individual countries, it was assumed thatdrug abuse was likely to be close to the respective

subregional average, unless other available indi-cators suggested that abuse levels were likely tobe above or below such average.

Even in cases where detailed information exists,there is considerable divergence in definitionsused, as well as time and place of the studies inquestion: general population versus specificsurveys of groups in terms of age, profession orspecial settings (such as hospitals and prisons);lifetime, annual or monthly prevalence; fre-quent use, problematic use, registered use etc.).All of this limits comparability. In order toreduce the error from simply adding up suchdiverse estimates, an attempt was made to ‘stan-dardize’ the very heterogeneous data set as faras possible. Thus, all available estimates weretransformed into one single indicator – annualprevalence among the general populationaged 15 and above, using transformation ratiosderived from analysis of the situation in neigh-bouring countries, and if such data were notavailable, on estimates from the USA, the moststudied country with regard to drug abuse.

Comparability also suffers as the methodologiesfor estimation differ from country to country;moreover, the utility of particular methodolog-ical approaches differs from drug to drug.Indeed, the methodology chosen may have asmuch of an impact on final results as underly-ing differences in the drug problem.n In order

m) UNDCP, for instance, has undertaken a number of rapid assessment studies in developing countries. They usually do not provide precisequantitative information on the overall extent of the problem, but they describe the country-specific drug abuse problem rather well, andthus provide some basis for rough estimates. cf. Bulletin on Narcotics, Special Issue on Rapid Assessment of Drug Abuse, Vol. 48, 1996.

n) Household surveys, for instance, have been shown to provide, in general, good results with regard to the overall level of drug abuse or theabuse level of a widely used substance such as cannabis, but less so for typical ‘problem drugs’ concentrated among marginalized sections ofsociety. According to data of the US National Household Survey, for instance, 3.8 million people consumed cocaine in 1998 (annual preva-lence), which is 1.7% of the population age 12 and above. However, once the drug taking habits of marginalized groups (homeless, peoplein prison, etc) have been properly taken into account, the US Office of National Drug Control Policy (ONDCP) estimated the total numberof cocaine users at 6.5 million people or 3% of the population age 12 and above (3.3 million hardcore and 3.2 million occasional users),suggesting that by means of a household survey only some 60% of the total number of cocaine users could be identified. Differences werefound to be even larger for heroin. While the US National Household Survey estimated the number of heroin users (annual prevalence) at253,000 people in 1998 (0.1% of the population age 12 and above), ONDCP estimates – including marginalized groups – arrived at a numberof 1.2 million people (of which 980,000 were hardcore users). In other words, only some 20% of the total number of heroin users could beidentified by means of a household survey in 1998. (On average, the share fluctuated around 30% in the 1990s.) Similar differences are alsofound in Europe. In Germany, for instance, the estimated number of problematic drug users (mostly opiate users) based on data of a nationalhousehold survey, was only 20% to 30% the estimates made by using various multiplier methods based on police and treatment data or com-binations of capture-recapture estimates and multivariate indicator calculations. Even if household survey data are excluded, differences ofscientifically valid estimates may still be significant. Estimates of problematic drug use for Italy, based on different data sets (police data, treat-ment data, HIV/AIDs data, death data) and multipliers can lead to results that may deviate by up to 100% from one another. In the UK, thehighest estimate for problematic drug use (based on the use of multivariate indicators) deviated by as much as 300% from the lowest esti-mate (based on the mortality multiplier approach).

CHAP__1 12.01.2001 0:32 Uhr Page 69

to minimize the potential error from the use ofdifferent methodological approaches, all avail-able estimates for the same country were takeninto consideration and – unless methodologi-cal considerations suggested a clear superiorityof one method over another – the mean of thevarious estimates was calculated and used asUNDCP’s country estimate.

