World Drug Report 2014

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Vienna International Centre, PO Box 500, 1400 Vienna, Austria Tel: +(43) (1) 26060-0, Fax: +(43) (1) 26060-5866, www.unodc.org WORLD DRUG REPORT 2014

The World Drug Report provides an annual overview of the major developments in drug markets for the various drug categories, ranging from production to trafficking, including development of new routes and modalities, as well as consumption. Chapter 1 of the World WORLD Drug Report 2014 provides a global overview of the latest developments with respect to opiates, cocaine, cannabis and amphetamines (including “ecstasy”) and the health impact of drug use. Chapter 2 zeroes in on the control of precursor chemicals used in the manufacture of illicit drugs. DRUG The Statistical Annex is published on the UNODC website: http://www.unodc.org/unodc/en/ data-and-analysis/WDR-2014.html

REPORT 2014

ISBN 978-92-1-148277-5

UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna

World Drug Report 2014

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Division for Policy Analysis and Public Affairs United Nations Office on Drugs and Crime P.O. Box 500 1400 Vienna Austria Tel.: (+43) 1 26060 0 Fax: (+43) 1 26060 5827

E-mail: [email protected] Website: www.unodc.org which willbeheldin2016. The high-level review wasmore problem,session oftheGeneral Assemblyontheworlddrug mission. These meetingsprovided contributionstoaspecial on Narcotic Drugs, followed by aregular sessionoftheCom was conductedinMarch 2014in Vienna by theCommission and Balanced Strategy toCounterthe World Drug Problem Action onInternational Cooperationtowards anIntegrated implementation ofthePolitical Declaration andPlan of problem. Ahigh-leveldebate ontheworlddrug review ofthe The report isbeingpublishedatakeymomentintheglobal of developments, basedonthebestavailable data. all oursocieties,by providing andanalysis aglobaloverview duction, traffickingandconsumptioncontinuestotakeon national communitytoaddress pro- thetollthatillicitdrug The Member States inaddressing area thiscrucial more effectively. presented intheWorld Report thisyear Drug cansupport eachyear.services setof dataonaccesstoservices The new dependencetreatment usersaccessingdrug in sixproblem drug There provision, remain serious gaps in service with onlyone and integration. focusing onprevention, treatment andsocialrehabilitation a firmemphasisonpublichealth,andincludesmeasures A balancedapproach relies onevidence-basedresponses, with and pledgedtostrengthen cooperation. human rights-centred cornerstone control of the drug system, conventions asthehealthand firmed theinternationaldrug from theHigh Level Review, inwhichgovernments reaf was emphasized intheJoint Ministerial Statement resulting grated approach, addressing bothsupplyand demand. This requires abalanced, cooperative, comprehensive and inte First andforemost, we have learnedthatsustainablesuccess understanding ofawayforward. we have learnedare valuable andwe have attainedashared simple answers tothese problems. Nevertheless, thelessons from thefindingsofpresent report, thatthere are no It is clear from the discussions at the high-level review, and production anduseofillicitdrugs. already vulnerabletotraffickingandrisinglevels oflocal instability ofregions, including West andEastAfrica,thatare trade,andthegrowinglence associatedwiththeillicitdrug opium cultivation andproduction inAfghanistan,thevio ably beenserioussetbacks,however, notleastthesurge in improvements intreatment delivery. There have alsoundeni through alternative development initiatives andwelcome including sustainablereductions cultivation inillicitdrug Plan ofAction have resulted insomeconsiderablesuccesses, Efforts todateimplementthePolitical Declaration and problem. drug young people,onthemosteffective waystocountertheworld ments butalsothescientificcommunity, civilsocietyand for anopen,inclusive dialogue, involving notjustGovern than a stocktaking exercise; it provided a much-needed forum PREFACE World Report 2014 is aimed athelping the inter Drug ------national communitycontinuestofaceincontrolling precur- area, namelythe results achieved andthechallengesinter The mission amongpeoplewhoinjectdrugs. have loweredharm reduction services remarkably HIVtrans We have seen thatcountrieshave adequatelyinvested in evidence-informed for all HIV key interventions populations. Organizations thisyear, UNODCiscommittedtoensuring As thechairofUNAIDSCommitteeCosponsoring andforthoseinprison. forpeoplewhousedrugs particularly hinder accesstoHIVprevention, treatment andcare services, countries toaddress thediscriminationthatcontinuesto much in the spirit of “One United Nations” and can help HIV. Iwelcome whichare thesecooperative efforts, very andarethe numberofpeoplewhoinjectdrugs livingwith World Bank and on the number of people who inject drugs Nations Programme onHIV/AIDS(UNAIDS)andthe (UNODC), the World Health Organization, theJoint United mates by the United Nations Office on Drugs and Crime In addition,forthefirsttimereport presents jointesti ing more effective policiesandfinding jointsolutions. theinternationalcommunityindevis ing evidencetosupport provid asatoolintheseefforts, Report 2014willserve - Drug problem in2016.IhopetheWorldbly ontheworlddrug as we move towards thespecialsessionofGeneral Assem issues ofviolenceandinsecurity. important This isparticularly lem and address themany challenges, including the related prob data andanalysis,tohelpusbetterunderstandthedrug cooperation, including with respect to transparent sharing of More broadly, we must continue to enhance international prevent diversion. countriestostrengthen to tional level andsupporting efforts mentation ofmeasures tocontrol precursors attheinterna- theBoard conventions entrust drug withassessing theimple tive mechanismsiscentralinthisregard. The international of the International Narcotics Control Board and its coopera and thismustremain akeysupplycontrol strategy. The work in reducing their diversion for illicit manufacturing of drugs, ures tocontrol precursor chemicalshave hadatangibleimpact cals present challenges. Evidence shows, however, that meas- Changes intheinternationalmanufacture andtradeofchemi eradication. through traditionalsupplyreduction approaches suchascrop whichcannotbecontrolled and traffickingofsyntheticdrugs, aswe continuetoseerisesinthemanufactureparticularly cals whileavoiding robust, theirdiversion must be very tional control systemfacilitatingthelegaltradeofsuchchemi chemicals for their manufacture or processing. An interna whetherplant-basedorsynthetic,requiresors. Alldrugs, World Report 2014 alsoaddresses Drug another important United Nations Office onDrugs andCrime Executive Director Yury Fedotov ------iii WORLD DRUG REPORT 2014 Acknowledgements

The World Drug Report 2014 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 for Policy Analysis and Public Affairs, and Angela Me, Chief of the Research and Trend Analysis Branch. Core team Research and study preparation Philip Davis Kamran Niaz Thomas Pietschmann Janie Shelton Antoine Vella Graphic design and layout Suzanne Kunnen Kristina Kuttnig Data processing and mapping support Preethi Perera Umidjon Rahmonberdiev Ali Saadeddin Editing and coordination Jaya Mohan

Review and comments Valuable comments and contributions were received from Conor Crean, Natascha Eichinger, Martin Raithelhuber and Justice Tettey (Laboratory and Scientific Section) and from several colleagues from the Division for Operations, the Division for Treaty Affairs and the secretariat of the International Narcotics Control Board.

The Research and Trend Analysis Branch is also grateful for the valuable advice provided by the following experts: Michael A. Cala Jesus Maria García Calleja Jonathan Caulkins Karl L. Dehne Peter Reuter Keith Sabin

The report also benefited from the work and expertise of many other UNODC staff members in Vienna and around the world. GLOSSARY Regional groupings II ANNEX I ANNEX EXECUTIVE SUMMARY EXPLANATORY NOTES Tables cultivation, production ondrug anderadicationprevalence PREFACE CONTENTS 1. RECENTSTATISTICS ANDTRENDANALYSIS OFILLICITDRUGMARKETS 2. PRECURSORCONTROL I. H. G. H. G. F. E. D. C. B. A. F. E. D. C. B. A.

Concluding remarks Reactions ofclandestineoperatorsfacingstronger precursor controls Effect ofprecursor control onthesupplyofillicitdrugs Key precursors usedintheillicitmanufacture ofdrugs Cannabis: overview New psychoactive substances Amphetamine-type stimulants:overview Patterns andtrends inproduction of, andtradetraffickinginprecursor chemicals Response oftheinter-nationalcommunity tothediversion ofprecursor chemicals The potentialvulnerabilityofthechemicalindustry What are precursor chemicals? Introduction Cocaine: overview Opiates: overview Regional trends use indrug Health andsocialimpact use:globaloverview Extent ofdrug

x 93 39 87 80 69 51 46 64 61 56 55 55 34 21 13 vii vii x iii ix 3 1 v i

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cerning thedelimitationofitsfrontiers orboundaries. country, territory, cityorarea orofitsauthorities,con- of theUnited Nations concerningthelegalstatusofany oftheSecretariatof anyopinionwhatsoever onthepart material inthispublicationdonotimplytheexpression The designationsemployed andthepresentation ofthe detail. by cross hatchduetothedifficultyofshowing sufficient Disputedparties. boundaries(China/India) are represented Jammu andKashmirhasnotyet beenagreed uponby the agreed upon by India andPakistan. The finalstatusof approximately the line of control in Jammu and Kashmir ance by theUnited Nations. Adottedlinerepresents used on maps do not imply official endorsement or accept The boundariesandnamesshown andthedesignations The following abbreviations have beenusedinthisReport: collected. in official use at the time the relevant data were Countries and areas are referred to by the names that were EXPLANATORY NOTES EMCDDA MDMA APAAN CICAD Europol INCSR INCB MDA BMK GDP LSD FAO FAO ISIC ATS 3,4-methylenedioxymethamphetamine 3,4-methylenedioxyamphetamine lysergic aciddiethylamide State Department Strategy Report, oftheUnited States International Narcotics Control Classification International Standard Industrial International Narcotics Control Board gross domesticproduct the United Nations Food andAgriculture Organization of European Police Office and Drug Addiction European Monitoring Centre forDrugs American States) Commission (Organization of Inter-American Drug Abuse Control benzyl methylketone amphetamine-type stimulants alpha-phenylacetoacetonitrile

- stated. References to“tons” are tometrictons,unlessotherwise type stimulantsexclude “ecstasy”. When referring use, all mentions toof drug amphetamine- stated. otherwise References todollars($)are toUnited States dollars,unless The 2012Revision. Affairs, Population Division, World Population Prospects: United Nations, ofEconomic Department andSocial The dataonpopulationusedinthisreport are from: sumption” are usedinthisreport. “drug abuse”, the neutral terms “drug use” and “drug con the distinctionsbetween “drug use”, “drug misuse” and Since there issomescientificandlegalambiguityabout UN COMTRADE 3,4-MDP-2-P E Online PEN NSDUH UNAIDS UNODC UNIDO P-2-P PWID WHO PMK PICS Pre-Export Notification Online 1-phenyl-2-propanone of America Human oftheUnited Services States ofHealthof theDepartment and Mental Health Administration Services Health oftheSubstance Abuse and National Survey onDrug Use and propanone 3,4-methylenedioxyphenyl-2- World Health Organization and Crime United Nations Office onDrugs Development Organization United Nations Industrial Statistics database United Nations Commodity Trade HIV/AIDS Joint United Nations Programme on people whoinjectdrugs piperonyl methylketone System Precursors Incident Communication

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regard totheprevalence useandproblem ofillicitdrug it canbeconcludedthatoverall theglobalsituationwith well as the relatively information on demand, limited new On thebasisof comprehensive informationonsupply, as cals usedinthemanufacture ofillicitdrugs. use. Chapter2zeroes inonthecontrol ofprecursor chemi mines (including“ecstasy”) andthehealthimpactofdrug with respect to opiates, cocaine, cannabis and ampheta 2014 provides a global overview of the latest developments well asconsumption. Chapter1oftheWorld Report Drug including development routes ofnew andmodalities,as categories, ranging from productiondrug to trafficking, marketsthe majordevelopments forthevarious indrug The World Drug Report provides of anannualoverview 1 usedisordersand thosewithdrug ordependence- use-byThe extentofproblem regular users drug drug stimulants group —atleastonceintheprevious year. to the cannabis, opioid, cocaine oramphetamine-type —mainlyasubstancebelonging had usedanillicitdrug cent and7.0peroftheworldpopulationaged15-64, and 324millionpeople,corresponding tobetween 3.5per Globally, itisestimatedthatin2012,between 162million countriesinAsia. a few can beascribedtothelower numberofdeathsreported in While thatestimateislower thanfor2011,thereduction deaths per million among the population aged 15-64. corresponds rateof40.0(range:20.8-49.3) toamortality drug-related deathswere reported in2012. That figure being lost.Anestimated183,000(range:95,000-226,000) able humanlives andproductive years ofmanypersons Drug usecontinuestoexactasignificanttoll,with valu consequences Drug useanditshealthsocial controlfrom perspective. apublichealthanddrug same timeorsequentially, remains amajorconcern,both understood as the use of two or more substances at the use drug respect Polydrug to specific drugs. use, which is generally That said,eachregion exhibitsitsown peculiarities with of theworldpopulation. usersincreasinglyof drug commensuratewiththegrowth EXECUTIVE SUMMARY or definitionthatmay beused. tion) of the American Psychiatric Association, or any similar criteria Diagnostic and Statistical Manual ofMental Disorders edi- (fourth Diseases (tenth revision) of the World Health Organization and the on clinicalcriteriacontainedinthe International Classificationof use disorders basedpeople diagnosedwithdrug or as drug-dependent onadailybasisand/or peoplewhousedrugs who injectdrugs, forexamplepeople engage inthehigh-riskconsumption ofdrugs, mayincludepeoplewho tocountryand may differfrom country There isnostandard use. definition ofproblem drug The definition 1 isgenerallystable,withthetotalglobalnumber - - - the number of people who inject drugs is12.7million the numberofpeoplewhoinjectdrugs ing on the most recent data available, jointly estimate that Bank andthe World Health draw Organization (WHO), Nations Programme onHIV/AIDS(UNAIDS),the World Office onDrugs andCrime (UNODC),theJoint United With regard use,theUnited toinjectingdrug Nations cocaine intheAmericas. those seekingtreatment inAsiaandEurope, asdid remained the most prevalent of abuse among drug primary the Americas, Oceania and Europe. Nonetheless, opiates cannabis usedisorders over in thepastdecade,particularly increase inthenumberofpersonsseekingtreatment for therethe leastharmfulillicitdrug, hasbeenanoticeable Although thegeneralpublicmayperceive cannabistobe eachyear.ence treatment services users globallyhave hadaccesstoorreceived depend - drug provision, as in recent years, only one in six problem drug people. However, there continuestobeagapinservice remains stable at between 16 million and 39 million 3 2 package ofnineinterventions, the implementationofanevidence-basedcomprehensive Addressing through HIV among people who injectdrugs, C. are who injectdrugs estimated tobelivingwithhepatitis 23.0 percent,respectively. More thanhalfofthepeople is 28.8 and lence of HIV among people who injectdrugs South-Eastern Europe, where itisestimatedthatthepreva- in tworegions oftheworld: South-West AsiaandEastern/ 0.9-4.8 million). pronounced That situationisparticularly livingwithHIVof1.7millionpersons(range: inject drugs arrived ataglobalestimateofthenumberpeoplewho UNODC, the World Bank, WHO andUNAIDSjointly arenumber ofpeoplewhoinjectdrugs livingwithHIV. It isestimatedthatanaverage of13.1percentthetotal vulnerabletoHIVandhepatitis C. particularly inject drugs The sharing of used injecting equipment makes people who average. use is4.6timeshigherthantheglobal of injectingdrug stark inEasternandSouth-Eastern Europe, where therate the populationaged15-64. prevalence of0.27percent(range:0.19-0.48cent) (range: 8.9million-22.4million). That corresponds toa 2012). Users:Drug 2012Revision (Geneva, World Health Organization, for Universal Access toHIVPrevention, Treatment andCare forInjecting WHO, UNODC,UNAIDS Technical Guide forCountriestoSet Targets purposes oftrend analysis. previous globalestimatesandnotbeusedasa comparisonforthe Therefore, these estimates should beunderstood asanupdate of countries andtheincrease inthenumberof countries reporting. theimprovedsurveys, coverage within andqualityofsurveillance sources, includingintegratedbiologicalandbehaviouralsurveillance These estimatesreflect themostrecent dataavailable from different 2 The problem isparticularly 3 asacomponentofwhatis - ix WORLD DRUG REPORT 2014 x WORLD DRUG REPORT 2014

also known as “harm reduction services”, is a major com- The global area of illicit opium cultivation in 2013 stood ponent of the global response to stop the spread of HIV. at 296,720 hectares — the largest area since 1998, when Of them, the four most effective interventions for HIV estimates became available. prevention, treatment and care are needle and syringe programmes, opioid substitution therapy (or other evidence- There is evidence that Afghan heroin is increasingly reach- based drug dependence treatment in the case of people ing new markets, such as Oceania and South-East Asia, who inject non-opioid drugs), HIV testing and counsel- that had been traditionally supplied from South-East Asia. ling, and antiretroviral therapy. The long-established Balkan route seems to remain a cor- ridor for the transit of Afghan heroin to the lucrative mar- The coverage of the four most effective interventions is kets in Western and Central Europe, but its importance greatest in Western and Central Europe, where harm has declined due to various factors such as more effective reduction interventions have been scaled up for more than law enforcement and a shrinking market in Western and a decade, leading to a decline in the number of newly diag- Central Europe, as seen by the decline in opiate use and nosed cases of HIV among people who inject drugs and seizures in the subregion and the reduced level of supply of AIDS-related deaths attributed to unsafe injecting drug compared with the peak levels of 2007. use. However, recent outbreaks of HIV among people who inject drugs in parts of Europe demonstrate how the HIV The so-called “southern route” is expanding, with heroin epidemic situation can change very rapidly in areas where being smuggled through the area south of Afghanistan services and interventions are scaled down. reaching Europe, via the Near and Middle East and Africa, as well as directly from Pakistan. It is well documented that a very high percentage of people who inject drugs have a history of imprisonment. Also, An emerging phenomenon among opioid-dependent drug both drug use and injecting drug use are highly prevalent users in the United States of America is that synthetic opi- among prison populations. The lack of access to and avail- oids are being replaced with heroin, driven by the increased ability of health care, especially drug dependence treatment availability of heroin in parts of the United States, and and HIV prevention, treatment and care services in pris- lesser costs to regular users to maintain their dependency. ons, is of major concern, since the prison population, at a Further, the reformulation of one of the main prescription minimum, should have access to services equivalent to pharmaceuticals abused, OxyContin, now makes it more those available to the general public. For instance, in difficult to snort or inject it. Europe, the proportion of prisoners who had used an illicit Following a sharp increase in 2011, global seizures of substance during incarceration ranged from 4-56 per cent. heroin and illicit morphine declined in 2012, while In Europe, the financial crisis seems to have had an impact remaining higher than the levels of 2010 and prior years. on drug use modalities, with related health and social con- The fluctuations were mainly driven by seizures in South- sequences. While there are no comprehensive data available West Asia and Western and Central Europe. However, in yet, two phenomena seem to have emerged in parts of 2012, there was an increase in heroin seizures in many Europe that have appeared in parallel to the financial crisis. other regions, mainly Eastern and South-Eastern Europe, First, there appears to be a shift in the pattern of drug use South Asia and Oceania. Significantly, heroin seizures, and which sometimes results in a higher risk of harm; and therefore presumably the flow of heroin, in key countries secondly, there has been a reduction in coverage of harm located along the “northern route” from Afghanistan to reduction services, which, according to recently published the Russian Federation, have gone down. At the same time, research, has increased the likelihood of unsafe injecting there is evidence of a significant number of small seizures behaviour, thus influencing the spread of infections such of home made desomorphine, which is likely serving as a as HIV and hepatitis C. substitute for heroin. The emergence of potentially more harmful behaviour, Drug profiles by category including the abuse of opioids such as fentanyl, has been Opiates noted among opioid-dependent persons in Estonia, Fin- land and the United States. It has been observed that Opiates and opioids top the list of problem drugs that opioid users may alternate between pharmaceutical and/ cause the most burden of disease and drug-related deaths or prescription opioids and heroin, depending on which worldwide. For the third consecutive year, Afghanistan, substance is more available, accessible and cheaper in the which has the world’s largest opium poppy cultivation, saw market. an increase in the area under cultivation (from 154,000 hectares in 2012 to 209,000 hectares in 2013). In addi- Cocaine tion, Myanmar witnessed expansion in the area of opium While cocaine manufacture and trafficking have had a seri- poppy cultivation, although less pronounced. In 2013, the ous impact in the Western hemisphere, there are indica- estimated global production of heroin rebounded to the tions that overall global availability of cocaine has fallen. levels seen in 2008 and 2011. The estimated net area under coca bush cultivation as of 31 December 2012 was the lowest since the beginning of Executive summary xi

Trend in main indicators of drug supply available estimates in 1990: 133,700 hectares, a decline of Trend in mainand drugindicators supply of reduction, drug supply 2003 and- 14 per cent from the estimate for 2011. drug supply reduction, 2003-20132013

Global cocaine seizures increased to 671 tons in 2012, 2.8 compared with the 634 tons seized in 2011. The main 2.6 2.4 increase in the quantities of cocaine seized were in South 2.2 America and Western and Central Europe. 2 1.8 Cocaine use is still relatively concentrated in the Americas, 1.6 1.4 Europe and Oceania, and practically all of the world’s 1.2 cocaine is produced in three countries in South America. 1 While there is no conclusive evidence with respect to the 0.8 0.6 extent of cocaine use in Africa and Asia, expert opinion Index (baseline 2003) 0.4 indicates that there may be pockets of emerging cocaine 0.2 use in those two regions, related to the rise in trafficking 0 through Africa and increased affluence in both 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 continents. Cultivation of opium poppy The most problematic use of cocaine is in the Americas. Cultivation of coca bush In North America, cocaine use has been declining since 2006, partly due to a sustained shortage. However, more Seizures of cocaine (base, paste, salts, "crack" and unspecified) recently, a slight increase in prevalence has been observed Seizures of cannabis (marijuana and hashish) in the United States, as has an increase in maritime seizures. Seizures of heroin and illicit morphine Seizures of ATSª In South America, cocaine consumption and trafficking have become more prominent, particularly in Brazil due to factors including its geographical location and a large Source: Seizure data: annual report questionnaire supplemented by other official sources. urban population. Cultivation data: UNODC estimates based on national illicit crop monitoring systems supported by UNODC supplemented by other In Western and Central Europe, the second largest market official data. after the Americas, indicators of overall supply suggest a a Including amphetamine, “ecstasy”-type substances, methampheta- possible rebound in the availability of cocaine; retail purity mine, non-specified ATS, other stimulants and prescription stimulants. For the categories of other stimulants and prescription stimulants, sei- has increased in some countries with sizable consumer mar- zures reported by weight or volume only are included. kets. On the other hand, they do not show an increase in demand. There has even been a decline in cocaine use in some of the countries that have had higher levels of use. In Europe, the market has changed over the past decade, The market has expanded in Oceania in recent years, but with cannabis herb produced locally or regionally now the region has a different pattern of use compared with gaining ground over cannabis resin, largely sourced from other consumer markets because it has a large body of users Morocco, which previously was the dominant cannabis (a high prevalence) who use the substance with low fre- substance in Europe, as evidenced by seizure data. quency, perhaps due to the high price of cocaine. New regulatory frameworks in the States of Colorado and Cannabis Washington in the United States and in Uruguay now make the recreational use of cannabis legal under some Cultivation and production of cannabis herb (“marijuana”) restrictions. The new laws also include provisions for the remains widespread, while production of cannabis resin supply chain, including both licensed and personal culti- (“hashish”) remains confined to a few countries in North vation. It is too early to understand the impact of these Africa, the Middle East and South-West Asia. In Afghani- changes on recreational and problematic use of cannabis stan, despite the fact that the area under cannabis cultiva- and in the broad range of areas that they may affect, includ- tion has been decreasing, the potential cannabis resin ing health, criminal justice, and public revenues and expen- production in 2012 was higher than in 2011 due to the ditures. It will take years of careful monitoring to greater yield per hectare. understand the broader effects of those novel regulatory frameworks in order to inform future policy decisions. Global cannabis use seems to have decreased, essentially reflecting a decrease in cannabis use estimates reported by Based on existing research, it can be argued that with a number of countries in Western and Central Europe. declining risk perception and increased availability, use and However, in the United States, the lower perceived risk of youth initiation may increase. Tax revenues from retail cannabis use has led to an increase in its use. At the same cannabis sales are expected to provide public revenue. time, more people using cannabis are seeking treatment However, expected revenue will need to be cautiously each year. weighed against the costs of prevention and health care. WORLD DRUG REPORT 2014 WORLD DRUG REPORT xii WORLD DRUG REPORT 2014

Amphetamine-type stimulants high-quality cannabis, heroin, methylenedioxymethamphetamine (MDMA) and cocaine. While it is difficult to quantify the global manufacture of amphetamine-type stimulants, the number of dismantled Finally, the proliferation of new psychoactive substances laboratories manufacturing amphetamine-type stimulants, continues to pose a challenge, with the number of new which were mostly manufacturing methamphetamine, psychoactive substances (348 such substances in December continued to rise. Manufacture of methamphetamine in 2013, up from 251 in July 2012) clearly exceeding the North America expanded once again, with a large increase number of psychoactive substances controlled at the inter- in the number of methamphetamine laboratories reported national level (234 substances). dismantled in the United States and Mexico. Drug-related crime Of the total of 144 tons of amphetamine-type stimulants seized globally, half were seized in North America and a Crime recorded by the authorities in relation to personal quarter in East and South-East Asia. Large quantities of use and trafficking of drugs assessed separately has shown amphetamine seizures continue to be reported in the an increase over the period 2003-2012, in contrast to the Middle East, in particular in Jordan, Saudi Arabia and the general declining trend in property-related and violent Syrian Arab Republic. crime. However, the proportion of drug offenders who Central and South-West Asia are emerging as new markets, were drug users with recorded offences for personal use with low levels of methamphetamine seizures and use being has remained stable, given the increased number of users reported by two countries in those subregions. South-West during that period. Worldwide, the large majority of drug Asia has also emerged as a significant production area for use offences are associated with cannabis. methamphetamine destined for East and South-East Asia. Crime related to drug trafficking varies depending on the Production in West and Central Africa is also emerging. type of drug and the supply patterns involved in different Seizures of “ecstasy” increased in 2012, with major quanti- regions. ties of “ecstasy” being seized in East and South-East Asia, The majority of persons arrested for or suspected of drug followed by Europe (South-Eastern and Western and Cen- offences are men; the involvement of women in drug tral Europe), which together accounted for over 80 per offences varies according to drug type, reflecting the drugs cent of global seizures of “ecstasy”. of preference among women. The highest percentage of The misuse of prescription stimulants or medications for women arrestees or suspects can be observed in relations attention-deficit hyperactivity disorder (ADHD) is not to crimes involving sedatives and tranquillizers (25 per uncommon, although only a few countries report any prev- cent). alence of misuse among the general and youth population. Precursor control Although misuse of prescription stimulants in other regions is not negligible, such abuse is reported mainly by coun- Most drugs, whether plant-based or synthetic, require tries in North and South America. chemicals to transform them into the final product. While New psychoactive substances and chemicals are only one of the components required for the clandestine manufacture of plant-based drugs (heroin and web-based marketplaces cocaine), they constitute the essential components of illic- While the Internet continues to be used as a means of drug itly manufactured synthetic drugs. trafficking and illicit trade in precursor chemicals, use of Given the growing manufacture of synthetic drugs, the the so-called “dark net” has been growing. The “dark net” control of such chemicals, known as precursors, has constitutes a virtual marketplace, which is inaccessible by emerged as a key supply control strategy because the tra- web search, and where it is difficult for law enforcement ditional approaches, such as eradication of illicit crops and authorities to identify website owners and users, as their alternative development, cannot be applied to synthetic identities remain hidden by means of sophisticated con- drugs. cealment methods. That makes the “dark net” a safe haven for buyers and sellers of illicit drugs, who trade principally There are potential vulnerabilities in the structure of and in a digital currency (Bitcoin). trends in the production of and trade in chemicals that are used in the illicit manufacture of drugs. The international While the overall proportion of drug transactions that take community has, over the years, strenghtened a control place in the “dark net” is unclear, the value of transactions, system aimed at enabling the legal trade of such chemicals as well as the range of drugs available, appears to be grow- while preventing their diversion into illicit manufacture. ing. The dismantling of one prominent “dark net” site, the “Silk Road”, uncovered that the site had approximately Some successes have been achieved in precursor control, $1.2 billion worth of total revenue from two to five years but they have prompted a range of reactions from the traf- of operations. There is evidence of a niche market on the fickers and manufacturers of illicit drugs, which create new “dark net” for new psychoactive substancesas well as for challenges for the international drug control system. Executive summary xiii

Vulnerabilities of the chemical industry 77 countries were engaged in the manufacture of precur- to diversion of precursors sor chemicals. The chemical industry has seen strong growth rates and A much larger number of countries were involved in trade geographical shifts over the past few decades, notably the in precursors. 122 countries reported exports of precursor past two decades, when global production doubled and chemicals over the period 2010-2012, while 150 countries trade more than tripled. Also during that period, the bulk reported imports. The largest exports of precursors were of production shifted to Asia, where the emerging chemi- reported by countries in Asia, followed by Europe and the cal industry is now characterized by a sizeable cluster of Americas. If only net exporting countries of precursor small competing enterprises. In contrast to the past situa- chemicals are considered, Asian countries account for 59 tion, when the chemical industry was dominated by large, per cent of total net exports over the 2010-2012 period. vertically integrated conglomerates, these new develop- Global exports in precursor chemicals rose at a rate similar ments have made the chemical industry potentially more to that of chemicals in general. vulnerable to the diversion of precursors. The licit requirements for and applications of various pre- Moreover, with more and more chemicals being traded cursors differ from country to country. The bulk (93 per across borders, a greater number of transit countries and cent) of the international trade in precursor chemicals, in the emergence of a number of chemical brokers and other terms of economic value, is of substances listed in Table II intermediaries, the potential avenues for diversion of pre- of the 1988 Convention. In 2012, the more strictly con- cursors to the clandestine manufacture of drugs have been trolled substances in Table I accounted for only 7 per cent increasing. of international trade in precursor chemicals, or 0.04 per cent of overall international trade in chemicals, and their Response by the international community export growth has been far lower than for Table II sub- Precursor control emerged as one of the key pillars of inter- stances. The most important Table I substances, in eco- national drug control in the United Nations Convention nomic terms, are acetic anhydride, used in the manufacture against Illicit Traffic in Narcotic Drugs and Psychotropic of heroin, followed by potassium permanganate, used in Substances of 1988. The Convention sets out specific the manufacture of cocaine, and pseudoephedrine, used measures for the manufacture and distribution of and in the manufacture of methamphetamine. international trade in a number of chemicals frequently The illicit trade in precursor chemicals cannot be quanti- used in the manufacture of drugs. These are listed under fied as easily as can the licit market, but information on two categories: the more strictly controlled substances in seizures can provide some partial information on trends. Table I and the relatively less controlled substances in Table II. The 1988 Convention entrusts the International Nar- Although annual seizures of precursor chemicals fluctuate cotics Control Board with the implementation of precursor greatly, the overall trend for Table I precursors seems to control at the international level. show an increase over the last two decades. By contrast, seizures of Table II substances, although fluctuating, have The system has been further enhanced by means of a been following a stable trend overall. The regional distri- number of resolutions adopted by the United Nations bution of seizures of precursors in Table I and Table II Commission on Narcotic Drugs, the Economic and Social shows a concentration in the Americas, followed, depend- Council and the General Assembly, as well as the Political ing on the time frame examined, by Europe or, in more Declaration adopted by the General Assembly at its twen- recent years, Asia. tieth special session, in 1998, and the Political Declaration and Plan of Action on International Cooperation towards Impact of precursor control on drug an Integrated and Balanced Strategy to Counter the World supply Drug Problem, adopted by the General Assembly in 2009, including their related action plans. As of December 2013, Measures employed to control precursor chemicals have 23 substances were under international control: 15 sub- had a tangible impact on reducing the diversion of chemi- stances in Table I and 8 substances in Table II of the 1988 cals to the illicit manufacture of drugs, as could be observed Convention. In March 2014, the Commission on Narcotic through various methods of analysis: Drugs decided to schedule alpha-phenylacetoacetonitrile a) Increased volume of chemicals saved from diversion. The (APAAN) in Table I of the Convention. number of shipments stopped before being diverted Production and trade of precursor increased sharply, and seizures of Table I precursors rose 12-fold from the period 1990-1992 to the period chemicals 2010-2012, the former period being the initial years There is licit use and licit trade of precursors, and control of international precursor control. This may point to includes the monitoring of the licit trade while preventing the effectiveness of precursor control, although it is not diversion. Through the analysis of information provided conclusive proof; by countries to UNODC and international trade statistics, b) High interception rates. Measuring seizures compared it can be concluded that over the period 2010-2012, some with the overall amount estimated to have been di- WORLD DRUG REPORT 2014 WORLD DRUG REPORT xiv WORLD DRUG REPORT 2014

verted into illicit manufacture, show that about 15 per New strategies by operators of drug cent of diverted potassium permanganate (in the range laboratories of 10-28 per cent) and 15 per cent of diverted acetic anhydride (in the range of 7-22 per cent) have been in- Improved precursor controls at the global level have tercepted over the period 2007-2012. Estimated diver- prompted clandestine operators of illegal laboratories to sions are equivalent to just 2 per cent of international develop a number of counter-strategies. Those strategies trade in potassium permanganate and 0.2 per cent of include: international trade in acetic anhydride; •• the use of more sophisticated ways to obtain precursor c) Higher volumes of precursor seizures compared with the chemicals volume of seizures of the substances those precursors are •• the use of transit countries with weak control systems used to manufacture. Seizures of precursors of “ecstasy”, expressed in terms of the amount of “ecstasy” they •• the emergence of organized criminal groups specialized could be used to manufacture (end-product equiva- in the supply of precursor chemicals lent), were almost a fifth larger than “ecstasy” seizures •• the creation of front companies to conceal illegal over the period 2007-2012. Seizures of amphetamine imports and methamphetamine precursors calculated in terms of their end-product equivalents were more than twice •• the domestic diversion and subsequent smuggling of as high as amphetamine and methamphetamine sei- precursor chemicals to final destinations in order to zures over the same period; bypass the international control system d) Reduced availability of drugs due to precursor control. •• the use of the Internet Three examples can be cited in which precursor con- •• the misuse of pharmaceutical preparations (notably trol appears to have reduced the supply of precursors preparations containing ephedrine or pseudoephedrine) and led to a consequent reduction in the availability and, of the drug. The first is the shrinking of the market for lysergic acid diethylamide (LSD), which could be •• the emergence of non-scheduled precursor chemicals, at least partly attributed to improved control of LSD including various pre-precursors that can be easily con- precursors. The shrinking of that market is reflected verted into the required precursors. in the 75 per cent decline in use of LSD among high school students in the United States over the period Thus, new pre-precursors for the manufacture of amphet- 1996-2013, which is highly correlated to the decreased amine-type stimulants have emerged in recent years, availability of the substance. The second example is the including APAAN, various esters of phenylacetic acid, decline in “ecstasy” use in many countries, associated 3,4-methylenedioxyphenyl-2-propanone, methyl glycidate with a lower purity of the substance, connected with and methylamine. Some of those substances, which are the limited availability of that drug’s main precursor in controlled only in a limited number of countries, have the period 2007-2010. Thirdly, the improved control become major substitutes for the precursor chemicals used of precursors of methaqualone seems to have led to a in the past and are now seized in greater quantities than decline in its availability and thus also its use over the are the internationally controlled precursors of ampheta- past two decades; mine-type stimulants. e) Prices in the illicit market. While the price of acetic an- Another counter-strategy is the manufacture of new psy- hydride in the licit market fluctuated between $1 and choactive substances that can be manufactured with chemi- $1.50 per litre in recent years, the price of illicit acetic cals not under international control. anhydride in Afghanistan rose over the years, at times reaching peaks of some $430 per litre (2011), up from All of these strategies used by clandestine manufacturers $8 in 2002. The price rises can be linked to improve- create a new set of challenges for the international precur- ments in precursor control. They also had an impact on sor control system. At the same time, they reflect the fact the cost of heroin production. The proportion of acetic that precursor control does have an impact. There are anhydride in total production costs of heroin in Af- already some instruments available at the international ghanistan rose from 2 per cent in 2002 to 26 per cent level to deal with the emerging problems — use of the in 2010 before falling to some 20 per cent in 2013. “know-your customer” principle, the limited international special surveillance list, the Pre-Export Notifications (PEN) Online and the Precursors Incident Communica- tion System (PICS) — but they are yet to be implemented in a number of countries. Their universal and effective implementation would be a step forward in meeting these challenges. Drug users (million) 100 150 200 250 300 350 50 - 208 Prevalence of illicit drug use drug of illicit (percentage) Prevalence users drug illicit of No. 2006 172 250 38 18

2007 211 155 250 16 38

2008 203 149 272

39 Drug users (million) 15 100 150 200 250 300 350 210

2009 50 - in the extent of illicit drug use, overallin the extent of illicit drug global prevalence illicit substance. to three timesmore likelythanwomentohave usedan and in terms of the substances used, generally, men are two tocountry among menandwomenvaries from country in theprevious year. use Althoughtheextentofillicitdrug amphetamine-type stimulant(ATS) group —atleastonce a substancebelongingtothecannabis,opioid,cocaineor —mainly population aged15-64hadusedanillicitdrug some 5.2 per cent (range: 3.5-7.0 per cent) of the world people (range:162million-324million)corresponding to Globally, itisestimatedthatin2012,some243million A. 1 them onlyperiodically, three tofive onceevery years. use,andmostcountriesthatdosoconduct ondrug surveys ing trend. However, notallcountriesconduct national “ecstasy”) haseitherremained stable orfollowed adecreas - whereas theuseofopiates, cocaineandATS (excluding has beenanincrease inopioidandcannabisusesince2009, With respect tothe different groups ofsubstances, there about 27millionpeople(range:16million-39million). usedisordersdrug ordependence, also remains stable, at use,byof problem regular usersandthosewith drug drug useisconsideredof drug tobestable.Similarly, theextent OF THEILLICITDRUGMARKET RECENT STATISTICS ANDTRENDANALYSIS Source: Estimatesbased ontheUNODCannualreport questionnaire. Fig. 1. 153 300 16 39 naire. (UNODC) by Member States through theannual report question- females reported totheUnited Nations Office onDrugs andCrime This isbasedontheprevalence useamongmalesand ratesofanydrug 2010 226 GLOBAL OVERVIEW EXTENT OFDRUGUSE: 208 Prevalence of illicit drug use drug of illicit (percentage) Prevalence users drug illicit of No. 2006 Drug users (million)

167 315 39 1 1 2 2 3 3 16

0 5 0 5 0 5 5 -

2011 240 0 0 0 0 0 0 0 172 250 38 18 Drug users (million) Global trends indruguse,2006-2012 100 150 200 250 300 350 2007 211 50 162 324 - 39 16 1 208 While there regional are trends varying 2012 242 250 155 N P 16 2006 38 r o

203 e 2008 4.9% . v

208 a of Prevalence of problem drug use (percentage) use drug problem of Prevalence problemNo of drugusers Prevalence of illicit drug use drug of illicit (percentage) Prevalence users drug illicit of No. 250 172 l 3 e 20062006 1 illic 8 149 272 n 8 39 15

2007 2 c

1 e 2009 210 i 5.8% 0.4% 0.9% 4.0% t

1 o

172 250 38

d 18 f 250 155 4.9% 16 rug

3 illi 20072007 211 153 300 8 16 39 2008 203 c

226 i

u 2010 t 0.4% 0.9% 3.5% 5.7%

se 155 250 d 16 38 r 272 149 r 3 15 ug 4.6% 203 2008s 2008 9 167 315 39 16 2009 210 u

2011 240 0.3% 0.9% 3.4% 6.2% se 149 272 39 15 Drug users (million)

150 200 250 300 350 100 300 153 ( 16 39 4.8% 210 p

20092009 50 162 324 - 39 16 e 2010 226 r 242 c 2012 6.7% 0.3% 0.9% 3.4% e 300 153 n 16 39 315 167 t 3 5.0% 4.9% 16 a 20102010 226 9 208 g Prevalence of problem drug use (percentage) use drug problem of Prevalence problemNo of drugusers

2011 240 Prevalence of illicit drug use drug of illicit (percentage) Prevalence users drug illicit of No. e

) 20062006 0.9% 3.6% 6.9% 0.3% 167 315 39 16 324 162 16 3 5.2% 0.4% 0.9% 4.0% 5.8%

20112011 240 9 172 250 38 18 2012 243 4.9%

20072007 211 0.3% 0.8% 3.5% 7.0% 162 324 39 16 Therefore, ratherthanlookingattheyear-to-year change, Europe and North America, representing nearly 12 per 33 countries, mostly countries of Western and Central 2012 data,updatedprevalence estimates are available for withalargepopulation. Forunless theyoccurinacountry have onlyaslightimpactonregion’s overall prevalence Also, year-on-year changesinacountry’s prevalence rate it is more to take a longer-term perspective. meaningful naire. Source: EstimatesbasedontheUNODCannualreport question- 4 0.4% 0.9% 3.5% 5.7% 5.2% 242 . 20122012 Fig. 2. 9 155 250 16 2006 38 % Index (baseline = 2009) 4.6% 20082008 203 100 105 110 115 120 4.9% 0% 1% 2% 3% 4% 5% 6% 7% 8% 80 85 90 95 0 0 5 4 Prevalence of problem drug use (percentage) use drug problem of Prevalence problemNo of drugusers . . . . 0.3% 0.9% 3.4% 6.2% 9 4 8 2006 0 149 272 % % % % 39 15

2007 4 4.8% . 210

20092009 9 0.4% 0.9% 4.0% 5.8% N P % different drugs,2009-2012 Trends intheprevalence ofuse 0 0 5 3 r o e 2009 . . . Annual prevalence among. population age 15- 4.9%

0.3% 0.9% 3.4% 6.7% 9 4 7 5 v

o 2007 a 153 300 4 % % % % f 16 39 2008 64 (percentage) "Ecstasy" Cocaine Cannabis l

. e 5.0% p 6 226

n 20102010 0.4% 0.9% 3.5% 5.7% rob % c 0 0 6 3

e . . . . 0.9% 3.6% 6.9%

9 3 2 4 0.3% 4.6% l o 2008 e 167 315 % % % % 4 39 16 f m 2009

. 5.2% p 8 240 20112011 0.3% 0.9% 3.4% 6.2% r d % 2010 obl 0 0 6 3 r

ug . . . . 0.3% 0.8% 3.5% 7.0% 9 3 7 4 2009 4.8% e 162 324 % % % % 39 16 5

m 2010 u . 5.2% 242 0 se

20122012 0.3% 0.9% 3.4% 6.7% d % 0 0 6 3 r r s ug . . . . 5.0% 4.9% 9 3 9 2010 6 0% 1% 2% 3% 4% 5% 6% 7% 8% 5 % % %

2011 % Prevalence of problem drug use (percentage) use drug problem of Prevalence problemNo of drugusers u . 2011 2

se 2006 Opioids Amphetamines Opiates 0.9% 3.6% 6.9% % 0.3% 0 0 7 3

( . . . . p 5.2% 8 0.4% 0.9% 4.0% 5.8% 3 5 0 5

e 2011 % % . % % 2 r 20Annual12 prevalence among population age 15- c 4.9% %

e 2007 0.3% 0.8% 3.5% 7.0% n 64 (percentage)

1 t 1 2 3 4 5 6 7 8 0 a 0.4% 0.9% 3.5% 5.7% 5.2% % % % % % % % % %

g 2012 2012 e ) 2008 4.6% 0% 1% 2% 3% 4% 5% 6% 7% 8%

A0.3% nnual0.9% prevalen3.4% ce among population6.2% age 15-64 (percentage) 2009 4.8% Annual prevalence among population age 15- 0.3% 0.9% 64 (percentage)3.4% 6.7% 2010 5.0% 1 0.9% 3.6% 6.9% WORLD DRUG REPORT 2014 0.3%

5.2% 2011 0.3% 0.8% 3.5% 7.0%

2012 5.2% 0% 1% 2% 3% 4% 5% 6% 7% 8%

Annual prevalence among population age 15- 64 (percentage) 2 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Table 1. Global estimates of users of different drugs, 2012

Number of users (millions of users) Prevalence (percentage) Best estimate Low High Best estimate Low High Cannabis 177.63 125.30 227.27 3.8 2.7 4.9 Opioids 33.04 28.63 38.16 0.7 0.6 0.8 Opiates 16.37 12.80 20.23 0.35 0.28 0.43 Cocaine 17.24 13.99 20.92 0.37 0.30 0.45 ATS 34.40 13.94 54.81 0.7 0.3 1.2 “Ecstasy” 18.75 9.4 28.24 0.4 0.2 0.6 Source: Estimates based on the UNODC annual report questionnaire.

Polydrug use A third pattern is observed when a drug is gradually replac- ing or being substituted by another drug due to changes in Polydrug use is the use of two or more substances at the price or availability or because the drug is in fashion. same time or sequentially;1 it is a common occurrence Common examples are heroin being substituted by oxyco- among both recreational and regular drug users2,3 in all done, desomorphine or other opioids, as observed in vari- regions. ous regions, or “ecstasy” being substituted by mephedrone There are three distinct patterns of polydrug use: or some other new psychoactive substance. One pattern is different substances being taken together to Various studies have documented the extent of polydrug have a cumulative or complementary effect.4,5 This pat- use. In a study conducted in 14 European countries in tern is commonly seen among cannabis and cocaine users, 2006, 60 per cent of cocaine users were polydrug users, of who may use the drug in combination with alcohol; other which 42 per cent used alcohol, 28 per cent used cannabis combinations are the use of heroin in combination with and 16 per cent used heroin.8 In another study, in the benzodiazepines,6 alcohol or other opioids (methadone, South-Eastern United States, 48.7 per cent of treatment oxycodone, etc.) and the use of cocaine in combination admissions were for polydrug use, with alcohol, cocaine with other stimulants. and cannabis being the most common substances.9 The A second pattern is the use of a drug to offset the adverse main risks and consequences of polydrug use, for both effects of another drug, e.g., cocaine and heroin use recreational and high-risk drug users, continue to be the (“speedball”), or cocaine use with other opioids,7 although severe health consequences due to the increased toxicity, in the latter case, there is also a complementary effect. overdose and death. From a policy perspective, it is important to understand the patterns of polydrug use because such use invalidates the established profile and characteri- 1 World Health Organization, Lexicon of Alcohol and Drug Terms zation of the user of a specific, single drug. (Geneva, 1994). 2 World Drug Report 2011 (United Nations publication, Sales No. E.11.X.10). 3 European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), “Polydrug use: patterns and responses”, Selected issue 2009 (Lisbon, November 2009). 7 Francesco Leri, Julie Bruneau and Jane Stewart, “Understanding 4 Ibid. polydrug use: review of heroin and cocaine co-use”, Addiction, vol. 5 Annabel Boys, John Marsden and John Strand, “Understanding rea- 98, No. 1 (January 2003), pp. 7-22. sons for drug use amongst young people: a functional perspective”, 8 EMCDDA, Annual Report 2009: The State of the Drug Problem in Health Education Research, vol. 16, No. 4 (2001), pp. 457-469. Europe (Lisbon, November 2009), p. 42. 6 Markus Backmund and others, “Co-consumption of benzodiaz- 9 S. Kedia and others, “Mono versus polydrug abuse among publicly epines in heroin users, methadone-substituted and codeine-substi- funded clients”, Substance Abuse Treatment, Prevention and Policy, tuted patients”, Journal of Addictive Diseases, vol. 24, No. 4 (2005). vol. 2, 2:33 (8 November 2007).

cent of the global population aged 15-64. Therefore, the surveyed countries (Australia, United States of America, trends and global annual estimates of overall drug use and Spain, Urban Afghanistan, and Pakistan), the illicit use of of different substances reflect only the changes in or revi- drugs is more common among men than women, but the sion of the estimates for those countries and regions. non-medical use of pharmaceutical drugs is nearly equiva- Drug use and gender lent, if not higher among women (see figure 3). Taking together the combined estimates of those five surveys, the Nearly all drug use surveys indicate that men are more illicit use of pharmaceuticals is notably different for the likely than women to use drugs such as opiates and can- two sexes, as nearly half the women with past-year drug nabis. However the gender gap shrinks when data on the use had used pharmaceuticals, compared with only one misuse of pharmaceuticals are considered. In five recently third of men. 2 users lem drug Globally, it isestimatedthatapproximately oneinsixprob treatment demandinAsia andOceania. bean. ATS useisresponsible forsizeable of proportions inLatinAmericaand theCarib Americas, inparticular major contributortothedemandfortreatment inthe Eastern andSouth-Eastern Europe andAsia.Cocaineisa per cent). Opioids dominate the demand for treatment in cent to40percent)andOceania (from 30percentto46 per cent),LatinAmericaandtheCaribbean(from 24per Eastern andSouth-Eastern Europe (from 8percentto15 ern and Central Europe (from 19 per cent to 25 per cent), total treatment admissionsforcannabisincreased in West between of 2003and2012theproportion ful illicitdrug, general publicmayperceive cannabistobetheleastharm- throughout theAmericas and inOceania. Althoughthe Treatment evidentinAfrica, forcannabisuseisvery have the highest negative impact on health in each region. for treatment canprovide that informationonthedrugs fore, typesthatcontributetothedemand analysingdrug ence reflects aproblematic level ofconsumption. There The need for treatment use disorders for drug and depend the demandfortreatment Problematic druguseasreflectedin B. maceutical substanceswhichareknowntobeabused. based onbestavailableestimatesandmaynotreflectallclassesofphar Note: Estimatedproportionsofnon-medicalusepharmaceuticalsare (EDADES) 2012. Encuesta Sobre AlcoholYDrogas enPoblaciónGeneralEnEspaña Pakistan, 2012,SubstanceAbuseMentalHealthSurvey Drug StrategyHouseholdSurveyReport(Australia),usein National UrbanHouseholdDrugUseSurvey, 2012,2010National Source: UNODCannualreport questionnaire, Afghanistan Fig. 3. Past-year prevalence differs from country to country andmay includepeoplewhoengage tocountry differs from country There isnostandard use. definitionofproblem drug The definition HEALTH ANDSOCIALIMPACT 1 1 1 1 1 2 0 2 4 6 8 0 0 2 4 6 8 % % % % % % % % % % % A use inthepast-year, bygender cal andnon-pharmaceuticalillicitdrug Estimated proportions ofpharmaceuti- u s P t 2 r ha a accesses treatment each year. However, l i a rm a c U e S uti A c a l S p a N i n on- A P f ha g ( u h r rm a b n a i st n a ) a c n e

u ti P a

c k a i st l a n ------5 4 3 20.8-49.3) deathspermillionpersonsaged15-64. 2012, corresponding rateof40.0(range: toamortality 183,000 (range:95,000-226,000)drug-related deathsin Drugs andCrime (UNODC)estimatesthatthere were can result use. from drug The United Nations Office on Drug-related death quently, theglobalnumberof drug-related deaths. mostly affectedtheregional totalforAsiaand,conse Kazakhstan and Uzbekistan), which (Islamic Republic of), countries(Iranof theupdatedestimatesfrom onlyafew related deaths. That revision waspredominantly theresult interpreted asadeclineintheglobalnumberofdrug- the deaths isadownward revision from thevalue publishedin The current estimateofthetotalnumberdrug-related Drug-related deaths in North America. Central Europe, oneinfourOceania, andoneinthree usersreceivingproblem drug treatment in Western and (primarily forcannabisuse),compared withoneinfive usersreceivingin 18problem drug treatment inAfrica there are largeregional disparities,withapproximately 1 tion recommended by the World Health Organization occurred. Naloxone, apure opioidantagonist,isamedica- by reversing theeffectsofopioidsafteranoverdose has reducing opioiddependency orrestricting supplybutalso Deaths from opioid overdose are preventable not only by alcohol. especially involving benzodiazepines and the use of of treatment use, for opioid dependence; andpolydrug to treatment, incarceration orself-imposedabstinence;lack tolerance duetoarecent periodofabstinencesuchasdue dose include the availability and purity of opioids; reduced typeimplicatedinthosedeaths.Riskfactorsforoverdrug the non-medical use of prescription opioids) are the main number ofdrug-related deaths,andopioids(heroin and Drug overdose contributor to the global isthe primary

World Report 2013.However, Drug thisshouldnotbe 2013. ing andreducing opioidoverdose mortality”, United Nations, June Discussion paperUNODC/WHO2013,“Opioid overdose: prevent- tion, 2004). vol. 1,M.Ezzati andothers,eds. (Geneva, World Health Organiza- Regional Burden ofDiseaseAttributable toSelected Major RiskFactors, use”,drug inComparative Quantification ofHealth Risks:Global and an alternative source isused:Louisa Degenhardt and others,“Illicit limitedreporting ofdatafromBecause countriesinAfrica, ofthevery use. tentional deathsandtrauma,duetodrug due to HIV acquired use, suicide, throughand unin- injecting drug but includesallorsomeofthefollowing: overdoses, fataldrug deaths The definitionofdrug-related deathsvaries amongMember States be used. Psychiatric Association,oranysimilarcriteria ordefinitionthatmay Statistical Manual ofMental Disorders (4thed.)oftheAmerican revision) of the World Health Organization andtheDiagnostic and teria containedintheInternational ClassificationofDiseases (10th usedisorders basedonclinicalcri- with drug orasdrug-dependent onadailybasisand/or peoplediagnosed peoplewhousedrugs drugs, forexample,peoplewhoinject in thehigh-riskconsumptionofdrugs, 5 3 is the most extreme form of harm that B. Healthandsocialimpact 4 - - 3 WORLD DRUG REPORT 2014 4 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 4. Changes in the primary drug of concern among people in treatment, by region, 2003-2012 100

n d 90 a

m 80 d e 70 ) n t e

g e 60 t m a n t a

e 50 t r e r c o f

p e 40 (

o n 30 20 r o p t i

P 10 0 2003 2012 2003 2012 2003 2012 2003 2012 2003 2012 2003 2012 2003 2012 North Latin America Eastern& South- Western America & the Caribbean Eastern & Central Africa America Asia Europe Oceania

Cannabis Opioids Cocaine Amphetamine-type stimulants Other Source: UNODC annual report questionnaire, national government reports.

Table 2. Estimated number of drug-related deaths and mortality rates per million persons aged 15-64 years, 2012 Mortality rate per million Number of drug-related deaths % of population aged 15-64 of countries Region Best Lower Upper Best Lower Upper where mortality estimate estimate estimate estimate estimate estimate data is available Africa 36,800 17,500 56,200 61.9 29.4 94.3 .. North America 44,600 44,600 44,600 142.1 142.1 142.1 100 Latin America and the Caribbean 4,900 4,000 7,300 15.1 12.6 22.7 80 Asia 78,600 11,400 99,600 27.7 4.0 35.0 9 Western and Central Europe 7,500 7,500 7,500 23.2 23.2 23.2 100 Eastern and South-Eastern Europe 8,700 8,700 8,700 37.9 37.9 37.9 100 Oceania 1,900 1,600 1,900 77.5 65.3 78.5 75 Global 183,100 95,500 225,900 40.0 20.8 49.3 Source: UNODC annual report questionnaire; Inter-American Drug Abuse Control Commission; Louisa Degenhardt and others, “Illicit drug use”, in Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, vol. 1, chap. 13, M. Ezzati and others, eds. (Geneva, World Health Organization, 2004). Note: Data for Africa have been adjusted to reflect the 2012 population. The wide range in the estimates for Asia reflects the low level of reporting from countries in the region. The best estimate for Asia is placed towards the upper end of the reported range because a small number of highly populated countries reported a relatively high mortality rate, which produces a high regional average. Two dots (..) indicate insufficient data. Also see footnote 4.

