Skip to main content

Full text of "World Drug Report 2017: Booklet 3: Market Analysis of Plant-Based Drugs: Opiates, Cocaine, Cannabis"

See other formats


@uU UNODC 


\ ns Office on Drugs and Crim 


MARKET ANALYSIS OF 
PLANT-BASED DRUGS 


Opiates, cocaine, cannabis 


WORLD FP 


DRUG G 
REPORT & 


ae 
UNODC 3H 
Research Y 


This booklet constitutes the third part of the World Drug Report 2017. 


© United Nations, May 2017. All rights reserved worldwide. 
ISBN: 978-92-1-148294-2 

eISBN: 978-92-1-060626-4 

United Nations publication, Sales No. E.17.X1.9 


This publication may be reproduced in whole or in part and in any form 

for educational or non-profit purposes without special permission from 

the copyright holder, provided acknowledgement of the source is made. 

The United Nations Office on Drugs and Crime (UNODC) would appreciate 
receiving a copy of any publication that uses this publication as a source. 


Suggested citation: 

United Nations Office on Drugs and Crime, World Drug Report 2017 

(ISBN: 978-92-1-148291-1, eISBN: 978-92-1-060623-3, United Nations publication, 
Sales No. E.17.X1.6). 


No use of this publication may be made for resale or any other commercial 

purpose whatsoever without prior permission in writing from UNODC. 

Applications for such permission, with a statement of purpose and intent of the 
reproduction, should be addressed to the Research and Trend Analysis Branch of UNODC. 


DISCLAIMER 


The content of this publication does not necessarily reflect the views or 
policies of UNODC or contributory organizations, nor does it imply any endorsement. 


Comments on the report are welcome and can be sent to: 


Division for Policy Analysis and Public Affairs 
United Nations Office on Drugs and Crime 
PO Box 500 

1400 Vienna 

Austria 

Tel: (+43) 1 26060 0 

Fax: (+43) 1 26060 5827 


E-mail: wdr@unodc.org 
Website: www.unodc.org/wdr2017 


PREFACE 


I am proud to say that this year we are marking 20 
years of the World Drug Report. 


Over the past two decades, the United Nations 
Office on Drugs and Crime (UNODC) has been 
at the forefront of global research into complex areas 
of drug use and supply, supporting international 
cooperation and informing policy choices with the 
latest estimates, information on trends and 
analysis. 


This year we are launching a new format, with the 
report available as five separate booklets: the execu- 
tive summary, together with the report’s conclusions 
and policy implications; a global overview of drug 
use and supply; a market analysis of plant-based 
drugs; a market analysis of synthetic drugs; and a 
thematic booklet on the links between drugs and 
organized crime, illicit financial flows, corruption 
and terrorism. We have done this in response to 
readers needs and to improve user-friendliness, 
while maintaining the rigorous standards expected 
from the Office’s flagship publication. 


The 2017 report comes at a time when the interna- 
tional community has acted decisively to achieve 
consensus on a way forward for joint action. 


The outcome document unanimously adopted at 
last year’s special session of the General Assembly 
on the world drug problem contains more than 100 
concrete recommendations for implementing bal- 
anced, comprehensive and integrated approaches to 
effectively addressing and countering the world drug 
problem. 


Moreover, at its sixtieth session, in March 2017, the 
Commission on Narcotic Drugs adopted resolution 
60/1, reinforcing commitment to implementing the 
outcome document and charting a course to the 
2019 target date of the 2009 Political Declaration 
and Plan of Action on the world drug problem, as 
well as strengthening action towards the Plan of 
Action’s agreed goals and targets. 


As the World Drug Report 2017 clearly shows, there 
is much work to be done to confront the many 
harms inflicted by drugs, to health, development, 
peace and security, in all regions of the world. 


Globally, there are an estimated minimum of 
190,000 — in most cases avoidable — premature 
deaths from drugs, the majority attributable to the 
use of opioids. 


The terrible impact of drug use on health can also 
be seen in related cases of HIV, hepatitis and 
tuberculosis. 


Much more needs to be done to ensure affordable 
access to effective scientific evidence-based preven- 
tion, treatment and care for the people who 
desperately need them, including those in prison 
settings. As just one example, this year’s report high- 
lights the need to accelerate accessibility to the 
treatment of hepatitis C, a disease whose negative 
health impact on people who use drugs is far greater 
than that of HIV/AIDS. 


Recent attention has focused on the threats posed 
by methamphetamine and new psychoactive sub- 
stances (NPS). However, as the report shows, the 
manufacture of both cocaine and opioids is increas- 
ing. These drugs remain serious concerns, and the 
opioid crisis shows little sign of stopping. 


The World Drug Report 2017 further looks at the 
links with other forms of organized crime, illicit 
financial flows, corruption and terrorism. It draws 
on the best available evidence and, most of all, high- 
lights the fact that much more research needs to be 
carried out in these areas. 


Corruption is the great enabler of organized crime, 
and opportunities for corruption exist at every stage 
of the drug supply chain. However, too little is 
known about how different types of corruption 
interact with drug markets. 


The outcome document of the special session of the 
General Assembly on the world drug problem and 


WORLD DRUG REPORT 2017 


Security Council resolutions express concern about 
terrorist groups profiting from drug trafficking, 
among other forms of transnational organized crime. 


It is well established that there are terrorists and 
non-State armed groups profiting from the drug 
trade — by some estimates, up to 85 per cent of 
opium poppy cultivation in Afghanistan is in terri- 
tory under influence of the Taliban. 


However, evidence on the organized crime-terrorism 
nexus remains patchy at best. Moreover, these links 
are not static. Relations between organized crime 
and terrorists groups are always evolving, much like 
drug markets themselves. 


As we have seen with the NPS market, drug use, 
supply, trafficking routes and the substances them- 
selves continue to shift and diversify at alarming 
speed. 


Drugs continue to represent a major source of rev- 
enue for organized crime networks, but business 
models are changing, with criminals exploiting new 
technologies, such as the darknet, that are altering 
the nature of the illicit drug trade and the types of 
players involved, with looser, horizontal networks 
and smaller groups becoming more significant. New 
ways of delivering drugs further point to the need 
to involve other sectors such as postal services in the 


fight against drug trafficking. 


Clearly, countries must be able to act and react to 
an ever-changing and formidable array of threats 
and problems. UNODC is fully engaged in strength- 
ening responses, working closely with our United 
Nations partners and in line with the international 
drug control conventions, human rights instruments 
and the 2030 Agenda for Sustainable Development, 
which are themselves complementary and mutually 
reinforcing. 


As the special session of the General Assembly and 
the recent session of the Commission on Narcotic 
Drugs have shown, the international community is 
equipped to respond swiftly and decisively to global 
drug-related challenges. 


For example, in March, the Commission scheduled 
two precursors and an analogue to the scheduled 
drug fentanyl. This important step will make it 
harder for criminals to illicitly manufacture fentanyl 
and its analogues and, I hope, can help to stem the 
tragic increase in opioid overdoses in recent years. 


However, there remains an enormous need for 
capacity-building and technical assistance, and fund- 
ing continues to fall far short of political 
commitment. Further resources are urgently needed 
to help all Member States implement the recom- 
mendations contained in the outcome document 
of the special session of the General Assembly and 
achieve related targets under the Sustainable Devel- 
opment Goals. 


The many evolving drug challenges also highlight 
the importance of prevention — science- and rights- 
based drug use prevention — but also prevention 
of crime, corruption, terrorism and violent extrem- 
ism, in line with commitments under the 
conventions and United Nations standards and 
norms. 


Finally, I ask all Governments to help us improve 
the evidence base for these reports. Areas such as 
the links between drugs, terrorism and insurgency 
clearly touch upon sensitive intelligence, and there 
are legitimate concerns about compromising sources, 
collection and operations. But if we want to effec- 
tively address drug challenges we need to strengthen 
international cooperation and information-sharing 
to the extent possible, to close the gaps and ensure 
that joint action is targeted, effective and timely. 


—_— 


Yury Fedotov 
Executive Director 
United Nations Office on Drugs and Crime 


CONTENTS 


EXECUTIVE SUMMARY — CONCLUSIONS AND POLICY IMPLICATIONS 


GLOBAL OVERVIEW OF DRUG DEMAND AND SUPPLY 
Latest trends, cross-cutting issues 


MARKET ANALYSIS OF PLANT-BASED DRUGS 
Opiates, cocaine, cannabis 


sx iailoiglaSSgiuts Seite nS ye oiled Sa oie sind Sad Sirk teeing Salo Sulele oad SG GT eel nga Sy Reams ay SEs 3 
CAPLAN ATOR ¥ NO GES  cosssnparsssnswecansganenscocsneusaspaedpreassaiaanitaneseiesainesiigesedeapeiabeeens 7 
Be UE IC Io Gisicdasqucevasavcusenrigvabascceapuiuiedanerinnsiarabsageieacsusadebanteaeidesrauntiaraaerekeiess 9 
DP Ree AN WN hes dxeyadecacuep ccteadb vecatonsieuadiah deep denen hora ratiaaevereuenart vudierespearrcadneranees 11 
Py Te OPIATE WIA! cinisprarsncavercsuetenacdsauasuatarichuudiatalanicastuapbaceniapniastharauer 13 
Global production of opiates increased by around 30 per cent in 2016... cee ceeseeeeeeeeeeteeeeneeetees 13 
Seizures of opiates have decreased in recent years ....scseesesseeeseseeeseeseeeeseecsensecssescaeeaeseeceeeasseeesesataeeeees 14 
Most opiates continue to be trafficked along the Balkan route ....eeeceeesesesseseseeeeseeeseeetecetseeseeneneeeees 16 
Seizures of opiates out of South-East Asia on the increase ....eceesesesseeseesceeeseseecseseseeeeeesseeeesesaeeeeees 20 
Seizures of opiates out of Latin America also on the increase.....scscesceseesesessesesesceseseseeeneeesseeeeeeesaeeeeees 21 
‘Theglobal:opiate:market ap pears:Stableleicre.: scien covssceesdeesedss resend saepenes caeedewepivsavevedeserataceeceyseesatraredeas 21 
Be COC AIIS MURINE Mecctaeccnsrinomcdrpeniuctareromerosyiarneese rena beryiaiedarhoney 25 
Coca bush cultivation on the increased in the last two years.....sssssssssesesseseesceeeeceeseeeceesceeaeeeceeeeeneens 25 
Record cocaine seizures in 2015, trafficked primarily from South 
America to North America, Western and Central Europe...c.cscccsecscsssssescreeseseecnseseseeceesesateeeeseeaeeeeees 27 
Global figures on cocaine use mask important regional patterns and trends ........cecseeeseseeeeeereneeetees 28 
Tratirck ise OF COCA eC siiees szscissssvaseseanseste sasessscvasiveasastusaeesnaess bis tabavs cbeaxeas la naeonasasiaasnthenpuaesietesbuseyes 31 
Ss, Gs ee A IRN Bs tcc cutee sees iecereaadssustcncuenade ences cseiuldnianerenendiacnbd tun: 37 
Cannabis production remains a global phenomenon oo... ccececcsseeesesenseseeeseeseseseeceeeseseeeteeatseeseceeneeesees 37 
Ganimabis tra th chet gs sacycitessalses dos svseseuens iar dezets ety ecu avec sisatecssiucisnigeidsiotsvasios isduedsshdens ianayeshdeaeseststaashienas 38 
Cannabis use has remained quite stable at the global level in recent years, 
despite indications that it continues to increase in Africa and ASia....cseeeceseeeescssteeeteceteeeteceeneeeteeneees 41 
Developments in measures regulating recreational cannabis use in the United States and Uruguay .....45 
PAININEX aces. ccaceadiastssapcnnadscdcdauaankad sovbentg ina déauedimemadegegeumbanaedsabsata@amaabcedetuaantaatacseies ah 
Br ir © cadiseaaton code dtuwenescstoos ta apamencin seen Gme ad aeddys cuereensteyenemetelieidesieveosiumontcle: 65 
Pe RO PINS 6 ccuserner erin ecnaaneerereste enn eenercemaeteyeeraereiwraenenvenvevaninee 67 


MARKET ANALYSIS OF SYNTHETIC DRUGS 
Amphetamine-type stimulants, new psychoactive substances 


“BOOKLET 5 THE DRUG PROBLEM AND ORGANIZED CRIME, 


ILLICIT FINANCIAL FLOWS, CORRUPTION AND TERRORISM 


Acknowledgements 


The World Drug Report 2017 was prepared by the Research and Trend Analysis Branch, Division for 
Policy Analysis and Public Affairs, United Nations Office on Drugs and Crime, under the supervision 
of Jean-Luc Lemahieu, Director of the Division, and Angela Me, Chief of the Research and Trend 


Analysis Branch. 


General coordination and content overview 
Chloé Carpentier 
Angela Me 


Analysis and drafting 
Kamran Niaz 
Thomas Pietschmann 


Data management and estimates production 
Enrico Bisogno 

Andrea Oterova 

Umidjon Rakhmonberdiev 

Ali Saadeddin 

Antoine Vella 

Editing 

Jonathan Gibbons 


Review and comments 


Graphic design and production 
Anja Korenblik 

Suzanne Kunnen 

Kristina Kuttnig 


Coordination 
Francesca Massanello 


Data Support 
Diana Camerini 
Raffaella Conconi 


Sarika Dewan 


Administrative support 
Anja Held 
Tulia Lazar 


The World Drug Report 2017 benefited from the expertise and invaluable contributions of UNODC 
colleagues in the Drug Prevention and Health Branch of the Division for Operations; the Corruption 
and Economic Crime Branch, the Organized Crime and Illicit Trafficking Branch and the Terrorism 
Prevention Branch of the Division for Treaty Affairs; and the Research and Trend Analysis Branch of 
the Division for Policy Analysis and Public Affairs. 


The Research and Trend Analysis Branch acknowledges the invaluable contributions and advice 
provided by the World Drug Report Scientific Advisory Committee: 


Jonathan Caulkins 

Paul Griffiths 

Marya Hynes 
Vicknasingam B. Kasinather 
Letizia Paoli 

Charles Parry 

Peter Reuter 

Francisco Thoumi 

Alison Ritter 

Brice De Ruyver 


The boundaries and names shown and the designa- 
tions used on maps do not imply official endorsement 
or acceptance by the United Nations. A dotted line 
represents approximately the line of control in 
Jammu and Kashmir agreed upon by India and Paki- 
stan. The final status of Jammu and Kashmir has 
not yet been agreed upon by the parties. Disputed 
boundaries (China/India) are represented by cross- 
hatch owing to the difficulty of showing sufficient 
detail. 


The designations employed and the presentation of 
the material in the World Drug Report do not imply 
the expression of any opinion whatsoever on the 
part of the Secretariat of the United Nations con- 
cerning the legal status of any country, territory, city 
or area, or of its authorities or concerning the delimi- 
tation of its frontiers or boundaries. 


Countries and areas are referred to by the names 
that were in official use at the time the relevant data 
were collected. 


All references to Kosovo in the World Drug Report, 
if any, should be understood to be in compliance 
with Security Council resolution 1244 (1999). 


Since there is some scientific and legal ambiguity 
about the distinctions between “drug use”, “drug 

. » <4 » « 
misuse” and “drug abuse”, the neutral terms “drug 
use” and “drug consumption” are used in the World 
Drug Report. 


EXPLANATORY NOTES 


All uses of the word “drug” in the World Drug Report 
refer to substances under the control of the inter- 
national drug control conventions. 


All analysis contained in the World Drug Report is 
based on the official data submitted by Member 
States to the United Nations Office on Drugs and 
Crime through the annual report questionnaire 
unless indicated otherwise. 


The data on population used in the World Drug 
Report are taken from: United Nations, Department 
of Economic and Social Affairs, Population Divi- 
sion, World Population Prospects: The 2015 
Revision. 


References to dollars ($) are to United States dollars, 
unless otherwise stated. 


References to tons are to metric tons, unless other- 
wise stated. R stands for the correlation coefficient, 
used as measure of the strength of a statistical rela- 
tionship between two or more variables, ranging 
from 0 to 1 in case of a positive correlation or from 
0 to -1 in case of a negative correlation. 


KEY FINDINGS 


Opium production on the increase 


In 2016, global opium production increased by one 
third compared with the previous year. Although 
there was also an increase in the size of the area under 
opium poppy cultivation, the major increase in 
opium production was primarily the result of an 
improvement in opium poppy yields in Afghanistan 
compared with the previous year. At 6,380 tons, 
however, total global opium production was still 
some 20 per cent lower than at its peak in 2014, 
and was close to the average reported in the past five 
years. 


Seizures of both opium and heroin have remained 
quite stable at the global level in recent years, sug- 
gesting a smooth supply of heroin, irrespective of 
annual changes in opium production. The quantity 
of heroin seized in North America increased sharply 
in 2015. This went in parallel with reports of 
increasing heroin use and heroin-related deaths in 
that subregion. 


Growing importance of Caucasus branch 
of the Balkan route 


Drug flows are in a constant state of flux. With the 
changes brought by globalization and the spread of 
new communications technologies, drug flows are 
characterized more than ever by rapid changes in 
trafficking routes, modi operandi and concealment 
methods. 


With about 40 per cent of global heroin and mor- 
phine seizures in 2015 being made in countries on 
the so-called “Balkan route”, the route appears to 
remain the world’s principal opiate trafficking route. 
While overall quantities seized on the Balkan route 
declined in 2015, an alternative branch of the route, 
through the Caucasus countries, appears to have 
been gaining in importance in recent years. That 
route circumvents Turkey, where the recent increase 
in flows of refugees heading towards countries in 
the European Union may have pushed traffickers 
to seek other options. 


Expansion of the cocaine market 


Data on drug production, trafficking and use point 
to an overall expansion of the market for cocaine 
worldwide. Following a long-term decline, coca bush 
cultivation increased by 30 per cent during the 
period 2013-2015, mainly as a result of increased 
cultivation in Colombia. Total global manufacture 
of pure cocaine hydrochloride reached 1,125 tons 
in 2015, representing an overall increase of 25 per 
cent over 2013. 


Cocaine use appears to be increasing in the two 
largest markets, North America and Europe. The 
prevalence of use of cocaine among the general pop- 
ulation and testing in the workforce suggest an 
increase in cocaine use in the United States. In 
Europe, early signs of increases in cocaine consump- 
tion, based on wastewater analysis, have been 
reported. 


The quantities of cocaine seized are also on the 
increase; they reach a record level of 864 tons in 
2015 worldwide. 


Cocaine trafficking expanding eastwards 


Although still comparatively small overall, there are 
indications that cocaine consumption in several 
countries in Asia continues to rise. Possible proof 
of this was a very large seizure (900 kg) of cocaine 
in Sri Lanka in 2016 and another of 500 kg in Dji- 
bouti in 2017, which was probably en route to Asia. 


Overall, in 2015, the quantities of cocaine inter- 
cepted in Asia increased by more than 40 per cent 
compared with the previous year, with increases 
reported across all subregions. 


Increasingly effective law enforcement 


Reflecting improvements in international coopera- 
tion, law enforcement seems to be becoming 
increasingly effective. Evidence of this is the fact 
that the estimated global interception rate of cocaine 
increased to between 45 and 55 per cent in 2015, 


WORLD DRUG REPORT 2017 


10 


a record level. The estimated global interception 
rate of opiates also rose from between 9 and 13 per 
cent during the period 1980-1997 to between 23 
and 32 per cent during the period 2009-2015. 


Crossover between plant-based and 
synthetic cannabinoids 


Synthetic cannabinoid receptor agonists were first 
reported in 2004 as new psychoactive substances 
(NPS). Synthetic cannabinoids are a diverse group 
of psychoactive substances that are dissimilar to tet- 
rahydrocannabinol (the principle psychoactive 
constituent of natural cannabis). 


Despite the predominance of synthetic cannabinoids 
on the spectrum of NPS, users of cannabis have 
reported that they prefer natural cannabis. The use 
of synthetic cannabinoids is perceived by users to 
be associated with more overall negative effects than 
the use of natural cannabis. Indeed, there is grow- 
ing recognition of the harms associated with 
intoxication resulting from the use of synthetic can- 
nabinoids. Such harms include tachycardia, 
psychosis, agitation, anxiety, breathing difficulties 
and seizures. It cannot be concluded, however, that 
the untoward or undesirable effects of synthetic can- 
nabinoids will limit their uptake or use. 


Most jurisdictions in the United States 
now permit access to medical cannabis 
while nine allow the cultivation of 
cannabis for recreational use 


The latest voter initiatives in the United States, in 
2016, allowed the legalization of cannabis for rec- 
reational use in an additional four states. Cultivation 
of cannabis for recreational use is now allowed in 
eight states and the District of Columbia. Of greater 
importance is that in those jurisdictions, with the 
exception of the District of Columbia, licences are 
now granted to for-profit companies to produce and 
sell a range of products for the medical and 
non-medical use of cannabis. 


In the jurisdictions where the recreational use of 
cannabis is now permitted, cannabis use has increased 
among the adult population and remains higher than 
the national average. This trend preceded the change 
in legislation in those jurisdictions, however. It is 
difficult to quantify the impact of the new cannabis 
legislation as it seems that a combination of elements 


was already in the process of changing the cannabis 
use market in those jurisdictions when the legaliza- 
tion measures were put in place. 


The major increase in cannabis use in those juris- 
dictions started in 2008, in parallel with measures 
allowing the medical use of cannabis (although the 
cannabis products dispensed have not gone through 
the rigours of pharmaceutical product development), 
decreasing risk perceptions of harm from cannabis 
use and an ongoing debate around the legalization 
of the medical and recreational use of cannabis. 
Since the approval of legalization measures, the 
increasing trend in cannabis use in those jurisdic- 
tions has continued. 


Yet while the increases in those jurisdictions are more 
marked than in states where such use has not been 
legalized, cannabis use has increased at the national 
level. The developments observed in the jurisdictions 
where the use of cannabis has been legalized (includ- 
ing the perception of risk of harm from cannabis 
use) appear to have affected the cannabis market 
and users’ perceptions of cannabis nationwide. It 
has been observed that increases in cannabis use 
across the United States are disproportionally asso- 
ciated with adults with a low socioeconomic status 
who are regular and heavy users of cannabis. 


Cannabis regulation in Uruguay 


In 2013, the Government of Uruguay approved 
legislation regulating the cultivation, production, 
dispensing and use of cannabis for recreational pur- 
poses. Since then, the Government has passed 
additional decrees and ordinances concerning the 
implementation of specific elements of the cannabis 
regulations. They include regulating the medical use 
of cannabis, the marketing and dispensation of can- 
nabis for recreational use, including through 
pharmacies, and the registration of recreational can- 
nabis users. However, the impact of the provisions 
regulating the recreational use of cannabis in Uru- 
guay will be evident only after they have been fully 
implemented, and will require close monitoring over 
time. 


INTRODUCTION 


Although presented as a stand-alone publication, 
this booklet constitutes the third chapter of the 
World Drug Report 2017. It presents market analysis 
for the three plant-based drugs — cocaine, opiates 
(opium, morphine and heroin) and cannabis — and 
examines current estimates and trends in their cul- 
tivation and production. The section on markets 
also examines recent developments in, and estimates 
of, seizures made on major trafficking routes and in 
destination countries, as well as significant develop- 
ments in the consumption of the plant-based drugs 
in all regions. 


million 
cannabis 


This booklet subsequently examines the major 
developments in the jurisdictions in the United 
States of America that have measures allowing 
cultivation of cannabis for recreational use, as well 
as issues surrounding the medical use of cannabis 
across the country. An analysis is presented of 
patterns and trends in cannabis use both among the 
adult and youth populations in those jurisdictions 
and in the United States as a whole. Finally, the 
booklet provides an update on the implementation 
of legislation in Uruguay regulating the recreational 
use of cannabis. 


million 
opiates 


Number of countries reporting drug seizures, 2010-2015 


rf 


164 


cannabis 


Bi, 


opiates 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


Global cultivation 


Global production 


Global seizures hoe 
heroin & morphine 


/ 


heroin § morphine 


Global number of users 


Notes: Data on cultivation and production/manufacture refer to 2016. Data on seizures and numbers of users refer to 2015. 
Seizures of different substances are of varying purity. Estimates of cultivation and eradication of opium poppy, production of opium, 
manufacture of heroin and prevalence of opioids and opiates use are available in the annex of booklet 2. 


Opium is illicitly produced in around 50 countries 
worldwide, with the main areas of production being 
located in three subregions. Countries in South-West 
Asia (mainly Afghanistan) supply markets in neigh- 
bouring countries and in countries in Europe, the 
Near and Middle East/South-West Asia, Africa and 
South Asia, with small proportions going to East 
and South-East Asia, North America and Oceania. 
Countries in South-East Asia (mainly Myanmar 
and, toa lesser extent, the Lao People’s Democratic 
Republic) supply markets in East and South-East 
Asia and in Oceania. Countries in Latin America 
(mostly Mexico, Colombia and Guatemala) mainly 
supply the United States of America and the more 
limited markets in South America. 


In 2016, the global area under opium poppy culti- 
vation increased in size by 8 per cent from the level 


of the previous year, to 304,800 hectares (ha), pri- 
marily reflecting an increase reported in the 
cultivation of opium poppy in Afghanistan that year 
(10 per cent). With 201,000 ha under opium poppy 
cultivation, Afghanistan accounted for roughly two 
thirds of the estimated global area under illicit 
opium poppy cultivation in 2016. 


No estimate of the area under opium poppy culti- 
vation in Myanmar in 2016 is available, but the 
2015 estimate was 55,000 ha, making Myanmar 
the world’s second largest opium-producing country 
that year (20 per cent of the total area under opium 
cultivation in 2015). A socioeconomic survey was, 
however, undertaken by the United Nations Office 
on Drugs and Crime (UNODC) in 2016 in Shan 
State,! which in recent years has accounted for 


1 UNODC and Myanmar, Central Committee for Drug Abuse 
Control, Evidence for Enhancing Resilience to Opium Poppy 
Cultivation in Shat State, Myanmar: Implications for Alterna- 
tive Development, Peace, and Stability (Bangkok, 2017). 


13 


WORLD DRUG REPORT 2017 


14 


FIG. 1 | Opium poppy cultivation and production of opium, 1998-20164 


8,000 320,000 
7,000 280,000 
wn 
= o 
2 6,000 240,000 & 
2 g 
= 5,000 200,000 £ 
2 < 
3 4,000 160,000 .S 
Ss WS 
mo) © 
© 3,000 120,000 2 
e 5 
2,000 80,000 9 
1,000 [| 40,000 
- 0 

oonoowteannmniedsg¥éuovyprnroowoaono0o#}>HNM THM © 

on 2 © es ee ee 

DNnDnDOTC]HA 8G CC CGO OO OOOO Oo oO Oo 

A AAN NNN NNN NNN NNN NNN LS 


Total area under cultivation 
= Production in other countries 
© Production in Mexico 
@ Production in Afghanistan 


Production in the Lao People's Democratic Republic, 
Mexico, Myanmar and other countries in 2016? 