All of this – pooling of national results, stan-dardization and extrapolation from sub-regional results in the case of data gaps – doesnot guarantee an accurate picture, but it shouldbe sufficient to arrive at reasonable orders ofmagnitude about the likely extent of drugabuse. Based on such calculations, UNDCP esti-mates that in the late 1990s there were some144 million people taking cannabis, some 29million taking amphetamine-type stimulantso,14 million taking cocaine and 13.5 milliontaking opiates (of whom some 9 million weretaking heroin.) The total number of drug usersis estimated to be some 180 million people,equivalent to 3% of global population or 4.2% ofthe population age 15 and above. As drug usersfrequently take more than one substance, the

total is not identical with the sum of the indi-vidual drug categories (see Table 4).

These estimates largely confirm previous onesof the abuse situation in the mid-1990s, pub-lished in the 1997 World Drug Report. Devia-tions from the previous aggregate estimates(such as for amphetamine-type stimulants andfor opiates) are in many cases the result of im-proved data quality rather than of actual in-creases or decreases in the number of abusers,and thus direct comparisons should not bemade. As far as comparison between the mid-1990s and the late 1990s is feasible, data largelyconfirm the abuse trends reported to UNDCPby Member States.

Most countries for which data were availableshowed minor increases in cannabis abuse.With regard to the amphetamine-type stimulants,prevalence data show strong increases in Eastand South-East Asia and Australia. In Europethe picture is mixed with some of the larger ATSmarkets showing signs of saturation and evendecline while in many of the smaller markets(those of Eastern Europe) ATS abuse is still

70

Table 4. Estimated number of drug abusers (annual prevalence) in the late 1990s – World

Illicit drugs Cannabis Amphetamine- Cocaine Opiates of which of which: type stimulants* heroin

Global (million people) 180.0 144.1 28.7 14.0 13.5 9.2

in % of global population 3.0% 2.4% 0.5% 0.2% 0.2% 0.15%

in % of global population 4.2% 3.4% 0.7% 0.3% 0.3% 0.22%age 15 and above

* Amphetamines (methamphetamine and amphetamine) and substances of the ecstasy group.

Source: UNDCP, DELTA (including UNDCP estimates).

o) Users of amphetamines (methamphetamine, amphetamine) and of substances of the ecstasy group (MDMA, MDA, MDME etc.); in manycountries ATS use is still a relatively recent phenomenon and there are indications of significant under-reporting. This bias has been partlyoffset by simply adding users of amphetamines and of ecstasy, even though there is some overlap between the two.

CHAP__1 12.01.2001 0:32 Uhr Page 70

71

Map

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CHAP__1 12.01.2001 0:32 Uhr Page 71

72

rising. By contrast, in the USA and a number ofLatin American countries overall abuse of ATSappears to have declined even though there areindications that ecstasy use – as in many otherparts of the world – is still on the rise. Data alsopoint to an increase in the number of cocaineabusers in Latin America, Europe, Australiaand Africa, going hand in hand with a stabi-lization in the USA; a stabilization/decline ofheroin abuse in Western Europe, parallel withan increase in many other parts of the world, in-cluding countries neighbouring Afghanistan,those along the Balkan route, and – though start-ing from comparatively lower levels – NorthAmerica and China.

The regional breakdown of prevalence estimates(see Map 13 and Table 5) shows that the high-est rates for cannabis abuse are found in theOceania region (with many countries reporting

double digit figures), followed by the Americas(both North and South) and Africa, particu-larly Western and Southern Africa. Thoughgrowing in Eastern Europe cannabis abuse isstill most widespread in Western Europe (5.5%).According to the 1998 British Crime Survey106

it appears to be particularly strong in the UK(9% of those aged 16-59 years), a similar level asin the USA (8.6% of those aged 12 years andabove according to the 1998 US householdsurvey).107 Comparatively low levels of cannabisuse in Asia (2%) are mainly due to low levels re-ported from China and Japan. Nonetheless,more than a third of the world’s cannabis usersare to be found in the highly populated Asiaregion, more than in the Americas or in Africa.

