This is the central warning of the World Drug Report 2024, released by the United Nations Office on Drugs and Crime (UNODC), which highlights the steady rise in drug consumption, the expansion of illicit markets and the growing social, health and environmental harms affecting countries across the world.

The global drug problem continues to worsen at an alarming pace.

According to the report, the emergence of new and highly potent synthetic opioids, combined with unprecedented supply and demand for other drugs, has intensified the impact of drug trafficking and problematic drug use.

In 2022, the number of people who used drugs worldwide reached 292 million, marking a 20% increase over the past decade.

“The production, trafficking and use of drugs continue to fuel instability and inequality, causing incalculable harm to people’s health, safety and well-being,” said Ghada Waly, Executive Director of the UN Office on Drugs and Crime.

She stressed the need to expand access to evidence-based treatment while strengthening prevention efforts.

Cannabis remains the most widely used drug globally, with an estimated 228 million users, followed by opioids (60 million), amphetamines (30 million), cocaine (23 million) and ecstasy (20 million).

The report raises particular concern over nitazenes, a group of synthetic opioids even more potent than fentanyl, which have been linked to a surge in overdose deaths in several high-income countries.

The consumption gap between men and women

Despite an estimated 64 million people suffering from drug use disorders, only one in eleven receives treatment. Access is even more limited for women: just one in eighteen women with drug use disorders receives care, compared to one in seven men.

Structural barriers, stigma and insufficient services continue to widen this gap.

The burden on criminal justice systems is also significant. In 2022, approximately seven million people worldwide had formal contact with law enforcement for drug-related offenses, mostly for personal use or possession.

That same year, 2.7 million people were prosecuted and more than 1.6 million were convicted, with major regional disparities in criminal justice responses.

The report underscores how drug trafficking empowers organized crime groups, which increasingly diversify into other illicit activities such as wildlife trafficking, financial fraud and illegal resource extraction.

In regions like the Golden Triangle, these dynamics destabilize vulnerable communities, forcing many into opium cultivation or illegal mining to survive.

Environmental damage is another growing consequence, with deforestation, toxic waste dumping and chemical pollution linked to illicit drug economies.

Meanwhile, cocaine production reached a record 2,757 tons in 2022, driven by a 12% increase in global coca cultivation. This surge has fueled violence along supply chains, particularly in Ecuador and the Caribbean, and increased health harms in destination countries, including parts of Europe.

Countries where consumption is legal: figures

In Canada, Uruguay and parts of the United States, evidence points to increased harmful use, a proliferation of high-THC products and rising hospitalizations linked to mental health disorders, especially among young adults.

The UN report also examines the effects of cannabis legalization in certain jurisdictions.

In addition, the report warns about the risks associated with the so-called “psychedelic renaissance.” While interest in therapeutic uses is growing, unsupervised and quasi-therapeutic use may outpace scientific evidence and undermine public health objectives.

Finally, the sharp decline in opium production in Afghanistan following its ban could have far-reaching implications, potentially affecting heroin purity, shifting consumption patterns and increasing demand for treatment services in transit and destination countries.

The report concludes that protecting the right to health of people who use drugs is a fundamental human rights obligation and a cornerstone of an effective global response to a crisis that shows no sign of slowing down.