International Aspects of CUD
Cannabis is the most prevalent illicit drug used around the world even while several countries have legalized recreational and medical use. This has led to increases in use, particularly among populations where prevalence has been generally low, for example, the elderly, and people with medical problems. With growing global use comes concern regarding problematic use and ways to prevent and treat it. This chapter attempts to summarize the epidemiology of cannabis use in most large areas of the world where data exist and what is known and not known regarding the incidence and prevalence of problematic cannabis use. Importantly, the chapter recognizes the need for continuous, systematic collection of standardized data that will improve knowledge about attitudes and risk perceptions, the nature and extent of cannabis use, and cannabis-related health, social, and economic consequences. Information about cannabis use in Africa; Asia, the Near East, and the Middle East; Europe; Oceania; and the Western Hemisphere provides regional perspectives and highlights geographical areas where data are scarce. The different approaches of the two primary international diagnostic guidelines for substance use disorders—the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from the American Psychiatric Association and the International Classification of Diseases (ICD-11) currently under development by the World Health Organization (WHO)—may contribute to international variations in defining cannabis use disorders and setting treatment priorities. Additionally, evidence-based prevention and treatment options, the global burden of disease attributed to cannabis use, and the impact of decreased perception of risk associated with cannabis use are summarized.
KeywordsCannabis International Prevalence Treatment Research
Australian Institute of Health and Welfare
American Psychiatric Association
Asia and Pacific Amphetamine-Type Stimulants Information Centre
Cannabis Abuse Screening Test
Inter-American Drug Abuse Control Commission
Cannabis use disorder
Cannabis Use Disorder Identification Test—Revised
Drug Abuse Information Network for Asia and the Pacific
Disability-adjusted life years
Diagnostic and Statistical Manual of Mental Disorders, 5th Edition
Economic Community of West African States
European Monitoring Centre for Drugs and Drug Addiction
European School Survey Project on Alcohol and Other Drugs
Global Burden of Disease
Global Student Health Survey
International Classification of Diseases, 11th Edition
Low- and middle-income countries
Middle East and North Africa
Ministry of Health
National Drug Strategy Household Survey (Australia)
National Institute on Drug Abuse
New psychoactive substances
New Zealand Health Survey
Pacific Island countries and territories
South African Community Epidemiology Network on Drug Use
Screening, brief intervention, and referral to treatment
Standard Joint Unit
Global Synthetics Monitoring: Analyses, Reporting and Trends
United Nations Office on Drugs and Crime
West African Epidemiology Network on Drug Use
World Health Organization
Youth Risk Behavior Study
- 1.Abebe W. Prevalence and consequences of substance use among high school and college students in Ethiopia: a review of the literature. Afr J Drug Alcohol Stud. 2013;12(2):107–18.Google Scholar
- 2.Abiama EE, Abasiubong F, Usen KB, Alexander UE. Prevalence of substance use and association with psychiatric illness among patients in Uyo, Nigeria. Afr J Drug Alcohol Stud. 2014;13(2):87–96.Google Scholar
- 3.American Psychiatric Association (APA). From planning to publication: developing DSM-5; 2013. https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets. Accessed 5 Oct 2017.
- 4.Argentine National Observatory on Drugs, Secretariat of Integrated Drug Policy. Fifth national study of high school students, 2011. p. 188; 2012. http://www.observatorio.gob.ar/media/k2/attachments/VZEstudioZNacionalZaZEstudiantesZdeZNivelZMedio.ZAoZ20121.pdf. Accessed 10 Oct 2017. [Spanish].
- 5.Australian Institute of Health and Welfare (AIHW). 2010 National drug strategy household survey report; 2011. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421314. Accessed 30 Aug 2017.
- 6.Australian Institute of Health and Welfare (AIHW). Technical notes; 2016a. http://www.aihw.gov.au/alcohol-and-other-drugs/data-sources/ndshs-2016/technical-notes/. Accessed 28 Aug 2017.
- 7.Australian Institute of Health and Welfare (AIHW). Data (NDSHS 2016 key findings); 2016b. http://www.aihw.gov.au/alcohol-and-other-drugs/data-sources/ndshs-2016/data/. Accessed 28 Aug 2017.