About 29 million people are estimated to betaking ATS, which is twice as many as those whowere taking cocaine or opiates. The bulk of this

Table 6. Estimated number of amphetaminesabusers (annual prevalence)

Number in % of of people population age

(in million) 15 and above

Oceania 0.6 2.9 Western Europe 3.1 0.8Eastern Europe 1.0 0.4

Europe 4.1 0.7 North America 2.1 0.7 South America 2.2 0.8

Americas 4.3 0.7 Asia 12.6 0.5 Africa 2.5 0.5 Global 24.2 0.6

above global average* close to global average: below global average**

* at least double the global prevalence rate.** less than half the global prevalence rate.


Table 5. Estimated number of cannabisabusers (annual prevalence)



Oceania 4.5 19.3North America 22.2 7.2South America 14.7 5.3

Americas 36.9 6.3Africa 27.2 5.8Western Europe 17.4 5.4Eastern Europe 4.7 1.5

Europe 22.1 3.5Asia 53.5 2.1Global 144.1 3.4




CHAP__1 12.01.2001 0:32 Uhr Page 72

73

Map

14.

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e an

d tr

affic

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mph

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ine-

type

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(ann

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CHAP__1 12.01.2001 0:32 Uhr Page 73

is amphetamine and methamphetamine, con-sumed by some 24 million people (0.6% thepopulation aged 15 years and above) world-wide. ATS are the second most widely abusedsubstance after cannabis, notably in Oceania,Europe, Africa and East and South-East Asia(see Map 14 and Table 6).

Overall inter-regional differences in the spreadof ATS, except in Oceania, are minor, thoughintra-regional differences remain important.High levels of ATS abuse in the Oceania regionare mainly found in Australia, which reporteda prevalence rate for amphetamines of 3.6% in1998.108 This is several times the global averageand exceeds the figures reported from the UK(3% in 1998),109 Europe’s largest market forATS.110 Such high figures do point to highlevels of consumption; but they may also haveto do with the specific social and legal context

in which studies take place. This results in thecase of Australia (and some other countrieswith a long tradition of social research) inmore readiness to admit to drug use, and thusfar less under-reporting than in countrieswhere drug users fear that such informationcould be used against them. Against this back-ground, significantly lower methamphetamineabuse rates reported from East and South-EastAsia do not necessarily mean that abuse levelsare substantially lower. Even such conservativeestimates suggest that about half of all users ofamphetamines worldwide are already found inAsia, mostly in East and South-East Asia. In anumber of these countries, including Japan,the Republic of Korea, Taiwan, Province ofChina, the Philippines and Thailand, use ofmethamphetamine already exceeds that of theopiates, the traditional substance of abuse in theregion. In addition to the instrumental use of

74

Table 8. Estimated number of cocaine abusers(annual prevalence)



North America 7.0 2.2 South America 3.1 1.1

Americas 10.1 1.7 Oceania 0.2 0.9 Western Europe 2.2 0.7Eastern Europe 0.1 0.04

Europe 2.3 0.4 Africa 1.3 0.3 Asia 0.2 0.01 Global 14.0 0.3




Table 7. Estimated number of ecstasy abusers(annual prevalence)



Oceania 0.4 1.6Western Europe 2.3 0.6Eastern Europe 0.3 0.1

Europe 2.6 0.4North America 1.2 0.4South America 0.02 0.01

Americas 1.2 0.2Africa 0.1 0.02

Asia 0.2 0.01Global 4.5 0.1




CHAP__1 12.01.2001 0:32 Uhr Page 74

75

Arab

ian

Map

15.

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affic

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of c

ocai

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CHAP__1 12.01.2001 0:32 Uhr Page 75

76

methamphetamine for truck drivers, fisher-men, students, sex-workers and other groups inthe entertainment industry, which has beenknown in the region for decades, large-scalerecreational use among high-school and uni-versity students has started spreading.

