Proponents of cannabis legalization often present legalization as a solution to overincarceration or trafficking and related violence. However, the conventions provide sufficient flexibility to address drug-related offences through alternatives to incarceration, in line with the principle of proportionality, and the provisions of the conventions should be implemented in accordance with internationally agreed human rights standards. INCB remains committed to ongoing dialogue with the States concerned with the aim of improving implementation of the conventions and safeguarding health and wellbeing. 

       The report also shows how a surge in illicit coca bush cultivation and cocaine production and trafficking has led to increased availability and use of cocaine of higher purity. INCB is working with Member States to prevent trafficking of chemicals used in illicit manufacture of cocaine and other drugs, and to identify solutions to the rapid diversification of chemicals used in illicit drug manufacture. 

       The Board remains deeply concerned about illicit opium poppy cultivation and opium production, as well as the illicit manufacture of methamphetamine, in Afghanistan. INCB calls upon the international community to continue to support drug control efforts in the country to promote public health, including for women.

       The opioid overdose crisis leading to significant loss of life in North America has continued to worsen, and has become one of the major issues on the INCB agenda. Trafficking in fentanyl and other dangerous non-medical synthetic opioids is expanding to other regions, as seen in Oceania. Under the GRIDS Programme, which has regional technical officers located in Africa, Asia and the Americas, INCB is supporting Governments in disrupting trafficking in these and other highly potent substances and preventing further loss of life. 

       Many countries lack mechanisms for the collection of data on drug use and treatment demand, which hinders efforts to develop evidence-based prevention and treatment programmes. INCB urges governments to develop national systems to this end and encourages bilateral assistance in this area, especially in Africa. 

     In the supplement ^[2] to the 2022 Annual Report, INCB is highlighting persistent inequities in the availability of internationally controlled narcotic drugs and psychotropic substances for medical and scientific purposes. These substances are essential for anaesthesia, palliative care, pain management and for the treatment of mental health and neurological conditions and opioid use disorder. Yet most of the world population still has limited or no access to controlled medicines, and patients are being left behind. Conversely, in some countries, excessive availability and over-prescription have contributed to an epidemic of drug use disorder and overdose. Data reported to INCB by Member States and civil society shows that some progress has been made but much more needs to be done. INCB's recommendations are aimed at improving affordability, accuracy of national estimates of licit requirements, training and awareness raising among health professionals, and legislative, regulatory and administrative changes. The INCB Learning programme is building the capacity of national authorities in these areas.

       Ensuring availability of controlled medicines is particularly challenged during humanitarian emergencies. INCB reminds governments of the possibility of utilising simplified procedures to expedite the international trade and provision of controlled medicines during emergencies and crises. 

      In closing, INCB commits to continuing cooperation with Member States to improve implementation of the drug control conventions and progress on the Sustainable Development Goals, particularly SDG 3 on health and wellbeing and SDG 16 on peace, justice and strong institutions. Only together can we ensure that no person is left behind.