@ Production in the Lao People's Democratic Republic 
@ Production in Myanmar 


Sources: UNODC calculations based on illicit crop monitoring surveys and responses to the annual report questionnaire. 


9 Only preliminary data are available for 2016. 


around 90 per cent of Myanmar’s total poppy cul- 
tivation and opium production. The survey revealed 
that the proportion of villages producing opium 
poppy fell from 31 per cent of all villages in Shan 
State in 2015 to 22 per cent in 2016: a decrease of 
almost 30 per cent. However, this trend has been 
offset by an increase in the size of the average area 
under opium poppy cultivation, from 0.4 ha to 0.6 
ha per household where cultivation is taking place, 
suggesting an increasing concentration of opium 
poppy cultivation in Shan State. At the same time, 
2016 saw an increase of 5 per cent in the price of 
opium, which may point to a decline in production 
(or an increase in demand). 


Based on 2014/2015 estimates (26,100 ha), the 
third largest area worldwide under opium poppy 
cultivation was identified as being that in Mexico. 
No estimate of the area under opium poppy 
cultivation in the Lao People’s Democratic Republic 
in 2016 is available, but the 2015 estimate was 
5,700 ha. 


Based on available cultivation and yield data, global 
opium production increased by more than 30 per 
cent from the level of the previous year, to around 


6,380 tons? in 2016. This increase was primarily a 
reflection of the rising level of opium production 
reported in Afghanistan (a 43 per cent increase from 
the level of the previous year), which was mainly 
the result ofa partial recovery in the extremely poor 
yields in its southern and western provinces recorded 
a year earlier. 


Of the 6,380 tons of opium produced worldwide 
in 2016, it is estimated that some 2,100 tons 
remained unprocessed for consumption as opium, 
while the rest was processed into heroin, resulting 
in an estimate of some 448 tons of heroin manu- 
factured worldwide (expressed at export purity). 


Seizures of opiates have decreased 
in recent years 


After a long-term upward trend since the beginning 
of the new millennium, global quantities of opiates 
seized, expressed in heroin equivalents, have been 


Ne 


Data for 2016 are still preliminary as information from 
other major producing countries, except Afghanistan, is 
still missing. Totals were calculated assuming that such 
cultivation and production remained unchanged from a 
year earlier. 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


FIG. 2 |Trends in the global interception rate of 
opiates, 1980-2015 
35 
£ 30 
=| 
=z 25 
BS 
a0 
ox 20 
25 
22 15 
cw 
=- & 
=z 10 
3 
5 5 
0) 
a2 of co nn 
oO 2 DD ne om= 
45 85 SR &a 


Sources: UNODC calculations based on illicit crop monitoring 
surveys and responses to the annual report questionnaire. 


Note: For details of the calculation methods, see the online 
methodology section of the present report. 


declining since 2011. That decline was exclusively 
the result of morphine seizures falling from a peak 
in 2011, when large amounts of morphine were 
seized in Afghanistan. Otherwise, seizures of both 
opium and heroin have remained quite stable at the 
global level in recent years, in line with a fluctuating, 
although overall stable, level of opium production. 


Largest seizures of opiates primarily in the 
Near and Middle East/South-West Asia 


Reflecting the high concentration of opium produc- 
tion in Afghanistan, the largest opiate seizures in 
2015 continued to be reported by countries in the 
Near and Middle East and South-West Asia, 
accounting for 97 per cent of the global quantity of 
opium, 94 per cent of morphine and 47 per cent of 
heroin seized that year. When all seizures of opiates, 
expressed in heroin equivalents, are considered, the 
Islamic Republic of Iran seized almost half (49 per 
cent) of the global total in 2015, followed by Paki- 
stan (16 per cent), China, Turkey and Afghanistan 
(6 per cent each) and the United States (5 per cent). 


In terms of seizures of heroin and morphine, Asia 
accounted for 70 per cent of the total quantity seized 
in 2015, while Europe accounted for 18 per cent 
and the Americas for 10 per cent, reflecting the 
concentration of opium production in Asia and 
Latin America, as well as opiate markets in Asia, 
Europe and North America. 


Seizures of heroin and morphine 
decreased in Europe in 2015, but 
continued to increase in the Americas 


The decrease in the quantities of heroin and mor- 
phine seized in Asia since the peak of 2011 came to 
a halt in 2015 when quantities intercepted stabilized. 


FIG. 3 | Countries reporting largest quantities of opiates seized, 2015 


Opium 
Iran (Islamic Iran (Islamic 
Republic of) Republic of) 
Pakistan Pakistan 
Afghanistan China 
France United States 
China Mexico 
United States India 
Colombia Colombia 
India Turkey 
Mexico Afghanistan 
Tajikistan Hungary 
Myanmar Canada 
Uzbekistan Russian 
Federation 


° 
8 is) 
te) o 
fo} a 
6 
a 


Seizures (kilograms) 


200,000 
300,000 
400,000 
500,000 


Source: UNODC, responses to the annual report questionnaire. 


Seizures (kilograms) 


Heroin 


Morphine 


Pakistan 
Iran (Islamic 
Republic of) 

China 


Turkey 
United States 


Afghanistan 
Russian 
Federation 
Viet Nam 


India 

United Kingdom 
Australia 
France 


2,000 
3,000 
4,000 
5,000 
6,000 
7,000 
8,000 


Seizures (kilograms) 


A 


15 


WORLD DRUG REPORT 2017 


16 


1G. 4 | Global opium production and quantities of opioids seized, 1988-2016 


9,000 
— 8,000 
vn 
5 7,000 
= 
> 6,000 
M4 
3 5,000 
2 4,000 
= 
5 3,000 
So 2,000 
1,000 
0 


Opium production 
Ma Heroin seizures 
= Seizures of pharmaceutical opioids 


Source: UNODC, responses to the annual report questionnaire. 


270 
240 
210 
180 
150 
120 


Opioid seizures (tons) 


2010 
2011 
2012 
2013 
2014 
2015 
2016 


ms Opium seizures in heroin equivalents 
lm Morphine seizures 


Note: A ratio of 10:1 was used to convert seizures of opium into seizures expressed in heroin equivalents. 


In Europe, on the other hand, the quantities of 
heroin and morphine seized, which had been 
increasing over the period 2011-2014, fell in 2015, 
particularly in West and Central Europe (-56 per 
cent). 


By contrast, the quantities of heroin and morphine 
seized in 2015 continued to increase in the Ameri- 
cas, particularly in North America (+21 per cent 
from the previous year). 


Seizures of pharmaceutical opioids have 
reached the second-highest level ever 
reported 


Largely linked to very large seizures of codeine and 
to comparatively smaller seizures of tramadol and 
buprenorphine, reported quantities of pharmaceuti- 
cal opioids seized grew exponentially in 2014, 
exceeding global seizures of opiates (expressed in 
heroin equivalents) for the first time ever. Most of 
the pharmaceutical opioids intercepted in 2014 were 
reported by countries in South Asia, followed by 
countries in the Near and Middle East, suggesting 
significant levels of diversion and misuse of such 
substances in those subregions. 


Although overall quantities of pharmaceutical opi- 
oids seized decreased in 2015, they were still larger 
than global heroin seizures and remained very high 
compared with the quantities intercepted before the 


peak of 2014. In 2015, pharmaceutical opioid sei- 
zures were dominated by tramadol, which, in terms 
of weight, increased more than fourfold from the 
level of the previous year. The largest seizures of 
pharmaceutical opioids in 2015 were reported in 
Africa, most notably in West and Central Africa, 
where large amounts of tramadol were seized, 
whereas most of the tramadol seized in the previous 
year was seized in countries in the Near and Middle 
East. The overall decline in seizures of pharmaceuti- 
cal opioids in 2015 was primarily linked to smaller 
quantities of codeine being seized in South Asia in 
2015 than in the previous year (for more details see 


booklet 2). 


Most opiates continue to be trafficked 
along the Balkan route 


The main trafficking routes of opiates out of Afghan- 
istan remain the so-called Balkan route (via the 
Islamic Republic of Iran and Turkey to West and 
Central Europe); the southern route (to South Asia, 
Gulf countries and other countries in the Near and 
Middle East and in Africa); and the northern route 
(through Central Asia to the Russian Federation). 
Seizures of heroin and morphine made along these 
routes (plus seizures made in Afghanistan, Pakistan 
and West and Central Europe) accounted for 75 per 
cent of global heroin and morphine seizures in 2015. 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


A 


FIG. 5 | Quantities of heroin and morphine FIG. 6 | Distribution of global quantities of heroin 
seized, by region, 1998-2015 and morphine seized in 2015 (N= 90 tons) 
160 
ne 6 ; Africa 
ceania 
§ 190 1% 1% Near and Middle East/ 
== South-West Asia 52% 
g 100 Americas 
2 80 10% 
> 
= 60 
= East and 
- 40 South-East 
Oo 20 Europe Asia 14% 
0 18% | South Asia 
WDHNDOANMNTNORWMDOANMT ——— 2% 
ONnooooooqooqoqoodtt dst tt dat et a 
NAMRNOoDWDWWGOACDVDGOCGVCCGVCCCOCCO FO A 
AANNNNNNNNNNNNN NN Central Asia and 
Transcaucasian countries 
@ Europe m& Americas Oceania 2% 
© Africa = Asia 
Source: UNODC, based on responses to the annual report Sources: UNODC, based on responses to the annual report questionnaire; 
questionnaire. and other government sources. 


FIG. 7 | Percentage distribution of quantities of heroin and morphine seized, by main trafficking 
route,? 1998-2015 


Seizures related to 
Afghan opiates 


Americas 

South-East Asia/Oceania 
Northern route 

Southern route 

Pakistan 

Balkan route 

Western and Central Europe 
Afghanistan 


~ D lee} 
oO oO oO 


(percentage) 


N 
fo) 


Proportion of global seizures 


oO 


ao DD Oo 
Dn BD OO 
a D O 
a AON 


2002 
2003 
2004 
2005 
2006 
2007 
2008 
2009 


2001 
2010 
2011 
2012 
2013 
2014 
2015 


9 Balkan route: Islamic Republic of Iran, South-Eastern Europe; southern route: South Asia, Gulf countries and other countries in the Near 
and Middle East, Africa; northern route: Central Asia and Transcaucasia, Eastern Europe. 


Source : UNODC calculations, based on responses to the annual report questionnaire. 


Seizure data suggest that the world’s largest opi- on the Balkan route in 2015, the largest quantities 
ate-related trafficking activities continue to take _ were seized in the Islamic Republic of Iran (24.4 
place along the Balkan route. Overall, 37 per cent tons), Turkey (8.3 tons) and the Balkan countries 
of the global quantity of heroin and morphine seized of South-Eastern Europe (0.9 tons). 


were reported by countries heavily affected by the THe importance of trafficking of Afghan opiates 


trafficking of Afghan opiates along the Balkan route through the Balkan route is difficult to assess because 
in 2015, or 43 per cent if seizures made in Westand a number of countries may be affected by different 
Central Europe are included (most of the quantities trafficking routes. For example, countries in Western 
seized in that subregion are related to trafficking via and Central Europe may be supplied with Afghan 
the Balkan route). A breakdown of seizures shows _ opiates via both the Balkan route and the southern 
that of the 34 tons of heroin and morphine seized _ route. Another example is Pakistan, which reported 


17 


‘(seulnjeW) 

spue|s] Pue/y/C4 BY} JAAO ALUBIaJaAOS HujusaUOD PUejad] UIBYLION Pue ulejG JeaID JO WOpPbuly payiufy ay, pue euljuabily JO SJUBWLUAAOH ay) UaaMjaq s}sIXa ajNdSIp \v pauiuajap Uaaq JaA JOU sey UePNS 
yinos pue uepns ay} uaamjaq Alepunog Jeuly ays ‘sayed ay} Aq uodn paaibe uaag Jaf JOU sey sIWIYysey pUe NUIWeS JO sN}eIs /eUY BY] ‘Ue}SI¥eY Pue elpuj Aq uodn paaibe JWYsey pUue NWUWEeF Ul /O1]UOD 

{0 aul] ay} Ajazewixoidde s}uasaida/ aul] PaLJOP ay ‘salepUNOG pPaulWiaj}apuN juasasdas saul] payseq ‘suoeN payUN ay} Aq aduezdarre JO JUaWAsJOpUA /eIDY4O AJdwI JOU OP dew siy} UO UMOYS salepUNoG 
ay! ‘Bulyayje. JO UO/JEUN}SAP 1X9U JO BUO AY} JO UONAWNSUOD JO ease AY) JOYA BJEI/PUl SMOIE JO S]UIOd Pua ‘ADUCUAAOJ }Se/ JO GUO AY] JO aINJIeJ/NUeW JO Base AY] JOYA BLCd/PUl SMOE AY) 4O SUIBLIO ‘Bul 
-YDUJel] JO UOI]IaJIP BY} JUaSaIdas SMOLIE MO/{ ‘Pa}Ia/Jas aq JOU ABW SMO}} AJEPUOIAS [JAAS A/IYM saznos Hulydije1 Huyjsixa JO aeripul Ajpeoig se pasap|suod aq 0} ase Ady} ‘ydNs se :aseqejep ainzias np 
Jenpiaipul pue asjeuuoljsanb yiodas jenuue ay} ul sajers Jaquiayy Aq payiodas se snp pazias so uojeuljsap pue ysued ‘ainuedap/ulblo JO AUNOD Jo siseq ay} UO pauiWajap ase SMO, BUlyDJl}] AY] !SAI0N 


‘aseqejep aunzias Bnip jenpiaipul pue asleuuonsanb Yoda jenuue 0} sasuodsai UO paseg ‘uO!eJoge|a DGONN :s821N0S 


anol UJaYyINOS <———— 
91NOJ WaYWON <t 
anol ueyjeg 


ybyy ul padnpoid sajeido jo 
pauoluaw Ajjuanbe. SO)! mm 


VOINANV s,a|doag oe/sewuUeAY\ Ul U 
AMOS. Aq pajersuab Buppyjen uloaH 


a uawy Ue] 
: Aq payejouab bu 


UGd CGT” 


/ se] 8|PP! f 
sewuekyy aa ® eee ; § 
/ PF yin5 uelsiad elpul 
7 ueysIxed 


eoUaWYy JO 
saves poyun 


TWYLNd> 
epeued 


uoljeiapay 
ueissny 


GLOZ-LLOZ ‘SMo|} BurPyjen azeido Ule/| 


ZL02 LYOd3dY ONYG ATYOM 


18 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


very large seizures in 2015 (17 tons) that were often 
destined for countries on the southern route, while 
the Islamic Republic of Iran reported that 85 per 
cent of the heroin it seized in 2015 transited Paki- 
stan prior to arriving on Iranian soil. 


Emergence of a new trafficking route to 
Europe via the Caucasus 


While overall seizures made along the Balkan route 
declined in 2015, an alternative branch of the route, 
through the Caucasus, seems to have been gaining 
in importance in recent years.>> 4 That route circum- 
vents Turkey, where the recent increase in flows of 
refugees heading towards countries in the European 
Union may have pushed traffickers to seek other 
options. 


Heroin trafficked along this route is shipped from 
the Islamic Republic of Iran to Armenia or Azerbai- 
jan and then to Georgia for shipment by sea to 
Ukraine (often Odessa) before being trafficked to 
Romania (or the Republic of Moldova), or directly 
from Georgia to ports along the Black Sea in Euro- 
pean Union countries (notably Romania), before 
re-entering the eastern branch of the main Balkan 
route in Romania for trafficking onward to the 
Netherlands (93 per cent of heroin trafficked into 
Romania, according to Romanian authorities in 
2015) and other countries in West and Central 
Europe. Romania, where for years the bulk of the 
heroin had previously transited Bulgaria (71 per 
cent in 2014), reported for the first time in 2015 
that the vast majority (93 per cent) of it had tran- 
sited Ukraine and only a small proportion (7 per 
cent) had transited Bulgaria. 


While the northern route maintains 
its relative importance, changes in the 
southern route are less clear 


Accounting for 5 per cent of total quantities of mor- 
phine and heroin seized in 2015, the next largest 
seizures reported in relation to Afghan opiates were 
made on the northern route. Most of the heroin 
destined for the northern route leaves Afghanistan 


Go 


Europol, SOCTA 2017: European Union Serious Organized 
Crime Threat Assessment (Crime in the Age of Technology 
(The Hague, 2017), p. 38. 

4 Individual seizures from the Drugs Monitoring Platform. 
For further information, see http://drugsmonitoring.unodc- 


roca.org. 


FIG. 8 | Quantities of heroin seized on the 
traditional Balkan route versus along 
the Caucasus branch of the Balkan 
route, 2009-2015 
Heroin and morphine seizures in 

Bulgaria, Greece and Turkey 
_ 20,000 
wn 
é 
> 15,000 
2 
= 
> 10,000 
ov 
x 
ra 
. 5,000 
ZB 
c 
& () 
=) a ° a N ~” + un 
= 8S 5 8 8 & 8 8 
N N N N N N N 
(le Turkey Ml Greece 


Ml Bulgaria - = = Trend 
Heroin and morphine seizures in 
the Caucasus countries,? Ukraine, the Republic of 
Moldova and Romania 


N 
[=] 
jo) 
oO 


Quantity seized (kilograms) 
6 
io} 
Oo 


500 
0 
a oO La. N foe) t+ wn 
fo} —t —t 1 oes bes ot cA 
oO oO fo) fo) fo) fo) fo) 
N N N N N N N 
(ll Caucasus MES Ukraine 


' Rep. of Moldova MEE Romania 
— — —Trend 


4 Armenia, Azerbaijan and Georgia. 
Source: UNODC, responses to the annual report questionnaire. 


via Tajikistan for onward trafficking either directly 
to Kazakhstan, or to Kyrgyzstan or Uzbekistan and 
subsequent trafficking to Kazakhstan and the Rus- 
sian Federation. The trafficking of heroin via 
Turkmenistan, which shares a long border with 
Afghanistan, has not played much of a role so far, 
but that could change with the emergence of the 
Afghan province of Badghis, bordering Turkmeni- 
stan, as one of key opium-producing provinces in 
Afghanistan in 2016. At the same time, a route from 
Afghanistan to Pakistan and the Islamic Republic 


A 


19 


WORLD DRUG REPORT 2017 


20 


of Iran, the Caucasus countries and the Russian Fed- 
eration has also been developing. The Russian 
Federation reported that some 20 per cent of the 
heroin seized on its territory in 2015 had been traf- 
ficked by this route. 


Afghan opiates trafficked on the southern route go 
to Pakistan (and partly to the Islamic Republic of 
Iran) for subsequent shipment to the Gulf countries 
and East Africa for shipment to Europe, either 
directly by air or via Southern or West Africa by air 
or by sea. Alternatively, drugs are trafficked along 
the southern route to India and other countries in 
South Asia for subsequent shipment to Europe or 
North America (mostly Canada). Countries in West 
and Central Europe reported that an average of 
roughly 6 per cent of the heroin found on their 
markets in 2015 had transited the southern route 
while 2 per cent had been directly shipped to Europe 
(mainly by air), although that figure differs greatly 
from country to country. The European countries 
most affected by opiates trafficked on the southern 
route in recent years are Belgium, Italy and possibly 
the United Kingdom of Great Britain and Northern 
Ireland. In 2015, almost 35 per cent of the heroin 
found in Belgium had transited the southern route 
(mainly via Burundi and Ethiopia). It was also 
reported that 12 per cent of the heroin found in 
Italy had transited the southern route (Qatar and 
the United Arab Emirates), while 9 per cent had 
transited Pakistan. Some 14 per cent of the heroin 
found in Germany was reported to have transited 
India, and France reported that 10 per cent had 
transited Madagascar in 2015. 


The portion of the global quantity of opiates traf- 
ficked via the southern route (as reflected in 
quantities seized) has fluctuated over the years; down 
from a peak of 9 per cent in 2014, it accounted for 
3 per cent of the global quantity of heroin and mor- 
phine seized in 2015. This decline was primarily the 
result of smaller quantities of heroin seized being 
reported by countries in Africa, where reported sei- 
zures of heroin and morphine fell from 7.1 tons in 
2014 to 0.7 tons in 2015. However, UNODC is 
aware of seizures, totalling more than 2.1 tons of 
high purity heroin, made in international waters off 
the coast of East Africa in 2015 by the Combined 
Maritime Forces, which were not included in reports 
of heroin seizures by Member States. 


The importance of the southern route in the traf- 
ficking of Afghan opiates is difficult to assess because 
of the weak capacity of interdiction and reporting 
of Member States in Africa. In addition, some of 
the opiates that transit Pakistan are destined for mar- 
kets supplied via the southern route. Opiates seized 
in Pakistan increased sharply from 8 per cent in 
2014 to represent 19 per cent of the global quantity 
intercepted in 2015, with the United Kingdom, 
Saudi Arabia and the United Arab Emirates (the 
latter country also for trafficking to other destina- 
tion markets) being reported as main destination 
countries. 


Seizures of opiates out of 
South-East Asia on the increase 


The markets supplied by opium produced in South- 
East Asia (notably Myanmar) are China and other 
countries in South-East Asia and Oceania. Little is 
currently known about trafficking flows from South- 
East Asia to Europe, Africa and the Americas. This 
is worth mentioning as in the past those regions 
were also supplied with opiates produced in South- 
East Asia (Europe in the 1970s; the United States 
from the late 1980s to the mid-1990s).5 


In line with increases in opium production reported 
in South-East Asia in recent years (30 per cent over 
the period 2010-2015), heroin and morphine sei- 
zures related to opiates produced in South-East Asia 
rose by 88 per cent, from 7.1 to 13.3 tons, over the 
period 2010-2015. This resulted in an increase in 
the overall proportion of heroin and morphine 
seized in countries predominantly supplied by opi- 
ates produced in Myanmar from 7 per cent of the 
global total in 2010 to 15 per cent of the global total 
in 2015. While the Australian authorities reported 
that just 26 per cent of the heroin they seized in 
2008 had originated in South-East Asia (Myanmar), 
the proportion rose to 90 per cent in 2014 and 98 
per cent over the period January-June 2015.° Simi- 
larly, the vast majority of the large quantities of 
heroin seized nowadays in China originates in 
Myanmar. 


wn 


United States Department of Justice, Drug Enforcement 
Administration , 2016 National Drug Threat Assessment 
Summary (November 2016), p. 47. 

6 Australian Criminal Intelligence Commission, Mlicit Drug 
Data Report 2014-15 (Canberra, 2016), p. 77. 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


FIG. 9 | Quantities of heroin and morphine 
seized in countries supplied by opiates 
produced in South-East Asia, 


1998-2015 


Quantity seized (kilograms) 


one 
Ano 
Ano 
eet 


m East and South-East Asia 
™ Oceania 


Source: UNODC, responses to the annual report questionnaire. 


Seizures of opiates out of Latin 
America also on the increase 


Opium and heroin produced in Latin America, most 
notably in Mexico, Colombia and Guatemala, is 
primarily destined for the United States market and, 
to a lesser extent, for local markets in Latin America. 
Exports from Latin America to other regions are 
still the exception; only Ecuador reported some small 
seizures of heroin in 2015 that were bound for 
Spain. Heroin seized in Canada originates mostly 
in South-West Asia. 


Reported quantities of heroin and morphine seized 
in North America increased by over 80 per cent in 
the last five years, from 4.4 tons in 2010 to 8 tons 
in 2015. In 2015, the proportion of heroin and 
morphine seizures linked to Latin American opiate 
production thus reached 10 per cent of the global 
total of heroin and morphine seizures. This went 
hand in hand with a reported heroin epidemic in 
the United States, where there has been a sharp 
increase in heroin-related deaths in recent years 
(booklet 2). According to the Heroin Signature Pro- 
gram of the Drug Enforcement Administration 
(DEA) of the United States, from the beginning of 
the new millennium to 2010 the bulk of the heroin 
in the United States market originated in Colombia, 
but that proportion subsequently declined as the 
proportion of heroin originating in Mexico 


Quantity seized (kilograms) 


FIG. 10 | Quantities of heroin and morphine seized 
in countries supplied by opiates produced 
in Latin America, 1998-2015 


onowrAannmnTnNnNWORWADOAANMNTY 
Onmnoooqonooonooce eae st ota 
NARMDOoDWWOWDWGAGGVCCDCGVCCGWCCCCCOCCO SO 
AANNNNNNNNNNNNNN Se 


South and Central America, Caribbean 
© North America 


Source: UNODC, responses to the annual report questionnaire. 


increased, reaching a proportion of 79 per cent of 
all heroin samples analysed in 2014, with most of 
the rest originating in Colombia and only 1 per cent 
in South-West Asia (i.e., Afghanistan).” There is, 
however, still a significant regional difference in the 
origin of heroin supplied to the United States 
market: almost all of the heroin found in cities in 
the western United States is of Mexican origin, while 
the bulk of heroin found in cities in the eastern 
United States still originates in South America 
(mainly Colombia).® 


The global opiate market 
appears stable 


Affecting some 0.4 per cent of the world population 
aged 15-64 years — the same proportion as in pre- 
vious years? — the global number of opiate users 
(i.e., users of opium, morphine and heroin) contin- 
ued to increase, although marginally, from 17.3 
million in 2014 to 17.7 million in 2015. 


At the global level, expert perceptions suggest that 
heroin use has been decreasing slightly since 2009, 
while opium use has remained largely stable. 


7 United States Drug Enforcement Administration, 2016 
National Drug Threat Assessment Summary, p. 47. 

8 Ibid., p. 48. 

9 — It must be noted, however, that these data only reflect 

trends in the parts of the world where data are available. 


A 


21 


WORLD DRUG REPORT 2017 


22 


FIG. 11 | Estimated number of global opiate 
users and opiate use perception index, 
1998-2015 

500 

400 

300 

200 

100 

0 

-100 

-200 

-300 

-400 

-500 


=0) 


Number of users (millions) 
Perception index (1998 


co oO 
aA Oo 
aA Oo 
a ON 


mm Estimated number of opiate users 


2004 
2006 
2008 


2002 
2010 
2012 
2014 


Heroin use perception index 
——— Opium use perception index 


Source: UNODC calculations, based on responses to the 
annual report questionnaire. 


Note: For details of the calculation methods, see the online 
methodology section of the present report. 


Differences in subregional trends remain significant, 
however. 


The prevalence of opiate use among the population 
aged 15-64 years continues to be relatively high in 
the Near and Middle East/South-West Asia (1.4 per 
cent), Central Asia (0.9 per cent), Europe (0.6 per 
cent) and North America (0.5 per cent). 