(WHO) that can be administered to immediately reverse Preventing non-fatal overdose cases the effects of an opioid overdose. It is highly effective and A major health consequence of high-risk drug use — safe and has no significant side effects and no potential for especially among regular opioid users and people who 6 misuse. inject drugs — that remains largely underreported is the A number of countries have implemented community- occurrence of non-fatal overdose cases.8 Various studies based programmes that make naloxone more readily avail- conducted among opioid users and people who inject drugs able to appropriately trained opioid users, their peers and have reported that the large majority of opioid users had family members. In the United States, for example, there survived an overdose episode in their lifetime (ranging were 188 local opioid overdose prevention programmes between 30 and 83 per cent, as reported in different distributing naloxone in 2010, and between 1996 and 2010, those programmes reported 10,171 opioid overdose opioid overdose prevention programs providing naloxone: United reversals through use of naloxone.7 States, 2010”, Morbidity and Mortality Weekly Report, vol. 61, No. 6 (17 February 2012), pp. 101-105. 8 Discussion paper UNODC/WHO 2013, “Opioid overdose: prevent- 6 Ibid. ing and reducing opioid overdose mortality” (United Nations, June 7 Centers for Disease Control and Prevention, “Community-based 2013). treatment services implications andprevention and People whoinjectdrugs,health resulting inlowered tolerance,andmisjudgesthedose. episodeofdetoxification),gone through ashort-term period ofabstinence(e.g.,afterincarceration orhaving use). Itdrug mayalsooccurwhen a personhashad a short ticularly alcoholandbenzodiazepines (seethebox onpoly example — are mixed with other sedating substances, par Most overdose casesoccurwhensubstances—opioids,for disabilities. result inprolonged hospitalization,braindamageand oedema, pneumoniaandcardiac arrhythmia,whichmay to morbidity, includingcerebral hypoxia, pulmonary death. are 20-25 non-fatal overdose cases to each drug-induced studies C infection. 494,000 years oflifewere lostworldwideduetohepatitis death asaconsequenceofHIVinfection,andfurther use,through prematuretion withunsafeinjectingdrug a majorpublichealthchallenge. infectionsinsomecountriesandresultingcent ofnew in (PWID) remainsdrugs high, constituting up to 40 per cases of HIVnumber among of people new who inject gramme onHIV/AIDS(UNAIDS)reports thatthe injecting equipment. The Joint United Nations Pro and hepatitisC,contractedby sharingofcontaminated blood-borne infectionssuchasHIV, aswell ashepatitisB implications duetothehighrisksoftransmission Unsafe serioushealth usecanhave very injectingdrug that in2010,1,980,000years oflifewere lostinconjunc - global burden dependence estimated ofdiseasefrom drug 13 12 11 10 9 2013), pp. 1564-1574. of DiseaseStudy 2010”, useanddependence: findingsfrom theGlobalto illicitdrug Burden L. Degenhardt and others, “Global burden of disease attributable demic 2013(Geneva, 2013). UNAIDS, 967. non-fatal heroin overdose”, Addiction, vol. 97,No. 8(2002),pp. 963- M. Warner-Smith, S.Darke andC.Day, “Morbidity associatedwith EMCDDA, problem”, usersinLondon:extentandnaturedose amonginjectingdrug ofthe No. 3(1996),pp. 405-411;B.Powis andothers, “Self-reported over- Prevalence andcorrelates ofnon-fataloverdose”, Addiction, vol. 91, and W. Hall, “Overdose amongheroin usersinSydney, Australia: I. Medicine, vol. 14,No. 7(July 2007),pp. 616-623;S.Darke, J.Ross usersatriskofnonfataloverdose”,injection drug Academic Emergency 80, No. 2(2003), pp. 220-229;P. O. Coffin and others, “Identifying usersinBaltimore,of drug Maryland”, Journal ofUrban Health, vol. between depressive symptomsandnonfataloverdose amongasample Association, 2010); K. E. Tobin relationship and C. A. Latkin, “The the Response, C.Cook,ed.(London,International Harm Reduction in overdoselooked: aglobalreview ofdrug andoverdose prevention”, in P. Coffin,S.Sherman andM.Curtis, “Underestimated andover- usersintheRussiandose amonginjectiondrug Federation”, ascited B. Sergeev andothers,“Prevalence andcircumstances ofopiateover- 10 Global State ofHarm Reduction 2010:Key Issues forBroadening 9 ). Additionally, it is estimated that in Europe, there Non-fatal overdose cansignificantlycontribute 11 13 Addiction, vol. 94,No. 4(1999),pp. 471-478. Global Report: UNAIDSReport ontheGlobal AIDSEpi- Annual Report 2010(Lisbon,2010). The Lancet,vol. 382,No. 9904(29August 12 Arecent studyonthe

- - - aged 15-64, and the prevalence of HIV among people who 2013), representing 83percentoftheglobalpopulation (compared with83countriesintheWorld Report Drug on theprevalence use in 89 countries ofinjecting drug 15 14 was12.7million(range:8.9 million-22.4 injected drugs estimate for2012ofthenumberpeoplewhohadrecently The jointUNODC/WHO/UNAIDS/World Bank global People whoinjectdrugs and HIVamongpeoplewhoinjectdrugs. change andtrends use intheepidemicofinjectingdrug challenging tasktoreliably assessglobalandregional differences and factors related to data quality makes it a wide onthesubject.Acombinationofmethodological to accessthegreatest numberofdatasetsavailable world- the scientificapproach tothemethodologywas usedand international andcivilsocietyorganizationstoensure that to abroad from group academia, ofexperts WHO andthe World Bank joinedforces andreached out In calculatingthe2012estimates,UNODC,UNAIDS, based ondatafrom 84countries. prevalence was of HIV among people who inject drugs lence wasbasedondatafrom 61countries. The estimated usepreva2008, forwhichtheestimateofinjectingdrug - to theUnited Nations onHIVandInjecting Drug Use in of thepublishedestimatesformerReference Group compared with what was available previously at the time drugs. This represents animprovement indatacoverage cent oftheestimatedglobalnumberpeoplewhoinject tries in the in111countries(comparedinject drugs with106coun- 50 countries. for hepatitisCandsyphilis)have beencarriedoutinover (which includeserological testsforHIVand,insomecases, veys andintegratedbiologicalbehaviouralsurveys sur- 2013) between 125and200behaviouralsurveillance been estimatedthatover thepast10years (from 2003 to carriedouttodateisnotprecisely known,surveys ithas While thenumberofintegratedbiologicalandbehavioural among them. HIVandhepatitisC,infectious diseases,particularly mate the size of those populations and the prevalence of in orderlations (such as people who inject drugs) to esti- designed tomeasure hard-to-reach andhiddenkeypopu- studiesspecifically logical andbehaviouralsurveillance overa considerableeffort thepast10years toconductbio- hasexpandedoverdrugs, thepastdecade. There hasbeen amongpeoplewhoinject inparticular who usedrugs, Knowledge regarding thebehaviourandhealthof people Current estimatesare basedontheinformationavailable Nations on HIV andInjecting Drug Use. Including all formermembersoftheReference Group totheUnited 2013. (IBBS)forkeypopulations”,surveys draftreport dated 28October E. deBuhr, “Assessment ofintegratedbiological andbehavioural World Report 2013),representing Drug 92 per 14

B. Healthandsocialimpact 15 regional, 5 WORLD DRUG REPORT 2014 6 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Table 3. Estimated number and prevalence (percentage) of people who inject drugs among the general population aged 15-64 years, 2012 People who inject drugs Region Subregion Estimated Number Prevalence (percentage) Low Best High Low Best High Africa 300,000 1,020,000 6,240,000 0.05 0.17 1.05 America 2,470,000 3,130,000 3,910,000 0.39 0.49 0.61 North America 1,770,000 2,060,000 2,360,000 0.56 0.66 0.75 Latin America and the 700,000 1,070,000 1,540,000 0.22 0.33 0.48 Caribbean Asia 3,480,000 4,650,000 6,190,000 0.12 0.16 0.22 Central Asia and 360,000 410,000 470,000 0.67 0.76 0.87 Transcaucasia East and South-East Asia 2,450,000 3,260,000 4,420,000 0.16 0.21 0.28 South-West Asia 390,000 650,000 920,000 0.22 0.37 0.51 Near and Middle East 30,000 70,000 130,000 0.03 0.08 0.13 South Asia 250,000 250,000 260,000 0.03 0.03 0.03 Europe 2,530,000 3,760,000 5,850,000 0.46 0.68 1.06 Eastern and South-Eastern 1,800,000 2,900,000 4,750,000 0.78 1.26 2.07 Europe Western and Central 740,000 870,000 1,100,000 0.23 0.27 0.34 Europe Oceania 120,000 130,000 160,000 0.49 0.53 0.66 Global 8,910,000 12,690,000 22,350,000 0.19 0.27 0.48 Source: UNODC annual report questionnaire, progress reports of UNAIDS on the global AIDS response (various years), the former Refer- ence Group to the United Nations on HIV and Injecting Drug Use, estimates based on UNODC data, and national government reports.

million), corresponding to a prevalence of 0.27 per cent HIV among people who inject drugs (range: 0.19-0.48 per cent) of the population aged 15-64. There are, however, large regional variations in terms of UNAIDS reports that for the 49 countries for which data data coverage and quality. are available, the prevalence of HIV among people who inject drugs is at least 22 times higher than among the The current estimate represents a slight downward revision general population and, in 11 countries, is at least 50 times in the global number of people who inject drugs from the higher.16 estimate published in the World Drug Report 2013. How- ever, this should not be interpreted as an actual decline in The joint UNODC/WHO/UNAIDS/World Bank global the number of people who inject drugs worldwide but estimate for 2012 of the number of people who inject rather as a revision of the estimate, following the first joint drugs living with HIV is 1.7 million (range: 0.9 million-4.8 UNODC/WHO/UNAIDS/World Bank data and meth- million), corresponding to an average prevalence of HIV odology review and independent expert consultations con- among people who inject drugs of 13.1 per cent. ducted at the end of 2013. This led to an updating of There are great challenges in collecting data on people who national estimates on people who inject drugs for 23 coun- inject drugs. They are often hard to reach and difficult to tries, including highly populated countries such as China sample. Surveys among people who inject drugs might and Indonesia. capture only people currently injecting drugs, and the By far the highest prevalence of injecting drug use, with a global estimate of people who inject drugs living with HIV rate 4.6 times the global average, is found in Eastern/ may not fully represent the number of people who have a South-Eastern Europe, where 1.26 per cent of the popula- lifetime history of injecting drug use and are living with tion aged 15-64 are estimated to have recently injected HIV but who are not currently injecting drugs. drugs. Within that subregion, notably high rates of inject- The current estimate of the prevalence of HIV among ing drug use are observed for the Russian Federation (2.29 people who inject drugs has been revised upwards from per cent), the Republic of Moldova (1.23 per cent), Belarus the estimate in the World Drug Report 2013. However, (1.11 per cent) and Ukraine (0.88-1.22 per cent). since the estimated total number of people who inject In terms of the actual numbers of people who inject drugs, drugs has been revised downward, the estimated global three countries (Russian Federation, China and the United number of people who inject drugs living with HIV States) combined account for 46 per cent of the global total. 16 UNAIDS, Global Report: UNAIDS Report on the Global AIDS Epi- demic 2012 (Geneva, 2012).

2011 of reducing HIV transmission among people who on HIVandAIDSadopted by theGeneral Assemblyin towards achieving the target set in the Political Declaration insight intochangesintheepidemic over time andprogress nosed each providesyear among people who inject drugs casesofHIVdiag- An examinationofthenumbers ofnew for 62percentoftheglobaltotal. stan, theRussian Federation andtheUnited States) account living withHIV, fourcountriescombined (China,Paki In termsoftheactualnumber ofpeoplewhoinjectdrugs and Ukraine (21.5percent). in boththeRussian Federation (range:18.4-30.7percent) with HIV, primarilyreflecting thehighprevalence observed areper centofpeoplewhoinjectdrugs thoughttobeliving stan. In Eastern/South-Eastern Europe, an estimated 23.0 prevalence of HIV among people in who Paki inject drugs are livingwithHIV, predominantly reflecting thehigh it isestimatedthat28.8percentofpeoplewhoinjectdrugs InHIV amongpeoplewhoinjectdrugs. South-West Asia, Two highprevalence regions standoutashavingavery of (China, theRussian Federation andtheUnited States). tries, includingthethree countrieswithlargepopulations 2013, whichledtoupdatednationalestimatesfor36coun consultationsconductedattheendof independent expert UNAIDS/World Bank dataandmethodology review and reflects theresults ofthefirstjoint UNODC/WHO/ remains essentiallythesame.Importantly, estimate thenew reports. Reference Group totheUnitedNationsonHIVandInjectingDrugUse,estimatesbasedUNODCdata,nationalgovernment Source: UNODCannualreport questionnaire; progress reports ofUNAIDSontheglobalAIDS response (variousyears),theformer Table 4. Global Oceania Europe Asia America Africa Region 2012 Estimated numberandprevalence (percentage) ofHIVamongpeoplewhoinjectdrugs, Europe andCentralWestern Europe andSouth-Eastern Eastern South-West Asia Near andMiddleEast South Asia East andSouth-EastAsia Transcaucasia Central Asiaand Caribbean Latin Americaandthe North America Subregion

917,000 320,000 364,000 196,000 331,000 148,000 197,000 44,000 88,000 20,000 26,000 49,000 24,000 1,000 1,000 Low - - - Estimated number 20 19 18 17 adeclineintheprevalencereduction ofinjecting services, are consistentwiththescaling-upofprovision ofharm and AIDS-related deathsamongpeoplewhoinjectdrugs 25 percent. diagnosedHIVcases The declineinnewly related deathsinthatregion declinedfrom 43percentto usetototalAIDS- contribution ofunsafeinjectingdrug in 2006to1792012 region, in lateryears ofthe inthewestern part WHO European usethat occurredAIDS attributed tounsafe injecting drug also inthesharpdeclinenumberofdeathsfrom and subsequentlydeclined. That development isvisible that theepidemicinregion wasgreatest inthoseyears casesbetween 1999and2003,indicatingnumber ofnew therewho injectdrugs, wasanoticeablepeakinthe In several European countries the transmissionofHIVwithinthatmost-at-riskgroup. reflect improved theyalsoreflect changesin surveillance, by 50percentbyinject drugs 2015. newly diagnosedcases(incidence)ofHIVamongpeople newly changes in the numbers of newly diagnosedcasesmay changes inthenumbersofnewly 1,667,000 HIV amongpeoplewhoinjectdrugs Office for Europe. inEurope HIV/AIDSsurveillance 2012. European Centre forDisease Prevention andControl/WHO Regional for thepurposesofitswork, seewww.euro.who.int/en/countries. For thelistofcountriesEuropean region asdefinedby WHO Eastern Europe. Countries of Western and CentralEurope andEasternSouth- annex). to Eliminate HIVandAIDS(General Assemblyresolution 65/277, Political Declaration onHIVandAIDS:Intensifying Our Efforts 667,000 719,000 188,000 312,000 556,000 189,000 267,000 123,000 52,000 21,000 31,000 79,000 19 1,000 3,000 withthenumberofdeathsdecliningfrom 1,358 Best 4,828,000 1,368,000 1,434,000 2,006,000 298,000 596,000 966,000 167,000 254,000 421,000 66,000 22,000 41,000 2,000 8,000 High 20 . During that time period,the 18 Best estimate(percentage) withahighoccurrence of B. Healthandsocialimpact Prevalence 17 Althoughthe

13.1 23.0 19.1 28.8 12.0 12.1 6.0 1.0 8.4 9.6 3.8 7.7 7.4 9.2 8.6 7 WORLD DRUG REPORT 2014 8 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 5. Countries with a high occurrence of and a change in the behaviour of people who inject drugs, newly diagnosed cases (incidence) of with less frequent injecting and safer injecting practices HIV among people who inject drugs in being observed in many Western European countries.21 Europe and Central Asia, 1993-2011 There are some exceptions to the general downward trend Western and Central Europe in the number of new HIV cases among people who inject 1,600 drugs in Europe, which demonstrate how the situation 1,400 with regard to the HIV epidemic can change very rapidly. 1,200 Greece (Athens) and Romania recently experienced significant increases in HIV cases among people who inject 1,000 drugs. Those outbreaks were related to the increased fre- 800 quency of injecting associated with a changing pattern of 600 injecting, from heroin to cocaine in Greece and to amphetamines in Romania, and an increase in the sharing of nee- 400 dles and syringes.22,23 The European Monitoring Centre 200 for Drugs and Drug Addiction (EMCDDA) notes a tem- who inject drugs (PWID) poral association between those outbreaks and the low 0 levels of harm reduction services in Greece (compared with 24

1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 international standards) and Romania. Number of of Number new cases of HIV among people Estonia Greece Latvia Lithuania Portugal Eastern/South-Eastern Europe has very high prevalence rates and numbers of people who inject drugs and people Eastern and South-Eastern Europe who inject drugs and are also living with HIV, predomi- 60,000 nantly reflecting the situation in the Russian Federation and Ukraine. In those two countries, the number of people 50,000 who inject drugs who are newly diagnosed with HIV each 40,000 year continues to be higher than in other countries of the region. According to the Russian Federal Research and 30,000 Methodological Centre for Prevention and Control of AIDS, the proportion of newly diagnosed cases of HIV 20,000 attributed to injecting drug use was 58.7 per cent in 2009 and 57.0 per cent in 2013. In Ukraine, the number of 10,000 newly diagnosed cases of HIV among people who inject

people whopeople inject drugs (PWID) drugs is levelling off at about 6,000-7,000 new cases annu- Number of new cases of HIV among of cases of new Number 0 ally. In Central Asia, a region with a high prevalence of injecting drug use, several countries with a high occurrence 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 of newly diagnosed cases (incidence) of HIV among people Russian Federation Ukraine who inject drugs have seen the incidence continue to rise 25 Central Asia over the past decade. Very high levels of risky injecting 2,000 behaviour are reported in the region and, although some 1,800 progress has been made in the scaling-up of HIV preven- 1,600 tion, treatment and care services for people who inject 26 1,400 drugs, many obstacles still remain. 1,200

1,000 21 L. Wiessing and others, “Trends in HIV and hepatitis C virus infec- 800 tions among injecting drug users in Europe, 2005 to 2010”, Eurosur- veillance, vol. 16, No. 48 (2011). 600 22 EMCDDA, “HIV outbreak among injecting drug users in Greece” 400 (Lisbon, November 2012). 200 23 EMCDDA, “HIV/AIDS among injecting drug users in Romania: people whopeople inject drugs (PWID) report of a recent outbreak and initial response policies” (Lisbon,

Number of new cases of HIV among of cases of new Number 0 2012). 24 EMCDDA and European Centre for Disease Prevention and Con- 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 Azerbaijan Georgia Kazakhstan trol, “Joint EMCDDA and ECDC rapid risk assessment. HIV in injecting drug users in the EU/EEA, following a reported increase of Kyrgyzstan Tajikistan Uzbekistan cases in Greece and Romania” (Lisbon, January 2012). Source: EMCDDA Statistical Bulletin 2013; European Centre for 25 The initial peak in reported HIV incidence in Central Asia in the Disease Prevention and Control/World Health Organization, table early 2000s is also in part related to the increase or initiation of HIV INF-104; Federal Scientific and Methodological Center for Preven- testing among people who inject drugs. tion and Control of AIDS, Russian Federation; Republican AIDS 26 Claire Thorne and others, “Central Asia: hotspot in the worldwide Center, Ministry of Health, Tajikistan. HIV epidemic”, Lancet Infectious Diseases, vol. 10, No. 7 (July 2010), 27 2.3 timeshigherthanforthosewhodidnotshare inject- the sharingofsyringes,forwhichriskinfectionwas The greatest riskfactorforHIVinfectionwasfoundto be the full implementation of harm reduction programmes. and mised thequalityandquantityofoutreach services positive. The authors reported compro that underfunding werestudy period,24.9percentoftheparticipants HIV- 12.4 per100person-years. At theendof24-month programmes, theHIVincidencerateamongthemwas ticipating in the study were attending basic risk reduction (between 2009and2011).Even thoughallofthosepar- overpeople whoinjecteddrugs aperiodoftwoyears drop-in centres inKarachifollowed 636HIV-negative In Pakistan, arecent study cohort (37percent). lence ofHIVamongpeoplewhoinjectdrugs highpreva andavery number ofpeoplewho inject drugs hasalargemost tothatprevalence rate,asthatcountry withPakistanpeople whoinjectdrugs, contributingthe South-West Asiahasthehighestprevalence ofHIVamong but there isalackofavailable data. levels ofHIV incidence among people who inject drugs, countries ofSouth-West Asiamighthave similarlyhigh the HIVharmreduction programmes studied.Other syringe programme coverage underminedthesuccessof of opioidsubstitutiontherapyandinadequateneedle ing equipment. The authorsconcludedthattheabsence a Based predominantly on behavioural survey data. a Basedpredominantlyonbehavioural survey percentage ofcountriesreportinglow, provision. andtheglobalaveragelevelofservice mediumorhighcoverageforthoseservices; tution therapyandantiretroviralamongpeoplewhoinjectdrugs thoseamongthemlivingwithHIV, accordingtotheTechnical Guide;the provisionforHIVtestingandcounselling,needlesyringeprogrammes,opioidsubsti Note: Thetableprovidestheclassificationandlevelofservice Source: UNODCannualreport questionnaire, UNAIDS. Table 5. viral therapyataspecifieddate who injectdrugsreceiving antiretro- Percentage ofallHIVpositivepeople substitution therapy people whoinjectdrugsonopioid Percentage ofopioid-dependent per year uted perpersonwhoinjectsdrugs Number ofneedles-syringesdistrib- the last12months needle andsyringeprogramme over drugs whowere reached bya Percentage ofallpeoplewhoinject the results the last12monthsandwhoknow drugs whowere testedforHIVin Percentage ofpeoplewhoinject frequently amongthehomeless”, PLOS ONE(16December 2013). inPakistan:inject drugs greater riskwithneedlesharing andinjecting R. N. Samo andothers,“High HIVincidenceamongpersons who pp. 479-488. Overview ofthelevelprovision ofharmreduction services

27 medium orhighcoverage Countries reporting low, 32% 35% 62% 49% 31% Low conductedinthree (percentage) Medium 31% 32% 20% 25% 29% Response atthegloballevel 37% 33% 18% 26% 40% High - -

tions, as a component of what are also known as “harm comprehensive- packageofnineevidence-basedinterven component oftheglobalresponse tothespread ofHIV. A Addressing is a major HIV among people who inject drugs inject drugs and treatmentofHIVamongpeoplewho Coverage ofservicesfortheprevention 15-64. B is6.7percent,corresponding to850,000peopleaged livingwithhepatitis percentage ofpeoplewhoinjectdrugs people aged15-64.For 2012,theglobalestimateof hepatitis Cis52.0percent,corresponding to6.6million whoarepercentage ofpeople whoinjectdrugs livingwith UNAIDS/World Bank globalestimatefor2012ofthe needles andsyringes. time ofgreatest riskforhepatitisCinfectionfrom sharing more easilythanisHIV. The firstyear ofinjectingisthe the sharingofcontaminatedinjectingequipmenteven among people and who is inject transmitted drugs through sis, liver cancer and death. Hepatitis C is highly prevalent Hepatitis BandCcanleadtoliver diseasesuchascirrho- Hepatitis amongpeoplewhoinjectdrugs 29 28 asoutlinedinthe of HIVamongpeoplewhoinjectdrugs, reduction” fortheprevention, treatment services, andcare reporting countries Number Wales”, users in Englandtitis B, hepatitis C, and HIV in injecting anddrug A. J.Sutton andothers, “Modelling theforce ofinfectionforhepa- pp. 396-405. study”, hepatitis C transmission of reducing syringe sharing: London case P. Vickerman, M. Hickman and A. Judd, “Modelling the impact on 74 79 55 85 83 of of

International, vol. Journal 36,No. ofEpidemiology 2(2007), BMC Infectious Diseases(2006). median Global value 36% 74 a 28,29 Classification ofcoveragetargets Less than The jointUNODC/WHO/ 20% 25% 20% 40% 100 Low 100 -200 25 -75% 20 -40% 20 -60% 40 -75% From -To Medium B. Healthandsocialimpact More than 75% 40% 60% 75% 200 High - 9 WORLD DRUG REPORT 2014 10 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Map 1. Service coverage for people who inject drugs and those among them living with HIV, classified according to the Technical Guide

G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G GG G G Opioid substitution therapy G G G G G G GGGG G G G G G G G G

high G G G G

Ç Ç

Ç Ç Ç Ç

G Ç ÇÇ G Ç medium G G ÇÇ G G G G G low G G G G G G Antiretroviral therapy G G G G G high G G medium G G low G no ART services G Needle and syringe programmes G high medium low Service exists, but coverage not known G no NSP services

No data

Source:Note: The bo uUNODCndaries and na mannuales shown and reportthe designa tiquestionnaire,ons used on this map do no t UNAIDSimply official en dandorseme nthet or ac cformereptance by th eReference United Nations. Group to the United Nations on HIV and Injecting Drug Dashed lines represent undetermined boundaries. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. Use.The final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. Note: In reporting on the level of service coverage via the annual report questionnaire, Member States have the option of categorizing the level of service coverage as “not applicable”. That response has been interpreted as meaning that there is no service coverage. For some countries the level of service coverage for needle and syringe programmes is not known, but the service is known to exist in that country. However, the scale of provision of needle and syringe programmes in those cases can vary substantially. The boundaries shown on this map do not imply official endorsement or acceptance by the United Nations. Dashed lines represent undetermined boundaries. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. The final boundary between the Sudan and South Sudan has not yet been determined.

WHO, UNODC, UNAIDS Technical Guide30 (referred to actually receive the intervention) and the distribution of hereafter as the Technical Guide) has been widely endorsed needles and syringes are presented using a classification of by high-level political bodies including the General Assem- “low”, “medium” or “high” as defined according to the bly, the Economic and Social Council, the Commission targets set in the Technical Guide. on Narcotic Drugs and the Programme Coordinating Board of UNAIDS. In addition, donor agencies, including In most countries, the extent of services provided to people the Global Fund to Fight AIDS, Tuberculosis and Malaria who inject drugs falls below the lower-level targets pre- (GFATM) and the United States President’s Emergency sented in the Technical Guide. However, global estimates Plan for AIDS Relief (PEPFAR) have committed to using mask important regional variations. that framework. The coverage of services is highest in Western and Central In order of priority, the four most important interventions Europe, with 50-60 per cent of reporting countries indi- are needle and syringe programmes, opioid substitution cating that a high proportion of people who inject drugs therapy, HIV testing and counselling, and antiretroviral are accessing needle and syringe programmes, opioid sub- therapy.31 stitution therapy, HIV testing and counselling and antiretroviral therapy services. In Eastern/South-Eastern Europe, National estimates of the level of service coverage in the despite the increase in service availability in some countries, community (the extent to which people who inject drugs access to needle and syringe programmes in particular remains low. In North America, none of the countries report a high level of access of people who inject drugs 30 WHO, UNODC, UNAIDS Technical Guide for Countries to Set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting to any of the services, with needle and syringe programmes Drug Users: 2012 Revision (Geneva, WHO, 2012). consistently reaching only a low proportion of people 31 Ibid. who inject drugs. In Latin America (no countries from the 32 and thehighestprevalencepeople whoinjectdrugs ofHIV In the16countries reported ahighlevel ofcoverage foranyoftheservices. intheregion butnocountry people whoinjectdrugs, South-West Asiahasthehighestprevalence ofHIVamong inmanycountriestheregion.people whoinjectdrugs ever, needle and syringe programmes are not reaching many Howing andcounsellingamongpeoplewhoinjectdrugs. of thecountriesreporting indicateahighlevel ofHIVtest significant numberofpeoplelivingwithHIV, 50percent and,amongthem,a number ofpeoplewhoinjectdrugs apy. In EastandSouth-East Asia,aregion withalarge and overall low levels ofaccesstoopioidsubstitutionther counselling, andaccesstoneedlesyringeprogrammes, two countriesindicateahighlevel ofHIVtestingand a region withahighprevalence use,only ofinjectingdrug is at a lowdrugs level. In Central Asia and Transcaucasia, “not applicable”, reflecting thatthepracticeofinjecting naire indicatedthatneedleandsyringeprogrammes were countries reporting through theannualreport question cated as relevant. Also six of the seven Latin American countries, opioidsubstitutiontherapywouldnotbeindi- low andtherefore,use ofopiatesisvery inreporting by noted thatinLatinAmericancountries,theprevalence of only low It numbersof peoplewhoinjectdrugs. shouldbe and opioidsubstitutiontherapy)are generallyreaching (needleandsyringeprogrammes interventions important Caribbean reported information),thetwooverall most assessed forthisfigure. coverage.16countrieshavebeen coverage as“notapplicable”.Thatresponsehasbeeninterpretedmeaningthatthereisnoservice service coverageviatheannualreportquestionnaire,MemberStateshaveoptionofcategorizinglevel Note: Inreportingonthelevelofservice Source: UNODCannualreport questionnaire, UNAIDS. Fig. 6. due to lack of reporting of service provisiondue tolackofreporting ofservice data. which have higherprevalence ratesmaynotbeincluded inthislist Tajikistan, Thailand, Ukraine andUnited States. Other countries Myanmar, Pakistan, Republic ofMoldova, Russian Federation, Spain, Canada,Georgia,Belarus, Indonesia, Kazakhstan,Latvia,Malaysia,

Percentage of countries 100 reporting onserviceprovision) ofinjectingdruguseandHIVamongpeoplewhoinjectdrugs Levels ofserviceprovision forcountrieswiththehighestprevalence rates(amongthose 1 2 3 4 5 6 7 8 9 0 0 0 0 0 0 0 0 0 0 N C 32 o o c t thathave thehighestprevalence of v da e o e s unse r t a ta i n g g e

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e m o r ra i f n m

n g ge e e e s e d l e L p N o e e - - - - d w d r e son i r stri d

ugs c l ov e but s &y 34 33 Western andCentral Europe) rangedfrom 4 to56per incarceration inindividual countriesinEurope (mostly tion ofprisonerswhohadusedanillicitsubstanceduring general population.EMCDDAreports thatthepropor- among prison populations, often more so than among the useareDrug useandinjectingdrug bothhighlyprevalent of drugs. ated foroffencesrelated totheuse,possession orsupply of thesamecontinent. siderably from region toregion andbetween different parts continent. pretrial detention),withthenumbersgrowing inevery more than10.2million peopleheldinprisons(including It is estimated that worldwide, on any single day, there are implications forhealth Drug useamongprisonersand therapy. and syringe programmes andopioidsubstitution provision withregard canbenoted,particularly toneedle living with HIV — a generally low drugs level of service and 66percentoftheglobalnumberpeoplewhoinject per centoftheglobalnumberpeoplewhoinjectdrugs —which account for 45 among people who injectdrugs w p e h e ra e o r d

Federation and Turkey): 225;andOceania: 151. countries: 98;countriesspanningEurope andAsia(e.g., Russian subcontinent): 62,EastAsiancountries: 160; Western European countries: 376;South/Central Asiancountries(mainlytheIndian States: 716, Canada: 118; South American countries: 202; Caribbean Southern African countries:205;North Americancountries: United prison populationrateper100,000for West Africancountries is46; The World Prison Population List(10th ed.)indicatesthatthemedian International Centre forPrison Studies). Roy Walmsley, “World Prison Population List” 10th ed. (London, ge y i

r n p ear i nge j e e r c t s s 33 M subt C However, prisonpopulationratesdiffercon- e o d v e i um i r t a u g t i

e on c

overa o f t 34

h o e p Many ofthoseheldare incarcer- r i o a ge p i d y a n t i r H C e i tro o g v h e v B. Healthandsocialimpact

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11 WORLD DRUG REPORT 2014 12 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Global Burden of Disease Study 2010: Estimating the burden of disease from drug dependence Illicit drug use can have a profoundly negative effect on a person’s health. It can lead to premature death, such as in the case of overdose, but can also severely curtail the quality of life through disability (any short-term or long-term health loss), such as from liver disease, or infection with HIV and hepatitis B and C as a result of sharing contaminated needles and syringes.1 These effects can be quantified in an indicator called “disability-adjusted life year” (DALY), which encompasses both the years of potential life lost due to premature death (YLL) and the years of life lived with disability (YLD). A recent study published by Degenhardt and others (2013)2 produced global estimates of disability-adjusted life years for illicit drug dependence3, and drug use as a risk factor for other health outcomes (schizophrenia from cannabis use, hepatitis and HIV from injecting drug use, and drug dependence as a risk factor for suicide).

The findings of that study reveal that in 2010, drug dependence on illicit drugs was responsible for 3.6 million years of life lost through premature death and 16.4 million years of life lived with disability globally. Combined, this is equal to 20 million years of disability-adjusted life years (representing 0.8 per cent of global all-cause disability-adjusted life years), an increase from 13.1 million years estimated for 1990. Opioid dependence contributed most to the burden of disease, being responsible for 55 per cent of years of life lost due to premature death and 44 per cent of years of life lost through disability. The increase in the global burden of disease from cannabis, amphetamine and cocaine dependence between 1990 and 2010 is essentially attributable to population growth, but this is not the case for opioid dependence. The burden of disease from opioid dependence increased by 74 per cent between 1990 and 2010, with 42 per cent of that increase attributable to an increase in the prevalence of opioid dependence. According to UNODC data, the prevalence of opioid use has been increasing globally over the past five years as a consequence of the increased misuse of prescription opioids, whereas the prevalence of opiate (heroin and opium) use has been stable at the global level and declining in some regions such as Europe. A total of 43,000 deaths were attributed to opioid dependence in 2010, which suggests that life expectancy was typically cut short by 46 years in each of those cases of death. The global burden of disease attributed to cannabis dependency is higher than that for cocaine. Although cocaine use is associated with greater harm, the far higher number of cannabis-dependent users results in the greater global burden of disease overall. Broadly speaking, males contribute two thirds of the number of years of life lost and years lived with disability for all drug types. Disability- adjusted life years rose sharply between the ages of 15-24, reaching a peak in the relatively young 20-30 age group, consistently across all drug types. Illicit drug use was estimated to be the cause of 0.8 per cent of disability-adjusted life years worldwide in 2010 (ranking as the 19th leading risk factor). In comparison, tobacco smoking was the cause of an estimated 6.3 per cent of global disability-adjusted life years, and alcohol the cause of an estimated 3.9 per cent. However, for drug use, disability-adjusted life years reach a peak among users aged 20-30 years, and among that age group it con- tributes a higher proportion to the burden of disease. The burden of disease from acquiring HIV through injecting drug use was estimated to be 2.1 million years in 2010, of which 2.0 million were from years of life lost through premature death. The burden of disease from hepatitis C acquired through injecting drug use is also high and was estimated to be responsible for 494,000 years of life lost in 2010 through premature death.

1 WHO, Neuroscience of psychoactive substance use and dependence (Geneva, 2004). 2 L. Degenhardt and others, “Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010”. 3 Defined as the presence of three or more indicators of dependence for at least a month within the previous year. These indicators consist of a strong desire to take the substance, impaired control over use, a withdrawal syndrome on ceasing or reducing use, tolerance to the effects of the drug, the need for larger doses to achieve the desired psychological effect, a disproportionate amount of time spent by the user obtaining, using and recovering from drug use, and persistence of drug taking despite the problems that occur.

cent, with 11 countries reporting levels of 20 per cent or Several studies document that a very high percentage higher. Further, countries reported proportions of prison- (56-90 per cent) of people who inject drugs report a his- ers who had injected drugs while incarcerated ranging from tory of imprisonment since starting injecting.36 An over- 0.7 to 31 per cent, with seven countries reporting rates of view of HIV in prisons in all regions identified rates of injecting drug use of 7 per cent or higher.35 infection many times higher than among the general popu-

36 WHO, UNODC and UNAIDS, Effectiveness of Interventions to Address HIV in Prisons, Evidence for Action Technical Papers (Geneva, 35 EMCDDA, Statistical Bulletin 2013. Tables DUP-3 and DUP-4. WHO, 2007). 38 37 those countries. countries foundratesgreater than10percentin20of lence inprisonsfor75low-income andmiddle-income lation. 9904 (29August2013),pp.1564-1574. Global BurdenofDiseaseStudy2010”, attributable toillicitdruguseanddependence:findingsfrom the Source: L.Degenhardt andothers,“Globalburden ofdisease Years (millions) Years (millions) by gender, 2010 use asariskfactorforotherhealthoutcomes, use disorders, andattributabletoillicitdrug tial lifelostduetopremature deathfordrug of lifelivedwithdisabilityandyearspoten- Estimated disability-adjustedlifeyears,years 0 0 1 1 2 2 1 1 2 2 pp. 32-41. income countries,TheLancetInfectious Diseases , vol.7; No. 1(2007), K. Dolan andothers,“HIVinprisonlow-income andmiddle- Ibid...... 0 5 0 5 0 5 0 5 0 5 0 5 37 A study that compiled information on HIV preva Y Y Y Y Y Y Y Y Cannabis use e e e e e e e e Cannabis a a a a a a a a as risk factor for rs rs rs rs rs rs rs rs dependence schizophrenia

o o l l o o l l 38 i i i i v v v v f f f f concern in The situationisofparticular e e e e l l l l Injecting drug i i i i d d d d fe fe fe fe Amphetamine use as risk factor w w w w

dependence l l l l os os os os i i i i for hepatitis C th th th th t, t, t, t, di di di di

m fe m fe Injecting drug Cocaine s s s s a a m m a a a a use as risk factor l l bi bi bi bi dependence e e a a s s for HIV l l l l l l e e i i i i t t t t s s y y y y

Opioid dependence , , , ,

Opioid m fe m fe The Lancet,vol.382,No. as risk factor for a a m m dependence l l suicide e e a a s s l l e e s s Cocaine dependence Other drug as risk factor for use disorders suicide Amphetamine dependence as risk All drugs factor for suicide - 41 40 39 conducted inCabo recent survey Verde in2012 remains attheglobalaverage —islow overall inAfrica.A use of other substances — except for cocaine, which than theglobalaverage (3.8percent). The prevalence of Central Africa (about 12.4 per cent) is probably higher suggest, however, thatcannabisuse,notablyin West and ation inAfricaisnotavailable. The limiteddataavailable Reliable andcomprehensive situ informationonthedrug Africa C. the communityoutside. toanextentequivalent tothoseavailable to these services prison population, at aminimum, should have access to in prisons is ofmajor concern, sincethecare services, dependencetreatmentcially drug andHIVprevention and The lackofaccesstoandavailability ofhealthcare, espe- ated healthconsequences. dependenceanditsassoci- options fordealingwithdrug is oneinwhichthere are limitedprevention andtreatment practice. This is of concern because the prison environment regular useofopioids thelevel ofillicitsubstanceuseinprisons,particular Although theavailability ofdataislimited,there isahigh men. lent amongwomeninprisonthanimprisoned useandHIVinfectionareprison, bothdrug more preva - women’s prisons. Although there are fewer women in egory vary.egory from Western andCentralEurope.Thecountriesincludedineachcat Note: Dataareavailableforonlyalimitednumberofcountries,mostly reports. national government Source: UNODCannualreport questionnaire, EMCDDAand Fig. 7.

REGIONAL TRENDSINDRUGUSE Prevalence (percentage) National ontheprevalence ofpsychoactive inquiry substanceabuse For useinprisons. detailsseeannexondrug UNODC/UNAIDS, “Women andHIVinprisonsettings”. 39 1 2 3 4 5 6 7 8 0 0 0 0 0 0 0 0 0 A n n use andHIVinfectionamongprisoners Prevalence ofdruguse,injecting o u d f a

r a l u

n p g u y r

e i l v l se i a c l i e t n 40 c e . Injecting isalsoacommon drugs I n u j se i e c t n i n

p g r d i s r C. Regionaltrends indruguse o u n g a m H o I V n M M Maxi I n g i t i e n n e

d p r f r-q i a m i e m r a n i c n u so u g u 41 t m a m e i o r n t found n i e l e r s - - 13 WORLD DRUG REPORT 2014 14 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

that 7.6 per cent of the population had used an illicit sub- Fig. 8. Prevalence of drug use in the United stance at least once in their lifetime, 2.7 per cent had used States, 2002-2012 an illicit substance in the past year and 1.6 per cent in the 18 past 30 days. Cannabis was the most popular drug (2.4 16 per cent reporting use in the past year) followed by cocaine (0.2 per cent annual prevalence). The survey also reported 14 common use of a “cocktail” containing crack cocaine and 12 cannabis. ATS use, although at low levels (0.1 per cent 10 lifetime prevalence), seems to be emerging. 8 In Nigeria, the expert perception is that there has been a 6 large increase in the use of cannabis, with some increase 4 42 in the use of ATS. According to the national survey on 2 Annual prevalence (percentage) alcohol and drug use in Nigeria conducted in 2009, aside 0 from alcohol, the non-medical use of tranquillizers had the

highest annual prevalence (5.5 per cent) among the popu- 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 lation aged 15-64 years. The misuse of prescription opioids Any illicit drug Cannabis was also reported to be high and more prevalent than the Cocaine Heroin use of heroin (3.6 per cent annual prevalence of other opi- "Ecstasy" Psychotherapeutics Pain relievers Tranquillizers oids, and 2.2 per cent annual prevalence of heroin). Stimulants High levels of use of other substances were also reported, Source: Substance Abuse and Mental Health Services Administra- with annual prevalence as follows: cannabis, 2.6 per cent; tion, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS amphetamine, 1 per cent; methamphetamine, 1.6 per cent; Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse “ecstasy”, 1.7 per cent; cocaine, 1.6 per cent; and crack, 2 and Mental Health Services Administration, 2013. per cent. The prevalence in the last year of people injecting drugs was reported as 1.9 per cent.43 10 years, increasing from 14.9 per cent in 2011 to 16.0 In South Africa, expert perception is that there is some per cent in 2012. That overall increase in drug use, led increase in the use of heroin and methamphetamine and mainly by the increase in cannabis use, is considered to be linked with lower risk perceptions of cannabis use, espe- some decrease in the use of crack cocaine (with use of other 46 drugs being stable).44 Treatment facilities report that can- cially among young people. The use of cannabis rose nabis remains the most common illicit substance used, from 11.5 per cent to 12.1 per cent and the non-medical particularly among young people. Almost half of the admis- use of psychotherapeutic drugs, particularly prescription sions at specialist treatment centres were primarily related opioids, rose from 5.7 per cent to 6.4 per cent after declin- to cannabis use disorders. Polydrug use appears to be a ing in 2011. In 2012, use of cocaine also increased slightly common phenomenon among drug users in treatment.45 among the adult population but remained stable or declined among youth.47 In 2012, drug use was reported Americas to be the highest among those in their late teens or twen- With the exception of opiate use, use of all other groups ties, while drug use among older adults, e.g., among those of substances (cannabis, opioids, cocaine, ATS and in their fifties, was also increasing, partly due to the ageing “ecstasy”) remains at levels higher than the global average cohort of “baby boomers”, whose levels of drug use have 48 in the region. been higher than those of previous cohorts. North America However, past-year use of any illicit substance declined from 19.0 per cent in 2011 to 17.9 per cent in 2012 among In the United States, past-year illicit drug use by persons the youth population aged 12-17 years, reaching the lowest aged 12 years or older reached the highest level in the past level in the previous 10 years. From 2011 to 2012, past- year and past-month use of almost all drug types declined

among the general population, conducted by the Ministry of Jus- tice of Cabo Verde, published in April 2013, in collaboration with UNODC. 46 United States, Department of Health and Human Services, Sub- 42 UNODC, annual report questionnaire replies submitted by Nigeria stance Abuse and Mental Health Services Administration, Center for for 2012. Behavioral Health Statistics and Quality, The NSDUH Report: Trends 43 Federal Neuropsychiatric Hospital, Aro, Substance Abuse in Perspec- in Adolescent Substance Use and Perception of Risk from Substance Use tive in Nigeria 2009: National Survey on Alcohol and Drug Use in (Rockville, Maryland, 2013). Nigeria 2012, Nigeria. 47 United States, Department of Health and Human Services, Substance 44 UNODC, annual report questionnaire replies submitted by South Abuse and Mental Health Services Administration, Results from the Africa for 2012. 2012 National Survey on Drug Use and Health: Detailed Tables (Rock- 45 Siphokazi Dada and others, “Alcohol and drug abuse trends”, update, ville, Maryland, 2013), table 7.2B. June 2013 (Cape Town, South Africa, South African Community 48 Ibid., Summary of National Findings, NSDUH Series H-46, HHS Epidemiology Network on Drug Use, 2013). Publication No. SMA 13-4795 (Rockville, Maryland, 2013). among the population aged 15 years or older remained In Canada,however, past-year useofcannabisin2012 cent. gencies involving opiatesand/oropioids rising183per the period 2004-2011, with the number of medical emer medical useofpharmaceuticalsincreased 132percentover use”). In addition, medical emergencies related to the non- interplaybetween illicitandpharmaceuticalopioid “The deaths intheUnited States have alsobeen reported (see women. painkiller overdose alsocontinuestorise,especiallyamong mine. treatment admissionsforcocaineandmethampheta sions foropiatesotherthanheroin, continuing increase inthepercentage oftreatment admis pain relievers (prescription opioids)isalsoreflected inthe In theUnited States, theincreasing non-medicaluseof or remained stableamongthe12-17years agegroup. 54 53 52 51 50 49 compared with1.1percentinEcuador, 0.5percentin Bolivia. CocaineusewashighinColombia(2.2percent) Colombia and 3.6 per cent in the Plurinational State of lence ofcannabisuserangedbetween 15.2percentin students inthefourAndeancountries,annualpreva- According conductedamonguniversity toarecent survey illicit substancesremains low inthesubregion. alence regions. With the exception of ATS, the use of other cocaine useiscurrently atlevels comparable tohigh-prev- cocaine remains high,especiallyinSouth America,where In South andCentralAmericatheCaribbean,useof Latin AmericaandtheCaribbean 2012) orthelongterm(2004-2012). prevalence term(2011- ofthosesubstancesintheshort about 1percent,andnochangeswere inthe observed Past-year useofotherillicitsubstanceswasestimated at older: from 6.7percentin2011to8.42012. increase incannabisuseamongthoseaged25years or unchanged from theprevious year, whilethere wasan summary of results for 2012;available fromsummary www.hc-sc.gc.ca. Health Canada,Canadian AlcoholandDrug Use Monitoring Survey: 13-4760 (Rockville, 2013). Maryland, VisitsDepartment , DAWN Series D-39,HHSPublication No. SMA ing Network, 2011:National Estimates of Drug-Related Emergency Abuse and Mental Health Administration, Services United States, ofHealth Department andHuman Substance Services, 2013. overdoses: agrowing epidemic,especiallyamongwomen”, 3July Centers forDisease Control andPrevention, “Prescription painkiller 13-4772 (Rockville, 2013). Maryland, Treatment, BHSISSeries Services S-65,HHSPublication No. SMA Set (TEDS):2001-2011.National Admissions toSubstance Abuse for Behavioral Health Statistics andQuality, Treatment Episode Data stance Abuse andMental Health Administration, Services Center United States, ofHealth Department andHuman Sub Services, - withmorphine-likeeffects. phene, tramadolandanyotherdrug meperidine, morphine,opium,oxycodone, pentazocine, propoxy- methadone, buprenorphine, codeine,hydrocodone, hydromorphone, “opiatesThe category otherthanheroin” includesnon-prescription Detailed TablesIbid., , tables7.5Band7.6B. 53 51 The numberofdeathsresulting from prescription 52 However, increases inheroin-related overdose 50 54 whichnow surpass Drug Abuse Warn Drug - 49 - - - per cent. As reported by experts, per cent.Asreportedthe useof methampheta by experts, 0.4 per cent, opiates at 0.35 per cent and cocaine at 0.05 by ATS (excluding “ecstasy”) at 0.7percent,“ecstasy” at use of1.9percentamongthoseaged15-64years, followed common illicitsubstance,withanannualprevalence of age. Tentative estimatessuggestthatcannabisisthemost isatlevels similartoorbelowillicit drugs theglobalaver- countries in Asia. Those data suggest that consumption of Reliable prevalence estimates are available for only afew Asia Colombia. highamongstudentsin was reported asbeingparticularly 0.2 percentin2009to0.952012. (LSD) amonguniversity students,whichincreased from was thehighprevalence ofuselysergicaciddiethylamide with regard tococaineuse.Amajorfindingofthesurvey 2012), asmallincrease intheuseofATS andstabletrends cannabis use(from 4.8percentin2009to7.9 in thefourcountriesthere hasbeenanoverall increase in paring thetrends between 2009and2012,amongstudents 0.7 percentinEcuador and0.5percentinPeru. Com ATS prevalence wasreported at 0.9percentin Colombia, Peru, and 0.3 per cent in the Plurinational State of Bolivia. 58 57 56 55 number ofcountriesfollowing adeclineforseveral years. increased use in 2012 being reported by in a experts also beenaresurgence inthe“ecstasy” market, with the Philippines andtheRepublic ofKorea. cern in Brunei Cambodia, Indonesia, Darussalam, Japan, ofcon- drug methamphetamineistheprimary crystalline Republic, Myanmar, Thailand and Viet Nam, whereas tries such as Cambodia, the Lao People’s Democratic Methamphetamine pillsare predominantly usedincoun- subregion since2009. among thethree typesmostusedincountriesthe drug has bothincreased and diversified. ATS have beenranked indicated thatinEastandSouth-East Asia,theuseofATS In the absence of reliable data, nationalhave experts survey psychoactiveof new substancesisontherise. “Ecstasy” useseemstobestagingacomeback,while formsreaching recordin pillandcrystalline levels in2012. East Asia, with accompanying seizures of methamphetamine mine continuestoriseinmostcountriesEastandSouth- Ibid. and thePacific November (Vienna, 2013). Amphetamine-Type Stimulants ChallengesforAsia andOther Drugs: UNODC, tember 2013). (reported inUNODC,Global SMART Update 2013,vol. 10,Sep- the synthetic phenethylamines 25B-NBOMe and 25C-NBOMe that substancessoldasLSDdidnotcontain suchsubstancebutrather from samplesobtainedinthree majorcitiesofColombiarevealed in itsuseandunusualhealtheffectsreported by users. The results lysed samplesofsubstancessoldasLSD,following areported increase The Colombianforensic oftheAttorney General’s experts Office ana- 2013). de Drogas enlaPoblación Universitaria, Informe Regional 2012(Lima, Comunidad Andina,IIEstudio Epidemiológico Andino sobre Consumo 56 Global SMART Update 2013, Patterns and Trends of C. Regionaltrends indruguse 58 57 55 There has There LSDuse - - 15 WORLD DRUG REPORT 2014 16 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

“Ecstasy” seizures more than tripled in 2012 compared Compared with East and South-East Asia, South-West and with the previous year. The new psychoactive substances Central Asia are marked by high prevalence of opiate use, market is also growing rapidly in the subregion. Ketamine with an accompanying high prevalence of people who use has been long-standing in the region. Its use is consid- inject drugs and who are living with HIV: 28.8 per cent ered to be stabilizing, while kratom continues to be used in South-West Asia and 7.7 per cent in Central Asia. The as a traditional stimulant in Malaysia, Myanmar and Thai- prevalence of opiate use in Afghanistan, Iran (Islamic land. The use of synthetic cannabinoids has also been Republic of) and Pakistan is among the highest globally (average of 1.5 per cent of the adult population in the three Fig. 9. Trends in registered drug users and countries), whereas it is 0.8 per cent in Central Asia — proportion of registered drug users by twice the global average. drug type in China, 2000 - 2012 Europe 120 2,500,000 In Europe, cannabis is by far the most commonly con- 100 2,000,000 sumed illicit substance, with an estimated 24 million past- year users (4.3 per cent of those aged 15-64), followed by 80 1,500,000 cocaine with 3.7 million past-year users (0.7 per cent of 60 those aged 15-64). The use of opioids and opiates is com- 1,000,000 parable to global average levels. ATS (excluding “ecstasy”) 40 are consumed at a level little below the global average, but

(percentage) the use of “ecstasy” is higher, with an annual prevalence of 20 500,000

Registered drug drug Registered users 0.5 per cent compared with the global average of 0.4 per 0 0 cent. Illicit drug consumption patterns are quite different between the two subregions in Europe. The use of cannabis 2001 2002 2003 2004 2005 2007 2008 2009 2010 2011 2012 Proportion of drug users by drug type type drug by users drug of Proportion and cocaine is much higher in Western and Central Synthetic drugs Europe, whereas the consumption of opioids and opiates Other opioids Other drugs is much higher in Eastern and South-Eastern Europe. Heroin Total drug users registered Western and Central Europe Registered heroin users In Western and Central Europe, although cannabis use Source:Information provided by China in the UNODC annual remains high (5.7 per cent annual prevalence), there is report questionnaire and the annual reports on drug control in China published by the Office of the National Narcotics Control evidence of trends of decreasing use, especially in countries 63 Commission. with long and established cannabis use. The recent household surveys in Poland and Italy show substantially reported in China, Indonesia, Japan, the Republic of Korea lower prevalence of cannabis use than previously reported, and Singapore.59 which can also be ascribed to methodological differences in those two most recent surveys.64 There is also an Experts from China report a stable situation with regard increasing diversity in the types of cannabis products to the consumption of cannabis, cocaine, and tranquilliz- available, especially high-potency herbal cannabis and the ers and sedatives. However, the number of registered drug synthetic cannabis-like products that are emerging in the users continued to increase. Opioid use remains high in subregion.65 China, with 1.272 million opioid users registered by the Cocaine consumption in Western and Central Europe end of 2012, compared with 1.18 million in 2011.60 The remains high, at 1 per cent of the adult population. How- proportion of heroin users among registered drug users ever, countries with high levels of use, e.g., Denmark, Italy, (59 per cent of users) decreased in 2012, as the number of Spain and the United Kingdom of Great Britain and registered synthetic drug users increased more than heroin Northern Ireland, report a declining trend in cocaine use users, especially because, as reported by the experts, there as well as in treatment demand.66 has been a large increase in the use of methamphetamine.61 Moreover, recent estimates of people who inject drugs — The past-year use of opioids, mainly heroin, is estimated primarily heroin — are lower than previous estimates. The as 0.4 per cent of the population aged 15-64. However, in estimated prevalence of people who inject drugs in China, Western and Central Europe, other opioids such as at 0.19 per cent in 2012, is less than the estimate of 0.25 buprenorphine, fentanyl and methadone are available in per cent for 2005.62 the illicit markets, with reports that heroin has been

59 Ibid. 63 EMCDDA, European Drug Report: Trends and Developments 2013. 60 China, National Narcotics Control Commission, Annual Report on 64 Use of cannabis in Italy was reported as 14.6 per cent in 2009 and 4 Drug Control in China 2013 (Beijing, 2013). per cent in 2011, while in Poland cannabis use was reported as 9.6 61 UNODC, annual report questionnaire replies submitted by China for per cent in 2010 and 3.8 per cent in 2012. 2012. 65 EMCDDA, European Drug Report: Trends and Developments 2013. 62 China National Centre for AIDS/STD Control and Prevention, 2012. 66 Ibid. 69 68 67 increase alsoreporting intheuseofopiates,withBelarus perceive and Ukraine,tion, Belarus experts a significant HIV. In twocountrieswithhighratesofopiateconsump - high prevalence of people living who inject with drugs prevalence aswell asa ratesofpeople whoinjectdrugs, The subregion is alsomarked by having oneofthehighest average levels, withanannualprevalence of0.6percent. per cent, respectively. “Ecstasy” useisalso above global ates, withannualprevalence ratesof1.2percentand0.8 is thehighlevel ofconsumptionopioids,notablyopi- The mainconcerninEasternandSouth-Eastern Europe Eastern andSouth-EasternEurope ability ofmethamphetamineinsomemarkets. displaced by methamphetamine,given theincreasing avail ofthesubregion,in parts there are concernsthatitisbeing populations. While amphetamineusehasbeenstabilizing tinues tobeseenascommonamongchronic drug-use adult population respectively. Injecting amphetamine con prevalence ofuse of0.6percentand0.5the used syntheticstimulantsinthesubregion, withanannual Amphetamine and“ecstasy” remain themostcommonly who injectdrugs. HIVinfectionsamongherointhe numberofnew users tions, thisislikelytohave contributedto the decline in tice, hasalsobeendeclining.Coupledwithotherinterven currently intreatment. Injecting heroin, acommonprac- declining, resulting ofheroin users inanageingcohort users enteringtreatment forthefirsttimehasalsobeen declining trends intheuseofheroin. The numberofheroin tries. replaced withfentanyl andbuprenorphine insomecoun- July 2013). from the2012/13CrimeSurveyforEnglandandWales” (London, Source: UnitedKingdom,HomeOffice, “Drugmisuse:findings Fig. 10.

Ibid. Ibid. Ibid. Annual prevalence (percentage) 67 10 15 20 25 30 0 5 Overall, mostcountriesinthesubregion report

2003/04 Wales, 2003/04-2012/13 Trends indruguseEnglandand C O C a oc pi 2004/05 68 n a a i te a n bi e s 2005/06 s 2006/07

2007/08

T A “Ec 2008/09 ra m s n phe ta qu 2009/10 s y” i ta l liz m

e 2010/11 i rs ne 69 2011/12

2012/13 - - - active substances that are currently available in the Austral psychoThere analoguesandnew - isawiderangeofdrug vents andinhalants,butadeclineintheuseof“ecstasy”. consumption ofcannabis,cocaine,hallucinogens,andsol In Australia, opinion points expert to an increase in the per cent. cocaine, 1.5percent;ATS, 2.1percent;and“ecstasy”, 2.9 nabis, 10.8percent;syntheticopioids,3.0 The region hashighlevels ofusemostsubstances:can- and New Zealand. No data are new available for 2012. Drug useinformationinOceania islimitedtoAustralia Oceania among theyouth population. cannabinoids isalsoperceived tobeincreasing, particularly opioids. prescription orover-the-counter preparations containing edly beingreplaced by cheaperandmore readily available opiate useinthesubregion. However, heroin useisreport The Russian Federation has the highest prevalence of the useofATS inthecountry. reported asstableinUkraine, andthere isanincrease in a significant increase in the use of opium. Heroin use is 78 77 76 75 74 73 72 71 70 well asphysicalandmentalwell-being. nificant effectsonjoblessnessandincomeinequality, as The global financial crisis had, and continues to have, sig Drug useandthefinancialcrisisinEurope andso-called“researchtrolled drugs chemicals”. analoguesofexistingcon synthetic cannabinoidsandnew the broad product name“ecstasy”, alargenumberofnew soldunder wide variety offorms:arangesyntheticdrugs available ina drugs has alsobeenadiversification ofnew prescription stimulantsandsyntheticcannabinoids. There an increase intheuse ofheroin, pharmaceutical opioids, In New have Zealand, reported experts thatthere hasbeen market. ian illicitdrug 103-108. European Journal ofPublic Health , vol. 23,No. 1 (February 2013),pp. crisis inSpain: care centres, evidence from primary 2006and2010”, Margalida mentalhealthrisksofeconomic Gili andothers,“The 347 (September 2013). crisis onsuicide:timetrend studyin54countries”, BMJ,vol. 17,No. Shu-Sen Chang andothers,“Impact ofthe2008globaleconomic 2011), pp. 1457-1458. omens ofaGreek tragedy”, TheLancet,vol. 378,No. 9801(October Alexander Kentikelenis andothers,“Health effectsoffinancialcrisis: Europe, impactandpolicyimplications” (Geneva, 2013). WHO, “Summary: Health, health systemsand economic crisis in Zealand. UNODC, annualreport questionnaire, replies submittedby New for 2012. UNODC, annualreport questionnaire, replies submittedby Australia Ibid. sian Federation for2012. UNODC, annual report questionnaire, replies submitted by the Rus- and Ukraine for2012. UNODC, annualreport questionnaire, replies submittedby Belarus 71 The useofATS, syntheticopioidsand 73 72 70 C. Regionaltrends indruguse 75,76,77,78 Although 74 - - - - - 17 WORLD DRUG REPORT 2014 18 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

The “dark net”, bitcoins and the increasing sophistication of online drug sales The online marketplace for illicit drugs is becoming larger and more brazen, now capitalizing on technological The “Silk Road” in numbersa advancements in private web transactions and virtual Estimated number of registrants: 200,000 online currency to protect the identities of suppliers, con- Total revenue from 2.5 years of operation: sumers and website administrators. Buyers and sellers are 9.5 million bitcoins (approx. $1.2 billion) connecting online via “dark net” sites1 and most often, Top three items for sale: “weed”, “drugs”, traffic drugs directly through the postal service. UNODC “prescriptions” global seizure data indicate that over the past decade, there Origin of sales: 44 per cent shipped from the United was a 300 per cent increase in cannabis seizures obtained States, 10 per cent from the United Kingdom through the postal service between 2000 and 2011, the a Nicolas Christin, “Traveling the “Silk Road”: a measurement analysis of a large anonymous online marketplace”, see footnote 6. United majority of which are coming from seizures reported from States of America FBI Indictment against the alleged administrator countries in Europe and the Americas.2 of the “Silk Road” website. The “dark net” cannot be accessed through traditional web in bitcoins belonging to the administrator.5 searches; it requires logging in through a web proxy, such While “Silk Road” sold approximately 24,400 drug prod- as to a Tor3 network, which connects to another location ucts, websites such as “The Armory” have taken over in the network, ensuring that the Internet Protocol (IP) broader elements of weapons and ammunitions trafficking address is not visible on either side of the transaction. after they were no longer available on the “Silk Road”.6 In These websites do not function as stores per se but work a research paper on the user experience of the “Silk Road”, in a manner similar to eBay,4 where users and buyers can an interviewee, after detailing his favourite purchases connect and are provided a venue to manage transactions (good-quality cannabis, 3,4-methylenedioxymethamphet- and track fraudulent sales. Transactions are mostly con- amine (MDMA), and 2,5-dimethoxy-4-iodophenethyl- ducted using the online peer-to-peer currency “bitcoin”, amine (2C-I)) stated that the “Silk Road” provided users which remains in escrow, until it is transferred to the seller with access to substances they otherwise would not have once the product is satisfactorily delivered. At the time of tried.7 this writing, 1 bitcoin was worth $625. While there are no reliable statistics on how many people Several websites such as “Black Market Reloaded”, “The are buying drugs on the Internet, the variety available and Armory” and “The General Store”, like the now defunct purchased on the “dark net” appears to be diverse and “Silk Road” website, sell a wide variety of products using growing. Because purchases and sales through the “dark this method. Despite the efforts to keep the site adminis- net” pose unique challenges for law enforcement and pre- trators, users and sellers unknown, 2013 saw the successful sents a niche market for high-quality drugs and new psy- dismantling of several of these large-scale online drug traf- choactive substances, if the past trend continues, it has the ficking operations, most notorious among them being the potential to become a popular mode of trafficking in “Silk Road”, which was seized by the Federal Bureau of controlled substances in years to come. Investigation of the United States, along with $28 million

5 United States, Federal Bureau of Investigation, “Manhattan U.S. 1 The term “dark net” refers to a distribution network of users, Attorney announces seizure of additional $28 million worth of obscured by encryption technology, and anonymized by hidden bitcoins belonging to Ross William Ulbricht, alleged owner and IP addresses. “Dark nets” are niches within the “deep web”, which operator of “Silk Road” website”, press release, 2013. includes network connected sites that are not searchable by major search engines. 6 Nicolas Christin, “Traveling the “Silk Road”: a measurement analysis of a large anonymous online marketplace”, in Proceedings of the 2 UNODC, individual drug seizure database. 22nd International Conference on the World Wide Web, International 3 “TOR” is the acronym for “The Onion Router” and works by World Wide Web Conference Steering Committee (Geneva, 2013), encrypting communications to relay Internet traffic through multi- pp. 213-224. ple proxies worldwide to mask users’ locations and hide servers. 7 M. C. Van Hout and T. Bingham, “‘Silk Road’, the virtual drug 4 An online auction and shopping website in which people and busi- marketplace: a single case study of user experiences”, International nesses buy and sell a wide variety of goods and services worldwide. Journal of Drug Policy, vol. 24, No. 5 (2013), pp. 385-391.