In Western Europe, abuse of amphetamines is0.8% of the population aged 15 years and above,which is a little more than in the Americas(0.7%). The UK, Spain, and in relative terms(i.e. compared to overall level of drug abuse)the Scandinavian countries, are faced with highlevels of consumption of amphetamines, mostlyamphetamine.111 In the USA, by contrast, life-time prevalence data show that about half of ATSabuse is related to the more potent metham-phetamine.112 The high levels of ATS abusereported from South Americas is linked to theuse of licit ATS anorectics,113 while ATS in North

America, Western Europe and increasingly inAsia, are mostly illicitly manufactured sub-stances. Use of ATS in Africa is found all acrossthe continent though it is particularly concen-trated in Western Africa, where these substancesare frequently sold in parallel markets.114

The strongest growth in recent years, however,was in abuse of the ecstasy drugs, notably MDMA(ecstasy) itself, even though in a number oflocations less than half of the pills sold underthe name of ecstasy actually contained MDMA.UNDCP estimates that some 4.5 million people– mostly teenagers and young adults – tookecstasy in the late 1990s (see Table 7). In contrastto the wide regional spread of amphetamines,ecstasy is still concentrated in a few regions:Europe (mainly Western Europe), North Amer-ica and Oceania (mainly Australia). Strong con-centrations of ecstasy use are found in Australia

Table 9. Estimated number of opiate abusers(annual prevalence)



Oceania 0.13 0.58Western Europe 1.22 0.34Eastern Europe 1.46 0.54

Europe 2.68 0.42Asia 8.62 0.35North America 1.12 0.36South America 0.32 0.12

Americas 1.44 0.20Africa 0.63 0.13Global 13.50 0.33




Table 10. Estimated number of heroin abusers(annual prevalence)



Oceania 0.60 0.27Europe 1.51 0.24Asia 5.74 0.24Americas 1.31 0.22Africa 0.57 0.12Global 9.18 0.22




CHAP__1 12.01.2001 0:44 Uhr Page 76

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Map

16.

Abus

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d tr

affic

king

of o

piat

es (i

nclu

ding

her

oin)

Leve

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CHAP__1 12.01.2001 0:44 Uhr Page 77

(annual prevalence of 2.4% in 1998, includingother designer drugs, among the general pop-ulation aged 14 years and above)115, the UK(1%) and in Spain (0.9% in 1997)116. In a fewEuropean countries, including Germany, theNetherlands and Switzerland, ecstasy is alreadythe second most widely abused substance aftercannabis. In line with the globalization of pop-ular youth culture, ecstasy now seems to bespreading rapidly across the globe.

Some 14 million people are estimated to takecocaine worldwide (see Map 15 and Table 8). Inthe USA, the world’s largest cocaine market, abusedeclined strongly over the last decade. House-hold survey data show a decline in the annualprevalence rate from 5.1% of the populationaged 12 years and above in 1985 to 2.1% in 1992,and 1.7% in 1998.117 Nonetheless, includingmarginalized groups not covered by a house-hold survey, the prevalence rate is estimated bythe authorities to be equivalent to 3% of thepopulation age 15 and above, about ten timesthe global average. Even though prevalencerates are lower in Canada and Mexico, abouthalf of the world’s cocaine users are found inNorth America. The next largest markets areSouth America (1.1%), Oceania (0.9%; mainlyAustralia) and Western Europe (0.7%). Highestabuse levels within Europe are reported fromSpain (1.6% in 1997),118 at least partly a conse-quence of strong links between Spain and coun-tries in Latin America. Abuse levels in EasternEurope, though rising, are still significantly lower(far less than 0.1%). Cocaine abuse in Africa isestimated at close to the global average, with aconcentration in Western Africa (notably Nige-ria) and in the south of the continent (Republicof South Africa). Given the lack of comprehen-sive national surveys, estimates for countries inAfrica are, however, subject to far higher levelsof potential error than data from other regions.Cocaine consumption in Asia is clearly belowglobal average, and almost negligible from aninternational perspective. This is partly ex-plained by the large-scale availability of cheapmethamphetamine and other amphetamine-type stimulants.