Tentative signs of an expansion of the 
opiate market in Europe 


A number of indicators suggest that the long-term 
downward trend in opiate use (since the late 1990s) 
may have come to an end. UNODC estimates of 
the overall prevalence of opiate use in Europe have 
shown a marginal upward trend since 2010.19 Such 
an increase has been reported most notably in Italy, 
where the rate of problem drug use related to the 
use of opioids increased from 0.45 per cent of the 
population aged 15-64 years in 2012 to 0.52 per 
cent in 2014, and heroin use, reflected in national 
household surveys, actually doubled between 2008 
and 2014, from 0.4 per cent to 0.8 per cent. There 
was also a slight increase in Czechia, where the preva- 
lence rate of problem drug use related to the use of 
opiates rose from 0.13 per cent in 2011 to 0.16 per 
cent in 2014, and in Cyprus, which reported an 
increase from 0.11 per cent in 2010 to 0.18 per cent 


10 World Drug Report 2017 (Booklet 2) and previous years. 


in 2014.!! In the last few years, increases in opiate 
use have also been reported by Latvia (2014), Liech- 
tenstein (2014), France (2013) and Estonia (2011). 
However, at present more countries continue to 
report decreases than increases in opiate use, and 
the majority of European countries continue to 
report overall stable levels of opiate use. 


In parallel to the possible increase in opiate use in 
Europe, there have been some reports of a rising 
number of deaths involving opiates in recent years. 
Following a decline in drug-related deaths in Ger- 
many, from 2,030 deaths in 2000 to 944 deaths in 
2012, which were to a large extent related to the use 
of opiates, drug-related deaths increased to 1,032 
cases in 2014 and 1,226 cases in 2015, which is 
equivalent to an increase of 30 per cent over the 
period 2012-2015.!2 Moreover, opioid-related 
deaths in England and Wales rose by 54 per cent, 
from 1,290 cases in 2012 to 1,989 in 2015, and 
deaths linked to heroin and/or morphine actually 
doubled over the period 2012-2015, from 579 to 
1,201 cases.!3 


FIG. 12 | Prevalence of problem opiate use 
in Western and Central Europe, 
2003-2015 


15-64 (percentage) 


oT nwo RWOD 
oo ooegsd & 
ooocmUcrmWUCUCUWUCOOUUCUCO 
NNN NNN SN 


m= Western and Central Europe 


Prevalence among the population aged 
2010 
2011 
2012 
2013 
2014 
2015 


Sources: UNODC calculations, based on responses to the 
annual report questionnaire and the European Monitoring 
Centre for Drugs and Drug Addiction (EMCDDA), Statistical 
Bulletin 2016 and previous years. 


11 EMCDDA, Statistical Bulletin 2016, Data and statistics, 
Problem drug use: Opioids—Trends. Available at www. 
emcdda.europa.eu/data/stats2016. 

12 Germany, Bundeskriminalamt, “Rauschgiftkriminalitat: 
Bundeslagebild 2015” (Wiesbadean, 2015) (and previous 
years). 


13. United Kingdom, Office for National Statistics, “Deaths 


MARKET ANALYSIS OF PLANT-BASED DRUGS A. The opiate market 


Significant increases in the number of deaths have 
also been reported by Portugal and Romania in 
recent years. In Portugal, the number of drug-related 
deaths (mostly attributable to opiates) rose from 19 
cases in 2011 to 37 cases in 2014, while they 
increased from 15 to 36 cases over the same period 
in Romania, !4 with opioids responsible for the high- 
est proportion of deaths among all drug groups. 


The opiate market in North America 
continues to grow 


Heroin use has been increasing for some time in 
North America, particularly in the United States, 
as reflected in both national household surveys and 
in heroin-related deaths. The proportion of heroin- 
related deaths per 100,000 inhabitants quadrupled 
between 2010 and 2015, clearly exceeding growth 
in overall opioid-related deaths, which almost dou- 
bled (from 6.8 to 10.4 per 100,000 inhabitants), 
and all drug-related deaths, which rose by a third 
over the period 2010-2015 (from 12.9 to 17.2 per 
100,000 population).!> 


Africa seems to be experiencing some of 
the sharpest increases in heroin use 


Information on the prevalence of opiate use in Africa 
and in Asia is very limited, making it difficult to 
identify solid trends; data reported in those regions 
must be interpreted with caution. Based on trend 
perceptions reported to UNODC by Member 
States, heroin use in Africa appears to have increased 
more than in other regions (followed by the Ameri- 
cas) over the period 2000-2015, reflecting the 
increasing spillover effect of heroin trafficking along 
the southern route. Increases in the use of opioids 
(primarily reflecting heroin use) in 2015 in East 
Africa were reported by Kenya and the United 
Republic of Tanzania, in Southern Africa by Mozam- 
bique, Zambia (and, in 2012, by South Africa), and 
in West and Central Africa by Nigeria and Céte 
CIvoire. 


In Asia, although heroin use is perceived to have 
declined slightly since 2010, it still seems to be 


related to drug poisoning in England and Wales: 2015 reg- 
istrations”, Statistical Bulletin (September 2016). 

14 UNODG, annual report questionnaire, 2015; EMCDDA, 
Statistical Bulletin 2016, Data and statistics. 

15 For more details, see Booklet 2 of the World Drug Report 
2017. 


FIG. 13 Annual prevalence of heroin use and 
heroin-related deaths in the United 
States, 2000-2015 


o 
c 
gs 4 o 
c=) 

o c 
s 3ev 
— 3 7 3 
29 st 
ov as 
ot (7) 
oe $ as) 
So. 2 [oa 
~ oO vo 
—) va 
o Ff A 
y ~ 

a ¢ 0 5 
50 1 cs 
gS 53 
a e 2 
2 Es 
~~ (0) ¢ 
o oo 
o ° ra) © a nN Ln en 
a rr) ° ) ro) a a Sa 
ro) rr) rr) rr) r=) ° 2 

N N N N N N g 

F 2 

(mm Prevalence of heroin use a 


Heroin-related deaths 


Source: United States, Substance Abuse and Mental Health 
Services Administration (SAMHSA), Center for Behavioral 
Health Statistics and Quality, Key Substance Use and Mental 
Health Indicators in the United States: Results from the 2015 
National Survey on Drug Use and Health, HS Publication No. 
SMA 16-4984, NSDUH Series H-5 (Rockville, Maryland, 2016) 
and Centers for Disease Control and Prevention, National 
Center for Health Statistics, Multiple cause of death data. 
Available at https://wonder.cdc.gov/mcd.html (last reviewed 
December 2016). 


higher now than in 2000. In 2015, declines in 
heroin use were perceived to have taken place in 
some countries in Central Asia and Transcaucasia 
(Kazakhstan, Kyrgyzstan and Uzbekistan), in South- 
East Asia (China (including Hong Kong, China) 
and Indonesia) and in the Near and Middle East 
(Qatar and the Syrian Arab Republic). In a few 
countries, however, there were perceived increases 
in heroin use in 2015, mostly linked to the traffick- 
ing of Afghan opiates; those countries included 
Afghanistan, several of its neighbouring States (Iran 
(Islamic Republic of), Pakistan and Tajikistan) and 
one Gulf country (United Arab Emirates), all of 
which are also used as transhipment locations. 


Information for India as a whole is not available, 
but there are indications of an increasing trend in 
the use of opioids in the Indian State of Punjab, 
bordering Pakistan. According to a study conducted 
in 2015, Punjab, which accounts for 2.2 per cent 
of India’s total population,!© was reported to have 
around 860,000 users of opioids (0.5 per cent of 


16 India, Ministry of Home Affairs, Office of the Registrar 
General and Census Commissioner, 2011 Census Data, 
Population. Available at www.censusindia.gov.in/. 


A 


23 


WORLD DRUG REPORT 2017 


24 


the population aged 15-64 years), including 230,000 
who were dependent on opioids and nearly 75,000 
who injected opioids. The study concluded that the 
new data for Punjab point to an increase in opioid 
use since the last national survey in 2001, which 
estimated that some 500,000 people in India were 
opioid dependent.!7 


Heroin use in Oceania declined over the period 
2000-2015, in line with reports of declines in heroin 
use in Australia and New Zealand. Latest annual 
prevalence data for Australia showed a decline in 
heroin use, from 0.2 per cent of the population aged 
14 years and older (heroin use had been at that level 
ever since the drastic fall following the heroin 
drought of 2001) to 0.1 per cent in 2013.18 


17 India, Society for Promotion of Youth and Masses, National 
Drug Dependence Treatment Centre and All India Institute 
of Medical Sciences, “Punjab opioid dependency survey: 
estimation of the size of opioid dependent population in 
Punjab”, brief report (2015). 

18 Australian Institute of Health and Welfare, 2103 National 
Drug Strategy Household Survey Detailed Report, Drug statis- 
tics series No. 28 (Canberra, 2014). 


FIG. 14 | Heroin use perception index, by region 


180 

Ss 170 

u = =160 

S 

= 

— 140 

a 

mw 10 

‘= 120 

c 

2 110 

2 

@ 100 

5 9 

oO 0 

a 

80 ! 

OvrvndmMr TF uNnwWORWDHOANMN TY 
oooooqooqoqoqo oot tt dt se a 
oooooqoqoooooo0o0oce0o fo 
NNNNNNNNNNN NNN Se 
== Africa ——— Americas 
— Asia Europe 


== Oceania 


UNODC calculations, based on responses to the annual report 
questionnaire 

Note: For details of the calculation method, see the online meth- 
odology section of the present report. 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


Global cultivation 


48 (2015) 
RNS 


x 
= 

t~ 
S 
[-"} 
(t} 
[--] 
[a 
% 

Gq 


Global production 


Global seizures 


364 
tons 


cocaine as seized 


Note: Data refer to 2015. Seizures are of cocaine of varying purity. Estimates of illicit cultivation and eradication of coca bush, manufacture 
of cocaine and prevalence of cocaine use are available in the annex of booklet 2. 


Coca bush cultivation fluctuated within an overall 
downward trend from its peak in 2000 to 2013. The 
trend was then reversed, with the total area under 
coca bush cultivation increasing by 30 per cent over 
the period 2013-2015, to return to the level reported 
in 2011. That increase was driven by a doubling of 
the area under coca bush cultivation in Colombia 
— by 44 per cent in 2014 and by 39 per cent in 
2015, to reach 96,000 ha. This may have been a 
consequence of different dynamics: a decrease in the 
perception among farmers of the risk of being 
affected by eradication (aerial spraying fell by 33 per 
cent from the previous year to 37,200 ha in 2015, 
and in October 2015 aerial eradication was com- 
pletely abandoned by the Colombian Government); 
local phenomena affecting the licit economy (for 
example, drought in Antioquia and southern Bolivar 
in 2015); and higher coca leaf prices. The increase 


was also related to the peace negotiations that led 
to expectations among farmers that they would ben- 
efit from alternative development and be in a 
stronger position to negotiate with the authorities 
if engaged in coca bush cultivation.!? Nonetheless, 
coca bush cultivation in Colombia in 2015 was still 
41 per cent lower than at its peak in 2000, a conse- 
quence of initially strong eradication efforts in 
combination with improved alternative development 
activities, particularly after 2007.29 


In Peru, the area under coca bush cultivation 
decreased after 2011, dropping to 40,300 ha in 
2015, which may have been the result of improved 
alternative development activities and increased 
eradication efforts (as reported by the Government). 


19 UNODC and Colombia, Colombia: Coca Cultivation Survey 
2016 (July 2016), p. 13 and Colombia: Coca Cultivation 
Survey 2014 (July 2015), p. 13. 

20 World Drug Report 2015 (United Nations publications, 
Sales No. E.15.X1.6), p. 113. 


25 


1/ 


n417 
O 


) ( 


WORLD DRUG REPORT 


26 


FIG. 15 | Global coca cultivation and cocaine manufacture, 1998-2015 


350,000 
300,000 
250,000 
200,000 
150,000 


100,000 


Area under coca cultivation 
(hectares) 


50,000 


0 


2004 
2005 
2006 


1998 
1999 
2000 
2001 
2002 | 
2003 


mmm Colombia (ha) 
mam Bolivia (Plurinational State of) (ha) 


2007 
2008 
2009 


Global cocaine manufacture (“new” conversion ratio) 


Potential manufacture of cocaine 
at 100 per cent purity (tons) 


2010 
2011 
2012 
2013 
2014 
2015 


mums Peru (ha) 
~=-=- Global cocaine manufacture 
(“old” conversion ratio) 


Sources: UNODC, coca cultivation surveys in Bolivia (Plurinational State of), Colombia and Peru, 2014 and previous years. 


Such efforts reached a record level of 35,900 ha of 
eradicated coca bush cultivation in 2015, up from 
12,000 ha in 2010.2! Similarly, in the Plurinational 
State of Bolivia, coca bush cultivation over the 
period 2010-2015 fell by 35 per cent, to 20,200 ha, 
reflecting, inter alia, its “politicas de control social 
en coordinacién con las organizaciones sociales pro- 
ductoras de coca’ (policy based on “voluntary” 
reductions in coca cultivation in the coca-growing 
areas, limiting cultivation to a maximum of | cato 
per family) ,23, 24, 25, 26 which went in parallel with 


eradication (as reported by the Government), par- 
ticularly in national parks and other areas outside 
accepted cultivation areas. Overall, coca bush eradi- 
cation almost doubled in the Plurinational State of 
Bolivia, from around 6,000 ha per year over the 
period 2005-2009 to around 11,000 ha per year 
over the period 2011-2015.27 


The total level of cocaine manufacture worldwide 
is estimated based on the area under cultivation, 
coca yield estimates and cocaine lab efficiency. The 
2015 estimate (expressed at 100 per cent purity) for 
the three Andean countries, Bolivia (Plurinational 
State of), Columbia and Peru, increased to 1,125 
tons28 and thus returned to the level seen in 2008. 
Global cocaine manufacture (based on the new con- 
version ratios)?? was 19 per cent higher than in the 
previous year and 25 per cent higher than in 2013. 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


FIG. 16 | Estimated global cocaine interception rates, 1980-2015 


60% 


50% 


40% 


30% 


20% 


10% 


Global interception rate 
(percentage) 


0% 


1980- 
1989 
1997 


1 
jo) 
a 
fop) 
ad 


1998- 
2008 
2009- 
2015 


60% 


50% 


40% 


30% 


20% 


10% 


Global interception rate 
(percentage) 


0% 


2010 
2011 
2012 
2013 
2014 
2015 


Sources: UNODC calculations, based on coca bush cultivation surveys, responses to the annual report questionnaire; and govern- 


ment reports. 


Note: Purity adjustment of seizures based on average unweighted purities at the global level. For details of the calculation methods, see 


the online methodology section of the present report. 


FIG. 17 | Global quantities of cocaine seized,@ by 
region, 1998-2015 

900 

800 

700 

600 

500 


0 
onoaAANMNTNWRWHDOANM TW 
Onmnoooqoqoqooqoqoo Ont tt te st ae a 
aAnDOOd oooo oo oooo0ocoo 
AANNNNNNNNNNNNNNN SS 


m= South America = Central America 


© Caribbean North America 

@ Western and Central Europe Other Europe 
Africa © Asia 

m@ Oceania 


4 Includes cocaine hydrochloride, coca paste and base, and “crack” 
cocaine; not adjusted for purity. 


Source: UNODC, responses to the annual report questionnaire. 


Record cocaine seizures in 2015, 
trafficked primarily from South 
America to North America, Western 
and Central Europe 


In 2015, global cocaine seizures rose 32 per cent 
from the level of the previous year to reach 864 tons 
(of varying purity), the highest level ever reported. 
The global interception rate nearly doubled from 
20-24 per cent in the 1980s to 34-53 per cent over 
the period 2009-2015; it reached 40-47 per cent in 
2014 and increased to 45-55 per cent in 2015, a 
record level. 


A total of 153 countries from all regions reported 
cocaine seizures over the period 2010-2015, suggest- 
ing that trafficking in cocaine is a global phenomenon. 
Nevertheless, 90 per cent of the cocaine intercepted 
in 2015 was in the Americas, most notably in South 
America, where production and, increasingly, con- 
sumption take place; in North America, the main 
consumer market worldwide; and in the transit 
regions of Central America and the Caribbean. The 
next largest portion of total quantities seized was 
reported in Europe (10 per cent), particularly in 
Western and Central Europe. Quantities intercepted 
in Asia, Africa and Oceania accounted for a minor 
proportion (0.5 per cent of the total). 


The largest increases from the previous year in quan- 
tities seized were reported in Oceania (63 per cent), 


A 


27 


WORLD DRUG REPORT 2017 


FIG. 18 | Quantities of cocaine seized in North America 
and annual prevalence of cocaine use in the 
United States and Canada, 2004-2015 


Prevalence (percentage) 


250 

= 

200 £ 

fe) 

2 

2 

mo] 

150 @ 

N 

ao 

Vv 

100 = 

£ 

c 

EY 

50 @& 

0 
nor nwo RWD COC TANM TST 
(os © © 2 ee © ee Se Se oe oe eo 
ooooowmlUlcODUCmCcUKmldmlUCUOUlUCONUCOUUCONC CO COCO 
NNNNNNNN NNN NS 


(mam United States (seizures) 
"> Mexico (seizures) 
mmm Canada (seizures) 


United States (annual prevalence among 


population aged 12 and older) 
Canada (annual prevalence among population 


aged 15 and older) 
United States (workforce testing results among 


the general workforce) 


Changes in the North American cocaine 
market 


North America, the world’s largest cocaine market, 
has shown an upward trend in the last few years fol- 
lowing a sharp decline between 2006 and 2012. 
Several indicators document the decrease and sub- 
sequent increase in cocaine use in the United States, 
including use in the general population and in the 
workforce. Similarly, data from Canada signalled 
strong declines in cocaine use in the second half of 
the first decade of the new millennium, followed by 
a subsequent increase, most of which occurred 
between 2013 and 2015.3° Those declines and sub- 
sequent increases in cocaine use are thought to be 
at least partly the result of changes in cocaine manu- 
facture in Colombia, which fell by 50 per cent over 
the period 2006-2012 (from 660 tons to 333 tons), 
before almost doubling again (to 646 tons) in 
2015.3! Asa result, the availability of cocaine in the 
United States was reported to have increased in 
2015.32 


This development is reflected in the quantities of 
cocaine seizures reported in North America, which 
fell by more than 50 per cent, from 202 tons in 


Sources: Responses to the annual reports questionnaire data; the United 
States National Household Survey on Drug Use and Health; Quest Diag- 
nostics, “Quest Diagnostics Drug Testing Index”, full year 2015 

tables" (September 2016), and previous years; the Canadian Tobacco, 
Alcohol and Drugs Survey (CTADS) 2015 and, for previous years, Health 
Canada, Canadian Alcohol and Drug Monitoring Surveys (CADUM). 


2006 to 87 tons in 2013, before rebounding to 141 
tons in 2015. Accounting for 93 per cent of all 
quantities of cocaine seized in North America, the 
largest cocaine seizures in North America in 2015 


28 


the Caribbean (51 per cent), North America (40 
per cent) and Europe (35 per cent) in 2015. 


Global figures on cocaine use mask 
important regional patterns and 
trends 


At the global level, cocaine use in terms of annual 
prevalence has remained stable in recent years, at 
around 0.4 per cent of the population aged 15-64 
years, although levels differ substantially among the 
subregions. The highest annual prevalence rates in 
2015 were reported in North America (1.8 per cent), 
Oceania (1.5 per cent) and Western and Central 
Europe (1.1 per cent). The largest number of cocaine 
users worldwide was found in North America (33 
per cent of the global total), followed by Western 
and Central Europe (20 per cent) and South Amer- 
ica, together with the Caribbean and Central 
America (17 per cent). 


were reported by the United States, followed by 
Mexico (6 per cent) and Canada (1 per cent). 


Cocaine trafficking to the United States 


As in previous years, the vast majority (90 per cent 
in 2015) of the cocaine trafficked to the United 
States originated in Colombia, while around 7 per 
cent of the coca leaf used in the manufacture of the 
cocaine found in the United States market appeared 
to have originated in Peru. However, forensic 
analysis indicated that less than 1 per cent of the 
cocaine samples in the United States market could 
be linked to cocaine hydrochloride actually 
manufactured in Peru: most of the samples trafficked 


30 Health Canada and Statistics Canada, Canadian Tobacco, 
Alcohol and Drugs Survey: 2015 summary. 

31 UNODC, Colombia: Coca Cultivation Survey 2015, p. 11; 

and issues of previous years. 

United States Drug Enforcement Administration, 2016 

National Drug Threat Assessment Summary, p. 87. 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


as cocaine from Peru showed chemical signatures 
consistent with those of cocaine hydrochloride 
produced in laboratories controlled by Colombian 
organized crime groups. This suggests that either 
some of the coca paste or cocaine base produced in 
Peru may be subsequently transformed into cocaine 
hydrochloride in Colombia before being shipped to 
the United States. It could also mean that Colombian 
controlled laboratories operating in other countries 
in the subregion, and using the same chemicals and 
production methods as in Colombia, were processing 
Peruvian coca paste and cocaine base into cocaine 


hydrochloride. 


DEA estimates suggest that 76 per cent of the 
cocaine departing South America transited the east- 
ern Pacific in 2015, often by ship or semi-submersible 
vessel, entering either Central America or Mexico 
before being transported overland to the United 
States. It then entered the country via major hub 
cities located in Arizona, California and Texas before 
being transported along interstate highways to vari- 
ous other hub cities, including Atlanta, Chicago and 
New York. Smaller amounts were transshipped 
through the western and eastern Caribbean (14 and 
9 per cent, respectively), often using “go-fast” ves- 
sels and, to a lesser extent, aircraft. While cocaine 
transported across the western Caribbean typically 
transits Mexico before entering the United States, 
cocaine shipped across the eastern Caribbean mainly 
enters the United States mainland via Puerto Rico 
and the Dominican Republic before reaching Miami 
or New York. The trafficking of cocaine via both 
the eastern Pacific and the Caribbean was reported 
to have increased in 2015.34 


Early signs of growth in the European 
cocaine market 


Cocaine seizures in Europe declined from a peak in 
2006 before starting to recover again over the period 
2009-2015. The supply of cocaine to Europe, 
prompted by production declines in Colombia, 
decreased after 2006 before recovering after 2009 
as traffickers started to make use of alternative 
sources from Peru and, to a lesser extent, the 
Plurinational State of Bolivia in order to offset the 
shortfall in supply from Colombia. In recent years, 


33 Ibid., p. 90. 


34 Ibid., pp. 96-98. 


FIG. 19 | Quantities of cocaine seized in Europe 
and annual prevalence of cocaine use 
in the European Union, 1998-2015 


1.5 120 
100 


80 


iz 
o 


60 


eS 
w 


40 


20 


S 
fo) 


Prevalence among the population 
aged 15-64 (percentage) 


AOMDOANNMTHNHNORWADOANMNTYH 
ano oa oa o 6 6 oO 6 a eat ea a 
aAnnOO oooooo0o°o oooo 
AANNNNNNNNNNNNNN SE 
© Cocaine seized in other European 


countries 


Cocaine seized in European Union 
member States 


= Estimated annual prevalence of cocaine 
use in European Union member States 
among the population aged 15-64 


Sources: UNODC calculations based on responses to the 
UNODC annual report questionnaire; and EMCDDA, Statistical 
bulletin 2016 and previous years. 


however, Colombia, in line with large increases in 
cocaine manufacture in the past two years, appears 
to have re-emerged as the main supplier to Europe. 


Overall supply of cocaine to Europe thus appears 
to be increasing again. However, data on cocaine 
use in the European Union, so far, only partially 
follow that trend. The overall prevalence of cocaine 
use in the European Union appears to have declined 
from a peak of around 1.3 per cent of the popula- 
tion aged 15-64 years (about half the rate reported 
in the United States) in 2007, before stabilizing, 
and affecting around 0.9 per cent of the population 
aged 15-64 years over the period 2011-2015. 


Data on cocaine use in individual countries across 
Europe continue to show a mixed picture with no 
clear overall trends emerging. Some countries with 
a high prevalence of cocaine use, such as the United 
Kingdom, Spain and Italy (by order of prevalence), 
as well as other countries in Western and Central 
Europe, including Germany, Austria, Denmark, Bel- 
gium, Czechia, Slovakia and Poland (by order of 
prevalence), have reported declines in recent years. 
However, cocaine use appears to have increased in 
a number of other countries in the subregion, 
including the Netherlands, France and Switzerland, 


Cocaine seizures (tons) 


29 


WORLD DRUG REPORT 2017 


30 


FIG. 20 | Benzoylecgonine (cocaine metabolite) found in wastewater per 1,000 inhabitants in Europe 
(based on data from 80 European cities), 2011-2016 


500 


400 


300 


200 


Amounts identified 
(mg/day per 1,000 inhabitants) 


assumption of 


Average (i) of 
reporting cities 
(number of cities 
shown in brackets) 


place in a city) 
Average (ii) 


80 cities (based on 


gradual increases or 
declines for years in 
which no wastewater 
analysis had taken 


250 
ce 
200 & 
Wl 
a 
150 o 
x 
x 
$ 
100 = 
50 


10 cities reporting 
in all six years 


Index (iv) (based on 
calculation of chained 
averages) 


Average (iii) 


Source: Calculations based on Sewage Analysis CORE Group Europe (SCORE). 


Note: The wastewater analysis took place in 26 countries over the period 2011-2016. All city results have been weighted by the popula- 

tion served by the respective drug treatment plants. The analysis in each city was based on the amounts of benzoylecgonine identified in 
wastewater over a seven-day period, which allowed for the calculation of a daily average of benzoylecgonine per 1,000 inhabitants living 
in the area served by the respective wastewater treatment plant. For details of the calculation methods, see the online methodology sec- 


tion of the present report. 


and some of the countries in South-Eastern Europe 
(Croatia and Romania). Overall, nine European 
countries perceived stable levels of cocaine use in 
2015, five perceived a decline, and five perceived 
an increase in the number of cocaine users, with 
large increases in 2015 being reported by Portugal 
and Romania. 


The analysis of benzoylecgonine (a cocaine metabo- 
lite) in wastewater, which can provide information 
about trends in cocaine consumption (i.e., tons con- 
sumed), shows a somewhat different picture. Based 
on data from 80 cities (accounting for 7 per cent of 
the population in the 26 participating European 
countries), results point to an increase in cocaine 
consumption since 2011, by some 30 per cent or 
more, depending on the methodology used. This is 
in line with quantities of cocaine seized that show 
an increase of more than 30 per cent over the period 
2011-2015 in Europe. In 2016, levels of benzo- 
ylecgonine found in wastewater turned out to be 


higher in 32 cities than in the previous year and 
lower in 8 cities. When the average for all the cities 
is used, cocaine consumption appears to have 
remained stable, although this is primarily the result 
of the wider coverage of surveillance sites over the 
years. 