European economies are recovering,79 reductions in health Data are not yet available to explore the comprehensive services related to austerity measures have been observed, impact of the crisis on drug markets, but early information with 15 out of 19 countries in Europe reporting cuts to describes two phenomena that have developed in parallel drug-related budgets ranging between 2 and 44 per cent.80 to the crisis: first, the reduction of services provided as a result of decreased funding, and second, a shift from more expensive to cheaper drugs (see below), and increased risk 79 European Commission, European Economic Forecast: Winter 2014 of harm due to the use of substances that require more (Brussels, 2014). 80 Claudia Costa Storti and others, “Economic recession, drug use and public health”, International Journal of Drug Policy, vol. 22, No. 5 (September 2011), pp. 321-325. injecting heroin. (mostly syntheticcathinones)andonly38.1percent most respondents (49.4percent)reportedly injecting ATS ofinjectionandin2012, reporting heroin asthemaindrug in2009 with97percent interviewed a shiftwasobserved, were noted. phetamine andcannabis,whichare lessexpensive drugs, more expensive, were butincreases inmetham- observed, Milan, Italy, decreases incocaineandheroin, whichare Forcheaper drugs. example,between 2008and2009in crisis, demandfor heroin declined, as users shiftedto In someofthecountriesmostaffectedby thefinancial Shifting trends inpatterns use ofdrug remain stable. expect the numberable, of experts dependent users to users inmanyofthehardest hitcountriesare notyet avail onthenumberofproblem drug drugs). While surveys frequent injections(see:HIVamongpeoplewhoinject 83 82 81 fluid. chloric acid,ethanolandcarbattery “Sisa” canbemadeinakitchenfrom ephedrine,hydro called“sisa”, stimulant-typedrug new hasbeenreported. polydrug usealsofacilitatedthoseshifts. polydrug Source: UNODC estimatesbasedonannualreport questionnaire supplementedbyotherofficial sources. Fig. 11. EMCDDA, 2012 in Romania Report ofarecent outbreak andinitialresponse policies”, Botescu Andrei users andothers,“HIV/AIDSamonginjecting drug 118, Nos. 2and3(November 2011),pp. 464-469. in 2009 detectedbyanalysis”, wastewater Alcohol Drug Depend, vol. consumption patterns Zuccato E.andothers,“Changesinillicitdrug 5 (September 2011),pp. 374-375. diluted by inertia”, International Journal Policy ofDrug , vol. 22,No. Jonathan globalrecession’s Caulkins,“The demand— effectondrug 82 recorded forpersonaldruguseoffences, 2003-2012 Comparison In Romania, amongpeoplewhoinject drugs, Index (baseline) 2003 81 83 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 1.6 In Greece, increased injectionofacheap C c 2 ( e ( P P Ra G P P a o ri i 0 e re e re s nde p l m 2 ti g o 0 rc rc te i 0 v v ht a ba 3 m t p e e 0 a a

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- 19 WORLD DRUG REPORT 2014 20 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Global trend in per capita crime rates for selected types of crime, 2003- Fig. 12. Global trend 2012in crime rates per Fig. 14. Share of the four major drug classes in population for selected types of crime, drug offender records, by region and 2003-2012 globally, 2012 1.5 Possession for personal use (27 countries) 1.4 1.3 1.2 100 1.1 1.0 75 0.9 0.8 50 0.7 Index (baseline 2003) 0.6 25

0.5 (percentage) All drugs 0 Cannabis

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Illicit opioids Cocaine Drug possession (45 countries) Illicit ATS Offender ª records Offender in given region Drug trafficking (47 countries) Robbery (63 countries) Rape (61 countries) Trafficking (25 countries) Homicide (126 countries) Burglary (51 countries) Motor vehicle theft (67 countries) 100 Source: UNODC estimates based on United Nations Survey of Crime Trends and Operations of Criminal Justice Systems, UNODC 75 Homicide Statistics, annual report questionnaire and European Monitoring Centre for Drugs and Drug Addiction. 50 Female offenders among persons recorded for drug-related offences, 25 Fig. 13. Female offenders among persons (percentage) by drug class and type of offence, All drugs recorded for drug-related offences, by 0 Cannabis 2012 Illicit opioids drug class and type of offence, 2012 Cocaine 25 Illicit ATS Offender ª records Offender in given region

r s 20

n d e Source: UNODC estimates based on annual report questionnaire.

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m connection with other substances are not included in the graph. Hence

a 5 the total may not add up to 100 per cent. p e s ( e l b Average of the five regions, weighted by the estimated number of a 0 offenders (for all drug types) in each region. l m r s s s s s s s e e d d d i t r o e e d g d n p e n r n n i b i e i n i d F t e y u a f a z a o o a a t i r i

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t to trafficking. In other regions, opioids or ATS take second s p t A c n i C a - n n m a s t O c u o n l i n i a a l l d s l t r t o o place for possession related to personal use. I a i e t e p e t n i S c H r h a n p n a s c r t In Asia, illicit opioids offer some competition to cannabis e m e s r t b A P n i u as the most prominent drugs for possession related to per-

S sonal use, and illicit ATS emerge as the most prominent Personal use offences (48 countries) for trafficking offences. Trafficking offences (57 countries) In Europe, illicit ATS ranked last among these four drug Source: UNODC estimates based on annual report questionnaire. classes in terms of trafficking offences, despite being in second place (after cannabis) in terms of personal drug use in records of drug-related crime, cannabis is clearly the offences. most prominent drug in cases of possession for personal use, followed by ATS (see figure 14). An analysis of the gender make-up of persons recorded for drug-related offences indicates that the population appre- Asia and the Americas both exhibit features which distin- hended for using controlled substances tends to be pre- guish them from the prevalent global trend. In the Ameri- dominantly male, in keeping with the picture that emerges cas, cocaine follows cannabis as the second most prominent from drug use data. The same is true for trafficking. For drug with respect to possession related to personal use, and all drug classes and with respect to both possession for was almost at par with cannabis (in first place) with respect personal use and trafficking offences (separately), less than Cultivation andproduction D. offences. drug-use offending by females,wasquitesimilarfortraffickingand class,intermsoffrequency(ranking) ofeachdrug of below 50percent.Moreover, therelative importance sonal use,buttypicallyonlymarginallyso,andstillfar for traffickingoffencesthanpossessionrelated toper- offemaleoffenderstendedtobehigher The proportion data forwomen. use andtraffickingoffences. use This conformswithdrug offemales, forbothproportions possession forpersonal tranquillizers standing out as the one with relatively high of sedatives and classes, with the category ous drug offemaleoffendersvaried significantlyforthevariportion of offenders wereone quarter female. However, that pro- 87 Lao People’s Democratic Republic in 2013 was estimated In South-East Asia, the total area under cultivation in the as pronounced asinAfghanistan. Myanmar, theincrease inthearea ofcultivation wasnot inHelmandincrease wasobserved andKandahar. ofthecountry,southern andwestern part whilethemajor of cultivation inAfghanistanwasnineprovinces inthe 154,000 ha in 2012to 209,000 ha in 2013. The main area of opiumpoppycultivation increased 36percent,from inAfghanistan,wheremain increase thearea wasobserved tivation wasseeninbothAfghanistanandMyanmar. The 1998 whenestimatesbecameavailable. Anincrease incul 2013 was296,720hectares (ha),thehighest level since The global area under illicit opium poppy cultivation in Source: 1997-2002: UNODC;since2003:NationalIllicitCrop MonitoringSystem supportedbyUNODC. Fig. 15. 2013. “Afghanistan findings”, 2013:summary opiumsurvey November ofCounterNarcoticsUNODC andMinistry ofAfghanistan, OPIATES: OVERVIEW

Hectares Opium poppycultivationanderadicationinAfghanistan,1997-2013 100,000 125,000 150,000 175,000 200,000 225,000 250,000 25,000 50,000 75,000 0

1997 58,000 Eradication Cultivation

1998 64,000

1999 400 91,000

2000 121 82,000

2001 8,000

2002 74,000 87 In In 80,000 - 2003 21,430 - 2012 inSouth-West Asia,andfrom 6tonsin2011to4.85 cent, respectively (from 117tonsin2011to82 Europe, where seizures declinedby 29percentand19 were reported inSouth-West Asiaand Western andCentral 19 percentin2012. The maindeclinesinopiateseizures Globally, seizures of heroin and illicit morphine went down Seizures to 2008estimatesof600tons(seefigure 16). unknown purity)hasalsoincreased to560 tons, comparable (5,500 tons). The potential production of heroin (of accounts for80percentoftheglobalopiumproduction 2011 and2008. The opiumproduction inAfghanistan at 6,883tons,whichisareturn in tothelevels observed The potentialproduction ofopiumin2013isestimated different countriesandregions). details on opium poppy cultivation and production in the tivation thatbegan after2006. survey. tion satelliteimagesandtimeofconductingthehelicopter methodologyintheuseofhigh-resolu due tothevarying estimates are notcomparablewiththeestimatesof2012 as 3,900ha(range:1,900-5,800ha).However, the2013 89 88 2004 131,000 seizures declinedby 58percentinMexico butincreased 0.723 tonsreported in2011).In North America,heroin 2011) andinSouth Asia(1.3tonsin2012compared with Zealand (1.09tonsin2012compared with0.61tonsin zures alsoincreased substantiallyinAustralia andNew increased quantitiesreported seized in Turkey. Heroin sei compared with9.88tonsin2011),mainlyasaresult of Eastern andSouth-Eastern Europe (15.98tonsin2012 tial increase inheroin seizures, however, wasreported in tons in2012 Western andCentralEurope). Asubstan-

Ibid. UNODC, 2005 5,103 104,000 88

2006 15,300 165,000 Myanmar continuedthetrend ofincreasing cul Southeast Asia Opium SurveySoutheast Asia 2013(Bangkok, 2013). 2007 19,047 193,000

2008 5,480 157,000

2009 5,351 123,000

2010 2,316 123,000 89

2011 3,810 131,000 (See tablesinannexIfor

2012 9,672 154,000

2013 7,348 209,000 D. Opiates:overview - - - 21 WORLD DRUG REPORT 2014 22 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 16. Global potential opium production, 1998-2013

9,000

8,000

7,000

6,000

5,000

4,000

Production (tons) Production 3,000

2,000

1,000

0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Afghanistan Myanmar Lao People's Democratic Republic Rest of the World

Source: 1997-2002: UNODC; since 2003: National Illicit Crop Monitoring System supported by UNODC.

Fig. 17. Seizures of heroin and illicit morphine, in selected countries and by region, 2003-2012

180 Oceania 160 Africa South Asia 140 Central and South America and Caribbean Eastern Europe 120 North America 100 Central Asia and Transcaucasian countries East and South-East Asia 80 Western, Central and South-Eastern Europe Seizures (Tons) 60 Near and Middle East /South-West Asia Iran (Islamic Republic of) 40 Pakistan Afghanistan 20 Turkey 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Source: UNODC data from annual report questionnaire and other official sources.

in the United States, to 5.5 tons in 2012, compared with million past-year users. Opiate use at levels much higher 4.8 tons in 2011. However, overall heroin seizures in North than the global average of 0.4 per cent remain in South- America have remained stable over the previous year. West Asia (1.21 per cent), Eastern and South-Eastern Europe (0.82 per cent) and in Central Asia and Transcau- Extent of use casia (0.81 per cent). Past-year use of opioids, including heroin and prescription Opiates: market analysis painkillers, is estimated at between 28.6 and 38 million people globally. Compared to the global average prevalence In comparison with other plant-based drugs, the global of 0.7 per cent, opioid use remains high in North America market for illicit opiates is perhaps the most complex. In and Oceania, with prevalence rates of 4.3 per cent and 3 contrast to cannabis, illicit cultivation and production per cent respectively. While opioid use has increased glob- feeding the illicit opiate market are limited to certain coun- ally over the past year, the main increase has been observed tries and regions. Consequently, illicit opiates are neces- in the United States. Although recent and reliable estimates sarily trafficked across large distances and through multiple are not available from Asia and Africa, many experts from countries in order to meet demand. In contrast to coca countries in those regions also perceive an increase in bush, illicit cultivation of opium poppy occurs on a sig- opioid use. The use of opiates (heroin and opium), how- nificant scale in at least three geographically distinct areas ever, remained stable globally, with 12.8 million to 20.2 — South-West Asia, South-East Asia and Latin America. in keysupplyindicators,along-termperspective (taking In spiteoftheapparent complexityandthefluctuations Long-term assessment various stagesof thesupplychain. that may involve diversion from licit to illicit markets at as licitpharmaceuticalproducts, resulting inaninterplay similar,cologically very are alsowidelyavailable andused more, opiatesandotheropioids,chemicallypharma- which isthenusedinthemanufacture ofheroin. Further usedtomanufactureconsumed asisandfurther morphine, and consumptionare For intertwined. instance,opiumis concentrated regions. in certain These layers of production illicit opiatesiswidespread andcannotbeassumedto routes diversifying accordingly. Moreover, demandfor rather thanfrom several —have blurred, withtrafficking assumed tooriginateinoneofthosesource regions — of illicitopiatesinagiven consumermarket couldbe Moreover thehistoricaldelineationswhereby thesupply 90 estimates ofglobalconsumptiondatetothelate1990s. With respect tothedemandside,earliestUNODC increased from 4-9percentin1991to18-30 the illicitmarket (bothexpressed inopiumequivalents) seizures of opiates to illicitly produced opiates present in ratio (sometimesreferred toasthe“interception rate”) of supply of opiates. UNODCestimates indicate that the steadily. This increase hasasignificantimpactonglobal mately 10kgofopiumper1heroin) increased quite (aggregated by assuming a conversion factor of approxi Over thesameperiod,seizures ofillicitopiatesworldwide Afghanistan in2013isexcluded. production ofopiumpoppy, even ifthesharpincrease in trend over the period 1991-2013 was one of increasing tuations attributabletoenvironmental factors),theoverall South-West Asia(disregarding year-on-year fluc transitory margin). However, owing tothetypicallyhigheryieldsin the highlevel of1991(even exceeding itby asmall 2013, returned forthe firsttimetoalevel comparableto mar. Global cultivation reached alow around 2005andin tion returned to an increasing trend, as of 2007, in Myan significantly (reaching arecord level in2013),andcultiva- decline inthatregion, cultivation in Afghanistan increased cultivated inSouth-East Asia;following asignificant As oftheearly1990s,opiumpoppywaspredominantly in theunderlyingfundamentalindicatorsat a global level. point)reveals1991 asastarting someelementsofstability in 2012. amount ofopiates present inthemarket. moving average ofopiumproduction isconsidered asaproxy forthe into heroin and in locations far removed from the source, a two-year seizures ofderived opiates,someofwhichare madeafterprocessing order toaccountforthedelaybetween theproduction ofopiumand needed for 1 kg of heroin at the point of manufacture. In addition, in at the pointof manufacture, and that a range of 7-10kg of opium are are believed to bepredominant) isnolessthanonethird ofthepurity which seizures atupper levels ofthesupplychain, in termsofweight, the weighted average purityofheroin seizures worldwide(among These calculationsare approximate andare derived by assumingthat 90 - - - -

becoming more discernable in the big picture, had the effect seizures by law enforcement authorities worldwide, while Numerically, itwouldappearthattheimpact ofopiate only marginally, ifatall,over theperiod1998-2012. (net ofseizures) peropiateuserappearstohave increased inherent intheseestimates,theavailable supplyofopiates standing the large degree of fluctuation and uncertainty Even withoutthatadditionaladjustment,andnotwith supply wouldmove even closertothetrend indemand. would suggestthattheappropriately adjustedtrend in times ofexcess production. If suchlossesdidoccur, it take into account any possible losses that may occur in are takenintoaccount.Further, theseestimationsdonot moves closertothegrowth trend indemandonceseizures the growth in supply. However, the growth trend in supply users. That growth in demand appears to be weaker than means thatthere hasbeenanincrease inthenumberof since the global population has also been increasing, this trend intermsofprevalence rateofannualuse.However, comparable. Nevertheless, theyindicateagenerallystable being continuallyupdated,andare therefore notstrictly of thelatestavailable data,usingamethodologythatwas Those estimateshave alwaysbeenproduced onthebasis uted tothedecline inseizures along thisroute, including declined inrecent years. Various factorsmayhave contrib and EuropeTurkey, viaIran (Islamic Republic of) has Balkan route, from Afghanistanto Western andCentral It appears that the flow of heroin along the long-established European markets andtheirrelationship toAfghanistan licit markets foropioids(includingopiates). destinations, andoftheinterplaybetween theillicitand sumer markets other than the long-established European heroin from Afghanistanbecomingmore available incon cant changesintheflows ofheroin outofAfghanistan, taken intoaccount. There isgrowing evidenceofsignifi- trendsfar from static,especiallywhenshorter-term are globally inthelongterm,illicitmarket foropiatesis Although globalsupplyanddemandmaybeevening out Recent trends fore subjecttoahighdegree ofuncertainty. useareestimates ondrug basedonlimiteddataandthere - been different. Moreover, to notethatthe itisimportant oftheinternationalcommunity happened hadtheefforts tain, forthepurposesofcomparison,whatwouldhave is anassessmentoftheendresult, butitisdifficulttoascer so astokeepsupplystable.Most importantly, thispicture be excluded: thatproduction adjustedtocorrect forseizures tained asaconsequenceofseizures, buttheoppositecannot words, onepossibilityisthattheavailable supplywascon- circumstances inorder tokeepmeetingdemand.In other it couldpossiblybetheoutcomeofsupplyadjustingto gone conclusionthatthere isinfactacausalrelationship; slowly thanopiumproduction. However, itisnotafore- in linewiththegrowth indemand,whichincreased more of bringing the apparently strong growth in supply more D. Opiates:overview - - - - 23 WORLD DRUG REPORT 2014 24 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Evolution of main opiate supply and supply reduction indicators, 1991 2013- Global prevalence of illicit opiate use Fig. 18. Evolution of main opiate supply and Fig. a20.nd suppGlobally of pr illievalencecit opiates of illicit per user, opiate use supply reduction indicators, 1991-2013 and supply199 8-of201 illicit2 opiates per user, 1998-2012

6 35 ) 1.8 1.2 5 30 1.6 1.0 1.4 1991) 25 Pe rcentage 4 19 98) 1.2 0.8 20

ne li ne 1.0 3 0.6 15 0.8 2 0.6 0.4 ( use ye ar

10 (base ex

Index (baseline Index 0.4 1 5 Ind 0.2 0.2

0 0 (percentage) rate Interception 0.0 0.0 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 199 8 199 9 200 0 200 1 200 2 200 3 200 4 200 5 200 6 200 7 200 8 200 9 201 0 201 1 201 2 lence of past- of eva lence Pr Interception ratea Available supply of opiates per past-year opiate Total opiate seizures in opium user, range (indexed) equivalents (indexed, left axis) Global population in the 15-64 age bracket Opium cultivation (indexed, left axis) (indexed, baseline 1998) Opium production (indexed, left axis) Global prevalence of past-year use of illicit opiates (percentage, right axis a The practical significance of the “interception rate” should be Global prevalence of past -year use of illicit approached with caution, as this concept is ultimately an abstract ratio which, depending on the context, may not always be intuitive (see foot- opiates (percentage, right axis) note 90). Available supply of illicit opiates per past-year Source: UNODC estimates based on annual report questionnaire user, line of best fit (indexed, baseline 1998) and national illicit crop monitoring systems supported by UNODC, supplemented by other official data. Source: UNODC estimates based on annual report questionnaire, national illicit crop monitoring systems supported by UNODC and UNPD population data, supplemented by other official data. Fig. 19. Comparison of growth rates in supply Note: Comparable data is not available for 1999, 2000 and 2007-2009. of and demand for illicit opiates, 1998-2012 the success of law enforcement authorities in key transit 2.0 countries and a decline in demand in the destination 1.8 market. 1.6 Based on UNODC estimates, the number of past-year 1.4 users of opiates in Western and Central Europe may have declined by almost one third between 2003 and 2012 1.2 (from 1.6 million to 1.13 million). This is also observed 1.0 for example, in the data from Germany, where the number of people arrested for the first time for heroin use fell stead-

Index (baseline 1998) (baseline Index 0.8 ily between 2003 and 2012 — overall, by more than one 0.6 half. Even so, in 2011 and 2012, there may have been a

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 certain deficiency in the available supply of heroin (which may yet be corrected), as the purity-adjusted price of Available supply of opiates, range (indexed) heroin underwent a distinct transition between 2010 and Opium production, 2 year moving average 2011, and maintained the increased level in 2012. Indeed, (indexed relative to line of best fit) the decline in heroin flowing on the Balkan Route appears Number of opiate users (UNODC estimates) (indexed relative to line of best fit) to have been too sudden to be accompanied by a corresponding drop in demand. The ensuing shortfall may have Opium production (line of best fit, baseline 1998) helped trigger the development of routes serving as alter- Available opium supply (line of best fit, natives to the Balkan route — whose emergence is sug- baseline 1998) gested by other evidence — to supply Europe, possibly via Number of opiate users (line of best fit, the Near and Middle East and Africa, as well as directly baseline 1998) from Pakistan, suggesting that the so called Southern Route is expanding.91 Source: UNODC estimates based on annual report questionnaire and national illicit crop monitoring systems supported by UNODC, 91 UNODC, The illicit drug trade through South-Eastern Europe, supplemented by other official data. 2014. ber 2012 in which heroin was seized from air passengers In ananalysisof120casesintheperiodJune 2006-Octo- affected by thisflow toasignificantextent. were alsomentioned.Italy appearstobe inparticular ofprovenance,try althoughEthiopia, Kenya andUganda previous years, appearstobethemostprominent asacoun tered annuallevels ofseizures significantly higher thanin Tanzania, whichthroughout theperiod2010-2012regis- Among East-Africancountries,theUnited Republic of istan) andSouth-Eastern Europe (including Turkey). Near andMiddle East/South-West Asia(includingAfghan regions intermsofnumbermentions,following the area ofprovenance, wasamongthemore prominent such ously never beenidentifiedby aEuropean asan country Europe; incontrast,2012,EastAfricawhichhadprevi indicated asaregion ofprovenance forheroin reaching reporting years 2002-2011,Africawasonlysporadically In thereplies tothe annual report questionnaires forthe 92 tries ofprovenance inthoseitineraries. well astheNear andMiddle East,alsoappeared ascoun- countries from Africa,includingEastand West Africa,as to theyear 2012.In additiontoEuropean countries,other period, thecasesinvolving Kenya related almostexclusively appeared tobeonthedecline oversit country thattime and followed by Kenya. While therole of Turkey asatran ofprovenance,most citedcountry secondonlyto Turkey on itinerariesinvolving Europe, c b a Production: Nationalillicitcrop monitoringsystemsupportedbyUNODC. Seizure data:UNODCannualreport questionnaire supplementedbyotherofficial data. Possiblyrepresentativeofthesouthern route. Taken asrepresentative ofthenorthernroute. Taken asrepresentative oftheBalkanroute. Fig. 21. pean airports, Germany Customs.pean airports, Data seizures from thedatabase onillicitdrug withrelation toEuro-

IndexedIndexed heroin heroin seizures seizures (baseline (baseline 2003 2003) ) 2003-2012 compared withheroin seizure trends inPakistanandopiumproduction inAfghanistan, Heroin seizure trends inkeycountriesandregionsroutes, alongtheBalkanandnorthern 0.5 1.5 2.5 3.5 0.5 1.5 2.5 3.5 1 2 3 0 Heroin seizures in Pakistan Pakistan in seizures Heroin axis) left (indexed, Central EuropeandWestern and of), Turkey(Islamic Republic Iran in heroin seizures Total Russian Asia CentralFederation and the in heroin seizures Total Average opium production in Afghanistan in preceding two years (tons, right axis) 0 1 2 3 Heroin seizures in Pakistan Pakistan in seizures Heroin axis) left (indexed, Central EuropeandWestern and of), Turkey(Islamic Republic Iran in heroin seizures Total Russian Asia CentralFederation and the in heroin seizures Total Average opium production in Afghanistan in preceding two years (tons, right axis) Heroinseizuretrends in countries key and regionsalong Balkan the Heroinseizuretrends in countries key and regionsalong Balkan the 2003 2003 and northern routes, compared with heroin seizure trends in and northern routes, compared with heroin seizure trends in Pakistanand opium production in Afghanistan, Pakistanand opium production in Afghanistan, 92 2004 2004 Pakistan wasthesecond 2005 2005 2006 2006 ͨ ͨ (indexed, left axis) left (indexed, (indexed, left axis) left (indexed, 2007 2007 - - - - 2008 2008 supplemented byotherofficial data. Source: Seizure data:UNODCannualreport questionnaire Fig. 22. HeroinHeroin seizures seizures (tons) (tons) 10 20 30 40 50 60 10 20 30 40 50 60 2009 2009 0 0 prominence of Turkey as a transit transit a as Turkey of prominence axis) Heroin seizures in Islamic Republic of Iran (left axis) (left and Central seizures in Western Europe Heroin axis) Heroinseizures South-Eastern in Europe (left axis) Europe Central (left of),South-Eastern Europe and Westernand Totalheroin seizuresIranin (Islamic Republic country of provenance for heroin (right axis) as Turkey identifying countries of Number prominence of Turkey as a transit transit a as Turkey of prominence Number of countries identifying Turkey as Turkey identifying countries of Number axis) Heroin seizures in Islamic Republic of Iran (left axis) (left and Central seizures in Western Europe Heroin axis) Heroinseizures South-Eastern in Europe (left axis) Europe Central (left of),South-Eastern Europe and Westernand Totalheroin seizuresIranin (Islamic Republic country of provenance for heroin (right axis) Heroin seizures in key locations locations key in seizures Heroin 2002 locations key in seizures Heroin 2002-2012 Turkey asatransitcountryforheroin, the Balkanroute andprominence of Heroin seizures inkeylocationsalong 2002 country for heroin, country for heroin, 2010 2010 along the Balkanroute and along the Balkanroute and 20032003 20042004 ᵃ 2011 ᵃ 2011 2003 2003 (indexed, left axis) left (indexed, (indexed, left axis) left (indexed, 20052005 - - 20062006 2012 2012 2012 2012 20072007 20082008 2002 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 2002 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 20092009 -

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NumberNumber of ofcountries countries 25 WORLD DRUG REPORT 2014 26 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 23. First-timeFirst-time arrestees arrestees for heroinfor heroin use usein Germany, in Germany, 2003-2012 2003-2012

6,000 1,600 1,400 5,000 1,200 4,000 1,000 3,000 800 (by age) 600 2,000 400 2012 time arresteestime for heroinuse

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Male arrestees, by year (left axis) Female arrestees, by year (left axis) Number of first Arrestees in 2003, by age group (right axis) Arrestees in 2012, by age group (right axis) Source: Germany Bundeskriminalamt. Data on individual heroin seizure cases93 from Pakistan patterns are likely most significant to the extent that they up to the first quarter of 2012 also confirm a recently reflect a broader tendency to source heroin from a given increasing frequency of use of airports in Europe (notably region using maritime or land transportation. The number the United Kingdom), the Near and Middle East (notably, of heroin seizure cases involving sea transport reported by in 2012, Oman and Saudi Arabia) and Bangladesh Pakistan was much more limited; however, since 2009 the (although that increasing mention of Bangladesh was offset only such cases with a known destination were predomi- by decreasing mention of other countries in South Asia) nantly of shipments being sent to West and Central Africa, as a destination for heroin couriers leaving Pakistan by air. with all others destined for Western and Central Europe. However, consignments trafficked via passenger aircraft are necessarily small, and it is not clear to what extent such A distinct market for heroin, also supplied for several years trafficking can affect the flow of heroin; these emerging by heroin from Afghanistan, is that of Eastern Europe, Heroin retail prices in Western and Central Europe and the United Fig. 24. Heroin retail prices in Western andStates, Central 2003 Europe-2012 and the United States, 2003-2012 1,200 35

1,000 30 25 800 20 600 Price 15 400 10

200 5

0 0 Central Europe (percentage)

2003ᵃ 2004ᵃ 2005 2006 2007 2008 2009 2010 2011 2012 purity inEquivalent Western and Equivalent average purity (12 countries, right axis)

Purity-adjusted retail price, weighted average, 12 countries in Western and Central Europe (United States dollars per pure gram) Purity-adjusted retail price, weighted average, 12 countries in Western and Central Europe (EUR per pure gram) Nominal price (unadjusted for purity), weighted average, 12 countries in Western and Central Europe (euros per gram) Purity-adjusted retailᵇ price in the United States (United States dollars per pure gram)

Source: For European countries, UNODC annual report questionnaire, EMCDDA, European Police Office (Europol). For the United States, Office of National Drug Control Policy, United States. a For 2003 and 2004, comparable price data for the United States were unavailable. b Purchases recorded in the System to Retrieve Information from Drug Evidence (STRIDE) database of the United States Drug Enforcement Agency.

93 UNODC IDS database. If thatisthecase,itwouldbeyet anotherinstanceofthe sources whentheinfluxofheroin subsequentlydeclined. ulated ademandforopioids,whichwasmetby alternative it isplausiblethattheincreased availability mayhave stim 1998 and2004.Since then,overall seizures declined,but betweensentative route) of that was northern observed the Russian Federation andCentralAsiatogether(repre- Central Asia.Amarked increase intotal heroin seizures in tities ofheroin flowing northwards from Afghanistanvia consumer market forillicitopiates,withsignificantquan the global average. The Russian Federation remains a major where thelevels ofopiateuseare significantlyhigherthan Source: UNODCestimates basedonannualreport questionnaire andUNPD populationdata,supplementedbyotherofficial sources. a airports IDEAS,GermanCustoms. Source: Databaseonillicitdrugseizures withrelation toEuropean N Fig. 26. Fig. 25. Data for2012wereincomplete. e a r

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2011-19 March 2012,96 experts in the Islamic Republic total for China for that year. It is likely that these quanti- of Iran, a country with relatively high rates of opium use, ties originate in Myanmar, in line with the increasing trend perceived an increase in both opium and heroin use. in opium poppy cultivation in this country in recent years. With respect to Afghanistan, a recent study97 conducted More broadly, South-West Asia (or countries therein) has by the United States Government found high (in compari- recently been mentioned as a source of heroin with increas- son with other countries) levels of use or exposure in the ing frequency by countries in South-East Asia, including urban population of Afghanistan (overall and among both Indonesia and Malaysia, both of which have registered men and women), with 2.6 per cent of the urban test increasing heroin seizures since 2006. Malaysia in particu- population (of all ages) testing positive for opioids (includ- lar has a significant market for heroin, with a relatively ing pharmaceutical opioids). Users of opioids in the form high level of heroin use (although declining according to of opium and heroin were predominantly men, while expert perception101), and an increasing inflow of heroin, women predominantly used codeine. Even a relatively high trafficked via sea and air cargo, facilitated by groups with proportion of children tested positive for opioid use ties to Pakistan (possibly in collusion with West African (including heroin): the study indicates that some 1.3 per groups active mainly in Malaysia in the trafficking of meth- cent of urban children were exposed to an opioid present amphetamine and cocaine) and intended for both the local in their physical environment or had been given the drug market and for onward trafficking.102 by an adult. Nevertheless, the main source for heroin in Malaysia likely Although the annual prevalence of use of illicit opiates in continues to be Myanmar.103 In addition to heroin, it East and South-East Asia is estimated to be significantly appears that the use of morphine is, or at least was in 2010, below the global average, this subregion accounts for widespread in Malaysia; moreover, in recent years, authori- approximately one fifth of all users globally, mainly by ties have dismantled a number of clandestine laboratories virtue of the large population of China. In the past, the processing heroin (seven in 2011), apparently producing heroin market in China was supplied mainly from South- a low purity end product.104,105 The fact that heroin sei- East Asia; although Myanmar in particular continues to zures in Pakistan have increased markedly since 2009, inde- be a major source country for heroin reaching China, it pendently of the trend in opium production in Afghanistan appears that around 2006, a surplus of heroin from and in contrast to seizures in key countries along the Afghanistan started to find its way to China, via Pakistan Balkan and northern routes, suggests a major transforma- and other countries in South-East Asia.98 By 2007, the tion in the flows out of Afghanistan, with Pakistan playing number of registered heroin users in China, which had an important role. declined in 2005, was on the increase, and heroin seizures in China followed a similar pattern, with a slight delay, Given the extensive coastline of Pakistan on the Indian which could be attributable to a time lag as law enforce- Ocean and that maritime channels generally provide the ment authorities adjusted their efforts to the changing flow. possibility of trafficking large quantities over long distances, it is likely that significant quantities of heroin are This evidence does not immediately translate into a con- trafficked by sea out of Iran (Islamic Republic of) and clusion that heroin use in China is on the rise, especially Pakistan. Seizures by the Pakistan Anti-Narcotics Force since some of these indicators could reflect drug supply (one of several law enforcement agencies in Pakistan) at and demand reduction efforts rather than supply itself; seaports reached almost 1.2 tons in 2013, more than indeed, the latest UNODC estimates suggest that annual double the annual amounts throughout the period 2010- prevalence of opiate use in China (in 2012) is lower than 2012.106 Reports of individual seizure cases also corrobo- previously thought (0.19 per cent of the general population aged 15-64, compared with 0.25 per cent in 2005). However, it seems clear that the share of heroin in the 101 UNODC, Patterns and Trends of Amphetamine-Type Stimulants and Chinese market originating in South-West Asia continues Other Drugs: Challenges for Asia and the Pacific (November 2013). to increase, as has also been indicated by Chinese 102 Ibid. authorities,99 who detected 98 instances of heroin traffick- 103 Malaysia assessed the proportion of seized heroin originating in Myanmar at 80 per cent in 2010. For the reporting year 2011, ing from South-West Asia in 2012 and 148 cases in Malaysia mentioned the Lao People’s Democratic Republic, Myanmar 2013.100 Heroin seizures in the Chinese province of and Pakistan as the main countries of provenance. Over the period Yunnan (bordering Myanmar), continued to increase, 2010-2012, Myanmar nationals accounted for the largest number of foreign nationals arrested for drug-related offences in Malaysia. See reaching 5.4 tons in 2012, constituting 74 per cent of the also UNODC, Patterns and Trends of Amphetamine-Type Stimulants, p. 92. 96 Solar Hijri calendar year 1390. 104 UNODC, Patterns and Trends of Amphetamine-Type Stimulants (November 2013). 97 United States, Department of State, Afghanistan National Urban Drug Use Survey (ANUDUS) (December 2012). 105 Country report submitted by Malaysia to the Thirty-seventh Meeting of Heads of National Drug Law Enforcement Agencies, Asia and the 98 World Drug Report 2011, pp. 73 and 74 and fig. 42. Pacific. 99 China, National Narcotics Control Commission, 2013 Annual Report 106 Pakistan Anti-Narcotics Force “Heroin and precursors trafficking on Drug Control in China (Beijing, 2013). through southern route”, presentation made at the UNODC work- 100 Ibid., 2014 Annual Report on Drug Control in China (Beijing, 2014). shop on Afghan opiate trafficking through the southern route, held origin fortheheroin traffickedinthosecases. of waters have confirmedthatAfghanistanisthecountry by theCombined Maritime Forces seizures inexcess of100kgeach)in2012and2013made analysisofseveral largeheroin seizurestory (atleastfive andPakistan. Labora- coast ofIran (Islamic Republic of) being transferred for maritime conveyance on the southern regions inAfrica,reinforces theevidencethatheroin is zures intheIndian Ocean, andcoastal aswell asinseaports significantsei international forces onspecific,particularly mation from nationallawenforcement agencies climbed torecord levels in2010and2011.Further infor- the increase wasmore also gradual,buttheproportion than inanyprioryear. In termsofthenumberseizures, record level in2009andsincethen,hasremained higher seizures madeby authoritiesofPakistan) rose sharplytoa ofprovenancestan wasmentionedasacountry (including of total weightproportion seized in cases for which Paki- consignments known tohave beentraffickedby sea,the on alimitednumberofofficiallyreported seizures ofheroin rate those maritime patternsofheroin trafficking. Based 109 108 107 database, Office oftheNationalNarcotics Control CommissionofChina(annualreports). Source: UNODCannualreport questionnaire, National illicitcrop monitoringsysteminAfghanistansupportedby UNODC,UNODCIDS Fig. 27.

operations in theIndian Ocean, made at the UNODC workshop on P bodies ofwater. shippinglanesin the Indianmost important Ocean and adjoining operates ininternationalwaters,encompassing someoftheworld’s Combined M Afghan opiatetrafficking,March 2014. trafficking: Nigeria’s experience”, madeattheUNODCworkshop on the National Drug LawEnforcement AgencyofNigeria on“heroin Republic of Tanzania andby on heroin trafficking inthecountry P on 24and25March 2014. resentation by theCombinedMaritime Forces oncounter-narcotics resentations by the Drug Control Commission of the United

supply inSouth-West Asia,2002-2012 Indicators ofher aritime Forces that isamultinationalnaval partnership

Proportion of consignmentsᵃ with planned destination in East and South East Asia (percentage) China China (including Hong Kong) planned as destination (bynumber, left axis) planned destination in rest the of East and South-East Asia (by number, left axis) Heroinseizures inPakistan, indexed(baseline 2002, rightaxis) Heroinseizures inChina, indexed (baseline 2007, rightaxis) Registeredheroin usersinChina indexed(baseline 2007, rightaxis) Percentage of reported heroin consignments trafficked air by seized by Pakistan Percentage of reported heroin consignments trafficked air by seized by Pakistan Production opiumof inAfghanistan, indexed (baseline2002, right axis) 10 20 30 40 50 0 0220 0420 0620 0820 0021 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 oin useandsupplyinChina,compared withselectedindicatorsofopiate 108 ininternational 109 107 and - of “brown sugar” (alsoreferred toas“low-quality heroin”) diversion ofopiumfrom licitcultivation andmanufacture of opium poppy in some pockets within India, suspected Moreover, Indian authoritiesalsoindicateillicitcultivation annual report questionnaire). itself (according toinformation submitted by India in the most of the remainder (54 per cent) originated in India seizures inIndia in2011wasassessedat45percent,while South-West oftotalheroin Asianoriginasaproportion of $72,bothinthesameyear). The share ofheroin of Western andCentralEurope andweighted by population, States and an average price, taken from 17 countries in per gramofheroin from South-West AsiaintheUnited gram, as of 2011, compared with a range of $100-$400 in India (reported to be the equivalent of $8.6-$13 per markets thanIndia, given therelatively low priceofheroin Asia. These destinationsare presumably more lucrative tions suchasEurope, theUnited States andSouth-East stan border andtendstobetraffickedonward todestina- from South-West Asia reaches India across the India-Paki the 2011UNODCannualreport questionnaire) heroin Pacific, andthereply submittedby India inresponse to National Drug LawEnforcement Agencies,Asiaandthe mitted by India to MeetingThirty-seventh ofHeads of According toIndian authorities nating inbothSouth-East AsiaandSouth-West Asia. in the15-64agebracket,isexposedtoillicitopiatesorigi India, withalmost18percentoftheworld’s population Afghan opiatetrafficking, March 2014. ( i.e. country report sub i.e. country 0.0 0.5 1.0 1.5 2.0 2.5 ᵃ ᵃ with with with Index D. Opiates:overview - - - 29 WORLD DRUG REPORT 2014 30 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Access to pain medication As stated in the International Narcotics Control Board (INCB) annual report for 2009, “One of the fundamental objectives of the international drug control treaties is to ensure the availability of narcotic drugs and psychotropic substances for medical and scientific purposes and to promote the rational use of narcotics drugs and psychotropic substances”. While opioids are essential in the management of pain experienced by millions of people who might be suffering from late-stage cancers, AIDS, surgical procedures and other debilitating diseases and conditions,1 they are also susceptible to abuse.2 This means that countries face the challenging task of balancing two public health needs: ensuring the availability of these controlled substances for medical purposes and preventing their misuse and diversion. Many countries have expressed concern about misuse, and available data show a high prevalence of misuse of prescription opioids in some countries. This includes the high-income countries,3 such as Australia, Canada and the United States that have high per capita consumption of opioids for medical purposes, and even lower-middle-income countries such as Nigeria and Pakistan, which have the lowest per capita consumption of opioids for medical purposes.4 That suggests that the dynamics of misuse of prescription opioids does not necessarily follow making opioids accessible or available for medical purposes.5 As a response to potential or real misuse of these medicines, many countries, contrary to the provisions of the drug control conventions, have laws and regulations that are unduly restrictive or burdensome,6 resulting in a situation where a large part of the population does not have access to most of the opioid medications commonly used for the treatment of pain and dependence syndrome.7 Globally, in 2011, the opioid consumption for medical purposes in morphine equivalence (ME) per person was 61.66 milligrams (mg) per person.8,9 This comprises six main opioids: fentanyl, hydromorphone, methadone, morphine, oxycodone and pethidine. However, there is a great disparity among levels of consumption and accessibility of pain medications. The high-income countries, which comprise 17 per cent of the global population, account for 92 per cent of the medical morphine consumed, whereas more than half of the countries that reported to INCB in 2011 had consumption levels of less than 1 mg of morphine per person. Comparison of per capita opioid consumption in morphine equivalence among lowest and highest consumption countries, 2011 Lowest consumption countries Highest consumption countries (mg per capita of morphine equivalence) (mg per capita of morphine equivalence) Nigeria 0.0141 Canada 812.1855 Myanmar 0.0152 United States 749.7859 Pakistan 0.0184 Denmark 483.1678 Australia 427.1240 Source: Pain and Policy Studies Group, University of Wisconsin-Madison. A survey conducted by INCB in 2011 found that the laws and regulations in place for control of pain medications in many countries were unduly restrictive or burdensome and were perceived to be a significant limitation on availability. Other impediments to accessibility to pain medication included insufficient training of health-care professionals in the recognition and management of pain, and economic and procurement impediments such as deficiencies in drug supply management due to low financial resources or low priority given to health care, among other areas.

1 WHO, Ensuring Balance in National Policies on Controlled Substances: Guidance for Availability and Accessibility of Controlled Medicines (Geneva, 2011). 2 UNODC, discussion paper based on a scientific workshop, entitled “ Ensuring availability of controlled medications for the relief of pain and preventing diversion and abuse: striking the right balance to achieve the optimal public health” (Vienna, 2011). 3 Based on the World Bank classification of income levels and development. 4 The annual prevalence of misuse of prescription opioids is as follows: Australia, 3.1 per cent; Canada, 1 per cent; Nigeria, 3.6 per cent; Pakistan, 1.5 per cent; and United States, 5.2 per cent. 5 B. Fischer and others, “Non-medical use of prescription opioids and prescription opioid related harms: why so markedly higher in North America compared to the rest of the world?” Addiction, vol. 109, No. 2 (February 2014), pp. 177-181, and the related debate. 6 Report of the International Narcotics Control Board on the availability of internationally controlled drugs: ensuring adequate access for medical and scientific purposes (United Nations publication, Sales No. E.11.XI.7), para. 131. 7 UNODC, discussion paper entitled “Ensuring availability of controlled medications for the relief of pain”. 8 INCB data on global per capita opioid consumption, 2011. 9 Pain and Policy Studies Group, “Global opioid global consumption, 2011” (University of Wisconsin-Madison), available at www.painpolicy.wisc. edu/2011-global-regional-and-national-opioid-consumption-statistics-now-available. in West andCentralAfricaisabove theglobalaverage, authorities. The estimatedannualprevalence ofheroin use tries, whichalsoextendstodatafrom lawenforcement is aconsequenceofthepaucitydatafrom Africancoun between 0.92millionand2.29million. That broad range the number of past-year users of opiates is estimated at In Africa, aside from its increasing role as a transit area, territory. Asia asbeingamongthesources forheroin reaching their and boththosecountrieshave longindicatedSouth-West although theflow toSri Lankahasreportedly declined, countries in South Asia, such as Bangladesh and Sri Lanka, Moreover, heroin originatinginIndia alsoreaches other market. of licitly produced into the illicit opium portion diverted domestic origin,quiteplausiblyderived from aminorpro consumer market inIndia ismainlysuppliedby heroin of by indigenousgroups. 116 115 114 113 112 111 110 to highlevels ofheroin production inMexico andMexican of heroin continuedtoincrease inthat country, likelydue According totheUnited States, in2012,theavailability Federal Police were ofSouth-West Asianorigin. of heroin samplesfrom seizures analysedby theAustralian and inthefirstsixmonthsof2012,approximately onehalf average. According toAustralian authorities, ania isestimatedtobemore thanfourtimestheglobal low. However, theannualprevalence ofopioiduseinOce In Oceania, theannualprevalence ofopiate useisrelatively via EastAfricaandtheNear andMiddle East. market, derivingitsheroin supplyfrom South-West Asia naire, South Africaisalsobelieved tobeamajorconsumer the latest available responses to the annual report question trafficking by air, notablythrough Nigeria. those subregions beinglongassociatedwithsmall-scale Australian Crime Commission, Illicit Data Report Drug . 2011-12 for inboundseizures and70percentforoutbound seizures. 90 percent;in2012,thecorresponding was25percent proportion thathadbeentraffickedby airin2004tobe heroin onitsterritory declined to3percentby 2011.Nigeria assessedthepercentage of other than Pakistan, this number peaked at 51 per cent in 2004 and as apercentage of allsuchseizure caseswithaknown destination consignments traffickedby airwithNigeria asadestination;expressed heroin. Over theperiod2000-2011,Pakistan reported 681heroin annual report questionnaire ascountriesofprovenance oftrafficked between eighth and twelfth among all countries mentioned in the Each year oftheperiod2002-2012,Nigeria consistentlyranked See UNODC,World Report 2013,pp. Drug 33-35. ment Agencies,AsiaandthePacific. the MeetingThirty-seventh ofHeads ofNational Drug LawEnforce- desh, India report submittedby andSri India Lanka;andcountry to UNODC, annualreport questionnaire, replies submittedby Bangla- Bangkok 21-24October 2013. of National Drug LawEnforcement Agencies,AsiaandthePacific, Report by IndiaCountry to the Thirty-seventh Meeting of Heads Bangkok 30October –2November 2012. National Drug LawEnforcement Agencies,AsiaandthePacific, Report by IndiaCountry tothe MeetingThirty-sixth ofHeads of Bangkok 21-24October 2013. of National Drug Law Enforcement Agencies,AsiaandthePacific, Report by IndiaCountry to the Thirty-seventh Meeting of Heads 113 110, 111 Thus, itappearsthatthe 115 116 Based on in2011 114 112 - - - -

in some countries and the manufacture of heroin in In LatinAmerica,despite illicit cultivation of opium poppy above). sumer market, is ofSouth-West Asianorigin(asdiscussed small inrelation tothesize oftheNorth Americancon reaching North Americafrom India, whileprobably still to theUnited States; itisplausiblethattheflow ofheroin both indicatedthatthere wasaflow ofheroin from India flow ofheroin from Canada.India andtheUnited States However, theUnited States hasnotreported asignificant to other countries, such as the Unitedexport States. in theuseofheroin across Canada,aswell aspossible 2013, andreported thatthiscouldbeduetoaresurgence of2012andinearly commercial airlines inthelatterpart increase inthenumberofheroin seizures from courierson enance forheroin reaching itsmarket, mentionedan and India asbeingamongtheprominent countriesofprov quantities. Canada,whichcontinuestoidentifyPakistan may bereaching theNorth Americanmarket inlarger inating inLatinAmerica,heroin from South-West Asia increase inheroin overdose deaths.Apart from heroin orig metropolitan areas intheUnited States experienced an traffickers expandinginto“white heroin” markets. 119 118 117 in theexpression ofthegenesbraincells. and persistent because it is related to significant changes by theopioid.Once established,that mechanismisstable being driven by normalliferewards orsalientstimulibut the opioid substance, with motivational reactions no longer “normal” mood. The entire reward systemishijackedby longer obtainareward butare aimingtore-establish a ance untilapointatwhichpeopleusingtheopioidno The rewarding effectisprogressively modulatedby toler- any negative consequence. dependence, seekingtoobtainthesubstanceinspiteof sive behaviourthatisthemaincharacteristicofopioid vulnerable individualsdevelop anuncontrollable compul pleasure and sedation. followeddescribe aninitialrush by feelingsofwarmth, able responses related tothebraindopaminerelease. Users  effect thatoccurs when the active compound binds tothe of opioid addiction Atis the powerful the heart rewarding pharmaceutical opioiduse The interplaybetweenillicitand heroin in2012. accounted forlessthan3percentofglobalseizures of America, CentralAmericaandtheCaribbeancollectively States, theprevalence ofopiateuseisrelatively low. South Colombia andMexico, destinedmainlyfortheUnited -opioid receptor, triggeringacascadeofintensepleasur- europa.eu. EMCDDA, Drug profiles, heroin. Available from www.emcdda. for 2012. UNODC, annualreport questionnaire, replies submitted by Canada United States for2012. UNODC, annual report questionnaire, replies submitted by the 119 Once regular use is established, D. Opiates:overview

117 Some 118 - - - -

31 WORLD DRUG REPORT 2014 32 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 28. Price of heroin and past-month prevalence of use of OxyContin and heroin in the United States, January 2006-December 2012 )

m 1,400 0.30 ) gr a g e e 1,200 r

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U 0 0.00 ( 6 7 8 9 0 1 2 0 0 0 0 1 1 1 r r r r r r r p0 6 p0 7 p0 8 p0 9 p1 0 p1 1 p1 2 a a a a a a a e e e e e e e S S S S S S S M M M M M M M ------l l l l l l l n n n n n n n u u u u u u u J J J J J J J a a a a a a a J J J J J J J Annual estimate of past-month prevalence of OxyContin use among population aged 12 or older (percentage, right axis) Annual estimate of past-month prevalence of heroin use among population aged 12 or older (percentage, right axis) Annual estimate of past-month prevalence of heroin and OxyContin use among population aged 12 or older (percentage, right axis) Average quarterly STRIDE heroin price, United States dollars per pure gram (left axis) Average annual STRIDE heroin price, United States dollars per pure gram (left axis) Source: Office of National Drug Control Policy, US Government and data from National Surveys on Drug Use and Health (NSDUH) of the Substance Abuse and Mental Health Services Administration and extracted from SAMHDA (Substance Abuse and Mental Health Data Archive) hosted by the Inter-university Consortium for Political and Social Research at the University of Michigan.

The use of multiple opioids is common among dependent and prescription opioids are strongly interconnected.123 users, who may choose one or the other depending on factors such as the local accessibility, availability and price of In the United States, the shift in the opioid market towards the opioids. heroin is also evidenced by high availability and lower prices of heroin. Also, fluctuations in the heroin market, In the United States, where over 5 million people abused reflected in the price of heroin since 2007, appear to have prescription pain relievers in 2010,120 those with the most compensated for the use of other opioids, notably Oxy- severe dependency on pharmaceutical opioids were found Contin, with the price of heroin correlating strongly with to be 7.8 times more likely to have used heroin in the past the past-month use of OxyContin (see figure 28). year.121 In 2012, people in the United States who had ever used heroin were almost five times more likely to have used In line with these findings, according to the United States pain relievers, for other than medical purposes, than people Drug Enforcement Agency, law enforcement officials in the general population, and about one third had mis- nationwide have noted prescription opioid abusers switch- used OxyContin, a commercial brand of oxycodone. Con- ing to heroin because it was cheaper and/or more easily versely, among people who had ever used OxyContin, obtained than prescription drugs. Given the variable levels almost one quarter had also used heroin.122 Another study of heroin purity, the replacement of heroin with prescrip- compared admissions rates for overdoses from prescription tion opioids is also fraught with risks of overdose. In several opioids and heroin between the years 1993 and 2009 and places in the United States, heroin overdoses have increased found that overdose from one strongly predicted an over- substantially. For example, in Minneapolis-Saint Paul, dose from the other — evidence that the markets of heroin overdoses tripled in the span of one year, rising from 16 overdoses in 2010 to 46 overdoses in 2011.124

120 United States, Department of Health and Human Services, National These changes in the heroin market have been concurrent Institute on Drug Abuse, “Topics in Brief: Prescription Drug Abuse” with national measures to control the misuse of prescrip- (December 2011), available at www.drugabuse.gov/publications/ topics-in-brief/prescription-drug-abuse. tion drugs. In 2010, OxyContin was modified to make it 121 C. M. Jones, “Heroin use and heroin use risk behaviors among non- a controlled-release formulation so that it could no longer medical users of prescription opioid pain relievers — United States, 2002-2004 and 2008-2010”, Drug and Alcohol Dependence, vol. 132, Nos. 1 and 2 (September 2013), pp. 95-100. 123 G. J. Unick and others, “Intertwined epidemics: national demo- 122 UNODC estimates based on data from the National Survey on Drug graphic trends in hospitalizations for heroin-and opioid-related over- Use and Health of the Substance Abuse and Mental Health Services doses, 1993-2009”, PLOS ONE, vol. 8, No. 2 (2013). Administration and extracted from the Substance Abuse and Mental 124 United States, Department of Justice, Drug Enforcement Adminis- Health Data Archive, hosted by the Inter-university Consortium for tration, “National Drug Threat Assessment Summary” (November Political and Social Research at the University of Michigan. 2013). 127 126 125 drug. treatment listed fentanylas their primary amphetamine: ates andheroin toillicitlymanufactured fentanyland usershave switchedfrominjecting drug home-madeopi- of prescription opioids.In Estonia,over thepastdecade, Europe appearstohave resulted inanincrease intheuse In contrast,thedeclining availability of of heroin inparts doubled. tanyl and hydromorphone use went up and heroin use had 35.6 per cent to 12.8 per cent), but as a replacement, fen- decrease inOxyContinmisuseamongtheclients(from after theformulationchangefound that ithadledtoa undergoing treatment foropioiddependencebefore and heroin. AUnited States-based studyof2,566patients were foundtobe switching to other opioids, including tion period(2009-2011),duringwhichOxyContinusers these measures canalso beseeninastudyover thetransi- or injected. andsnorted be crushed Tangible impactsof Research attheUniversityofMichigan. hosted bytheInter-university ConsortiumforPoliticalandSocial SAMHDA (SubstanceAbuseandMentalHealthDataArchive) Mental HealthServicesAdministrationandextractedfrom on DrugUseandHealth(NSDUH)oftheSubstanceAbuse Source: UNODCestimatesbasedondatafrom NationalSurveys Fig. 29. (2012). Information provided by Estoniain theannualreport questionnaire (Lisbon, November 2012). EMCDDA, “Fentanyl inEurope: EMCDDAtrendspotter study” 367 (2012),pp. 187-189. formulation ofOxyContin”, New England Journal ofMedicine, vol. Cicero T. J.,Ellis M.S. and Surratt H.L.,“Effect ofabuse-deterrent Past-month prevalence of heroin use 125

(percentage) OxyContin use in the United States, population aged outlier year 2007) year outlier bothheroin and OxyContin (not considering Line ofexcluding best fit, past monthusers of bothheroin and OxyContin Line ofexcluding best fit, past-monthusers of OxyContin Excluding past-monthusersboth of heroinand OxyContin Including past-month users of both heroin and Correlationof heroinuse versus 0.04 0.06 0.08 0.10 0.12 0.14 past-month prevalence among OxyContin useintheUnitedStates, Correlation ofheroin useversus population aged12orolder, 2006-2012 past 126 0.05 in2012,87.5percentoftheclients - Past month prevalenceamong - month prevalence of Oxycontin use use Oxycontin of prevalence month 0.10 2007 2012 (percentage) 12 or older, 0.15 0.20 2006

- 127

0.25 Also, land suggestthatdomestically produced “home bake” — a cost 40-50Australian dollars. an equivalent amountofheroin atretail priceswouldhave 60 mgofoxycodone cost20-30Australian dollars,while Australia, in 2011 and 2012 shows that a tablet containing of pricedata forheroin andoxycodone in Queensland, cantly, displacingmorphineinsomecases. substitute. In particular, useofoxycodone increased signifi and someconsumersresorted toprescription opioidsasa patterns, supply drop and a consequent change in consumption land. In 2001, the heroin market in Australia a underwent inAustraliaA similartrend canbeobserved andNew Zea- taining codeine. preparation made from over-the-counter medicines con such asacetylatedopiumanddesomorphine,ahome-made replacement withlocalandreadily available substances Federation, decreased availability ofheroin ledtoitspartial heroin inEstoniaandFinland. reports thatfentanylandbuprenorphine have displaced related tofentanylanditsderivatives. in overdose deathsinEstonia,80percentofwhichwere between 2011and2012,there wasa38percentincrease 134 133 132 131 130 129 128 in other regionsopioid use can be observed for which These trends intheoverlap ofheroin andprescription heroin.alternative tocostlyimported involving prescription painkillers — remains a cheaper locally produced substancemadefrom achemicalprocess former. lars per100mg),despitethegreater size ofthepurchase unitofthe was doubletheper-unitpriceof“homebake” (50 New Zealand dol- heroin duringthereporting yearsof imported 2011and2012,which (approximately 807United States dollars,using2012exchange rates) New Zealand reported apriceof1,000New Zealand dollarspergram ian Crime Commission,Illicit Data Report Drug 2011-12. higher relative to oxycodone. Price and purity data from the Austral- tion (ifitcouldbequantified)wouldrender thepriceofheroin even discount” possiblyarisingfrom thisdiscrepancy, butsuchacorrec- of bulkingagents). The comparisondoesnotcorrect forthe“bulk higher than the relevant purchase unit for oxycodone (60 mg, net would beequivalent to121-151mgofpure oxycodone, whichis times thatofoxycodone. Under thoseassumptions,0.25gofheroin quantities notlargerthan2g),andapotencyforheroin of2.67-3.33 purity inQueensland of18.1percent(median)attheretail level (for ofagramheroin inQueensland,quarter takingintoaccounta This comparisonisbasedonapriceof100Australian dollarsfora 280-284. Australia”, and others,“Prescription ofopioidanalgesics andrelated harmsin on medicalprescriptions ofthesesubstances.See Amanda Roxburgh ferentiated intoappropriate prescribing useandnon-medical use— p. 69.Similar trends alsoemergefrom data—whichcannotbedif- in intheAustraliansurveyed Illicit Drug Reporting System, presented Assessment based on data on morphine and oxycodone injection Research Centre, University ofNew South Wales, 2013). in Australia, 2001to2013(Sydney, National Drug andAlcohol Amanda Roxburgh andothers,Trends Use inDrug andRelated Harms World Report 2013. Drug INCB/2012/1). Report of the International Narcotics Control Board for 2012 EMCDDA, “Drugnet Europe 2014). 85” (January-March Trends Use inDrug andRelated Harms inAustralia, 2001to2013, 131 inwhichmostindicatorsofheroin usedeclined Medical Journal ofAustralia, vol. 195,No. 5(2011),pp. 130 133 129 Price datafrom New Zea Similarly, intheRussian 134 132 128 D. Opiates:overview A comparison Acomparison INCBnow (E/ - - - 33 WORLD DRUG REPORT 2014 34 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

limited data are available. In Afghanistan, a survey in urban Fig. 30. Coca bush cultivation 2003-2012 households showed that over half the women surveyed who reported opioid use (64 per cent) were combining heroin 200,000 and/or opium with pharmaceutical painkillers, and 9 per 175,000 cent of opioid-using women used only a prescription 150,000 opioid.135 In recent years, the misuse of tramadol (a lower 125,000 potency opioid) has also been reported.136 in parts of 100,000 75,000 Africa, the Middle East and Asia. Hectares 50,000 What is clear is that the people who are dependent on 25,000 opioids will move between the different opioids, inter- 0 changing one for another, all the while increasing their

risks of serious health consequences. However, in the pres- 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 ence of accessible and evidence-based treatment, the situ- Bolivia (Plurinational State of) ation can be prevented, while supply reduction efforts Peru alone are likely to induce a balloon effect where one con- Colombia trolled substance is replaced by another. Source: Bolivia: 2002: CICAD and US Department of State, INCSR. Since 2003: National Illicit Crop Monitoring System supported by UNODC. Colombia: National Illicit Crop Monitoring E. COCAINE: OVERVIEW System supported by UNODC. Peru: National Illicit Crop Monitor- ing System supported by UNODC. Cultivation and production Seizures Coca bush cultivation, which remains limited to Plurina- tional State of Bolivia, Colombia and Peru, continued to Globally, cocaine seizures have slightly increased over the decline in 2012 with the net area under coca bush cultiva- past year, going up to 671 tons in 2012, compared with tion on 31 December 2012 totalled 133,700 ha, a decline 634 tons in 2011, driven largely by increased seizures in of 14 per cent from the previous year’s estimates and the South America139 (418 tons in 2012 compared with 362 Seizures of cocaine worldwide and in tons in 2011) and in Western and Central Europe, another lowest levels since the beginning of available estimates in selected countries, 2003-2012 1990. That decline was driven mainly by a 25 per cent major cocaine market, where seizures increased from 63 decline in coca bush cultivation in Colombia, from an tons in 2011 to 71.2 tons in 2012. Seizures of cocaine worldwide and in estimated 64,000 ha in 2011 to 48,000 ha in 2012. How- Seizures of cocaine worldwide900 and in ever, those figures refer to the net area under coca cultiva- selected countries, 2003-2012 Fig.selected 31. Seizures countries, of cocaine 2003-2012800 worldwide and in tion on 31 December of the year given. In 2012, the selected countries,700 2003-2012 Colombian Government manually eradicated 34,486 ha 600 900 of cultivation and conducted aerial spraying of 100,549 900 500

800 Tons ha. The addition of geographical data available on the pres- 800 400 700 ence of coca bush cultivation shows that 135,000 ha had 700 300 600 137 600 200 been under cultivation at some point during 2012. The 500 500 100 greatest reduction in coca bush cultivation in Colombia Tons

Tons 400 400 0 took place in the departments of Nariño, Putumayo, 300 Guaviare and Cauca.138 The decline in coca bush cultiva- 300 200 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 200 tion observed in the Plurinational State of Bolivia contin- 100 100 Rest of the world ued in 2012 (25,300 ha in 2012 compared with 27,200 0 0 Central America and Caribbean ha in 2011) and in Peru, where it declined to 60,400 ha Western and Central Europe 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

from 62,500 ha in 2011. As a result, the estimated global 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 North America Rest of the world production of cocaine has also declined. In Colombia, the Rest of the world South America Central America and Caribbean potential production of pure cocaine was estimated at 309 Central America and Caribbean Colombia Western and Central Europe tons, the lowest level since 1996. (For details see tables on Western and Central Europe United States North America coca bush cultivation and production estimates in annex.) North America South America South America Colombia Colombia 135 United States, Department of State, Bureau for International Narcot- Source: UNODC annualUnited report States questionnaire and other official ics and Law Enforcement, Demand Reduction Program Research sources.United States Brief, “Afghanistan National Urban Drug Use Survey” (December Note: Includes seizures of cocaine salts, coca paste, cocaine base and 2012). crack cocaine. 136 World Drug Report 2013 and Report of the International Narcotics Board Control for 2012 (E/INCB/2012/1). 137 UNODC, Government of Colombia, Colombia: Coca cultivation 139 However, there remains the possibility of double-counting of quanti- survey 2012 (June 2013). ties of cocaine seized, considering that there are joint operations con- 138 Ibid. ducted by national agencies together with agencies of other countries. possible rebound insomemarkets. In addition,given that ever, in2012,there were signsofalevelling-off oreven a availability ofcocaine has fallen in the medium term.How- Overall, thelatestsupplyindicatorssuggest thattheglobal Cocaine: marketanalysis to 1.0percentin2012. Europe declinedfrom anestimated1.3percentin2010 below, prevalence ofcocaineusein Western andCentral 2011 and2012)duetoanumberoffactorsexplained been anincrease incocaineuseNorth America(between Western and Central Europe (1 per cent). While there has prevalence rates,respectively), Oceania (1.5percent)and and South America(1.8percentand1.2annual annual prevalence). Cocaineuseremained highinNorth million estimatedpast-year usersglobally(0.4percent Cocaine useremained stableover 2012,with14million-21 Extent ofuse 140 Mexico. via to alargeextentinColombia andtoenterthecountry Cocaine reaching theUnited States isbelieved tooriginate in 2005or2006. testing, amongother indicators, all exhibit turning points workforce testing positive forcocainebasedon urinalysis use amongthegeneralpopulation,percentage ofthe ico border, prevalence of past-month and past-year cocaine and United States authoritiesalongtheUnited States-Mex ment Agency, seizures by theUnited States CoastGuard (STRIDE) database oftheUnited States Drug Enforce System toRetrieve Information from Drug Evidence purity (wholesale, retail and overall) as recorded in the decreased levels ofavailability anduse. The average cocaine availability, beginningaround 2006,resulting insustained United States experiencedasignificant drop in cocaine Numerous indicatorsshow thatthecocainemarket inthe believed tohave takenplaceover thelongterm. the efficiencyofcocainemanufacture process thatare that recent declineistempered by theimprovements in of available estimates(1990).However, thesignificanceof of cultivation down toitslowest level sincethebeginning 2011. declinein2012brought thetotalareaThe further 153,000-157,000 ha,returned tothatrangein2010and which hadbeenquitestableintheperiod2003-2006,at around 2007.Indeed, thetotalarea undercultivation, represented a return to equilibrium following a surplus inmeeting globaldemandorbrought aboutashortage However, it is not clear whether the gradual decline by approximately between 2007and2012. onequarter Global cultivation ofcocabushisestimatedtohave fallen to theextentofphenomenoninAfricaandAsia. kets, there degree withrespect isacertain ofuncertainty cocaine useisstillrelatively mar- concentratedincertain naire, theUnited States assessedthat95percent ofcocaineseized In itsreply totherelevant questionintheannualreport question- 140 On thebasisofassessment Drug - - 141 population aged 12 years or older rose from 1.5 per cent the estimatedprevalence ofpast-year cocaineuseinthe zures rose from 89tonsin 2010to106tonsin2011,and market indicatorschangedin2011and2012: cocainesei In the United States, the trend in some of the cocaine Colombia halved between 2007and2012. cocaine inNorth America.Cultivation ofcocabushin may also have of particular contributed to the shortage marked declineincocabushcultivation inColombia ficking organizationsinMexico. traf cocaine andviolentconflictsbetween competingdrug well asapossiblyself-perpetuatingcycle of ofshortages uted tothe reduced availability inthe United States, as the activitiesofColombiantraffickersmayhave contrib- facture thathindered ofcocaine,law enforcement efforts appears that,inadditiontothedecrease in levels ofmanu Enforcement Administration of the United States, it Note: Values in2006indicatedbrackets. Source: Office ofNationalDrugControl Policy, USGovernment. Fig. 32.

