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With 200 Million Users Worldwide, are Drugs a Pandemic?

The journal _Lancet_ is the latest to jump into the wealth of research and discussion on addiction, and its first paper in a series focuses on the global burden of disease caused by illicit drug use. The headline-worthy statistic? Study authors Louisa...

by Derek Mead
Jan 6 2012, 8:20pm

The journal Lancet is the latest to jump into the wealth of research and discussion on addiction, and has just published its first entry in a series of papers focused on the global burden of disease caused by illicit drug use. The headline-worthy statistic? Study authors Louisa Degenhardt, of the University of New South Wales, and Wayne Hall, of the University of Queensland, estimate that between 149-271 million people worldwide use illegal drugs every year, with the authors pegging the probably number within that range at around 200 million.

That would equate to about 1 in 20 people between the ages of 15 and 64 worldwide. Whether or not that number sounds high or low — let us know what you think below — the study found that drug use was highest in high-income countries. Accordingly, the burden of disease caused by illicit drugs was highest in wealthy nations, where it was similar to the burden caused by alcohol but far less than that caused by tobacco. That suggests that, of the three groups, tobacco creates the most health problems worldwide.

What’s truly intriguing about the study is the uncertainty of the user estimation, which is evidenced in the huge range presented in the paper. The authors highlight this, saying that because these drugs are illegal, it’s much harder to accurately estimate their usage statistics as compared to alcohol and tobacco. According to Degenhardt and Hall, this lack of precision is an unintended consequence of drug prohibition that hampers research into the true effects drug use has on the the world population.

“Intelligent policy responses to drug problems need better data for the prevalence of different types of illicit drug use and the harms that their use causes globally," they wrote in the paper. "This need is especially urgent in high-income countries with substantial rates of illicit drug use and in low-income and middle-income countries close to illicit drug production areas.”

As would be expected, weed enthusiasts were the most prevalent, making up 125-203 million of the total. Amphetamines came in second, with 14-56 million users, while 14-21 million people use cocaine worldwide. Opiates are least popular, with 12-21 million users worldwide. According to the paper, the greater uncertainty for estimates of cannabis and amphetamine use is "attributable to the scarcity of credible estimates of their prevalence of use in many countries, and the varying prevalence seen within countries that have made estimates." In other words, rates of cannabis and amphetamine use are surveyed less thoroughly and less frequently than other drugs, which adds difficulty to compiling accurate of usage statistics.

According to the UN Office on Drugs and Crime, cannabis is most popular in Oceania (mainly populated by Australia and New Zealand), with up to 15 percent of that region’s populace aged 15-64 using it. Oceania is also the global leader in amphetamine use (2.8 percent of the population), while North America led in cocaine (1.9 percent) and the Near and Middle East led in opiates (1.4 percent).

The study classified four types of adverse health effects: acute toxic effects, including overdoses; acute effects of intoxication, such as accidental injury and violence; development of dependence; and adverse health effects of sustained chronic, regular use, such as physical diseases. For example, while smoking pot doesn’t lead to overdoses or the spread of blood-borne pathogens, many users develop a dependence. Opioids, on the other hand, can cause all four types of ill effects.

The study cites World Health Organization data from 2004 (the most recent available) to suggest that, yearly, 250,000 deaths worldwide were attributable to illicit drug use, lower than the 2.25 million for alcohol and 5.1 million for tobacco. On the other hand, drug use leads to 2.1 million years of life lost yearly (what a macabre statistic), as compared with 1.5 million for alcohol. That’s because drug deaths tend to affect young people, while alcohol-related deaths are mainly limited to the middle-aged and elderly.

The estimates for total number of users in a study like this are less important than the trends, like the fact that tobacco still causes more health issues worldwide than drugs or alcohol, and that while drug use leads to fewer total deaths than alcohol use, the people dying drug-related deaths are younger than those dying from alcohol and tobacco use. The biggest point lies in the uncertainty of the population statistics themselves. There are plenty who would argue that’s a necessary evil of the worldwide drug war, but at the same time, it’s hard to fathom developing smart drug policies without having quality data. Beyond that, with about 3 percent of the world’s population using illicit drugs (the number of problem users is much lower), it’s time to ask: What are our drug policies even doing?