For information only - not an official document

  25 March 2021


Hidden epidemic of drug use among older people highlighted by International Narcotics Control Board's Annual Report


In its 2020 Annual Report, the International Narcotics Control Board:

  • highlights a global hidden epidemic: the use of drugs among older people;
  • addresses the impact of the COVID-19 pandemic on access to medicines, prevention and treatment services for people with mental health and substance abuse disorder, and on the illicit drug market;
  • expresses concern about the number of overdose deaths from methamphetamine and synthetic opioids and about the developments relating to the non-medical use of cannabis;
  • notes its ongoing concern about the high level of illicit production of opium in Afghanistan in 2020;  
  • urges governments to apply proportionate responses to drug-related offences based on the rule of law and human rights;  
  • marks the 60th and 50th anniversaries of the 1961 Single Convention on Narcotic Drugs and the 1971 Convention on Psychotropic Substances with a special report, stresses need for universal implementation.

VIENNA, 25 March (UN Information Service) - At a time of increased demand for controlled medicines due to the COVID-19 pandemic, the International Narcotics Control Board (INCB) warns of 'a hidden epidemic: drug use among older persons' and the harm the pandemic has caused to the health and well-being of this population group.

In its Annual Report published today, INCB highlights that as the world population ages, there is an increased vulnerability to drug use and drug dependence for older people. Substance use and related disorders among the older population have risen over the past years, but this demographic has been largely overlooked. INCB calls on governments to focus on drug use among older persons and extend and integrate support to help reverse this alarming trend.

INCB expresses concern over the negative effect of the COVID-19 pandemic on the global supply chain of medicines. Government measures intended to curb the spread of the virus led to shortages of some controlled substances for medical and scientific purposes. Increased demand for the treatment of patients with COVID-19 have created further shortages and disrupted treatment and other health-related services.

INCB stresses that people with mental health and substance use disorders have been particularly affected by the COVID-19 pandemic. Mobility restrictions and social isolation have imposed greater strain on people with mental health and substance use problems and worsened disorders at times.

The President of the INCB, Cornelis de Joncheere, said: "At a time when resources are already stretched, people affected by drug use disorders must not be left behind. INCB calls on governments to ensure that services for prevention, treatment and rehabilitation continue to be provided."

INCB expresses concern about the high number of drug overdose deaths - especially related to fentanyl and methamphetamine. INCB notes that the COVID-19 pandemic has further exacerbated the problem.

INCB remains concerned about steps taken by some governments towards legalizing cannabis for non-medical purposes and reiterates the need for States to take measures that limit the production, manufacture and trade of cannabis to medical and scientific purposes.

A hidden epidemic: the use of drugs among older persons

As the world population ages, the number of older people with drug use disorders has also been increasing. Data has shown an increase of use of pain relievers, tranquilizers, benzodiazepines and sedatives by older people over the past decade. However, drug use surveys have largely overlooked people over 65 years old. Older people with substance use problems also face unique age-related challenges, including isolation or physical challenges. INCB recommends increasing research about drug use disorders among older people as a first step to counteracting this dangerous trend and calls on governments to improve access to necessary health and treatment services designed for this population group.

Cornelis de Joncheere said: "The pandemic has caused great harm to the health and the well-being of older people. However, there is also a hidden epidemic of drug use affecting this population group. Drug use and drug-related deaths among older people have been on the rise, as has the number of older people in treatment for drug use problems."

Impact of the COVID-19 pandemic on access to medical supplies

The COVID-19 pandemic has increased demand for some controlled medicines. At the same time, lockdowns, border controls, and social distancing measures have disrupted the global supply chain of medicines. This has not only disrupted manufacturing and logistics of key pharmaceutical ingredients, but also impacted health-related services and access to medication, including for people with mental health and substance use disorders.

The surge in demand for medicines necessary for the treatment of patients with COVID-19 has further reduced the availability of some medicines containing controlled substances. To address the lower supply, some governments have resorted to contingency plans, which in turn have caused shortages of certain medicines in other countries. INCB is recommending that countries review their forecasted demand for medicines containing controlled substances and streamline administrative and logistical requirements. INCB calls on all governments to ensure continued access to prevention and treatment services for people with mental health and substance use problems.

Cornelis de Joncheere said: "The impact of the COVID-19 pandemic on mental health is yet to be fully seen, and evidence-based prevention and treatment services must be stepped up to stem an increase in drug use disorders and in mental health conditions. This is the shared responsibility of us all. Building back better from the unprecedented challenges of 2020 and ensuring progress towards achieving the Sustainable Development Goals requires the international community to work harder and smarter."

Impact of the COVID-19 pandemic on illicit drug trafficking 

Travel restrictions and other social-distancing measures put in place to combat the spread of the coronavirus have also influenced illicit drug markets. This has seemingly resulted in shortages of some drugs and higher prices on the illicit market. Further, there are indications that the purity of local illicit drug supplies has decreased and adulterants such as fentanyl are being used, increasing overdose rates.

INCB reports growth in online drug dealing through encrypted communications by organized crime. Open web and darknet markets, social media and online forums also seem to play a more prominent role in obtaining drugs by users. This development poses additional challenges for law enforcement agencies. INCB reiterates the importance of implementing the obligations under  the international drug control conventions and encourages countries to address links between drug-related crimes and other forms of organized crime.

INCB is committed to close cooperation through supporting governments either directly or through its capacity building programmes, including INCB Learning and the GRIDS Programme and urges governments to fully implement the respective recommendations contained in the 2020 reports for the benefit of their communities.

Afghanistan's illicit production of opium remained high

The production of opium in Afghanistan remained high in 2019 and Afghanistan accounted for nearly 84 per cent of the global opium production over the past five years. Further, there have been no signs of a decrease in the supply of heroin of Afghan origin to consumer markets globally. INCB remains concerned about the deteriorating drug control situation in Afghanistan, and maintains a close dialogue with the Government under articles 14 and 14 bis of the Single Convention on Narcotic Drugs, and calls on the international community to provide technical and financial assistance to support the country with its drug control efforts.

Cornelis de Joncheere said: "If illicit drug cultivation and production, drug trafficking, drug use and drug use disorders in Afghanistan are not comprehensively addressed, broader efforts on sustainable development, prosperity and peace in Afghanistan are unlikely to be effective." 

INCB urges governments to apply proportionate responses to drug-related offences based on the rule of law and human rights  

INCB continues to call on Governments to implement the international drug control conventions with full respect for the rule of law and human rights. Approaches should be based on principles of proportionality when determining responses to drug-related offences and respect for human rights to achieve the Sustainable Development Goals.

Cornelis de Joncheere said: "Drug trafficking and drug-related violence should be addressed through comprehensive and balanced measures, and responses to drug-related criminal conduct must be proportionate and respect human rights and the rule of law."

60th and 50th anniversaries of the 1961 Single Convention on Narcotic Drugs and the 1971 Convention on Psychotropic Substances

INCB marks the 60th and 50th anniversaries of the two drug control Conventions with a special report reviewing their achievements and highlighting challenges the international community faces today.  Since their inception, nearly universal adherence has been achieved as almost all Member States are parties to the Conventions today.

INCB recognizes that one of the main challenges for States when implementing their obligations under the Conventions is to achieve balance between guaranteeing the availability of controlled drugs medically needed and the prevention of abuse, illegal production, and trafficking.

INCB stresses that in fighting drug-related crime, government responses should always be proportionate and addressed through the formal criminal justice system consistent with the Universal Declaration of Human Rights. 

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For further information, please contact:

INCB Secretariat
Tel.: (+43-1) 26060-4163
Email: incb.secretariat[at]

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