2013). tration, United States, ofJustice, Department Drug Enforcement Adminis - made intheUnited States. of CentralAmericacollectively accountedfor96percentofseizures which cocaine entered the United States, Mexico and the countries fromin 2012originatedColombia.In termsofthelastcountry IndexIndexIndexIndex (baselineIndexIndexIndex (baseline (baseline (baselineIndex (baseline (baseline (baselineIndex 2006 (baseline 2006 2006) 2006(baseline 2006 2006 )2006)) ) )2006)) 2006) 0.0 0.2 0.0 0.4 0.2 0.6 0.4 0.8 0.6 1.0 0.8 1.2 1.0 1.4 1.2 1.4 0.0 0.0 0.0 0.0 0.2 0.0 0.2 0.2 0.2 0.4 0.2 0.0 0.4 0.4 0.4 0.6 0.2 0.4 0.6 0.6 0.6 0.4 0.8 0.6 0.8 0.8 0.8 0.6 1.0 0.8 1.0 1.0 1.0 0.8 1.2 1.0 1.2 1.2 1.2 1.0 1.4 1.2 1.4 1.4 1.2 1.4 1.4 1.4 0.0 0.2 0.4 0.6 0.8 1.0 1.2 1.4 (6,726) (267,256) cocaine Numberoverdose of deathsinvolving cocaine primarytreatmentNumber of admissions for (267,256) cocaine (184) population per cocaine 100,000 primarytreatmentNumber of admissions for Numberhospital of emergency room visits for cent) (0.72 testing per analysis (184) population per cocaine 100,000 positiveforcocaine, based onworkplaceurine Numberhospital of emergency room visits for testing workforce of general Percentage cent) (0.72 testing per analysis positiveforcocaine, cent) based onworkplace per (1.0 urine older or years 12 population testing workforce of general Percentage of monthpast usePrevalence among cent) per (1.0 older or years 12 population of monthpast usePrevalence among Numberpastmonth of users(2.4 million) Numberpastmonth of users(2.4 million) (106 tons) by States Coast United seizures Guard Cocaine (106 tons) by States Coast United seizures Guard Cocaine cent) per (85 purity Wholesale cent) per (85 purity Wholesale purity (73 per cent) Retail purchase (6,726) purity (73 per cent) Retail purchase Numberoverdose of deathsinvolving cocaine (6,726) (267,256) cocaine primarytreatmentNumber of admissions for (267,256) cocaine primarytreatmentNumber of admissions for Numberoverdose of deathsinvolving cocaine (267,256) cocaine primarytreatmentNumber of admissions for primarytreatmentNumber of admissions for (184) population per primarycocaine 100,000 treatmentNumber of admissions for (184) population per cocaine 100,000 (267,256) cocaine (184) population per cocaine 100,000 Numberhospital of emergency room visits for (184) population per cocaine 100,000 Numberhospital of emergency room visits for primarytreatmentNumber of admissions for cent) (0.72 testing (184) per population analysis per cocaine 100,000 Numberhospital of emergency room visits for cent) (0.72 testing per analysis Numberhospital of emergency room visits for cent) (0.72 testing per analysis positiveNumberforhospitalcocaine, of emergency based onworkplace roomurine visits for cent) (0.72 testing per analysis positiveforcocaine, based onworkplaceurine (184) population per cocaine 100,000 cent) (0.72 testing per analysis positiveforcocaine, based onworkplaceurine testing workforce of general Percentage positiveforcocaine, testing based workforce of onworkplacegeneral Percentage urine Numberhospital of emergency room visits for positiveforcocaine, based onworkplaceurine testing workforce of general Percentage testing workforce of general Percentage cent) (0.72 testing per analysis cent) per (1.0 older or years 12 testing workforce of population general Percentage cent) per (1.0 older or years 12 population positiveforcocaine, based onworkplaceurine cent) per (1.0 older or years 12 population of monthpast usePrevalence among cent) per (1.0 older or years 12 population of monthpast usePrevalence among testing workforce of general Percentage cent) per (1.0 older or years 12 population of monthpast usePrevalence among of monthpast usePrevalence among of monthpast usePrevalence among cent) per (1.0 older or years 12 population Numberpastmonth of users(2.4 million) Numberpastmonth of users(2.4 million) of monthpast usePrevalence among Numberpastmonth of users(2.4 million) Numberpastmonth of users(2.4 million) Numberpastmonth of users(2.4 million) Numberpastmonth of users(2.4 million) (106 tons) cent) per (85 purity Wholesale cent) per (85 purity Wholesale by States Coast United seizures Guard Cocaine cent) per (85 purity Wholesale cent) per (85 purity Wholesale cent) per (85 purity Wholesale purity (73 per cent) Retail purchase purity (73 per cent) Retail purchase cent) per (85 purity Wholesale purity (73 per cent) Retail purchase purity (73 per cent) Retail purchase purity (73 per (6,726) cent) Retail purchase (6,726) (6,726) Numberoverdose of deathsinvolving cocaine (6,726) Numberoverdose of deathsinvolving cocaine purity (73 per cent) Retail purchase (6,726) Numberoverdose of deathsinvolving cocaine Numberoverdose of deathsinvolving cocaine (267,256) cocaine Numberoverdose of deathsinvolving cocaine (267,256) cocaine National Drug Threat 2013(November Summary Assessment cocaine per 100,000 population (184) population per cocaine 100,000 Numberhospital of emergency room visits for cent) (0.72 testing per analysis positiveforcocaine, based onworkplaceurine testing workforce of general Percentage cent) per (1.0 older or years 12 population of monthpast usePrevalence among Numberpastmonth of users(2.4 million) Wholesale purity (85 per cent) per (85 purity Wholesale purity (73 per cent) Retail purchase (6,726) Numberoverdose of deathsinvolving cocaine (267,256) cocaine primarytreatmentNumber of admissions for Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market Indicators ofcocaine thein market 200220022002200220022002200220022002 relative to2006 the UnitedStates,2002-2012,indexed Indicators ofthecocainemarketin the United States, 2002 States, United the 2002 States, United the the United States, States, United the States, United the States, United the States, United the States, United the 2002 States, United the the United States, States, United the indexed relative to 2006 to relative indexed 2006 to relative indexed indexed relative to to relative indexed to relative indexed to relative indexed to relative indexed to relative indexed 2006 to relative indexed 200320032003200320032003200320032003 to relative indexed

200420042004200420042004200420042004

200520052005200520052005200520052005

200620062006200620062006200620062006

200720072007200720072007200720072007 2002 2002 2002 2002 2002 2002 141 200820082008200820082008200820082008 In addition,the 2006 2006 2006 2006 2006 2006 ------2012, 2012, 2012, 2012 2012 2012 2012 2012 2012, 200920092009200920092009200920092009 2012 E. Cocaine:overview 201020102010201020102010201020102010 , , , , , , 201120112011201120112011201120112011

201220122012201220122012201220122012 - - - 35 WORLD DRUG REPORT 2014 36 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Equivalent average purity, 14 countries in Fig. 33. Annual prevalence of cocaine use and Fig. 35. Cocaine retail prices in the United Western and Central Europe cocaine seizures in the United States, States and Western and Central 2001-2013 Europe, 2003-2012

) 2.8 300 50 Purity-adjusted retail price, weighted

g e 2.6 200 ) 2.4 45 average, 14 countries in Western and n t a 250 40 Central Europe (United States dollars per

e 2.2 t o n s (

r c 2.0 35 pure gram) 150 s 1.8 200 p e

( 30

1.6 u r e Purity-adjusted retail price, weighted e z 1.4 i 150 25 average, 14 countries in Western and e n c 100 s Price

e 1.2 20 l Central Europe (Euros per pure gram)

a 1.0 100 n e v 0.8 i 15 (percentage) 0.6 50 a 10 p r e

50 Purity-adjusted retail price in the United l and and Europe Central 0.4 C o c 5 0.2 Equivalent average purity, 14 countries in States (United States dollars per pure 0 0 gram)

0.0 0 Equivalent purity in Western ᵃ n u a EquivalentWestern and average Central purity, Europe 14 countries in ª 1 2 3 4 5 6 7 8 9 0 1 2 A 3 0 0 0 0 0 0 0 0 0 1 1 1 EquivalentWestern and average Central purity, Europe 14 countries in 1 0 0 0 0 0 0 0 0 0 0 0 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 0 2012 2 2 2 2 2 2 2 2 2 2 2 2 Western and Central Europe 2 Nominal price (unadjusted for purity), Equivalent average purity, 14 countries in weighted average, 14 countries in West 300 Total cocaine seizures (right axis) 50 Purity-adjusted retail price, weighted 300 4550 Purity-adjustedaverage,Western and14 countries Central retail Europe price,in Western weighted and and Central Europe (Euros per gram) 250 Annual prevalence of cocaine use among 300 405045 Purity-adjustedaverage,Central Europe 14 countries (Unitedretail price,in States Western weighted dollars and per 250 population aged 12 years or older (left 354540 average,Centralpure gram) Europe 14 countries (United in States Western dollars and per 200 axis) 250300 35 50 Centralpure gram) Europe (United States dollars per 200 3040 Purity-adjusted retail price, weighted Maritime seizures (right axis) pure gram) 200150 253530 45 Purity-adjustedaverage, 14 countries retail price,in Western weighted and

Price 250 Central Europe (United States dollars per 150 Maritime seizures, shifted upward and 2030251 40 Purity-adjustedaverage,Central Europe 14 countries (Eurosretail price, inper Western pure weighted gram) and

Price 100 pure gram) 150 year forward (right axis) 152520 average,Central Europe 14 countries (Euros inper Western pure gram) and 100 35 (percentage) Price 200 102015 CentralPurity-adjusted Europe (Eurosretail price, per pure weighted gram) Source: 100Office50 of National Drug Control Policy (US Government),30 (percentage) Purity-adjusted retail price in the United Substance50 Abuse and Mental Health Services Administration.51510 and Europe Central average, 14 countries in Western and (percentage) Purity-adjustedStates (United States retail dollarsprice in per the pure United Price 150 25 and Europe Central a 500 0105 Statesgram)Central (United Europe States (Euros dollars per pure per gram) pure Equivalent purity in Western

Prevalence data for 2013 were unavailable. ᵃ Purity-adjusted retail price in the United 0 50 20 and Europe Central gram) Equivalent purity in Western

ᵃ States (United States dollars per pure

1000 Year2003 -on2004 -year2005 2006 changes2007 2008 2009 in past2010 2011 -year0 2012

15 (percentage) gram) Equivalent purity in Western Purity-adjusted retail price in the United ᵃ Nominal price (unadjusted for purity), 2003 2004 2005 2006 2007 2008 2009 2010 2011 Fig. 34. cocaineYear-on-year use and changes first-time in use past-year in 2012 the 10 States (United States dollars per pure

and and Europe Central Nominalweighted price average, (unadjusted 14 countries for purity), in West

50 2003 2004 2005 2006 2007 2008 2009 2010 2011

cocaine use and first-time use2012 in the gram) United States, by age bracket, 2012 Nominalweightedand Central price average, Europe (unadjusted 14(Euros countries perfor purity),gram) in West United States, by age bracket, 20125 versus 2011 Equivalent purity in Western weightedand Central average, Europe 14(Euros countries per gram) in West 0 versus 2011 0 ᵃ Source: ForandNominal European Central price countries, Europe (unadjusted UNODC(Euros per forannual purity),gram) report question- 50 naires, EMCDDAweighted and Europol;average, for 14 the countries United States,in West estimates 2003 2004 2005 2006 2007 2008 2009 2010 2011 40 2012 based on theand 2013 Central National Europe Drug (Euros Control per Strategy gram) Data Supple- 2011 30 ment, Office of National Drug Control Policy, United States. 20 a For 2012, comparable price data for the United States were unavailable.

versus 10 0

2012 -10 particular, the apparent rebound in cocaine use in 2012 -20 -30 may be associated with a slight comeback in cocaine avail- -40 ability towards late 2011. However, in 2013 seizures -50 returned to a declining trend, suggesting that was only a transitory aberration. Moreover, the increase in past-year 35+ 12-13 14-15 16-17 18-20 21-25 26-34

Overall use in 2012 appears to have been driven by the consump-

Percentage change, tion patterns of older users, including past users returning Change in number of past-year first- time cocaine users to the habit, rather than a predisposition of younger people Change in number of past-year cocaine at risk of initiating cocaine use; indeed, the number of users first-time users actually declined in 2012, while the trend Source: Substance Abuse and Mental Health Services Administra- in past-year use was increasing only in the older age tion, United States. categories. South America, long the source of the world’s cocaine in 2011 to 1.8 per cent in 2012, following a steady decline supply, has seen an increase in terms of consumption of between 2006 and 2011. cocaine (including crack). The number of past-year cocaine The general behaviour of the cocaine market in the United users in South America was estimated at almost 2 million States from 2006 onward appears to be that of a tight in the period 2004-2005 and 3.35 million in 2012. A sig- market where use patterns were constrained by, and thus 142 to a certain extent followed, the available supply. In well (significantly better than seizures at the south-west border). When a time lag of one year from the supply indicator (seizures) to the demand indicator (prevalence) is introduced (comparing seizures 142 From around 2005 onward, seizures at sea appear to correlate well in the period 2004-2011 to prevalence in the period 2005-2012, with the prevalence of cocaine use, suggesting that maritime seizures rather than using the period 2004-2011), the correlation coefficient reported by the United States reflect cocaine availability reasonably improves from 0.89 to 0.96. 143 weighted average ofthepurity-adjustedretail pricein West ability ofbothpriceandpurity data,theestimated in Western andCentralEurope with relatively goodavail- dom. Consequently, on the basis of data from 14 countries markets, such asFrance, Germany and theUnited King- cocaine increased insomecountrieswithsizeable consumer Italy registered decreases. However, theretail purityof major consumercountriessuchasFrance, Germany and Belgium, Spain and, to a lesser extent, Portugal, while transitcountries,notably important concentrated inafew to 71tonsby 2012. The increase in2012was,however, zures reached alow in2009at53tonsandclimbedback lowing aclear decline from the peak of2006,cocaine sei- suggest apossiblerebound inavailability ofcocaine.Fol - In Western andCentralEurope, supplyindicatorsoverall dents (ofallages)at3percentin2009. prevalence ofuse ofcocainepowder amongcollegestu lege studentsinBrazilian statecapitalsestimatedtheannual dates to 2005. A more recentsurvey survey of cocaineuseinBrazil basedonageneralpopulation population. The last official estimate of annual prevalence as well astococaineconsumption,dueitslargeurban a convenient staging area for cocaine trafficked to Europe), cocaine trafficking,duetoitsgeography(whichmakesit thatisvulnerabletoboth of South America;itisacountry Brazil containsapproximately onehalfofthepopulation formsofcocainebase. well asothercrude smoking of various forms of cocaine, including crack as nificant componentofcocaineuseinSouth Americaisthe Source: UNODCannualreport questionnaire and otherofficial data. Fig. 36. Students inthe 27Brazilian State Capitals (Brasilia, 2010). Survey ontheUse ofAlcohol, Tobacco amongCollege andOther Drugs Brazil, National Drug Policy Secretariat (SENAD),First Nationwide

Population in 2012 (thousands) 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000 (typical purityandranges) Reported retail puritiesofcocainesaltsinWestern andCentralEurope, 2011and2012 0

Austria 2011 Reportedretailpurities of cocaine saltsWestern inand Central Austria 2012 Lower end of purity range Population 2012 in Estonia 2011 Estonia 2012 France 2011 France 2012 Germany 2011 Germany 2012

Hungary 2011 (typical purity and ranges) 143 Hungary 2012 Europe,

amongcol Ireland 2011 Ireland 2012 Latvia 2011 Latvia 2012 2011 - - - Luxembourg 2011

Luxembourg 2012 and ability, of itwouldraisethequestion ofwhetheraportion trend inusecontinuestodiverge from thetrend inavail- 144 and remained high in 2012, at 1.6 tons. In particular, past- seizures inOceania reached arecord of1.9tonsin2010, are higher than in Western and Central Europe. Cocaine the market hasexpandedinrecent years andwhere prices One suchpossibledestinationcouldbeOceania, where and CentralEurope. ing markets outsidetheestablished markets in Western the cocaineenteringEurope ispossiblydestinedforemerg by anincreasing supplyoriginatingin Peru, Europe (ifconfirmedtobereal), couldpossiblybedriven timelag. a short The apparent increasing availability in that changesinusemayfollow changesinavailability with supply indicators such as seizures, prices and purity, and usually updatedlessfrequently andlesspromptly than cation, however, isinconclusive, given thatdataonuseare in cocaineuse Western andCentralEurope; thatindi- indicate anychangesintherecent overall decreasing trend On thedemandside,datacurrently available donot highest level since2005. lent (constant across countries) purity returning to its ern andCentralEurope fellsignificantly, withtheequiva-

Typical purity Typical Upperpurity end of range Malta 2011

Malta 2012 2012 on National Drug Control Policy. also out by datafrom Australia (seefigure 38andrelevant discussion). See since 2005.Anincrease incocaineoriginating Peru isalsoborne cantly lower thanbothColombiaandPeru, itfellto the lowest level State of Bolivia, where the cultivation area continued to be signifi- one third lessthanthepeaklevel of2007,andinthePlurinational years (by 34percent),whilein Colombiaitstoodatapproximately 2012. As of 2011, cultivation in Peru had increased for six consecutive was probably too recent to have animpact on indicators in Europe in The smalldeclineincocabushcultivation inPeru registered in2012 Norway 2011

Cocaine Smuggling in 2011 Norway 2012 Slovakia 2011 Slovakia 2012 Slovenia 2011 Slovenia 2012 Spain 2011 Spain 2012 Switzerland 2011

, produced for the United States Office Switzerland 2012 United Kingdom 2011 United Kingdom 2012 0 10 20 30 40 50 60 70 80 90 100

Purities (percentage) E. Cocaine:overview 144 andifthe

- 37 WORLD DRUG REPORT 2014 38 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 37. Annual prevalence of cocaine use Fig. 38. Origin of coca leaf used to produce (2012) versus cocaine retail prices, Origincocaine of coca as leafa proportion used to produce of analysed cocaine as a proportion of nominal and adjusted by purchasing analysedseizures seizures made bymade the byAustralian the Australian Federal Police, by power parity (unadjusted for purity), by Federalnumber Police, and by by total number weight and ofby seizures,total 2007-2012 region, 2011-2012 weight of seizures, 2007-2012

450 2 100 r s

1.8 t h e a 400 90 l ) n i 350 1.6 e g e d o l

80 l 1.4 u s

300 n t a m

e 70

o n a 1.2 n e i

250 r c t i a g r a 1 60 p e r o c 200 ( r n a c

0.8 t p e

e 50

150 o f k n t e

0.6 c / i e

Percentage 40

r s 100

0.4 n c b r a a

e l 50 l 30 a

o l 0.2 g e v D a 0 0

4 20 ª e e e h d n n a a e a p r e 6 i

t r a c a p p h - n p l s i i c n e u e i r a o o 5 t o A a

r r r o r 10 e s t b 1 d f e n u u S u a b r

n c i A m E E E E r

e d

l O n u a a A a 0

n h a s t a s t A t r a C h c a t

i t u l r r E 2007 2008 2009 2010 2011 2012ª n a o W e e o e r S t N C m n A e Unclassified (by weight) Mixed (by weight) C Bolivian (by weight) Colombian (by weight) Annual prevalence in 15-64 age bracket Peruvian (by weight) Unclassified (by number) (percentage, right axis) Mixed (by number) Bolivian (by number) Retail price adjusted by purchasing power parity, Colombian (by number) Peruvian (by number) 2011-2012, weighted average (international dollarsb per gram, left axis) Source: Australian Crime Commission. a January-June only. Nominal (unadjusted) retail price, weighted average (United States dollars per gram, left axis) tralia (including possibly through Europe) although, as of Source: UNODC estimates based on World Bank Purchasing Power mid-2012, Colombia remained foremost among the three Parities and annual report questionnaire, supplemented by other official sources producer countries. a Price data for Africa were available from a very limited number of In Eastern Europe, seizures of cocaine continue to be lim- countries. ited. Aside from Latin America, countries in Eastern b An international dollar would buy in the region concerned a comparable amount of goods and services a United States Dollar would buy in Europe exclusively cited European countries as transit the United States. countries for cocaine reaching their territory in 2010-2012. It is likely that the Baltic region serves as an entry point year use of cocaine among the general population aged 14 for cocaine entering the Russian Federation.146 Limited years or older in Australia rose from 1.6 per cent in 2007 quantities of cocaine may also reach Central and Eastern to 2.1 per cent in 2010, although the average frequency of Europe from the south, via countries in Eastern and South- 145 consumption appears to be low, possibly due to the high Eastern Europe, including countries traditionally associ- prices. Indeed, this is corroborated by the fact that Oceania ated with the Balkan route for heroin entering Europe.147 is something of an exception among the major consumer markets, in that both the price and the prevalence are rela- The extent of drug trafficking and consumption in Africa tively high, while the retail price would be expected to have is hard to assess. Although seizures in the subregion of West an inverse relationship to the levels of use, especially when and Central Africa remained below 3 tons in 2012 (includ- adjusted for purchasing power parity (all other factors ing 2.2 tons seized in Cabo Verde alone), cocaine traffick- being equal). ing via West Africa to Europe is believed to be continuing. In 2012, Algeria in particular registered a spike in cocaine In terms of the number of cocaine seizure cases in 2012, seizures, reporting that cocaine transited through countries categorized by country of departure, Australia ranked the in West and Central Africa prior to seizure, and identify- Netherlands first and Germany second. It is likely that the ing trafficking by air as the main mode of transportation. majority of those seizures were of small consignments; in Some of the cocaine may also be diverted to other destina- terms of weight, and with reference to a slightly different reporting period (July 2011-June 2012), the most prominent European country was the United Kingdom (in fifth 146 Finland, Latvia and Lithuania all identified the Russian Federation as place). Moreover, it appears that Peru has increased in being among the destinations of cocaine seized on their territory at importance as a country of origin of cocaine reaching Aus- least once over the reporting years 2010-2012. 147 This is suggested by a combined analysis of replies to the annual report questionnaire submitted by Albania, Austria, Belarus, Bulgaria, 145 Amanda Roxburgh and others, Trends in Drug Use and Related Harms Hungary, Poland, Romania, Serbia, Turkey and Ukraine. See also the in Australia, 2001 to 2013, p. 108. World Drug Report 2013, pp. 44-45. 149 148 cocaine, includingcountriesinAsiaandAfrica.Israel and of countrieswithasmall,possiblyemergingmarket for by adisparate group has beenidentifiedasatransitcountry ates, aprominent stopover pointforairpassengertraffic, Emirates and Israel (in that order). The United Arab Emir seized inHong Kong, China,followed by theUnited Arab aggregate quantitiesofcocaineseizures inAsiawere those which countriesare affectedfirst.In 2012,thelargest including affluence sumption, trafficking and trade in cocaine emerge, factors its firstinroads inthiscontinent,andaspocketsofcon to changethatassessment.Nevertheless, cocainehasmade and themostrecent available evidencedoesnotgive reason The extentofcocaineuseinAsiahasalwaysbeenlimited, the United Republic of Tanzania. global scale,have alsoincreased inrecent years, notablyin Seizures of cocaine in East Africa, while still small on a plete thepicture ofthe situationinthatcountry. the paucityofsupply-sidedata,itwasnotpossibletocom ently expandingconsumermarket forcocaine.Owingto firming thecontinuedexistenceofasizeable andappar 15-64 agebracketin2008to1.02percent2011,con- rose from 0.78 per cent of the general population in the The estimatedprevalence ofcocaineuseinSouth Africa a linkwithSouth Africa. tions, possiblyincludingAsia;itisalsolikelythatthere is Note: Prevalencefiguresdisplayedasmovingaverage. Source: UNODCannualreport questionnaire. Price per pure gram (United States dollars) Fig. 39. See alsotheWorld Report 2013,p. Drug 40. none were seized enteringtheregion from South Africa. 9 seized by Nigeria) were seized ontheirwaytoSouth Africa,but since 2006,asmallnumber(14)ofcocaine consignments(including among individualcocaineseizures madein West andCentralAfrica year fromenance forseized 2009to2012.However, cocaineevery Nigeria identifiedSouth Africaasbeingamongthecountriesofprov - 1 1 2 2 3 0 5 0 5 0 5 P P 0 0 0 0 0 0 0 uri re v ty a l - countries, 2003-2012 Europe, weightedbypopulationof adjusted priceinWestern andCentral Cocaine consumptionandpurity- e a

nc 2003-2005 d j e us

of te 2004-2006 149 d c o r c appeartoplay a role in determining e a

t 2005-2007 i a n 148 i e l

pri us 2006-2008 e c e (2012dollars)

i n 2007-2009 th e

pa 2008-2010 s t- y

e 2009-2011 a r ( a 2010-2012 g e

1 1 1 2 5 . 5 - 6 4 ) - - - - Prevalence (percentage) 152 151 150 ity over thatperiod. theassumptionofapossibleincreasesupports inavailabil Afghanistan between December 2011 andDecember 2012 tons in 2011. The decline in the price of cannabis resin in estimated at 1,400 tons in 2012, compared with 1,300 resin production, duetohigheryieldsper hectare, was 10,000 ha,down from 12,000hain2011.But potential 2012, thetotalarea undercultivation ofcannabiswas basis ofavailable cultivation andproduction estimates,in Middle EastandSouth-West Asia.In Afghanistan, onthe countriesinNorthis confinedtoonlyafew Africa,the inthe world, country duction. While cannabisherbisgrown in almostevery estimate thegloballevels ofcannabiscultivation andpro - indoor warehouse operations, thus making it difficult to ranging from personalcultivation tolarge-scalefarmand Cannabis cultivation remains widespread in most regions, Cultivation andproduction F. 25 kg)seized inJapan, Saudi Arabiaand Thailand in2011. of the population, were the quantities (each in excess of below 100kgin2011;more significant,relative tothesize countries. with Jordan andtheSyrian astransit ArabRepublic serving Lebanon appear to be destination countries for cocaine, Note: Prevalencefiguresdisplayedasmovingaverage (STRIDE) databaseoftheUnitedStatesDrugEnforcement Agency. from theSystemtoRetrieveInformationfrom DrugEvidence Abuse andMentalHealthServicesAdministrationpricedata Source: UNODCannualreport questionnaire, and Substance Fig. 40. Price per pure gram (United States dollars) 100 120 140 160 180 200 stan opiumpricemonitoring monthlyreport” (December 2012). of Counter-Narcotics,UNODC and Afghanistan, Ministry “Afghani - World Report 2013. Drug UNODC annualreport questionnaire andotherofficial data. CANNABIS: OVERVIEW 20 40 60 80 Purity-adjusted retail (2012 dollars) retail price Purity-adjusted of use in 15-64) the cocaine (age Prevalence past-year 0 150

2003-2005 2003-2012 adjusted price,UnitedStates, Cocaine prevalence andpurity- Annualseizures inChinaandIndia were

2004-2006 152

151 2005-2007 theproduction of cannabis resin 2006-2008

2007-2009

2008-2010

2009-2011 F. Cannabis:overview

2010-2012 0 0.5 1 1.5 2 2.5 3

- Prevalence (percentage) 39 WORLD DRUG REPORT 2014 40 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Among countries reporting in 2012 through the annual South Asia (India and Sri Lanka) and most expensive in report questionnaire, Italy, the United States and Ukraine East and South-East Asia. reported eradication of a large number of plants and cul- As for eradication of outdoor sites and plants, the United tivation sites. States reported a major decrease in sites eradicated (6,470 Seizures sites eradicated in 2012 compared with 23,622 sites in Seizures of hashish (cannabis resin) Global cannabis herb seizures in 2012 were reported at Fig. 42. worldwideSeizures ofand cannabis in selected resin countries, worldwide 5,350 tons, down from the 6,260 tons reported in 2011. and in selected2003 -countries,2012 2003-2012 With the exception of the Caribbean and Europe, seizures 1,800 have declined slightly in most regions. The largest quantities of cannabis herb were seized in North America, which 1,600 accounts for over 64 per cent of seizures worldwide. 1,400 In contrast to cannabis herb, cannabis resin seizures 1,200 increased in 2012, with 1,269 tons seized, compared with 1,000 Tons 1,058 tons in 2011. Resin seizures increased significantly 800 in Afghanistan, from 62 tons in 2011 to 160 tons in 2012, 600 and in North Africa (mainly due to increases reported in Algeria (rising from 53 tons to 157 tons) and, to a lesser 400 extent, in Morocco (rising from 126 tons to 137 tons). 200 Spain accounts for 26 per cent of global cannabis resin 0 seizures; although seizures in that country declined slightly

from 2011 (356 tons) to 2012 (326 tons). 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Rest of the world Based on an analysis of supply indicators for cannabis herb North Africa at the retail level (see annex for details), availability remains Near and Middle East /South-West Asia high in the Americas and appears to be growing in the Western, Central and South-Eastern Europe subregion of Western and Central Europe and in South- Spain Eastern Europe. Despite reports of falling seizures, con- Pakistan sumer access to marijuana herb is likely increasing in North Morocco America, Oceania, Western and Central Europe and Afghanistan South-Eastern Europe. When retail prices are adjusted by Source: UNODC annual report questionnaire. taking into account purchasing power in order to compare prices worldwide, cannabis herb is found to be relatively Cannabis herb seizures worldwide and Fig. 43. Seizures of cannabis herb worldwide inexpensive in North America, cheapest in Africa and in selected countries, 2003-2012 and in selected countries, 2003-2012 7,000 Fig. 41. Production of cannabis resin in Afghanistan and seizures in neigh- 6,000 bouring countries, 2009-2012

5,000

n 4,000 450 i n

o 400 4,000 3,500 Tons t i ) u c

350 n s ) 3,000 3,000 t o ( ro d esin powder 300 p d t on s 2,500 r ( e 2,000 e z n

250 i d e

t a 2,000 s w

s 200 1,000 t y n i p o 1,400

1,500 1,300 t i n n i 150

s 0 fgh a u a

r e 1,000 A

Q l 100 a 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 oduction in Afghanistan (tons) 500 50 nt i Estimated range of r p r

t e Oceania o 0 0 P 2009 2010 2011 2012 Europe Asia Tonsons ofof cannabiscannabis seizedseized (Afghanistan,(Afghanistan, … Pakistan, Islamic Republic of Iran) Central and South America and Caribbean Africa Estimated range of resin powder production in Afghanistan (tons) North America Point estimate (tons) United States of America Mexico Source: Afghanistan cannabis surveys (published by UNODC) and UNODC annual report questionnaires. Source: UNODC annual report questionnaire. to beincreasing inthe region. nearly halfofthecountriesinAsiaconsidercannabisuse miological datafrom Asiaare from notavailable, experts 2011), butitisnotknown towhatextentthedecrease was 155 154 153 In theUnited States, between 2006 and2010,there was pitalizations related tocannabisusehave beenincreasing. In majorconsumermarkets, treatment enrolment andhos substance of abuse. tries ranking cannabis as the primary ues toexpand, with almosttwo thirds of reporting coun- Worldwide, thecannabismarket (herb andresin) contin- markets Lower perceived riskand increased harm inconsumer Cannabis: marketanalysis again between 2011 and 2012. declined in Canada between 2008 and 2011, increasing followed anupward trend intheUnited States the largestcannabisherbmarket, prevalence rateshave global average. Over thepastfive years inNorth America, regions with prevalence rates considerably higher than the a lesserextent, Western andCentralEurope remain the West and Central Africa, North America, Oceania and, to 2.7 and4.9percentofthepopulationaged15-64years. estimated tohave usedcannabis,corresponding tobetween In 2012,between 125millionand227peoplewere Extent ofuse tivation siteseradicatedare given inthetablebelow. tries reporting highnumbersofcannabisplantsandcul- in theStates ofColoradoand Washington. The othercoun to increasing licitcultivation cannabislaws duetothenew due todeclininglawenforcement activityinthatarea or Source: UNODCannualreport data. questionnaire andgovernment Table 6. Costa Rica Philippines Italy Tajikistan Ukraine United States Country (inorder ofarea eradicated) Brazil Chile Indonesia New Zealand Republic ofMoldova UNODC, annualreport questionnaire for2012. Survey (Ottawa, 2013). Health Canada,2012 CanadianAlcoholandDrug Use Monitoring Future Surveys”. Abuse andMental Health Administration Services ,“Monitoring the United States, ofHealth Department andHuman Substance Services, Countries reporting eradicationofcannabisplantsandsites,2012 154 Although recent epide- 1,224,738 4,114,911 2,180,121 2,200,000 3,631,582 Eradication (outdoors) 965,320 616,133 216,902 341,395 119,059 152,961 Plants 153 but 155 - -

1,318 6,470 159 Ibid. 158 157 156 dependence. to theincreased usedisorders riskofdrug and potency anddependence,thattrend maybecontributing in 2011.Because oftherelationship between increased States increased from 8.7percentin 2007 to11.9percent seized oreradicatedcannabisherbcrops intheUnited of Mississippi, levels oftetrahydrocannabinolin (THC) ing tothePotency Monitoring Project oftheUniversity related treatment admissions. visits department a 59 per cent increase in cannabis-related emergency tion surveyoftheUnitedStates. Source: SubstanceAbuseandMentalHealthServices Administra- Sites 188 129 291 Fig. 44. 5 Threat 2013,p. Summary Assessment 12. United States, Drug Enforcement Administration, National Drug National Drug Threat. Summary Assessment Data from Treatment Episode Data setasreported in the2013 2013), p. 12. tration, United States, ofJustice, Department Drug Enforcement Adminis- Prevalence (percentage) 10 15 20 25 30 35 40 45 0 5 National Drug Threat 2013(November Summary Assessment and older, UnitedStates,2008-2012 of cannabisherbamongpeople12years Lifetime, past-year, andpast-monthuse 159 2008 10.3 Australia Italy Chile New Zealand United States Latvia Switzerland Slovakia 6.1 41

156 Past-month (12+) Past-month (12+) Past-year (12+) Lifetime anda14percentincrease incannabis- 2009 41.5 11.3 6.6 157 2010 41.9 11.5 , 6.9 158 Eradication (indoors) Additionally, accord 302,377 17,668 18,526 21,202 83,450 7,706 Plants 3,796 2,927 2011 41.9 11.5 7 F. Cannabis:overview 2012 42.8 12.1 7.3 1,377 2,596 Sites 322 783 458

4 - 41 WORLD DRUG REPORT 2014 42 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 45. Trends in lifetime use among school Fig. 47. Change in inflation-adjusted retail children, United States, 2008-2013 price, from the biennium 2009-2010 to the biennium 2011-2012, weighted 40 36.4 36.4 36.4 34.8 average (percentage) 35 32.4 32.8 29.8 South-Eastern 28.8 28 Europe 30 26.7 27.5 Central Asia and 23.9 Transcaucasia 25 South America, Central America, and the Caribbean 20 Western & Central Europe 13.7 12.5 12.7 Oceania 15 10.9 11.8 11.4 Eastern Europe 10

Prevalence (percentage) East and South-East Asia 5 Africa 0 North America 2008 2009 2010 2011 2012 2013 Rest of Asia 8th Grade 10th Grade 12th Grade -1 -0.5 0 0.5 1 1.5 2 2.5 3

Source: Monitoring the Future Survey, United States. Source: UNODC annual report questionnaire.

Fig. 46. Average price per gram of cannabis Increase in supply of cannabis herb in South-Eastern herb self-reported by users, by level Europe and Central Asia of quality, United States, 2010-2013 With respect to supply measures, although global seizures 16 have declined 24 per cent (from 7,049 tons in 2010 to 5,351 tons in 2012), the market for cannabis herb has 14 become more diversified, with the largest percentage 12 increases in seized herb noted in markets where cannabis 10 resin had previously been predominant throughout West- 8 ern, Central and South-Eastern Europe. Concomitant with the seizure increases, prices of cannabis herb have increased dollars) 6 significantly in South-Eastern Europe and Central Asia. 4 Since 2009, cannabis prices in Turkey have increased the 2 most among all countries reporting worldwide. Increases Price per gram (UnitedStates 0 in herb price were also noted in the region, in Azerbaijan, 2010 2011 2012 2013 Kazakhstan, Kyrgyzstan, Greece and Uzbekistan. Average price Overall, cannabis resin seizures have increased for the third Low quality straight year, with decreases in the Americas and Europe Source: PriceOfWeed.com. and increases in Africa and Asia. Further, the price of resin has also increased in Kazakhstan, Kyrgyzstan and Pakistan, a regional phenomenon potentially related to higher levels The phenomenon of increased harm is not unique to one of regional interdictions, which is likely resulting in supply specific region. Nearly two thirds of those enrolled in drug shortfalls at the consumer level. treatment in Africa listed cannabis as their primary drug Seizures of cannabis herb now equivalent to cannabis of use, and in Brazil, increasing dependence among can- resin in the European markets nabis users has been reported.160 In a recent national survey in Pakistan, three in four past-year cannabis users There continues to be evidence that cannabis resin is (mostly users of cannabis resin), were found to be depend- decreasing in popularity in Europe. Whereas cannabis resin ent.161 However, among key informants, the herbal form had previously dominated the market, now there are nearly of cannabis (consumed in a traditional drink called equivalent levels of resin and herb seizures, implying a “bhang”) was ranked as the tenth most harmful drug, continuing shift away from imported resin coming mainly whereas resin was ranked as the second most harmful.162 from Morocco to more locally or regionally produced cannabis herb. Unfortunately, drug use surveys typically do not distinguish between cannabis resin and herb; therefore this cannot be corroborated by drug use data. 160 Data from the Brazilian National Alcohol and Drugs Survey (BNADS Price declines in North America together with higher II), Cannabis use in Brazil, 2012. potency levels 161 UNODC and Pakistan, Drug use in Pakistan, 2013. 162 Ibid. Regarding the cannabis herb market in countries with regu- 169 168 167 166 165 164 163 concern that“a numberofStates thatare tothe parties The International Narcotics Control Board hasexpressed legal, production, distributionandconsumptionofmarijuana rado guay Recent policy changes to cannabis regulation in Uru Changing cannabispolicyintheAmericas variable, indicatingmore retail market integration. price ofcannabisherbintheUnited States hasbecomeless ties ofcannabisherbhave converged, implyingthatthe has risen40percent.Overall, thepricesofvarious quali- per cent,andthepriceofmedium-qualitycannabisherb but thepriceofhigh-qualitycannabisherbhasfallen20 the price,adjustedforquality, hasfallenonly6percent, chases reported tothePriceOfWeed website, since2010, inflation. According toself-reported informationonpur- cannabis herbdeclined12percent Between 2009and2012intheUnited States, thepriceof changes inratesofinterdiction andinpricesare expected. changessuchastheUnitedlatory States andUruguay, Source: UNODCannualreport questionnaire Fig. 48. For non-medicaland non-scientificuses. prohibit cannabisproduction, trafficking andpossession. The United States federalControlled Substances Act continuesto sect. 16).Available atwww.fcgov.com/mmj/pdf/amendment64.pdf. (United States, ConstitutionoftheState XVIII, ofColorado,art. Data from Amendment64:Use and Regulation ofMarijuana pdf. Available athttp://lcb.wa.gov/publications/Marijuana/I-502/i502. United States, State of Washington, Initiative Measure No. 502. tion andsaleforrecreational use. use. legislation nowThe new permitscannabiscultivation, produc- “reasonable quantity” intendedexclusively (ofanydrug) for personal law legislationalready exempted from punishmentthepossessionofa Uruguay, LawNo. 19.172.In Uruguay, priortopassingofthenew website. mation fortheUnited States, submittedtothePriceOfWeed.com Price dataretrieved onself-reported price,qualityandlocationinfor- UNODC, annualreport questionnaire. 167 165 169 Ratio of cannabis resin: cannabis herb intheUnited States andinthestatesof Washington undersomeconditions,suchaspurchasing age. 1 1 1 1 1 2 0 2 4 6 8 0 0 2 4 6 8 Trends inseizures ofcannabisresin andherb,Europe, 2003-2012 2 0 0 3

2 0 0 4 2 0 0 5 168 2 0 now maketheauthorized 0 6 163 2 0 afteradjustmentfor 0 7 2 0 166 0 8 andColo 2 0 0 9 164 2 0 1 0 - - 2 0 1 sider the negative impact of such developments.” In the ments andtheinternationalcommunitytocarefully con- than medicalandscientificones” anditurged“all Govern intended toregulate theuseofcannabisforpurposesother 1961 Convention are consideringlegislative proposals 173 172 171 170 thatpromoteadvertisements andencourageconsumption. zation impliesmotivated selling,whichcanleadtodirected behaviours.Commerciali also significantlyaffectdrug-use market willchange,thecommercialization ofcannabismay tion duction, personalcultivation andretail commercializa a licitsupplychain,includinglarge-scalelicensingforpro “medical” cannabislawsby allowing theestablishment of from current casesofdepenalization, decriminalizationor legislationcoulddiffersubstantially The impactofthenew the contextsofeachjurisdiction. changes, butrathermeasurabledistinctchangesreflecting there isunlikelytobeoneuniformimpactofthesepolicy Because oftheseandothernotabledifferences ineachlaw, limit on the amount that can be purchased each month. of cumulative purchasescentral registry per buyer nor any chases ofupto1oz(28g)are allowed peroutlet,withno 40 g per month), in adatabasetomonitorcumulative purchases (maximum significantly. For example,inUruguay usersmustregister lawsvary details, designandimplementationofthenew session andconsumptionofcannabisare now legal, the Although in those three jurisdictions, the purchase, pos will leadtoanincrease inrelated publichealthcosts”. Board’s opinion “the likely increase in the abuse of cannabis 1 2 0 173 mote production, consumption andprofits. enter themarket anduseanymeansthatare withinthelawtopro- In thestates ofColoradoand Washington, for-profit businessescan United States, State 2. ofColorado,Amendment64,sect.5,part Uruguay, LawNo. 19.172. INCB/2013/1). Report oftheInternational Narcotics Control Board for2013(E/ 1 2 of the market. While it is not yet clear how the 0 2 4 6 8 1 1 1 0 0 0 0 , , , 0 2 4 0 0 0 0 0 0 0 0 0 0 Quantity seized (tons) 171 but in the State of Colorado, pur ( resin tocannabisherbweight Ratio ofse ( S ( S ( resin tocannabisherbweight Ratio ofse E E E We e e uro urop urop i i z z ure ure s tern pe e e s s ) ) )

of of & Ce i i z z cannabis cannabis ur ur ntr e e s s of of a l F. Cannabis:overview

E cannabis cannabis u re he rope s rb i n ) 170 172 ------

43 WORLD DRUG REPORT 2014 44 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

For instance, in the case of tobacco companies, advertising a risk of heavy dependence, lung problems, memory was directed to attract new users, which resulted in effec- impairment, psychosocial development problems and tive marketing to youth.174 mental health problems, and poorer cognitive performance associated with early initiation and persistent use between Because laws of this kind have never before been enacted the early teenage years and adulthood.180, 181 For youth or implemented in a national or state jurisdiction, no pre- and young adults, more permissive cannabis regulations vious case studies are available to predict what changes correlate with decreases in the perceived risk of use,182 and should be expected. Thus, monitoring and evaluation will lowered risk perception has been found to predict increases provide critical data for policymakers. For this reason, it in use.183 is important that the impacts of this legislation are measured against a number of factors, ranging from the impact Although it is an important metric to monitor, increases on health and criminal justice (effects on the individual as in prevalence of cannabis use may not provide a reliable well as institutions and society) to the balance of public revenues against costs and to other social impacts. Services Administration has shown initiation of marijuana use At this time, countries and states surrounding Uruguay, before the age of 15 is associated with higher risk of other drug use Colorado and Washington have not adopted similar regu- at 26 or older, and that those who tried marijuana before the age latory or legislative measures. In consideration of this, addi- of 15 were six times more likely to be dependent on an illicit drug at 26 or older (relative to those who initiated marijuana at 21 or tional outcomes that need to be monitored include drug older). (See Joseph C. Gfroerer, Li-Tzy Wu and Michael A. Penne, tourism, cross-border leakage and access and availability Initiation of Marijuana Use: Trends, Patterns, and Implications, Sub- to youth in neighbouring jurisdictions. stance Abuse and Mental Health Services Administration, Rockville, Maryland, 2002.) Health 180 M. H. Meier and others, “Persistent cannabis users show neuro- psychological decline from childhood to midlife, Proceedings of the While research has not conclusively established the impact National Academy of Sciences of the United States of America, vol. of more lenient laws on cannabis consumption, an increase 109, No. 40 (October 2012), pp. E2657-E2664. in prevalence of cannabis use from recreational use sales is 181 A. Caspi and others, “Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the expected, although it is also possible that the primary effect catechol-Omethyltransferase gene: longitudinal evidence of a gene X – particularly in the first decade or so – may differ from environment interaction”, Biological Psychiatry, vol. 57, No. 10 (15 longer-term impacts. Expert analyses predict that the legali- May 2005), pp. 1117–1127; Wayne Hall and Louisa Degenhardt, “Adverse health effects of non-medical cannabis use”, The Lancet, vol. zation of cannabis will most likely reduce production costs 374, No. 9698 (October 2009), pp. 1383–1391; Wayne Hall, “The 175 substantially, which would in turn be expected to put adverse health effects of cannabis use: What are they, and what are downward pressure on prices over time, although whether their implications for policy?”, International Journal of Drug Policy, vol. 20, No. 6 (2009), pp. 458–466; A. D. Schweinsburg, S. A. lower prices materialize in the first few years or only in the Brown and S. F. Tapert, “The influence of marijuana use on neuro- longer term is unknown. Since cannabis consumption cognitive functioning in adolescents”, Current Drug Abuse Review, responds to prices, the lower price will probably lead to vol. 1, No. 1 (2008), pp. 99–111; D. M. Fergusson and J. M. Boden, 176 “Cannabis use and later life outcomes”, Addiction, vol. 103, No. higher consumption. It is estimated that for each 10 6 (2008), pp. 969–976 and discussion pp. 977–968; E. Gouzou- per cent drop in price, there will be an approximately 3 lis-Mayfrank, “Dual diagnosis psychosis and substance use disorders: per cent increase in the total number of users177 and a 3-5 theoretical foundations and treatment” [article in German], Zeitschrift 178 für Kinder- und Jugendpsychiatrie und Psychotherapie, vol. 36, No. 4 per cent increase in youth initiation. (2008), pp. 245–253; J. Macleod and others,“Psychological and social sequelae of cannabis and other illicit drug use by young people: a Initiation and use among youth and young adults is of systematic review of longitudinal, general population studies”, The particular concern due to the established increased risk of Lancet, vol. 363, No. 9421 (2004), pp. 1579–1588; John Curtis, harm, such as other drug use and dependent drug use,179 “Study suggests marijuana induces temporary schizophrenia-like effects”, Yale Medicine, vol. 39, No. 1 (Fall/Winter 2004); “Neuro- toxicology: neurocognitive effects of chronic marijuana use charac- 174 United States, Center for Public Health and Tobacco Policy, “Cause terized”, Managed Care Weekly Digest (16 May 2005); J. McGrath and effect: tobacco marketing increases youth tobacco use - findings and others, “Association between cannabis use and psychosis-related of the 2012 Surgeon General’s report (Boston, 2012). Available at outcomes using sibling pair analysis in a cohort of young adults”, www.tobaccopolicycenter.org/documents/SGR%20NY%205-25-12. Archives of General Psychiatry, vol. 67, No. 5 (2010), pp. 440-447; L. pdf. Goldschmidt and others, “Prenatal marijuana exposure and intelli- 175 Researchers estimate that the pre-tax retail price will decline by more gence test performance at age 6”, Journal of the American Academy of than 80 per cent, but the eventual consumer price will depend on Child and Adolescent Psychiatry, vol. 47, No. 3 (March 2008), pp. 254- the tax-structure. See Beau Kilmer and others, Altered State? Assessing 263; J. M. Tertrault and others, “Effects of marijuana smoking on How Marijuana Legalization in California could Influence Marijuana pulmonary function respiratory complications: a systematic review”, Consumption and Public Budgets (Santa Monica, California, RAND Archives of Internal Medicine, vol. 167, No. 3 (2007), pp. 221-228; Corporation, Drug Policy Research Center, 2010). BMJ-British Medical Journal, “Cannabis use doubles chances of vehicle crash, review finds”, in Science Daily (10 February 2012). 176 J. P. Caulkins and others, “Design considerations for legalizing cannabis: lessons inspired by analysis of California’s Proposition 19”, 182 S. Khatapoush and D. Hallfors, “Sending the wrong message: did Addiction, vol. 107, No. 5 (2011), pp. 865-871. medical marijuana legalization in California change attitudes about and use of marijuana”, Journal of Drug Issues, vol. 34, No 4 (Octo- 177 Beau Kilmer and others, Altered State? ber 2004), pp. 751-770. 178 Rosalie Liccardo Pacula, “Examining the impact of marijuana legaliza- 183 See L. D. Johnston and others, Monitoring the Future National tion on marijuana consumption: insights from the economics litera- Survey Results on Drug Use 1975-2012: Key Findings on Adolescent ture” (RAND Corporation, Working Papers, July 2010). Drug Use (Institute for Social Research, University of Michigan, 179 Research by the United States Substance Abuse and Mental Health 2012). the United States found that while cannabis-related hos- that decriminalized drug possessionforpersonaluseinthat decriminalized drug lawreformsof othersubstances.Afterdrug inPortugal effect whereby greater useofcannabisleadstogreater use suchasheroin) or,drugs conversely, acomplementary replaces othersubstances(suchasalcoholormore harmful determine if there is a substitution effect whereby cannabis to to try Looking at the health impact, it is also important also becarefully monitored. as well astheage ofinitiationandsustaineduse—should areas ofharmfuluse—suchasheavy and harmhasnotbeenconclusively established).Critical than inpastyears (althoughaclearlinkbetween potency lawsandmayleadtogreaterthe new healthconsequences translate intomore potentcannabisbeingavailable under cannabis inEurope andNorth America, that there is a general, demonstrated increased potency of use cannabisonlyoccasionally. One aspecttoconsideris estimate ofthegreatest impactonhealth,sincemanyusers 189 188 187 186 185 184 such asincarceration. In countrieswithdepenalization can range from a warning to more severe consequences, possessionforpersonaluse,andpenalties system fordrug to whichanindividualwillencounterthecriminaljustice control conventionsnational drug determinestheextent The different wayscountries have implementedtheinter- inthelegislation. to explicitlimitationssetforth bution, willcontinuetorequire routine monitoringowing nabis-related activities, suchascultivation, saleanddistri laws,whereasthe contextofnew control ofothercan- sonal consumption are likely to decrease significantly in Criminal justiceprocedures related topossessionforper- Criminal justice went down.drugs cannabis intheperiod1975-1978,admissionsforother pital admissionswent upafterthedecriminalizationof cocaine remained stableat4-6percent. for heroin decreased from 33per centto15percent,and of referrals in2001to65percent2005,butreferrals 2001, referrals non-scientific purposes, butthere are to variations from country associated withpossessionoruseofcannabis fornon-medicalor titatively (amountofpenalty)orqualitatively (typeofpenalty), Depenalization refers toanypolicythatreduces penalties,quan- pp. 737-747. American Statistical, vol. 88,No. Association 423(September 1993), episodes:1975-1978”,Journalpital emergencyroom drug ofthe Model, effectofmarijuanadecriminalisationonhos- Karyn “The kent.ac.uk. Drug Policy Programme, December 2007).Available athttp://kar. useinPortugal”,of drug Briefing Paper 14(Beckley Foundation Caitlin Hughes andAlexStevens, effectsofdecriminalization “The cia). addiction”of drug (ComissõesparaaDissuasão da Toxicodependên- Panel ofthree peopleknown asthe“commission forthe dissuasion Heavy useisdefinedasdailyornearuse. January 2014),pp. 308-319. on potency”, International Journal Policy ofDrug , vol. 25,No. 2(18 effectsofmedicalmarijuanalaws E. L.Sevigny andothers,“The 186 forcannabisincreased from 47percent 188

185 ordependentuse, 187 184 One studyin whichmay 189 -

194 193 UNODC, 192 191 190 viduals whohadbeengiven onlyinfringementnotices; tions for cannabis offences with a second group of indi- area, agroup ofindividualsthatreceived criminalconvic- example, a research study in Australia compared, in one tutional criminal justice system and the individual. For regarding cannabis possession affect both the broader insti ingly permissive lawsoncannabisisnotaneasytask.Laws To estimatetheoverall criminaljusticeimpactofincreas- were ultimatelyprosecuted, convictedandincarcerated. no datathatcanshow how manyofthoseapprehended region oftheworld. majority ofcasesinevery There are encounters with authorities, cannabis is involved in the lawoffences)). drug-related crime(drug offences has increased by one third (see the section on pected orarrested useandpossession )forpersonaldrug people whohave beenincontactwiththeauthorities(sus Over thepastdecade,across 45countries,thenumberof ington meansthatnosuchmechanismisprovided for. cannabis in Uruguay and the states of Colorado and Wash or rehabilitation. legalstatusofthepossession The new whereby theindividualwouldstillfacesomeconsequences eliminated, butthere remains acriminaljustice encounter of possessionforpersonaluse,penaltiesare reduced or analysis ofthepotentialimpactcannabislegalizationin 20-30 per cent cuts in profits. tives that passed inColorado and Washington —with losses of nearly $3 billion fromestimate the cartel initia- Although littleresearch isavailable onthetopic,experts and Washington smallcannabismarket). constituteavery their populationsizes, Uruguay andthestatesofColorado only modestlyaffectedaftercannabislegalization.(Given cocaine, heroin andmethamphetamine)would likelybe markets (e.g., ating inotherillicitactivitiesanddrug much ofcannabiscultivation islocal, isunknown. cartels criminal networks Because ofdrug so change in several cases, the expected impact on the broader Although ithasbeenmentionedasarationaleforpolicy offence. lems andaccommodationdifficultiesattributedtotheir employment consequences,recidivism, relationship prob those convictedwere farmore likelytoexperienceadverse Available atwww.imco.org.mx. técnico”, Alejandro Hope andEduardo Clark, “Si losvecinos legalizan:reporte (Oxford University Press, 2010). Robin Room andothers,Cannabis Policy Moving Beyond Stalemate vol. 10,No. 4 (1999), pp. 299-303. Australia andtheirevaluation”, International Journal Policy ofDrug , S. Lentonandothers,“Lawsapplyingtominorcannabisoffencesin arrested for cannabis-related offencesin2011. drug number ofarrests isseenintheEuropean Union, withnearly800,000 year forcannabispossession.Asimilarorder ofmagnitudeinthe In theUnited States, approximately 750,000peopleare arrested each penalties ortonopenalties. possession oruse,from criminalpenaltiestoadministrative orcivil inalization impliesachangeinthenature oftheconsequences intherespective lawsand howcountry theyare enforced. Decrim- 191 , 192 Instituto Mexicano para laCompetitividad(October 2012). World Report 2011. Drug

194 However, in another 193 drug cartels oper- cartels drug 190 F. Cannabis:overview Amongthese - - - -

45 WORLD DRUG REPORT 2014 46 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

the state of California on Mexican drug trafficking organi- G. AMPHETAMINE-TYPE zations, researchers concluded that legal changes in one state (in this case, California) would not be enough to STIMULANTS: OVERVIEW greatly diminish the market for Mexican cannabis, but if Production, trafficking and prices dropped significantly nationwide as a result of the consumption spillover to other states, cartel revenue could be affected substantially in the long term. The authors could not une- While it is difficult to quantify the global production of quivocally predict a decline in drug-related violence in ATS, the number of ATS-manufacturing laboratories that Mexico as a result of cannabis legalization, as there was no were dismantled increased from 12,571 (12,567 ATS labs basis for comparison.195 in addition to four labs producing ATS in conjunction Economic costs and benefits with non-ATS substances) in 2011 to 14,322 in 2012 — nearly all of these (96 per cent) were manufacturing meth- Tax revenues from retail cannabis sales may provide sig- amphetamine. In North America, methamphetamine nificant revenue, although there is uncertainty concerning manufacturing has expanded again. In 2012, a large how much can be raised. In the ballot initiative of Colo- increase in methamphetamine laboratories seized was rado, it was stipulated that tax revenues from the sale of reported by the United States (12,857 in 2012 from cannabis were to be used to provide $40 million for school 11,116) and Mexico (259 from 159). A significant increase construction. Based on assumptions about the size of the in the number of amphetamine laboratories dismantled in market, it was estimated that the ballot measure would 2012 was reported by the United States (from 57 to 84) bring in as much as $130.1 million in revenue over the and the Russian Federation (from 27 to 38). period 2014-2015.196 Legalization may also increase income and social security tax revenues by shifting labour For the second year, ATS seizures reached an all-time high from criminal to legal and taxed activities. of 144 tons, up 15 per cent from 2011, due in large part to increases in methamphetamine seizures. Over the past However, in Uruguay and the states of Washington and five years, methamphetamine seizures have almost quad- Colorado, significant costs will also be incurred through rupled, from 24 tons in 2008 to 114 tons in 2012. Of the the establishment of programmes to deter cannabis abuse total of 144 tons of ATS seized globally in 2012, approxi- and regulate the new industry. Based on assumptions mately half were seized in North America alone and regarding the size of the consumer market, it is unclear approximately a quarter in East and South-East Asia. Large how legalization will affect public budgets in the short or quantities of amphetamine seizures continue to be reported long term, but expected revenue will need to be cautiously in the Middle East, in particular by Jordan, Saudi Arabia balanced against the costs of prevention and health care. and the Syrian Arab Republic. In addition to the impact on health, criminal justice and the economy, a series of other effects such as consequences Seizures of “ecstasy” have resurged after the drop in 2011. related to security, health care, family problems, low per- Major quantities of “ecstasy” were seized in East and South- formance, absenteeism, car and workplace accidents and East Asia, followed by Europe (South-Eastern Europe and insurance could create significant costs for the state. It is Western and Central Europe). All three regions account also important to note that legalization does not eliminate for nearly three quarters of global “ecstasy” seizures. trafficking in that drug. Although decriminalized, its use and personal possession will be restricted by age. Therefore, Amphetamine-type-stimulants: the gaps that traffickers can exploit, although reduced, will market analysis remain. Diversification and expansion of the global The collection of reliable data both before and after these methamphetamine trade policy changes will support the evaluation of the health, criminal justice and economic consequences of the new In 2012, methamphetamine accounted for the majority of regulatory frameworks. Further, careful study of the effects ATS seizures (80 per cent), approximately 114 tons of the on local and transnational organized crime networks will total 144 tons of ATS seized worldwide. Nearly two thirds allow evidence-based decisions to inform policy in this area (64 per cent) of global methamphetamine seizures occurred at the national and regional levels. The impact of this in North America, and one third in East and South-East legislation can be evaluated only if it is appropriately Asia. Although Mexico, the United States, China, Thailand measured through reliable data-gathering and regular and Iran (Islamic Republic of), in that order, continue to monitoring efforts. report the highest amounts of methamphetamine seized worldwide, there is evidence that methamphetamine trafficking is becoming more global in nature, with noteable 195 Beau Kilmer and others, Reducing Drug Trafficking Revenues and increases from 2011 to 2012 observed in West and Central Violence in Mexico, Would Legalizing Marijuana in California Help? (Rand Corporation, 2010), e-book. Africa (from 45 kg to 598 kg) and Oceania (from 457 kg 196 See “The fiscal impact of Amendment 64 on state revenues” (Colo- to 2,283 kg). Growing methamphetamine markets have rado, Colorado State University, 24 April 2013). also been observed in Central Asia and Transcaucasia, as 198 197 kg in2008totheequivalent of44tonsin 2012 (aggregat of methamphetamine seized in Mexico increased from 341 production inMexico. Over thepastfive years, the amount increases andprecursor indrug seizures, expanded againinrecent years asevidencedby significant In North America,methamphetamine manufacturing has in Pakistan. West Asia,withrecent detectionofmethamphetamineuse In addition,methamphetaminemarkets grew inSouth- 2008 to76kgin2012. seizures reported increased from lessthanakilogramin Note: Total ATS includesamphetamine,“ecstasy”-typesubstances,methamphetamine,non-specifiedATS, otherstimulantsandprescriptionstimulants. Source: UNODCannualreport questionnaire andotherofficial sources. sources. Source: UNODCannualreport questionnaire and other official Fig. 50. Fig. 49.