The analysis at the city level shows high values of 
benzoylecgonine in wastewater per 1,000 inhabit- 
ants in Antwerp, London, Zurich, Barcelona and 
Amsterdam, as well as in other cities in Switzerland, 
the Netherlands, Germany, Belgium, Spain, Den- 
mark and Italy (by level of benzoylecgonine). 
Differences within countries can, however, be large, 
as reflected in the high level of benzoylecgonine 
found in Dortmund, in western Germany, and the 
low level found in Dresden, in the east of the coun- 
try. Levels too low to be detectable were reported in 
some cities in Finland and Romania, while low levels 
were found in some cities in Greece, Poland and 
Sweden. 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


FIG. 24 | Benzoylecgonine (cocaine metabolite) found in wastewater per 1,000 inhabitants, 2016 (or 


latest year available) 


BP 
N 
jo) 
oO 


City data 


Global unweighted average 


Amounts identified (mg/day per 1,000 inhabitants 
aS 
je) 
Oo 


FUMTDUN INDOSD WO Gs yp SOS ST sohafaiatctad LK idatdrieto ates tga et tS basa pb te ke toh bh td dh 
> | 
x au 
2) yg 
7 q 
ui 4) \9 q 2g Set 
ayy] Py Fe CURE ig a] | 9 HSE | ig [a dd 
ia |) = 4 g 4 SI ig is hi a 
4 lg i 
X g {e] 
@ Ss my 4 
Europe Other locations 


Source: Sewage Analysis CORE Group Europe (SCORE). 


The level of benzoylecgonine per 1,000 inhabitants 
reported in Fort-de-France, Martinique, the French 
department located in the Caribbean, was far higher 
than in Europe. The same was the case in Medellin, 
Colombia, which is located near some of the world’s 
largest clandestine cocaine manufacture centres, and 
where the level of cocaine detected in wastewater 
exceeded the level found in the capital, Bogota. Ben- 
zoylecgonine levels identified in both Montreal, 
Canada, and in Seattle, United States, also turned 
out to be higher than both the European and the 
global averages. By contrast, no benzoylecgonine 
was detected in wastewater in Busan, Republic of 
Korea, or in Auckland, New Zealand. 


Trafficking of cocaine 
Trafficking of cocaine to Europe 


Among the main coca-producing countries, the 
main country of origin/departure of seized cocaine 
shipments to Europe continues to be Colombia, 
which accounted for 43 per cent of reports by Euro- 
pean countries in the annual report questionnaire 
over the period 2010-2015, followed by Peru (33 
per cent) and the Plurinational State of Bolivia (23 
per cent). When data analysis is limited to 2015, 


the proportion of reports citing Colombia increases 
to 67 per cent, which tallies with the increase in 
cocaine manufacture reported by Colombia and the 
largely stable levels of cocaine production in the 
other two countries. 


The single most frequently mentioned non- 
European country of departure of shipments of 
cocaine to Europe over the period 2010-2015 was 
Brazil, followed by Colombia, Peru, Ecuador, the 
Dominican Republic, Argentina and the Bolivarian 
Republic of Venezuela. The main points of entry of 
cocaine into Europe have for many years been the 
countries of the Iberian Peninsula, as well as the 
ports of Rotterdam, Netherlands, and Antwerp, 
Belgium.> Spain and the Netherlands were also the 
two main European countries of departure and 
transit of cocaine identified by European countries 
over the period 2010-2015, highlighting their role 
as trafficking and distribution hubs for cocaine in 
the region.3° Spain has remained the European 
country seizing the largest amounts of cocaine over 
the past two decades, accounting for a third of the 


( 


31 


WORLD DRUG REPORT 2017 


32 


The analysis of wastewater in 80 European cities in 2016 
(or latest year available), covering a population of some 
37 million people, the equivalent of around 7 per cent of 
the total population of the countries where the analyses 
took place (504 million people), suggests that an average 
of 259 mg of benzoylecgonine per 1,000 inhabitants 
per day was found in wastewater in those cities (95 per 
cent confidence interval: 179-340 mg).@ 


Using such per capita figures for the European Union, 
countries of the European Free Trade Association and 
Balkan countries not members of the European Union 
(with a total population of 538 million people) and the 
multipliers (correction factors) found in the literature, 
to convert benzoylecgonine found in wastewater into 
cocaine consumption equivalents (a ratio of between 
2.3 and 3.59),5 cocaine consumption in Europe may 
have ranged from 117 tons of pure cocaine to 183 tons 
(depending on the correction factors found in the litera- 
ture) per year in 2016. When taking into consideration 
the 95 per cent confidence intervals of per capita use 
of benzoylecgonine, the range increases to 81-240 tons 
for 2016. 


total quantity intercepted in the region over the 
period 2010-2015, followed by Belgium and the 
Netherlands. 


Increasing trafficking in South America 
linked to growing Colombian cocaine 
production 


Some of the most striking increases in cocaine sei- 
zures worldwide over the period 2010-2015 were 
reported in South America, where seizures rose from 
364 tons in 2010 and 392 tons in 2014 to 526 tons 
in 2015, arise of 34 per cent from the previous year. 
This rise can be linked to increased cocaine produc- 
tion in Colombia and increasing trafficking activities 
out of Colombia. A sharp increase in quantities of 
cocaine seized in 2015 was reported by Colombia, 
Venezuela (Bolivarian Republic of), Ecuador, Suri- 
name and Guyana (58 per cent overall from the 
previous year). Colombia again reported the largest 
quantities of cocaine seized worldwide in 2015 (34 
per cent of the global total) and accounted for 57 
per cent of all cocaine seized in South America, fol- 
lowed by Ecuador (12 per cent) and the Bolivarian 
Republic of Venezuela (12 per cent). This suggests 


An important caveat is that the cities were not randomly 
selected. As most of the cities are in Western Europe, 
where cocaine use is relatively high (and bearing in mind 
that cocaine use is still more of an urban phenomenon 
than a rural one), the application of ex-post stratifications 
with regard to the location of the cities suggests that 
this estimate needs to be adjusted downwards. Given 
the information currently available, it appears likely that, 
based on wastewater data, actual cocaine consumption 
in the European Union, countries of the European Free 
Trade Association and Balkan countries not members 
of the European Union falls somewhere within a broad 
range of 64-208 tons. (For more details, see the online 
methodology section of this report.) 


that more than 80 per cent of cocaine seizures made 
in South America were linked to cocaine produced 
in Colombia. By contrast, the countries mostly 
affected by the trafficking of Peruvian and Bolivian 
cocaine in 2015, including Argentina, Bolivia (Pluri- 
national State of), Brazil, Chile, Peru and Uruguay, 
reported an overall decrease of 21 per cent in the 
quantity of cocaine seized, compared with the pre- 
vious year. 


Identified by countries in the Americas over the 
period 2010-2015, the main cocaine destination 
country in North America was the United States, 
followed by Mexico and Canada; in South America, 
it was Brazil. In Europe, the main destination coun- 
tries, by number of reports, were Spain, Italy, the 
Netherlands, Belgium and the United Kingdom. 


Cocaine trafficking stable via 
Central America while increasing via 
the Caribbean 


Based on seizures, cocaine trafficking via Central 
America appears to have remained relatively stable 
in 2015, when a total of 86 tons of cocaine were 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


seized, roughly the same quantity as in the previous 
year and down slightly from the quantity seized in 
2010 (93 tons). The largest quantity seized in 2015 
was reported by Panama (53 tons or 62 per cent of 
all cocaine seized in Central America), followed by 
Costa Rica (20 per cent) and Guatemala (7 per cent). 
In 2015, the quantity of cocaine seized in Panama 
(all from Colombia) increased by more than 50 per 
cent from the previous year. 


In the Caribbean, the quantity of cocaine seized rose 
from 8 tons in 2010 to 15 tons in 2014 and 23 tons 
in 2015, with most seizures being reported by Puerto 
Rico, followed by the Dominican Republic. Cocaine 
arriving in Puerto Rico is almost exclusively destined 
for the United States mainland, often entering the 
country via Florida, 3” while cocaine transiting the 
Dominican Republic is destined for the United 
States and Canada, as well as Europe, with Belgium, 
Italy, Spain and Switzerland reporting the Domini- 
can Republic to be a significant transit country for 
cocaine trafficking. 


Limited Information on cocaine trafficking 
via Africa 


Reflecting the rapidly growing importance of Africa, 
particularly West Africa, as a transit area for cocaine 
trafficking, the total quantity of seized cocaine 
reported by countries in Africa increased from 0.8 
tons in 1998 to 5.5 tons in 2007, before falling to 
3.4 tons in 2010 and 1.2 tons in 2015. Among the 
non-European transit countries for cocaine men- 
tioned in the replies to the annual report 
questionnaire, countries in Africa accounted for 9 
per cent over the period 2010-2015, mostly West 
Africa, and a further 3 per cent concerned countries 
in the Gulf region. The decline in quantities of 
cocaine intercepted in Africa in recent years has gone 
in parallel with a decrease in the number of reports 
in Europe of African countries being used as transit 
areas. This trend may, however, be the result of a 
poor capacity of detection and reporting rather than 
a decrease in the flow of cocaine, as reflected in some 
significant seizures of cocaine shipments destined 
for Africa. For example, in March 2015, the Boliv- 
ian authorities seized 5.9 tons of cocaine that would 
have been destined for West Africa (Ghana and 


37 United States Drug Enforcement Administration, 2016 
National Drug Threat Assessment Summary. 


Burkina Faso). More recently, in January 2016, the 
Bolivian authorities reported the seizure of 8 tons 
of cocaine (within a shipment of 80 tons of barium 
sulphate) destined for West Africa (Céte d'Ivoire) 
via Argentina and Uruguay. In January 2017, Dji- 
bouti authorities reported the seizure of 0.5 tons of 
cocaine from a container on route from Brazil to 
Spain, its final destination. This was the single larg- 
est cocaine seizure in East Africa since 2004, when 
1.1 tons of cocaine were seized in Kenya. 


African countries report Brazil (58 per cent) as the 
most frequent departure/transit country for cocaine 
trafficked to Africa in the period 2010-2015, fol- 
lowed by Colombia (20 per cent), Chile (10 per 
cent) and Peru (8 per cent). As for countries in the 
same region, they report Nigeria as the most fre- 
quent transit country in Africa, followed by South 
Africa, Ghana, Mali and the Niger. Cocaine transit- 
ing Africa over the period 2010-2015 was reported 
to be destined mainly for countries in Europe (80 
per cent; notably Italy, Spain, France, the United 
Kingdom and the Netherlands), followed by desti- 
nations in North America (15 per cent; mainly the 
United States) and Asia (4 per cent; China and 
Malaysia). 


Most of the cocaine seized in Africa over the period 
2010-2015 was intercepted in West and Central 
Africa (83 per cent), while 11 per cent was inter- 
cepted in North Africa. The largest seizures were 
reported by Cabo Verde, followed by the Gambia, 
Nigeria, Chad and Ghana, which are all located in 
West and Central Africa. 


Signs of increase in the trafficking of 
cocaine to Asia 


Cocaine seizures in Asia increased from 0.4 tons in 
1998 to 1.2 tons in 2014 and 1.7 tons in 2015. 
Overall, in 2015, quantities of cocaine intercepted 
in Asia increased by more than 40 per cent from the 
previous year, with increases reported in all subre- 
gions. Although still comparatively small overall, 
there are indications that cocaine consumption 
among the upper socioeconomic groups in several 
Asian countries continues to rise.38 


38 UNODC annual report questionnaire data; Tim Lindsey 
and Pip Nicholson, Drugs Law and Legal Practice in South- 
east Asia: Indonesia, Singapore and Vietnam, (Oxford, Hart 
Publishing Ltd, July 2016); Sania Farooqui, “India becomes 


A 


33 


((seulAjey\) spue|s} 
puejy/e4 ay} 12A0 AjUbs/asaAos HujusaUOD PUe/aJ] LIBYLJON PU UIE}LIG JAIN JO WOPbHUly pay/UP) ay] PU CUI}UEHJYY JO S]UBWIUJEAOH ay) UaaMjaq S}sIXa ayndsip  ‘pauluajap uaag Ja JOU sey UePNS YyINOS 
pue uepns ay) usamjag Alepunog jeul ay ‘sayied ay}? Aq uodn paaisbe uaaq }a4 JOU sey JiWYsey Pue NuWeL JO sN}ejs JEU. aYJ ‘UeISIy¥ed Pue elpul Aq uodN paaibe siwWiysey PU NWWES Ul /O1JUOD JO aUlT 

ay} Aazewixosdde sjuasasdas aul] PaYOp ayy ‘sawepuNnog paujwuazapun juasasdas saul] Payseg “SUCHEN payUs) ay Aq adue}dadde JO JUBWASIOPUA /eIDYJO AJA! Jou Op dew siy2 UO UMOYsS sal/epUNOG ay 
‘Buryryses 

{O UOEUIJSAP JX9U JO BUO AY} JO UONJAWINSUOD 4O BAe AY} JBYIA JEI/PUl SMO JO SJUJOA Pua ‘@DUCUAAOJA }Se/ JO UO BY} JO a1NJDe{NUW JO PAJE AY} JAYJJA AJEd/PUI SMOe 94} JO SUIBLIO /BUIyDJeN 

JO UOI}IAJIP AY} JUAaSadas SMOLC MO}4 /pa}dajjas ag Jou Aew smoY AJePUOIAS /eJANAS a/IYM SA}NOJ BulyDyJe12 HUIISIXE JO aAIJed/PU! ApeOsG Se PasaPISUOD aq O} ase AY} ‘YONS se :aseqezep anzias Bnup 
Jenpiaipul pue asleuuonsanb joded jenuue ay} ul! sajze1s sequiayy Aq pajiodas se shnup pazias Jo uoeuyjsap pue jsued ‘ainjsedap/ulbio JO A1JUNOD JO SISeq BY} UO PAUIWALap ase SMOLJ HULyDJJes] @YL :SA]ON 


‘aseqeyep aunzias Gnup jenpiaipul pue auleuuonsanb oda jenuue 0} sasuodsad uO paseg ‘UOI}eJOge|a DGONN :a2/NOS 


aud ay 
Ize1g Le Z 4INOs 
er1JauUy Jo ( / elesisny 
$9215 pauun ) l 


| 


Le 


J 
ot 


~~ 
N yb beegonperso> 


rae visv 
= 1sv3-HLNOs 


yin 


ISN 


= 


<i ©¢ 


Ze1g ) 
nad if 
BIquo|oD / 


ed1JaU JO 


GLOZ-LLOZ ‘SMO|} BuPyD14Je4) BUIEIOD ULE 


34 


ZL02 LYOd3dY ONYG ATYOM 


MARKET ANALYSIS OF PLANT-BASED DRUGS BB. The cocaine market 


The largest cocaine seizures in Asia over the period 
2010-2015 were made in East and South-East Asia 
(56 per cent) and in the Near and Middle East/ 
South-West Asia (40 per cent). More recently, in 
two individual cases, 0.2 tons of cocaine was seized 
from a container shipped from Brazil (November 
2016) and 0.9 tons, being shipped from Ecuador 
to India (December 2016), were seized in Sri Lanka. 
A number of smaller cocaine seizures were made in 
various locations in India, in Pakistan, in Hong 
Kong, China, Shenzhen, China, Taiwan Province 
of China, and Lebanon in 2016. 


Among all Latin American countries, Brazil was the 
most frequently reported as the country of depar- 
ture/transit of cocaine shipments to Asia over the 
period 2010-2015 (37 per cent), followed by 
Colombia (19 per cent), Peru (10 per cent), the 
Plurinational State of Bolivia (10 per cent), Mexico 
(8 per cent) and Argentina (8 per cent). Many of 
those shipments transited Africa, mainly through 
Nigeria and South Africa, while, in Asia, transit 
through the Near and Middle East (United Arab 
Emirates, followed by Jordan, Lebanon and the 
Syrian Arab Republic) and South and South-East 
Asia (Thailand; Hong Kong, China; and India) were 
most frequently reported. Cocaine shipments to 
Asia were mostly reported as being destined for 
Israel, Lebanon, China and Indonesia (by number 
of reports). 


Cocaine market in Oceania potentially 
growing again 


Cocaine seizures in Oceania increased from around 
0.1 tons in the late 1990s to 1.9 tons in 2010, before 
falling to 0.8 tons in 2014, then recovering to 1.2 
tons in 2015. Australia accounted for 99 per cent 
of cocaine seized in Oceania over the period 1998- 
2015, including in 2015. The largest quantity of 
cocaine was seized in New South Wales, with Sydney 
remaining the main entry point of cocaine into the 
country®? and the location with the highest level of 


cocaine trafficking centre as drugs follow rise of rich”, The 
Guardian (London), 1 October 2015; Bryan Harris “Mexi- 
can cartel smuggling cocaine into Hong Kong amid boom- 
ing demand for drugs”, South China Morning Post (Hong 
Kong), 2 February 2014. 

39 Australian Criminal Intelligence Commission, J/licit Drug 
Data Report 2014-15, pp. 89-101. 


cocaine consumption (almost seven times the 
national average based on wastewater analysis) .4° 


Annual prevalence of cocaine use among the general 
population aged 14 years and older in Australia dou- 
bled from 1 per cent in 2004 to 2.1 per cent in 2010 
and remained at that level in 2013 — a very high 
level by global standards: five times the global aver- 
age and twice that in the European Union. Moreover, 
there are indications that cocaine consumption 
might have increased in Australia over the period 
2013-2015, based on the median number of days 
“ecstasy” users and injecting drug users consumed 
cocaine, the number of cocaine-related arrests, the 
proportion of detainees having used cocaine and 
wastewater analysis.4! Cocaine prices were reported 
to have declined slightly in the reporting year 
2014/15, to 185,000—240,000 Australian dollars 
per kilogram, while cocaine purity increased slightly, 
suggesting that cocaine availability may have 
increased.42 


Nevertheless, actual consumption of cocaine (the 
quantity consumed), as opposed to the prevalence 
of cocaine use (number of users) seems to be still 
quite limited in both Australia and New Zealand. 
This may be due to the very high price of cocaine 
in that part of the world.43 The demand for treat- 
ment for cocaine use continues to be low despite 
high rates of prevalence of use. This pattern is also 
reflected in wastewater analysis: while the annual 
prevalence of cocaine use in Australia is around twice 
that in the European Union, wastewater data in 
Australia suggest that actual cocaine consumption 
per 1,000 inhabitants is clearly below the average 
for the European Union.“4 


40 Australian Criminal Intelligence Commission, University 
of Queensland and University of South Australia, National 
Wastewater Drug Monitoring Program, Report No. 1 (Can- 
berra, March 2017), p. 36. 

41 Australian Criminal Intelligence Commission, Illicit Drug 
Data Report 2014-15, p. 97. 

42 Ibid., pp. 96-98. 

43 UNODC annual report questionnaire data, and Australian 
Criminal Intelligence Commission, //licit Drug Data Report 
2014-15. 


44 Australian Criminal Intelligence Commission, the Uni- 


versity of Queensland and University of South Australia, 
National Wastewater Drug Monitoring Program, Report 1, 
March 2017, p. 42. 


A 


35 


WORLD DRUG REPORT 2017 


36 


Forensic analysis of cocaine intercepted in Australia 
revealed that in 2015 most of the cocaine in the 
Australian market continued to originate in Colom- 
bia. The origin of 49 per cent of the cocaine seized 
by the Australian Federal Police was reported to be 
Colombia, while 40 per cent was of Peruvian origin, 
compared with, respectively, 69 per cent and 21 per 
cent in cocaine seizures reported by custom 
authorities.4 


The most frequently reported departure/transit 
countries in the Americas for cocaine shipped to 
Oceania in the period 2010-2015 were (in order of 
importance) the United States, Canada, Chile, 
Brazil, Peru, Colombia, Argentina, Panama and 
Mexico; in Asia, they were Hong Kong, China; 
mainland China; and Thailand. In the reporting 
year 2014/15, the Australian authorities reported 
as key embarkation points, in terms of quantities of 
cocaine seized, the United States, followed by Brazil; 
Hong Kong, China; Malaysia; the United Arab 
Emirates; Trinidad and Tobago; France; India; and 
Thailand.46 


45 Australian Criminal Intelligence Commission, //licit Drug 
Data Report 2014-15, Canberra 2016, p. 93. 
46 Ibid., p. 91. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


Global seizures = 6% 
resin 


Global number of users 


Note: Data refer to 2015. Estimates of illicit cultivation, production and eradication of cannabis and prevalence of cannabis use are avail- 


able in the annex of booklet 2. 


Cannabis plant cultivation — either through direct 
indicators (cultivation or eradication of cannabis 
plants) or indirect indicators (seizures of cannabis 
plants, domestic cannabis production being indi- 
cated as the source of seizures, etc.) — was reported 
on the territory of 135 countries in the period 2010- 
2015, covering 92 per cent of the world population. 
Given the absence of systematic measurements, how- 
ever, the extent and trends in cannabis cultivation 
and production are difficult to assess. Most indirect 
indicators come from law enforcement authorities 
and, to a certain extent, reflect their priorities and 
resources.47 


Morocco remains the country most reported by 
Member States as the source of cannabis resin, fol- 
lowed by Afghanistan and, to a lesser extent, 
Lebanon, India and Pakistan. In contrast to traf- 
ficking in cannabis resin, which is not only 
intraregional but also interregional (notably, traf- 
ficking from North Africa to Europe), trafficking 
in cannabis herb continues to be largely intrare- 
gional. Thus, it is more useful to identify the 
countries most frequently reported at the regional 
level as countries of origin over the period 2010- 
2015 (see box). 


47 For more details, see World Drug Report 2015, box on 


“Interpreting drug seizures”, p. 27 


Countries most frequently 
reported as countries of 
origin of cannabis herb, by 
region/subregion, 2010-2015 


e The most often reported source country for 
transnational shipments in North America was 
Mexico, followed by Canada. Although this 
does not mean that Mexico is the largest 
producer of cannabis in North America. 
Significant amounts of cannabis herb are 
produced in the United States, though mostly 
for domestic consumption and not for export. 


In South America, the Caribbean and Central 
America, the most frequently reported source 
countries of cannabis herb were Colombia and 
Paraguay, followed by Jamaica. 


In Africa, the most frequently reported source 
countries were Nigeria, Mozambique, Ghana 
and Swaziland, although it is difficult to 
identify specific countries in Africa, because a 
number of other countries were also reported. 


In Asia, the most frequently identified source 
country was Afghanistan, followed by Kyr- 
gyzstan, Myanmar, the Lao People’s Democrat- 
ic Republic, Lebanon, India and Nepal. 


In Europe, the two most frequently mentioned 
source countries for cross-border trafficking 

of cannabis herb were the Netherlands and 
Albania. 


37 


WORLD DRUG REPORT 2017 


38 


Eradication as an indicator of cannabis production 


Measuring the extent of eradication is challenging because 
some countries report eradication in terms of hectares, while 
others report in terms of numbers of cannabis plants eradi- 
cated, weight of cannabis plants seized or number of cannabis 
cultivation sites eradicated. This makes comparisons of eradi- 
cation difficult. 


The largest areas of eradicated cannabis cultivation over 
the period 2010-2015 were reported by Mexico, followed 
by Morocco and Nigeria. The largest numbers of cannabis 
cultivation sites eradicated were reported by the United 
States, followed by Ukraine, the Netherlands and the Russian 


Available indicators of the distribution of eradication of cannabis 


production, by region, 2010-2015 


100 


0 
0 17 
0) 
0 
0) 


Hectares of | Cannabis Cannabis Sites 
cannabis plants plants seized eradicated 
eradicated eradicated (n=2,955 tons (n=751,000) 
(n=18,000 (n=27 million per year) 

per year) per year) 


Proportion (percentage) 


cannabis herb 


Federation. The largest numbers of cannabis plants eradicated 
were reported by Nigeria, followed by the United States, the 
Philippines and Paraguay. Finally, the largest quantities of 
cannabis plants seized were reported by Bolivia (Plurinational 
State of) and Peru, followed by Jamaica. 


The combination of the various indicators suggests that the 
world’s largest areas of cannabis cultivation subjected to 
eradication over the period 2010-2015 were located in the 
Americas. This may indicate the global predominance of that 
region in cannabis cultivation, but may also point to the extent 
to which law enforcement authorities have been prioritiz- 
ing the eradication of cannabis 
cultivation, which could also 
have played a role. The second 
largest area of cannabis culti- 
vation eradicated was in Africa, 
followed by Asia and Europe, 
then Oceania. The average dis- 
tribution of cannabis eradication 
turns out to be quite similar to 
that of overall cannabis herb 
and resin seizures reported at 
the global level over the period 
2010-2015. Patterns of cultiva- 
tion may differ from patterns of 
law enforcement operations tar- 
geting cannabis cultivation; in 
Africa, in particular, where law 
enforcement capabilities are 
quite modest, the importance 
of cannabis cultivation may be 
greater than that indicated by 
the extent of eradication and 
seizures. 


Oceania 
m Europe 
mAsia 
m= Africa 
= Americas 


Memo: 


and resin 
seized 
(n=7,270 tons 
per year) 


Global quantities of cannabis resin and 
herb seized, 1998-2015 


Quantity seized (tons 
& 
ro) 
j=) 
Oo 


1,000 
00 eee af | 
WHOAANMTNORWADOANM TF 
Nnonodoqoncdcodc oc qd ocd Od dt tat co a 
NANODWAWDAAGVCGVCGVCGVCVACVCCCOC COCO 80 
AANNNNNNNNNNNNS rn 


Cannabis resin | Cannabis herb 


Source: UNODC, based on responses to the annual report 
questionnaire. 


Based on quantities intercepted, the trafficking of 
cannabis seems to have stabilized at a high level in 
the past decade (compared with the level in the late 
1990s). Over the period 2010-2015, quantities of 
herbal cannabis seized were more than four times 
those of cannabis resin, with some 6,000 tons of 
cannabis herb and 1,300 tons of cannabis resin inter- 
cepted annually. In 2015, the largest cannabis herb 
seizures worldwide were reported by Mexico, fol- 
lowed by the United States, Nigeria, Paraguay and 
Egypt; the largest cannabis resin seizures were 
reported by Spain, Pakistan and Morocco, followed 
by Afghanistan and Algeria. 


2015 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


A 


FIG. 23 | Global quantities of cannabis seized, annual average, by product and by country, 


2010-2015 


Cannabis herb 
Quantity seized (tons) 


Cannabis resin 
Quantity seized (tons) 


0 1,000 2,000 0 100 200 300 
United States Spain 
Mexico Pakistan 
Paraguay Morocco 
Colombia Algeria 
Nigeria Afghanistan 
Egypt Iran (Islamic Rep. of) 
Brazil France 
Morocco Italy 
Bahamas Egypt 
Argentina Turkey 
India Saudi Arabia 
Turkey Portugal 
Other Other 


7 10 40 


20 
Proportion of global quantity seized (percentage) 


30 


20 
Proportion of global quantity seized (percentage) 


- 10 30 


Source: UNODC, based on responses to the annual report questionnaire. 


rising levels of cannabis consumption), reflecting a 
possible fall in cannabis production in Mexico,*8 as 
well as an overall reduction in the priority given to 
cannabis interdiction as the cultivation, production, 
trade and consumption of cannabis has become legal 
in several jurisdictions in the United States in recent 


The Americas, followed by Africa, 
continue to report the majority of 
cannabis herb seizures 


In 2015, almost two thirds (64 per cent) of the total 
quantity of cannabis herb seized worldwide was 


seized in the Americas, most notably in Mexico, 
followed by the United States, Paraguay and Brazil. 
Accounting for more than a quarter (28 per cent) 
of the global total, the second largest seizures of 
cannabis herb were reported in Africa, mostly in 
Nigeria, Egypt and Morocco. Asia accounted for 5 
per cent of the total quantity of cannabis herb inter- 
cepted worldwide in 2015, most of which was seized 
by India, followed by Bangladesh, Kazakhstan, Indo- 
nesia and Thailand; 3 per cent of the total was seized 
in Europe, mostly by Turkey, followed by the United 
Kingdom, the Russian Federation, Spain and the 
Netherlands; and 0.1 per cent of the total was seized 
in Oceania, mostly in Australia. 