- 8.Australian Institute of Health and Welfare (AIHW). National drug strategy household survey 2016: detailed findings. Canberra: AIHW; 2017. Drug Statistics series no. 31. Cat. No. PHE 214.Google Scholar
- 11.Brown SJ, Mensah FK, Ah Kit J, Stuart-Butler D, Glover K, Leane C, Weetra D, Gartland D, Newbury J, Yelland J. Use of cannabis during pregnancy and birth outcomes in an aboriginal birth cohort: a cross-sectional, population-based study. BMJ Open. 2016;6(2):e010286. https://doi.org/10.1136/bmjopen-2015-010286.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Bullen P, Dyson B, Peiris-John R, Utter J, Robinson E, Crengle S, et al. Youth2000 survey series: the health and wellbeing of secondary school students in Christchurch; 2013. https://www.fmhs.auckland.ac.nz/assets/fmhs/faculty/ahrg/docs/christchurch- report.pdf. Accessed 30 Aug 2017.
- 14.Chilean National Observatory on Drugs. Eleventh national study on drugs in school populations in Chile; 2015. p. 27. [Spanish].Google Scholar
- 17.Degenhardt L, Bucello C, Calabria B, Nelson P, Roberts A, Hall W, Lynskey M, Wiessing L, GBD Illicit Drug Use Writing Group, Mora ME, Clark N, Thomas J, Briegleb C, McLaren J. What data are available on the extent of illicit drug use and dependence globally? Results of four systematic reviews. Drug Alcohol Depend. 2011;117(2–3):85–101. https://doi.org/10.1016/j.drugalcdep.2010.11.032.CrossRefPubMedGoogle Scholar
- 18.Economic Community of West African States (ECOWAS). Support to ECOWAS regional action plan on illicit drug trafficking related organised crime and drug abuse in West Africa. In: ECOWAS Drug Unit: the project; 2016. http://www.edup.ecowas.int/all-about/the-project/. Accessed 2 Oct 2017.Google Scholar
- 19.European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report: trends and developments 2017. Publications Office of the European Union, Luxembourg. http://www.emcdda.europa.eu/publications/edr/trends-developments/2017. Accessed 18 Oct 2017.
- 23.GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1659–724. https://doi.org/10.1016/S0140-6736(16)31679-8.CrossRefGoogle Scholar
- 26.Guvendeger Doksat N, Zahmacioglu O, Ciftci Demirci A, Kocaman GM, Erdogan A. Association of suicide attempts and non-suicidal self-injury behaviors with substance use and family characteristics among children and adolescents seeking treatment for substance use disorder. Subst Use Misuse. 2017;52(5):604–13.CrossRefGoogle Scholar
- 27.Harris SK, Csémy L, Sherritt L, Starostova O, Van Hook S, Johnson J, Boulter S, Brooks T, Carey P, Kossack R, Kulig JW, Van Vranken N, Knight JR. Computer-facilitated substance use screening and brief advice for teens in primary care: an international trial. Pediatrics. 2012;129(6):1072–82.CrossRefGoogle Scholar
- 29.Inter-American Drug Abuse Control Commission (CICAD). Report on drug use in the Americas; 2015. (OAS. Official Records Series; OEA/Ser.L). ISBN 978-0-8270-6373-0. http://www.cicad.oas.org/oid/pubs/DrugUseAmericas_ENG_web.pdf. Accessed 10 Oct 2017.
- 35.Ludick WK, Amone-P’Olak K. Temperament and the risk of alcohol, tobacco, and cannabis use among university students in Botswana. Afr J Drug Alcohol Stud. 2016;15(1):21–35.Google Scholar
- 36.Maslowsky J, Capell JW, Moberg DP, Brown RL. Universal school-based implementation of screening brief intervention and referral to treatment to reduce and prevent alcohol, marijuana, tobacco, and other drug use: process and feasibility. Subst Abuse. 2017;11:1178221817746668.PubMedPubMedCentralGoogle Scholar
- 38.National Academies of Sciences, Engineering, and Medicine. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research; 2017. https://www.nap.edu/catalog/24625/the-health-effects-of-cannabis-and-cannabinoids-the-current-state. https://doi.org/10.17226/24625. Accesed 11 Oct 2017.