P UNODC andP and Psychotropic Substances of1988(E/INCB/2012/3). the United Nations Convention againstIllicit Traffic inNarcotic Drugs Narcotics Control Board for2012 on theImplementation ofArticle 12of Narcotic andPsychotropic Drugs Substances: Report of theInternational SeizuresAmount (equivalent seized (tons)in tons) recursors andChemicalsFrequently Used intheIllicit Manufacture of 10 15 20 25 30 35 40 45 50 0 5 Seizures (equivalent in tons)

Weight (tons) 13 Mexico 197 100 120 140 160 amphetamine seizures, 2010-2012 Countries r Global seizur 20 40 60 80 31 0 44 Drug useinPakistanakistan, Drug , 2013. 0320 0520 0720 0921 012012 2011 2010 2009 2008 2007 2006 2005 2004 2003 54 States of States America 14 United 24 29 eporting thehighestmeth- 73 es ofamphetamine-typestimulants,2003-2012 10 China 14 60 16 Thailand 6 198 10 63 withlarge-scale 10 Republic 66 (Islamic 1 Iran of) 2010 2012 2011 4 3 58 - 77 nited States, Drug Enforcement Administration, “National Drug 199 North America”). purity and potency following precursor regulations in the box “Does supply control work? Methamphetamine following restrictions onprecursor accessinMexico (see of methamphetamineishigh,thepotencylikelydecreased of2012.Althoughthepurity cent inthesecondquarter in theUnited States continued to increase, reaching 93 per in Mexico in2005and2007,methamphetaminepurity availability ofprecursors andthemanufacturingprocesses States-Mexico border. half of the seizures in the United States occur at the United United States Drug Enforcement Agency, approximately in 2012,upfrom 9.5tonsin2008.According tothe United States continuestoseize largequantities,29tons ing seizures reported by weight and by volume). The Source: UNODCannualreport questionnaire. Fig. 51.

Seizures (equivalent in kilograms) Threat Summary” Assessment (November 2013). U Seizures (kilograms) 50,000 10,000 20,000 30,000 40,000 Other stimulants Non-specified ATS Methamphetamine 75 -

Oceania stimulants inSouth-EastAsiaand Seizur 125 0820 0021 2012 2011 2010 2009 2008 144 es ofamphetamine-type 199 G. Amphetamine-typestimulantss:overview After several disruptions tothe Afterseveral disruptions Methamphetamine substances Ecstasy-type Amphetamine Total Prescription stimulants Amphetamine substances "Ecstasy"-type

47 WORLD DRUG REPORT 2014 48 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Does supply control work? Methamphetamine purity and potency following precursor regulations in North America Methamphetamine production is dynamic, with multiple processes capable of producing the same end product. The two most common methods are (a) phenylacetic acid > 1-phenyl-2-propanone (P-2-P) > methamphetamine or (b) pseudoephedrine/ephedrine > methamphetamine. P-2-P production methods result in a less potent form of methamphetamine because of the contamination of the potent d-isomer with the less potent l-isomer, known as a racemic mixture.

In the United States, in the early 1990s, methamphetamine was produced using ephedrine, which was restricted by the United States ephedrine single ingredient product regulation in 1995, resulting in a drop from nearly 80 per cent purity to approximately 20 per cent. In the following years, the purity increased during the subsequent two years and dropped in 1998, after the adoption of further pseudoephedrine/ephedrine product regulations. After early 1999, despite several precursor regulations in the United States and Canada, the purity continued to increase until 2005, when Mexico initiated precursor control programmes. Subsequently, purity again dropped, climbing briefly and then dropping again after the arrest of a large supplier to Mexico.1 Since 2007, the purity has increased, now reaching 93 per cent. However, according to researchers, this high-purity methamphetamine is less potent because it is a racemic mixture. Because the lower potency is associated with less dependence, authors conclude the supply of harmful methamphetamine has in fact, decreased.2

Price and purity of methamphetamine in the United States, 2005-2012 16,000 100

14,000 90 80 12,000 70 10,000 60 8,000 50

6,000 40 30 4,000 (percentage) Purity Price per gram in US dollarsUS in gram per Price 20 2,000 10

0 state precursor regulation Texas Mexico reduction in psuedophedrine imports Domestic restrictions on psuedophedrine Gon/Unimed Pharm Chem de Mexico Closure of Ye precursor chemical company Mexico prescription requirement Mexico precursor chemical ban 0 Jul-Sep11 Jul-Sep10 Jul-Sep09 Jul-Sep08 Jul-Sep07 Jul-Sep06 Jul-Sep05 Apr-Jun12 Apr-Jun11 Apr-Jun10 Apr-Jun09 Apr-Jun08 Apr-Jun07 Apr-Jun06 Apr-Jun05 Oct-Dec11 Jan-Mar12 Oct-Dec10 Jan-Mar11 Oct-Dec09 Jan-Mar10 Oct-Dec08 Jan-Mar09 Oct-Dec07 Jan-Mar08 Oct-Dec06 Jan-Mar07 Oct-Dec05 Jan-Mar06

Bulk dollars/ gram Purity

Source: Data from the System to Retrieve Information from Drug Evidence (STRIDE) database of the United States Drug Enforcement Agency.

1 J. K. Cunningham, L. M. Liu and R. Callaghan, “Impact of US and Canadian precursor regulation on methamphetamine purity in the United States”, Addiction, vol. 104, No. 3 (March 2009), pp. 441-453. 2 J. K. Cunningham and others, “Mexico’s precursor chemical controls: emergence of a less potent types of methamphetamine in the United States”. Drug and Alcohol Dependence, vol. 129, Nos. 1 and 2, (April 2013), pp. 125-136.

Seizures of methamphetamine have been surging in East Darussalam, Cambodia, Singapore and Viet Nam. After a and South-East Asia and Oceania. Between 2011 and drop in seizures in 2010, Myanmar reported seizures of 2 2012, approximately 70 per cent (12 of 17 countries) of tons compared with 33 kg in 2011.200 the reporting countries in the region noted an increase in Emergence of methamphetamine in South-West and seizures of methamphetamine. Although China and Thai- Central Asia land regularly seize the largest amounts, those numbers increased only marginally in relative terms from 2011 to Central Asia is emerging as an ATS market, reporting 253 2012, while the quantity of methamphetamine seized in kg of ATS seizures, 183 kg of which were reported by Australia increased over 400 per cent, from 426 kg to 2,268 Kazakhstan. For the first time, in 2012, Tajikistan reported kg. Major increases were observed in countries that regularly report smaller numbers of seizures, such as Brunei 200 UNODC annual report questionnaire and other official sources. seizures of63kgmethamphetamineand21,740tablets 203 202 201 13.9 millionto54.8estimatedusers.ATS use monly usedgroup ofillicitsubstancesworldwide,with ATS, excluding “ecstasy”, constitutethesecondmostcom Extent ofamphetamine-type stimulantand“ecstasy” use markets. years, with amphetamine trafficking moving to other methamphetamine traffickinghastakenplaceinrecent In neighbouring Turkey, a shift towards “ecstasy” and Republic, inthatorder. are those of Saudi Arabia, Jordan and the Syrian Arab zures (56 per cent). In the region, the largest seizure totals seized in2012,representing more thanhalfofglobalsei- Near andMiddle East/South-West Asia,withover 12tons Amphetamine continuestodominatethemarket inthe Amphetamine reported 3.8tons. of ephedrineseizures, andIran (Islamic Republic of) methamphetamine. In 2011, India reported over 6 tons been increases in seizures of ephedrine, a precursor of to reports madetoINCB According usesurveys. had beenundetectedinpriordrug marks anemergenceofthesubstanceinarea, which inthepastyear.aged 15-64)hadusedthedrug imately 19,000people(0.02percent ofthepopulation first timeinanationalsurvey, whichestimatedthatapprox In Pakistan, methamphetamineusewasdetectedforthe of Iran destinedforSouth-East Asia(Malaysia). cepted alargeamountshippedfrom theIslamic Republic was from oneincidentinwhichcustomsofficialsinter of “ecstasy”. The methamphetamineseized in Tajikistan Source: International NarcoticsSource: Control International Board annualreport 2013 Fig. 52.

ous reports. International Narcotics Control Board annual report 2012 andprevi- UNODC andPakistan, useinPakistan Drug , 2013. (CARICC) Information Bulletin No. 114,11June 2012. Central AsianRegional Information andCoordination Centre Seizures (kilograms) 1,000 2,000 3,000 4,000 5,000 6,000 7,000 0 (Islamic Republicof),2010-2011 Ephedrine seizures inIndiaandIran India 1 , 848 2010 203 2,738 Iran, Islamic Republic of , intheregion there have also 6,308 2011 3,809 201 202 That

- - - 204 tries in these regions consider ATS use on the rise. Oceania and Africaare from notavailable, mostofthecoun experts estimatesofATSper centin2011.Whilenew useinAsia reported inMexico, from 0.02percentin2008to0.12 highest levels since1997. workforce, however, nearlytripledin2012,reaching the amine andmethamphetamineamongtheUnited States cent in2012. The positive ratesofurinanalysisforamphet all ATS prevalence from 1.8percentin2011to2.1 has increased (see figure 56), leading to an increase in over prevalence ofothertypesstimulants(amphetamines) has remained stableforthepastthree years. However, the amphetamine usewere down, and the past-year prevalence use. In theUnited States, treatment admissionsformeth- estimates forNorth Americaindicateanincrease inATS decrease inATS usein Western andCentralEurope, the Within the different regions, while there is a reported remained stablein2010and2011,butincreased in2012. Source: UNODCannualreport questionnaire. Source: UNODCannualreport questionnaire. Fig. 54. Fig. 53.

New Jersey, November 2013). United States, Quest Diagnostics, “Drug Testing Index”, (Madison, Seizures (equivalent in Quantity (equivalent in kilograms) kilograms) 2 1 1 1 1 1 10,000 15,000 20,000 25,000 , , , , , , 5,000 2 4 6 8 0 0 2 4 6 8 A “Ec 0 0 0 0 0 0 0 0 0 0 m 0 0 0 0 0 0 0 0 0 0 0 - stimulants inTurkey, 2008-2012 Seizures ofamphetamine-type Republic, 2008-2012 Saudi ArabiaandtheSyrianArab Amphetamine seizures inJordan, s phe ta s 2 y”- ta 008 2008 m Syrian Arab Republic Arab Syrian Arabia Saudi Jordan ty i ne pe G. Amphetamine-typestimulantss:overview

s 2 204 ubs 0 2009 0 Anincrease inprevalence was 9 ta nc e 2 s 010 2010 Metha 2011 m 2011 phe ta

m 2012 2012 i

- - - 49 WORLD DRUG REPORT 2014 50 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Fig. 55. Seizures of amphetamine-type Fig. 56. Prevalence of past-year methampheta- stimulants in Central America, South mine and stimulant use and treatment America and the Caribbean (2008-2012) admissions for methamphetamine, 300 among persons 12 years or older, United States, 2008-2012 250 1.4 125,000

200 1.2 120,000 1 115,000 150 0.8 110,000 100 0.6 105,000 50 0.4 100,000 0 0.2 95,000 2008 2009 2010 2011 2012 older (percentage) Seizures (equivalent in kilograms) 0 90,000 Non-specified ATS Methamphetamine 2008 2009 2010 2011 2012 Treatment admissions (number) Past year use amongthose 12 and "Ecstasy"-type substances Amphetamine Treatment admissions for methamphetamine

Source: UNODC annual report questionnaire. Prevalence of methamphetamine use among those 12 and older Prevalence of stimulant use among those 12 and (2.1 per cent) Central America and North America (1.3 older per cent and 1.4 per cent respectively) are the regions with Source: Survey results of the United States Substance Abuse and Mental Health Services Administration Treatment Episode Data prevalence rates higher than the global average, while the Set, 2000-2011, national admissions to substance abuse treat- rates in West and Central Africa and Asia remain compa- ment services. rable to the global rates of ATS use. of misuse of prescription stimulants of 1.3 per cent, the “Ecstasy” rate is nearly 4 times higher among the youth population. A similar pattern of higher rates of misuse of prescription With between 9.4 million and 28.2 million estimated past- stimulants is seen in the other countries, with the excep- year users in 2012, its use declined globally in the period tion of El Salvador, where the prevalence is quite low 2010-2012, mainly in Western and Central Europe. Nev- among youth, 0.2 per cent, compared with 3.28 per cent ertheless, Oceania (2.9 per cent), North America (0.9 per among the adult population. cent) and Europe (0.5 per cent) remain regions with prevalence rates higher than the global average of 0.4 per cent. Increase in ketamine and mephedrone treatment admissions in the United Kingdom Misuse of prescription stimulants In the United Kingdom, there has been a decrease in preva- The misuse of prescription stimulants or medications for lence of ketamine and mephedrone use in England and attention deficit hyperactivity disorder is not uncommon, Wales among both the adult population (aged 16-59) and although only a few countries report prevalence of misuse young adults (aged 16-24).205,206 However, there has been among the general and youth population. With the excep- an increase in the number of people seeking treatment for tion of Indonesia, all countries reporting misuse of pre- ketamine and mephedrone over the past six years. Although scription stimulants are from South and North America. users of ketamine and mephedrone account for only 10 This, however, does not preclude that misuse of prescrip- per cent of young people in specialist services and 2 per tion stimulants is not common in the other countries or cent of adults in treatment, there are clear signs of an regions. Rather, the detection of such misuse in some coun- increase in treatment demand for drug use disorders related tries may be related to better monitoring. The prevalence to club drugs such as ketamine and mephedrone in the of misuse of prescription stimulants varies considerably United Kingdom. While “ecstasy” remains the most among the few countries reporting, ranging from 3.28 per common club drug reported in treatment demand, the cent among the general population in El Salvador to 0.1 number of ketamine and mephedrone users seeking treat- per cent in Argentina. With the exception of El Salvador, ment has risen between 2005/06 and 2010/11.207 Indonesia and Costa Rica, the misuse of prescription stimulants is higher among men. In El Salvador, the prevalence is 3.7 per cent among women compared with 2.78 per cent 205 The annual prevalence of mephedrone declined from 1.1 per cent in 2011/12 to 0.5 per cent in 2012/13 in the adult population and among men. from 3.3 per cent to 1.6 per cent among young adults, while ketamine annual prevalence has declined from 0.6 per cent to 0.4 per cent in Compared with rates for the general population, countries the adult population and from 1.8 per cent to 0.8 per cent among report a higher level of misuse of prescription stimulants young adults over the same period. among the youth population (mostly those 15-16 years 206 United Kingdom, Home Office, “Drug misuse: findings from the old). In Costa Rica, compared with the annual prevalence 2012/13 Crime Survey for England and Wales” (London, July 2013). 207 United Kingdom, National Treatment Agency for Substance Misuse, Venezuela (Bolivarian Republic of) Republic (Bolivarian Venezuela Venezuela (Bolivarian Republic of) Republic (Bolivarian Venezuela 208 gence of new psychoactivegence ofnew substancesincountries in of July 2012. This increase wasdue toreports oftheemer their markets, upfrom 70outofatotal80countriesas countries reported the emergence of such substances on active substanceswasavailable asofDecember 2013,94 psychoOf 103countriesforwhichinformationonnew - Update H. Source: UNODCannualreport questionnaire; dataofcountriesvariesfrom 2005to2012. Note: survey periodvariesbycountry.Note: survey Source: UNODCannualreport questionnaire. Fig. 58. Fig. 57. Venezuela (Bolivarian Republic of) Republic (Bolivarian Venezuela a detailed chapter on new psychoactivea detailedchapteron new substances. This isanupdatefrom theWorld Report 2013,whichcontains Drug emergingtrendsClub drugs: andrisks(London,November 2012). SUBSTANCES NEW PSYCHOACTIVE El Salvador El El Salvador El Costa Rica Costa Venezuela (Bolivarian Republic of) Republic (Bolivarian Venezuela Costa Rica Costa 208 Argentina Argentina 2008-2011* among youthaged15-16years, Misuse ofprescription stimulants Annual prevalence ofmisuseprescription stimulants Uruguay Uruguay Ecuador Ecuador Canada Canada Brazil Chile Brazil Chile United States United 0 New Zealand New 0 El Salvador El Annual prevalence (percentage) prevalence Annual Annual prevalence (percentage) prevalence Annual Costa Rica Costa Argentina 0.2 Indonesia 0.2 0.32 Uruguay 0.32 Ecuador Canada Brazil Chile Peru 1 1 1.18 1.2 El Salvador El 1.17955 Costa Rica Costa 1.2 1.4 Argentina 1.4 Uruguay 2 Ecuador 1.7 Canada 0 2 1.7 Brazil Chile 0.1 0.1 0.11 0.14 2.7 2.7

0 0.5 0.3 Annual prevalence (percentage) prevalence Annual 0.37 4 0.2 0.32 0.5 0.51 4

0.7 0.7 4.5 1 1.17955 1.2 4.5 1.4 1 2 1.7 6 - Annual prevalence (percentage) prevalence Annual 6 2.7 1.3 209 to UNODCreached 348, December 2013,thenumberofsuchsubstances reported market more thandoubledover theperiod2009-2013.By psychoactiveThe numberofnew substancesontheglobal countries). Asia (7 additional countries) and Africa (6 additional ber 2013 were reported in Europe (9 additional countries), spread ofthosesubstancesbetween July 2012andDecem global phenomenon. truly The largest increases in the psychoactiveuse ofnew substancesisthusemergingasa South America and in a number of African countries. The Europe and North America, as well as Oceania, Asia and New psychoactive substancesare now found in mostof tries) andAfrica(8additionalcountries). Europe (9additionalcountries),Asia(7 coun- United Kingdom. Treatment AgencyforSubstanceMisuse,NationalHealthService, Source: ClubDrugs:Emergingtrends andrisks(2012),National 1.5

Treatment entries for club Fig. 59. Early warning advisory on new psychoactive onnew substances,UNODC. Early warningadvisory

4 drug use 1.6 1000 2000 3000 4000 5000 6000 7000 4.5 2 0 2005/2006 and2010/2011 club drugsintheUnitedKingdom, Number oftreatment entriesfor 6 Total 2.5 209 upfrom 251 suchsubstances 3 Youth H. Newpsychoactivesubstances 3.28 3.5 Overall Male Female Total Male Female 2011/12 2005/6 2011/12 2005/06 Adults 4 - 51 WORLD DRUG REPORT 2014 52 1. RECENT STATISTICS AND TREND ANALYSIS OF THE ILLICIT DRUG MARKET

Are amphetamine-type stimulants substituting cocaine in the United States? In the United States, cocaine use has declined but use of Positive urinanalysis tests for amphetamine- amphetamines group substances is on the rise. According type stimulants among the United States to Quest Diagnostics, on the basis of urinanalysis, the workforce, 2000-2012 number of positives for amphetamine as a metabolite 1.00 (including, therefore, cases of methamphetamine use, in 0.90 1.00 addition to prescription use and illicit use of ampheta- 0.80 0.90 0.70 mine) among the general workforce in 2012 were the 0.80 highest since 1997, and positive drug tests for prescription 0.700.60 medications such as Adderall more than doubled between 0.600.50 1992 and 2012.1 Survey data reported over this period for 0.500.40 the general population aged 12 or older also indicate a 0.400.30 doubling in the past-month use of Adderall, stable use of 0.300.20 methamphetamine, and declining use of cocaine since 0.200.10 0.100.00

2007. Taken together, these data indicate that the increase (percentage) tests of number

number of tests (percentage) tests of number 0.00

in positive amphetamine tests in the general workforce is 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 POSTIIVITY = Number of positives / POSTIIVITY = Number of positives /

likely attributable to prescription amphetamine as opposed 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Amphetamines (AMPS) to methamphetamine. Indeed, subtracting methampheta- Amphetamines (AMPS) mine positives from the total for all positive tests classified CocaineCocaine as “amphetamines” shows a distinct transition in 2007, Methamphetamine (METH) Methamphetamine (METH) when the decline in cocaine began, with the growth rate AMP = AMPS - METH (2000-06) over the period 2007-2012 being four times that rate over AMP = AMPS - METH (2007-12) the period 2002-2006. It would appear that the positivity AMP = AMPS - METH (2000- Trendline06) AMP = AMPS - METH (2000-06) rate for amphetamine now exceeds the historic level Trendline AMP = AMPS - METH (2007-12) reached by the rate for cocaine in the United States in the period 2000-2006. This evidence, although not conclu- Source: Quest Diagnostics and United States Office on National sive, points to the possibility that amphetamines are being Drug Control Policy used as a substitute for cocaine.

1 United States, Quest Diagnostics, “Drug Testing Index”, (Madison, New Jersey, November 2013). Available at www.questdiagnostics.com/home/ physicians/health-trends/drug-testing.

as of July 2012,210 and 166 substances in 2009 (see figure stances were introduced,211 prevalence of the use of syn- 60). Thus, by now, the number of new psychoactive sub- thetic cannabinoids and of “bath salts” (synthetic stances clearly exceeds the number of psychoactive sub- cathinones) declined by some 30 percent among high stances controlled at the international level (234 substances: school students. Annual prevalence of synthetic cannabi- 119 controlled under the 1961 Single Convention on Nar- noid use fell from 11.4 per cent in 2011 to 7.9 per cent in cotic Drugs and 115 under the 1971 Convention on Psy- 2013 and prevalence of use of “bath salts” declined from chotropic Substances). 1.3 per cent in 2012 to 0.9 per cent in 2013 among twelfth grade students.212 In England and Wales, annual preva- The overall increase over the period August 2012-Decem- lence of mephedrone, a synthetic cathinone, fell by more ber 2013 was mostly due to new synthetic cannabinoids than 60 per cent, from 4.4 per cent among those aged (50 per cent of newly identified new psychoactive substances) followed by new phenethylamines (17 per cent), other substances (14 per cent) and new synthetic cathinones (8 per cent) (see figure 61). 211 In 2011, mephedrone, methylenedioxypyrovalerone (MDPV) and five synthetic cannabinoids were placed under temporary control Progress has been made in some areas. In the United States, (United States, Drug Enforcement Administration, “Schedules of where national controls on some new psychoactive sub- controlled substances: temporary placement of three synthetic cathinones into Schedule I”, Final order, 21 CFR Part 1308, Docket No. DEA-357). In 2012, these substances, along with 26 synthetic cannabinoids were placed permanently under control within the This information is based on information submitted by Member Controlled Substance Act (as amended by the Synthetic Drug Abuse States through surveys and submissions to UNODC from laboratories Prevention Act of 2012). participating in the international collaborative exercises programme. 212 National Institute on Drug Abuse, United States, Monitoring the 210 UNODC, The Challenge of New Psychoactive Substances (Vienna, Future Survey (December 2013). Available at http://monitoringth- March 2013). efuture.org/data/13data.html#2013data-drugs. 216 215 214 213 over thesameperiod. mine, which is also controlled, fell from 2.1 to 0.8 per cent took placeinthesameperiod.Prevalence ofuseketa- substances psychoactiveabout thehealthrisksassociatedwithnew activities aimedatraisingawareness users amongdrug While noclearlinkhasyet beenestablished,Government 16-24 years in2010/11to1.6percent2012/13. August-December 2012. some substancesreportedin2013,thereferenceperiodmayhavebeen Note: The2012figuresrefertoinformationreceivedbyJuly2012.For advisoryonnewpsychoactivesubstances. warning Source: UNODC,World DrugReport2013andUNODCearly Fig. 60. 100 150 200 250 300 350 400 50 2012/13 Crime Survey forEngland and Wales”. United Kingdom,Home Office, “Drug misuse:findingsfrom the intheUniteddrug KingdomMisuse ofDrugs Act (1971). In 2010,mephedrone wasinitially placedundercontrol as a classB cation ofNovel Substances project (www.wedinos.org). (www.talktofrank.com) and the Welsh Emerging Drugs andIdentifi - For example,through theInternet website “Talk toFrank” website 2012/13 Crime Survey forEngland and Wales”. United Kingdom,Home Office, “Drug misuse: findingsfrom the 0 NPS identified in previous years previous in identified NPS year currentfirst timeidentified in NPS the for 2009 102 214 psychoactive substancesatthe Number ofnewlyidentifiednew (cumulative) global level,2009-December2013 andtheintroduction ofnationalcontrols 2010 40 216 2011 37 2012 8 2013 97

213 215

tories. collaborativeexercises fornationaldrugtestlabora- international submissions toUNODCfrom laboratoriesparticipatinginthe stances, basedoninformationsubmittedbyMemberStatesand advisoryonnewpsychoactivesub- Source: UNODCearlywarning 100 120 Fig. 61. 20 40 60 80 0 60 48 Synthetic cannabinoids NPS reported up toNPS reported 2012 July Aug 2013 2012-Dec NPS reported reported toUNODCbyDecember2013 New psychoactivesubstances 58 16 Phenethylamines 44 Synthetic cathinones 8 25 Tryptamines 2 13 24 Others H. Newpsychoactivesubstances 20 Plant-based substances 2 12 Piperazines 3 4 5

ketamine and phencyclidine-type substances

Aminoindanes 3 53 WORLD DRUG REPORT 2014

is, thecontrol ofchemicalsusedto manufacture plant- stances of1988:thecontrol ofprecursor chemicals,that Illicit Traffic in Narcotic Drugs and Psychotropic Sub the adoptionofUnited Nations Convention against vention insupply reduction since hasgainedimportance tocontrol illicitfinancialflows.efforts keyinter Afurther alternative development programmes, eradication) and trafficking organizations,tion, dismantlement of drug treatment), interdic (drug supplyreduction interventions including demandreduction programmes (prevention, address problem inacomprehensive theworlddrug way, States and theinternationalcommunityover the years to A numberofstrategieshave beendeveloped by Member A. 3 2 1 involving a large number of substances which have wide- ufacture Precursor of drugs. control is a complex area Nonetheless, chemicalsare stillavailable fortheillicitman and preventing diversion. Board inassistingMember States inmonitoringlicittrade the work doneby theInternational Narcotics Control the Assemblyin2009,andtheirrelated actionplansand Strategy toCounterthe World Drug Problem, adoptedby tional Cooperationtowards anIntegrated andBalanced session, in1998,andthePolitical Declaration onInterna adopted by theGeneral Assemblyatitstwentieth special on Narcotic Drugs, aswell asthePolitical Declaration of the Economic and Social Council and the Commission Such progress hasbeenstrengthened through resolutions Progress hasbeenmadewithregard toprecursor control. as alternative development oreradication,cannotbeused. control measures appliedtoplant-basedsubstances,such nowadays are forwhichtraditionalsupply- syntheticdrugs foundonthemarket oftheillicitdrugs ing proportion criminals.”most valuable toolsinthebattleagainstdrug to deny traffickers the chemicals they need is one of our legitimate commerce. Regulation oflegitimatecommerce points where trafficking intersectswith of the few ... drug tomanufacture isone drugs ment ofchemicalsnecessary Chemical Action Task Force pointedoutthat“the procure- Asearlyasthe1990s, based andsyntheticdrugs. This hasbecomeeven more relevant over time,asagrow - PRECURSOR CONTROL

of the1988Convention. sibility for precursor control at the 12international level under article The International Narcotics Control Board isgiven theprimerespon- the World Drug Problem. Cooperation towards anIntegrated andBalanced Strategy toCounter States ofthePolitical Declaration and Plan ofAction onInternational Commission on Narcotic Drugs ontheimplementation by Member 2014 jointministerialstatementof thehigh-level review by the Progress madeinprecursor control washighlighted in theMarch Summit (Washington, D.C.,June 1992),p. 11. Chemical Action Task Force, Status Report forthe1992Economic INTRODUCTION 3

1 2 - - - - -

B. control. while keepinganunderlyingfocusondrug trol, covering boththelicitandillicitsideofthissector present ananalysisofthevarious aspectsofprecursor con the international level do not apply. The pages ahead will psychoactive substances,towhichthecurrent controls at emergence ofsubstituteprecursors, pre-precursors andnew challenges, suchasthegrowing role oftheInternet, the precursor control on the supply and new of illicit drugs It framework. the regulatory willthenanalysetheeffectof of internationalinterdependence andthedevelopment of tion oflicitproduction andtradeinchemicals,thedegree The present withareview oftheevolu chapterwillstart - licit andillicitsectors. It involves manyplayers andmultiplelinksbetween the spread legitimateusesandwhichcanbeeasilysubstituted. 6 5 4 trolled underthe1988Convention. was broadened to encompass all chemicals that are con problem, counter theworlddrug related measures toenhanceinternationalcooperation bly atitstwentieth specialsession,inJune 1998,and the In thePolitical Declaration adoptedby theGeneral Assem- orpsychotropicnarcotic drugs substances”. “substances frequently usedinthe illicitmanufacture of does notmakeanysuchdistinctionandspeaksonlyof legal basisforprecursor control atthe internationallevel, quences, however. 12ofthe1988Convention, the Article This scientificdistinctiondoesnotentaillegalconse facturing process, suchas“reagents” and“solvents”. be distinguishedfrom otherchemicalsusedinthemanu- substance duringthemanufacturingprocess. the molecularlevel, orpsychotropic intoanarcotic drug as thechemicalsubstancesthatbecomeincorporated,at “precursorscientific pointofview chemicals” are defined that are employed inthemanufacture From ofdrugs. a The term“precursor chemicals” broadly refers tochemicals

General Assembly resolutions S-20/4A-E. are typicallyusedtopurifytheendproduct. incorporated intothemolecularstructure oftheendproduct. They substances. They do not “react” with other substances and are not are liquidchemicalsubstancesusedtodissolve ordisperseonemore ofthemolecular structure oftheendproduct. “Solvents”become part of anothersubstanceduringthemanufacture of a drug. They donot “Reagents” are chemicals that react in the reaction with, or take part (New York,1998). against Illicit Traffic inNarcotic andPsychotropic Drugs Substances 1988 United Nations, ontheUnited Commentary Nations Convention CHEMICALS? WHAT ARE PRECURSOR

6 theterm“precursors” 2

4 They can They 5 - - - 55 WORLD DRUG REPORT 2014 56 2. PRECURSOR CONTROL

C. THE POTENTIAL VULNERABILITY Fig. 1. Output of the global chemical industry, OF THE CHEMICAL INDUSTRY 1963-2010 TO THE DIVERSION OF 4,000 PRECURSOR CHEMICALS 3,500 3,000 1. Trends and patterns in the 2,500 production of chemicals 2,000 dollars Over the past century, the chemical industry has been one 1,500 of the main economic growth sectors, and it continues to 1,000 grow strongly, both in volume and in geographical terms, Billions of constant 2010 500 involving an ever larger number of players. Asia has become 0 the new centre for manufacture, and the increasing number

of intermediaries provides greater opportunities for 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 diversion. Source: UNODC estimates based on UNIDO INDSTAT 2 database. The total number of “establishments” in the chemical sector rose worldwide from approximately 61,000 in 1981 lars from $620 billion in 1990 to about $1,110 billion in to 67,000 in 1990, 83,000 in 2000 and close to 97,000 11 in 2010.7 This reflects an expansion of the production base 2010. This growth was larger than the growth of the of chemicals and thus potentially expands the possibilities entire manufacturing sector and global GDP (see figure for the diversion of chemicals. This is exacerbated by a 2). As a result, the proportion represented by the chemical growing number of “chemical operators” who are also sector in the overall value added of manufacturing increased involved in the trade of such substances.8 from less than 11 per cent in 1990 to close to 13 per cent by 2010. Expressed as a percentage of global GDP, the Data from the United Nations Industrial Development value added of the chemical industry accounts for about Organization (UNIDO) suggest that chemicals are now 2 per cent, which is comparable to the value added of agri- being manufactured in most countries.9 Of the 148 Gov- culture, which accounts for 3 per cent of global GDP. . ernments that reported manufacturing output data to UNIDO over the 1990-2010 period, 142 also declared The observed stronger growth of output (5.8 per cent production of chemicals. annually during the 2000-2010 period) as compared with value added12 (3.5 per cent) in the chemical industry (see The rapid expansion of the chemical sector can also be figure 3) suggests a trend of companies redefining their observed in terms of output. The production output of core products and spinning off non-core production and the chemical industry, expressed in constant United States services to new companies. This can be explained by a dollars, almost doubled between 1990 and 2010, and rose reduced vertical integration of the chemical industry, more than fourfold between 1960 and 2010 to approxi- mainly as a consequence of the emergence of new produc- mately $3,800 billion (see figure 1). tion sites in developing countries. One side effect of this The “value added”10 of the global chemical industry, which has been increased intra-industry trade in chemicals can be directly compared with the notion of gross domestic between continents, which increases the risk of diversion product (GDP), shows an increase in constant 2010 dol- of chemicals used in the clandestine manufacture of drugs. While the chemical sector has been growing over the past few decades, it is still characterized by some geographical 7 UNODC estimates, based on data contained in the 2013 edition of the UNIDO INDSTAT 2 database at the two-digit level of Interna- concentration and by significant shifts in production, tional Standard Industrial Classification (ISIC) Revision 3. 8 International Narcotics Control Board, Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psy- 11 The data presented here are UNODC estimates based on country chotropic Substances: 2012 (New York, 2013), paras. 45-49. data provided by the World Bank (for the value added of manufac- 9 Information from the INDSTAT 2 database, which has entries turing in United States dollars) and by the UNIDO INDSTAT 2 regarding the chemical industry of 158 countries and areas over the database (for the proportion of the manufacturing sector comprised 1963-2010 period. Data are missing mainly from a few island coun- by the chemical sector), as reported by the World Bank. For missing tries and, in recent years, from countries affected by serious conflict years within a time series for a particular country, an interpolation was in Africa. applied. For missing data at the beginning or end of a time series, the 10 The value added of the manufacture of chemicals is defined as the assumption was made that results remained unchanged from the first sum of gross output less the value of intermediate inputs used in (or last) reporting year. the production for industries classified under International Standard 12 The concepts of value added and output are different economic Industrial Classification (ISIC) major division 3 by UNIDO as measures of overall production. Value added measures the value of chemical industries. This comprises ISIC groups 351 (manufacture the final product regardless of the number of companies involved in of industrial chemicals) and 352 (manufacture of other chemical the intermediate production steps, while output measures the value products). The ISIC groups 353 (petroleum refineries), 354 (miscel- of the products produced during all production steps. Countries with laneous products of petroleum and coal), 355 (rubber products) and higher levels of output and similar levels of value added may reflect 356 (plastic products) are not included. an overall lower degree of vertical integration. Union ofSoviet Socialist Republics. Initially, onlyone Northern Ireland) and—after World War II—theformer France andtheUnited KingdomofGreat Britain and North America(United States ofAmerica,Germany, most chemicalshave beenproduced in Europe andin which hasimplicationsforprecursor control. Traditionally, (percentage ofvalueaddedinmanufacturing) (accessedinAugust2013 athttp://data.worldbank.org/indicator). Source: UNODCestimates basedonWorld Bankindicatorson“Manufacturing, value added(inconstant2005dollars)and“Chemicals (accessed inAugust2013athttp://data.worldbank.org/indicator). “Chemicals (percentage ofvalueaddedinmanufacturing)” “Manufacturing, valueadded(inconstant2005dollars)”and Source: UNODCestimatesbasedonWorld Bankindicatorson Fig. 4. Fig. 2.

Percentage 0 1 2 3 4 2.6 Regional distributionofthevalueaddedchemicalindustry, 1990-2010 manu value addedoftheglobaleconomy, Average annualgrowth ofthe industry 0 Percentage 0 GDP 10 15 20 25 30 35 40 45 1990-2010 0 5 facturing andthechemical 42 2.7 Manufacturing 0

All Americas 37 Americas 32 2.9

North America 30 Chemical industry 9 Rest of Americas 2.5 7 GDP 2000-2010 35 2.8 All Europe 27 0 Manufacturing C. Thepotentialvulnerabilityofthechemicalindustrytodiversionprecursor chemicals Europe 32

Western/Central Europe 24 3.5

0 0

3 Chemical industry Rest of Europe 2 21 35 Asian country —JapanAsian country —wasincludedamongmajor All Asia erating the eighth-largest value added of chemicals in 1990 up from 21percentin1990.Chinaadvanced from gen- cent oftheglobalvalue addedofmanufacture ofchemicals, Europe (seefigure 4).By 2010,Asiaaccountedfor35per gained market share at the expense of North America and in Asia(notablyEast,South andSouth-East Asia)have Over decades, however, the past few a number of countries chemical producers. tor). base andWorld Bankindicators(http://data.worldbank.org/indica - Source: UNODCestimatesbasedontheUNIDOINDSTAT 2data- Fig. 3. 19

Asia Percentage 30 East & South-East Asia 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 2

Rest of Asia industry and thevalueaddedforchemical Average annualgrowth oftheoutput 5 1990-2010 - 3.3 Output Africa 1 All Africa 2.4 1

- Value added Value

Oceania - 2000-2010 5.8 2010 2000 1990 1 All Oceania 1 3.5 57 WORLD DRUG REPORT 2014 58 2. PRECURSOR CONTROL

to second place (following the United States and ahead of Fig. 6. Regional distribution of output of the Japan) in 2010. India progressed from fourteenth place in chemical industry, 2010 1990 to fifth place by 2010, following Germany and ahead 50 of Brazil and Mexico. 44 45 39 An analysis of long-term output trends for the chemical 40 35 sector reveals similar patterns (see figure 5). Above-average 29 30 26 growth rates were reported in particular in Asia, notably 23 in East, South and South-East Asia, and output growth 25 22 accelerated further during the 2000-2010 period. By 2010, Percentage 20 China reported the world’s largest chemical industry 15 output, ahead of the United States, Japan, Germany, 10 France, Brazil, the Republic of Korea, Italy, India, the 5 1 1 0 Netherlands, the United Kingdom, the Russian Federation and Switzerland (in that order).13 The production output

of these 13 countries accounted for more than three quar- Asia All All Africa All All Europe

ters (78 per cent) of the global output of the chemical Oceania All All Americas All

industry. NorthAmerica

Fig. 5. Average annual growth in the output East/South-East Asia

of the chemical industry, globally and Western/Central Europe by region Asia Americas Europe AfricaOceania 10.0 9.8 9.0 Source: UNODC estimates based on the UNIDO INDSTAT 2 data- 8.0 6.9 base. 7.0 5.8 5.9 6.0 nies in China (27 per cent), followed by the European 5.0 4.3 Union (20 per cent), the United States (15 per cent) and 3.5 3.7 Percentage 3.5 4.0 3.1 3.4 Japan (6 per cent). The single largest European producer 3.0 2.1 2.1 was Germany (5.7 per cent of global sales). The largest 2.0 producer in Latin America was Brazil (3.2 per cent), 1.0 although its sales still lagged behind Asia’s third largest 0.0 producer, the Republic of Korea (4.3 per cent). Other

Asia important producers included France (3.0 per cent of Africa Global

Europe 15

Oceania global sales), Taiwan Province of China (2.2 per cent), Americas 1963-2010 1990-2010 2000-2010 the Russian Federation (2.1 per cent) and the Netherlands (1.9 per cent).16 Source: UNODC estimates based on the UNIDO INDSTAT 2 database. All of these production shifts have potential implications The importance of Asia’s chemical industry as measured for the control of precursor chemicals. A chemical industry in terms of output (44 per cent, see figure 6) exceeds its concentrated among big companies facilitates the control importance in terms of value added (35 per cent, see figure of chemicals that can be diverted for the illicit manufacture 4). The opposite is true for the Americas and Europe. This of drugs, while a more scattered production system suggests that chemical mass products are increasingly being increases the number of trade lines and, ultimately, the risk produced in Asia, while there is still a concentration of of diversion. Control systems were initially developed some value-added intensive production of chemicals in mostly in North America and in Europe, where the chemi- North America and in Western and Central Europe. cal industry was dominated by large, vertically integrated companies. This facilitated national controls, including Data on the sales of the chemical industry for 2011 (€2,744 through voluntary cooperation with the authorities. The billion, or $3,822 billion) suggest that by that year 52 per emerging chemical industry in Asia, in contrast, is charac- cent of global turnover was credited to companies in Asia (see figure 7). Taken together, Asia, Europe and North America accounted for 92.5 per cent of world chemical 15 Despite its sizable chemical industry, Taiwan Province of China does sales in 2011.14 The largest sales were reported by compa- not participate in international precursor control. The International Narcotics Control Board encouraged the Government of China to work with Taiwan Province of China to devise practical ways and means of addressing the issue, notably in the areas of pre-export noti- 13 This ranking is based on UNIDO data for 2010 or the latest year fications, suspicious shipments and diversions of precursors involving available (adjusted for inflation). Taiwan Province of China (see Precursors Report, 2013, para. 33). 14 Companies and Markets, “Global Chemicals Market” (11 July 2013). 16 European Chemical Industry Council, “Chemicals sales by country: Available from www.companiesandmarkets.com. top 30” (2012). Available from www.cefic.org. C. The potential vulnerability of the chemical industry to the diversion of precursor chemicals 59

Fig. 7. Regional distribution of sales of Fig. 8. Global exports of the chemical the chemical industry, 2011 industry, 1990-2012 2,000 2,000 1,800 553 1,600 1,500 1,400 164 1,200 244 1,000 1,000 800 143 209 600 500 Billions of dollars 1024 Billions of dollars 400 751 655 200 79 0 0 Asia Europe Americas Rest of the world 1990 1992 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 China Japan in current US dollars Republic of Korea Rest of Asia EU-27 Rest of Europe in constant 2012 US dollars NAFTA Latin America Source: UNODC estimates based on the United Nations Commod- Rest of the world ity Trade Statistics database (UN COMTRADE), Standard Interna- Note: NAFTA means North American Free Trade Agreement countries. tional Trade Classification Revision 3. EU-27 means the States Members of the European Union as of 2011. Sources: European Chemical Industry Council Chemdata Interna- Fig. 9. Average annual growth in chemical tional, “World chemicals sales: geographic breakdown” and OANDA (for conversion of euros into United States dollars). exports, output and value added of the chemical industry (in constant dollars)

17 10 terized by a much greater number of smaller enterprises, 8.7 thus posing a bigger challenge to the authorities. 8 2. Trends and patterns in 6.1 5.8 international trade in chemicals 6 Growth in international trade in chemicals outstripped growth in the global production of chemicals. While Percentage 4 3.5 3.3 output doubled between 1990 and 2010, chemical exports, 2.4 expressed in constant 2012 United States dollars, grew to 2 more than three-and-a-half times the size (see figure 8).