About 13.5 million people or 0.3% of the globalpopulation aged 15 years and above are estimatedto consume opiates; most of this is heroin con-sumption which amounts to some 9 millionpeople (see Map 16 and Tables 9 and 10). Al-most two thirds of all users of opiates are foundin Asia; Europe accounts for some 20%. Ocea-nia, Europe and Asia also have the highest percapita consumption of opiates – ranging from0.4%-0.6% of the population aged 15 years andabove, while abuse of opiates in the Americas(0.2%) and Africa (0.1%) is below the globalaverage. In South America abuse of opiates is stillat very low levels, though this could change ifthe current expansion of production in Colom-bia were to continue.

The highest levels of abuse in Asia – clearlyexceeding 1% of the population aged 15 yearsand above – have been reported from the LaoPDR, Iran and Pakistan,119 i.e. either opiumproducing or transit countries for opiates. Thelargest number in absolute terms is found inIndia (though the prevalence of less than 0.5%of the population aged 15 years and above issmaller than in some of India’s neighbouringcountries). The mean estimates for India con-verge towards a figure of around 3 millionpeople,120 slightly more than the total estimatefor Europe as a whole. Total estimates for East-ern Europe (close to 1.5 million) exceed thosefor Western Europe (1 to 1.5 million people;with an average of about 1.2 million) whereabuse of opiates has stabilized or declined inrecent years.

The highest levels of opiate abuse in WesternEurope among the larger countries are stillreported from Italy,121 though these have beengoing down in the 1990s, and from the UK, oneof a few countries in Western Europe whereconsumption, notably of smokeable heroin, isstill on the rise. The largest market for opiatesin Eastern Europe is the Russian Federation.Russian authorities estimate some 3 milliondrug abusers of which at least a third areaddicted to opiates.122 All available indicatorsclearly show that abuse is rising fast in Russia.

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Even though available estimates are not veryprecise, there is little doubt that opiate abuse ina number of countries of Eastern Europe, partic-ularly those along transit corridors, has reachedproblematic proportions in recent years. Onehalf of 1% of the population aged 15 years andabove, on average, are estimated to consume opi-ates, often in the form of ‘kompot’ (in Russia, theUkraine and Poland), a brew made out poppystraw that is injected. Heroin abuse is still belowlevels found in Western Europe, but is increasingrapidly.

There was also a general increase in the numberof opiate abusers in North America in the 1990s:most of this is heroin related. Estimates pro-

vided by the US authorities suggest that theremay have been almost one million hard-coreheroin abusers in the late 1990s.123

Another major market for opiates, which hasbeen growing in recent years, is China. Esti-mates provided by the authorities in China arestill rather small, given the size of the country’spopulation (0.06% of the population aged 15years and above). However, the reported rise ofaddiction to opiate addiction in the 1990s hasbeen strong (from 250,000 registered users in1993/94 to some 600,000 registered users in1998/99), and it is possible that the actual num-ber could well be larger. Some 80% of opiate ab-use is already linked to heroin.

E N D N O T E S

1. UNDCP, Afghanistan Opium Poppy Survey 1999, p. 1.

2. UNDCP, Global Illicit Drug Trends, 2000 (ODCCP Studieson Drugs and Crime), Vienna 2000, p. 39.

3. A likely turnover of drug sales of US$ 360 billion for 1995(range US$ 100-US$ 1,000 billion) had been calculated.UNDCP, Economic and Social Consequences of Drug Abuse andIllicit Trafficking (UNDCP Technical Series, Vienna 1997, p. 51.