The subregion reporting the largest quantity of can- 
nabis herb seized in 2015 remained North America 
(39 per cent of global seizures). Following a peak in 
2010, however, seizures of cannabis herb in North 
America declined by 55 per cent up to 2015 (despite 


years. 


By contrast, cannabis herb seizures more than dou- 
bled over the period 2010-2015 in Africa and South 
America. Meanwhile, cannabis herb seizures 


48 


This is in line with a decline in cannabis eradication 
reported by Mexico and, more importantly, with falling 
cannabis herb seizures along the Mexico-United States 
border over the period 2010-2015. While seizures of most 
drugs along that border have increased in recent years, can- 
nabis herb seizures, in terms of both quantities and number 
of seizure cases, fell significantly between 2010 and 2015. 
Quantities of cannabis herb seized along the Mexico-United 
States border fell from more than 1,300 tons in 2010 

to 900 tons in 2015 (United States Drug Enforcement 
Administration, 2016 National Drug Threat Assessment, p. 
135). Note that none of the states bordering Mexico had 
legalized cannabis over the period 2010-2015 and that can- 
nabis continues to be prohibited at the federal level in the 
United States, which suggests that reduced seizures along 
the Mexico-United States border may have been the result 
of lower trafficking flows of cannabis herb from Mexico to 
the United States. 


39 


WORLD DRUG REPORT 2017 


40 


Tons 


FIG. 24 | Quantities of cannabis herb seized, by 
region/subregion, 1998-2015 


7,000 
6,000 
5,000 
4,000 
3,000 
2,000 
1,000 
fy) 
WHoOANMTANORWDAOANANMN TY 
Nnonodoqonqncenco oa oo eod dt dt td dt a 
NAODATCAGCCGCCCGC CCC CCC 0 80 
AANNNNNNNNNNNNNN Sen 


© North America 
@ South America, Caribbean and Central America 
' Europe 
Asia 
Oceania 
m Africa 


Sources: UNODC, responses to the annual report question- 
naire; and government reports. 


remained relatively stable in Asia and in Europe, 
with increases and decreases of less than 15 per cent. 
The main sources of cannabis herb in Europe are 
within the region itself, most notably the Nether- 
lands and Albania, although the European Police 
Office (Europol) has also identified Czechia as an 
important distribution hub for cannabis herb traf- 
ficked to neighbouring countries.*? 


The largest quantities of cannabis resin 
intercepted continue to be reported in 
West and Central Europe, the Near and 
Middle East/South-West Asia and North 
Africa 


In most years of the past two decades, the largest 
seizures of cannabis resin have been reported in 
Western and Central Europe. In 2015, however, at 
38 per cent of the global total, the largest amount 
of seizures of cannabis resin took place in the Near 
and Middle East/South-West Asia, most notably in 
Pakistan, Afghanistan and Iran (Islamic Republic 
of). The next largest seizures of cannabis resin took 
place in Western and Central Europe (35 per cent; 


49 Europol, SOCTA 2017: European Union Serious and 
Organized Crime Threat Assessment, p. 36. 


Tons 


with seizures mostly reported by Spain, followed by 
Italy and France), while 26 per cent of the global 
total was seized by countries in North Africa (most 
notably Morocco, followed by Algeria and Egypt). 


In contrast to the slight decline in seizures of can- 
nabis herb worldwide over the period 2010-2015, 
cannabis resin seizures actually increased, reflecting 
a twofold increase in interceptions in North Africa 
and substantial increases (78 per cent) in the Near 
and Middle East/South-West Asia. The opposite 
was observed in Europe, however, where the overall 
quantity of cannabis resin seized, as a proportion of 
the global total, declined from 77 per cent in 1998 
to 53 per cent in 2010 and 35 per cent in 2015. 
This decline primarily reflects the falling market 
share of cannabis resin in the European cannabis 
market as cannabis herb, mostly from domestic 
European production, has been gaining in 
popularity. 

Cannabis resin mainly continues to be smuggled 
from Morocco to Europe and to other countries in 
North Africa, as well as from Afghanistan to neigh- 
bouring countries, particularly Pakistan and the 
Islamic Republic of Iran. It also seems that cannabis 
resin produced in Lebanon supplies markets in other 


FIG. 25 | Quantities of cannabis resin seized, by 
selected subregion, 1998-2015 


1,800 
1,600 
1,400 
1,200 
1,000 

300 

600 


2003 
2004 
2005 
2006 
2007 
2008 
2009 
2010 
2011 
2012 
2013 
2014 
2015 


oc AN 
oo 
oo 
NN 


m@ Near and Middle East/South-West Asia 
= North Africa 

@ Eastern and South-Eastern Europe 

= Western and Central Europe 


Sources: UNODC, responses to the annual report question- 
naire; and government reports. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


countries in the Near and Middle East, most nota- 
bly the Syrian Arab Republic, Jordan and Israel, as 
well as markets in Egypt, Cyprus and Turkey. 


In addition to ongoing direct shipments of cannabis 
resin from Morocco to Spain and subsequent ship- 
ments by land to France, Italy and the Netherlands, 
for further distribution to other European countries, 
Europol has reported an emerging trafficking route 
from Morocco to Libya (either by sea or by land) 
and then on to Italy. Although both UNODC and 
Europol data estimate that most of the cannabis 
resin found in Europe continues to originate in 
Morocco, it seems that Afghan cannabis resin is also 


trafficked to Europe, often using Albania as a first 
distribution hub.*? 


Cannabis use has remained quite 
stable at the global level in recent 
years, despite indications that it con- 
tinues to increase in Africa and Asia 


Equivalent to an estimated 183 million annual users 
in 2015 (range: 128-238 million), roughly 3.8 per 
cent of the global population (2.7-4.9 per cent) used 
cannabis in the past year. This proportion has not 
changed over the past decade and is only slightly 
higher than the prevalence of cannabis use estimated 
for 1998 (3.4 per cent). Nonetheless, as the world 
population has grown, so has the number of can- 
nabis users (by 28 per cent since 1998). Analysis of 
the perception of changes in drug use, as reported 
by Member States, also suggests an increase in the 
number of cannabis users, although the increase 
appears to have slowed down since 2010. Cannabis 
use in Africa and in Asia, however, are perceived to 
have continued to increase relatively rapidly in the 
past five years. 


Cannabis use continues to increase in 
North America 


Data on the prevalence of cannabis use and expert 
perceptions suggest that cannabis use has been rising 
over the past decade in the Americas. UNODC esti- 
mates for the Americas show an increase from 37.6 
million people (or 6.5 per cent of the population 
aged 15-64 years) who used cannabis in 2005>! to 


50 Ibid., pp. 35 and 36. 


51 World Drug Report 2007 (United Nations publications, 
Sales No. E.07.X1.5), p. 114. 


FIG. 26 | Estimated number of cannabis users and 


cannabis use perception index, 1998-2015 


1,250 
1,000 
750 


Number of cannabis users (millions) 


1998 
1999 
2000 
2001 
2002 
2003 
2004 
2005 
2006 
2007 
2008 
2009 
2010 
2011 
2012 
2013 
2014 
2015 


(@ Cannabis users 


annabis use perception index 


a0 


Source: UNODC calculations based on responses to the annual reports 


questionnaire. 


= 0) 


Cannabis use perception index (1998 


Note: For details of the calculation methods, see the online methodology 


section of the present report. 


FIG. 27 | Cannabis use perception index, by 
region, 2010-2015 


— 130 
° 
r=) 
a 125 
S 120 
° 
x 
x 115 
ov 
2 110 
< 
© 105 
= 
2 
$ 100 
vu 
a 95 
oO a N faa] s+ wn 
a a om a t a 
Oo oO Oo oO oO oO 
N N N N N N 
— Africa Asia 
—— Americas Europe 
Oceania 


Source: UNODC, responses to the annual report questionnaire. 


49.2 million (or 7.5 per cent of the population aged 
15-64 years) in 2015. The rise in cannabis use 
appears to have been most pronounced in the United 
States, where, following some marginal declines in 
the prevalence of cannabis use between 2002 and 
2007, the annual prevalence of cannabis use 
increased (by 34 per cent) to 13.5 per cent of the 
population aged 12 years and older over the period 
2007-2015. This resulted in an overall increase of 
43 per cent in the number of past-year cannabis 


A 


41 


WORLD DRUG REPORT 2017 


42 


users, and of 54 per cent in the number of past- 
month users.>2 The major expansion in cannabis 
use across the United States has been the increase 
in regular and heavy cannabis users: the prevalence 
of daily or nearly daily use of cannabis among adults 
almost doubled from 1.9 per cent in 2002 to 3.5 
per cent in 2015, and the number of daily or near- 
daily cannabis users grew by 67 per cent over the 
period 2007-2015. 


Since 2002, the major increase in past-month can- 
nabis use has been observed among those aged 26 
years and older. An increase in the number of new 
initiates has also been seen among the older age 
groups, especially those aged 26 years and older. 


The high prevalence and frequency of cannabis use 
observed among adults in the United States has been 
associated with those who perceive no risk of harm 
from cannabis smoking; with those from lower 
socioeconomic groups with no more than a high 
school diploma, without health insurance, and in 
part-time employment; those who are unable to 
work due to disability; those who are unemployed; 
and those who consider that the state in which they 
reside permits the medical use of cannabis.53:54 
Moreover, those who are daily or near-daily adult 
cannabis users without a college degree spend an 
average of almost 9 per cent of their household 
income on cannabis, while median past-month 
cannabis users spend on cannabis nearly the same 
amount as a person who smokes one pack of 
cigarettes a day spends on cigarettes for more details 
about cannabis use in the United States, see the 
following section.>° 


In Oceania, cannabis use in Australia increased 
slightly between 2007 and 2013, from an annual 
prevalence of 9.1 per cent to 10.2 per cent of the 
population age 14 years and older, although that 
was still significantly below the level reported in 
1998 (17.9 per cent). 


2 For more details, see subsequent discussion in this chapter. 
53 Wilson M. Compton and others, “Marijuana use and use 
disorders in adults in the USA, 2002-14: analysis of annual 
cross sectional surveys”, Lancet Psychiatry, vol. 3, No. 10 
(2016), pp. 954-964. 

54 Steven S. Davenport and Jonathan P. Caulkins, “Evolution 
of the United States marijuana market in the decade of 
liberalization before full legalization”, Journal of Drug Issues, 
vol. 46, No. 4 (2016). 

Ibid. 


wi) 
wi) 


FIG. 28 |Annual cannabis prevalence rates in 
the United States, the European Union, 
Australia, and at the global level, 1979- 
2015 


N 
oO 


R 
eal 


nn 


Annual prevalence (percentage) 
= 
=] 


(=) 


DHoAMMOnDDAAMNnRDAMMNBRDAAAMMN 
RAWAONDWDADANHDAAAAGWGOCGOR ra 
DAAAAAARAAARARWDOWDWDDODOO 
Ant At A TA A TA AA AANNNNNNN SN 


= European Union: prevalence among the 
population aged 15-64 

«=== Australia: prevalence among the population 
aged 14 and older 


=—— United States: prevalence among the 
population age 12 and older 


=== Global: prevalence among the population 
aged 15-64 
Sources: UNODC, responses to the annual report questionnaire; 


SAMHSA, EMCDDA and the Australian Institute of Health and 
Welfare. 


Cannabis use trends in Europe 


The average past-year prevalence of cannabis use 
among the general population (aged 15-64 years) 
has remained stable over the past decade in the Euro- 
pean Union member States, at around 6.6 per cent. 
However, at an annual prevalence of 13.3 per cent, 
cannabis use remains much higher among young 
people aged 15-34 years.°° Around 3 million adults 
(1 per cent) in the European Union member States 
are estimated to be daily or near daily cannabis users, 
70 per cent of whom are between 15 and 34 year 
of age and mostly male. 


In the three countries with a high-prevalence of 
cannabis use, Germany, Spain and the United 
Kingdom (England and Wales), cannabis use has 
remained stable, while Denmark and France have 
experienced an increase in cannabis use. Many 
countries in Europe with historically low prevalence 


56 EMCDDA, European Drug Report: Trends and Developments 
2016, (2016 Luxembourg, Publications Office of the Euro- 
pean Union, 2016). 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


FIG. 29 |Trends in past-month use of cannabis among adults (aged 15-64 years) in selected 
high-prevalence countries 


18 
16 
14 
12 
10 


Prevalence (percentange) 


oN FF DD OW 


ounwom anToot ounot OMNWOOaN ocoMuNAaAnSt MNWWOWAM ANMTONO 
S0edn COOHH SOOKXHX SOOSGH SSCGdH COOSOdH adda 
SSSCG SOSOCGCG SOOO SSOSGGO SSSSCGCG SSOSGSGGG SGORDR000 
NANNN NANNN NANNN NANNNN NANNNANN NANNNN NANNANAN 
>_~_o~So SS 
Saddaa 
Denmark Finland France Germany Italy Spain SooOoOO 
NANNANNSN 


Source: EMCDDA, Statistical Bulletin, 2016. 
Note: The data for the United Kingdom are from England and 
Wales only. 


of cannabis use, such as Finland, have reported an 
increase in cannabis use in recent years and are now 
high-prevalence countries. Other countries in 
Europe that have shown an increase in past-year 
cannabis use in recent years include Bulgaria, 
Czechia and Sweden.>” 


Decreasing trend in cannabis use 
in England and Wales 


Cannabis use in England and Wales has significantly 
declined over the past two decades. Although the 
annual prevalence of cannabis use remained stable 
between 2009/10 and 2015/16, at around 6.5 per 
cent of the adult population, the past-month preva- 
lence of cannabis use decreased by 14 per cent over 
the same period. In 2015/16, less than half (47 per 
cent) of past-month cannabis users reported that 
they used the drug less than once a week, while only 


14 per cent said they used cannabis daily or almost 
daily.>8 


7 Ibid. 

8 Deborah Lader, ed., Drug Misuse: Findings from the 2015/16 
Crime Survey for England and Wales, 2nd ed., Statistical Bul- 
letin 07/16 (London, Home Office, 2016). 


nN 


United Kingdom 


FIG. 30 | Trends in cannabis use in England 
and Wales, by age groups, 1996-2015/16 


A 


os 35 zs === 12 months 
& 30 S =— 30 days 
£ § — Lifetime 
5 25 6 
o o 
o 20 2 
= o 
g is & 
a 10 § 
g 2 
ro 
2 5 yg 
a £ 
0s 
wo omnnnk axa mM i L 
Dn Oo OD O 289 VO aA aA a — 
non jw~j QBDBHueowrewr a 
aaontswowaonrd 
Oo GO CO CO oA oA ol 
oOo Oo Oo Oo oO Oo 
N N N N N N N 
— 16-19 
= ——— 20-24 
8 
S ——45-54 
u 55-59 
wo 
roa) 
ro) 
= 
x 
7) 
Ss 
£ 


oO onnnre DAM 
Dn oO 9 fC 8G 8G A aA a 
o- oO ™ = SS SS SS OS SS 
aA wan Fy oOo WO ON Tt 
So O90 O89 OG 8A a =a 
So Oo oOo Oo Oo oO Oo 
NNN NN NN 


Source: Deborah Lader, ed., Drug Misuse: Findings from the 
2015/16 Crime Survey for England and Wales, 2nd ed., Statistical 
Bulletin 07/16, (London, Home Office, 2016). 


43 


WORLD DRUG REPORT 2017 


44 


Cannabis use is higher among younger 
age groups than older age groups, but it 
is increasing among older age groups 


In England and Wales, there is a higher rate of can- 
nabis use among young adults aged 16-19 years and 
those aged 20-24 years than among the older age 
groups, although both past-year and past-month 
prevalence have decreased significantly among young 
adults since 1996. Higher levels of cannabis use in 
the past-year were also reported among those adults 
who consumed alcohol three or more days a week 
in the past month, were unemployed or economi- 
cally inactive, had a lower perception of risk of harm, 
as well as among those who visited nightclubs or 
bars/pubs on four or more occasions in the past 
month. While overall cannabis use is low among 
the older age groups (45-54 years and 55-59 years), 
there has been a significant increase among those 
age groups since 1996. Reflecting the ageing cohort 
of cannabis users that reported relatively higher can- 
nabis use in the past, the past-year prevalence of 
cannabis use among 45-54 and 55-59 year olds has 
increased significantly: from 1.4 per cent and 0.5 
per cent, respectively, in 1996, to 2.3 per cent and 
1.5 per cent in 2015/16.>9 


Cannabis use among 15-16 year olds has 
declined in Europe 


In 2015, the annual prevalence and past-month 
prevalence of cannabis use among 15-16 year olds 
in Europe was reported to be 13 per cent and 7 per 
cent, respectively; on average, that age group had 
used cannabis 8 or 9 times in the past 12 months. 
Lifetime prevalence of cannabis use among adoles- 
cents varies from country to country, ranging from 
37 per cent in Czechia and 31 per cent in France to 
7 per cent in both Sweden and Norway. Contrary 
to the trends in the adult population, a decrease in 
the prevalence of cannabis use among adolescents 
was observed in Czechia, Denmark, Finland and 
France. 


In Europe, a number of factors may play a signifi- 
cant role in determining the varying trends between 


59 Ibid. 

60 EMCDDA and European School Survey Project on Alcohol 
and Other Drugs, ESPAD Report 2015: Results from the 
European School Survey Projects on Alcohol and other Drugs 
(Lisbon, 2016). 