This pattern became even more pronounced during the 0 2000-2010 period (see figure 9). Value added Output Exports As a consequence, global chemical exports rose from rep- 1990-2010 2000-2010 resenting 25 per cent of the global output of the chemical Source: UNODC estimates based on World Bank indicators, IND- industry in 1990 to 33 per cent in 2000 and 43 per cent STAT 2 and UN COMTRADE. in 2010. With ever more chemicals being traded among an increasing number of countries, the possibility of diver- quent work of the World Trade Organization. Although sion of chemicals has increased. the value added generated by the chemical industry The chemical industry is widely seen as one of the most accounted for “just” 1.9 per cent of global GDP in 2010, globalized of all manufacturing industries, and this glo- the proportion that chemicals comprise of global exports balization is still in progress,18 facilitated by reduced is almost six times as high — and rising (see figure 10). import duties as a consequence of several rounds of the The relationship between the production and trade of General Agreement on Tariffs and Trade and the subse- chemicals is not linear. Countries with high levels of production are not always the biggest exporters of chemicals, 17 The average output per “establishment” of the chemical industry and almost a quarter of countries have larger chemical during the 2007-2009 period amounted to $81 million in the Neth- exports than domestic production.19 A more linear cor- erlands, $64 million in Belgium and $59 million in Germany. This was more than three times the average output per establishment in China ($18 million), more than eight times the average output per 19 This applies to 34 out of 146 countries and areas for which both establishment in India ($7 million), 15 times the average in Hong export and domestic production data were available. Adding countries Kong, China, or Viet Nam ($4 million) and more than 40 times the and areas which exported chemicals but did not report production of average in Thailand ($1.25 million in 2006) (INDSTAT 2 database). chemicals, the overall proportion of countries and areas where exports 18 MBendi Information Services, “World chemicals: global chemical exceeded domestic production would rise to above 40 per cent (80 out industry overview”. Available from www.mbendi.com. of 192). WORLD DRUG REPORT 2014 WORLD DRUG REPORT 60 2. PRECURSOR CONTROL

Fig. 10. Proportion of the chemical industry in tries, but instead involve an increasing number of brokers global GDP and of chemical exports in and other intermediaries in the supply chain. Not only global merchandise exports does this provide more opportunities for diversion, it 12 makes the effective application of the “know your cus- 11.1 tomer” principle21 more difficult to achieve. 10 8.6 8.9 8 D. RESPONSE OF THE INTER-

6 NATIONAL COMMUNITY

Percentage 4 The idea of controlling precursors as one of the strategies for controlling the overall manufacture of drugs and thus 1.9 2 their consumption (for non-medical purposes) dates back to the early 1930s. It was only in the late 1980s, however, 0 1990 2000 2010 Value2010 added that an effective international precursor control system was of chemical devised. That system was further strengthened over the Chemical exports as a percentage of Valueproduction added following decades. total global exports of chemicalas a productionaspercentage a percentageof global 1. Conventions concluded under the of GDPglobal auspices of the League of Nations GDP

Source: UNODC estimates based on World Bank indicators and The basic idea of precursor control was already present in UN COMTRADE. the Convention for Limiting the Manufacture and Regu- lating the Distribution of Narcotic Drugs of 1931, which relation is observed between the levels of exports and had provisions for the international control of a limited imports of chemicals (see figure 11), which underlines the number of “convertible substances”,22 i.e. substances that importance of re-exports20 and the fact that trade flows could be converted into a product capable of producing are not always directly from producing to consuming coun- addiction.23

Fig. 11. International trade in chemicals, 2012 or latest year available (30 largest exporting countries and territories)

200 Exports Imports 150

100

Billions of dollars 50

0 Italy USA India Israel Brazil Spain Japan China France Ireland Poland Austria Mexico Canada Sweden Belgium Hungary Thailand Malaysia Germany Denmark Indonesia Singapore Switzerland Netherlands Saudi Arabia Rep. Koreaof United Kingdom Russian Federation Source: UN COMTRADE. Hong Kong, China 21 The “know your customer” principle, for those who manufacture or market chemicals, is set out in the Political Declaration adopted by the General Assembly at its twentieth special session and the measures to enhance international cooperation to counter the world drug problem (General Assembly resolutions S-20/4 A-E). 22 Any product obtained from any of the phenanthrene alkaloids of opium or from the ecgonine alkaloids of the coca leaf. 23 Article 11 of the 1931 Convention made it clear that no manufacture or trade in such products should be allowed “unless and until it has 20 Data on 127 countries and areas for the year 2012 show a correlation been ascertained to the satisfaction of the Government concerned that coefficient of r = 0.93 between imports and exports. the product in question is of medical or scientific value”. D. Response of the international community 61

Another reference to the need for precursor control can be 3. Convention on Psychotropic found in the Convention for the Suppression of the Illicit Substances of 1971 Traffic in Dangerous Drugs of 1936. That Convention introduced an obligation to seize such precursors and con- The requirements relating to the introduction of precursor tained penal provisions for the manufacture, conversion, control were broadened in the Convention on Psychotropic extraction and preparation of drugs,24 which also had an Substances of 1971 to include chemicals used in the manu- impact on the handling of precursor chemicals. Both Con- facture of psychotropic substances.28 Precursors were thus ventions were superseded by the Single Convention on in principle under international control, with provisions Narcotic Drugs of 1961. for such substances to be seized and confiscated. There was a general obligation for taking “measures of supervision” 2. Single Convention on Narcotic regarding such substances, though much was left to the Drugs of 1961 discretion of Member States. Thus, only a few countries introduced a comprehensive control regime. Moreover, the A general reference to precursor control, asking for the 1971 Convention did not include a provision for the “supervision”25 of such substances, is also found in the scheduling of specific substances that were convertible into Single Convention on Narcotic Drugs of 1961 as amended a psychotropic substance.29 This changed only with the by the 1972 Protocol, which is still in force today. In addi- 1988 Convention. tion, it allowed substances “convertible into a drug” to be scheduled.26 The 1961 Convention also obliged parties to 4. United Nations Convention seize precursor chemicals and to introduce penal provisions against Illicit Traffic in Narcotic for the illegal manufacture, extraction and preparation of Drugs and Psychotropic such drugs.27 Substances of 1988 (a) The basic control system The United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 24 In article 2 of the 1936 Convention, each of the High Contract- enjoys nearly universal adherence30. ing Parties agreed “to make the necessary legislative provisions for severely punishing, particularly by imprisonment or other penalties The basic idea of the Convention is to regulate the trade of deprivation of liberty … the manufacture, conversion, extraction, of a number of chemicals which can be used for the manu- preparation … of narcotic drugs, contrary to the provisions of the … conventions”. Article 10 of the Convention states that “any narcotic facture of drugs by allowing their trade for licit purposes drugs as well as any substances and instruments intended for the and prevent their diversion for illicit manufacture of drugs. commission of any of the offences referred to in article 2 shall be The 1988 Convention establishes a legal basis for the con- liable to seizure and confiscation”. This was the first international obligation relating to precursor control. Nonetheless, the practical trol of precursors and calls for the establishment of an importance of this obligation remained limited, as only 13 countries appropriate administrative framework, working mecha- (Belgium, Brazil, Canada, China, Colombia, Egypt, France, Greece, nism and standard operating procedures to prevent the Guatemala, Haiti, India, Romania and Turkey) signed and ratified the Convention (Thomas Pietschmann, “A century of international drug diversion of such substances. There are hundreds of chemi- control”, Bulletin on Narcotics, vol. LIX, Nos. 1 and 2 (2007). cals that are or could be used in the manufacture of illicit 25 Article 2, paragraph 8, of the 1961 Convention states that “the Parties drugs. Of those, a total of 23 chemicals were internation- shall use their best endeavours to apply to substances which do not fall ally controlled under the 1988 Convention as of January under this Convention, but which may be used in the illicit manufacture of drugs, such measures of supervision as may be practicable”. 2014: 15 substances under the stricter rules foreseen for This definition of a “substance” was left very broad on purpose, as the substances in Table I (for which pre-export notifications authors admitted that they could not foresee what kind of substances are foreseen) and 8 under the less stringent rules for sub- would be employed in the illicit manufacture of drugs in the future. 31 Article 2 is important because it lays down a general obligation for stances in Table II. This list is regularly updated. The the control of precursors used in the manufacture of narcotic drugs. In the discussion of the plenipotentiary conference that adopted the 1961 Convention, acetic anhydride, used in the conversion of mor- 28 Article 2 states that “the Parties shall use their best endeavours to phine into heroin, was explicitly mentioned as a substance to which apply to substances which do not fall under this Convention, but paragraph 8 would apply (Commentary on the Single Convention on which may be used in the illicit manufacture of psychotropic sub- Narcotic Drugs, 1961 (New York, 1962)). stances, such measures of supervision as may be practicable”. Sub- sequently, article 22 also follows closely the wording of the Single 26 Article 3, paragraph 3 (iii), of the 1961 Convention enables the scope Convention, laying down in its paragraph 3 that “any psychotropic of controlled substances to be extended to any substance “convertible substance or other substance, as well as any equipment, used in or into a drug”. Thus, one finds ecgonine, an alkaloid of the of coca intended for the commission of any of the offences referred to … shall plant which itself is not addictive but which can be converted into be liable to seizure and confiscation”. cocaine, in Schedule I of the 1961 Convention. 29 Thus lysergic acid, for instance, which is easily convertible into lyser- 27 The specific provisions for precursor control of the 1936 Convention gic acid diethylamide (LSD), could not be scheduled under the 1971 entered the 1961 Convention in article 37: “Any drug, substances Convention. and equipment used in or intended for the commission of any of the offences, referred to in article 36, shall be liable to seizure and confis- 30 The Convention has been ratified by or acceded to by 187 countries cation.” Article 36 states that each Party shall “adopt such measures as and areas (plus the European Union). will ensure that … production, manufacture, extraction, preparation 31 Substances listed in Table I are specifically required in the manufac- … of drugs contrary to the provisions of this Convention … shall be ture of narcotic drugs or psychotropic substances. Substances listed in punishable offences when committed intentionally”. Table II are mostly solvents, cleaning agents and chemical reagents. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 62 2. PRECURSOR CONTROL

total number of controlled chemical substances in Table I tional trade in precursor chemicals (e.g. notification of and II nearly doubled from 12 in 1988 to 23 by 2013. The suspicious shipments, seizures, proper labelling and docu- increase over the past two decades has been most notice- mentation, establishment of a comprehensive monitoring able for substances in Table I, rising from 6 in 1988 to 16 system,34 including pre-export notifications for substances following the decision of the Commission on Narcotic in Table I)35 while guaranteeing Member States a high Drugs in March 2014 to add alpha-phenylacetoacetonitrile degree of confidentiality36 and limiting controls (e.g. exclu- (APAAN) to Table I. sion of pharmaceutical preparations from controls).37 (b) Role of the International Narcotics Substances controlled under the Control Board 1988 Convention (as of January The 1988 Convention also clarified the roles of the vari- 2014) ous actors. The primary role of precursor control lies with the individual Member States;38 the International Narcot- Table I Table II ics Control Board was given the prime responsibility for Acetic anhydride Acetone precursor control at the international level. N-acetylanthranilic acid Anthranilic acid Ephedrine Ethyl ether The Board is responsible, along with States parties, for Ergometrine Hydrochloric acid recommending to the Commission on Narcotic Drugs the Ergotamine Methyl ethyl ketone scheduling or rescheduling of chemical substances to be Isosafrole Piperidine controlled at the international level. While the World Lysergic acid Sulphuric acid Health Organization (WHO) plays a key role in the sched- 3,4-Methylenedioxyphenyl- Toluene uling of narcotic drugs and psychotropic substances under 2-propanone the 1961 and 1971 Conventions, the Board was given this Norephedrine role for precursor chemicals.39 It also collects statistics Phenylacetic acid relating to precursors, reports on progress made in precur- 1-Phenyl-2-propanone Piperonal Potassium permanganate the normal conduct of business and the prevailing market conditions. Pseudoephedrine 34 Article 12, paragraph 9, lists the following measures that each party shall take with regard to international trade in substances in Table I and Table II: (a) Establish and maintain a system to monitor international trade in Paragraph 1 of article 3 of the 1988 Convention requires such substances in order to facilitate the identification of suspicious parties to establish as criminal offences the manufacture, transactions; (b) Provide for the seizure of any such substance if there is sufficient transport and distribution of the listed precursor chemicals evidence that it is for use in the illicit manufacture of a narcotic drug in the knowledge that they are to be used in or for the ille- or psychotropic substance; gal cultivation, production or manufacture of drugs. (c) Notify, as soon as possible, the competent authorities and services of the parties concerned if there is reason to believe that the import, export or transit of such a substance is destined for the illicit manu- As in the 1961 and 1971 Conventions, the 1988 Conven- facture of narcotic drugs or psychotropic substances; tion requires States parties to take appropriate measures to (d) Require that imports and exports be properly labelled and docu- prevent the diversion of precursor chemicals.32 mented; (e) Ensure that documents referred to in subparagraph (d) above are Article 12 lays down more specific control measures for maintained for a period of not less than two years and may be made the manufacture and distribution (e.g. licensing, preven- available for inspection by the competent authorities. 33 35 Article 12, paragraph 10, contains the core principle of international tion of the accumulation of large stocks) and interna- precursor control: the obligation of an exporting country, if asked by an importing country, to issue a “pre-export notification” for substances listed in Table I. This then entails some form of a clearance 32 Article 12, paragraph 1, contains a general statement that “the Parties or permission to be granted from the competent authorities of the shall take the measures they deem appropriate to prevent diversion importing country. Importing countries can adopt stricter measures of substances in Table I and Table II used for the purpose of illicit and request a pre-export notification not only for substances in Table manufacture of narcotic drugs or psychotropic substances, and shall I but also for some or all of the substances in Table II. A number of cooperate with one another to this end”. countries have made use of this provision. 33 Article 12, paragraph 8 (a), states that “the Parties shall take the 36 See article 12, paragraph 11. measures they deem appropriate to monitor the manufacture and 37 Article 12, paragraph 14, for example, excludes pharmaceutical prepa- distribution of substances in Table I and Table II which are carried rations from precursor controls if such substances cannot be easily out within their territory”. Paragraph 8 (b) proposes the following used in the manufacture of drugs: “The provisions of this article shall concrete measures that parties may take to that end: not apply to pharmaceutical preparations, nor to other preparations (i) Control all persons and enterprises engaged in the manufacture containing substances in Table I or Table II that are compounded in and distribution of such substances; such a way that such substances cannot be easily used or recovered by (ii) Control under licence the establishment and premises in which readily applicable means”. such manufacture or distribution may take place; (iii) Require that licensees obtain a permit for conducting the afore- 38 In the case of States members of the European Union, the prime said operations; responsibility is with the European Union, not the individual member (iv) Prevent the accumulation of such substances in the possession of States. manufacturers and distributors, in excess of the quantities required for 39 See article 12, paragraphs 2-7. D. Response of the international community 63

sor control40 and reports annually to the Commission on 6. Political Declaration and Action the implementation of article 12.41 Plan adopted by the General Moreover, the Board has been given a special role in moni- Assembly at its twentieth special toring the implementation of precursor control measures session by Member States in accordance with the requirements of the 1988 Convention.42 The potential sanctions of the Precursor control received a new impetus from the Politi- cal Declaration adopted by the General Assembly at its Board are limited, however, to bringing an issue to the 47 attention of the parties, the Economic and Social Council twentieth special session, in 1998, and the related measures to enhance international cooperation to counter the and the Commission on Narcotic Drugs; it is then up to 48 these bodies to deal with the issue. This is in contrast to world drug problem, which contained separate resolu- the broader powers given to the Board (e.g. recommend- tions on the Action Plan against Illicit Manufacture, Traf- ing an “import ban”) in cases of non-compliance with the ficking and Abuse of Amphetamine-type Stimulants and other drug conventions.43 their Precursors and on the control of precursors. In addition to collecting data and preparing reports to alert In its resolution S-20/4 B, on control of precursors, the policymakers about new trends, the Board also engages in General Assembly asked Member States to implement operational activities. It assists Member States in conduct- many of the proposals made under the 1988 Convention. ing joint law enforcement operations under the banner of Member States were requested to adopt and implement Project Cohesion (with regard to chemicals used in the the “proposals” of article 12 of the 1988 Convention, manufacture of plant-based drugs) and Project Prism (with including the establishment of a system of control and regard to chemicals used in the manufacture of synthetic licensing of the enterprises and persons engaged in the drugs) to detect unlawful precursor shipments. In response manufacture and distribution of substances listed in Tables to various action plans and resolutions, the Board estab- I and II of the 1988 Convention. Similarly, exporting lished and maintains a limited international special surveil- States were requested to issue pre-export notifications for lance list of non-scheduled substances for the identification substances in Table I to the competent authorities in of substitute chemicals used in the illicit manufacture of importing countries (irrespective of whether an importing drugs.44 It has also issued the Guidelines for a Voluntary country had requested such a notification). In addition, Code of Practice for the Chemical Industry, and established information exchange (from data on licit manufacture to the Pre-Export Notification Online (PEN Online) system, imports and exports) was highlighted as being crucial for as well as the Precursors Incident Communication System precursor control, as was strengthened cooperation with (PICS), a secure online tool to enhance real-time commu- associations of the chemical trade and industry which could be achieved by issuing guidelines and/or a code of nication and information sharing between national 49 authorities.45 conduct. Most importantly, the principle of “know your customer”50 5. Resolutions passed by the was introduced at the international level. It obliges the General Assembly, the Economic seller of precursor chemicals to investigate the credentials and Social Council and the of the purchaser and, if in doubt, to involve the authorities. Commission on Narcotic Drugs

Following the adoption of the 1988 Convention, a total strengthening of monitoring and control systems at the points of of 36 resolutions relevant to precursor control were passed entry of precursors (airports, ports, customs ports), the real-time exchange of information, backtracking investigations, the promotion by the General Assembly, the Economic and Social Council of participation in Project Prism and Project Cohesion, chemical and the Commission on Narcotic Drugs during the 1991- profiling, training in precursor control, the provision to International 2013 period. While some of those resolutions were geared Narcotics Control Board of annual estimates of legitimate requirements for precursors of amphetamine-type stimulants, trafficking towards simply raising awareness, others were very focused, via the Internet, the development of joint actions with the national dealing with specific aspects of precursor control.46 chemical industry, the promotion of a voluntary code of conduct for the chemical industry, the smuggling of precursors to and within Afghanistan, use of the Pre-Export Notification Online system for 40 Ibid., para. 12. precursors and pharmaceutical preparations containing ephedrine and pseudoephedrine, treatment of safrole-rich oils, ephedra, PMK 41 Ibid., para. 13. (=3,4-methylenedioxyphenyl-2-propanone (3,4-MDP-2-P)), nore- 42 Article 22 sets forth action that the Board may take if it has reason phedrine and potassium permanganate. A comprehensive summary of to believe that the aims of the Convention in matters related to its the resolutions relevant to precursor control is available from http:// competence are not being met. incb.org/incb/en/precursors/resolutions.html. 43 See article 14, paragraph 2, of the 1961 Convention and article 19, 47 General Assembly resolution S-20/2. para. 2, of the 1971 Convention. 48 General Assembly resolutions S-20/4 A-E. 44 That list contained more than 50 substances in 2012. 49 See General Assembly resolution S-20/4 B, paras. 4, 7 (a) (i) and 9 45 For more information, see http://incb.org/incb/en/precursors/precur- (b). sors/tools_and_kits.html. 50 Ibid., para. 9 (c). In addition, the “know your customer” principle is 46 Topics addressed included the following: controls for non-scheduled found in several resolutions of the Economic and Social Council and substances, the Precursors Incident Communication System, the the Commission on Narcotic Drugs. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 64 2. PRECURSOR CONTROL

In addition, the document highlighted the challenges aris- national trade, the Plan of Action identified the new prob- ing from the use of “substitute chemicals”. In that context, lem of precursors being diverted “from domestic it proposed to prepare a limited international special sur- distribution channels” in countries where they were manu- veillance list of substances currently not in Tables I and II factured or imported.55 of the 1988 Convention. This was subsequently implemented by the Board. Moreover, States were asked to apply Responding to this new challenge, the Plan of Action asked monitoring measures, in cooperation with the chemical Member States to “increase efforts, beyond international industry, so as to prevent the diversion of substances trade controls, to prevent the diversion of precursors, and included on the special surveillance list. In addition, States pharmaceutical preparations containing the precursors ephedrine and pseudoephedrine, from domestic channels were asked to “consider punishing, as a criminal offence 56 … the diversion of non-scheduled chemical substances to be smuggled across borders.” with the knowledge that they are intended for use in the Another new element is the invitation to Member States illicit manufacture of narcotic drugs or psychotropic to “consider ‘marking’ certain chemical shipments for pos- substances”.51 sible future use if scientific advances ensure the appropriate use of such tools, taking into account the potential burden 7. Political Declaration and Plan of this would place on authorities and industry”.57 Action of 2009 Precursor control also played a role in the 2009 Political E. PATTERNS AND TRENDS IN Declaration and Plan of Action on International Coopera- PRODUCTION OF, AND TRADE tion towards an Integrated and Balanced Strategy to Coun- ter the World Drug Problem. The Plan of Action AND TRAFFICKING IN underlined the need for “a global approach in order to … PRECURSOR CHEMICALS prevent the diversion of synthetic drugs and their precursors into illicit channels in all manufacturing, transit and 1. Licit activities consumer countries” and, in the Political Declaration, States Members of the United Nations decided to establish (a) Production and trade patterns of 2019 as a target date for States “to eliminate or reduce sig- substances in Table I and Table II nificantly … the diversion of and illicit trafficking in Detailed information on global production of all 23 chemi- 52 precursors”. cals under international control is not available. There is, The 2009 Plan of Action shows how the precursor market however, some information on the geographical spread of had changed over time. It recognized that pharmaceutical the licit manufacture of precursor chemicals, suggesting preparations and chemicals not under international control that such production is a global phenomenon. 53 were being substituted for controlled precursors. To Twenty Governments officially reported production of respond to these new challenges, the Plan of Action invited substances in Table I during the 2010-2012 period. Com- Member States to expand the use of pre-export notifica- bining this information with trade statistics (Governments tions to non-scheduled substances and pharmaceutical reporting more exports than imports of Table I precursor preparations. Furthermore, Member States were asked to chemicals during the 2010-2012 period) suggests that pro- “develop systems (for example, shared online recording duction of Table I precursors is probably taking place in systems) to prevent precursor chemicals from being 47 countries and areas. The manufacture of Table I and diverted into illicit channels from community Table II precursors may occur in 77 countries and areas, 54 pharmacies”. representing about half of the 163 countries and areas for 58 While acknowledging that regulatory controls helped to which information is available (see map 1). The com- prevent the diversion of precursor chemicals from inter- 55 Ibid., para. 39. 56 Ibid., para. 41 (s). 51 General Assembly resolution S-20/4 B, para. 14 (b). 57 Ibid., para. 41 (u). That provision has not been widely used so far. 52 See Official Records of the Economic and Social Council, 2009, Supple- While that could represent a major leap forward in strengthening and ment No. 8 (E/2009/28), chap. I, sect. C, Plan of Action, para. 33; improving backtracking investigations, there are concerns about the and Political Declaration, para. 36. costs involved and its actual value added. In addition, the “marking” 53 Ibid., Plan of Action, paras. 35 and 39. While the 1988 Conven- involved in the provision could be potentially problematic if applied tion excluded pharmaceutical preparations from the control efforts to chemicals used in the manufacture of pharmaceutical products, (para. 14), the 2009 Plan of Action, as a consequence of the changed entailing expensive litigation if patients claim that such pharmaceuti- situation, stated in its paragraph 36 (c) that Member States should cals have been contaminated. “strengthen controls, including through the Pre-Export Notifica- 58 Twenty Governments reported licit manufacture of any of the 15 tion Online system, where required, for the import and export of Table I precursor chemicals during the 2010-2012 period, out of preparations containing precursor chemicals, such as ephedrine and a total of 104 Governments reporting to UNODC in part I of the pseudoephedrine, which could be used in the manufacture of amphet- annual reports questionnaire. According to UN COMTRADE, 73 amine-type stimulants”. countries exported Table I precursor chemicals during the 2010-2012 54 Ibid., paras. 41 (k) and (r). period, i.e. almost half of the countries contained in that database. E. Patterns and trends in production of, and trade and trafficking in, precursor chemicals 65

Map 1. Potential manufacture of precursor chemicals (Table I and Table II), 2010-2012

Reported Table I precursors production No reported Table I precursors production Production of precursors unknown

No questionnaire received Table I and Table II precursor exports larger than imports, 2010-2012 (excluding countries reporting Table I production)

Note: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Sources:Dashed lines Annualrepresent undetermined reports boundaries. questionnaire Dotted line represents of UNODC approximately and the UN Line ofCOMTRADE. Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. The final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. Note: The boundaries shown on this map do not imply official endorsement or acceptance by the United Nations. Dashed lines represent undetermined boundaries. The dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The final status of Jammu and Kashmir has not yet been agreed upon by the parties. The final boundary between the Sudan and South Sudan has not yet been determined. bined population of the area concerned accounts for about elements: the size of their chemical industry, the domestic 77 per cent of the world’s population. demand for chemicals and the trade sector, which may also be influenced by the existence of large seaports. The cor- The largest proportion of licit exports of the 23 interna- relation between exports and imports of precursor chemi- tionally controlled chemical precursors during the 2010- cals during the 2010-2012 period was weaker than for 2012 period were from countries in Asia (41 per cent of chemicals in general, suggesting that re-exports, though the total in value terms), followed by countries in Europe common, occurred less frequently for precursor chemicals and the Americas (see table 1). than for chemicals in general. The largest proportion of such exports in Asia during that If only the “net exports” of precursors are considered (i.e. period were made by the Republic of Korea, followed by the difference between precursor exports and precursor Japan, Singapore, Thailand, China and India. The largest imports), which may be a better reflection of underlying exporter in Europe was Belgium, followed by Germany, production, data show an even stronger concentration of the Netherlands and Spain. In the Americas, the list was such “net exports” of precursors from countries in Asia (59 topped by the United States, followed by Canada, Mexico per cent of the total). and Brazil. The main exporter in Africa was South Africa, followed by Zambia, Nigeria, Egypt and Kenya. The larg- If the analysis is restricted to Table I precursor chemicals, est exporter in the Oceania region was Australia, followed the largest proportion of licit exports during the 2010- by New Zealand. The role of different countries in the licit 2012 period were reported, in descending order, by Bel- trade of controlled precursors can be a function of multiple gium, China, Mexico, the United States, India, Germany, the Netherlands and Switzerland. Aggregated to the Thirty-eight countries reported higher exports of Table I precursors regional level, the largest proportion of exports and imports than imports during the 2010-2012 period. If exports exceed imports of substances listed in Table I were accounted for by Europe in a country over a period of time, local manufacture is probably (44 per cent of exports and 65 per cent of imports), Asia taking place. Combining information from the annual reports questionnaire and UN COMTRADE, the number of “potential” Table I (29 per cent and 18 per cent, respectively) and the Ameri- manufacturing countries could rise to 47. Extending the analysis to all cas (27 per cent and 14 per cent, respectively). In terms of substances controlled in Table I and Table II, UN COMTRADE data net exports, Asia accounts for 50 per cent of the global show exports of internationally controlled precursors by 122 countries and imports by 150 countries. If one includes countries reporting total (mainly China, followed by India) and the Americas domestic precursor production, the potential number of countries for 38 per cent (mainly Mexico, followed by the United involved in the manufacture of precursor chemicals rises to 77. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 66 2. PRECURSOR CONTROL

Table 1. Regional distribution of trade in internationally controlled precursors (Table I and Table II), 2010-2012

Exports Imports Net exporting countries (122 countries; N = $7.8 billion per year) (150 countries; N = $8.6 billion per year) (29 countries; N = $3.1 billion per year)

Africa, Oceania, Africa, Oceania, Africa, Oceania, 2% 0.1% 3% 1% 3% 0% Americas, Americas, 16% Americas, 5% 19%

Asia, Asia, 41% Europe, 41% Asia, 32% 59% Europe, 40% Europe, 36%

Source: Data from UN COMTRADE (based on HS07 classification).

States), while Europe accounts for “just” 12 per cent, required, inter alia, in the production of fertilizers, deter- reflecting the fact that a significant proportion of European gents, pharmaceuticals, insecticides, anti-freezes, explo- precursor chemical exports are nowadays “re-exports” of sives, textiles and lubricants. imported substances. The economic importance of international trade in sub- (b) Economic importance of substances stances listed in Table I is far lower. Table I precursors, listed in Table I and Table II which are under tighter control, account for only 7 per cent of international trade in precursors. Expressed as a Data from UN COMTRADE indicate that precursor proportion of total exports, substances in Table I comprise chemicals account for a very small share of the overall a mere 0.04 per cent of all chemicals traded at the global market for chemicals. Total international trade59 in pre- level. The most important substance in Table I is acetic cursor chemicals amounted to approximately $9 billion in anhydride, which is employed, inter alia, in the manufac- 2012,60 which is equivalent to just 0.5 per cent of total ture of heroin. It accounts for global international licit international trade in chemicals. trade of some $0.4 billion, or about 4 per cent of global Although there were 15 substances listed in Table I and exports in precursor chemicals. The next most important only 8 in Table II, the latter substances accounted for 93 Table I precursors are potassium permanganate, involved per cent of the international trade in precursor chemicals, in the manufacture of cocaine (exports of $70 million, or based on 2012 data (see table 2). The largest (licit) inter- 0.8 per cent of global exports of precursor chemicals) and national trade amounts were reported for toluene (40 per pseudoephedrine ($63 million, or 0.7 per cent), which is cent of total exports in 2012), a chemical used as a solvent used in the manufacture of methamphetamine, followed (paint thinner) and as an octane booster in gasoline fuels, by piperonal ($44 million, or 0.5 per cent) part of the although it is also used in the processing of cocaine. The manufacture of 3,4-methylenedioxy-N-methylampheta- second-largest amounts were reported for acetone (22 per mine (MDMA), commonly known as “ecstasy”. cent), a widely used solvent and a chemical used in cocaine (c) Trends in the licit trade of Table I and and heroin processing, followed by sulphuric acid (14 per Table II precursors cent), a chemical used in the manufacture of cocaine, and amphetamine-sulphate, which in the licit market is Expressed in constant United States dollars, global exports of precursor chemicals rose almost fivefold during the 1996-2012 period.61 Even accounting for inflation, such 59 International trade is defined here, in line with the definition used exports still rose threefold over this period. by the Board, as the total levels of exports or imports, whichever is greater. Global exports should, in theory, largely equal global imports, There was, however, a marked difference between Table I except for minor differences. Owing to a lack of consistent reporting, however, there are important data discrepancies, i.e. some countries report exports, but not all of their trading partners report the cor- 61 The subsequent analysis of international trade will be based, unless responding imports, and vice versa. otherwise indicated, on information contained in UN COMTRADE. 60 October 2013 data from UN COMTRADE, based on HS07 clas- Those data have the advantage of being readily available and, in sification for precursor chemicals and Standard International Trade contrast to trade data submitted by Member States to the Board, not Classification Revision 3 for global imports and exports of chemicals. being subject to any confidentiality clauses. E. Patterns and trends in production of, and trade and trafficking in, precursor chemicals 67

Table 2. International trade in precursor chemicals, 2012 As a As a Licit exports percentage Licit imports percentage Chemical Used in manufacture of Schedule (in millions of global (in millions of of global substance of dollars) precursor dollars) precursor exports imports Potassium Cocaine Table I 70.3 0.8 56.7 0.7 permanganate Heroin, conversion of phenylacetic acid to P-2-P and conversion of Acetic anhydride Table I 361.8 4.49 415.4 4.8 anthranilic acid to N-acetylanthranilic acid Ephedrine Table I 10.0 0.1 7.5 0.1 Pseudoephedrine Table I 63.3 0.8 51.2 0.6 Amphetamines (methamphetamine/ P-2-P Table I 2.9 0.04 2.8 0.03 amphetamine) and methcathinone Phenylacetic acid Table I 11.3 0.1 28.4 0.3 Norephedrine Table I 2.2 0.03 1.2 0.01 3,4-MDP-2-P Table I 0.3 0.00 0.3 0.00 Piperonal Table I 44.1 0.5 42.7 0.5 MDMA (“ecstasy”) Safrole Table I 0.06 0.0 0.05 0.0 Isosafrole Table I 3.8 0.05 2.8 0.03 Lysergic acid Table I 0.6 0.01 0.8 0.01 Lysergic acid diethylamide (LSD) Ergotamine Table I 3.6 0.04 5.7 0.07 Ergometrine Table I 0.7 0.01 1.0 0.01 N-acetylanthranilic Table I 1.3 0.02 0.8 0.01 Methaqualone acid Anthranilic acid Table II 12.1 0.1 5.2 0.1 Phencyclidine Piperidine Table II 432.6 5.2 420.0 4.8 Toluene Table II 3,273.3 39.5 3,208.4 36.8 Cocaine Methyl ethyl Table II 711.5 8.6 768.4 8.8 ketone Acetone Table II 1,794.4 21.7 1,881.0 21.6 Cocaine and heroin Ethyl ether Table II 27.1 0.3 28.7 0.3 Cocaine and amphetamine sulphate Sulphuric acid Table II 1,144.9 13.8 1,455.1 16.7 Cocaine, heroin, methamphetamine, Hydrochloric acid Table II 308.0 3.7 330.1 3.8 “ecstasy” and phencyclidine Table I 574.0 616.0 7.1 Internationally controlled precursors Table II 7,703.9 8,096.7 92.9 Table I and Table II 8,280.0 8,713.9 100.0 All chemicals 1,764 429 1,764 429 Precursors as a percentage of international trade in chemicals 0.5 0.5 Source: October 2013 data from UN COMTRADE (based on HS07 classification for precursor chemicals and Standard International Trade Classification Revision 3 for global chemicals imports and exports). and Table II precursors. While Table II precursor chemicals Fig. 12. Global exports of precursor chemicals rose three-and-a-half times in constant dollars over the in constant 2012 dollars, 1996-2012 1996-2012 period, the increase in the more strictly con- 9,000 1,800 trolled substances in Table I amounted to 35 per cent (see 8,000 1,600 figure 12). 7,000 1,400 6,000 1,200 2. Trafficking in Table I and Table II 5,000 1,000 substances 4,000 800 3,000 600 One way to examine trafficking in precursor chemicals is 2,000 400 to analyse statistics relating to seizures, although these may 1,000 200 reflect variations in law enforcement efforts and changes 0 0

in trafficking patterns. Information on seizures also pro- Millionsof 2012 constant dollars Millions of constant 2012 dollars vides only a partial picture of trafficking of precursors 1996 1998 2000 2002 2004 2006 2008 2010 2012 because law enforcement activities in this area are geared All internationally controlled precursors (left axis) towards the prevention of diversion (e.g. via stopped sus- Table II precursors (left axis) picious shipments) and the detection of clandestine Table I precursors (right axis) laboratories. Source: Data from UN COMTRADE (based on HS96 classification). WORLD DRUG REPORT 2014 WORLD DRUG REPORT 68 2. PRECURSOR CONTROL

Fig. 13. Global seizures of substances in Table I, in tons, 1989-2012

1,400 Cocaine precursor

1,200 Heroin precursor ATS precursors 1,000 Others

800 Tons 600

400

200 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Note: Preliminary data for 2012; figures may increase once additional information becomes available. Cocaine precursor: potassium permanganate Heroin precursor: acetic anhydride Amphetamine-type stimulants precursors: P-2-P, phenylacetic acid, ephedrine, pseudoephedrine, norephedrine, 3,4-MDP-2-P, safrole, isosafrole and piperonal Others: lysergic acid; ergometrine, ergotamine and N-acetylanthranilic acid. Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years).

Compared with seizures of all drugs, seizures of precursors Preliminary figures for 2012, in contrast, show some of are concentrated in a smaller number of countries and are the lowest seizure figures for substances in Table I in the the result of fewer operations. They are often the result of past two decades (see figure 13). Declines were reported joint international operations and are characterized by the primarily for phenylacetic acid and acetic anhydride. Some interception of large volumes per seizure case. A relatively of the decline also reflects the fact that seizure information low, though rising, number of Governments report such is not yet available from all countries, i.e. totals may still seizures. The number increased from 37 in 2002 to 61 in rise. Seizures of potassium permanganate, several of the 2012,62 reflecting improvements in precursor control as precursors of amphetamine-type stimulants and the pre- well as a greater geographical spread in the smuggling of cursors of lysergic acid diethylamide (ergotamine, lysergic precursors. The number of Governments reporting seizures acids) rose in 2012. of precursors is still, however, only half of the number reporting drug seizures (124 in 2012). Over the 2002-2012 Seizures of substances in Table II show a different pattern. period, 96 Governments reported seizures of precursors, Overall seizures of such substances peaked in 2002 and in compared with 146 reporting seizures of drugs.63 2004 (see figure 14). The 2002 peak was mainly the result of acetone seizures, while the 2004 peak was linked to sei- Owing to the smaller number of seizures involved, seizures zures of hydrochloric acid. Since then, overall seizures have of precursors are characterized by large annual fluctuations, been at far lower levels. The underlying trend, except for which makes trend analyses difficult to interpret and often the two peaks, appears to have been stable. This is in con- rather speculative. trast to international licit trade in these substances, which The annual fluctuations have been very large for seizures has greatly increased over the past two decades. In recent of Table I precursors, which peaked in 2011, primarily years, seizures of substances in Table II have been domi- reflecting a massive rise of seizures of the amphetamine- nated mainly by seizures of sulphuric acid and/or acetone. type stimulants precursor phenylacetic acid and its deriva- During the 1990-2012 period, seizures of substances in tives64 and some increases in acetic anhydride, potassium Table II accounted in volume terms for almost 98 per cent permanganate, ephedrine and safrole. of all seizures of chemicals controlled under the 1988 Convention.

62 The number of countries reporting seizures of Table I precursors The regional distribution of seizures of substances in Table to the Board rose from 32 in 2002 to 51 in 2012; the number of I and Table II shows a concentration in the Americas, fol- countries reporting seizures of Table II precursors rose from 28 to 45 lowed, depending on the time frame used, by either Europe during the same time period. or Asia. The largest overall precursor seizures in volume 63 Data from the annual reports questionnaire of UNODC. terms during the 2002-2012 period were reported by coun- 64 The peak in 2011 occurred in the wake of the international Operation Phenylacetic Acid and Its Derivatives, conducted under the auspices tries in North America (59 per cent of the total), followed of Project Prism, which deals with precursors of synthetic drugs. by South America (12 per cent), Europe (4 per cent) and F. Key precursors used in the illicit manufacture of drugs 69

Fig. 14. Global seizures of Table II substances in volume terms, 1989-2012

70,000 Acetone Sulphuric acid 60,000 Hydrochloric acid Ethyl ether 50,000 Piperidine Methyl ethyl ketone 40,000 Tons Anthranillic acid Toluene 30,000 Table II substances Overall trend 20,000

10,000 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Note: Preliminary data for 2012; figures may increase once additional information becomes available. Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years).

Asia (3 per cent). Africa accounted for 0.05 per cent and Potassium permanganate is also used in the illicit manu- the Oceania region for 0.02 per cent. facture of cocaine. It is employed in the processing of coca paste into cocaine base, and is critical for achieving a If the analysis is restricted to more recent years (2007- proper crystallization of cocaine HCl later in the process, 2012), the largest seizures were made in South America and ultimately for obtaining high-quality cocaine.66 (60 per cent of the total), followed by North America (17 per cent), Asia (15 per cent, of which the bulk (13 per cent (b) International trade of the world total) were made in East and South-East Asia) Global exports of potassium permanganate (based on data and Europe (8 per cent). Seizures in the Oceania region from UN COMTRADE) amounted to 25,400 tons in accounted for 0.1 per cent and Africa for 0.04 per cent of 2012, exceeding globally reported imports (17,500 tons).67 the total. This indicates discrepancies in the reporting of trade sta- F. KEY PRECURSORS USED IN tistics, along with possible underreporting of imports. THE ILLICIT MANUFACTURE The value of global exports of potassium permanganate amounted to slightly more than $70 million in 2012 OF DRUGS (equivalent to 0.004 per cent of global chemical exports in 2012), up from $23 million in 1996 (see figure 15). 1. Key chemical used in the manufacture of cocaine: During the 2007-2012 period, a total of 66 Governments potassium permanganate reported exports of potassium permanganate, while 141 Governments reported imports. Total exports amounted (a) Use to $55.3 million per year during the period. The largest Potassium permanganate has a broad range of licit applica- exporters were China (54 per cent of the total), followed tions, mostly derived from its characteristic as an oxidizing by the United States (14 per cent), Belgium (11 per cent) agent in chemical reactions. Those applications include and India (7 per cent). use as a disinfectant for hands; for the treatment of der- The largest importer of the substance in South America matitis, fungal infections and mouth ulcers; for fruit pres- during that period was Brazil, with imports of about 1,000 ervation and disinfection of vegetables; treatment of tons per year, more than 90 per cent of which originated drinking water and wastewater; and as an oxidant and in China. Annual licit imports into the three main cocaine- reagent for the synthesis of various organic compounds. producing countries were far lower: 45 tons for Peru, 29 Significant amounts are required for the synthesis of ascor- tons for Colombia and 6 tons for the Plurinational State bic acid (used for vitamin C tablets) and saccharin (an of Bolivia. The potassium permanganate required (385 artificial sweetener). Solutions of potassium permanganate with hydrogen peroxide were used to propel rockets65 and are still used to propel torpedoes. 66 H. L. Schlesinger, “Topics in the chemistry of cocaine”, in Bulletin on Narcotics, Issue 1 (1985), pp. 63-78. 67 If correctly reported, total imports and exports at the global level 65 Josef Köhler and others, Explosivstoffe (Wiley-VCH, July 2008). should be equal in weight terms. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 70 2. PRECURSOR CONTROL

Fig. 15. Global exports of potassium Fig. 16. Global seizures of potassium permanganate, 1996-2012 permanganate, 1989-2012 80.0 200 70.0 60.0 150 50.0

Tons 100 40.0 30.0

Millions of of Millions dollars 50 20.0 10.0 0 0.0 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years). Exports in current dollars Exports in constant 2012 dollars South America accounted for 88 per cent of seizures, Source: Data from UN COMTRADE. reflecting the use of the substance in the illegal manufacture of cocaine in the Andean region, followed by Asia (9 tons per year) for the manufacture of illegal cocaine68 is per cent), mostly China (8 per cent of total global seizures). rather large compared with an annual total of 1,500 tons The bulk of the seizures made by China took place in of legal imports into South America, Central America and 2012, reflecting improved control measures in that coun- the Caribbean during the 2007-2012 period, suggesting try. The International Narcotics Control Board reported that diversion from the licit market happens before it that more than three quarters of all pre-export notifications reaches the region and/or that it is being produced domes- for potassium permanganate in 2011 were issued by China, tically in clandestine laboratories in the Andean region.69 followed by the United States and India.70 (c) Trafficking The largest seizures worldwide were reported by Colombia Following initially high seizures of potassium permanga- (80 per cent during the 2007-2012 period), followed, in nate in 1989, when the substance was placed under inter- the Americas, by the Plurinational State of Bolivia (4 per national control, seizures remained rather modest during cent) and Peru (2 per cent). Average annual seizures fell by the following decade before rising sharply in 1999 in the half in Colombia during the 2007-2012 period as com- wake of Operation Purple (launched under the auspices pared with the 2002-2006 period, but more than tripled in Peru and rose 27-fold in the Plurinational State of Boliv- of the International Narcotics Control Board in April 71 1999), which focused on the tracking of potassium per- ia. Those patterns reflect a decline in cocaine production manganate and led to a temporary shortage of the chemical in Colombia, as well as the growing importance of both in the Andean region. As a consequence, alternative sub- the Plurinational State of Bolivia and Peru as not only coca-producing countries72 but also cocaine-manufactur- stances were used and operators of cocaine laboratories 73 (notably in Colombia) experimented with the illegal pro- ing countries. duction of potassium permanganate in clandestine laboratories. Further noteworthy seizures were made during 70 International Narcotics Control Board, Precursors Report, 2012, para. the 2004-2007 period as part of Operation Cohesion. Sei- 96. zures subsequently declined, in parallel with declines in 71 Seizures of potassium permanganate in the Plurinational State of Bolivia surged between 2006 (104 kg) and 2011 (9,914 kg) before global cocaine production and falling purity levels in North falling in 2012 (954 kg). These trends were in parallel with the America, until 2009 and remained at lower levels before destruction of coca base and HCl laboratories in that country, rising climbing again in 2012 (see figure 16). from 645 in 2000 to 2,622 in 2005, 4,074 in 2006 and 5,299 in 2011, before falling to 4,508 in 2012. (UNODC, Estado Plurina- Thirty-nine Governments reported seizures of potassium cional de Bolivia: Monitoreo de Cultivos de Coca 2012 (July 2013)). permanganate during the 2002-2012 period, including 31 72 The average annual area under coca cultivation declined in Colom- bia by 71 per cent between 2000 and 2012, or 18 per cent during Governments during the 2007-2012 period. Global aver- the 2007-2012 period as compared with the 2002-2006 period. In age annual seizures of the substance totalled 65 tons during contrast, it increased in Peru by 39 per cent during the 2000-2012 the 2007-2012 period, equivalent to 0.3 per cent of global period, or 23 per cent during the 2007-2012 period as compared with the 2002-2006 period, and it increased in the Plurinational licit exports. State of Bolivia by 73 per cent between 2000 and 2012, or by 15 per cent during the 2007-2012 period as compared with the 2002-2006 period. (See chapter I of this edition and previous World Drug Reports.) 68 See calculations in subsection 1 (a) of section G below. 73 The number of dismantled cocaine paste, base and crystallization 69 International Narcotics Control Board, Precursors Report, 2013. laboratories rose in the Plurinational State of Bolivia from 3,093 units F. Key precursors used in the illicit manufacture of drugs 71

There are indications that significant amounts of potas- (b) International trade sium permanganate are produced illegally in the Andean Estimates of annual licit production of acetic anhydride region. In 2011, Colombian authorities dismantled seven range from 1.1 million tons (2011)79 to 2.13 billion litres, laboratories producing the substance; in 2012, eight such or 2.3 million tons,80 per year. The latest estimate of the laboratories were dismantled.74 The International Narcot- International Narcotics Control Board is close to 1.5 mil- ics Control Board cites estimates that between 60 and 80 lion tons per year.81 per cent of the potassium permanganate used in Colombia is obtained nowadays through illicit manufacture of the Global exports of acetic anhydride in 2012 reached substance using manganese dioxide as a starting material.75 397,000 tons, while global imports reached 414,000 tons, Backtracking investigations also suggest that potassium suggesting that international trade amounts to some 28 permanganate has been diverted from domestic distribu- per cent of global production of the substance. Global licit tion channels abroad and then smuggled into the Andean exports of acetic anhydride rose, in real terms, by 80 per region and/or that alternative chemicals have been used.76 cent during the 1996-2012 period (see figure 17). This Smaller amounts were also seized in Argentina, Brazil, was less than the rise in chemical exports in general. Chile, Ecuador and Venezuela (Bolivarian Republic of), i.e. in countries neighbouring the three main cocaine-pro- Fig. 17. Global exports of acetic anhydride, ducing countries, during the 2007-2012 period. In 2013, 1996-2012 small amounts were also found in dismantled cocaine- 500.0 processing laboratories in the Dominican Republic and 77 Panama. 400.0 2. Key chemical used in the manufacture of heroin: acetic 300.0 anhydride 200.0 (a) Use Millions of of dollars Millions Acetic anhydride is used mainly as an acetylating and dehy- 100.0 drating agent in the chemical and pharmaceutical industries. It is a versatile reagent and is used, inter alia, in the 0.0 production of aspirin and the conversion of cellulose to cellulose acetate, a substance used for photographic films, 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 adhesives, synthetic fibres and as a frame material for eye- Exports in current dollars glasses. It is also used as a wood preservative, for polishing Exports in constant 2012 dollars metals and in the production of brake fluid, dyes and explosives. Source: Data from UN COMTRADE (based on HS96).

In addition, acetic anhydride is used in the manufacture During the 2007-2012 period, 118 Governments reported of heroin and, to a lesser extent, in the manufacture of importing acetic anhydride, while 45 reported exports of other drugs, such as methaqualone, or in the conversion the substance. The largest exporters in Asia were China of phenylacetic acid to P-2-P. The synthesis of heroin, also and Japan; in North America, the United States and known as “diacetylmorphine”, is a simple one-step acetyla- Mexico; and in Europe, Belgium and the Netherlands. In 78 tion reaction of morphine using acetic anhydride. terms of “net exports”, North America predominates (Mexico followed by the United States). in 2007 to 5,299 units in 2011. Similarly, the number of dismantled coca paste and base laboratories in Peru rose from 649 in 2007 to Officially reported licit imports into South-West Asia, 1,498 in 2011 while the number of cocaine crystallization laboratories however, were very small. There were no licit imports into there rose from 16 in 2007 to 21 in 2010 and still 19 in 2011. In contrast, the number of cocaine paste/base laboratories in Colombia Afghanistan. Licit imports into Pakistan fell from 149 kg declined from 3,147 in 2008 to 2,200 in 2011 while the number of dismantled cocaine crystallization laboratories fell in Colombia from 296 to 200 over the same period. (UNODC, Colombia, Monitoreo de Cultivos de Coca 2011 and previous years; Peru, Monitoreo de Cultivos mended Methods for Testing Opium, Morphine and Heroin (New York, de Coca 2011 and previous years; and Estado Plurinacional de Bolivia, 1998), p. 7. Monitoreo de Cultivos de Coca 2011 and previous years.) 79 “Acetic Acid Global Market to 2020” (GBI Research, 1 Febru- 74 Data from the annual reports questionnaire of UNODC. ary 2013). Available from www.companiesandmarkets.com. See also www.plastemart.com/Plastic-Technical-Article.asp?LiteratureI 75 International Narcotics Control Board, Precursors Report, 2013, para. D=1918&Paper=global-acetic-acid-market-estimated-15.5-million- 97. tons-2020. 76 International Narcotics Control Board, Precursors Report, 2012, para. 80 International Narcotics Control Board, Precursors Report, 2012, box 95. 1. One kilogram of acetic anhydride is equivalent to 0.926 litres of 77 International Narcotics Control Board, Precursors Report, 2013, para. acetic anhydride. 98. 81 International Narcotics Control Board, Precursors Report, 2013, para. 78 United Nations International Drug Control Programme, Recom- 106. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 72 2. PRECURSOR CONTROL

in 2008 to 14 kg in 2012, according to data from UN Fig. 18. Global seizures of acetic anhydride, COMTRADE. That is far below the requirements of 1989-2012 Afghanistan’s opiate industry. No licit acetic anhydride 250,000 imports were reported by the Islamic Republic of Iran or any of the other countries bordering Afghanistan (except 200,000 China). Yet, clandestine heroin production and seizures of acetic anhydride in West Asia, notably in Afghanistan, were 150,000 substantial. This suggests that most of the acetic anhydride destined for the subregion originates as diversions made Litres 100,000 outside the subregion.82 50,000 In Asia, relatively large imports of acetic anhydride during the 2007-2012 period were reported by China (24,400 0 tons per year), the Republic of Korea (10,600 tons), Sin-

gapore (6,700 tons), Thailand (4,000 tons) and India 1989 1991 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 (1,200 tons). Historically, the largest importer in South- Acetic anhydride Overall trend Eastern Europe has been Turkey (1,400 tons per year), an Source: International Narcotics Control Board, Precursors Report, important trans-shipment location for acetic anhydride 2013 (and previous years). diverted in Europe and smuggled into Afghanistan. During the same period in Asia, relatively large exports were Countries close to Afghanistan are at a particular risk of reported by Saudi Arabia (17,100 tons per year), the being targeted to obtain and traffic acetic anhydride into United Arab Emirates (15,800 tons),83 China (11,400 Afghanistan. “That applies particularly to China, India, tons), Japan (8,200 tons), Singapore (5,700 tons) and India Islamic Republic of Iran and Uzbekistan – countries that (2,300 tons). manufacture acetic anhydride or countries in which a significant amount of the substance is available because of (c) Trafficking domestic or international trade” 86 as well as to Iraq 87. Following increases in seizures of acetic anhydride in the Two recent large seizures made in Pakistan88 and the 1990s, and a peak reached in 2001 in the wake of the Islamic Republic of Iran89 show how these countries con- implementation of Operation Topaz (which started in late tinue to be used as transit countries for such shipments. 2000), seizures fell in the first few years of the new mil- The next largest seizures were reported by countries in lennium, possibly as a delayed reaction to the 2001 Afghan Europe90 (27 per cent of the total during the 2007-2012 opium poppy ban, before recovering as precursor control period). The largest, in order of size, were made in Slove- gained a new impetus in the wake of the introduction of nia, Hungary, the Russian Federation, Bulgaria and Operation Cohesion in 2006. Even though seizures Slovakia. declined in 2012, the underlying trend seems to be upwards (see figure 18). During the 2002-2012 period, Turkey reported regular Seizures of acetic anhydride were reported by 43 Govern- seizures of acetic anhydride, typically originating in West- 91 ments during the 2002-2012 period. Global annual sei- ern and Central Europe. Overall seizures of acetic anhy- zures during the 2007-2012 period amounted to dride in Turkey have shown a downward trend, possibly approximately 131,000 litres, equivalent to just 0.03 per reflecting the declining importance of Europe as a source cent of global imports. region. The largest seizures were made in “West Asia”84 (34 per cent of the world total), mostly reflecting seizures made in 86 International Narcotics Control Board, Precursors Report, 2012, para. Afghanistan (22 per cent of the world total). 112. 87 In January 2012, Iraqi authorities objected to a shipment of 32 Afghanistan has no legitimate trade in or manufacture of tons of acetic anhydride from China. (INCB, 2012 Precursors and acetic anhydride. Despite that fact, sizeable quantities of chemicals frequently used in the illicit manufacture of narcotic drugs and psychotropic substances, New York 2013, p. 25). the substance are diverted each year from domestic trade 88 In mid-2013, for instance, 15 tons of acetic anhydride were seized in other countries before being smuggled into while transiting Pakistan on its way to Afghanistan (International Afghanistan.85 Narcotics Control Board, Precursors Report, 2013, para. 111). 89 A recent example was a shipment of 17.8 tons of acetic anhydride from China via the Islamic Republic of Iran to Afghanistan, which 82 International Narcotics Control Board, Precursors Report, 2013, paras. was seized by the Iranian authorities in June 2013. (International 109-112. Narcotics Control Board, Precursors Report, 2013, para. 111). 83 This reflects huge exports of 94,749 tons of acetic anhydride in 2008, 90 According to the International Narcotics Control Board classification, while no exports were reported in other years. which excludes Turkey. 84 According to Board classification, West Asia includes countries in the 91 One of the largest cases involved the seizure of 17 tons of acetic Near and Middle East, Central Asia, Turkey and the Caucasus. anhydride in Turkey in December 2010 on a truck which had loaded 85 International Narcotics Control Board, Precursors Report, 2012, para. the chemicals in Slovakia and was, officially, said to be transporting 106. disinfectants. F. Key precursors used in the illicit manufacture of drugs 73

Seizures in North America, which accounted for 26 per sold as food supplements or pills to lose weight and reduce cent of the world total during the 2007-2012 period, were body fat. made mainly by Mexico (15 per cent of the world total) 95 and the United States (11 per cent). Such seizures were A total of 113 Governments reported licit requirements increasingly linked to the illicit manufacture of metham- for ephedrine to the Board, and 108 reported requirements phetamine, and increased after 2009. for pseudoephedrine (out of a total of 153 Governments reporting).96 The bulk of the requirements for these sub- Seizures in East and South-East Asia accounted for 11 per stances concerned pseudoephedrine (see figure 19). The cent of the world total during the 2007-2012 period, pri- largest licit demand for those substances was in Asia (60 marily reflecting seizures made in China (8 per cent of the per cent of the total), followed by the Americas (18 per world total), followed by the Republic of Korea and Japan. cent), Europe (13 per cent), Africa (8 per cent) and the The only other country in South-East Asia reporting Oceania region (0.4 per cent). The single largest markets annual seizures during the 2002-2010 period was Myan- for ephedrine and pseudoephedrine in volume terms were mar, the world’s second-largest producer of opium. India (18 per cent of the world total) and China (17 per cent), followed by the United States (13 per cent), the As reported by the Interational Narcotics Control Board, United Kingdom (4.2 per cent), the Republic of Korea “while seizures are an important indicator of the level of (3.9 per cent), Switzerland (3.3 per cent), Pakistan (3.2 activity of drug trafficking organizations, it is important per cent), Egypt (3.1 per cent), Singapore (2.9 per cent), to note that they are also indicators of known diversions Indonesia (2.7 per cent), the Islamic Republic of Iran (2.5 that have been successful. The international precursor con- per cent), the Syrian Arab Republic (2.3 per cent) and trol system is primarily aimed at the prevention of diver- Nigeria (1.5 per cent).97 sion. Comparative figures on stopped, suspended or suspicious shipments show that although seizures of acetic Fig. 19. Licit requirements for ephedrine and anhydride during the period 2008-2011 amounted to pseudoephedrine, 2012 (or latest year 551,000 litres, nearly double that amount — 943,000 available) litres — was either stopped or suspended (a total of 761,000 litres) or identified as suspicious (182,000 litres) 1,800 80 through the PEN Online system."92 1,600 1,400 3. Key methamphetamine 1,200 precursors: ephedrine and 1,000 Tons pseudoephedrine 800 1,688 600 (a) Use 94 400 Ephedrine and/or pseudoephedrine have been the key pre- 200 cursors used in the manufacture of methamphetamine for 330 0 many years. In addition, they are used in the illegal manu- Ephedrine Pseudoephedrine facture of methcathinone, another amphetamine-type stimulant. Pseudoephedrine preparations Pseudoephedrine Ephedra, known as má huáng in traditional Chinese Ephedrine preparations medicine, contains both ephedrine and pseudoephedrine. Ephedrine Its use has been documented since the Han Dynasty (206 Note: Based on information from 153 Governments. B.C.-220 A.D.),93 in the treatment of asthma and Source: International Narcotics Control Board, Precursors Report, bronchitis and as a stimulant. Licit uses of ephedrine as a 2013, annex II. pharmaceutical product include cough medicine (bronchodilators), while pseudoephedrine is often used in nasal decongestants. In combination with promethazine, ephedrine is used to combat seasickness. Ephedrine is also 18th list (April 2013). found on the WHO list of essential medicines “for use in 95 “Annual legitimate requirements for ephedrine and pseudoephedrine include quantities of those substances that may be manufactured spinal anaesthesia during delivery, to prevent domestically and/or imported into the country to provide adequate hypotension”.94 In addition, ephedrine preparations are supplies of each chemical for estimated medical, scientific, research and industrial needs; licit export requirements; and establishment and maintenance of reserve stocks.” (International Narcotics Control 92 International Narcotics Control Board, Precursors Report, 2012, para. Board, “Issues that Governments may consider when determining 115. annual legitimate requirements for ephedrine and pseudoephed- 93 Woodburne Levy and Kavita Kalidas, “Use of addictive medications rine”. Available from www.incb.org/incb/en/precursors/precursors/ and drugs in athletics”, in Principles of Addictions and the Law: Appli- tools_and_kits.html.) cations in Forensic, Mental Health, and Medical Practice, Norman S. 96 International Narcotics Control Board, Precursors Report, 2013, annex Miller, ed. (Academic Press, 2010), pp. 307-308. II. 94 World Health Organization, WHO Model List of Essential Medicines: 97 Ibid. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 74 2. PRECURSOR CONTROL

(b) International trade (c) Trafficking Global international trade in ephedrine and pseudoephed- While there has been a marked upward trend in overall rine declined during the 1996-2012 period (see figure 20). seizures of precursors used in the manufacture of methamphetamine and amphetamine (see figure 21), that has not Global exports of ephedrine amounted to, on average, 133 been the case with regard to the “traditional” metham- tons per year during the 2007-2012 period, or roughly phetamine precursors, ephedrine and pseudoephedrine. half of reported imports (264 tons per year). That discrepancy once again indicates problems with regard to report- Global seizures of ephedrine and pseudoephedrine peaked ing of trade statistics. in the second half of the 1990s and again in 2004 before falling in subsequent years (see figure 22). Thirty Governments reported exports of ephedrine, while 92 reported imports, during the 2007-2012 period. The The initial increases were in line with reports of strong largest ephedrine exports were reported by India (59 per growth in the clandestine manufacture of methampheta- cent). The largest imports were reported by the United mine since the mid-1990s. The declines in recent years States (20 per cent) and Egypt (19 per cent), followed by seem to reflect improved controls for these substances, the Republic of Korea (8 per cent) and Nigeria (6 per cent). along with the emergence of alternative precursor chemicals such as phenylacetic acid and a number of chemicals Global pseudoephedrine exports amounted to, on average, not under international control. In addition, data show 1,136 tons per year during the 2007-2012 period, exceed- that the use of pharmaceutical preparations containing ing imports (863 tons per year). Thirty-five Governments ephedrine or pseudoephedrine has increased in recent reported exports of pseudoephedrine, while 96 Govern- years.99 ments reported imports during that period. The largest exports were reported by India (52 per cent of the total), Seizures of ephedrine were reported by 54 Governments followed by Germany and China. According to the United and seizures of pseudoephedrine by 50 Governments States Department of State, Taiwan Province of China was during the 2002-2012 period. Total seizures of both sub- actually the third-largest exporter worldwide of pseu- stances amounted to, on average, 56 tons per year during 100 doephedrine during the 2009-2011 period.98 The largest the 2007-2012 period, equivalent to 21 per cent of pseudoephedrine imports during the 2007-2012 period global licit imports (based on UN COMTRADE data), a were recorded by the United States (25 per cent), followed very high proportion as compared to potassium perman- by Egypt (8 per cent). ganate or acetic anhydride, which both had ratios of clearly less than 1 per cent.

Fig. 20. Global exports of ephedrine and The bulk of the seizures were made by countries in North pseudoephedrine, 1986-2012 America (43 per cent) and East and South-East Asia (22 per cent), reflecting the concentration of global metham- 180 phetamine production in those two regions, followed by 160 Central America (14 per cent), an emerging transit region. 140 The largest seizures by individual countries during the 120 2007-2012 period were reported by the United States (32 100 per cent of the total), followed by China (18 per cent) and 80 Mexico (11 per cent). 60 East and South Asia continue to be the origins of pseu- Millions of of dollars Millions 40 doephedrine and ephedrine used in illicit manufacture of 20 methamphetamine in the region and in Oceania.101 Sei- 0 zures of ephedrine and pseudoephedrine in Mexico have been declining strongly following improved controls in the 1996 1998 2000 2002 2004 2006 2008 2010 2012 country in 2009, which prompted clandestine operators Pseudoephedrine in current dollars of methamphetamine to shift to alternative precursors. Ephedrine in current dollars While Mexico is a major supplier of methamphetamine, Ephedrine and pseudoephedrine in the country does not seem to have clandestine facilities or constant 2012 dollars

Source: Data from UN COMTRADE. 99 International Narcotics Control Board, Precursors Report, 2013 (and previous years). 100 Based on international trade data collected by the International Nar- cotics Control Board, the proportions during the 2007-2011 period amounted to 14 per cent for bulk ephedrine and 2 per cent for pseu- 98 United States Department of State, Bureau of International Narcotics doephedrine (Precursors report, 2012, table 1). and Law Enforcement Affairs, International Narcotics Control Strategy 101 UNODC, Patterns and Trends of Amphetamine-Type Stimulants and Report, vol. I (March 2013), chapter on “Chemical controls”. See also Other Drugs: Challenges for Asia and the Pacific, Global SMART Pro- the same report from previous years. gramme 2013. F. Key precursors used in the illicit manufacture of drugs 75

Fig. 21. Global seizures of key amphetamines precursors, 1989-2012

1,200,000 Ephedrine (kg) Pseudoephedrine (kg) 1,000,000 Norephedrine (kg) P-2-P (litres) 800,000 Phenylacetic acid (kg) TOTAL 600,000 Overall trend Kilograms/litres 400,000

200,000

0 1999 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Note: Preliminary data for 2012; data for ephedrine and pseudoephedrine include pharmaceutical preparations. Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years).