4. Office of National Drug Control Policy, National DrugControl Strategy, 2000 Annual Report, p. 28, referring toNational Institute on Drug Abuse, National Institute onAlcohol Abuse and Alcoholism, The Economic Costs of Alco-hol and Drug Abuse in the United States (Rockville, MD: U.S.Department of Health and Human Services, 1998),http://www.nida.nih.gov/Economic-Costs/Chapter1.html#1.10, January 11, 2000. Both economic costs and US GDPdata are for 1995. GDP data based on OECD, NationalAccounts of OECD countries, vol. 1, March, 2000.

5. Office of National Drug Control Policy, National DrugControl Strategy, 2000 Annual Report, p. 81.

6. International Narcotics Control Board, Report 1999, NewYork 2000, p. 34.

7. UNDCP, Annual Reports Questionnaire Data.

8. Office of National Drug Control Policy, National DrugControl Strategy, 2000 Annual Report, p. 81.

9. Institute for Defense Analyses, An Empirical Examinationof Counterdrug Interdiction Program Effectiveness, January 1997,IV-6.

10. Bureau of International Narcotics and Law Enforce-ment Affairs, 1999 International Narcotics Control StrategyReport, (Policy and Program Development), p. 27.

11. Alvaro Camacho Guizado, Andrés López Restrepo, “Per-spectivas Criticas Sobre El Narcotráfico en Colombia: Anal-ysis de Una Encuesta, in: Alvaro Camacho Guizado, AndrésLópez Restrepo, Francisco E. Thoumi, Las Drogas: UnaGuerra Fallida, Visiones Criticas, pp. 1-91 (notably pp. 52-55).

12. Institute for Defense Analyses, An Empirical Examina-tion of Counterdrug Interdiction Program Effectiveness,January 1997, IV-6.

13. UNDCP (Research Section), ‘Cannabis as an illicit nar-cotic crop: a review of the global situation of cannabis con-sumption, trafficking and production’, in UNDCP, Bulletinon Narcotics, ‘Double issue on cannabis: recent develop-ments’, Vol. XLIX (1997) and (1998), New York 1999, pp. 45-85.

14. Interpol, Cannabis World Report 1999, Lyon, 1999, p. 6.

15. UNDCP, Annual Reports Questionnaire Data.

16. INCSR 1999. Bureau of International Narcotics and LawEnforcement Affairs, 1999 International Narcotics ControlStrategy Report, (Chapter on Colombia, p. 1), Washington,March 2000.

17. Interpol, Cannabis World Report 1999, Lyons, 1999, p. 11.

18. Van der Werf, R., ‘Registration of illegal production inthe national accounts of the Netherlands’, joint OECD/ECE/Eurostat meeting on National Accounts, Paris, 3-6June 1997 (Voorburg, Statistics Netherlands, 1997), quoted

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in Trimbos Institute (Reitox Focal Point), National Report1997, the Netherlands, draft version, p. 61.

19. UNDCP, Global Illicit Drug Trends, 2000 (ODCCP Studieson Drugs and Crime), Vienna 2000, p. 198.

20. Ibid, p. 34.

21. Ibid, pp. 62 and 92.

22. Interpol, 1999 Trends and Patterns of Illicit Drug Traffic,March 2000.

23. Interpol, Cannabis World Report 1999, Lyon 1999.

24. UNDCP, Trends 2000, op.cit., pp. 10-21.

25. Interpol, 1999 Trends and Patterns of Illicit Drug Traffic,March 2000, p. 4.

26. Ministry of Interior – Turkish National Police Depart-ment of Anti-Smuggling and Organized Crime, TurkishDrug Report ‘99, Ankara 2000, pp. 6-8.


