Epidemiology of alcohol and drug use

Abstract

This chapter describes trends in the prevalence and patterns of alcohol and illicit drug use. While methodological differences, imprecise estimates and lack of data preclude firm conclusions on the global situation and trends in substance use, the available data suggest that alcohol and illicit drug consumption varies widely between societies. Per capita alcohol consumption is highest in the European Union and lowest in the South-East Asian and Eastern Mediterranean regions. There is a general long-term trend towards harmonisation of alcohol consumption, with decreasing levels in regions with traditionally high levels and increasing levels in regions with low levels. Trend data from surveys showed an increase in heavy episodic drinking among pupils in many European countries in the past decade, especially among girls. Prevalence rates of illicit drug use are generally lower in the European Union compared to the USA, Canada and Australia, for which most research data are available. However, there are large variations between EU countries. Cannabis is worldwide the most frequently used illicit drug. Prevalence rates among young people tend to stabilise or decline in the past years, after a general increasing trend in the 1990s. Annual cocaine prevalence is higher among the general population of the USA and Canada compared to Australia and the EU, while annual prevalence of ecstasy and amphetamine use is highest in Australia. Within Europe, cocaine generally dominates the stimulant markets in the Western and Southern regions, albeit restricted to a few large countries. Amphetamines are the main stimulants in North, Central and Eastern Europe. Injecting drug use increases the risk of transmission of blood-born infectious diseases, like HIV and hepatitis B and C. China, the USA and Russia have the largest numbers of drug injectors. In terms of (midpoint) prevalence, highest rates are found in Azerbaijan and lowest in Cambodia.