Fig. 22. Global seizures of ephedrine and pseudoephedrine, 1989-2012

200,000 Ephedrine (bulk)

Ephedrine (preparations) 150,000 Pseudo-ephedrine (bulk) Pseudo-ephedrine 100,000 (preparations)

Kilograms Total

50,000

0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years). chemical plants that synthesize or manufacture pseu- region, followed by the Lao People’s Democratic Republic; doephedrine or ephedrine powder. Mexico dismantled 259 Malaysia; the Philippines; Thailand; Indonesia; Japan; methamphetamine laboratories in 2012, up from a few Macao, China; Hong Kong, China; Cambodia; and the dozen a few years earlier, and it reported the world’s largest Republic of Korea. Traditionally, most of the shipments of aggregrated amount of seizures of methamphetamine for ephedrine and pseudoephedrine to countries and areas in the period 2010-2012. the region originate within the subregion or in South Asia. Most of the seizures of these precursors in East and South- 4. Key amphetamine precursors: East Asia involved ephedrine (80 per cent). There was also P-2-P and phenylacetic acid a significant domestic demand for both ephedrine and pseudoephedrine. China alone dismantled 228 clandestine (a) Use laboratories producing methamphetamine in 2012.102 Sig- nificant seizures of ephedrine were also reported by Myan- One of the key precursors for the manufacture of ampheta- mar, another key producer of methamphetamine in the mine (and in recent years also of methamphetamine) is phenyl-2-propanone (P-2-P), or phenylacetone, also 102 International Narcotics Control Board, Precursors Report, 2013, para. known as benzyl methyl ketone (BMK). This substance is 48. mainly used for the manufacture of amfetamine and some WORLD DRUG REPORT 2014 WORLD DRUG REPORT 76 2. PRECURSOR CONTROL

of its derivatives, as well as for the synthesis of another Fig. 23. Global exports of P-2-P and stimulant drug, propylhexedrine. The latter substance is phenylacetic acid, 1986-2012 frequently sold over-the-counter as an inhalant (e.g. Ben- 35 zedrex) to provide temporary relief of nasal congestion, and as an appetite suppressant (e.g. Obesin). 30 Global licit requirements for P-2-P reported to the Board 25 amount to some 65 tons per year, a modest amount com- 20 pared with the reported requirements for ephedrine (close to 400 tons) or pseudoephedrine (more than 1,700 tons). 15 The bulk of the reported licit requirements for P-2-P was 10 from countries in North America (96 per cent of the total), of dollars Millions 5 followed by Europe (4 per cent). Small requirements were also reported by Governments in Oceania, Asia, South 0 America and the Caribbean.103 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 One of the potential precursors for P-2-P is phenylacetic acid, which itself is employed to treat type II hyperam- Phenylacetic acid (PAA) P-2-P monemia, a metabolic disturbance characterized by an P-2-P and PAA in constant 2012 US$ excess of ammonia in the blood that can lead to encepha- lopathy (a brain disorder). Moreover, phenylacetic acid is Source: Data from UN COMTRADE. used in the production of penicillin G (benzylpenicillin), as well as in the treatment of syphilis, diphtheria, menin- lower imports were reported mainly from Mexico, the gitis, gonorrhoea, aspiration pneumonia and septic arthri- United Kingdom and Spain. Declines in 2012 can be tis. Phenylacetic acid is also used in some perfumes. ascribed to falling exports from China; declines in imports were mainly the result of improved controls in Mexico. (b) International trade (c) Trafficking Average global exports of P-2-P during the 2007-2012 period amounted to 77 tons, while average annual imports The overall trend with regard to total combined seizures amounted to 143 tons, once again indicating significant of P-2-P and phenylacetic acid appears to have been reporting discrepancies. Fifteen Governments reported upwards (see figure 24). The rise in seizures until 2011 was exports of P-2-P during the 2007-2012 period. The largest primarily a result of seizures of phenylacetic acid, which is exporters were France (51 per cent), followed by India (14 increasingly being used in North American methampheta- per cent) and Egypt (14 per cent). mine production. The peak in 2011 may in part have been The number of Governments reporting imports of P-2-P a result of the transfer of phenylacetic acid from Table II during the 2007-2012 period amounted to 52. The largest to Table I of the 1988 Convention in that year and thus importers were the United States (53 per cent), followed of stricter monitoring and controls. Moreover, the inter- by China (17 per cent), Jordan (6 per cent), Poland (5 per national Operation Phenylacetic Acid and its Derivatives, cent) and Egypt (4 per cent). In 2012, the largest import- conducted under Project Prism in 2011 by the Board, ers was the United States, followed by Pakistan. appears to have played an important role. International trade in phenylacetic acid is substantially Average annual seizures of P-2-P during the 2007-2012 larger. Total exports amounted to 4,800 tons per year and period amounted to 8.3 tons, while average annual seizures total imports to 5,900 tons per year during the 2007-2012 of phenylacetic acid reached 216.7 tons. Seizures of the period. The largest exporter during the 2007-2012 period latter were higher than those of ephedrine and pseu- was China (75 per cent), followed by the United States (16 doephedrine. Global seizures of P-2-P were equivalent to per cent) and India (7 per cent). The largest importer was 6 per cent of global P-2-P imports, and phenylacetic acid Mexico (32 per cent). A total of 32 Governments reported seizures were equivalent to 4 per cent of global phenylacetic 104 exports of phenylacetic acid, while 79 reported imports of acid imports during the 2007-2012 period. These were phenylacetic acid during the 2007-2012 period. smaller proportions than for ephedrine and pseudoephedrine (based on UN COMTRADE data). Combined global exports of P-2-P and phenylacetic acid in 2012 remained at similar levels as in 1996 (see figure Seizures of P-2-P were reported by 22 Governments and 23). A decline of 59 per cent in exports of phenylacetic seizures of phenylacetic acid by 20 Governments during acid during the 2007-2012 period was linked mostly to lower exports by the United States, China and India, while 104 Based on international trade statistics collected by the Board, seizures of P-2-P were equivalent to 15 per cent of international trade, 103 In total, 24 countries reported licit requirements for P-2-P to the and phenylacetic acid equivalent to 11 per cent of international Board. (International Narcotics Control Board, Precursors Report, trade during the 2007-2011 period. (International Narcotics Control 2013, annex II.) Board, Precursors Report, 2012, table 1.) F. Key precursors used in the illicit manufacture of drugs 77

Fig. 24. Global seizures of P-2-P and phenylacetic acid, 1989-2012

P2P 60,000 Phenylacetic acid

239,000 TOTAL 50,000 1,022,200 Overall trend

40,000

30,000 Litres/kilograms 20,000

10,000

0 1999 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years). the 2002-2012 period, fewer than the number reporting Safrole, a precursor of 3,4-MDP-2-P and MDMA seizures of ephedrine or pseudoephedrine. (“ecstasy”), is produced mainly from the sassafras plants. According to a study in South-East Asia, the plant is found During the 2002-2012 period, 38 per cent of global P-2-P largely in China, Myanmar and Cambodia107. Other stud- seizures were made in Europe, which is the main ampheta- ies reveal that it can also be produced from a number of mine production centre, followed by East and South-East plants grown in other parts of the world, notably in the Asia (32 per cent) and North America (30 per cent). Americas.108 In East and South-East Asia, more than 360 During the 2007-2012 period, most seizures were made plants containing essential oils rich in safrole were identi- in North America (50 per cent), where P-2-P has been fied. The most widely used plants are those of the Cin- used in the manufacture of methamphetamine. The larg- namomum genus109. Sassafras oil is used mainly in the est seizures were reported by Mexico (38 per cent of the manufacture of safrole, which is used in the manufacture total), followed by the Netherlands and Canada (12 per of pesticides, insecticides and some fragrances. Safrole is cent each) and Belgium and China (10 per cent each). also used for its antiseptic properties and as a pediculicide In the case of phenylacetic acid, North America accounted to treat lice. In addition, it serves as an additive in products for 98 per cent of total global seizures during the 2007- such as root beer, sassafras tea or pinga com sassafras (Brazil). 2012 period. Forensic profiling of seized methampheta- Given indications of its carcinogenic properties, however, mine in the United States confirmed that nearly all safrole has been banned as a food additive in a number of methamphetamine is now being manufactured using phe- countries, including the United States and several Euro- nylacetic acid or other P-2-P-based methods (94 per cent pean Union countries.110 Similarly, for health reasons, the of all samples tested in the second quarter of 2012, up International Fragrance Association issued a recommenda- from 69 per cent in 2010 and close to 0 per cent in tion in 1987 to prohibit or limit its use in fragrance 2007).105 ingredients. 5. Key “ecstasy” precursors: Isosafrole, another precursor of 3,4-MDP-2-P, is an isomer 3,4-MDP-2-P, safrole, isosafrole of safrole. Although it can be produced synthetically out and piperonal of safrole, it is also derived from sassafras oil. It is used in the fragrance industry. Isosafrole is used for making soaps (a) Use

The “traditional” precursor for the manufacture of MDMA 107 “Safrole-rich essential oils — risk of illicit use”, in Eastern Horizons (“ecstasy”) is 3,4-methylenedioxyphenyl-2-propanone (UNODC Regional Centre for East Asia and the Pacific, Summer- Autumn 2007), pp. 9-10. (3,4-MDP-2-P), also known as PMK (piperonyl methyl 108 Sérgio Rocha and Lin Chau Ming, 1999, “Piper hispidinervum: a ketone) or in international trade statistics as 1-(1,3-ben- sustainable source of safrole” in Perspectives on new crops and new zodioxol-5-yl)propan-2-one.106 Its licit use is limited. uses, J. Janick, ed. (American Society for Horticultural Science Press, Alexandria, VA, 1999), pp. 479-481. 109 UNODC, Amphetamines and Ecstasy: 2008 Global ATS Assessment 105 International Narcotics Control Board, Precursors Report, 2012, para. (August 2008), p. 103. 76. 110 Joint FAO-WHO Expert Committee on Food Additives, WHO Food 106 That terminology may have led to some misunderstandings, however, Additives Series 16. Available from www.inchem.org/documents/jecfa/ and thus resulted in erroneous classifications. jecmono/v16je22.htm. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 78 2. PRECURSOR CONTROL

and perfumes, as well as in the manufacture of preserva- Fig. 25. Global exports of 3,4-MDP-2-P, safrole, tives as an antiseptic agent. It is also a key precursor for isosafrole and piperonal, 1996-2012 the manufacture of piperonal. 90 Piperonal, a further precursor for 3,4-MDP-2-P and 80 3,4-methylenedioxyamphetamine (MDA), is another 70 organic compound commonly found in fragrances and 60 flavours. Piperonal occurs in a range of plants, including 50 dill, violets, black pepper and vanilla, but it is also pro- 40 duced by oxidation of isosafrole. Piperonal itself is some- 30 111 times used in aromatherapy. of dollars Millions 20 (b) International trade 10 0 In terms of legal trade, piperonal is nowadays by far the

most important substance among the “ecstasy” precursor 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 chemicals. Global piperonal exports increased during the MDP2P 1996-2012 period, while exports of the other chemicals Safrole declined after reaching a peak in 1998. The strong decline Isosafrole in exports of “ecstasy” precursors between 1998 and 2000 Piperonal was the result mainly of a fall in isosafrole exports, reflect- Ecstasy precursors in constant dollars ing improvements in precursor control owing to a signifi- Source: Data from UN COMTRADE. cant upward trend in “ecstasy” use in key markets in the 1990s (see figure 25). widely traded substance among MDMA precursors, A total of 38 Governments reported exports of “ecstasy” according to UN COMTRADE data. Average annual precursor chemicals during the 2007-2012 period, exports during the 2007-2012 period amounted to 1,759 amounting to, on average, $42 million per year. Imports tons of piperonal, 62 tons of 3,4-MDP-2-P, 25 tons of were reported by 102 Governments ($45 million per year). isosafrole and 9 tons of safrole. If all of these exports are The largest exporters of“ecstasy” precursor chemicals were transformed into 3,4-MDP-2-P equivalents (based on the China (56 per cent) and Hong Kong, China (21 per cent). conversion ratios of the International Narcotics Control The largest importers were Hong Kong, China (18 per Board), the aggregated figure amounts to some 1,000 tons cent) and the United States (17 per cent), followed by per year. The bulk of these exports in volume terms is Germany (9 per cent), Spain (7 per cent), Switzerland (7 accounted for by piperonal (91 per cent), followed by per cent) and the United Kingdom (5 per cent). China 3,4-MDP-2-P (6 per cent), isosafrole (2 per cent) and saf- was the largest net exporter during the 2007-2012 period. role (1 per cent). Calculations on the import side reveal a 112 The totals primarily reflect international trade in piperonal similar pattern. of about $41 million per year. Exports of the substance Expressed in common 3,4-MDP-2-P equivalents, Board were reported by 26 Governments; imports were reported statistics suggest that about two thirds of international by 84 Governments. trade in “ecstasy” precursors relates to piperonal, and The second most widely traded substance was isosafrole: almost a third to safrole and oils rich in safrole. The other 18 Governments reported exports and 53 reported imports. substances, isosafrole and 3,4-MDP-2-P, account for less They recorded annual exports of about $1 million and than 1 per cent of the total (see figure 26). imports of $2.8 million per year during the 2007-2012 Based on such figures, the overall international trade in period, again indicating some significant reporting gaps. (potential) “ecstasy” precursors would have amounted to, Exports of 3,4-MDP-2-P amounted to about $0.3 million on average, 6,580 tons in 3,4-MDP-2-P equivalents during annually, while imports totalled $1.5 million per year the 2007-2011 period. This is a significant discrepancy as it is more than six times the figure found in UN during the 2007-2012 period, again indicating inconsist- 113 encies in reporting. There were a total of 15 Governments COMTRADE . The differences, of course, raise ques- that reported exports and 46 that reported imports. 112 Average annual imports of 1,726 tons of piperonal, 71 tons of isosaf- For safrole, 15 Governments reported exports and 45 role, 40 tons of 3,4-MDP-2-P and 18 tons of safrole during the reported imports. They recorded total exports of $0.09 2007-2011 period. This would amount to approximately 1,000 tons million and imports of $0.17 million per year. in 3,4-MDP-2-P equivalents. 113 The comparison made exaggerates the actual difference, as sassafras oil In both value and volume terms, piperonal is the most is not specifically reported in UN COMTRADE statistics. Neverthe- less, excluding sassafras oil, the overall total based on International Narcotics Control Board statistics would have still been almost five 111 For more information, see http://micro.magnet.fsu.edu/primer/tech- times larger than shown in the UN COMTRADE statistics. This is niques/polarized/gallery/pages/heliotropinsmall.html. mainly owing to differences in the reported trade in piperonal, which F. Key precursors used in the illicit manufacture of drugs 79

Fig. 26. International trade in potential If total seizures during the 2002-2012 period are consid- “ecstasy” precursors in 3,4-MDP-2-P ered, most seizures of “ecstasy” precursors were for safrole equivalents, 2007-2011 (44 per cent), followed by 3,4-MDP-2-P (33 per cent), piperonal (23 per cent) and isosafrole (0.2 per cent). There have been frequent changes in the type of “ecstasy” precursors used, however. In most years during the 1996-2006 period, the “traditional” “ecstasy” precursor, 3,4-MDP-2-P, MDP2P Piperonal was the most widely seized substance. During the 2007- 0.002% 68% 2012 period, improved controls of 3,4-MDP-2-P Isosafrole prompted organized criminal groups to look for alterna- Safrole and 0.20% safrole tives, which led to the use of safrole and various safrole- containing oils containing oils. For the same period, about 85 per cent of (sassafras oil) all seizures of “ecstasy” precursors turned out to be related 32% to safrole, 8 per cent to piperonal and only 7 per cent to 3,4-MDP-2-P. Less than 1 per cent were related to isosafrole. All of this is in sharp contrast to licit international Source: UNODC calculations based on International Narcotics trade, which is dominated by piperonal. Control Board, Precursors Report, 2012. Seizures of all of the “ecstasy” precursors during the 2007- tions as to the underlying reasons for this apparent over- 2012 period amounted to, on average, 13.5 tons or, reporting or underreporting by Member States in the case expressed in 3,4-MDP-2-P equivalents (based on Board of “ecstasy” precursors. conversion ratios), 8.5 tons, equivalent to close to 1 per cent of global exports or imports of these substances.114 (c) Trafficking This is a higher rate than for potassium permanganate or In line with global seizures of “ecstasy”, the overall trend acetic anhydride, although a lower rate than for ampheta- with regard to the seizure of “ecstasy” precursors was mine precursors. upwards in the 1990s, peaking in 2000 and again in 2007 A breakdown by subregion of seizures of “ecstasy” precur- before falling sharply during the 2007-2010 period and sors during the 2007-2012 period shows that more than remaining, despite some recovery, at lower levels until 2012 two thirds (69 per cent) of seizures were in East and South- (see figure 27). Overall seizures of “ecstasy” precursors East Asia and a fifth of them in North America, followed amounted to some 16 tons per year during the 2002-2012 by Oceania (6 per cent) and Europe (4 per cent). period and were thus far lower than seizures of amphetamine precursors (209 tons per year during the same Safrole was seized primarily in East and South-East Asia period). (82 per cent of the total during the 2007-2012 period),

Fig. 27. Global seizures of 3,4-MDP-2-P, safrole, isosafrole and piperonal, 1989-2012

60,000 3,4-MDP-2-P (litres) Isosafrole (litres) 50,000 Safrole (litres) Piperonal (kg) 40,000 Total Overall trend 30,000 Litres /kilograms 20,000

10,000

0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Source: International Narcotics Control Board, Precursors Report, 2013 (and previous years).

114 The calculation shows a ratio of 0.85 per cent for the 2007-2012 period. Based on trade statistics of the International Narcotics Con- is much larger in the Board data and more than offsets the smaller trol Board, the proportion amounted to 0.15 per cent during the numbers reported by the Board in the other categories. 2007-2011 period (see Precursors Report, 2012, table 1). WORLD DRUG REPORT 2014 WORLD DRUG REPORT 80 2. PRECURSOR CONTROL

followed by North America, Europe and the Oceania 1. Interception rates of diverted region. The largest seizures were reported by Thailand and chemicals Malaysia, followed by Australia, the United States, Canada Two figures are needed to estimate the interception rates and Cambodia. Average global seizures of safrole rose of diverted chemicals: the amount seized and the amount almost fourfold between the 1989-2006 period (3,042 required for the clandestine manufacture of the respective litres per year) and the 2007-2012 period (11,381 litres). end product. The estimated amount of the chemicals Piperonal was seized mainly in North America (account- required plus the amount seized gives an estimate of the ing for 95 per cent of the total during the 2007-2012 total amount diverted. Expressing the seizures as a propor- period), followed by Europe. Global piperonal seizures tion of such diversions gives the interception rate. amounted to, on average, 1.1 tons per year during the Given the strong yearly fluctuations in seizures, the fol- 2007-2012 period, down from 2.9 tons per year during lowing calculations cover a longer period (2007-2012) and the 1989-2006 period. have been made for two substances: potassium permanga- The “traditional” precursor of “ecstasy”, 3,4-MDP-2-P, was nate and acetic anhydride. They reveal average interception seized mainly in North America (60 per cent during the rates of about 15 per cent of the chemicals diverted. 2007-2012 period) and in Oceania (35 per cent) and, to (a) Key chemical used in the manufacture of a lesser extent, in East and South-East Asia and Europe. cocaine: potassium permanganate The largest seizures were reported by Canada (60 per cent) and Australia (35 per cent). Global 3,4-MDP-2-P seizures Average annual global cocaine manufacture was an esti- amounted to, on average, 919 litres per year during the mated 966 tons (range: 835-1,097 tons) over the period 2007-2012 period, down from 5,278 litres per year during 2007-2012116. On average, some 385 tons of potassium the 1989-2006 period. China was often identified to be permanganate (range: 167-603 tons) per year were required the most common source of this substance, although for such cocaine manufacture over this period.When sei- improved controls by that country have helped to reduce zures are included, this suggests that, on average, some 450 its availability. Given the shortage of illegal 3,4-MDP-2-P, tons (range: 232-668 tons) of potassium permanganate there are indications, according to the Board, that India were diverted from licit channels during the period 2007- may be emerging as a new source.115 2012, which gives a global interception rate of diverted potassium permanganate of about 15 per cent (range: 117 G. EFFECT OF PRECURSOR 10-28 per cent) for the period 2007-2012 (see table 3). CONTROL ON THE SUPPLY This is a rather high interception rate, given the small proportion of diverted potassium permanganate as compared OF ILLICIT DRUGS with the global international trade in the substance (2 per cent of global exports of potassium permanganate were The most obvious measure of the success of the precursor diverted during the period 2007-2012) (range: 1-3 per control system is the number of shipments that are stopped cent; see table 4). and the number of seizures made. There are, however, additional ways of measuring the effectiveness of precursor Global cocaine manufacture declined by about a quarter control, some of which are set out below. over the period 2007-2012 (range: 23-30 per cent),118

Table 3. Global interception rate of potassium permanganate for the period 2007-2012 Minimum Maximum Midpoint Average annual global cocaine manufacture, 2007-2012 (tons) 835 1,097 966 Amount of potassium permanganate needed for the 20 55 - manufacture of 100 kg of cocaine Average annual amount of potassium permanganate required 167 603 385 for illicit cocaine production (tons) Average annual seizures of potassium permanganate (tons) 65 65 65 Average annual amounts diverted (tons) 232 668 450 Average annual interception rate (per cent)a 10 28 15 Source: UNODC estimates based on World Drug Report data. a Minimum: 65 tons/668 tons = 10 per cent; maximum: 65 tons/232 tons = 28 per cent. 116 Global cocaine manufacture estimates amounted to between 1,024 and 1,064 tons for 2007, 865-1,122 tons for 2008, 842-1,110 tons for 2009, 788-1,060 tons for 2010, 776-1,051 tons for 2011 and 714-973 tons for 2012 (World Drug Report data). 117 Estimates by the International Narcotics Control Board arrived at an interception rate of between 12 and 25 per cent for the period 2007- 2011 (International Narcotics Control Board, Precursors Report, 2012, 115 International Narcotics Control Board, Precursors Report, 2013, para. para. 98). 75. 118 World Drug Report data. G. Effect of precursor control on the supply of illicit drugs 81

Table 4. Diversion as a proportion of international trade in potassium permanganate, 2007-2012

Minimum Maximum Mid-point Average annual amounts of potassium permanganate diverted (tons) 232 668 450 Global average annual exports of potassium permanganate (tons) 22,186 22,186 22,186 Global average annual imports of potassium permanganate (tons) 17,233 17,233 17,233 Global average annual international trade (maximum export/import) 22,186 22,186 22,186 (tons) Diversion as a proportion of international trade (per cent) 1.0 3.0 2.0 Source: UNODC estimates based on data from the International Narcotics Control Board, World Drug Report and UN COMTRADE.

Table 5. Global acetic anhydride interception rate, 2007-2012 Minimum Maximum Midpoint Average annual global heroin manufacture, 2007-2012 (tons) 479 479 479 Amount of acetic anhydride needed for the manufacture of 100 100 250 134 kg of heroin (litres) Average annual amounts of acetic anhydride required for the 479,000 1,197,500 641,860 manufacture of heroin (litres) Average acetic anhydride seizures, 2007-2012 (litres) 97,000 131,000 114,000 Average annual amounts diverted for the manufacture of heroin 576,000 1,328,500 755,860 (litres) Average annual interception rate (per cent)a 7 22 15 Source: UNODC estimates based on International Narcotics Control Board and World Drug Report data. a Minimum: 97,000/(1,197,500+97,000) = 7 per cent; maximum: 131,000/(479,000+131,000) = 22 per cent. which suggests that diversions of potassium permanganate litres were diverted annually (range: 576,000-1,328,500) may have declined by similar proportions. Falling seizures for use in the clandestine manufacture of heroin. That of potassium permanganate over that period may also indi- results in a global interception rate of about 15 per cent cate a reduction in diversion attempts. for acetic anhydride diverted for the manufacture of heroin122 (range: 7-22 per cent) (see table 5). (b) Key chemical used in the manufacture of heroin: acetic anhydride This can be considered a rather high interception rate, given the extremely small proportion of acetic anhydride Global heroin manufacture was estimated at about 479 119 that is actually diverted as compared with the global inter- tons per year during the period 2007-2012, resulting national trade in the substance (0.2 per cent of global in requirements for some 642,000 litres (range: 479,000- imports of acetic anhydride during the period 2007-2012 1,197,500 litres) of acetic anhydride per year for the manu- (range: 0.14 per cent-0.33 per cent) (see table 6)). facture of heroin.120 Including seizures,121 some 756,000 2. Reduction in drug availability 119 The estimate of 479 tons has been calculated as the average of annual heroin manufacture estimates, which are derived from annual opium The present section focuses on the extent to which precur- production (686 tons of heroin in 2007, 600 tons in 2008, 427 tons sor control results in a reduction in the availability of drugs. in 2009, 383 tons in 2010, 467 tons in 2011 and 311 tons in 2012). A reduction in the availability of drugs may be brought While the annual heroin figures derived from opium production estimates may be incorrect for individual years as a result of the accumu- about by seizing drugs or reducing the availability of the lation or depletion of opium stocks in such years, over a longer period raw materials used in their manufacture. It must be pointed of time such changes in stocks, in general, do not play much of a role. out, however, that the seizure of precursor chemicals is This suggests that the 2007-2012 average may be a good estimate for actual average annual heroin manufacture during that period. only one of the strategies used to reduce the illicit supply 120 According to International Narcotics Control Board data, between 1 of precursors. The prime objectives of precursor control and 2.5 litres of acetic anhydride are required for the manufacture of are preventing precursor chemicals from being diverted to 1 kg of heroin (midpoint estimate of 1.75 litres). However, the bulk of the world’s heroin is manufactured in Afghanistan and, according to UNODC studies, the amounts of acetic anhydride used in North America, where those precursors are then used to manufacture Afghanistan typically range from 1 to 1.5 litres for a kilogram of methamphetamine. The subsequent calculation of seizures of acetic heroin (midpoint 1.25 litres). Afghanistan accounted for 83 per cent anhydride was thus based on two scenarios: (a) all acetic anhydride of the world’s total opium production during the period 2007-2012. seized was intended for use in the manufacture of heroin (seizures of This gives a best estimate of about 1.34 litres of acetic anhydride per 131,000 litres); and (b) all acetic anhydride seized in North America kilogram of heroin at the global level. The best estimate thus suggests was for use in the manufacture of methamphetamine (remaining that the heroin manufactured required some 642,000 litres of acetic acetic anhydride seizures: 97,000 litres). The actual figure is most anhydride. UNODC estimates are based on International Narcotics likely somewhere in between the two. Control Board and World Drug Report data. 122 According to International Narcotics Control Board estimates, less 121 Not all seizures of acetic anhydride have been related to the manu- than 17 per cent of globally diverted acetic anhydride was seized each facture of heroin. Acetic anhydride is also used in the conversion year during the period 2007-2011 (International Narcotics Control of phenylacetic acid to P-2-P, which is of particular importance in Board, Precursors Report, 2012, para. 106). WORLD DRUG REPORT 2014 WORLD DRUG REPORT 82 2. PRECURSOR CONTROL

Table 6. Estimated diversion as a proportion of international trade in acetic anhydride, 2007-2012

Minimum Maximum Midpoint Average annual amounts of acetic anhydride diverted for the 576,000 1,328,500 755,860 manufacture of heroin (litres) Global average annual international trade (imports) (litres) 405,218,382 405,218,382 405,218,382 Diversion as a proportion of international trade (per cent) 0.1 0.3 0.2 Source: Based on UN COMTRADE data.

Table 7. Precursor seizures in end product equivalents versus end product seizures, based on averages for the period 2007-2012 Amount of Ratio of precur- Amount of drugs that could have been Chemical substance/ drugs seized sor seizures to manufactured, in end product equivalents Drugs precursor(s) (street purity) end product sei- (in tons) (in tons) zures (per cent) Minimum Maximum Midpoint Potassium 118.6 326.1 222.4 Cocaine 674.4 33 permanganate Heroin and Acetic anhydride 52.28 130.6 97.4 103.1 95 morphine 3,4-MDP-2-P, safrole, MDMA 6.8 9.0 7.9 6.7 118 isosafrole, piperonal (“ecstasy”) Ephedrine, pseudo Amphetamine ephedrine, norephe 163.1 226.1 194.6 and metham- 81.9 238 drine, P-2-P, phenylacetic phetamine acid Source: UNODC data from the annual reports questionnaire; and International Narcotics Control Board, Precursors Report, 2013.

illicit channels and identifying and dismantling clandestine ratories. The amount of precursors often exceeds the end laboratories. Thus, in quantitative terms, stopped ship- products found in those laboratories. An additional expla- ments of suspicious chemicals are often more important nation is that the regions in which parts of the illegal pro- than seizures of precursor chemicals. Nonetheless, seizures duction of amphetamine-type stimulants have traditionally of precursor chemicals are quite significant when compared taken place have invested heavily in precursor control in with seizures of end products. recent years. Moreover, much of the manufacture and consumption of amphetamines tends to be local or regional, (a) Seizures of precursor chemicals as while trade in or smuggling of precursor chemicals is often compared with seizures of drugs international and entails the crossing of borders. These Another approach to assessing reductions in the availability aspects tend to facilitate the interception of precursors. of drugs is to compare seizures of precursor chemicals with seizures of drugs. This provides a comparison between the (b) Reductions in supply of drugs possibly efforts, which target the end products, with precursor con- linked to precursor control trol efforts. Such an analysis for the period 2007-2012 Significant amounts of precursor chemicals have been reveals that seizures of potassium permanganate, expressed intercepted in recent years. Taking precursors out of the in terms of the amounts of cocaine that could have been market, however, may not be sufficient to yield a reduction produced with that chemical, were equivalent to about a in the supply of a drug. Nonetheless, in some cases, pre- third of actual cocaine seizures. The acetic anhydride sei- cursor control appears to have played a role in reducing zures, expressed in terms of the amounts needed for heroin the supply of drugs. production, were almost equivalent to the total amounts (i) Lysergic acid diethylamide of heroin and morphine seized. When converted into “ecstasy” equivalents, the total amount of “ecstasy” precur- Lysergic acid diethylamide (LSD) was highly popular in sors seized over the period 2007-2012 exceeded actual several countries in the 1960s and the 1970s. However, “ecstasy” seizures by a fifth. When converted into ampheta- consumption has declined in most parts of the world, mine equivalents, total seizures of amphetamine and meth- including the main consumer markets, over the past two amphetamine precursors were more than twice as high as decades. actual seizures of amphetamine and methamphetamine 123 (see table 7). Data from England and Wales showed a decline in LSD use among 16-24 year olds from 4.5 per cent in 1996 to One of the explanations for the large amounts of amphetamine-type stimulant precursors seized could be that such 123 United Kingdom, Home Office, Drug Misuse: Findings from the 2012 precursors are often seized at the sites of clandestine labo- to 2013 Crime Survey for England and Wales (London, 2013). G. Effect of precursor control on the supply of illicit drugs 83

Table 8. Annual prevalence and perceived availability and risk of using LSD among twelfth-grade students in the United States, 1996-2013 Annual Perceived Year Perceived risk of harm prevalence availability “Fairly easy” or “very easy” Trying LSD once or twice Using LSD regularly to get LSD constitutes a great danger constitutes a great danger 1996 8.8 51.3 36.2 77.8 2013 2.2 24.5 34.9 66.8 Change (per cent) -75 -52 -4 -14 Source: Lloyd D. Johnston and others, Monitoring the Future National Survey Results on Drug Use: 1975-2013.

0.4 per cent during the 2012-2013 period, a decline of 90 However, methaqualone use became increasingly concen- per cent. A number of surveys in other countries also trated in South Africa. In the 1980s and the early 1990s, showed strong declines in LSD use.124 methaqualone, known locally as Mandrax, was the second- 125 most-used drug in the country (after cannabis). While it Data on secondary school students in the United States is still used in South Africa, there are indications that its showed a decline of 75 per cent in the use of LSD during usage has declined. In 2000, 33 per cent of all treatment the period 1996-2013. That decline occurred alongside a related to psychoactive substances (excluding alcohol) in strong decline in the reported availability of LSD in the four South African towns was reported to have been related country (reduction of 52 per cent during the period 1996- to Mandrax;128 this proportion fell to 19 per cent by 2013), which seems to have been the prevailing factor in 129 126 2011. The decline in methaqualone use around the explaining the decline in its use (see table 8). Improved world is also reflected in seizures: global seizures declined controls over LSD precursors seem to have contributed to from a peak of 54 tons in 1994 to 11 tons in 2002 and the reduction in the availability of LSD. Expressed in con- 0.2 tons in 2012. India (47 per cent of total) and South stant dollars, global exports of the main LSD precursors Africa (45 per cent), followed by China (7 per cent), (ergotamine, ergometrine and lysergic acid) declined by reported the largest seizures of methaqualone during the 78 per cent between 1996 and 2012, which reduced the 130 127 2000-2012 period. At the same time, global legal potential for diversion of those chemicals. exports of the two main methaqualone precursors, N-acet- (ii) Methaqualone ylanthranilic acid and anthranilic acid, fell by some 70 per cent between 2002 and 2012.131 There are indications that the misuse of methaqualone, a sedative-hypnotic drug that has similar effects to barbitu- (iii) “Ecstasy” rates, is less widespread than it used to be. Precursor control The availability of MDMA (“ecstasy”) has declined in appears to have played a role in that reduction. Initially recent years, which appears to have been largely a result of widely used in North America, often under the brand name improved precursor control at the global level, notably in Quaalude, and in Europe (notably in the United Kingdom) China.132 in the late 1960s and early 1970s, it was listed as a controlled substance in the 1971 Convention and was eventu- Reduced availability had an impact on “ecstasy” use. ally withdrawn from many developed markets in the early Declines in the use of “ecstasy” were reported from a 1980s. Though some clandestine laboratories in Mexico number of countries in Europe, North America and Oce- and other countries continued underground production ania in recent years. In England and Wales, a key “ecstasy” in the 1980s, improved controls of N-acetylanthranilic market in Europe, use of the drug declined from a peak of acid and anthranilic acid appear to have halted those activi- 6.8 per cent among 16-24 year olds during the 2001-2002 ties since the 1990s. period to 2.9 per cent during the 2012-2013 period.133

128 Andreas Plüddemann and others, Monitoring Alcohol and Drug Abuse 124 Annual prevalence of LSD use among young adults (aged 15-34) Trends in South Africa, Proceedings of SACENDU Report Back Meet- fell in Ireland from 2.9 per cent in 1998 to 0.6 per cent during the ings: January-June 2002, Phase 12, October 2002 (Cape Town, South period 2010-2011; in Latvia from 1 per cent in 2003 to 0.1 per cent Africa, South African Community Epidemiology Network on Drug in 2011; and in Hungary from 1.3 per cent in 2001 to 0.3 per cent in Use, 2002). 2007 (European Monitoring Centre for Drugs and Drug Addiction, Statistical Bulletin 2013 (Lisbon, 2013)). 129 Siphokazi Dada and others, Monitoring Alcohol and Drug Abuse Treatment Admissions in South Africa: August 2012, Phase 31, July to 125 See Lloyd D. Johnston and others, Monitoring the Future National December 2011 (and previous years) (Cape Town, South Africa, South Survey Results on Drug Use: 1975-2013 – 2013 Overview: Key Findings African Community Epidemiology Network on Drug Use, 2012). on Adolescent Drug Use (Ann Arbor, University of Michigan, 2014). 130 UNODC, data from the annual report questionnaires. 126 The correlation between annual prevalence and perceived availability of LSD turned out to be very strong during the 1996-2013 period, 131 Data from UN COMTRADE. amounting to r = 0.93 (statistically significant at α = 0.01). The 132 International Narcotics Control Board, Precursors Report, 2013, para. decline in perceived availability was much sharper than the decline in 75. the perceived risk of harm during that period (see table 8). 133 Drug Misuse: Findings from the 2012 to 2013 Crime Survey for England 127 Data from UN COMTRADE. and Wales. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 84 2. PRECURSOR CONTROL

Fig. 28. Trends in the annual prevalence of “ecstasy” use among the adult population in selected countries in Oceania, Europe and North America 4.0 3.5 3.5 3.4 3.0 3.0 2.4 2.4 2.2 2.2 2.0 1.9 2.0 1.8 1.6 1.4 1.4 1.2 1.2

Percentage 1.3 1.0 1.0 0.7 0.7 0.5 0.4 0.6 0.2

0.0 2004 2007 2010 2004 2010 2011 1998 2001 2011 2005 2010 2001 2010 2012 2008 2010 2012 2001/02 2003/04 2006/07 2010/11 2012/13 2006/07 2010/11 2007/08 Australia Czech England and Ireland (age Spain (age France USA (age Canada (age 15+) Republic Wales (age 16-59) 15-64) 15-64) (age 15- 12+) (age (age 15-64) 64) 15+) Oceania Western and Central Europe (selected countries) North America

Source: Australian Institute of Health and Welfare, 2010 National Drug Strategy Household Survey Report, Drug Statistics Series No. 25 (Canberra, July 2011); United States, Department of Health and Human Services, Substance Abuse and Mental Health Services Adminis- tration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publica- tion No. SMA 13-4795 (Rockville, Maryland, 2012); Drug Misuse: Findings from the 2012 to 2013 Crime Survey for England and Wales; and European Monitoring Centre for Drugs and Drug Addiction, Statistical Bulletin 2013.

Table 9. Annual prevalence and perceived availability of and risk of using “ecstasy” among twelfth-grade students in the United States, 2000-2013 Annual Perceived Perceived Year prevalence availability (per cent) risk (per cent) “Fairly easy” or “very easy” Trying “ecstasy” once or twice to get “ecstasy” constitutes a great danger 2000 3.6 51.4 37.9 2013 1.5 35.1 47.5 Change (per cent) -58 -32 25

Source: Lloyd D. Johnston and others, Monitoring the Future National Survey Results on Drug Use: 1975-2013.

This was not an exception: most European countries lence rate of “ecstasy” use among students in the twelfth reported declines over the past few years and overall grade fell by 58 per cent between 2000 and 2013. That “ecstasy” consumption in countries of the European Union went hand in hand with a decline of about 32 per cent in and the European Free Trade Association appears to have the perceived availability of “ecstasy”. While the number fallen by almost half among those aged 15-34 in recent of those who considered that there was a great risk in taking years, based on a comparison of the pooled results of recent “ecstasy” increased between 2000 and 2005, they declined surveys for the 2007-2012 period with surveys for the thereafter, and the perceived availability of “ecstasy” on the 1998-2006 period.134 General population surveys also market declined during the 2000-2013 period (see table indicate declines in the use of “ecstasy” in Oceania, as well 9). as a sharp decline (of more than 50 per cent) in North America in recent years (see figure 28). There are also indications in other countries that the decline in the availability of MDMA has played a key role Data from the ongoing United States study Monitoring in the decline of “ecstasy” use. Overall exports of “ecstasy” the Future, undertaken by the Institute for Social Research precursors fell by 41 per cent between 1998 and 2012.135 at the University of Michigan, show that the annual preva- Average annual seizures of “ecstasy” precursors declined by

134 European Monitoring Centre for Drugs and Drug Addiction, Statisti- cal Bulletin 2013. 135 Data from UN COMTRADE. G. Effect of precursor control on the supply of illicit drugs 85

57 per cent during the 2007-2012 period compared with Fig. 29. Prices of acetic anhydride per litre in the 2000-2006 period. At the same time, average annual Afghanistan, in dollars, 1998-2013 seizures of the end product, “ecstasy”, fell by 39 per cent 450 over the same period and by 70 per cent between 2007 431 400 376 and 2012. The proportion of MDMA found in substances 350 335 sold as “ecstasy” also declined.136 All those data suggest 350 300 230 that improvements in the control of “ecstasy” precursors 300 304 221 at the global level have played a key role in reducing the 250 190 availability of MDMA, which, in turn, has been an impor- 200 167

Dollars 140 tant factor in the decline in “ecstasy” use. 150 90 (c) Price: the case of acetic anhydride 100 65 50 24 25 Another expected impact of precursor control should be a 8 0 measurable increase in the prices paid by operators of clan-

destine laboratories, and hence in illicit production costs, 1998 2002 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 as compared with the normal licit market prices. This is Nangarhar (average prices) demonstrated in the case of acetic anhydride. Afghanistan (unweighted average of 6 different (i) Import and export prices qualities, based on monthly price data) The average global export and import prices of acetic Afghanistan (data from annual opium survey) 137 anhydride, if traded in large quantities, amount to about Source: UNODC, The Global Afghan Opium Trade: A Threat $1 per litre, according to UN COMTRADE data. They Assessment; UNODC and Afghanistan, Ministry of Counter Nar- cotics, opium surveys; and Afghanistan drug price monitoring did not change much during the period 2007-2012. Export monthly reports. prices in all major exporting countries fluctuate around that figure. Similarly, according to a market analysis by the International Narcotics Control Board, wholesale prices (iii) Differences in prices depending on the source for acetic anhydride fluctuate around $1.50 per litre.138 Trafficking in acetic anhydride into Afghanistan emerged Of 46 countries for which export prices could be estab- as a lucrative business as it had limited risks compared with lished, 34 indicated an export price of less than $5 per litre drug trafficking even though traffickers are forced to take over the 2007-2012 period. Higher export prices were the more expensive option of smuggling acetic anhydride reported by, inter alia, some countries along the Balkan from countries where it has already been diverted. During route and countries along the “silk route”. Similarly, import the 2007-2010 period, the prices in Asia of acetic anhy- prices exceeding $5 per litre were reported in, inter alia, dride from illicit sources ranged from $4-$6 in the Repub- several countries along the Balkan route and along the “silk lic of Korea, $12 in China and $60 in India to $200-$300 route”, as well as countries in East and South-East Asia. It in Pakistan. In Europe, they were reported to have ranged from $25 in Slovakia and $100 in Bulgaria to $200-$225 is not clear if the higher prices reflect different market 139 dynamics or attempts by some intermediaries to purchase in Turkey, all in 2010. acetic anhydride for non-legal purposes. Nonetheless, some traders have been making extraordinar- (ii) Prices paid by operators of clandestine heroin ily high profits. In a seizure case in 2008, an Afghan traf- laboratories ficker admitted procuring 12 tons of acetic anhydride from the Republic of Korea, for which $50,000 had been The prices paid by operators of clandestine laboratories, paid.140 That equated to a purchase price of about $4 per in general, tend to be far higher than those paid for acetic litre, at a time when the average wholesale price of acetic anhydride on the licit market. In Afghanistan, the world’s anhydride in Nangarhar, Afghanistan, stood at about $300 largest opium-producing and heroin-manufacturing coun- per litre (see figure 29). try, average prices for acetic anhydride during the 2008- 2011 period were reported to have ranged from $300 to (iv) Differences in price linked to perceived quality $430 per litre (see figure 29), clearly exceeding the price Prices also differ significantly according to perceived qual- of about $1 charged by the main licit suppliers of the ity. In total, six different quality levels of acetic anhydride substance. are regularly monitored in Afghanistan. The monthly price monitoring data for Afghanistan in 2013 showed a range 136 UNODC, Global Smart Update 2012, vol. 7, March 2012, p. 4. from $76 per litre for quality “C” acetic anhydride in 137 The export prices are calculated by dividing the global value of December 2013 to $247 per litre in July 2013 for quality exports of acetic anhydride by global exports of the substance in kilograms; import prices are calculated by dividing the global value of imports of acetic anhydride by global imports of the substance in kilograms. 139 UNODC, The Global Afghan Opium Trade, p. 147. 138 International Narcotics Control Board, Precursors Report, 2013. 140 Ibid., p. 114. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 86 2. PRECURSOR CONTROL

“A” acetic anhydride.141 Differences in the price of acetic acetic anhydride prices in Afghanistan during the 2002- anhydride in Afghanistan often go hand in hand with dif- 2013 period is weak (r = 0.17), and not statistically ferences in the perceptions of the origin of the significant. substance.142 In 2011, opium production, as well as seizures of heroin (v) Changes of price over time and morphine, increased sharply. The increase may have In addition, prices change significantly over time. Average reflected an underlying growth in Afghan opiate manufac- annual prices of a litre of acetic anhydride amounted to an ture, resulting in greater demand for acetic anhydride, average of $24 (range: $13-$34) in Afghanistan in 1998. which may explain the further price rise of that substance Following the ban on opium production in 2001, heroin in 2011. manufacture also declined, as did the demand for acetic The situation changed again in 2012, when both opium anhydride. As a consequence, acetic anhydride prices fell production and heroin seizures fell in Afghanistan. The to a low of $8 per litre in Nangarhar in 2002. Average apparent decline in Afghan heroin manufacture seems to annual prices in Afghanistan as a whole increased thereafter have prompted a decline in the demand for acetic anhy- to more than $430 per litre by 2011, before decreasing in dride. At the same time, the sharp decline in global seizures 2012 and 2013. of acetic anhydride in 2012 may have eased the previous Price increases over the 2002-2011 period, notably between shortage of the chemical. In parallel, a worsening security 2007 and 2011, may be linked to improvements in pre- situation facilitated the smuggling of acetic anhydride into cursor control. One element at the international level may the country. All of this contributed to a reduction of the have been the rescheduling of acetic anhydride from Table risk premium and, thus, to lower acetic anhydride prices II to Table I of the 1988 Convention in 2001, which in 2012. The trend also continued in 2013, leading the resulted in tightened international control, owing to the International Narcotics Control Board to express fear that increasing use of pre-export notifications. In addition, vari- the supply of acetic anhydride may be rising again in ous international cooperation efforts, such as Project Cohe- Afghanistan.145 sion, reduced the readiness of companies to provide (vi) Importance of the illicit acetic anhydride significant quantities of acetic anhydride to unknown or market in Afghanistan suspicious customers. In 2008, the Afghan authorities officially prohibited all imports of acetic anhydride.143 Pre- Based on data contained in the UNODC study The Opium cursor control efforts were also strengthened in Pakistan Economy in Afghanistan: An International Problem,146 the (which started seizing acetic anhydride 2008 onwards), the overall size of the acetic anhydride market may have been Islamic Republic of Iran and some other countries in the about $5 million in 2002. The market increased drastically vicinity of Afghanistan.144 In parallel, average annual sei- over the next few years. By 2009, the total amount of acetic zures of acetic anhydride at the global level rose from anhydride smuggled into Afghanistan was estimated at 46,000 litres per year during the 2004-2007 period to between 380 and 570 tons (midpoint estimate: 475 tons). 147,000 litres per year during the 2008-2010 period, and Prices typically ranged between $250 and $450 per litre then to 198,000 litres in 2011, thus contributing to a at the time, which resulted in a market value of between shortage on the Afghan market. $130 and $200 million in 2009 (midpoint estimate: $165 147 In 2012, however, global seizures of acetic anhydride fell million). by more than half to about 89,000 litres. At the same time, Based on data reported in UNODC, Afghanistan: Opium acetic anhydride prices in Afghanistan fell from $431 per Survey 2013,148 demand for acetic anhydride may have litre to $230 per litre, which suggests that the availability amounted to between 525 and 735 tons in 2013 (midpoint may have increased. estimate: 630 tons). As a result of falling prices, the overall Some of the increases in the price of acetic anhydride acetic anhydride market in Afghanistan appears to have between 2002 and 2011 may also have been linked to the fallen to between $116 and $162 million (midpoint esti- 149 expansion of opium production in Afghanistan, and thus mate: $140 million). That is equivalent to about 0.7 the higher demand for acetic anhydride to convert morphine into heroin. This relationship, however, is complex. 145 International Narcotics Control Board, Precursors Report, 2013, para. Acetic anhydride prices in Afghanistan only partially fol- 112. lowed the trends of opium production. In fact, the statisti- 146 UNODC, The Opium Economy in Afghanistan: An International Problem (New York 2003). cal correlation between Afghan opium production and 147 UNODC, The Global Afghan Opium Trade, p. 146. 148 UNODC and Ministry of Counter Narcotics of Afghanistan (Decem- 141 UNODC and Afghanistan, Ministry of Counter Narcotics, Afghani- ber 2013). stan drug price monitoring monthly reports. 149 In 2013, the UNODC annual opium survey estimated heroin manu- 142 UNODC, The Global Afghan Opium Trade, p. 147. facture in Afghanistan at between 350 and 490 tons, which would have resulted in a demand for acetic anhydride of between 525,000 143 United States Department of State, Bureau of International Narcotics and 735,000 litres. Given an average price of $221 per litre according and Law Enforcement Affairs, International Narcotics Control Strategy to this report, the acetic anhydride market in Afghanistan can be esti- Report, vol. 1, Drug and Chemical Control (March 2009). mated to have ranged from $116 to $162 million in 2013. (Estimates 144 International Narcotics Control Board, Precursors Report, 2011. based on data from UNODC, Afghanistan: Opium Survey 2013.) H. Reactions of clandestine operators facing stronger precursor controls 87

per cent of Afghan GDP and compares with a total (farm- Fig. 30. Estimated proportions of acetic gate) value of Afghan opium production of about $950 anhydride in total heroin manufacture million in 2013. costs in Afghanistan, 2002-2013 30 (vii) Acetic anhydride as a cost factor in heroin 26 manufacture 25 The high prices of acetic anhydride in Afghanistan during 20 the 2008-2011 period, which ranged from $300-$430 per 20 litre, became an important cost factor for Afghan heroin 15 manufacturers.

Percentage 10 An estimate of heroin manufacture costs in Afghanistan revealed that acetic anhydride accounted for a mere 2 per 5 2 150 cent of the total in 2002. In contrast, an estimate in 0 151 May 2010 found overall production costs of about 2002 2010 2013 $1,600 per kilogram of brown heroin (up from less than Source: Estimates based on The Opium Economy in Afghanistan: $600 in 1998152). The bulk of the cost came from opium An International Problem; The Global Afghan Opium Trade: A (73 per cent) and acetic anhydride (26 per cent). Other Threat Assessment; and Afghanistan: Opium Survey 2013. chemicals such as activated carbon (charcoal), ammonium chloride, calcium oxide, hydrochloride acid, acetone and acetic anhydride in the overall production costs for heroin concentrated ammonia solutions accounted for just 1 per ($1,500-$1,600 per kilogram) declined to some 20 per cent cent of the total cost. of total manufacture costs by 2013. That is, however, still 10 times higher than in 2002 (see figure 30). The increase could have been even larger, but clandestine laboratory operators seem to have reacted to the rising prices of acetic anhydride by minimizing its use to about H. REACTIONS OF CLANDESTINE 1 litre per kilogram of heroin, often compromising on the OPERATORS FACING STRONGER quality of the heroin manufactured. While typical purity PRECURSOR CONTROLS for Afghan heroin destined for overseas export had remained at about 70 per cent (range: 50-80 per cent)153 Improved precursor controls at the global level have for years, data sent to UNODC by the Special Testing and prompted clandestine operators of illegal laboratories to Research Laboratory of the Drug Enforcement Adminis- develop a number of counterstrategies, including the use tration of the United States showed that the average purity of more sophisticated ways to obtain precursor chemicals, of heroin samples seized across Afghanistan had fallen to and substitute them with non-controlled “pre-precursors” 37 per cent in 2007 and 32 per cent in 2008.154 The foren- to manufacture the needed precursors, as well as the sic laboratory of the Counter Narcotics Police of Afghani- development of new psychoactive substances to which the stan confirmed that many heroin samples continued to current controls do not apply. While all of these have a low level of purity in the first six months of 2011.155 counterstrategies constitute a challenge for the ongoing development of precursor control at the national, regional In 2011, the cost of acetic anhydride as a proportion of total and international levels, they are at the same time an heroin manufacture costs appeared to have remained at the indication that precursor control is having an impact. same level as in 2010 (about 26 per cent), before declining in 2012 and 2013 as a result of falling acetic anhydride 1. More sophisticated ways to prices. Based on data reported in UNODC, Afghanistan: obtain precursor chemicals Opium Survey 2013, and based on the use of 1.5 litres of acetic anhydride per kilogram of heroin, the proportion of (a) Creation of specialized groups to obtain precursor chemicals

150 UNODC, The Opium Economy in Afghanistan, p. 139. One of the strategies of operators of clandestine laborato- 151 UNODC, The Global Afghan Opium Trade, p. 151 ries has been to hire specialists to organize the purchase of 152 UNODC, The Opium Economy in Afghanistan, p. 136. precursor chemicals. Such specialists are well aware of the 153 UNODC, World Drug Report 2010, p. 138. actual status of the implementation of the 1988 Conven- 154 In total, 41 heroin samples were analysed in 2008 and 40 samples in tion by various Governments. Moreover, they tend to be 2007. In 2007, the tested heroin samples had a purity ranging from well connected and often can guarantee the supply of the less than 1 per cent to 86 per cent; in 2008 the purities ranged from chemicals. In general, chemical trafficking organizations less than 1 per cent to 91 per cent. Data suggested that the purity of heroin was low in the south of Afghanistan. In contrast, high purity have become increasingly resourceful, organized and adapt- levels were reported in Kabul in both 2007 and 2008 and heroin able in order to circumvent the growing number of control purity levels were also quite high in the north in 2007 and in the east measures.156 in 2008. 155 UNODC and Afghanistan, Forensic Laboratory of the Counter Narcotics Police of Afghanistan, “Laboratory Information Bulletin” 156 International Narcotics Control Board, Precursors Report, 2011, para. (LIB/1/2011), p. 2. 158. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 88 2. PRECURSOR CONTROL

(b) Creation of front companies precursor control efforts such as issuing pre-export notifications, participating in PICS and providing relevant infor- Investigations made in El Salvador and Guatemala revealed mation on seizures and suspicious shipments to the the set-up of front companies or the use of existing com- International Narcotics Control Board. According to the panies operating in industries in which there is a well- United States Department of State, in 2011 Taiwan Prov- established licit demand for the required chemicals. While ince of China was the third largest importer of ephedrine the competent national authorities are, in general, well and the third largest exporter of pseudoephedrine world- aware of the kind of business in which the controlled wide.158 It also trades in a number of other substances chemicals are used, it is far more difficult for them to iden- under international control, including acetic anhydride. tify actual requirements, as it is often possible to substitute Methamphetamine laboratories have been detected by the one chemical for another. Unless regularly monitored, or authorities. Significant seizures of precursors in recent years if no inside information from competitors or employees is have been made by the local authorities.159 Even though provided, such diversions of chemicals from licit front they may act in good faith, the mere fact that significant companies can remain undetected for many years. None- quantities of such substances are traded outside the inter- theless, the authorities in a number of countries have been national precursor control system constitutes an inherent successful in dismantling at least some such risk that such trade flows may be diverted. The Board thus companies.157 stressed in its latest report that “the current situation rep- (c) Identification of weak links in the resents a significant weakness in the international control international control system system.”160 Another strategy has been to identify weak links in the (d) Identification of weaknesses at the international control system and to use them as sources national level (diversion from domestic for the purchase of precursor chemicals. While practically sources) all countries have signed and ratified the 1988 Convention Given the ongoing improvements in the control of the (187 out of 193 United Nations Member States), there are international trade in precursor chemicals, another strategy still a number of countries that have not invoked article has been to identify weaknesses at the national level in 12, paragraph 10 (a), of that Convention and do not individual countries. Organized criminal groups targeting require pre-export notifications. precursor chemicals often do not wait until the chemicals This applies to a number of countries in Africa, as well as enter the international market and thus become subject to some countries in Central America, Western and Central tight monitoring. Instead, they divert the chemicals in the Asia, South-East Asia and Oceania. Those countries are original manufacturing country, or in some subsequent particularly vulnerable to being targeted as transit countries transit country that has a legitimate demand for such by precursor trafficking organizations. chemicals. The chemicals are then smuggled out of that country to the final country of destination, thus bypassing The same applies to countries that have yet to register with the international control system developed for monitoring the PEN Online system — mostly countries in Africa — the international trade in such substances. and to countries that do not participate in PICS — again mostly African countries, as well as some countries in In this regard, the organizations trafficking precursor South America, the Near and Middle East, Central Asia, chemicals use methods similar to drug trafficking organi- South-East Asia and Europe. In fact, the International Nar- zations. Their advantage, however, is that the customs and cotics Control Board has in recent years identified a port authorities of most countries are not as well equipped number of shipments of controlled chemicals that transited to detect smuggled precursor chemicals as they are to detect such countries in Africa, Central America, South America, smuggled drugs. Moreover, the penalties in most countries the Near and Middle East, Central Asia, South-East Asia are less severe for trafficking of precursors than for drug and the Balkan region. trafficking, while profit margins can be very high. A special case is Taiwan Province of China, which has a (e) Use of the Internet highly sophisticated chemical industry, including for the Another strategy has been to expand the supplier base by manufacture of several precursor chemicals; however, looking for new suppliers on the Internet. The specific owing to its status, it does not participate in international problems related to the Internet addressed in chapter 1, in

157 In El Salvador and Guatemala, for instance, police investigated the operations of more than a dozen front companies, including compa- 158 United States Department of State, Bureau for International Nar- nies involved in pesticides, clothes and furniture, that had been set up cotics and Law Enforcement Affairs, International Narcotics Control to smuggle precursor chemicals in large quantities from China into Strategy Report (March 2013). Central America in 2011 and 2012. The clandestine labs were apparently controlled by the Mexican Sinaloa cartel, and the final market 159 Food and Drug Administration, Ministry of Health and Welfare, for the methamphetamine was the United States. (Elyssa Pachico, Statistics Table for Seized Narcotics Drugs and Controlled Drugs in “Investigations in El Salvador, Guatemala reveal thriving trade in pre- Taiwan. Available from www.fda.gov.tw/EN/download.aspx. cursor chemicals” (27 June 2012). Available from www.insightcrime. 160 International Narcotics Control Board, Precursors Report, 2013, para. org.) 33. H. Reactions of clandestine operators facing stronger precursor controls 89

the box titled “the ‘dark net’ bitcoins and the increasing seizures of ephedrine preparations and 28 reporting sei- sophistication of online drug sales”, apply to precursors as zures of pseudoephedrine preparations.163 About 17 per well. cent of all ephedrine and pseudoephedrine seizures over that period were in the form of pharmaceutical 2. Use of alternative precursors preparations. (a) Pharmaceutical preparations Awareness of such problems rose following a number of operations conducted under the auspices of Project Prism One way to circumvent the rules governing the interna- in recent years. While in Operation Crystal Flow, con- tional trade in bulk chemicals has been to focus on phar- ducted in 2007, more than 90 per cent of the ephedrine maceutical preparations containing precursor chemicals.161 and pseudoephedrine seizures were still related to bulk Pharmaceutical preparations are largely excluded by the ephedrine and pseudoephedrine, that proportion fell to 1988 Convention, which states, in article 12, paragraph less than 75 per cent in Operation Ice Block in 2008 and 14, “The provisions of this article shall not apply to phar- to just a third in Operation Pila, conducted in 2009 and maceutical preparations, nor to other preparations contain- early 2010.164 ing substances in Table I or Table II that are compounded in such a way that such substances cannot be easily used Post-operational communications issued between April or recovered by readily applicable means”. The lack of con- 2010 and August 2012 led to the seizure of 8.8 tons of trols has, in particular, affected pharmaceutical prepara- ephedrine in bulk and more than 24 tons in the form of tions containing ephedrine and pseudoephedrine. While preparations, i.e. 73 per cent of the ephedrine and pseu- such substances contained in nasal decongestants, bron- doephedrine seized was in the form of pharmaceutical chodilators and various cold medicines have positive prop- preparations,165 clearly indicating the rapidly growing role erties for persons in need, they can be misused. of pharmaceutical preparations as inputs for the manufacture of methamphetamine. Before 2010, several of the In this context, in the 2009 Political Declaration and Plan stopped shipments of pseudoephedrine preparations went of Action, Member States were explicitly asked to prevent from South Asia and South-East Asia with the destination the diversion of such pharmaceutical preparations from of Central America and Mexico, but the shipments to domestic and international trade (Plan of Action, para. 41 Mexico have declined following stricter controls in that (s)). In the light of continuing challenges, the Commission country. 166 on Narcotic Drugs adopted resolution 54/8 in March 2011, in which Governments were encouraged to adopt (b) Use of substitute chemicals and regulatory frameworks to control the production, distribu- “pre-precursors” tion and commercialization of pharmaceutical preparations Another strategy of the operators of clandestine laborato- containing ephedrine and pseudoephedrine, to utilize the ries has been to shift from substances controlled under the PEN Online system and to apply similar control measures 1988 Convention to non-controlled substitute chemicals for such pharmaceutical preparations as for bulk precursor and/or to non-controlled “pre-precursors”. Instructions on chemicals. the use of such chemicals are also available on the Global seizures of pharmaceutical preparations containing internet. ephedrine or pseudoephedrine increased from negligible Examples of such substitute chemicals for the manufacture levels in the 1990s to 5.6 tons in 2006 and 36.1 tons in of amphetamine or methamphetamine are: APAAN, vari- 2011 before falling again to 4.1 tons in 2012. The largest ous esters of phenylacetate and P-2-P bisulfite adduct (see diversions of ephedrine and pseudoephedrine preparations figure 31). An example for the manufacture of “ecstasy” is over the period 2007-2012 were reported from North 3,4-MDP-2-P methyl glycidate, sometimes abbreviated as America (60 per cent) and East and South-East Asia (20 MMDMG or PMK-glycidate. Substances such as the per cent), the two largest methamphetamine-producing bisulfite adduct of P-2-P and MMDMG are often also regions, followed by the Oceania region (10 per cent), referred to as “masked” precursors, as their use helps crimi- Europe (4 per cent), South Asia (4 per cent), and Central nals to conceal the normal form of precursors of amphet- America and the Caribbean (2 per cent); smaller amounts amine-type stimulants by packaging and smuggling them were seized in South America and West Asia.162 The number of Governments reporting seizures of pharmaceu- in a way that has heretofore been rather uncommon and tical preparations containing such substances amounted thus difficult for law enforcement agencies to detect. to 37 over the period 2007-2012, including 18 reporting

163 International Narcotics Control Board, Precursors Reports, 2012 and 161 Over the years, the operators of clandestine laboratories have identi- 2013. fied simple means for extracting pseudoephedrine from such preparations, e.g. by dissolving the tablets in isopropyl alcohol. (UNODC, 164 International Narcotics Control Board, Precursors Report, 2012, figure Patterns and Trends of Amphetamine-Type Stimulants and other Drugs: XI. Asia and the Pacific, 2011, p. 43.) 165 Ibid., para. 35. 162 International Narcotics Control Board, Precursors Report, 2013, annex 166 International Narcotics Control Board, Precursors Report, 2014 and VI. previous years. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 90 2. PRECURSOR CONTROL

Fig. 31. Use of non-controlled substitute chemicals in the manufacture of amphetamine-type stimulants

Flexible manufacture of amphetamines Flexible manufacture of MDMA

piperonal isosafrole safrole esters of phenylacetate alpha-phenylacetoacetonitrile P-2-P bisulfite adduct (APAAN)

3,4-methylenedioxyphenyl-2-propanone (3,4-MDP-2P) phenylacetic acid 1-phenyl-2propanone (P-2-P) ephedrine/ benzyl methyl ketone (BMK) pseudoephedrine PMK glycidate MMDMG

MDMA

amphetamine methamphetamine

Internationally not controlled Internationally controlled Psychotropic substances precursors precursors Source: UNODC, Global Smart Update, vol. 7, March 2012, pp. 5-6. Note: alpha-phenylacetoacetonitrile (APAAN) will be internationally controlled in 2015.