28. Interpol, Heroin World Report 1999, Lyon, 1999, p. 30.

29. UNDCP, Trends 2000, op.cit., p. 182.

30. UNDCP, 1999 Afghanistan Opium Poppy Survey 1999,Islamabad 1999.


32. Ibid.

33. Interpol, 1999 Trends and Patterns of Illicit Drug Traffic,Lyon, March 2000, p. 5.

34. Interpol, Heroin World Report 1999, Lyon, 1999, pp. 7-8.

35. Office of National Drug Control Policy, The NationalDrug Control Strategy: 2000 (and previous years), Washing-ton 2000 (and previous years).

36. Interpol, 1999 Trends, op.cit., p. 8.

37. Ibid.

38. Francisco Thoumi, ‘Las Drogas Illegales y RelacionesExteriores de Colombia: Una Vision desde el Exterior’, inA. C. Guizado, A.L. Restrepo, F. Thoumi, Las Drogas: UnaGuerra Fallida – Visiones críticas, (TM Editores, IEPRI (UN))Santafé de Bogota, 1999, p. 124.

39. U.S. Drug Enforcement Agency, ‘Russian OrganizedCrime and the Drug Trade: a domestic intelligence brief’,January 1998.


41. UNDCP, Trends 2000, op.cit.

42. International Narcotics Control Board, Report 1999,New York 2000, p. 41.

43. Substance Abuse and Mental Health Services Adminis-tration (SAMHSA), National Household Survey on DrugAbuse, 1999,Washington 2000 and previous years.

44. Office of National Drug Control Policy (ONDCP), TheNational Drug Control Strategy, 1996: Program, Resource, andEvaluation, Washington 1996 and ONCDP, The NationalDrug Control Strategy, 2000, Washington 2000.

45. Australian Institute of Health and Welfare, 1998National Drug Strategy Household Survey, First results, Can-berra, p. 5.


47. SAMHSA, National Household Survey on Drug Abuse, 1999and previous years, op.cit.

48. European Monitoring Centre for Drugs and DrugAddiction, Annual Report on the state of the drugs problem inthe European Union, 1999, Lisbon 1999 (and previous years).





53. Ibid.

54. UNDCP, ICPO, WCO, ‘Significant Seizures Data Base’,2000 (based on information collected in UNDCP/ICPO/WCO seizure data sharing project).


56. UNDCP, ICPO, WCO, ‘Significant Seizures Data Base’,2000.

57. Interpol, Cannabis World Report 1999, Lyon, 1999, p. 18.

58. Ibid.

59. UNDCP, South Asia, Drug Demand Reduction Report, NewDehli, 1998.


61. Ibid.

62. Interpol, Cannabis.., op.cit., p. 8.


64. Interpol, 1999 Trends.., op.cit., p. 13.

65. Interpol, Cannabis.., op.cit., p. 8.

66. United States Department of State, International NarcoticsControl Strategy Report, March 1997, p. 464.

67. UNDCP, ‘Cannabis as an illicit narcotic crop: a reviewof the global situation of cannabis consumption, traffick-ing and production’, in UNDCP, Bulletin on Narcotics,

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Double issue on cannabis: recent development, VolumeXLIX and L, New York 1999, pp. 45-83.


69. UNDCP, Cannabis.., op.cit., p. 48.

70. UNDCP, Amphetamine-type Stimulants: A Global Review,Vienna 1996.

71. Hilary Klee, ‘Patterns of Amphetamine-Misuse in SevenNations: Factors Affecting Growth and Decline’, in HilaryKlee, Amphetamine Misuse, International Perspectives on Cur-rent Trends, 1997, pp. 291-319.


