global illicit drug trends 2003 - United Nations Office on Drugs and ...

Global Illicit Drug Trends <strong>2003</strong>
Chapter 1. Trends: Consumption – Opium / Heroin
1.3.2. OPIUM / HEROIN
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The opiates, notably heroin, continue to be the
main problem <strong>drug</strong>s in the world. In Asia,
Europe and Oceania, which together have about
three quarters of the world’s total population,
about two thirds of treatment demand is related to
the abuse of opiates. Even in the USA, where
cocaine was traditionally the main problem <strong>drug</strong>,
more people were admitted for heroin abuse
treatment (28% of all treatment demand excluding
alcohol) than for cocaine abuse (25%) in 1999 and
2000.
Opiate abuse (including heroin) over the 2000-
2001 period is estimated to affect almost 15
million people or 0.4% of the population age 15
and above. About 10 million people are estimated
to be abusing heroin, slightly more than 0.2% of
the population age 15 and above.
Most opiate abusers (about 7½ million or half of
the world’s total opiate abusing population) are
found in Asia, primarily in the countries around
Afghanistan and Myanmar. The highest
prevalence rates have been reported from Iran,
the Lao PDR and from Kyrgyzstan. The overall
largest number of opiate users, however, is found
in India, though prevalence rates in India are
lower than in neighbouring Pakistan or Myanmar.
A recently conducted national household survey in
India found that 0.7% of the male population age
10 and above consumed opiates, which is
equivalent to about 0.4% of the total population
age 15 and above. The total number of opiate
abusers in Europe is estimated to amount some
4½ million people, accounting for some 30% of
the <strong>global</strong> total. Two thirds of Europe’s opiate
users are found in East Europe, reflecting very
high levels of opiate abuse reported from the
Russian Federation. IDU related HIV data and
independently conducted school surveys under
the ESPAD project in 1999 also seem to confirm
this a . Nonetheless, some of the difference in the
overall prevalence rates of the general population
between West and East Europe is also due to
a The weighted average (by the size of the youth population) of
life-time prevalence of heroin use among 15-16 years old in
West Europe (ESPAD survey data and other surveys for
Germany, Spain, and the Benelux countries) was 1.7%, less
than half the average rate found in Eastern Europe (3.8%).
(UNODC, Global Illicit Drug Trends 2002).
differences in methods for calculating national
estimates and the differences are far less
significant if only heroin consumption is
considered. The West European estimates are
largely based on the concept of “problem” <strong>drug</strong>
users, applying various estimation techniques:
different multiplier methods, capture-recapture
methods, multivariate indicators, etc. The estimate
for the Russian Federation is derived from the
number of registered <strong>drug</strong> abusers and the
reported proportion of opiate abusers. The
majority of opiate abusers in the Russian
Federation (and in some other C.I.S. countries)
consume a brew of poppy straw (known as
‘kompot’) which is injected. Heroin abuse,
however, is on the rise, accounting for more than
20% of all registered <strong>drug</strong> opiate abusers and for
more than 40% of all opiate abusers undergoing
treatment in the Russian Federation.
Opiate abuse levels in Oceania (not taking the
heroin drought of 2001 into account) and of North
America are above the <strong>global</strong> average, and so is
Europe if taken as a whole. Abuse levels in South
America and Africa are below the <strong>global</strong> average.
The rather high rates traditionally reported from
the Oceania region, compared to West Europe,
possibly reflect methodological differences more
than underlying differences in the level of <strong>drug</strong>
abuse. In 2001, the reported household data for
Australia showed a large decline in the levels of
heroin abuse, to levels below the West European
average. It remains to be seen, however, whether
abuse will stay at these lower levels. As the
circumstances of the heroin drought and the
consequent decline were exceptional, the lower
figures have not yet been used in the calculation
of UNODC <strong>global</strong> estimates.
Methodological issues also appear to play a role
in the different prevalence rates of West Europe
and North America. Estimates for the <strong>United</strong>
States, the largest heroin market in North
America, combine occasional and chronic use. If
only heroin ‘problem use’ (West Europe) and
heroin ‘chronic use’ (USA) are considered, then
the rates in North America and West Europe are
very similar.
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