Substance use and related disorders among the older population have risen over the past years, but this demographic has been largely overlooked, stated UN-linked International Narcotics Control Board terming its as the "hidden epidemic". In its annual report published, INCB highlighted that as the world population ages, there is an increased vulnerability to drug use and drug dependence for older people. At a time of increased demand for controlled medicines due to the Covid-19 pandemic, the INCB in its report 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.
The board calls on governments to focus on drug use among older persons and extend and integrate support to help reverse this alarming trend. The report recommended that analysis and research are undertaken in relation to relevant existing national health record systems for older persons in order to provide preliminary estimates of the scale of the hidden prevalence of undiagnosed drug use, including the misuse of prescription medications, and related comorbidities among older persons. "Older persons who use drugs are more likely to suffer from stigma, social exclusion and isolation from family and friends," the report pointed. Such increased stigma was identified in a study of older persons in Austria, Germany, Poland and Scotland, United Kingdom. It was found that the impact of stigma on older persons who use drugs can be profound and can be a significant barrier to treatment and recovery The report stated that in terms of ensuring access to a continuum of care for older persons who use drugs, it is recommended that existing outreach services for people who use drugs be expanded or developed to include domiciliary and peripatetic services and that those outreach services be used as a gateway or entry point to a continuum of integrated care for the most marginalized of older persons who use drugs The report also 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," stated the report. The board 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," it stated. Cornelis de Joncheere, the INCB president, 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." The international board expresses concern about the high number of drug overdose deaths - especially related to fentanyl and methamphetamine. It notes that the Covid-19 pandemic has further exacerbated the problem. The board remains concerned about steps taken by some governments towards legalising 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. The board recommended 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. The board recommended that countries review their forecasted demand for medicines containing controlled substances and streamline administrative and logistical requirements. It 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." The president of the board further stated this is the shared responsibility of 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. The report stated that 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," it stated. The board 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. 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. The board 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." The board urges governments to apply proportionate responses to drug-related offences based on the rule of law and human rights 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."
The Annual Report, the International Narcotics Control Board:
- 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.
The board calls on governments to focus on drug use among older persons and extend and integrate support to help reverse this alarming trend. The report recommended that analysis and research are undertaken in relation to relevant existing national health record systems for older persons in order to provide preliminary estimates of the scale of the hidden prevalence of undiagnosed drug use, including the misuse of prescription medications, and related comorbidities among older persons. "Older persons who use drugs are more likely to suffer from stigma, social exclusion and isolation from family and friends," the report pointed. Such increased stigma was identified in a study of older persons in Austria, Germany, Poland and Scotland, United Kingdom. It was found that the impact of stigma on older persons who use drugs can be profound and can be a significant barrier to treatment and recovery The report stated that in terms of ensuring access to a continuum of care for older persons who use drugs, it is recommended that existing outreach services for people who use drugs be expanded or developed to include domiciliary and peripatetic services and that those outreach services be used as a gateway or entry point to a continuum of integrated care for the most marginalized of older persons who use drugs The report also 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," stated the report. The board 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," it stated. Cornelis de Joncheere, the INCB president, 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." The international board expresses concern about the high number of drug overdose deaths - especially related to fentanyl and methamphetamine. It notes that the Covid-19 pandemic has further exacerbated the problem. The board remains concerned about steps taken by some governments towards legalising 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. The board recommended 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. The board recommended that countries review their forecasted demand for medicines containing controlled substances and streamline administrative and logistical requirements. It 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." The president of the board further stated this is the shared responsibility of 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. The report stated that 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," it stated. The board 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. 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. The board 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." The board urges governments to apply proportionate responses to drug-related offences based on the rule of law and human rights 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."