73. UNDCP, ICPO, WCO, ‘Significant Seizures Data Base’,2000.


75. Ibid, pp. 132-139.

76. Ibid, pp. 10-21.


78. Ibid, p. 44.

79. Ministry of Interior/Turkish National Police, TurkishDrug Report ‘99, Ankara 2000, pp. 21-22.

80. UNDCP, Amphetamine-type Stimulants ..., op.cit., p. 73.

81. UNDCP, Trends 2000, op.cit., pp.10-21.

82. UNDCP, Amphetamine-type Stimulants ..., op.cit., p. 48.


84. Ibid, p. 16.


86. Council of Europe, Cooperation Group to CombatDrug Abuse and Illicit Trafficking in Drugs (PompidouGroup), Treated Drug Users in 23 European Cities – Data1997, Trends 1996-97, Pompidou Group Project on TreatmentDemand: Final Report (Council of Europe Publishing), Stras-bourg, October 1999 and European Monitoring Centre forDrugs and Drug Addiction (EMCDDA), Extended annualreport on the state of the drugs problem in the European Union,1999, Lisbon 1999.

87. Centre for Drug Research (WHO Research and Train-ing Centre: Universiti Sains Malaysia), Report of the AsianMulticity Epidemiology Work Group, 1997, Penang (Malaysia)and UNDCP, Annual Reports Questionnaire Data.


89. Office of the Narcotics Control Board, Thailand Nar-cotics Annual Report 1998-1999, Bangkok 1999, pp. 51-56(and previous years).

90. Council of Europe, Treated Drug Users ..., op.cit., pp.55-56.

91. EMCDDA, Extended annual report 1999..., op.cit., p. 54.


93. Ibid.

94. Council of Europe, Treated Drug Users ..., op.cit., p. 104.


96. Comision Interamericana para el Control del Abuso deDrogas (CICAD), Resumen Estadístico sobre Drogas, 1999,Washington D.C., Sept. 1999, pp. 64-65, and CICAD/OAS,SIDUC 1998 Preliminary Report, Washington 1998, p. 27.


98. Substance Abuse and Mental Health Services Adminis-tration (SAMHSA), Treatment Episode Data Set (TEDS),1992-1997.

99. Ibid.

100. Ibid.

101. CICAD, Resumen .., op.cit., pp. 64-65; Canadian Centreon Substance Abuse (CCSA) and Addiction Research,Canadian Drug Profile, 1999, and SAMHSA, Treatment ...,op.cit.

102. UNDCP, UNICRI, Behman Hospital, ‘UNDCP GlobalStudy on Illicit Drug Markets – Study in Greater Cairo’,(Draft), Cairo, 2000, p. 19.

103. Unweighted average of treatment in Johannesburg/Pre-toria, Cape Town, Durban, Port Elizabeth, in MedicalResearch Council, South African Community Epidemiology Net-work on Drug Use (SACENDU), Monitoring Alcohol and DrugAbuse Trends, Proceedings of Report Back Meetings, March 2000,July-December 1999, May 2000.

104. UNDCP, The Drug Nexus in Africa (ODCCP Studies onDrugs and Crime), Vienna, March 1999, p. 25.

105. Ibid, p. 26.

106. Home Office, Drug Misuse Declared in 1998: Results formthe British Crime Survey (Research Study 197), London 1999.

107. Substance Abuse and Mental Health Services Admin-istration (SAMHSA), National Household Survey on DrugAbuse, 1998, Rockville, MD, 1999.

108. Australian Institute of Health and Welfare (AIHW),1998 National Drug Strategy Household Survey, Canberra,August 1999.

109. Home Office, British Crime Survey, op.cit.

110. EMCDDA, 1999 Annual Report, op.cit., p. 52.

111. Ibid.

112. SAMHSA, National Household Survey 1998, op.cit.

113. INCB, Report 1999, op.cit., p. 42.

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114. UNDCP, Drug Nexus, op.cit., pp. 20-21.





119. UNDCP, Trends 2000, op.cit., p. 182-185.

120. UNDCP, South Asia Drug Demand Reduction Report, NewDelhi, p. 260.


122. UNDCP, Trends 2000, op.cit., p. 182-185.

123. Office of National Drug Control Policy, National DrugControl Strategy: 2000 Annual Report, Washington 2000, p. 116.

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