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Drug Use Trends ISBN 978-0-8270-6793-6 REPORT ON DRUG USE IN THE AMERICAS 2019 Luis Almagro Farah Urrutia Secretary General Secretary for Multidimensional Security Organization of American States Organization of American States Nestor Mendez Adam E. Namm Assistant Secretary General Executive Secretary Organization of American States Inter-American Drug Abuse Control Commission Organization of American States OAS Cataloging-in-Publication Data Inter-American Drug Abuse Control Commission. Report on drug use in the Americas, 2019. p. ; cm. (OAS. Official records ; OEA/Ser.L) ISBN 978-0-8270-6793-6 1. Drug abuse--America. 2. Drugs--America. 3. Drinking of alcoholic beverages--America. 4. Inhalant abuse--America. I. Title. II. Inter-American Observatory on Drugs. III. Inter-American Drug Use Data System. IV. Series. OEA/Ser.L/XIV.6.6 2019 COPYRIGHT© (2019) Organization of American States. All the rights reserved under International and Panamerican Conventions. No portion of the content of this material may be reproduced or transmitted in any form, nor by any electronic or mechanical means, totally or partially, without the express consent of the Organization. Prepared and published by the Inter-American Drug Abuse Control Commission (CICAD), Organization of American States (OAS), Report on Drug Use in the Americas 2019, Washington, D.C., 2019. Comments on the report are welcome and can be sent to: [email protected] The contents expressed in this document are presented exclusively for informational purposes and do not necessarily represent the opinion or official position of the Organization of American States, its General Secretariat or its member states. ACKNOWLEDGEMENTS The Report on Drug Use in the Americas 2019 was prepared by the Inter-American Observatory on Drugs (Spanish acronym OID) of the Inter-American Drug Abuse Control Commission (Spanish acronym CICAD), which is located within the Secretariat on Multidimensional Security (SMS) of the Organization of American States (OAS). General coordination and content overview of the report Marya Hynes Primary authors and analysis Graciela Ahumada Juan Carlos Araneda Pernell Clarke Francisco Cumsille Marya Hynes Assistance for design and production Paula Demassi Jonathan Navas Igor Teubner The CICAD Executive Secretariat (CICAD/ES) would like to thank the national drug observatories (NDO) in OAS member states, without which this report would not have been possible. The CICAD/ES also recognizes the invaluable contributions of the Report on Drug Use in the Americas 2019 Review Committee members for their advice and comments: Luis Alfonzo, Maria Elena Alvarado, Adriana Bacelar Gomes, Maria Veronica Brasesco, William Cabanillas, Raul Martin del Campo, Jorge Delva, Alma Cecilia Escobar de Mena, Jenny Fagua Duarte, Richard Miech, Maristela Goldna del Monteiro, Bryce Pardo, Rosa Sandoval, Hector Suarez, and Jorge A. Villatoro Velazquez. The CICAD/ES gratefully acknowledges the contributions of the following institutions: The International Narcotics Control Board (INCB), the Pan American Health Organization (PAHO), the United Nations Office on Drugs and Crime (UNODC), and the U.S. National Institute on Drug Abuse (NIDA). Special thanks to the Government of the United States of America, through the Department of State’s Bureau of International Narcotics and Law Enforcement (INL), for its support. FOREWORD I am pleased to present the third edition of the National drug observatories (NDOs) throughout Report on Drug Use in the Americas (previous the Hemisphere need to be further strengthened reports were issued in 2011 and 2015). The to ensure that national drug information systems Inter-American Observatory on Drugs (OID, not only collect data but also monitor, analyze, by its Spanish language acronym) of the Inter- and interpret the information collected, as well American Drug Abuse Control Commission as report and communicate the results both (CICAD, by its Spanish language acronym) has nationally and regionally. The emergence of served as a focal point for drug research in the drugs such as new psychoactive substances, as Americas since its inception in 2000. The work well as the misuse of opioids and other controlled of the OID’s dedicated team of researchers has medications, require new methodologies to been an essential element in strengthening measure consumption and evaluate interventions. the capacity of the member countries of the The OID has been working with NDOs to develop Organization of American States (OAS) to gather early warning systems and drug information and analyze evidence needed to construct networks that generate information at national effective drug policies. and regional levels in response to these vexing problems. Nevertheless, political commitment Accurate and comparable data on drug use is by our member states is essential to make these essential for Western Hemisphere countries initiatives reality. as they design evidence-based policies and programs to address the drug problem Our expectation is that the fourth edition of this effectively. This evidence-based approach report will be published in 2023, maintaining is highlighted in CICAD’s Hemispheric Drug the four-year interval as the first three editions Strategy and its Plan of Action 2016-2020, were published in 2011, 2015, and 2019. My with the stipulation that such evidence, colleagues in the CICAD Executive Secretariat whenever possible, should conform to standard and I stand ready to work with member states methodologies to allow for the comparison of data over the next several years as they carry out among countries. Governments are encouraged new surveys so as to provide updated drug use to strengthen relationships with academic and statistics for the fourth edition. Additionally, research institutions, as well as with specialized given this report’s exclusive focus on drug non-governmental organizations so as to foster consumption, I would like the CICAD Executive scientific research that generates evidence on Secretariat to issue a report on drug supply in the demand for drugs. Likewise, the outcome the not distant future. document of the 2016 United Nations General Assembly Special Session (UNGASS 2016) on the I trust this publication will allow OAS member World Drug Problem highlights the importance states to better address their national drug use of promoting and improving the systematic challenges. collection of information, and cites drug use epidemiology as a key tool for developing effective drug strategies. While OAS member states have come a long way in their efforts to generate and analyze drug data, there are still many challenges Ambassador Adam E. Namm ahead, including an ongoing need for quality Executive Secretary information to generate sound public policies. Inter-American Drug Abuse Control Commission TABLE OF CONTENTS Introduction ................................................................................ 8 1.1 Alcohol use in the general population .................................. 9 Harmful or high-risk alcohol use in the general population ................ 12 Trends in alcohol use in the general population ............................. 13 Perception of high risk of drinking to intoxication in the general population ....................................................................... 17 1.2 Alcohol use among secondary school students .................... 17 Binge drinking among secondary school students .......................... 24 Trends in alcohol use among secondary school students ................... 28 Perception of high risk of drinking to intoxication among secondary school students ..................................................... 34 1.3 Alcohol use among university students ................................ 35 Hazardous or harmful drinking among university students ................ 37 Perception of high risk of drinking to intoxication among university students ............................................................. 40 Table of Contents Introduction ................................................................................. 41 2.1 Tobacco use in the general population .................................. 42 Trends in tobacco use in the general population .............................. 45 2.2 Tobacco use among secondary school students .................... 48 Trends in tobacco use among secondary school students ................... 54 Perception of high risk of tobacco use among secondary school students . 61 2.3 Tobacco use among university students ................................ 62 Trends in tobacco use among university students ............................ 64 Introduction ................................................................................. 67 3.1 Marijuana ............................................................................. 68 3.1.1 Marijuana use in the general population .............................. 68 Trends in marijuana use in the general population ........................... 71 Perception of high risk of marijuana use in the general population ........ 78 Ease of access and direct offers of marijuana in the general population ... 80 3.1.2 Marijuana use among secondary school students ................... 81 Trends in marijuana use among secondary school students ................ 87 Table of Contents Perception of high risk of marijuana use among secondary school students ........................................................................... 98 Perception of ease of access and direct offers of marijuana among secondary
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