- 39.New Zealand Ministry of Health (MOH). Cannabis use 2012/13: New Zealand health survey. 2015. http://www.health.govt.nz/publication/cannabis-use-2012-13-new-zealand-health-survey. Accessed 10 Oct 2017.Google Scholar
- 41.Rehm J, Crépault J-F, Fischer B. The devil is in the details! On regulating cannabis use in Canada based on public health criteria; comment on “Legalizing and regulating marijuana in Canada: review of potential economic, social, and health impacts”. Int J Health Policy Manag. 2017;6(3):173–6.CrossRefGoogle Scholar
- 46.Selemogwe M, Mphele S, Manyanda K. Drug use patterns and socio-demographic profiles of substance users: findings from a substance abuse treatment programme in Gaborone, Botswana. Afr J Drug Alcohol Stud. 2014;13(1):43–53.Google Scholar
- 47.South African Community Epidemiology Network on Drug Use (SACENDU). Update; 2017. http://www.mrc.ac.za/adarg/sacendu/SACENDUupdatejUNE2017.pdf. Accessed 29 Sept 2017.
- 48.Ugwuoke KA, Ifeanyichukwu O. A study of drug use pattern among inmates of Jos Prison, Nigeria. Afr J Drug Alcohol Stud. 2016;15(1):11–9.Google Scholar
- 49.United Nations Office on Drugs and Crime. World drug report 2016. Austria: UNODC; 2016. ISBN: 978-92-1-148286-7, eISBN: 978-92-1-057862-2, United Nations publication, Sales No. E.16.XI.7.Google Scholar
- 50.United Nations Office on Drugs and Crime. World drug report 2017. Austria: UNODC; 2017. ISBN: 978-92-1-148291-1, eISBN: 978-92-1-060623-3, United Nations publication, Sales No. E.17.XI.6.Google Scholar
- 51.United Nations Office on Drugs and Crime. UNODC supports the establishment of national epidemiology network on drug use in Liberia and Cote d’Ivoire. In: UNODC West and Central Africa Field Office. 13, 2017; 2017b. http://www.unodc.org/westandcentralafrica/en/2017-07-13-ecowas-epidemio-liberia2017.html. Accessed 2 Oct 2017.
- 52.United Nations Office on Drugs and Crime (UNODC) Statistics Online. Drug use and health consequences. Annual prevalence, adults: Cannabis; 2017a. https://data.unodc.org/. Accessed 2 Oct 2017.
- 53.United Nations Office on Drugs and Crime (UNODC) Statistics Online. Drug use and health consequences. Annual prevalence, youth: Cannabis; 2017b. https://data.unodc.org/. Accessed 2 Oct 2017.
- 54.United Nations Office on Drugs and Crime Middle East and North Africa (UNODC MENA). Regional programme for the Arab States (2016–2021); 2016. https://www.unodc.org/documents/middleeastandnorthafrica//Regional-Programme-doc/Regional_Programme_for_the_Arab_States_2016-2021.pdf. Accessed 2 Oct 2017.
- 55.Uruguayan National Observatory on Drugs, National Drug Board. Sixth national survey on drug use in high school students 2014: research report. Montevideo: Junta Nacional de Drogas; 2014. p. 52. [Spanish].Google Scholar
- 56.U.S. Centers for Disease Control and Prevention Youth risk behavior survey (YRBS); 2017. https://www.cdc.gov/healthyyouth/data/yrbs/results.htm. Accessed 31 Aug 2017.
- 59.White V, Williams T. Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2014. http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/Publishing.nsf/content/E9E2B337CF94143CCA25804B0005BEAA/$File/National-report_ASSAD_2014.pdf. Accessed 28 Aug 2017.
- 62.World Bank. World Bank country and lending groups; 2017. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed 10 Oct 2017.
- 63.World Health Organization (WHO). ICD-11 Beta: expectations, concerns and known issues; 2017a. http://www.who.int/classifications/icd/revision/betaexpectations/en/. Accessed 6 Oct 2017.
- 64.World Health Organization (WHO). ICD-11 Beta draft; 2017b. https://icd.who.int/dev11/. Accessed 6 Oct 2017.
- 65.World Health Organization (WHO). The health and social effects of nonmedical cannabis use; 2016. ISBN: 978 92 4 151024 0, World Health Organization publication. http://www.who.int/substance_abuse/publications/cannabis/en/. Accessed 18 Oct 2017.
- 66.World Health Organization (WHO) Global school-based student health survey (GSHS). Country fact sheets; 2017. http://www.who.int/chp/gshs/factsheets/en/index.html. Accessed 31 Aug 2017.