FIG. 31 | Trends in cannabis use among 15-16 
years old in Europe 


_ 20 35 
oo 

Bp 18 30 8 
2 16 5 
8 14 25 § 
2 

g 2 20 = 
a 10 ate] 
£ 8 15 ¢ 
a < 
g i 10 5 
= ° 
a 35 > 
0 0s 

un fon) ise) DP a un & 

(op) fo)) (o) (o) d od = 

a a o °o fo) fo) g 

a | N N N N o 

= Lifetime 8 
== Past-month 9 
~~~ Past-year o 
a 


—— Perceived availability of cannabis 


Source: ESAPD Report 2015. 


countries in cannabis use among young people.°! 
The perceived availability of cannabis and number 
of cannabis-using friends are positively related to 
cannabis use behaviours, while there is a negative 
correlation between perceived risk of harm in using 
cannabis and its actual use. The association between 
perceived cannabis use among peers and cannabis 
use among adolescents is stronger in European coun- 
tries where access to cannabis is perceived to be 
difficult. The influence of the immediate social situ- 
ation seems to be more strongly associated with 
cannabis use among 15-16 year olds than are distal 
influences related to the broader social 
environment. 


Increase in treatment of cannabis use 
disorders among young adults in Europe 


In Europe, there was a 50 per cent increase from 
2006 to 2014 in the number of first-time entrants 
for treatment of cannabis use disorders. The vast 
majority (86 per cent) of people entering treatment 
primarily for cannabis use disorders were aged 34 
years or younger, with the mean age being 25 


61 Daniela Piontek and others, “Individual and country-level 
effects of cannabis-related perceptions on cannabis use: a 
multilevel study among adolescents in 32 European coun- 
tries”, Journal of Adolescent Health, vol. 52, No. 4 (2013), 
pp. 473 -479. 

62 Ibid. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


FIG, $2 | Trends in cannabis use among 15-16 year olds in selected countries 


50 


Prevalence (percentage) 
—_ N w pS 
oo 86 8 


jo) 


Past-month 
2011 m2015 


Lifetime Past-year 


m1999 ™2003 m 2007 


| 
- 
ite) 
te) 
ui 


Www Php f 
ounon 


Prevalence (percentage) 
N 
uw 


Past-month 


Lifetime 


Past-year 
©1999 ©2003 2007 m2011 © 2015 


Source: ESAPD Report 2015. 


years. This increase in treatment of cannabis use 
disorders can be attributed to the availability of more 
harmful and higher-potency cannabis products — 
which are in turn associated with an increase in the 
severity of dependence and disorders — as well as 
to an increase in the availability of treatment and 
referral practices.o4 65, 66, 67 


63 EMCDDA, “Perspectives on drugs: characteristics of fre- 
quent and high-risk cannabis users” (Lisbon, 2013). 

64 TT. P. Freeman and A. R. Winstock, “Examining the profile 
of high-potency cannabis and its association with severity of 
cannabis dependence”, Psychological Medicine, vol. 45, No. 
5 (2015), pp. 3181-3189. 

65 EMCDDA, European Drug Report: Trends and Developments 
2016. 

66 Jonathan Schettino and others, Treatment of Cannabis- 
related Disorders in Europe, EMCDDA Insights Series No. 

7 (Luxembourg, Publications Office of the European 
Union, 2015). 


67 See World Drug Report 2016. 


— 30 ; 
v Denmark 
& 25 ————_, 
o 
9 20 
2. 
= 15: 
ao 
12) 
& 10 
g 
o 5 
a 
0) 
Lifetime Past-year Past-month 
©1995 1999 2003 m2011 © 2015 
12 
g 
8 10 
c 
3 8 
i) 
& 6 
g 
c 4 
2 
3 2 
i 
Lifetime Past-year Past-month 
©1995 ©1999 ™2003 m2007 | 2011 2015 


Developments in measures regulating 
recreational cannabis use in the 
United States and Uruguay 


This section reviews trends in cannabis use in the 
United States, where there has been state-level legali- 
zation of cannabis cultivation and sale for recreational 
use in some states and for medical use of cannabis 
in others. The World Drug Report 2016 looked at 
the outcome of cannabis legislation in terms of 
developments in public health, public safety, crimi- 
nal justice and cannabis markets. This section 
presents some further developments in cannabis 
legislation in the United States and, in particular, 
reviews the extent of exposure of the adult and youth 
populations to cannabis, as well as the interplay 
between the use of cannabis for recreational and 
medical purposes. The section also provides a brief 
update on the status of implementation of cannabis 
regulation in Uruguay. 


A 


45 


WORLD DRUG REPORT 2017 


46 


Preferences and patterns of use of plant-based cannabis and synthetic 


cannabinoids 


The emergence of synthetic cannabinoid receptor agonist sold 
under names such as “Spice” and “K2", as new psychoactive 
substances, was first reported in 2004 and they have since 
been increasingly reported in different parts of the world. 
Synthetic cannabinoids comprise different products with 
chemical structures dissimilar to tetrahydrocannabinol (THC) 
(the principle psychoactive constituent of natural cannabis). 


Effects of synthetic cannabinoid receptor 
agonists 


There is growing recognition and reporting of the harm asso- 
ciated with intoxication with synthetic cannabinoids, which 
results in emergency room visits. The symptoms include tachy- 
cardia, psychosis, agitation, anxiety, breathing difficulties and 
seizures. The literature also shows that the use of synthetic 
cannabinoids has unpredictable negative psychological and 
physiological effects. Intoxication with some forms of syn- 
thetic cannabinoids can have severe effects; for instance, 
in an outbreak in New York, people reported experiencing 
“zombie-like” severe depressant effects after intoxication 
with the synthetic cannabinoid AMB-FUBINACA. 


Experiences of cannabis users 


The self-reported experiences of cannabis users who had 
recently used synthetic and natural cannabis show that almost 
all recent synthetic cannabinoid users reported that they had 
used natural cannabis, which they preferred over synthetic 
cannabinoids and used for a greater number of days. The 
use of synthetic cannabinoids is associated with more overall 
negative effects than the use of natural cannabis, including 
greater effects on the lungs, hangover effects and a greater 
level of anxiety and paranoia, as reported by users. Among 


those cannabis users, natural cannabis was considered to pro- 
duce more memory impairment than synthetic cannabinoids, 
and was perceived to be more addictive. Natural cannabis 
was, however, considered a more consistent product than 
synthetic cannabinoids. 


Overall, synthetic cannabinoids represent a diverse group of 
potent psychoactive compounds that are considered a substi- 
tute for natural cannabis but may result in acute intoxication 
and have long-term negative effects on health. Many cannabis 
users, such as those in prison settings, may substitute cannabis 
with synthetic cannabinoids to avoid sanctions (for details, see 
booklet 4 of this report). However, it cannot be concluded that 
the untoward or undesirable effects of synthetic cannabinoid 
receptor agonists will limit their uptake or use. 


In 2016, voters in California, Maine, Massachusetts 
and Nevada voted to allow the legalization of can- 
nabis for recreational use in their jurisdictions, while 
voters in one state rejected the proposition to legal- 
ize cannabis cultivation and use. The approved 
measures allow adults aged 21 years and older in 
those four states to possess cannabis for personal use 
and to grow cannabis plants at home. The total 
number of state-level jurisdictions that now allow 
use of cannabis for recreational purposes has grown 
to eight, plus the District of Columbia.°® ©? Of 
much greater importance is that all those jurisdic- 
tions, not including the District of Columbia, are 


68 Home cultivation is not allowed in the State of Washing- 
ton. The number of plants allowed in each state varies. 


69 National Conference of State Legislatures (www.ncsl.org). 


now licensing or are in the process of developing 
licensing schemes to enable for-profit companies to 
produce, market and sell a wide range of cannabis 
products. All of the states that have legalized can- 
nabis use had prior measures allowing the medical 
use of cannabis. 


The regulations that allow the sale and personal use 
of cannabis across the different jurisdictions 
permitting such measures differ in their provisions 
as well as in their implementation, as summarized 
in the annex of this booklet. Nevertheless, the states 
that voted in favour of the cultivation, sale and 
personal possession of cannabis for recreational use 
in 2016 have some measures that are similar to those 
passed by the four states that had previously 
permitted recreational cannabis use. These measures 
include: the establishment of a regulatory authority 
and a commercial system of production and supply 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


MAP 3 | Jurisdictions in the United States that allow recreational use, medical use of cannabis and 


those that allow no access to cannabis 


Recreational 
HS Medical 

Limited medical 

No access laws 


Source: Based on information from the National Conference of State Legislatures (NCSL) as of 12 May 2017. 


Notes: The boundaries shown on this map do not imply official endorsement or acceptance by the United Nations. 


by private enterprises; taxation at retail and, in some 
jurisdictions, at the production or cultivation levels; 
certain restrictions on advertisements; packaging 
and labelling restrictions on edibles; and measures 
concerning health and safety standards. California, 
Maine, Massachusetts and Nevada also allow 
on-premises consumption of cannabis at retail or 
specially licensed establishments.”° As it is partly 
within the federal territory, the District of Columbia 
allows “home grown and home use” because people 
can still be arrested for possession of cannabis in the 
federal territory.”! Many issues remain unresolved. 
The legislation that was approved in most of these 
states did not set a maximum limit on THC content, 
whereas states such as Oregon have since done so; 
other states such as California are in the rule-making 
process for the implementation of cannabis 
legislation. 


In the 2016 election, voters in four other states, 
Arkansas, Florida, Montana and North Dakota, 


70 BOTEC Analysis, “Cannabis report: the 2016 election and 
ballot initiatives”, 26 October 2016. Available at http:// 
botecanalysis.com/cannabis-the-election/; accessed 12 May 
2017. 

71 Department of Health of the District of Columbia, “Mari- 
juana in the District of Columbia’, LaQuandra S. Nesbitt 
and others, eds. (July 2016). 


voted for measures to allow medical cannabis. In 
April 2017, West Virginia also passed legislation, 
making a total of 29 states that now have compre- 
hensive laws allowing the production, sale and use 
of cannabis for medical conditions. These include 
the states with measures allowing the production 
and sale of cannabis for recreational use. In the Dis- 
trict of Columbia, the law allows patients to obtain 
cannabis for medical use only from a dispensary 
licensed by the District’s Health Department and 
does not allow patients or their caregivers to grow 
cannabis. A further 16 states have laws that allow 
the use of products containing low THC levels and/ 
or high cannabidiol (CBD) levels for medical con- 
ditions such as epileptic seizures or seizure 
disorders.72 


The evaluation of the impact of the measures allow- 
ing the commercial production, sale and recreational 
use of cannabis on health, criminal justice and other 
outcomes requires regular monitoring over time, 
and it may take years to determine their long-term 
effect on cannabis use and associated harm among 
adults, as well as their influence on cannabis use 


72 National Conference of State Legislatures, “State medical 
marijuana laws”, 21 April 2017. Available at www.ncsl.org/ 
research/health/state-medical-marijuana-laws.aspx. 


A 


47 


WORLD DRUG REPORT 2017 


48 


Medical marijuana in the United States 


Many countries have regulations that allow the use of can- 
nabinoid-based medications. Similar to the approval of any 
pharmaceutical product, the approval of cannabinoid-based 
medications typically follows an established protocol in which 
clinical trials have proved the preparation to be effective for 
determined conditions and recommendations are made on dos- 
ages and conditions for use. In the United States, the approval 
of cannabis for medical purposes has followed a more com- 
plex pattern. The United States Food and Drug Administration 
(FDA), the federal agency in charge of approving medications 
for the United States market, has so far approved three non- 
botanical formulations based on the molecular structure of 
cannabinoids — dronabinol, a synthetic 9-tetrahydrocannabi- 
nol, its oral capsule and liquid formulations and, nabilone, 
a synthetic analogue of THC for oral use. Several additional 
cannabinoid-based medications — Sativex@ (composed of THC 
and CBD), Epidiolex (cannabidiol oil) and another CBD oral 
solution were each granted Fast Track designations by FDA 
to facilitate development and expedite FDA review of their 
respective therapeutic indications.b According to the United 
States National Academies of Sciences, Engineering and Medi- 
cine, in California, clinical and preclinical trials of cannabinoids 
were initiated in 2000, with 13 out of the 21 approved studies 
completed. In Colorado, research on the medicinal benefits of 
cannabis products was initiated in 2015.¢ 


As of May 2017, independent of the approval of pharmaceuti- 
cal preparations, the use of cannabis products, such as herb (for 
vaporizing), extracts (tinctures), edibles and capsules for medical 
purposes, has been introduced in 29 states through statutory 
laws or constitutional amendments as voter initiatives, either 
through direct ballot or through state legislatures.¢ Although 
most states currently have, or had in the past, a therapeutic 
research programme, the cannabis products that are dispensed 
have not been developed through rigorous scientific processes. 
No products “developed” from state research programmes 
have received FDA approval. While the conditions that allow 
medical use of cannabis vary in each of those 29 states, most 
of the states require that a physician submit a signed form 
to the state regarding a person’s eligibility for such use and 
most have a programme for registering patients for medical 
use of cannabis based on the physician's recommendation. In 
California and Maine, however, the registration of patients is 
considered voluntary or optional, whereas the state of Wash- 
ington has no system for the registration of medical cannabis 
users in place. Many states such as California allow medical 


among adolescents.’> Indeed, since the effects of 
changes in one state spill over and affect other states, 
there remain limitations to the evaluation of the 
effects of these policy changes due to extraneous 


3 Wayne Hall and Megan Weier, “Assessing the public health 
impacts of legalizing recreational cannabis use in the USA”, 
Clinical Pharmacology and Therapeutics, vol. 97 (June 
2015), pp. 607-615. 


use of cannabis for a broad set of indications that may include 
any serious medical condition for which cannabis could provide 
relief.4.¢ In some states the law requires the state to produce 
and distribute cannabis products, including plants (for vapor- 
izing), tinctures and capsules, in clinical settings, while in other 
states doctors are required to prescribe cannabis products and 
monitor the results. However, these measures have proved 
unworkable as they require physicians or clinics to violate fed- 
eral law. While the states that allow medical use of cannabis 
have passed legislation regulating the production, sale and 
dispensation of medical cannabis, there are differences in the 
manner and length of time in which these measures have 
been implemented. 


Although there are plans by the National Institute on Drug 
Abuse at the national level to provide a range of clinically 
relevant cannabis products for research, there are significant 
regulatory barriers for conducting such research on the health 
effects of different cannabis products. Also, those products 
need to be comparable with or relevant to the range of medi- 
cal cannabis products used by consumers in the states where 
use of medical cannabis is permitted.f In most of those states 
the range of products currently available for medical purposes 
has not gone through the rigours of research in product devel- 
opment, clinical trials determining health effects, optimum 
dosage, standardized dosing, methods of administration and 
overall quality control measures employed for all pharmaceuti- 
cal products. 


4 As of September 2016, Nabiximols has been lau 
countries and approved in a further 12. 


ed in 15 


> National Academies of Sciences, Engineering, and Medicine, The 
Health Effects Of Cannabis And Cannabinoids: The Current State 
of Evidence and Recommendations for Research (Was' hington, D. 
C, National Academies Press, 2017). 


- Marijuana Policy Project, “State-by-State medical marijuana 
hington, D. 


Rosalie L. Pacula and others, “State medical marijuana laws: 
understanding the laws and their limitations”, Journal of Public 


Health Policy, vol. 23, No. 4 (2002), pp. 23, 413-439. 


- Fairman, J, B., “Trends in registered medi 
pation across 13 US states and District of C 
Alcohol Dependence, 159 (2016) 72-79. 


emies of Sciences, Engineering, and Medicine, The 
's of Cannabis and Cannabino 


factors.74 One example of these limitations is the 
comparison of trends in the perceived risk of can- 
nabis use in the states that have, and those that have 
not, legalized cannabis. Risk perceptions of harm 
negatively influence cannabis use behaviours and 


74 Wayne Hall and Megan Weier, “Has marijuana legalization 
increased marijuana use among US youth”, JAMA Paediat- 
rics, Vol. 171, No. 2 (February 2017), pp. 116-118. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


are considered a protective factor; however, risk per- 
ceptions among the general population have 
declined over the years in the entire United States 
due to a number of factors, which include: the spill- 
over effects of policy debates over legalization; an 
increase in cannabis use, which is perceived to be 
less risky among users; and the media coverage of 
the medical use of cannabis in many states.7> In 
addition, legislation and contexts vary considerably 
across states that have passed legislation legalizing 
recreational and medical cannabis. Therefore, gen- 
eral analysis comparing states that allow recreational 
markets with those that do not has limitations. 


The following sections review some of these issues 
in an attempt to understand the influence of meas- 
ures regulating cannabis production and use on 
behaviours related to cannabis use in the general 
population. 


The approval of state-level cannabis regu- 
lations has occurred in an environment of 
overall increase in cannabis use across the 
United States 


It is challenging to measure the health impact of the 
new regulations implemented by some of the states 
in the United States since cannabis laws have 
changed in concomitance with a series of other ele- 
ments that have changed the cannabis market not 
only in the concerned states, but across the entire 
United States. Overall, cannabis use has increased 
in the United States among adults aged 18 years and 
older since 2002.76 This has occurred in an environ- 
ment with decreasing perceptions of risk of harm 
from cannabis use, in which some states have per- 
mitted the medical use of cannabis, and with 
extensive media coverage of state level debates 
around the medical use or legalization of cannabis 
for recreational use. 


The increase in cannabis use has been among heavy 
users and those aged 26 years or older, in particu- 
lar.”7 The high prevalence and frequency of cannabis 


75 Ibid. 


76 Alejandro Azofeifa and others “National estimates of 
marijuana use and related indicators — National Survey on 
Drug Use and Health”, United States, 2002-2014. MMWR 
Surveillance Summaries 2016; 65, No. SS-11, pp.1-25. 
Ayailable at http://dx.doi.org/10.15585/mmwr.ss651 lal. 


rijuana use and use 
: analysis of annual 
cross sectional surveys”, Lancet Psychiatry 2016; 3: 954-64. 


77 Wilson M. Compton and others, “M 
disorders in adults in the USA, 2002-1 


A 


FIG. 33 | United States: cannabis use patterns, risk 
perception, availability and medical cannabis 
among the population aged 18 years and 
older, 2002-2015 


280 
= re By 2007, 12 states had 
o ] i 
SF 520 Bie gsules allgennne 
& 200 medical cannabis use q 
S 180 
= 160 
& 140 
= 120 
100 
80 
Novwunwo nrwWaDdATANmMDa TY 
oo eo o8 Ge 8 Bs st Ft st st a 
Oo oo o0ocmUmcmPWUCcUOUCOUCOOUCUCOUCOUCUCO 
NNNNN NNN NNN NN SN 


—— Past-year use 
=== Past-month use 
== Daily or near daily use 
— No risk of harm 
Availability 
== People resident in state with medical use legalized 


Sources: Key Substance Use and Mental Health Indicators in the 
United States: Results from the 2015 National Survey on Drug Use 
and Health, 

and earlier surveys and adapted from Compton and others, “Mari- 
juana use and use disorders in adults in the USA, 2002-14: analysis 
of annual cross sectional surveys”, Lancet Psychiatry 2016; 3: 954-64. 


Note: Compton and others analysed the trends in cannabis use from 
2002-2014. 


use observed among adults has been associated with 
those who perceive no risk of harm from cannabis 
smoking; among those from lower socioeconomic 
groups; and those residing in a jurisdiction that per- 
mitted the medical use of cannabis.7®: 7? According 
to data from the National Survey on Drug Use and 
Health (NSDUH), the past-month prevalence of 
cannabis use among the population aged 12 years 
and older in the United States increased from 6.2 
per cent in 2002 to 8.3 per cent in 2015, with an 
estimated 22 million people aged 12 years and older 
being current (past-month) cannabis users in 
2015.80 Since 2008 there has been a consistent 
year-on-year increase in cannabis use among the 


78 Ibid. 

79 Davenport and Caulkins, “Evolution of the United States 
marijuana market”. 

80 Center for Behavioral Health Statistics and Quality, “Key 
substance use and mental health indicators in the United States: 
Results from the 2015 National Survey on Drug Use and 
Health” (HHS Publication No. SMA 16-4984, NSDUH 


Series H-51). Retrieved from http://www.samhsa.gov/data/. 


49 


WORLD DRUG REPORT 2017 


50 


FIG. 84 | Cannabis use in the past month among the population aged 12 years and older in the 
United States as a whole, in states with measures allowing recreational cannabis market, 


and other selected states, 2002-2015 
States allowing 


Past-month prevalence (percentage) 
be 
(=) 
| 
| 
| 
| 
| 


4 a a a PR Ae a PP A 
2 
Nossrtreunwonrwoeandaocntnoawat ww 
(oo © ee 2 2 © ee 2 ee oe ee 
oooo°ncncmcuUmmcUcUKUlmlUCcUlUmlUCUCOUcUCUOU hDSYrhlUhYWhUh PO CUO 
NNNNNNNNNN ANON 
~~ ~~ nS ~~ ~~ nN nN rN Lf De | bed 
NmnmtrnuworR WOOHOO COO + 
oooooeococmcUmUWDClUKUOUMUWVACCUNNON NAN 
oOo 0Oo0UlcUMmMUrmUmUCOMUCOUCUCUNOUCUCUCOONUCO Oo 
NNNNN NNN SN N 
United States Alaska 
California —— Colorado 
District of Columbia Maine 
Massachusetts Nevada 
Oregon Washington 


Past-month prevalence (percentage) 


4 
2 } 
Nomornwo BR wWODOTANM TST 
(os © 2 © © ee © Se oe ee ee 
ooooo°”cooo0o0o06lUrttTl YSU SUD 
NNNNNNN NNN DAN MNS 
~~  “ S ss SS Ss Se Ss EE et ci Ss. 
Nosrvrnvonrwoaananodcrodort 
OoooocmUmDWCUUUOUCNOUUCUNDCMWACUCUNNON NN Gt 
oOo Oo0lOmOUlUmUCOUCOUUCUCOUCUCOOCUCOO oO 
NNNNN NNN ES N 
United States Florida 
Illinois Maryland 


New Hampshire 


Source: Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug 
Use and Health, earlier surveys and SAMHSA State level estimates for the different years. Except for 2002, the state level esti- 
mates are presented as two-year averages. Alaska, Colorado, California, Maine, Nevada and Oregon had medical cannabis in 


2000 or earlier. 


population aged 12 years and older, particularly in 
those states that currently allow the production and 
sale of cannabis for recreational use among adults. 
In those states, rates of cannabis use higher than the 
national average have been observed, although they 


FIG. 35 | United States: trends in cannabis 
use initiation in the past year, by age 
groups, 2002-2015 


180 


160 


100) 


140 


120 


100 


Index (2002 


80 


60 = 


Oot NM TY 
ee ee et et oe 
ooOo0O0UmUmUWmUCDOUCUCOO 
NNN NN SN 


== 12-17 years ——— 18-25 years 26 or older 


Source: Elaborated from NSDUH presented in Rachel N. Lipari 
and others, “Risk and protective factors and estimates of sub- 
stance use initiation: results from the 2015 National Survey on 
Drug Use and Health” (SAMHSA, October 2016). 


precede any measures to legalize cannabis. The 
increase in cannabis use, although not in all states, 
can also be seen in those states that have not legal- 
ized recreational use of cannabis. Overall, the 
increasing trend in cannabis use is considered to be 
associated with provisions of medical cannabis — 
with the evidence suggesting an overall reciprocal 
relationship between social attitudes and cannabis 
use patterns.®! Beginning with California in 1996 
and followed by Alaska, Oregon and Washington 
in 1998, 12 jurisdictions had made provisions for 
the medical use of cannabis by 2007. The cumula- 
tive effects of these policy changes might have led 
to changes in the risk perceptions of harm from 
cannabis use among the adult population and a sub- 
sequent increase in cannabis use.82 


81 Rosalie L. Pacula and others, “Assessing the effects of 
medical marijuana laws on marijuana use: the devil is in the 
details”, Journal of Policy Analysis and Management, vol. 34, 
No. 1 (2015), pp. 7-31. 

82 Compton and others, “Marijuana use and use disorders in 
adults in the USA, 2002-14”. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


FIG. 36 | Past-month prevalence of non-medical 
cannabis use among older age groups, 
prior to and following the legalization 
of medical cannabis use, 2004-2013 


After medical 
cannabis 


Before medical 
cannabis 


@ 12 
8 
5 10 
2 
a 8 
g 
£ 6 
rc 
a 4 
a 
Ss 2 
c 
fo) 
—E 0 
% 
