Drugs (psychoactive)

Psychoactive drugs are substances that, when taken in or administered into one's system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions. Psychoactive drugs belong to a broader category of psychoactive substances that include also alcohol and nicotine.  “Psychoactive” does not necessarily imply dependence-producing, and in common parlance, the term is often left unstated, as in “drug use”, “substance use” or “substance abuse”.

Production, distribution, sale or non-medical use of many psychoactive drugs is either controlled or prohibited outside legally sanctioned channels by law. Psychoactive drugs have different degrees of restriction of availability, depending on their risks to health and therapeutic usefulness, and classified according to a hierarchy of schedules at both national and international levels. At the international level, there are international drug conventions concerned with the control of production and distribution of psychoactive drugs: the 1961 Single Convention on Narcotic Drugs, amended by a 1972 Protocol; the 1971 Convention on Psychotropic Substances; the 1988 Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances.

The use of psychoactive drugs without medical supervision is associated with significant health risks and can lead to the development of drug use disorders. Drug use disorders, particularly when untreated, increase morbidity and mortality risks for individuals, can trigger substantial suffering and lead to impairment in personal, family, social, educational, occupational or other important areas of functioning. Drug use disorders are associated with significant costs to society due to lost productivity, premature mortality, increased health care expenditure, and costs related to criminal justice, social welfare, and other social consequences.

About 270 million people (or about 5.5% of global population aged 15-64) had used psychoactive drugs in the previous year and about 35 million people are estimated to be affected by drug use disorders (harmful pattern of drug use or drug dependence). It is estimated that about 0.5 million death annually are attributable to drug use with about 350 000 male and 150 000 female deaths. Opioid-related deaths, largely due to synthetic opioids, have recently changed the mortality trends in some high-income countries . More than 42 million years of healthy life loss (DALY) were attributable to drug use in 2017; that is about 1.3% of the global burden of disease. It is estimated that worldwide there are almost 11 million people who inject drugs, of whom 1.4 million live with HIV and 5.6 million - with hepatitis C.

Since its creation, WHO has played an important role within the UN system in addressing the world drug problem. WHO activities to counter the world drug problem can be presented under the following main dimensions:

• prevention of drug use and reduction of vulnerability and risks;
• treatment and care of people with drug use disorders;
• prevention and management of the harms associated with drug use;
• access to controlled medicines; and
• monitoring and evaluation.

Target 3.5 of UN Sustainable Development Goal 3 sets out a commitment by governments to strengthen the prevention and treatment of substance abuse. Several other targets are also of particular relevance to drug policy-related health issues, especially target 3.3, referring to ending the AIDS epidemic and combating viral hepatitis; target 3.4, on preventing and treating noncommunicable diseases and promoting mental health; target 3.8, on achieving universal health coverage; and target 3.b, with its reference to providing access to affordable essential medicines.

In April 2016, the thirtieth Special Session of the UN General Assembly (UNGASS) reviewed the progress in the implementation of the 2009 Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem and assessed the achievements and challenges. In resolution S-30/1, the General Assembly adopted the outcome document of the special session on the world drug problem entitled “Our joint commitment to effectively addressing and countering the world drug problem”. The UNGASS marked a shift in the overall drug policy discourse to highlight the public health and human rights dimensions of the world drug problem and to achieve a better balance between supply reduction and public health measures.