(i) alpha-Phenylacetoacetonitrile: a precursor for affecting Austria, Belgium, Estonia, France, Germany, P-2-P Latvia, Luxembourg and the Netherlands, with the latter country accounting for almost half of all incidents.171 It An example of the use of substitute chemicals has been the appears that the final destination of the shipments was the ever wider use of APAAN, until recently a non-controlled Netherlands, while the shipments of APAAN typically precursor that can be easily converted into P-2-P at a ratio originated in China.172 of 1.4 to 1.167 It emerged as a substitute chemical for P-2- P-based manufacture of methamphetamine in Asia and for The misuse of APAAN, however, is not just a European P-2-P-based amphetamine laboratories in Europe, thus problem. In 2012, Canada informed other countries of circumventing the improved controls over P-2-P. the seizure of two shipments of APAAN totalling 6.7 tons. The two shipments originated in China.173 APAAN was originally discovered in a large-scale methamphetamine manufacturing laboratory in Malaysia in The increased trafficking in APAAN has been attributed 2006, and since 2009 has been seized in various European to its availability and low cost. As a consequence, the Inter- countries.168 The International Narcotics Control Board national Narcotics Control Board recommended to the reported that in 2011 three European countries seized Commission on Narcotic Drugs that APAAN be included APAAN totalling more than 3.5 tons, of which the bulk in Table I of the 1988 Convention.174 169 was seized in the Netherlands. For 2012, six European (ii) Esters of phenylacetic acid and other non- countries reported seizures totalling 17.5 tons, with the scheduled precursors for the manufacture of largest seizures reported from Belgium, the Netherlands amphetamines and Hungary. Seizures of P-2-P, in contrast, declined in Europe from some 5,500 litres in 2010 to 2,700 litres in Ethyl phenylacetate and methyl phenylacetate 2011 and 800 litres in 2012,170 possibly indicating a shift Another example of the spread of non-controlled sub- away from P-2-P towards APAAN. stances as precursor chemicals has been the use of various Between April and October 2012, authorities in Belgium, Bulgaria, the Netherlands and Romania communicated 17 incidents involving 13.6 tons of APAAN, all of which 171 Ibid., para. 85. originated in China. Over the period November 172 Ibid., para. 84. 173 International Narcotics Control Board, Precursors Report, 2012 para. 2012-November 2013, 29 incidents were communicated, 89. 174 The Board sent an official communication to the UN Secretary-Gen- eral to formally initiate procedures for the scheduling of APAAN in 167 International Narcotics Control Board, Precursors Report, 2013, para. March 2013. The Secretary-General invited Member States to express 82. their opinion. A total of 42 Governments responded to the question- 168 UNODC, Global Smart Update 2012, vol. 7, March 2012, p. 5. naire, which confirmed that there was practically no legitimate use of that substance for industry. On the basis of those responses, the 169 International Narcotics Control Board, Precursors Report, 2012, para. Board submitted a recommendation to the Commission on Narcotic 88. Drugs to include APAAN in Table I of the 1988 Convention, and the 170 International Narcotics Control Board, Precursors Report, 2013, p. 80. Commission approved that proposal in March 2014. H. Reactions of clandestine operators facing stronger precursor controls 91

esters of phenylacetic acid.175 While phenylacetic acid is amounts of that substance were also seized in Canada (9.8 a controlled substance under the 1988 Convention, this tons). In 2012, the Australian authorities reported the sei- is not the case for its esters.176 Examples of such trafficked zure of 11 tons of hypophosphorous acid in New South esters are ethyl phenylacetate and methyl phenylacetate. Wales.181 Both can be easily converted into phenylacetic acid. In June 2012, the Mexican authorities dismantled a meth- Significant amounts of such esters were seized as part of amphetamine laboratory where styrene, an industrial start- the International Narcotics Control Board’s Operation ing material for the production of plastics (polystyrene), Phenylacetic Acid and its Derivatives, launched in March was used as a key precursor. In 2007, there was a report of 2011. It led to seizures of some 610 tons of derivatives of some smaller seizures of styrene in Australia. 182 phenylacetic acid in ports, warehouses and laboratories in Latin America. Mexico alone seized 421 tons. The opera- In Europe and in Asia, Governments have reported seizures tion also led to important seizures in Belize, El Salvador, of a number of other non-scheduled pre-precursors for Guatemala and Nicaragua. Ethyl phenylacetate was the P-2-P in recent years, including benzaldehyde and benzyl most commonly identified ester.177 Mexico seized 369 tons cyanide. Larger amounts were seized in the Philippines and 177,000 litres of ethyl phenylacetate in 2011 and El (2,400 litres), while smaller amounts of benzaldehyde (less Salvador seized 157 tons. In addition, Mexico seized than 100 kg) were seized in 2012 in Estonia, Germany, 313,000 litres of methyl phenylacetate in 2011. Those Hungary, Poland and the Russian Federation. In 2012, were substantial amounts, exceeding seizures of other attempts were also made to smuggle benzyl cyanide to methamphetamine precursors.178 Lebanon (520 litres), together with equipment for illicit amphetamine manufacture.183 Though there have been declines in seizures since 2011, (iv) Substitute chemicals for the manufacture of they remain significant. Authorities in Mexico, where ethyl “ecstasy”: 3,4-MDP-2-P methyl glycidate phenylacetate has been under control since 2009, reported the seizure of 72 tons and 46,000 litres in 2012179 and Substitute chemicals have also emerged for the manufac- Guatemala reported the seizure of 16 tons in a warehouse ture of MDMA (“ecstasy”), notably following the intro- in 2012. As in previous incidents, the chemical had origi- duction of improved controls over 3,4-MDP-2-P by nated in China. 180 China. This led to a shortage of “ecstasy” precursors over Despite extensive misuse of the esters of phenylacetic acid the period 2007-2010. In the Netherlands, which is iden- for the clandestine manufacture of methamphetamine, no tified by many European countries as the source of attempts have been made to schedule them at the interna- “ecstasy”, the content of MDMA in products sold as tional level. “ecstasy” fell from some 90 per cent over the 2000-2004 period to around 70 per cent in 2009 before recovering to (iii) Phenylacetamide, benzylchloride, hypophos- 82 per cent in 2010 and 91 per cent in 2011.184 Recent phorous acid, styrene, benzaldehyde and benzyl trends indicate a further recovery of the “ecstasy” market. cyanide This has been made possible by the increasing use of safrole-rich oils and the “discovery” of a number of non- Even if all of the esters of phenylacetic acid were controlled, controlled substitute chemicals. One such chemical is there would still be a large number of substitute chemicals 3,4-MDP-2-P methyl glycidate, which can be easily con- available. For instance, the Mexican authorities reported verted into 3,4-MDP-2-P. It is frequently made out of the seizure in 2011 of a variety of other non-scheduled piperonal (a controlled “ecstasy” precursor).185 chemicals used in the manufacture of methamphetamine, including phenylacetamide (300 tons), benzylchloride 3,4-MDP-2-P methyl glycidate was initially detected in (77,000 litres) and small amounts of 2-phenylethanol. Ear- Australia in 2004, following the seizure of a 44-gallon drum lier, the Mexican authorities had reported seizures of mislabelled as glycidyl methacrylate, which the authorities hypophosphorous acid (1,941 litres in 2009). Large expected to be linked to MDMA production.186 In 2010

175 UNODC, Global Smart Update 2012, vol. 7, March 2012, pp. 5-6. 176 Contrary to the substances controlled under Schedule I of the 1961 181 International Narcotics Control Board, Precursors Report, 2013, para. Convention, where esters are automatically under international con- 93. trol. 182 International Narcotics Control Board, Precursors Report, 2012, para. 177 International Narcotics Control Board, Precursors Report, 2011, para. 92. 90. 183 International Narcotics Control Board, Precursors Report, 2013, para. 178 Average annual phenylacetic acid seizures at the global level amounted 92. to some 217 tons per year over the period 2007-2012, seizures of 184 European Monitoring Centre for Drugs and Drug Addiction – Trim- ephedrine amounted to some 29 tons and seizures of pseudoephed- bos instituut, Report by the Reitox National Focal Point The Netherlands rine to some 18 tons. Drug Situation 2012, p. 154 (and previous years). 179 International Narcotics Control Board, Precursors Report, 2013 para. 185 UNODC, Global Smart Update, vol. 7, March 2012, pp. 4-5. 91. 186 M. Collins and others, “Methyl 3-[3′,4′-(methylenedioxy)phenyl]- 180 International Narcotics Control Board, Precursors Report, 2013 para. 2-methyl glycidate: an ecstasy precursor seized in Sydney, Australia”, 70. Journal of Forensic Sciences, vol. 52, No. 4 (July 2007), pp. 898-903. WORLD DRUG REPORT 2014 WORLD DRUG REPORT 92 2. PRECURSOR CONTROL

187 the substance was found in the Netherlands, together Fig. 32. Global seizures of methylamine, with instructions on how to convert it into “ecstasy”. In 2007-2011 total, the Netherlands authorities seized 1.2 tons of the substance in 2010, including 1 ton seized in an air-freight shipment from China that had been mislabelled. Subse- 0 quently, the substance also appeared in Slovakia, Belgium, 0 Poland and Estonia188 as well as in Denmark in a shipment 6 5 ,

that had originated in China and was destined for the Neth- 500,000 4 7 8 ,

erlands.189 Over the period November 2012-November s e

2013, the Netherlands authorities reported the seizure of t r e i / l

only 690 grams of 3,4-MDP-2-P methyl glycidate, inter- s 200,000 cepted at the Amsterdam airport in a package sent from m

China via a courier service to the Netherlands. The sub- o g r a l 190 i stance was mislabelled as methyl cellulose. K 100,000 (v) Methylamine: a universal precursor in the manufacture of amphetamine-type stimulants Methylamine is another non-scheduled chemical that has - emerged in recent years in the clandestine manufacture of 2007 2008 2009 2010 2011 2012 amphetamine-type stimulants. When combined with P-2-P, it can be used for the manufacture of methampheta- Methylamine (kilograms) mine or, if combined with 3,4-MDP-2-P, it can produce Methylamine (litres) “ecstasy”. Trend On the basis of seizure patterns, the largest amounts of this Source: International Narcotics Control Board, Precursors Report, chemical appear to be currently used for the manufacture 2012, figure III. of methamphetamine. Seizures of methylamine have been reported in increasing numbers since 2004, primarily by the United States. By mid-2011, Mexico had reported countries in North America, though seizures have also been three seizures of methylamine at seaports, totalling more made in Oceania, Europe and East and South-East Asia. than 154,000 litres, originating in China.193 Large seizures were also reported in some countries in Central America. Following years of seizures totalling a few hundred kilo- El Salvador seized almost 69 tons in two shipments in June grams, the amounts seized rose to 665 tons and 478,000 2011, destined for Guatemala.194 In 2011, Mexico litres in 2011 (see figure 32). Large-scale seizures also con- 191 accounted for 56 per cent of global seizures of methylamine, tinued in 2012 (197 tons and 208,000 litres). Though followed by the United States (38 per cent).195 In 2012, smaller than a year earlier, they still exceeded seizures of seizures of methylamine took place again primarily in “traditional” precursors of amphetamine-type stimulants 192 Mexico (197 tons and 150,000 litres), followed by (less than 50 tons in 2012). Honduras (51,000 litres), the United States (6,929 litres) The largest seizures of methylamine in recent years have and Poland (403 litres).196 been reported by Mexico, where this chemical has been controlled since November 2009. In 2010, Mexico 3. Production of new psychoactive reported seizures of 44.3 tons and 47,300 litres of substances methylamine and it accounted for more than 90 per cent Another strategy to circumvent controls of precursor of global seizures of this substance. The next largest seizures chemicals has been to opt for the manufacture of new were reported by the Netherlands, followed by Canada and psychoactive substances. As of end-2013, 348 such substances had been identified, exceeding the number of substances already under international control (234 in 187 International Narcotics Control Board, Precursors Report, 2010, para. 62. 2013). The categories of such substances most frequently 188 UNODC, Global Smart Update, Volume 7, March 2012, pp. 4-5. identified have been, in order of frequency, synthetic 189 International Narcotics Control Board, Precursors Report, 2011, para. 99. 190 International Narcotics Control Board, Precursors Report, 2013, para. 193 International Narcotics Control Board, Precursors Report, 2011, para. 89. 95 191 Ibid., para. 90. 194 International Narcotics Control Board, Precursors Report, 2011, para. 95. 192 Global seizures in 2012: pseudoephedrine, 25 tons; ephedrine, 7 tons; P-2-P, 6,800 litres; phenylacetic acid, 2 tons; safrole, 2,000 195 International Narcotics Control Board, Precursors Report, 2012, para. litres; piperonal, 336 kg; 3,4-MDP-2-P, 228 litres; isosafrole, 10 litres 93. (International Narcotics Control Board, Precursors Report, 2013, p. 196 International Narcotics Control Board, Precursors Report, 2013, para. 81). 90. adopted precursor control asoneofitsstrategiestofight the internationalcommunity, inthe1988Convention, substantial progress madeover thepasttwodecades,since The analysisoftheprecursor control sectorhighlightsthe I. seems toberatherlimited. being, traffickinginthesechemicalsatthegloballevel psychoactiveof new substances.Nonetheless, forthetime acquire suchchemicalsandusetheminthemanufacture foroperatorsofclandestinelaboratoriesto opportunities them are, ingeneral,easytoobtain. This offersplentyof choactive substances, the chemicals needed to produce Given thelackofaglobalcontrol psy mechanismfornew phencyclidines andketamine,as well as aminoindanes. various plant-basedsubstances,piperazines, tryptamines, cannabinoids, phenethylamines,syntheticcathinones, 197 UNODC, being smuggledacross borders. topreventefforts precursors from domesticchannelsfrom Plan ofAction, Member States were alsoaskedtoincrease substances andpharmaceutical preparations. In the2009 use of pre-export notifications to include non-scheduled Plan ofAction, Member States were invitedtoexpandthe offence. Moreover, inthe2009Political Declaration and sion ofnon-scheduledchemicalsubstancesacriminal Member States were askedtoconsidermakingthediver- list,andstances includedonthespecialsurveillance the chemicalindustry, toprevent thediversion ofsub should apply monitoring measures, in cooperation with plan onprecursors alsoprovided thatMember States to identify potential precursor shipments. The 1998 action International Narcotics Control Board tohelpauthorities 1988 Convention is regularly prepared and updated by the listofsubstancesnotin surveillance Tables IandIIofthe plan onprecursor chemicals,alimitedinternationalspecial its twentieth specialsession,in1998,anditsrelated action Political Declaration adoptedby theGeneral Assemblyat already inplace.In linewiththerequest containedinthe Some fordealingwiththisproblem are oftheinstruments tional” precursor chemicals. chemical substances emerge and are able to replace “tradi- cursor control willfaceinthefuture, asever more new clearly highlight,atthesametime,challengesthatpre strategies of operators of clandestine laboratories The new been linked,interalia,toimproved precursor controls. LSD useand“ecstasy” useinrecent years appeartohave and potassiumpermanganatewasseized. Reductions in precursorcent ofthediverted chemicalsaceticanhydride Over theperiod2007-2012,about15per of somedrugs. sor control hashadanimpactontheillicitmanufacture measures, there is sufficient evidence to show that precur - been eliminated by the introduction of precursor control production. illegal drug production has notWhile drug CONCLUDING REMARKS World Report 2013,p. Drug 71. 197 - - -

such chemicalsare notjeopardized. guaranteeing thatlicitmanufacture of, tradeinanduseof chemicals for operators of clandestine laboratories, while be aimedateffectively limitingtheavailability ofsuch control system, whether local or international, must thus of legitimateuses.Anysor chemicalshave awidespectrum tonotethatmostprecurAt thesametime,itisimportant mentation oftheinternationalinstruments. tries. The challengeistheeffective anduniversal imple States, they await implementation in a number of coun While alloftheseactionshave beenagreed onby Member I. Concludingremarks - - - 93 WORLD DRUG REPORT 2014

TABLES ANNEX I Cannabis Poland Philippines New Zealand Morocco Mexico Lebanon Latvia Italy of America United States Ukraine Tajikistan Costa Rica Chile Bulgaria Brazil Herzegovina Bosnia and Australia Albania Azerbaijan Afghanistan Country Cannabis cultivation,production anderadication,2012 Cultivated (ha) 52,000 10,000 3,500 529 8 6 Eradicated (ha) 5,000 9,058 800 21 22 4 8 6 able (ha) Harvest- 47,000 2,700 0 0 Indoor Production (tons) 760 Outdoors 38,000 12,166 1,400 185 308 50 302,377 Indoors 21,202 18,526 17,668 Plants eradicated 3,796 7,706 6,913 1,224,738 4,114,911 3,631,582 2,200,000 2,180,121 Outdoors 119,059 965,320 616,133 216,902 58,156 33,000 35,146 2,807 7,538 101 Indoors Sites eradicated 2,596 1,377 458 783 687 322 42 4 Outdoors 1,318 6,470 188 129 627 154 291 121 240 3 5 3 i WORLD DRUG REPORT 2014 ii ANNEX I - .. Low Low

High stable for for Moderate increasing increasing Moderate, Moderate, Moderate, Moderate, Moderate, ate decline High, stable High, stable Low, moder Low, consumers Assessment Assessment of availability of availability

4 1 .. -7 73 29 16 -37 -12 205 164 Average Average inflation inflation change in change in (percentage) adjusted price adjusted price

9 .. -8 89 35 22 25 14 -24 268 206 price price Average Average change in change in (percentage)

- a .. 18 3.7 9.1 0.2 0.4 17.7 22.1 11.5 16.7 13.8 per gram) price, 2011-2012, price, 2011-2012, ity-adjusted retail ity-adjusted retail weighted average weighted average (international dollars Purchasing power par Purchasing - .. 18 11 3.9 9.4 0.1 0.5 17.3 28.3 24.4 14.1 justed) price justed) price lars per gram) age in US dol - (weighted aver Nominal (unad -

.. 32 32 50 -40 -32 -36 -38 -21 111 112 (percentage) from biennium biennium from nium 2011-2012 nium 2011-2012 2009-2010 to bien - Change in seizures Change in seizures

.. 4.0 0.3 4.0 1.7 0.6 0.2 0.2 0.9 0.05 16.5 2012 2012 Annual Annual (milligrams) seizures per per seizures capita in 2011- 1 2 2 1 2 .. 8 17 17 67 0.1 2011-2012 2011-2012 Seizures in in Seizures global total) (percentage of of (percentage -

Cannabis herb supply indicators An international dollar would buy in the region concerned a comparable amount of goods and services a United States Dollar would buy in the States. South-West Asia South-West Region Central and South America and the Caribbean South-Eastern Europe Western and Central Europe Central Asia and Transcauca East and South-East Asia Near and Middle East/ Eastern Europe sia countries South Asia Oceania Africa North America Notes: Two dots (..) indicate insufficient data. All averages are weighted by population. Notes: Two a Tables on drug cultivation, production and eradication and prevalence iii

Cocaine

Global illicit cultivation of coca bush, 2002-2012 (Hectares) 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Bolivia (Plurinational 21,600 23,600 27,700 25,400 27,500 28,900 30,500 30,900 31,000 27,200 25,300 State of) Colombia a 102,000 86,000 80,000 86,000 78,000 99,000 81,000 73,000 62,000 64,000 48,000

Peru b 62,500 60,400

Peru c 46,700 44,200 50,300 48,200 51,400 53,700 56,100 59,900 61,200 64,400

Total 170,300 153,800 158,000 159,600 156,900 181,600 167,600 163,800 154,200 155,600 (d) 133,700

Sources: For Bolivia (Plurinational State of), 2002: CICAD and United States Department of State, International Narcotics Control Strategy Report; since 2003: national illicit crop monitoring system supported by UNODC. For Colombia and Peru: national illicit crop monitoring system supported by UNODC. Note: An account of the different concepts for different areas and their effect on comparability was presented in the World Drug Report 2012 (pp. 41-42). In the continuing efforts to improve comparability of estimates between countries, the estimated net area under coca bush cultivation at the reference date of 31 December is presented for Peru in addition to the area under coca bush cultivation in Peru as seen on satellite imagery. The reference date of 31 December is also used for the estimated area under coca bush cultivation in Colombia. The estimates presented for the Pluri- national State of Bolivia represent the area under coca bush cultivation as seen on satellite imagery. a Net area on 31 December. Estimates from 2009 were adjusted for small fields, while estimates for previous years did not require that adjustment. b Net area on 31 December. c Area as interpreted from satellite imagery. d The global coca cultivation figure was calculated using the area as interpreted on satellite imagery for Peru.

Potential production of sun-dried coca leaf, 2005-2012 (Tons)

2005 2006 2007 2008 2009 2010 2011 2012 Bolivia (Plurinational 28,200 33,200 36,400 39,400 40,100 40,900 33,500 30,400 state of) 34,200- 37,300- 37,900- 38,600- 31,900- 28,900- Range 38,300 41,800 42,300 43,100 35,400 31,900

Peru 97,000 105,100 107,800 113,300 119,000 120,500 126,100 119,700

85,400- 91,000- 93,200- 97,600- 102,400- 103,000- 110,300- 103,300 Range 108,600 119,200 122,000 127,800 134,200 136,300 142,100 - 136,100

Sources: For Bolivia (Plurinational State of): potential sun-dried coca leaf production available for cocaine manufacture is estimated by the national illicit crop monitoring system supported by UNODC. Source of estimates for leaf yield is UNODC for Yungas de la Paz, and United States Drug Enforcement Administration (DEA) for Chapare (DEA scientific studies). The estimated amount of coca leaf produced on 12,000 ha in the Yungas of La Paz, where coca cultivation is authorized under national law, was deducted (ranges: upper and lower bounds of the 95 per cent confidence interval of the estimated coca leaf yield). For Peru: potential sun-dried coca leaf production available for cocaine manufacture is estimated by the national illicit crop monitoring system supported by UNODC. A total of 9,000 tons of sun-dried coca leaf production was deducted, which, according to Government sources, is the amount used for traditional purposes (range: upper and lower bounds of the 95 per cent confidence interval of the estimated coca leaf yield. Note: The estimates for 2011 and 2012 are not directly comparable ; for a discussion of the different concepts, see the World Drug Report 2012, pp 41-42. WORLD DRUG REPORT 2014 WORLD DRUG REPORT iv ANNEX I

Potential production of fresh coca leaf, 2005-2012 (Tons) 2005 2006 2007 2008 2009 2010 2011 2012 Colombia 555,400 528,300 525,300 389,600 343,600 305,300 263,800 231,700 Range 305,300-349,600 179,200-284,200

Potential production of fresh coca leaf in oven-dried equivalent, 2005-2012 (Tons)

2005 2006 2007 2008 2009 2010 2011 2012 Colombia 164,280 154,130 154,000 116,900 103,100 91,600 79,100 69,500 Range 91,600-104,880 Sources: National Illicit Crop Monitoring System supported by UNODC. Notes: Owing to the introduction of an adjustment factor for small fields, estimates since 2010 are not directly comparable with those of previous years. The ranges reflect the uncertainty associated with the estimates. For Bolivia (Plurinational State of) and Peru, the ranges are based on confidence intervals, and the best estimate is the midpoint between the upper and lower bounds of the range. In the case of Colombia, the range is estimated on the basis of the area under coca cultivation in the two previous years. The methodology used to calculate uncertainty ranges for production estimates is still under development, and figures may be revised when more information becomes available.

Potential manufacture of 100% pure cocaine, 2005-2012 (Tons) 2005 2006 2007 2008 2009 2010 2011 2012 Bolivia 80 94 104 113 n.a. n.a. n.a. n.a. (Plurinational state of) Colombia 680 660 630 450 410 350 345 309

Range 350-400 240-377

Peru 260 280 290 302 n.a. n.a. n.a. n.a. Total 1,020 1,034 1,024 865 * * * * Sources: For Bolivia (Plurinational State of): Government calculations based on coca leaf yield surveys by UNODC (Yungas of La Paz) and United States DEA scientific studies (Chapare). For Colombia: national illicit crop monitoring system supported by UNODC and DEA scientific studies. Due to the introduction of an adjustment factor for small fields, estimates since 2010 are not directly comparable with those of previous years. For Peru: Government calculations, based on a coca leaf to cocaine conversion ratio from DEA scientific studies. Notes: Owing to the ongoing review of conversion factors, no point estimate of the level of cocaine production could be provided since 2009. Because of uncertainty about the level of total potential cocaine manufacture and about the comparability of the estimates of the various countries, the figures were estimated as ranges (842-1,111 tons in 2009, 788-1,060 tons in 2010, 776-1,051 tons in 2011 and 714-973 tons in 2012). Detailed information on the ongoing revision of conversion ratios and cocaine laboratory efficiency is available in the World Drug Report 2010 (p. 249). Figures in italics are being reviewed. Information on estimation methodologies and definitions can be found in the section on methodology in the online version of this report.

Reported cumulative eradication of coca bush (ha), 2005-2012) 2005 2006 2007 2008 2009 2010 2011 2012

Bolivia (Plurinational manual 6,073 5,070 6,269 5,484 6,341 8,200 10,460 State of) 11,044

Colombia manual 31,980 43,051 66,805 95,634 60,544 43,690 33,727 30,486

spraying 138,775 172,026 153,134 133,496 104,771 101,939 103,302 100,549 Peru manual 7,605 9,153 10,188 11,102 10,091 12,239 10,290 14,235

Ecuador manual 18 9 12 12 6 3 14 ..

Venezuela (Bolivarian manual 40 0 0 0 0 ...... Republic of)

Source: UNODC annual report questionnaire and database on estimates and long-term trend analysis (DELTA); Government of Bolivia (Plurinational State of), Colombia and Peru. Notes: Totals for Bolivia (Plurinational State of) since 2006 include voluntary and forced eradication. Totals for Peru include voluntary and forced eradication. Two dots (..) indicate that data are not available Tables on drug cultivation, production and eradication and prevalence v .. Low decline decline increase Medium High, stable Low, moderate moderate Low, Low, moderate moderate Low, High, moderate High, moderate consumers Assessment of Assessment of availability for availability for High, slight increase 9 .. -4 -4 19 29 10 -11 in inflation- (percentage) adjusted price adjusted price Average change change Average 1 8 1 .. 25 19 48 20

age) price price Average Average - (percent change in change in

a 77 90 15 255 375 145 164 237 per gram) price, 2011-2012, price, 2011-2012, Purchasing power power Purchasing weighted average weighted average parity-adjusted retail parity-adjusted retail (international dollars 83 83 92 10 391 188 112 167 gram) justed) retail justed) retail Nominal (unad - price, weighted price, weighted average (United average (United States dollars per States dollars per 6 4 -8 -7

57 17 22 -30 2011-2012 2011-2012 to biennium to biennium (percentage) Change in sei - zures from bien - from zures nium 2009-2010 nium 2009-2010 1

2.9 5.6 0.3 46.4 137.4 244.4 959.6 2011-2012 2011-2012 (milligrams) per capita in per capita in Annual seizures Annual seizures 0.26 0.47 0.11 0.03 0.21 10.26 17.55 71.10 total) of global of global 2011-2012 2011-2012 Seizures in in Seizures (percentage (percentage Cocaine supply indicators Oceania Africa North America Region Central and South America and the Caribbean South-Eastern Europe Western and Central Europe Eastern Europe Asia An international dollar would buy in the region concerned a comparable amount of goods and services a United States Dollar would buy in the States. cocaine. Due to the paucity of data, price data and seizure data are not adjusted for purity. Notes: Seizure data are based on aggregates of seized cocaine salts, “crack” cocaine, base, coca paste and unspecified cocaine. Due to the paucity data, price seizure not adjusted for purity. All averages are weighted by population. In order to preserve comparability between countries and over time, price data are based on records of cocaine salts only. dots (..) indicate insufficient data. Two a WORLD DRUG REPORT 2014 WORLD DRUG REPORT vi ANNEX I

Opium/Heroin

Net cultivation of opium poppy in selected countries, 1999-2013 (Hectares)

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

SOUTH-WEST ASIA

Afghanistan 90,583 82,171 7,606 74,100 80,000 131,000 104,000 165,000 193,000 157,000 123,000 123,000 131,000 154,000 209,000

Pakistan 284 260 213 622 2,500 1,500 2,438 1,545 1,701 1,909 1,779 1,721 362 382 382

Subtotal 90,867 82,431 7,819 74,722 82,500 132,500 106,438 166,545 194,701 158,909 124,779 124,721 131,362 154,382 209,382

SOUTH-EAST ASIA Lao People's Democratic 22,543 19,052 17,255 14,000 12,000 6,600 1,800 2,500 1,500 1,600 1,900 3,000 4,100 6,800 3,900 Republic a

Myanmar a 89,500 108,700 105,000 81,400 62,200 44,200 32,800 21,500 27,700 28,500 31,700 38,100 43,600 51,000 57,800

Thailand b 702 890 820 750

Viet Nam b 442

Subtotal 113,187 128,642 123,075 96,150 74,200 50,800 34,600 24,000 29,200 30,100 33,600 41,100 47,700 57,800 61,700

LATIN AMERICA

Colombia 6,500 6,500 4,300 4,153 4,026 3,950 1,950 1,023 715 394 356 341 338 313

Mexico c 3,600 1,900 4,400 2,700 4,800 3,500 3,300 5,000 6,900 15,000 19,500 14,000 12,000

Subtotal 10,100 8,400 8,700 6,853 8,826 7,450 5,250 6,023 7,615 15,394 19,856 14,341 12,338 12,338 12,338

OTHER Other countries d 2,050 2,479 2500 2500 3,074 5,190 5,212 4,432 4,184 8,600 7,700 10,500 16,100 11,900 13,300 TOTAL 216,204 221,952 142,094 180,225 168,600 195,940 151,500 201,000 235,700 213,003 185,935 190,662 207,500 236,420 296,720

Source: For Afghanistan: 1998-2002: UNODC; 2003-2012: National Illicit Crop Monitoring System supported by UNODC. For Pakistan: annual report questionnaire, Government of Pakistan, United States Department of State. For the Lao People’s Democratic Republic: 1998-1999: UNODC; 2000-2012: National Illicit Crop Monitoring System supported by UNODC. For Myanmar: 1998-2000: United States Department of State; 2001-2012: National Illicit Crop Monitoring System supported by UNODC. For Colombia: 1998-1999: various sources; From 2000: National Illicit Crop Monitoring System supported by UNODC. For 2008-2012, production was calculated based on regional yield figures and conversion ratios from the United States Department of State/DEA. For Mexico: estimates derived from United States Government surveys. Note: Figures in italics are preliminary and may be revised when updated information becomes available. Information on estimation methodologies and definitions can be found in the methodology section of the online version of the present report. a May include areas that were eradicated after the date of the area survey. b Owing to continuing low cultivation, figures for Viet Nam (as of 2000) and Thailand (as of 2003) were included in the category “Other countries”. c The Government of Mexico does not validate the estimates provided by the United States, as they are not part of its official figures and it does not have information on the methodology used to calculate them. The Government of Mexico is in the process of implementing a monitoring system in collaboration with UNODC to estimate illicit cultivation and production. d Eradication and plant seizure reports from different sources indicate that illicit opium poppy cultivation also exists in the following subregions: North Africa, Central Asia and Transcaucasia, Near and Middle East/South-West Asia, South Asia, East and South-East Asia, Eastern Europe, South-Eastern Europe, Central America and South America. Starting in 2008, a new methodology was introduced to estimate opium poppy cultivation and opium/ heroin production in those countries. The estimates are higher than the previous figures but have a similar order of magnitude. A detailed description of the estimation methodology is available in the online version of the present report. Tables on drug cultivation, production and eradication and prevalence vii

Global potential production of oven-dry opium in selected countries, 1999-2013 (Tons)

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

SOUTH-WEST ASIA

Afghanistan 4,565 3,276 185 3,400 3,600 4,200 4,100 5,300 7,400 5,900 4,000 3,600 5,800 3,700 5,500

Pakistan 9 8 5 5 52 40 36 39 43 48 44 43 9 9

Subtotal 4,574 3,284 190 3,405 3,652 4,240 4,136 5,339 7,443 5,948 4,044 3,643 5,809 3,709 5,500

SOUTH-EAST ASIA Lao People's Democratic 124 167 134 112 120 43 14 20 9 10 11 18 25 41 23 Republic

Myanmar 895 1,087 1,097 828 810 370 312 315 460 410 330 580 610 690 870

Thailand a 8 6 6 9

Viet Nam a 2

Subtotal 1,029 1,260 1,237 949 930 413 326 335 469 420 341 598 635 731 893

LATIN AMERICA Colombia 88 88 80 52 50 49 24 13 14 10 9 8 8 8

Mexico b 43 21 91 58 101 73 71 108 150 325 425 300 250

Subtotal 131 109 171 110 151 122 95 121 164 335 434 308 258 258 258

OTHER Other countries c 30 38 32 56 50 75 63 16 15 139 134 181 281 208 232

TOTAL 5,764 4,691 1,630 4,520 4,783 4,850 4,620 5,810 8,091 6,841 4,953 4,730 6,983 4,906 6,883

Source: For Afghanistan: 1998-2002: UNODC; 2003-2012: National Illicit Crop Monitoring System supported by UNODC. For Pakistan: annual report questionnaire, Government of Pakistan, United States Department of State. For the Lao People’s Democratic Republic: 1998-1999: UNODC; 2000-2012: National Illicit Crop Monitoring System supported by UNODC. For Myanmar: 1998-2000: United States Department of State; 2001-2012: National Illicit Crop Monitoring System supported by UNODC. For Colombia: 1998-1999: various sources; From 2000: National Illicit Crop Monitoring System supported by UNODC. For 2008-2012, production was calculated based on regional yield figures and conversion ratios from the United States Department of State/DEA. For Mexico: estimates derived from United States Government surveys. Note: Figures in italics are preliminary and may be revised when updated information becomes available. Information on estimation methodologies and definitions can be found in the methodology section of the online version of the present report. The opium production estimates for Afghanistan for 2006-2009 were revised after data quality checks revealed an overestimation of opium yield estimates in those years. a Owing to continuing low cultivation, figures for Viet Nam (as of 2000) and Thailand (as of 2003) were included in the category “Other countries”. b The Government of Mexico does not validate the estimates provided by the United States, as they are not part of its official figures and it does not have information on the methodology used to calculate them. The Government of Mexico is in the process of implementing a monitoring system in collaboration with UNODC to estimate illicit cultivation and production. c Eradication and plant seizure reports from different sources indicate that illicit opium poppy cultivation also exists in the following subregions: North Africa, Central Asia and Transcaucasia, Near and Middle East/South-West Asia, South Asia, East and South-East Asia, Eastern Europe, South-Eastern Europe, Central America and South America. Starting in 2008, a new methodology was introduced to estimate opium poppy cultivation and opium/ heroin production in those countries. The estimates are higher than the previous figures but have a similar order of magnitude. A detailed description of the estimation methodology is available in the online version of the present report. WORLD DRUG REPORT 2014 WORLD DRUG REPORT viii ANNEX I

Global potential production of opium and manufacture of heroin of unknown purity, 2004-2013 (Tons) 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Total potential opium production 4,850 4,620 5,810 8,091 6,841 4,953 4,730 6,983 4,906 6,883 Potential opium not processed into heroin 1,197 1,169 1,786 3,078 2,360 1,680 1,728 3,400 1,850 2,600 Potential opium processed into heroin 3,653 3,451 4,024 5,012 4,481 3,273 3,002 3,583 3,056 4,283 Total potential heroin manufacture 529 472 553 686 600 427 383 476 385 560

Notes: Only for Afghanistan, the proportion of potential opium production which is not converted into heroin within the country could be estimated. For all other countries, for the purpose of this table, it is assumed that all opium potentially produced is converted into heroin. If the total potential opium production in Afghanistan in 2012 were converted into heroin, the total potential heroin production in Afghanistan would be 786 tons and global production would be total 923 tons. The estimates for 2006 - 2009 were revised due to the revision of opium production figures for Afghanistan. Figures in italics are preliminary and may be revised when updated information becomes available.

Reported opium poppy eradication in selected countries, 2003 to 2013 (Hectares)

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Afghanistan 21,430 a 5,103 15,300 19,047 5,480 5,351 2,316 3,810 9,672 7,348

Bangladesh 8 22

Colombia 3,266 3,866 2,121 1,929 375 381 546 711 299 319

Egypt 34 65 45 50 98 121 89 222 1

Guatemala 489 720 449 536 1,345 918 1,490 590

India 494 167 12 247 8,000 624 2,420 3,052 5,746 Lao People’s 4,134 3,556 2,575 1,518 779 575 651 579 662 707 397 Democratic Republic

Lebanon 4 67 27 8 21 4

Mexico 20,034 15,926 21,609 16,890 11,046 13,095 14,753 15,491 16,389 15,726

Myanmar 638 2,820 3,907 3,970 3,598 4,820 4,087 8,268 7,058 23,718 12,288

Nepal 19 4 1 21 35

Pakistan 4,185 5,200 391 354 614 0 105 68 1,053 592

Peru 57 98 92 88 28 23 32 21

Thailand 767 122 110 153 220 285 201 278 208 205 264

Ukraine 28 436 Venezuela 0 87 154 0 0 0 (Bolivarian Republic of)

Viet Nam 100 32 38 99 31 38 35

Sources: UNODC annual reports questionnaire, Government reports, reports of regional bodies, and the United States International Narcotics Control Strategy Report Notes: In this table, only eradication reported in terms of area is considered. Eradication reported in terms of number of plant seizures can be found in the annex on seizures of the electronic version of the World Drug Report located at https://www.unodc.org/wdr/ a Although eradication took place in 2004, it was not officially reported to UNODC. Tables on drug cultivation, production and eradication and prevalence ix .. ..

increase Moderate Moderate High, stable High, stable Low, increasing Low, Moderate, slight Moderate, slight High, decreasing consumers Assessment of Assessment of availability for availability for Moderate, decreasing Moderate, decreasing .. 2 .. -7 -6 73 39 27 -29 -24 169 in inflation in inflation (percentage) adjusted price adjusted price Average change change Average

.. .. -3 -1 94 60 39 23 -15 -20 price price 243 Average Average change in change in (percentage)

.. .. 70 184 51.8 23.2 63.7 198.5 265.2 158.8 284.7 per gram) a (international price, 2011-2012, price, 2011-2012, Purchasing power power Purchasing weighted average weighted average dollars parity-adjusted retail parity-adjusted retail -

.. .. 90 272 97.8 25.6 11.6 45.8 68.9 125.3 423.4 gram) age in US age in US dollars per dollars per justed) price justed) price (weighted aver Nominal (unad -

8 15 38 27 -28 -20 -31 -43 -18 -52 140 2011-2012 2011-2012 to biennium to biennium (percentage) Change in sei - nium 2009-2010 nium 2009-2010 zures from bien - from zures

0.2 0.2 1.7 0.1 1.7 0.5 0.4 0.2 0.01 0.01 0.04 Annual Annual capita in capita in 2011-2012 2011-2012 (milligrams) seizures per per seizures 1 8 3 1 1 2 7 1 49 12 14 total) of global of global 2011-2012 2011-2012 Seizures in in Seizures (percentage (percentage

An international dollar would buy in the region concerned a comparable amount of goods and services a United States Dollar would buy in the States. Heroin supply indicators Heroin Africa North America Eastern Europe South Asia Oceania Region Central and South America countries Transcaucasian East and South-East Asia Near and Middle East/South- Asia West South-Eastern Europe Western and Central Europe and the Caribbean Central Asia and Central Asia and rity. Two dots (..) indicate insufficient data. dots (..) indicate insufficient data. Two Notes: All averages are weighted by population. Due to the paucity of data, price data and seizure not adjusted for pu rity. a

WORLD DRUG REPORT 2014 WORLD DRUG REPORT x ANNEX I 0.4 0.2 0.4 0.4 0.2 0.4 0.4 0.5 0.3 0.6 0.1 0.5 0.5 0.3 0.8 1.6 0.4 0.6 0.8 0.05 Upper

0.3 0.2 0.2 0.3 0.1 0.1 0.2 0.2 0.2 0.2 0.1 0.4 0.3 0.2 0.8 0.9 0.2 0.5 0.8 0.03 Lower Prevalence Prevalence (percentage)

0.3 0.2 0.3 0.4 0.1 0.2 0.3 0.4 0.3 0.3 0.1 0.5 0.3 0.2 0.8 1.2 0.3 0.5 0.8 0.04 Best Best estimate 60 20 310 520 310 450 160 160 120 120 2,290 1,140 4,700 4,440 3,400 1,200 1,200 1,800 1,800 1,490 1,490 3,090 3,090 1,890 1,890 Opiates 12,990 20,200 20,200 Upper

40 50 20 90 920 160 130 200 430 420 7,480 2,500 2,410 2,150 1,050 1,050 1,430 1,430 1,280 1,280 2,920 2,920 1,880 1,880 12,800 12,800 Lower Number Number (thousands) 40 80 20 220 320 290 440

110 110 1,840 1,000 9,860 3,340 3,320 2,770 1,620 1,620 1,420 1,420 3,000 3,000 1,890 1,890 1,120 1,120 16,400 16,400 Best Best estimate 0.5 3.4 0.8 0.7 0.4 0.5 0.4 2.3 0.7 0.2 4.3 0.3 0.5 0.3 0.9 2.4 0.4 0.7 1.2 0.4 Upper

0.2 2.3 0.6 0.1 0.1 0.2 0.3 2.2 0.2 0.1 4.2 0.3 0.3 0.2 0.9 1.4 0.2 0.7 1.2 0.4 Lower Prevalence Prevalence (percentage) 0.3 3.0 0.7 0.2 0.2 0.4 0.4 2.3 0.4 0.2 4.3 0.3 0.4 0.2 0.9 1.9 0.3 0.7 1.2 0.4

Best estimate 50 830 520 360 490 190 190 870 870 3,140 1,100 1,150 4,740 6,540 3,610 4,100 4,100 2,810 2,810 1,290 1,290 15,380 38,200 38,200 14,710 14,710 13,600 13,600 Upper Opioids

90 60 40 900 560 130 440 230 460 800 800 9,040 2,530 3,880 2,170 3,930 3,930 2,790 2,790 1,140 1,140 28,600 28,600 14,210 14,210 13,320 13,320 Lower Number Number (thousands)

40 740 250 320 340 470 100 100 830 830 1,930 1,020 3,370 5,190 2,890 4,010 4,010 2,800 2,800 1,210 1,210 11,920 33,000 33,000 14,440 14,440 13,460 13,460 Best Best estimate 9.7 4.9 7.1 6.6 9.1 8.4 6.6 2.7 5.7 3.1 4.1 1.5 4.8 5.2 4.5 4.5 2.7 2.7 5.7 5.7 14.5 13.3 11.3 Upper

3.3 9.1 2.7 1.4 2.2 3.5 5.2 8.0 1.2 2.5 5.6 1.0 2.4 0.4 2.0 1.7 4.2 2.1 5.7 11.2 Lower Prevalence Prevalence (percentage)

7.5 3.8 4.1 4.3 5.0 8.1 2.5 2.6 5.7 1.9 3.5 0.6 3.4 3.5 4.3 2.4 5.7 10.8 12.4 11.2 Best Best estimate 720 720 3,540 8,670 7,700 2,220 1,810 1,810 6,210 6,210 57,530 10,580 30,570 88,100 23,440 13,200 49,240 53,300 53,300 35,430 35,430 15,340 15,340 24,800 24,800 18,590 18,590 Upper 227,300 227,300 Cannabis

320 320 660 660 2,220 2,070 2,850 2,950 1,310 5,910 5,450 4,750 4,750 19,860 11,990 28,900 16,230 51,090 51,090 35,040 35,040 15,080 15,080 23,220 23,220 18,460 18,460 125,300 125,300 Lower Number Number (thousands)

690 690 680 680 2,650 6,210 5,610 4,230 1,870 9,390 5,470 5,470 44,560 28,510 54,610 10,140 33,210 51,820 51,820 35,230 35,230 15,220 15,220 24,000 24,000 18,530 18,530 Best 177,600 177,600 estimate

Region or Region or subregion East Africa North Africa Southern Africa West and Central and Central West Africa Caribbean Central America North America South America Central Asia and Central Asia and Transcaucasia Near and Middle Near and Middle East/ South West Asia East and South- East Asia South Asia Eastern and South-Eastern Europe Western and Cen - tral Europe Annual prevalence of the use cannabis, opioids and opiates, by region Annual prevalence Africa Oceania Global estimate Americas Asia Europe Source: UNODC estimates based on annual report questionnaire data and other official sources. data and other official questionnaire UNODC estimates based on annual report Source: Tables on drug cultivation, production and eradication and prevalence xi ------0.5 0.3 2.9 0.6 0.4 0.6 0.6 0.1 0.9 0.2 0.7 0.4 0.6 0.7 Upper

------0.5 0.1 2.9 0.2 0.2 0.5 0.1 0.9 0.1 0.1 0.1 0.5 0.5 0.04 Lower Prevalence Prevalence ------(percentage)

0.5 0.2 2.9 0.4 0.3 0.5 0.2 0.1 0.9 0.1 0.4 0.2 0.5 0.6 Best Best estimate ------40 720 310 160 160 550 550 1,880 6,630 1,680 1,680 3,530 3,530 2,800 2,800 3,260 3,260 1,580 1,580 28,200 18,850 "Ecstasy" Upper ------

10 20 350 700 140 190 190 9,400 2,650 1,630 1,630 1,630 2,960 2,960 2,740 2,740 2,740 2,740 1,110 1,110 Lower Number Number (thousands) ------50 30 720 250

370 370 1,080 3,180 3,210 3,210 2,770 2,770 3,000 3,000 1,340 1,340 1,650 1,650 18,800 10,750 Best Best estimate - - - - 1.5 2.2 1.2 0.9 1.0 1.2 1.9 1.3 1.6 0.6 1.2 1.3 0.3 0.6 0.5 0.6 Upper

- - - - 0.2 1.7 0.3 0.2 0.4 0.8 0.1 1.3 1.2 0.4 0.2 0.2 0.1 0.4 0.2 0.6 Lower - - - - Prevalence Prevalence (percentage) 0.9 2.1 0.7 0.6 0.7 1.0 0.8 1.3 1.4 0.5 0.7 0.6 0.2 0.5 0.4 0.6

Best estimate - - - - 530 830 820 520 520 340 340 8,950 1,220 7,600 7,600 5,100 5,100 1,640 1,640 3,220 3,220 1,230 1,230 1,980 1,980 54,800 34,520 20,400 Upper

- - - - 20 410 260 300 370 340 340 470 470 1,360 4,530 3,440 5,250 5,250 3,710 3,710 1,170 1,170 2,400 2,400 1,920 1,920 13,900 Lower Number Number ATS (excluding "ecstasy") ATS (thousands) - - - -

510 740 610 440 210 210 340 340 850 850 5,200 8,980 6,370 6,370 4,410 4,410 1,410 1,410 2,800 2,800 1,950 1,950 34,400 19,520 Best Best estimate - - - 0.8 1.9 0.4 0.9 1.1 1.5 1.2 0.6 1.8 1.3 0.7 0.4 1.0 0.03 0.08 0.07 0.05 Upper

- - - 0.1 1.5 0.3 0.2 0.2 1.4 0.2 0.6 1.7 1.2 0.6 0.1 1.0 0.02 0.02 0.02 0.02 Lower - - - Prevalence Prevalence (percentage)

0.4 1.5 0.4 0.8 0.7 1.5 0.6 0.6 1.8 1.2 0.7 0.2 1.0 0.02 0.05 0.03 0.03 Best Best estimate - - - 40 460 730 140 330 330 170 170 810 810 4,680 2,430 2,230 1,100 9,580 9,580 5,690 5,690 3,390 3,390 3,970 3,970 3,160 3,160 20,900 Upper Cocaine - - - 30 50

60 800 380 160 540 430 370 160 160 290 290 8,970 8,970 5,460 5,460 3,300 3,300 3,400 3,400 3,110 3,110 14,000 Lower Number Number (thousands) - - - 30 90 380 640

480 180 180 160 160 540 540 2,590 1,600 1,330 9,260 9,260 5,580 5,580 3,340 3,340 3,670 3,670 3,140 3,140 17,200 Best estimate

Region or Region or subregion East Africa North Africa Southern Africa West and Central and Central West Africa Caribbean Central America North America South America Central Asia and Central Asia and Transcaucasia East and South- East Asia Near and Middle Near and Middle East/ South West Asia South Asia Eastern and South-Eastern Europe Western and Cen - tral Europe Annual prevalence of the use cocaine, amphetamines and “ecstasy”, by region Annual prevalence Africa Oceania Global estimate Americas Asia Europe Source: UNODC estimates based on annual report questionnaire data and other official sources. data and other official questionnaire UNODC estimates based on annual report Source: WORLD DRUG REPORT 2014 WORLD DRUG REPORT xii ANNEX I

Prevalence of drug use among persons held in prisons Annual Number of Year of prevalence of Region Subregion Country persons held Three main drugs estimate any illicit drug in prisons use America North America Canada 2011 56.72 14,141 Cannabis Cocaine salts Opiods South America Argentina 2009 64.4 55,000 Ecuador 2007 33.9 15,736 Cannabis Cocaine Tranquilizers Asia Central Asia Armenia 2012 ∙∙ ∙∙ Cannabis and Transcaucasia Opioids Pharmaceutical opioids Kyrgyzstan 2010 15 7,000 East and Indonesia 2010 17.04 133,252 South-East Asia China, Macao SAR 2012 25.6 488 Ketamine Cannabis Methamphetamine Malaysia 2011 39 12,214 Heroin/morphine "Syabu" "Ganja" Myanmar 2011 30 1,544 Amphetamines Cannabis Opiates Near and Middle East Israel 2012 51.8 10,485 /South-West Asia Lebanon 2012 ∙∙ 2,249 Cannabis Cocaine Heroin Europe Eastern Europe Belarus 2011 ∙∙ 1,200 Opium Cannabis Tranquillizers Russian Federation 2012 14.8 701,517 Cannabis Cocaine Opioids Southeast Europe Bulgaria 2011 21.6 9,000 Heroin Cannabis Amphetamines Croatia 2010 17.3 ∙∙ Romania 2011 2 29,284 Opioids Cannabis "Ecstasy" Western and Belgium 2010 ∙∙ ∙∙ Amphetamine Central Europe Cannabis Cocaine salts Czech Republic 2012 37.7 20,000 Cannabis "Ecstasy"-type substances Methamphetamine Denmark 2010 8 3,969 France 2003 ∙∙ 61,604 Cannabis Cocaine Opioids Germany 2011 33 70,041 Cannabinoids Opioids Amphetamines Hungary 2008 8.4 16,328 Cannabis "Ecstasy" Amphetamines Italy 2012 23.84 65,701 Latvia 2011 17.7 4,588 Amphetamine Cannabis Sedatives and tranquillizers Lithuania 2012 14.61 9,734 ATS Opioids Netherlands 2007 57 13,260 Cannabis Cocaine Heroin Tables on drug cultivation, production and eradication and prevalence xiii

Slovakia 2012 17.24 10,850 Heroin Cannabis Methamphetamine Slovenia 2011 21.6 4,975 Spain 2011 ∙∙ 70,472 Cannabis Cocaine salts Heroin Sweden 2011 42 6,250 Oceania Oceania Australia 2012 70 29,383 Cannabis Methamphetamine Pharmaceutical opioids

New Zealand 2011 5.5 8,600 ATS Cannabis Opioids

Source: UNODC annual report questionnaire. Note: Two dots (∙∙) indicate that data are not available.

Morbidity among persons held in prisons

Year of Hepatitis B Hepatitis C HIV Infection Region Subregion Country estimate Prevalence Number Prevalence Number Prevalence Number America North America Canadaa 2008 ∙∙ ∙∙ 30.2 3,907 1.72 222 United States 2010 ∙∙ ∙∙ ∙∙ ∙∙ 1.46 ∙∙ of Americab South America Uruguay 2004 8.5 5.5 Asia Kazakhstan 2012 ∙∙ ∙∙ ∙∙ ∙∙ 2.2 ∙∙ Central Asia and Kyrgyzstan 2010 10 ∙∙ 10 ∙∙ 15 ∙∙ Transcaucasia Tajikistan 2011 ∙∙ 3,000 ∙∙ 3,000 China, Hong 2012 ∙∙ ∙∙ ∙∙ ∙∙ 0.74 ∙∙ Kong SAR East and Indonesia 2011 ∙∙ ∙∙ ∙∙ ∙∙ 3.63 ∙∙ South-East Asia Indonesia 2010 ∙∙ ∙∙ 0.84 ∙∙ ∙∙ 5,106 Malaysia 2011 0.18 66 1.23 445 3.04 1,102 Republic of 2011 226 Europe Eastern Europe Moldova Western and Belgium 2011 5.8 ∙∙ 22.4 ∙∙ 4.8 ∙∙ Central Europe Czech Republic 2009 16.2 ∙∙ 41.6 ∙∙ 2.4 ∙∙ Finland 2010 ∙∙ ∙∙ 84 1,600 2 40 France 2012 ∙∙ ∙∙ 4.8 3,000 2 1,220 Germany 2011 ∙∙ ∙∙ 14.3 ∙∙ 1.2 ∙∙ Hungary 2012 1.25 35 7.01 194 0.13 3 Latvia 2012 ∙∙ ∙∙ ∙∙ ∙∙ 6 450 Lithuania 2011 ∙∙ ∙∙ ∙∙ ∙∙ 4.1 396 Luxembourg 2007 9 72 52.6 417 5.2 41 Slovakia 2012 3.82 41 36.84 395 0.47 5 Source: UNODC annual report questionnaire unless otherwise stated. a Source: Public Health Agency of Canada b Source: United States Department of Justice Note: Two dots (∙∙) indicate that data are not available. WORLD DRUG REPORT 2014 WORLD DRUG REPORT

• • • • • • • • • defined asfollows: designations. These are notofficialdesignations. They are This report usesanumberofregional andsubregional ANNEX II Regional groupings • • • • • • • • • istan andUzbekistan. Kyrgyzstan, Tajikistan,Kazakhstan, Georgia, Turkmen- Central Asiaand Transcaucasia: Armenia,Azerbaijan, ian Republic of). guay, Peru, Suriname, Uruguay and Venezuela (Bolivar- Brazil, Chile,Colombia,Ecuador, Guyana, Paraof), - South America:Argentina,Bolivia(Plurinational State America. North America:Canada,Mexico and United States of temala, Honduras, Nicaragua andPanama. Central America:Belize, CostaRica,El Salvador, Gua- and Tobago. Lucia, Saint Vincent andtheGrenadines and Trinidad Grenada, Haiti, Jamaica, Saint KittsandNevis, Saint Bermuda, Cuba, Dominica, Dominican Republic, Caribbean: AntiguaandBarbuda, Bahamas, Barbados, and Togo.Leone Niger, Nigeria, Sao Tome andPrincipe, Senegal, Sierra Guinea, Guinea-Bissau, Liberia,Mali, Mauritania, Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Congo, Côted’Ivoire, Democratic Republic ofthe eroon, Cabo Verde, CentralAfricanRepublic, Chad, West andCentralAfrica:Benin, Burkina Faso, Cam- bia andZimbabwe. Mozambique, Namibia, South Africa,Swaziland, Zam- Southern Africa:Angola,Botswana,Lesotho,Malawi, Sudan, Sudan and Tunisia. North Africa:Algeria,Egypt, Libya, Morocco, South Tanzania. Seychelles, Somalia, Uganda andUnited Republic of Ethiopia, Kenya, Madagascar, Mauritius, Rwanda, East Africa:Burundi, Comoros, Djibouti,Eritrea, • • • • • • • • • • • • • • Tonga, Tuvalu, Vanuatu andsmallislandterritories. Palau, Papua New Guinea, Samoa, Solomon Islands, Nauru, Newcronesia Zealand, (Federated States of), Oceania: Australia, Fiji, Kiribati,Marshall Islands, Mi- and Northern Ireland. den, Switzerland andUnited Kingdom ofGreat Britain Portugal, San Marino, Slovakia, Slovenia, Spain, Swe- bourg, Malta, Monaco, Netherlands, Norway, Poland, Ireland, Italy, Latvia,Liechtenstein,Lithuania,Luxem- Finland, France, Germany, Greece, Hungary, Iceland, gium, Cyprus, Czech Republic, Denmark, Estonia, Western andCentralEurope: Andorra,Austria, Bel- Turkey. bia, theformer Yugoslav Republic ofMacedonia and vina, Bulgaria, Croatia, Montenegro, Romania, Ser- South-Eastern Europe: Albania,BosniaandHerzego - Federation andUkraine. Eastern Europe: Republic Belarus, ofMoldova, Russian pal andSri Lanka. South Asia:Bangladesh, Bhutan, India, Maldives, Ne - Republic, theUnited ArabEmirates and Yemen. Lebanon, Oman, Qatar, Saudi Arabia,theSyrian Arab region thatincludesBahrain, Israel, Jordan, Kuwait, and Yemen. The Near and Middle East refers toasub- Arabia, Syrian ArabRepublic, United ArabEmirates dan, Kuwait, Lebanon,Oman, Pakistan, Qatar, Saudi Iraq, Israel, JorBahrain, Iran- (Islamic Republic of), Near andMiddle East/South-West Asia:Afghanistan, Nam. of Korea, Singapore, Thailand, Timor-Leste and Viet Malaysia, Mongolia, Myanmar, Philippines, Republic Indonesia, Japan, LaoPeople’s Democratic Republic, bodia, China,Democratic People’s Republic ofKorea, East andSouth-East Asia:Brunei Cam- Darussalam, xv WORLD DRUG REPORT 2014

and hydrochloride) coca bush.Purification ofcocapasteyieldscocaine(base coca paste (or coca base) range past year dividedby thenumberofpeoplegiven age age rangewhohave atleastonceinthe usedagiven drug annual prevalence —thetotalnumberofpeopleagiven and itsanalogues) stances (3,4-methylenedioxymethamphetamine (MDMA) amphetamine, methcathinone and the “ecstasy”-group sub called amphetamines,whichincludesamphetamine,meth Substances of1971 and are from thegroup of substances national control intheConvention onPsychotropic posed of synthetic stimulants that were placed under inter amphetamine-type stimulants—agroup ofsubstances com have becomeavailable inrecent years necessarily refer inventions buttosubstancesthat tonew health threat. In thiscontext, the term“new” doesnot or the1971Convention, butwhichmayposeapublic under theSingle Convention onNarcotic Drugs of1961 in apure formorapreparation, thatare notcontrolled new psychoactive substances—ofabuse,either for smoking chloride through conversion processes tomakeitsuitable crack cocaine—baseobtainedfrom cocainehydro GLOSSARY — an extract of the leaves of the - - - - - sized inthebody poppy, theirsyntheticanaloguesandcompoundssynthe- opioids —agenerictermappliedtoalkaloidsfrom opium nition thatmaybeused can Psychiatric Association,oranysimilarcriteriadefi- Manual of Mental Disorders edition) of the Ameri (fourth Health Organization andtheDiagnosticStatistical Classification ofDiseases(tenthrevision) ofthe World based onclinicalcriteriacontainedintheInternational usedisordersdiagnosed withdrug orasdrug-dependent onadailybasisand/orpeople peoplewhousedrugs drugs, forexamplepeoplewhoinject consumption ofdrugs, users—peoplewhoengageinthehigh-risk problem drug poppy, aftermowing poppy straw (except —allparts theseeds)ofopium opium, morphineandheroin ucts derived from theopiumpoppyplant,including opiates —asubsetofopioidscomprisingthevarious prod - - xvii

WORLD DRUG REPORT 2014