oO 
a 


——— 26-39 years ——— 40-64 years 65+ 


Source: Silvia S. Martins and others, “State-level medical 
marijuana laws, marijuana use and perceived availability of 
marijuana among the general US population”, Drug and 
Alcohol Dependence, vol. 1 (December 2016), pp. 26-32. 


Medical cannabis use regulations may 
have influenced the risk of adult non- 
medical cannabis use 


Compared with the other states, those that allow 
medical use of cannabis have higher prevalence of 
past-month non-medical use of cannabis in all age 
groups. But laws that permit the medical use of can- 
nabis appear, as yet, to have had little effect on the 
prevalence rate of recreational use of cannabis among 
adolescents, while they may have influenced the risk 


of non-medical cannabis use among the adult popu- 
lation.83; 84, 85 


In the states that allow medical cannabis use, past- 
month non-medical use of cannabis increased 


83 Melanie M. Wall and others, “Prevalence of marijuana use 
does not differentially increase among youth after states pass 
medical marijuana laws: commentary on Stolzenberg et al. 
(2015) and reanalysis of US National Survey on Drug Use 
in Households data 2002-2011”, [nternational Journal of 
Drug Policy, vol. 29 (2016), pp. 9-13. 

84 Deborah S. Hasin and others, “State medical marijuana 
laws and adolescent marijuana use in the United States: 
1991-2014”, Lancet Psychiatry, vol. 2, No. 7 (July 2015), 
pp. 601-608. 

85 Silvia S. Martins and others, “State-level medical marijuana 
laws, marijuana use and perceived availability of marijuana 
among the general US population”, Drug and Alcohol 
Dependence, vol. 1 (December 2016), pp. 26-32. 


significantly among the population aged 26 years 
and older from 5.8 per cent to 7.2 per cent over the 
period 2004-2013. Among the younger age groups 
(12-17 years and 18-25 years), however, changes in 
the prevalence of non-medical cannabis use were 
not statistically significant and not considered to be 
related to the measures that allow the use of can- 
nabis for medical purposes.8° Cannabis users living 
in the states that have measures allowing medical 
cannabis use also reported a higher perception of 
easy availability of cannabis. Although this percep- 
tion has not changed among the younger age groups 
(12-17 and 18-25) since medical cannabis laws were 
introduced in those states, there has been a signifi- 
cant increase in the perceived easy availability of 
cannabis among those aged 26 years or older.87 Past- 
month recreational cannabis use and the perceptions 
of easy availability of cannabis have increased sig- 
nificantly in all the older groups since the passing 
of medical cannabis laws.88. 89 


Difference between recreational and medi- 
cal users in the United States 


In March 2016, around 1.2 million people were 
estimated to be registered for medical cannabis cards 
across the United States, 9! which corresponds to 
eight medical cannabis patients per 1,000 popula- 
tion. The highest rates of registration per 1,000 
population were in Colorado (19.8), California 
(19.4), Washington (19.2) and Oregon (19.2); states 
with the longest standing medical cannabis provi- 
sions.?2 However, these estimates should be 
considered with caution as several states do not 
maintain registries of medical cannabis. 


86 Ibid. 

87 Ibid. 

88 Ibid. 

89 Alejandro Azofeifa and others “National estimates of mari- 
juana use and related indicators — National Survey on Drug 
Use and Health”. 

90 Estimated number of medical cannabis users registered in 
21 out of 23 states and the District of Columbia that have 
medical cannabis laws. 

91 ProCon.org, “Number of legal medical marijuana patients 
(as of 1 March 2016)”. Available at http://medicalmari- 
juana.procon.org/view.resource.php?resourceID=005889 


(last updated on 3 March 2016). 


92 The medical cannabis law in California was passed in 1996, 
in Oregon and Washington in 1998 and in Colorado in 
2000. 


A 


51 


WORLD DRUG REPORT 2017 


52 


In the United States, the National Academies of Sciences, Engi- 
neering and Medicine recently published The Health Effects of 
Cannabis and Cannabinoids: the Current State of Evidence and 
Recommendations for Research. A summary of NAS evidence 


of the therapeutic effects of products based on cannabis and 
cannabinoids and the statistical association between cannabis 
use and the incurrence of health conditions can be found in 
the annex of this booklet. 


According to the National Academies of Sciences, 
Engineering and Medicine, there is evidence that 
medical use of cannabis-based products is effective 
for a limited number of conditions? (see the annex 
of this booklet). However, it is likely that in the 
medical cannabis system in place in the jurisdictions 
in United States, not all of the people who have a 
condition that may qualify for medical cannabis 
products are registered; conversely, many patients 
who are registered may not even have a medical 
condition.” Studies also suggest that younger reg- 
istrants may be more likely to engage in the diversion 
of medical cannabis or may only be registered in 
order to circumvent the laws prohibiting recreational 
cannabis use, although the exact extent of this is not 
known.” Trends in the characteristics of people 
participating in medical cannabis programmes can 
help understand the public health and policy issues 
surrounding access to medical cannabis, although 
this information is not available uniformly in all 
states with such programmes.?© Based on data from 
the states where multiple data points on registered 
medical cannabis use were available, the majority 
(between 50 per cent and 75 per cent) of patients 
registered in medical cannabis programmes were 
male. The age distribution of participants in eight 
states shows that a large proportion of registrants 
were in their 40s and 50s. However, this was differ- 
ent in states such as Colorado and Arizona where 
young adults (18-30 years) made up around one 
quarter of the participants in medical cannabis 
programmes.?” 


93 The Health Effects of Cannabis and Cannabinoids. 

94 “Number of legal medical marijuana patients”. Available 
at http://medicalmarijuana.procon.org/view.resource. 
php?resourceID=005889. 

95 Fairman, “Trends in registered medical marijuana participa- 
tion”. 

96 Ibid. 


97 Ibid. 


In many jurisdictions the medical cannabis market 
is used for both medical and recreational purposes. 
According to a national consumer panel survey of 
adults in 2014, more than one third of the 
respondents reported current use of medical cannabis 
for both medical and recreational purposes.?® Those 
who use medical cannabis solely for medical purposes 
tend to use it for alleviating perceived medical 
symptoms in addition to alleviating anxiety, 
depression or other psychological symptoms.®? 
Recreational cannabis users who access the medical 
cannabis market may be a heterogeneous group who 
use cannabis for different motives, including 
experimentation, coping and other social or 
psychological reasons.!99, 101 NSDUH data from 
2013 and 2014 show that medical cannabis use was 
associated with the older age groups, poorer health 
status and with anxiety disorder.!92 Furthermore, 
among people reporting medical cannabis use the 
prevalence of daily or almost daily cannabis use was 
three times higher than among those reporting 
recreational use, although the same proportion (11 
per cent and 10 per cent, respectively) of individuals 
who used cannabis recreationally or medically met 
the criteria for cannabis use disorders. Both groups 
had similar levels of depression, although medical 
cannabis users were less likely to meet the criteria 
for alcohol use disorder or to use other illicit drugs. 
Similarities in correlates of medical and non-medical 
cannabis users, especially co-occurrence of psychiatric 
conditions and other substance use, suggest that 
some cannabis users may access medical cannabis 
without a diagnosed medical need.103 104 


98 Gillian L. Schauer, and others, “Toking, Vaping, and Eating 
for Health or Fun Marijuana Use Patterns in Adults, U.S., 
2014” American Journal of Preventive Medicine, vol. 50, No. 
1, pp. 1-8 (January 2016). 

99 Wilson M. Compton and others, “Use of marijuana for 
medical purposes among adults in the United States”, JAMA, 
vol. 317, No. 2 (2017), pp. 209-211. 

00 Lewei A. Lin and others, “Comparing adults who use can- 

nabis medically with those who use recreationally: results 

from a national sample”, Addictive Behaviors, vol. 61 

(2016), pp. 99-103. 

Wilson M. Compton and others, “Use of marijuana for 

medical purposes among adults in the United States”, 


JAMA, vol. 317, No. 2 (2017), pp. 209-211. 
02 Ibid. 
03 Ibid. 


04 Marcel O. Bon-Miller and others, “Selfreported cannabis 
use characteristics, patterns and helpfulness among medi- 
cal cannabis users”, American Journal of Drug and Alcohol 
Abuse, vol. 40, No. 1 (2014), pp. 23-30. 


0 


= 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


Has cannabis use among high school 
students changed in states that have 
legalized recreational cannabis use? 


One important element in understanding the impact 
of legalizing recreational use of cannabis is to 
examine the extent to which such measures have 
influenced and affected the use of cannabis by 
adolescents. Current research on the subject remains 
inconclusive, however. National data show that, in 
contrast to the increase in cannabis use among 
adults, the prevalence of past-year and past-month 
cannabis use across the United States has declined 
among 8' and 10 grade high school students and 
has remained unchanged among twelfth graders in 
the past five years or so. Similarly, current daily use 
or near daily use has declined among 8‘ and 10t 
graders and has remained at similar levels among 
twelfth graders over the same period.!95 


Some studies have looked at state level data and 
concluded that past-year cannabis use is higher 
among twelfth grade students in states with laws 
permitting the use of cannabis for medical purposes 
than in states without such laws (38.3 per cent vs. 
33.3 per cent), although these studies suggest that 
these differences precede those measures, presum- 
ably, in part, because states that allow the use of 


medical cannabis have had very liberal medical can- 
nabis laws. 196, 107 


A study based on data from the Monitoring the 
Future survey compared trends in cannabis use 
among high school students in Colorado and Wash- 
ington over the periods 2010-2012 and 2013-2015 
with those in states that had not, at that time, legal- 
ized recreational use of cannabis.!98 The study 
showed that there was an increase in cannabis use 
among eighth and tenth graders in the state of 


105 Lloyd D. Johnston and others, Monitoring the Future 
National Survey Results on Drug Use, 1975-2016: Over- 
view, Key Findings on Adolescent Drug Use (Ann Arbor, 
Michigan, University of Michigan Institute for Social 
Research, 2017). 

106 United States, National Institute on Drug Abuse, Moni- 
toring the Future Survey: High School and Youth Trends 
(revised December 2016). 

107 Deborah Hasin and others, “State medical marijuana laws 
and adolescent marijuana use in the United States: 1991- 
2014. 

108 Magdalena Cerda, and others “Association of state recrea- 
tional marijuana laws with adolescent marijuana use”, /AMA 


Pedriatic, vol. 171, No. 2 (February 2017). 


Washington after cannabis had been legalized. In 
Colorado, cannabis use among eighth and tenth 
graders remained stable or decreased, while in states 
that had not legalized recreational cannabis use it 
declined. Past-month cannabis use among twelfth 
graders remained at similar levels in Colorado, 
Washington and in states that had not legalized rec- 
reational cannabis use. However, the data used in 
this study were not representative at state level. Dif- 
ferent data from the State Healthy Youth Survey 
showed that the prevalence of cannabis use among 
tenth graders remained unchanged in Washington 
during the period 2001-2014.199 


Different trends in different states could relate to 
exposure to the medical cannabis market. The 
expansion of for-profit dispensaries in Colorado had 
effectively legalized the commercial supply of can- 
nabis before the laws were passed to allow for 
recreational use. Cannabis use among youth may 
not have changed as they would have already formed 
their attitudes and beliefs about cannabis use and 
were therefore less likely to be influenced by legali- 
zation measures. 


Earlier studies found no differences in rates of 
change in cannabis use among youth or in the per- 
ceived risk of cannabis use between states that allow 
medical cannabis use and those that do not.1!® 111 
It is not conclusive whether legalizing cannabis for 
recreational use among adults would influence its 
use among adolescents,!!? and further quality data 
and analysis representative at state level of long-term 
trends are required to address the question. 


09 Anar Shah and Mandy Stahre, “Marijuana use among 10th 
grade students — Washington, 2014”. Morbidity and Mortal- 
ity Weekly Report, 65 (30 December 2016), pp. 1421-1424. 
DOE: http://dx.doi.org/10.15585/mmwr.mm65505 lal 

10 Melanie M. Wall and others, “Adolescent marijuana use 

from 2002 to 2008: higher in States with medical mari- 

juana laws, cause still unclear”, Annals of Epidemiology, vol. 

21, No. 9 (September 2011) pp. 714-716. 

Sam Harper, Erin C. Strumpf and Jay S. Kaufman, “Do 

medical marijuana laws increase marijuana use? Replication 

study and extension”, Annals of Epidemiology, vol. 22, No. 3 

(March 2012), pp. 207-212. 


Cerda and others “Association of state recreational mari- 


an 
a 


an 
N 


juana laws with adolescent marijuana use”. 


A 


53 


WORLD DRUG REPORT 2017 


54 


Has problematic use of cannabis increased 
as a result of increased cannabis use in the 
United States? 


It has been noted that in the current environment 
of lower risk perceptions of harm from cannabis use 
and measures allowing the medical or non-medical 
use of cannabis, the number of new cannabis users 
among older adults, and/or of older adults resum- 
ing cannabis use, has increased. However, trends in 
cannabis use disorders are mixed. At around 1.5 per 
cent, the prevalence of cannabis use disorders! 13 
among the adult population (18 years and older) of 
the United States remained stable during the period 
2002-2015, while the proportion of cannabis use 
disorders among regular adult users declined from 
14.8 per cent in 2002 to 11 per cent in 2015.1!4 
Similar trends could be observed in the population 
aged 12 years and older: the proportion of cannabis 
use disorders among past-year cannabis users 
decreased by almost one third (from 16.7 per cent 
in 2002 to 11.9 per cent) in 2014).!!5 The overall 
prevalence of cannabis use disorders among the pop- 
ulation aged 12 years and older as well as among all 
the other age groups, except for those aged 26 years 
and older, declined during the period 2002-2015. 
It appears that the national trend was driven by large 
declines among the younger age groups, whereas 
adults aged 26 years and older actually experienced 
diverging trends, with increases in the prevalence of 
cannabis use disorders over the past few years. 


There is no significant difference observed in the 
extent of cannabis use disorders among adults in 
the states that have measures for the medical or 


113 Cannabis use disorder, according to the Diagnostic and Sta- 
tistical Manual of Mental Disorders, Fifth Edition (DSM-5) 
is defined as a problem-causing pattern of cannabis use 
leading to clinically significant impairment or distre 


as 
manifested by at least two distinguishing symptoms (e.g., 
cannabis is taken in larger amounts or for longer periods 
than intended; experience of craving; continued cannabis 
use despite the experience of physical, social, or interper- 
sonal problems caused by cannabis use) occurring within a 
12-month period. 


114 Data from the National Survey on Drug Use and Health as 
reported in Compton and others, “Marijuana use and use 
disorders in adults in the USA, 2002-14”. 


115 Alejandro Azofeifa, Margaret E Mattson, and others 
“National Estimates of Marijuana Use and Related Indica- 
tors — National Survey on Drug Use and Health”, United 
States, 2002-2014. MMWR Surveillance Summaries 2016; 65 
(No. SS-11):1-25. DOI: http://dx.doi.org/10.15585/mmwr. 
ss6511al 


FIG. 87 | Trends in cannabis use disorders among 
daily or near daily users in the United 
States, by age group, 2002-2015 


150 
140 
Se 130 
= 120 
i} 
iN 110 
8 100 
NX 90 
5 80 
< 70 
60 
50 
Nomoto nR WAKO ATAN MD TY 
Se Se Se Se Se Se ee 
ee eo ee oe) 
NNNNN NNN NNN NSN 
Overall (12 years and older) 
——12to17 
—— 18 to 25 


26 or older 


Source: Key Substance Use and Mental Health Indicators in 
the United States: Results from the 2015 National Survey on 
Drug Use and Health 


recreational use of cannabis and those that do not 
have such measures in place. However, the policy 
changes allowing the recreational use of cannabis 
may potentially increase cannabis use disorders 
among adults in the longer term.!!6 


Cannabis use disorders are higher among those 
adults (18 years or older) without a high school 
diploma, among adults in part-time employment 
or not employed due to disability, among those who 
have never married, among those who have specific 
substance use disorders (tobacco, alcohol, cocaine 
and prescription opioids) and among adults who 
have experienced a major depressive episode. !!7 


Cannabis regulation in Uruguay: 
provisions and recent developments 


In 2013, the Government of Uruguay approved 
legislation (Law No. 19.172) regulating the cultiva- 
tion, production, dispensing and use of cannabis 
for recreational purposes.!!8 As the provisions regu- 
lating the recreational use of cannabis are being 
implemented gradually it is, however, too early to 
detect any effects from the regulations implemented 
to date. 


116 bid. 


117 Compton and others, “Use of marijuana for medical 
purposes among adults in the United States”, pp. 209-211. 

118 The main elements of regulation are given in the annex of 
this booklet. 


MARKET ANALYSIS OF PLANT-BASED DRUGS C. The cannabis market 


FIG. 38 | Prevalence and proportion of cannabis use disorders among daily or near daily adult (18 
years or older) cannabis users, in the United States, 2002-2015 


United States 


Daily or near daily use among adults 
Cannabis use disorders among adults 


Percentage of cannabis use disorders 
among adults 


j F 
ge 35 3 
2 © 
ro 3 i) 
= 2 5 
6 5 25 € 
3S © 
oe 2 wn 
its) = 
oc of o 
9o15 z 
SE ie} 
>> 1 2 
=y me} 
SO o 
Go O05 7) 
Ye & s 
09 oO me 
vs NOFTMNORWDDOCANMY I 2 
< Segeoeoeoeogoogsddddad © 
$ SSSCOCDSCSCoOSCOCoOOCSO < 
a) NANNNNNNNNANAN AA < 
© 6 
> o 
£ S 
a o 
Qo 

© 

s 

cof 

o 

o 

=) 

o 

a 


“ California 
3 4 ee 20 g 
iad 3S 
2 35 8s 
2 16 & 
< 3 < 
< A] 14 {o} 
52 
8 5 25 2 & 
3 3 © 
wn 
5 Bp 2 10 £ 
9o15 8 2 
Ss €& ° 
6 
> 0 1 = 
SS a 
3D OS 27 2 
* 6 s 
2 0 0 # 
gS OtTMNONnWADOCANM ST oa 
i<j oooo oo OF Ft aaa c 
uo i a a, a eg: ag agg: eg: Tay Se: Seay 
ra sssesseagegage § 
> oooooooecnooeomUmcUODUDOlCUCO S 
uo NNNNNNNN NN eS =_ 
a ° 
Daily or near daily use among adults e 
. . iv] 
Cannabis use disorders among adults 2 
Percentage of cannabis use disorders Fs] 
among adults 2 


Sources: Wilson M. Compton and others, “Marijuana use and use disorders in adults in the USA, 2002-14: analysis of annual 
cross sectional surveys”, Lancet Psychiatry, vol. 3, No. 10 (2016), pp. 954-964; Alejandro Azofeifa, Margaret E. Mattson and Rob 
Lyerla, “Supplementary material State level data: estimates of marijuana use and related indicators — national survey on drug 
use and health, California, 2002-2014” (Rockville, Maryland, Center for Behavioral Health Statistics and Quality, Substance Abuse 


and Mental Health Services Administration, (2016). 


Since adopting the legislation, the Government has 
passed a number of additional decrees and ordinances 
concerning the regulation of specific elements such 
as regulating the medical use of cannabis, the mar- 
keting of non-medical cannabis through pharmacies, 
as well as the registration of users, marketing and 
dispensation of cannabis for recreational use, etc. 


In accordance with the Uruguayan legislation, 
cannabis for recreational use can be obtained via 
registration with the national Institute for Regulation 
and Control of Cannabis (IRCCA) by opting for 
one of the three options: pharmacies, clubs or 
individual cultivation. Since the adoption of the 
law, some aspects of cannabis regulation have been 
implemented while other aspects, such as 
dispensation through pharmacies and commercial 
production, are being considered with provisions 
for monitoring compliance and controlling 
diversion. Key provisions and recent developments 
in each of these areas are summarized in the 
following sections.!!9 


119 The information in this section is taken from the Institute 
for Regulation and Control of Cannabis. 


Domestic cultivation 


Domestic cultivation is meant for personal or shared 
use in a household in which each adult is allowed 
to cultivate up to six cannabis plants for personal 
consumption, with the final product not exceeding 
480 grams in weight per year. The system for the 
registration of domestic cannabis cultivation was 
created in August 2014. Those who had already 
been cultivating cannabis had a period of up to six 
months to register with IRCCA. As of January 2017, 
6,057 individuals had been registered for the domes- 
tic cultivation of cannabis — thus the production of 
2,907 kg of cannabis had been authorized up until 
then. 


Cannabis clubs 


Cannabis clubs are registered and accredited as “civil 
associations” by the Ministry of Education and Cul- 
ture and then registered with IRCCA for the purpose 
of collective cultivation, production and use of can- 
nabis among their members. As of January 2017, 
33 cannabis clubs had been registered in the country, 
each one with a minimum of 15 and a maximum 
of 45 adult members, with data about the club and 


A 


os, 


WORLD DRUG REPORT 2017 


56 


its members being protected. IRCCA has developed 
guidelines for operating conditions, infrastructure 
and other measures relating to cannabis clubs. A 
licence for cannabis cultivation is valid for three 
years, and each club can plant up to 99 cannabis 
plants, with an output proportional to the number 
of club members, and which may not exceed 480 
grams of cannabis per person per year; any excess 
production is taken over by IRCCA. By the end of 
2015, cannabis clubs had declared a total of 23.8 
kg of cannabis produced; in 2016, they declared a 
total of 121.89 kg. 


Sale through pharmacies 


The dispensation of cannabis for recreational use 
will be allowed through “first class community phar- 
macies”, as defined in the regulations and registered 
with IRCCA for the purpose. Although the dispen- 
sation of cannabis has not yet started, by February 
2017, 83 pharmacies had expressed their interest, 
of which 14 had been registered. Pharmacies will 
sell cannabis exclusively to adults (18 years or older) 
who are registered in the system, with the total 
amount sold not to exceed 10 g per person per week 
or 40 g per month. Uruguayan citizenship or per- 
manent residency in Uruguay is, however, required 
for registration. At the time of writing, the price of 
cannabis had been set at approximately $1.30 per 
gram, which may be readjusted at the time of 
dispensing. 


Individuals registered for cannabis use 
through pharmacies 


As also foreseen in other national laws and regula- 
tions, cannabis regulation in Uruguay recognizes 
the need for the protection of the personal data of 
those who are registered for personal cannabis use. 
IRCCA is developing a computer system for user 
registration that will use biometrics for the identi- 
fication and validation of users. As foreseen by the 
law, the individual anonymization process will be 
reversible only at the request of a competent judge. 
At the time of writing, no individual had been reg- 
istered to obtain cannabis through pharmacies. 


Commercial production of cannabis 


In August 2014, IRCCA began the process of solic- 
iting the interest of potential producers and 
distributors of cannabis for recreational use through 


pharmacies. Interested parties were required to pro- 
vide a detailed plan of production, facilities, varieties 
to be produced, phytosanitary management, records 
and quality control, product packaging and label- 
ling conditions. The levels of THC, cannabidiol and 
cannabinol in proposed cannabis varieties have also 
been evaluated. Two enterprises have been granted 
a licence to produce 2 tons of cannabis each for 
distribution through pharmacies. The price for dis- 
tribution from the producer to pharmacy has been 
established at $0.90 per gram, which will be adjusted 
annually. The product will be packaged with a maxi- 
mum content of 10 g in containers that will preserve 
the product for a minimum of six months. 


Limited scale of legal supply to date 


As noted, only 6,057 individuals and 33 clubs with 
up to 45 members can now produce cannabis legally, 
potentially providing legal supply to only around 
7,500 out of the estimated 140,000 past-month 
cannabis users who live in Uruguay. The impact of 
provisions regulating the recreational use of cannabis 
will only be evident after those have been fully 
implemented and will require close monitoring over 
time. 


3 


(LLOZ ‘sSAJd SAallUapedy |eUOIeN ‘D “q ‘uO\Hulysenn) YIeasay JOJ SUOEPUBWIIODAY PUe adUAaPIAJ JO a}e15 
JUALIND BY ‘sploulqeuueD pu siqeuueD JO SI2AYJ YIeaH ay, ‘auldipa\| pue ‘Huaauibuy ‘saduaps jo saiwapery |euoNeN :a2unos 


sisolajas a}dyjnuu 
Jo uled dIUOJUD YIM sjenplAlpul 
ul SWOdUWAS anissaidap Bulsnpay 
:(sploulqeuued) ewwoone|6 YIM payeld 
: -osse aunssaid yejndoes}uU!l HulAojdy 
: (sploulqeuued) eluUaWap YIM 
payelsosse suuoydwAs HulAoiduu 
(sploulqeuued) 
sISOUdASA WAOJUBIYdOZIYIS JO 
eluaJYdoziyps YUM S|enpiAlpul 
Ul S9WOD]NO YYeay jeqUa/\ e: 
(sploulqeuued) 

SODUEJSGNS BAIDIPPe JO asN ay} 
WO} adUaUNISge BUIASIUDY e! 
(JOUIGeUOIJP PUe aUO|IGeU) e1UO}SAQ e: 


ANNEX 


(sploulqeuued) (sploulqeuued) abeyuoweey 

eIsBU!ysAP ParnpUl-edopone| — ieiyeyenui Jo Aunful ulesq Dewey 

BU} JO BSESSIP SUOSUIAJEd YUM: 2 Jaye (Aujigesip ‘Ayjeyow "3"1) 

payelsosse suio}duuAs Wa}sAs JO}O/\ @! sau0>4No Ja}Jaq pue sploulqeuued 

(sploulqeuued |210) aseasip suo} - uvaMjaq UOl}eIDOsSsSe |edI}S112}S 
-Buluny Yim payelosse swoydwcs © JO SDUAPIAA PayIUUll| SI VAY] e: 
auyelydAsdounau UleLa> PU BalOUD e: (jeu Ayyenb-s1ey jews ‘ajBuis e : 

(sploulqeuue>) © ‘guojiqeu) sapsosip ssaijs DIeWNed} 

SISOJA|IS Jesaze| WydouyoAwe : -jsod jo swojduiAs BulAojdu 

UUM pazelsosse suo}dwuAsS ° (joIpiqeuued) siapsosip 

(sploulqeuued) Ajalxue |eID0S YUM S|eNpIAIpU! Ul 

Ainful pioo jeuids wo Bunyjnse1 : ysa, Buryeads dGnd e Aq passasse 

sishjesed YiIM sjualyed ul Ayi}seds e: se ‘suuoydwAs Ajaixue BulAojd 

(sploulqeuued) Asdajid e: (sajnsde> >H) awospuAs 

(JOUIqeUOIP) aWOIPUAS : S,a}¥euNOL $o sWO}dWWAS HuUIAOJdWU 

JaMog a|qeyl JO SWO}MWAS e? —(sproulqeuued je10 puke siqeuue>) 

(sploulqeuued) : swio}duAs Aydiyseds sisouajas ajd 

esOMauU elxeJOUe pue aWOIPUAS = -I}]NW paunseatu-Ue!D!UI|D HulAoJdW 

21X9YDED PIXIIOUL Paye!d0Sse-J9DULD e Salv 

(sploulqeuued) /AIH YM payeposse sso] }YBIaM 


ewol|O Hulpn|dul ‘suadued}e: Bulseaidap pue ayijadde Hulseaiou 


(sjourxiqeu AjewWUd 
‘sploulqeuued) sisoua|ds ajdiqjnw 
pue uled d1uoyp ‘elbyeAWouqis 
‘guojpuds eaude daajs anljyansysqo 
UUM payelosse adueqinysip daa|s 
UUM S|ENPIAIPU! Ul S8LUOD}NO 

daa|s wia}-OYs HuUIAOJdU] 


“404 
aAIDajjoul ae 
sploulqeuued 
Jo siqeuued 
yey} adUuapIAg 


(sploulqeuued 
je10) swoyduuAs Ayd13seds sisosajos 
a|diyjnw payodai-juaned HulAoidw 


(sploulqeuued |e40) BulylwoA : "40s 

pue easneu paonpul-Adevayjoway : aAIDajo ase 
fO JUBWLAN BY} U! SOWS-NUY e! splourqeuued 
(siqeuued) syjnpe_ : 4o siqeuued 

ul uled DIUOIUD JO UaWeaL ee: + =}EY} BIUAPIAZ 


SPIOUIQUUD PUP SIGUUED JO SPayja DNadewau | 


Sf 


: sBnp pDIII! JaYZO pue 
: suasn Ajlep : ‘ondeqo} ‘|oyorje Bulpn|oul ‘sadueysqns 

(6upjows : 40 Jejnbas Buowe Ajejnsied APJOSIP = 404 Japyosip asnge aduelsqns e Jo/pue 

siqeuued jeUJa}eW) (asn aduejsqns Jaye]: Jejodig Buidojanap jo pooyljay!] e : aUapUadap aduUelsgns jo JuaWdojaraq 
pue JuaWaAalyse Iiwapere/UO!IUHOD sJaPJOSIP DIOYDAsd UUM sjenpiaipul swiodwics Japsosip 
‘gwopuds yjeap Ue! Uappns Huowe (suojeuionyey “6'a) eluaiydo | ssaus 2eWNes-1sod Jo Ajuanas 

“6'a) HuUdsjyO ay} Ul SAWOD}NO Jaje] e: -ZIYIS JO SWwO}dUAs AAI}ISOd Ul aseas>DU| e: — pasealdul pue asn siqeuued Wa|qold °: 
9SOPIJBAO SIQeUUeD WO} Hulyjnsad Ujeode uolue}je : juawieal} duyelysAsd se) Aloysiy e pue : 
(asn siqeuued jed1Ipaw-UOU ‘|e1auab) pue Ajowaw ‘Huluses| JO SUIEWOP ; asn siqeuUed Wa|qoJd Jo aduaysisiad 
saunful Jo sjuapiooe jeuoednd99 e: = AAIHJUHOD ay} Ul s}uaWeduu! pue asn (asn siqeuued JejnBai) Japsosip 

(asn siqeuued SIGeUUED WO} SUBUNSGE POUleIsSNS e: — Ayaixue |eID0S JO BdUAPIDU! Paseadu| e: 


payodai-}jas) AyjeuOW asned-||V7 e: Sa|OJ |e!D0s ayelidoudde uola|dwo> 
(asn siqeuued JejnBau) snuiA ewoylided Ajjejusudojanap ul juawabebua ApIINS JO adUAPIDU! Pasea.DU| e. 
UBWUNY 2/0 JO a2UaPIDU! Pasea.Ul « 40 BuIUONDUN} [eos PaIleEdU| ®: <5c4 Jaineay BOW adUApIUI JaYBIY e 
(asn joulqeuolp BWOIU! MO] JO/PUe : YUM sidwae apioins pue uoleap! 


JO SIeUUeD) AIH YIM sjenpiaipul juawAojdwaun 40 sa}e1 PaseaidU| e: 


jepiains Jo aduap!dul paseadu| e: 
UI SNJE{S BUNWWI! UO Saja asJaAPY « : 


SPWOIINO UONEINP® | — siapyosip aaissaidap Jo jUadojanap 
pue Juawanaiyse diwapere pailedu e: 


(Bulyjouus siqeuued) sjenpiAipul Ayyeay : BU} JO} S11 PaSPAIDU! ||PWUS VY @: sajewia 
Ul SasUOdsaL |[99 SUNLWWLUI aSJaAPE JAYIO e: (6urjouus (asn siqeuue> | — pue sajew uaamjaq JaJLIp 
(Bupjows siqeuued) uonequasexa | SIGeUUeD JeLa}eU) YUN o1e> BAISUBIU! Jejn6ai) ssapsosip sejodiq YUM : jou saop asn siqeuUed Wa} 


euyyse JO JUaUdOjaAap CLUS e 
(Bulyous siqeuue>) 
CdOD JO} suoissiwipe |e}IdSOH e: 


[PFEUOSU 94} 0} ]UEJU! AYR JO UOISSIIPY * —_pasouGeIp sjenpiaipul ul elUeWod«Y —-goud jo aduauNDa1 ayy ING 
(6urjous siqeuued jeusayewu) Ja4yOW | pue ejuew 4o swo}dwics pasea/du} e: ~—‘asn siqeuued wajqoid Jo 
BY} 40} suo|ed!|dW0> ArUeUBald « asn siqeuued jo Aioysiy e pue | Ajanas ayy pue ajew Bulag 


(asn siqeuued (6uljouus siqeuued) sjenpiAipul sJapsosip 2OYDAsd YM sjenpiAipul asn siqeuued 
fO saa DluOIYD) UODIeLUI | Ayyeay Ul saurjoYA> Aioyewwe|jul : GHuowe aduewojied anijiubod sayag e: wa|qoid Buidojanap 0} Uols 
eIDIIOAW 91NDe JO YS pasea.du| e 1E4PAES JO UONPoAd ayy U! aseadep Y & (asn siqeuued aynde) : -saifoud ayy pue Aruanba,j 
(asn siqeuued : (Bulyouls siqeuued jeuolses30) uojuaye pue Aiowaw ‘Buluses] jo | asn siqeuued ul saseaJauU 
jequaied) Buds}1o ul ewoysejqoinau_ ASN OIIEGO} JO} Pa|OJUO UBYM = suleWOp aAI}UBOD ay} Ul JUaL!edUI| e: suasn juanbad} SOW 
Jo ewoyAd0NSe ‘eWODIesoAWOpgeys | (GdOD) aseasip AleUoW|nd anyonaysqo. : je6a| si siqeuued : au} BuoWe ysl IsaybHiy ayy 
‘elwaeyna| Wse|qoyduud| aynde ; —-!UO1YP Buldojanap jo ysl pasesidu| e: JO asn ayy aiaym saleis pallu ; yym ‘sasoypAsd JayjO JO elu 
‘elWaeyNa| JSe|qOYdWA|-UOU a{NdV e: sajagelpaid Jo ys1 paseasuUl| e? ayy Ul sayeys Ul SUONeINdod dUIeEIpaed | -aiydoziyds Jo JUaWdojanaq 
eBiwaeyna| plojaAw aynde | sajaqeip pue Buowe ‘ssaujsip Aioyesidsas Bulpnpul : (Bulyjouus 
Huldojanap Jo SI juanbasqns e: aWOJpUAS DIOGeJaW JO }Sl pesedsaeq °: ‘sauntul BSOPJBAO JO SI PasedtDU| e iqeuued |eusa}ewW) Huds}jo 
Janued Jappejq 10 ewores abeyuoway swoyduAs Ajoyesidsas ul S}UaWaACIdU! dU} 4O TUBIaM YLIG JaMo7 
sisodey ‘Jadued jeue adUeD : PIOUUDPIEQNS JO aAO1}S JILWUSYDS| e: pue Hulyous siqeuued JO UO!}essaD e SBYSEID a[DIYOA 
ajiuad ‘ewoyduA| s| u6POH-UON : (6ulyouus siqeuued) UO UeJUL (Bulyouus siqeuued) JOJOW JO SII paseasuU “"pue 
‘sewOl|O JUeUBI|eEW aDUeD |EDIAJAD jeipsesoAw aynse Jo HuabbH} aul e: Aydeded JeLUA PDO} JAUBIH e: (Bulyjous siqeuued Wa} asn siqeuue> 
JaDUed a}e\SOJd JO BdUAPIDU| & (Bulyows siqeuued DIUdIUD (Hulyouls siqeuued) :  -Huo}) saposida sity suoIg useM}eq 
Bulyows siqeuued) JO Juanbauy ‘jUaUND) SINOWWNY {Jad asn DIUOIYD YUM JOU Ing ‘asn ane : d1UdIYD JUaNbad aioW pue uolze10sse 
Jadued jeabeydosa jo aduUap!dU| e WJab Je)Nd!}S9} adA}-eWOUILWAS-UON e uum saiueuAp Aemile parodu| e peueasiits Ajoyesdsal assOn yeriysizeys 


SUO!IPUOD YYeay PUe asn siIqeuUeDd UBEMIaq UO!EIDOsSe JeDIISIEIS - 


L102 LYOdd¥ ONY AlYOM 


58 


x< 
fr 
= 
= 
<x 


JapJOsIp ssai}s 
d112WNed}-Jsod 4O }UaWUCO|aAaq e 
SJaPJOSIP aAISSaidap JO 


swo}dwuAs JO asuNOD ay} Ul SBHueYD e: 


asn siqeuued wa|qoid 

Jo jUaUOJaAep au} JO} SIOPe} ASI Be 

: asnge |enxas pooypyiyd pue sinoieyaq 

jeldosizue ‘adueWJOLad jooyds 100d 

‘asn adueysqns jejuaed ‘asn auljod!u 

‘asn joyooje ysily JO abe saHunoA e 
‘sunoiaeyaq jeuolyisoddo ‘asn siqeuued : 
jo Aduanbad ay} aduadsajope Hung e: 
asn siqeuued wajqoid | 

0} asn siqeuued Wo} UOIssaiHO1d 

JU} JO} SIOJDE} SU ue BUO|e dua 
-Ppuadap aUljOIIU JOU |OYOD|e JAULIAN e: 
asn siqeuued Wwa|qoid Jo juawdojanap 
BUY} JO} JO}De} YSU e SI SHNUp pasnge ; asn siqeuued 
}O ASN PSUIQWOD ay} O} aINSOdX] e: “ walqoid Jo yuauidojanap ay 
asn siqeuued Wa|qoid Jo JUaWdO|aAeP = jo} JOD} YSU e SI aGe Valea 
AU} JO} JO}De} YSU e SI ajetu HUlag e: ue ye asn siqeuued buelU 
asn SIGeUURD Zasn siqeuued Wa|qold 0} asn 
Wwa|qgold jo JUatUdo|aAap ay} JO} | siqeuUed Jo UOISSaiBOld ay 
JO1D2} SU _& JOU SI GHAV IWUSdISE|OPY @! Jo} siopeY YSU ae sayaueHID 


asn siqeuued : Huljows pue ajew Hulag 
wa|qoid $0 juawdojanap OY} JO} JOPIe} : asn siqeuued wajqoid se) 
SLU SI Japsosip anissaidap ole e: yuawdojarap au} 104 J0jDe 
: asn : ysl & JOU S| BdUaDSajOpe 
asn siqeuued Wwagoid Jo juawdojanap = siqeuued Wajgoid jo Juawdojanap ayy | BuUNp (GHaY) Japsosip Ar! 
AY} JO} SIOJDL} YSU ae UOIssaidap :JO4 SJO]DE} YSU JOU ale Suapsosip sejodiq | -anoeiadAy WOYap uonUae 
pooypy|iyd pue Ajaixue pooypyiyD e: pue Siapsosip Ayjeuosiad ‘AaIxuyy e: Jo JUaW}eaI} JUR|NUUITS 
: SJ2PJOSIP 
asn siqeuued walgoid Jo Juatudojanap aioYyrAsd YUM sjenpiaipul Buowe 
AY] JO} $10]DE} YSU ae UOIssaidap (Daye paqun|q ‘6'a) eluasydoziyas : 
pooypyjiyd pue Ajaixue pooyp|iyD e: 40 suo} dwAs aatyeBau 40 HulUaslO\ °: 
; (asn siqeuued A\iep) 5) : JadUeD DOU Puke Pedy JO BdUBPIDU] e: 
'sijizeday |eiIA YL sjenpiaipul ul aseasip | (Bulyouus 


siqeuue>) JaUe> Hun| $o aduapIdU| e: 


DIJEday JO SISOIGI} JAI] 4O UOISSAIBOLd e: 


S9DUPYSQNs }ID 


II]! PUE 4191] JayJO Jo: 
sujayjed asn pue sa}ed ay} ul sabuey> e: 


ASN ODDLQO} JO UO!EI IU] @: 

Japlosip 

SSaJJS DIJEWUNeJ]-]SOd ULM SjenplAlpul 
Huowe swo}dwAs Japsosip ssauys : 
aIWeEWUNeW}-1s0d JO AyaAas paseadu| e: 
(asn siqeuued Ajlep-eau) 

Ajalxue JO SWO\dWAs pasealdu| e: 
Ayalxue |e1D0s 1dadxa ‘apsosiIp 
Ayaixue jo adfj Aue jo Juawdojanag e: 


(LLOZ ‘SSAJq SAlWAPedY |CEUOIEN ‘D “q ‘UO}HUIYseNA) YOJeasay JOJ SUOEPUBWIWODAY PUL adUAaPIAJ JO a}e1S 
JUALIND AY] ‘splourqeuuey puy sigeuued JO S2AYJ YYeIH ay, ‘auldipa|\| pue ‘Huaaulbuy ‘saduaps jo saiwapedy |euoNeN :adnos 


9dUNpIAZd 
42410 


“-pue 
asn siqeuue> 
uzamjeq 
uolenosse 
jeansneys oj 


(o>) 
ie) 


s}uawadinbed 
uoljesjsibay 


2U9}U0) JHL Wnwixe|\] 


payloads 10N 


xe} Jaye wesb 
Jad adud jiejas aBessay 


uolssassod 
Jeuosiad JO} S}iwul] awes 


6 / ‘sjuapisas-UON 
6 ¢'9z ‘sjuapisay 


euenflvew 
[!2]81 JO} payed ON 
“MosH BWOY JO} S2A 


SUO!}DIN}Sa1 BwWeS 
0} palqns jou sasodind — : 
JEDIPAW JO} UOIJEAIYIND “UO! : 


sbul|paas anja. 
euenfliew JO °Z0 S°Z 


uoissassod 
jnjme| Ul UOSad ay} Jo 


-PAI}JND BWOY Yqiyold ued : HulaMo}} aq ued : : 
: : 1 : : JUISUOD UUM JO UOISsassod : 
suaumo Ayadoig ‘Jaquinu : YDdIYM Jo xIS ‘pjoyasnoy_—: HulaMol} aq ued i : : 
uolpedijuap! |euosiad Jad sjuejd anjam  YpIuM Jo aaiu} ‘sjue|d xIS MEALS Kemer sie (lane : Mt ae oan: : a aba 


uM pabbe} pue Mala wos : ‘uosjad Jad sjue|d xis 
Aeme s6uljpaas Jo Junowe : 
payiuljun ‘sjuejd aunjewiuul 
aAJIM} ‘S}UR|d aINJEW XIS 


jou ‘buuaMoly aq ued 
UDIUM JO aaiuy ‘s}Ue|C xIS 


ayeuaauo? 6g pe ayes UU B g Ayquenb 
(6 802) 2092 JaMO|} ZO | uoissassod |euosiad 
paypeds 10N aUON 
LZ LZ abe wnuwiuly 
Snipe oy jes pue feruansy ee 


Aljsaso4 pue UONeAIASUOD : UONDNPOJ jeldsaWWOD a}e| 
‘aunynouby jo uawyedaq : -nbai 0} uo 
Hulapisuod ‘ajqesijdde jon 


fo juaWedaq) UOIsIAIG 
juawaaJojuy euentlie/\| 


JouJUOD euenfluey| Jo Neaing JO1JUOD abesaAag I}OYod|\7) Ayoyuyne Asozeinbay 


pieog |OJJUO> euenlel\ 


ZL0¢ ysnony 


uorennind : BL0Z : uondope 
eee Ut St elt ‘uolduunsuod ‘uolssassod |, YOHA|N »  Arenuer 1 Aqpanssiaqg =: eset a : ajna Jo ayep pauinbas 
} UO!| ‘LL0Z Jeuosiag :G102 Alenigay ‘UO!duinsuo> ‘uolssassod | Q sanuani| ing ‘pareys oN, UOGwINsuoD ‘uolssassod /po}uawiajdu ayeq 


Ayenuer / uo Dajja ayey 


J2UOSIAg 


Loz Jaquiasaq 


Loz Areniqa4 


9LOZ JaqUIaAON ZLOZ JaqUIaAON passed ajeq 
| uorjsand 79 Juawpuawy anu 
AAIEILIU! JO, SAIEIIU! 1810, : SUSLNBUSLiLS SANeHIN Ieh Of | SAEIIU! 1810), | aUNJeIs a}e}s ‘BANLIU! 1210/ : ssa201g je6a7 


edWAWY JO Sa}e}1S pa}LiuA ay} ul SUOHDIPSUN! UIYUIM siIqeuUed JO asn ay} Builzije6a| 104 suonejnbay | 


L102 LYOdd¥ DNYG AlYOM 


60 


ANNEX 


saseyoind : : sajes pue uolnpoid jena : : ‘ padagieas te : 
Aiestiseisp 10 jou nq : : es Glas Wondneie , 8102 peed [IDM saluesuedsip : pos eRe ‘saseypund i 
’ : po fees : $0 Hulsuad!| apim-ayeyg =: Avesuadsip JO} Jou 1Nq suo!) : 

sa}e}s JaYyJO WOd} sjualjed pamoje saesuadsip : uolssassod ‘paziuboal 'sann2ajO> pue sanjeiadoo> | ~ipuod panoidde 104 paziu seauEs ep 


saziuboda, ‘saliesuadsip jou sjualjed 3}e}s-}o-]No 


‘uoiesysibad AreyUnjon - AujsI 


-Bodai sjuaijed 9}e}s-}0-]NO 
: -BaJ Jualled “E007 PUe 9661 : 


‘uolyedjsi6a1 sauesuadsip 
ou ‘Aujsi6as JUaeY :866L 


‘pued UO!DeLNUAP! JO : : Ipaysixa Apeasje saesuadsip 


GLOZ JOQUISAON 
ul pajeadas uolduinsuod 
3J0}S-Ul UO UeQ JAI}e4 
‘pa1qiyoid 
JO pamoyle Ajqinijdxa JON 


uolduuNsuOd ayis 
UO Molle Jey} SSauISNgOJIIW 
JO WHO} ay} Ul s}sixa Ae 


: “9DJO} Se} : 
pemol|y7 © Ay Aq uonebysarul yapun pamoy|e JON 


Ajyualnd ‘pamolje ION 


SAXe} Sales : : 
Jedoj Juadued ge oldq : : aouno Jad G1 ¢ 3e 
XB] Sajes ayeys juad sad GZ : sanea| UO SadUNO : paxe] ae sanea| pue sways 
; > qyblam bnup sad c/77G | “Ha ‘Jue|d yjosweduaujo : 
yayew jensawwod ou : = £102 Ajnf ul yuad sadg ; a 4 : 
JI€}a1 UO asioxa jUad Jad QL ‘aiqedidde 10N © 0} paseaidap aq 0} xe} sajes saniey Jaye JBMO|JUO =:  ‘JaunydeynuewW yNpoid 40 uoiexey 


aouno yyblam Alp sad S776$ : BO}s [!219/ 0} AqIoey UOeA 
euenlwew [12191 UB) Jad QL : ‘|leJes UO aSIDXa JUSD Jad G] ; -1)ND WJ SuaJsues} JO Sales 

‘UONeAI|ND : : uO aduno Jad xe} asinxa OSF$ 
UO XP} asioxa JUaD Jad GI 


uaJp|iy> 0} 


: : uaJp|IyD 0} jeadde youued ; — YyeaH II\qGNg JO UOISIAIG 
eae de 36 ae :  SPNpoid “sIyauaq yyJeay | SAdIMAS JeDOS pue UYJeaBH | 
SHUod ES oun. gate Ream ou 2 spe ey een sousipne 24 | anjun 4O suule|> JO JuaWasi} ; JO JuaWedaq eyseiy Bulsieapy 
$O SWIE|D JO JUalUASIaApe : ‘ajqeaidde Jon © Jo quad sed gg ueyy ow | : ae : re 
asje} UO SUONDINSAY "LZ | © OU YUM elpaul 0} parunsay JaAPe asj2j UO SUOIPIISAY ; ayy Aq PaUIWJa}ap aq O} 


19A0 aSOU} 01 PaIDUISay “LZ JaA0 asOU} O} papUIsay suonejn6Ba Hulsianpe jeul4 


uap|IYyD 0} Huljeedde asow 
pnpoid axew 0} paubisap 
saniippe ule}uod you Aew 


UaJp|IYd : : uaJp|iyd Oo} Buljeadde 
Yo ToQUAS SH UOIpIND| | yy 1U=IOD ploutge ee pounbe! BulBErped 
pamoyje jou Ajjua.n> © $0 Upeal Jo Ino day, : see Gusiod pue eae a © JuejsisaJ-pilyD “abexred Jed | — sa|qIpa uo suo}ISEY 
sjeqe| Bulusem ‘Bulaas ‘Buwuas iad DH) BW OL pamoj|e DHL snousbowoy : 
paxoed Ajjenpiipul ydee ul » $O Bui Qg ueY} aoW OU ‘bul 
DHL Jo Hw OL yo winwixeyy : -AJaS a|OUIS JO} DHL JO Hw g : 


sajqipa pue sjanpoud ‘sjaqey : 
pue bulyded sjuaipasbul 
fo 4s1] ‘suonejnbas 
Ul padojanap aq 0} S}iWI| 
Aduayod pue azis Bulas 


s}UaWYs!|qe}se 
Jo uol}ed0] pue Jaquunu 
ajeinbas Aew sal}ijed0} 

‘sauoys JO JAQUUNU |e}0} [WW 
you Aew AjuoyyNe a3e15 


saJojs siqeuued : uole/]UadU0D : sal0}s 


gHON jlejau pasuacty : yaxJeW UO SHUT »  siqeuued |le}a1 pasuad!q 


UO!NqIySIp jel4awiwW0>D 


azis UO paseq sad} OM} : Salp|IDe} : SadAy Bullyea ‘siainyeynuew : i 
‘SJOJEAI}IND pasuar!y : UOILEAIYIND SIGeuUeD Pasuad!] : puUe SYOJeAN|ND pasuadr] Steen sq PUUEA Ps eta7t : Mor Snpoue [Elio Mun 


61 


s}uawasinbas 
uonesjsibay 


: : i pauinba jou 
fo Aue JOf WDD] UUM ‘saA : : 5 UONDA}JOD eJep |eUOSIaq 


| AQ pexl} 
UOUa}ID paysabOns) JUa}Uod 


pauinbay jou 
UOHDI}JOD BYEP JeUOSJaq 


Ajjentul 18S JON Aljenul 18s JON Ajjeniul 3s JON 3U9}U09 DHL WNWIxe|| 


xe} Jaye wesb 
Jad adud jieyas abesaay 


: : uolssassod : uolssassod 
6 g'8z : 67 : Jeuossad JO} se sjiwul] awes : jeUOsJad JO} Se S}ILUI| BWeS 

Body} ajes) yaaM Jad : i : : ae 
5 OL ce i 6 OV ; : :  Alqewinsaid ‘paiyidads 10N 


SWOY a4} UIYM pamoj|y pamoye ON BHuneys jeuossadiazuy 


pasaysibas 0} saisewieyd 


: Woy Aeme Salil GZ aq SN : awoy je payiwied 

: pue plojpue] $o uolssiwuad : eueNfleW palip JO ‘ZO OL 
YUM pasojsua Ul JO JOOpUl : ‘MaiA Od Aeme aduapisad 

ul Aadoid uo avjam} ueyy : ajbuis e ul Z| ‘sjuejd 9 

JOW OU ‘sjUe|d XxIS 
a}e4]Ua2U0D HG'¢ 


JaMO|f “ZO | 


uoneanjn>s awoH 


JaMO}} Ul SjUe|d XIS pamolle JON : JaMo}} Ul s}ue|d INC4 


6 g7Z :awoy Ty 
6 ¢°8z :dIIGnd uy 


pasinbas Auapisal 


ajesjuaaUu0D 6g Aynuenb 
(6 S°8Z) JAMO} °ZO | uolssassod |euosiad 


uefenbnin jusueWad JO QUON 
diysuaziyio ueXenBnin 
Le 
(VDDUl) (pieog : UoIss|LWO> pieog Aiosiapy siqeuued (7 


pue ‘UOISSIWIWUOD 


siqeuues 40 jO1]U0D pue jOuUOD JoNbIT aU AWWO}) : 
: : jOuuoOD siqeuued (| 


uoljejnBay ay} JO} ainyysu) | pseog siqeuue>d pue sonbty 


JOuyUOD Jonbi] uobal9 


sajes Apewueyd : : sajes jlejai 72107 Avenue 
‘LLOCZ-PIN : . : : : : 
SanBSAKOl : sales |lelay “Loz Aine ee ee 8Loz Auenuer | Aq adejd ul : LL0Z 4990190 | : uondope 
ene aes = uonduinsuod ‘uolssassod | A in eae Gone a : aq oO} suoneinbas pue LOZ ; Bumeys panss| seouea ajn4 yo ayep pauinbas 
; : jeuosiag :Z10Z Jaquiadeq © Arenuer | uo payjasaye, : = “LLOZ Jaquiaydas 1 : /pa}uawajdu ayeq 
UOHAIIND |2UOSIad : : uoleanjnd : : : 
‘voz ysnony : :  ‘uoldunsuod ‘uolssassod 
: : Jeuosiad :GLOz Ajnr 


Me| |eEUO!eU 


‘aNeNIU JUALULAAOD ainyeys ayeys ‘aaeliul 110A, ainyels ayels ‘BAeNIU! 1a10/A, SAEIIU! 1810), BAILENIU! BJO, ssa201g je6a7 


(panuluod) Aenbnip pue edWawWy JO Sa}e}1S Pa}iuA ay} Ul SUOHDIPSUN! UIYIM siqeuUed JO asn ay} Builzije6a| 104 suonejnbay | 


Z£10¢@ LYOddY¥ ONY AlYOM 


62 


OM 
Jaded eperayn 3no jjl¥ IsNwW 


UONEAIIND BWOH ?Z7L0Z 


x ; pean d : oan Pitia : Squaied ‘yejiuuls Ajjenueysqns : paziubodaJ JOU sjualyed 

wi aAl}Da}Ja aA JOU Inq : 6661 ‘VLOZ [NF Ul pausdo : -Pere| ‘i | Aq » ase sauuwuelBold s,ajeys =; = a}e}S-4O-]NO ‘sauesuadsip 

S$ ‘passed ‘pL0Z ; S2404s ISIN “ZLOZ JaQWaAON | PEZHOUINE AHeSP 1OU Wd | Jayjo fi sjuaned ayeys jo | — ‘spued uo!JeD1yhUAP! JO SyaeNar? Ie)Peul 
< ; » Jo se panoidde sauesuadsip | palsixe Apeauje saesuadsip = Bool! sig. Aiasib ee ape 

< “‘pie> uonesyuap! io uonen — ‘ANSIBaA quand ‘B66L yNO azjuBor~1 ‘sayesuadsip | AnsiGai juaned ‘€107/ZL0Z 


ON ‘ped uo!edjN Uap! 
Jo Aysibas Juaied :000Z 


-siBa1 OU ‘| LOZ/0L 07/6661 


Jeak jad Jaquaw 


: uolduunsuo>-a}!s-Uo 
6 Jed tonpoud Pep 40 : : : » moje yey} syuawysi|qeise 
O8r WNuwIxew ‘sjUueid 66 : pamo]le JON : pamoyje JON : paljinads 10N : vaiaenia: ABUL fol sqnj)> siqeuue> 
0} dn ajennind 0} pamoye : : : : 135! ut 


yBnoyye pamojje ION 


SIBQUIAW Gph-GL UUM sqn|> : 


juad Jad € 0} dn xe} JeD0) 
USI|Ge1sa O} SalUNWWOD 


Xe} sajes juad Jad /¢ [290] 40} suol.do YM 


-‘aimyny °SL0z Aine LLOZ Xe} sales yuad sad f | : 
ay) ul xe] asodwi ued: aes eee : 910z Alenuer ¢ : |l2qa1 UO aSIOXa JUAad Jad G| | |le}a1 UO asIDxa JUD Jad G/'¢ : uonexey 
Hnoyye ‘xe} 0 : : : Jaye xe} sajes juad Jad : : 
mS Osr ee oe »  ypeaye xeyquadjad sz Eee a 


n- A : Loz 
SUOC OUNTHOE AM, <> scaussacncy 6 BR GRACED 
Wod} sees le]0J UO XP] ON 


Hulsiuaape 
: yqiyoid Jo ajejnBas wan : : 
ai(cUr : UO!}EIO] SsauIsNg 1e ssallejas 0} AjuoyINe sey UOISssIWUOD : suolje/n6ai ul ul pado ee) uawonu> Buisnuen 
PeHA4Old JO, UBIS BUD O} PaywWIT =: ~—- fOMJUOD JONDIT UO|H|IQ-~—sE_ PadojaAap aq 0} SUOIpI\SAY : on Aa s na e oe ssa : ISHISAPY 
:  Isauesuadsip jo Jouayxa : Pune HOHISOY : 


uo payinbas ubis Ayjug 


| $9q Pseog | 

: sonbr] 93235 ay} Aq paroidde : uaspyiyd : : 

: aq sjaqe; pue sabeyded =; 0} Huljeadde jou ‘ssadoid_: : s}ualpaibul 

sponpoid pasnyul-euenfuew : jeroiddeaid e obapun oy : 51/5346 10 > $0 4st] “suolejnBa ul 

‘Buljjaqe| DHL ‘buibeysed =: — spnpoud ajqipa ‘Hulas Peli! JON :  padojanap aq 0} s}!wl| 
fooid-pyiyd ‘Hulsas : paxped Ajjenpiaipul yea ul: : Aduajod pue azis Buluas 

pabexded Ajjenpiaipul » DHL Jo bw OL yo wnwixeyy : : 

weaulDHLJoHwoQL : : 


Sa]qipa uo suo UyseY 


: ; : : sassaulsnq 
: : salojys siqeuued : uoizeindod Aq uolyesjUadUOD : JO UO!eIadO AY} YIqIYyold JO : 
salewdeyd pasuacty sJajle}al Pasuad!] : \ielas pasuad] jayew UO SW Yuu ‘ayein6as ued sanyjes0) UO!}NG}sSIp jeI4aWWO>D 


‘sjuauuysiqe}sa pasuad'y 


n : : : : : 
dieu ae » slaanpoud siqeuued pasuad!] | siadNpoud siqeuued pasuad!] | — JUaWWYsI|qe\sa pasuad] =| =~ SJuaWWYsI|qeysa pasuad1] == UONNINpoud jel4auwoD 


63 


GLOSSARY 


amphetamine-type stimulants — a group of sub- 
stances composed of synthetic stimulants that were 
placed under international control in the Conven- 
tion on Psychotropic Substances of 1971 and are 
from the group of substances called amphetamines, 
which includes amphetamine, methamphetamine, 
methcathinone and the “ecstasy”-group substances 
(3,4-methylenedioxymethamphetamine (MDMA) 
and its analogues). 


amphetamines — a group of amphetamine-type 
stimulants that includes amphetamine and 
methamphetamine. 


annual prevalence — the total number of people of 
a given age range who have used a given drug at 
least once in the past year, divided by the number 
of people of the given age range, and expressed as a 
percentage. 


coca paste (or coca base) — an extract of the leaves 
of the coca bush. Purification of coca paste yields 
cocaine (base and hydrochloride). 


“crack” cocaine — cocaine base obtained from 
cocaine hydrochloride through conversion processes 
to make it suitable for smoking. 


cocaine salt — cocaine hydrochloride. 


new psychoactive substances — substances of abuse, 
either in a pure form or a preparation, that are not 
controlled under the Single Convention on Narcotic 
Drugs of 1961 or the 1971 Convention, but that 
may pose a public health threat. In this context, the 
term “new” does not necessarily refer to new inven- 
tions but to substances that have recently become 
available. 


opiates — a subset of opioids comprising the various 
products derived from the opium poppy plant, 
including opium, morphine and heroin. 


opioids — a generic term applied to alkaloids from 
opium poppy (opiates), their synthetic analogues 
(mainly prescription or pharmaceutical opioids) and 
compounds synthesized in the body. 


problem drug users — people who engage in the 
high-risk consumption of drugs; for example, people 
who inject drugs, people who use drugs on a daily 
basis and/or people diagnosed with drug use disor- 
ders (harmful use or drug dependence), based on 
clinical criteria as contained in the Diagnostic and 
Statistical Manual of Mental Disorders (fifth edi- 
tion) of the American Psychiatric Association, or 
the International Classification of Diseases (tenth 
revision) of the World Health Organization. 


people who suffer from drug use disorders/people with 
drug use disorders — a subset of people who use 
drugs. People with drug use disorders need treat- 
ment, health and social care and rehabilitation. 
Dependence is a drug use disorder. 


prevention of drug use and treatment of drug use dis- 
orders — the aim of “prevention of drug use” is to 
prevent or delay the initiation of drug use, as well 
as the transition to drug use disorders. Once there 
is a drug use disorder, treatment, care and rehabili- 
tation are needed. 


65 


66 


The World Drug Report uses a number of regional 
and subregional designations. These are not official 
designations, and are defined as follows: 


East Africa: Burundi, Comoros, Djibouti, 
Eritrea, Ethiopia, Kenya, Madagascar, 
Mauritius, Rwanda, Seychelles, Somalia, 
Uganda and United Republic of Tanzania 


North Africa: Algeria, Egypt, Libya, Morocco, 
South Sudan, Sudan and Tunisia 


Southern Africa: Angola, Botswana, Lesotho, 
Malawi, Mozambique, Namibia, South Africa, 
Swaziland, Zambia and Zimbabwe 


West and Central Africa: Benin, Burkina Faso, 
Cameroon, Cabo Verde, Central African 
Republic, Chad, Congo, Céte d'Ivoire, 
Democratic Republic of the Congo, Equatorial 
Guinea, Gabon, Gambia, Ghana, Guinea, 
Guinea-Bissau, Liberia, Mali, Mauritania, 
Niger, Nigeria, Sao Tome and Principe, Senegal, 
Sierra Leone and Togo 


Caribbean: Antigua and Barbuda, Bahamas, 
Barbados, Bermuda, Cuba, Dominica, 
Dominican Republic, Grenada, Haiti, Jamaica, 
Saint Kitts and Nevis, Saint Lucia, Saint 
Vincent and the Grenadines and Trinidad and 
Tobago 


Central America: Belize, Costa Rica, 
EI Salvador, Guatemala, Honduras, Nicaragua 
and Panama 


North America: Canada, Mexico and United 
States of America 


South America: Argentina, Bolivia 
(Plurinational State of), Brazil, Chile, 
Colombia, Ecuador, Guyana, Paraguay, Peru, 
Suriname, Uruguay and Venezuela (Bolivarian 


Republic of) 


REGIONAL GROUPINGS 


* Central Asia and Transcaucasia: Armenia, 
Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, 
Tajikistan, Turkmenistan and Uzbekistan 


East and South-East Asia: Brunei Darussalam, 
Cambodia, China, Democratic People’s 
Republic of Korea, Indonesia, Japan, Lao 
People’s Democratic Republic, Malaysia, 
Mongolia, Myanmar, Philippines, Republic of 
Korea, Singapore, Thailand, Timor-Leste and 
Viet Nam 


South-West Asia: Afghanistan, Iran (Islamic 
Republic of) and Pakistan 


Near and Middle East: Bahrain, Iraq, Israel, 
Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi 
Arabia, State of Palestine, Syrian Arab Republic, 
United Arab Emirates and Yemen 


South Asia: Bangladesh, Bhutan, India, 
Maldives, Nepal and Sri Lanka 


Eastern Europe: Belarus, Republic of Moldova, 
Russian Federation and Ukraine 


South-Eastern Europe: Albania, Bosnia and 
Herzegovina, Bulgaria, Croatia, Montenegro, 
Romania, Serbia, the former Yugoslav Republic 
of Macedonia and Turkey 


Western and Central Europe: Andorra, Austria, 
Belgium, Cyprus, Czechia, Denmark, Estonia, 
Finland, France, Germany, Greece, Hungary, 
Iceland, Ireland, Italy, Latvia, Liechtenstein, 
Lithuania, Luxembourg, Malta, Monaco, 
Netherlands, Norway, Poland, Portugal, San 
Marino, Slovakia, Slovenia, Spain, Sweden, 
Switzerland and United Kingdom of Great 
Britain and Northern Ireland 


Oceania: Australia, Fiji, Kiribati, Marshall 
Islands, Micronesia (Federated States of), 
Nauru, New Zealand, Palau, Papua New 
Guinea, Samoa, Solomon Islands, Tonga, 
Tuvalu, Vanuatu and small island territories 


@\ UNODC 


We 


Sey United Nations Office on Drugs and Crime 


To celebrate 20 years since its inception, the World Drug 
Report 2017 is presented in a new five-booklet format 
designed to improve reader friendliness while maintaining the 
wealth of information contained within. 


Booklet 1 summarizes the content of the four subsequent 
substantive booklets and presents policy implications drawn 
from their findings. Booklet 2 deals with the supply, use and 
health consequences of drugs. Booklet 3 focuses on the 
cultivation, production and consumption of the three 
plant-based drugs (cocaine, opiates and cannabis) and on the 
impact of new cannabis policies. Booklet 4 provides an 
extended analysis of the global synthetic drugs market and 
contains the bulk of the analysis for the triennial global 
synthetic drugs assessment. Finally, Booklet 5 contains a 
discussion on the nexus between the drug problem, organized 
crime, illicit financial flows, corruption and terrorism. 


Enhanced by this new format, the World Drug Report 2077 is, 
as ever, aimed at improving the understanding of the world 
drug problem and contributing towards fostering greater 
international cooperation for countering its impact on health 
and security. 


The statistical annex is published on the UNODC website: 
www.unodc.org/wdr/2017 


ISBN 978-92-1-148294-2