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GLOBAL DIMENSION AND BURDEN OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE

GLOBAL DIMENSION AND BURDEN OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE Isidore S. Obot, PhD, MPH. Department of Mental Health and Substance Abuse World Health Organization Geneva. Introduction. Pattern of Substance Use World-wide Tobacco Alcohol Illicit Drugs

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GLOBAL DIMENSION AND BURDEN OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE

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  1. GLOBAL DIMENSION AND BURDEN OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE • Isidore S. Obot, PhD, MPH. • Department of Mental Health and Substance Abuse • World Health Organization • Geneva

  2. Introduction Pattern of Substance Use World-wide • Tobacco • Alcohol • Illicit Drugs Global Burden of Psychoactive Substance Use • Tobacco • Alcohol • Illicit Drugs Conclusions

  3. Smoking in the World • Number of cigarettes smoked in • 1970 - 3.1 trillions • 1980 - 4.4 trillions • 2000 - 5.5 trillions • Number of cigarettes smoked everyday: over 15 billion • One in three smoked in China where average number of cigarettes per man per day rose from 10 in 1992 to 15 in 1996.

  4. Smoking in Brazil • Annual per capita consumption declined from 1,309 in 1970 to 858 in 2000, with the peak in 1980 at 1,895 per person. • Overall rate, 2000: 31% • Males - 35% • Females - 27% • Youth - 11%

  5. Framework Convention on Tobacco ControlFCTC • Adopted in 2003 • Signed by 94 countries • Ratified by 9 countries • No of countries needed: 40

  6. Proportion of alcohol consumers in WHO sub-regions

  7. Drinking Pattern Values for Selected WHO Regions

  8. 12 leading selected risk factors as causes of disease burden measured in DALYs Developed countries Developing countries High Mortality Low Mortality 1 Underweight Alcohol (6.2%) Tobacco (12.2%) 2 Unsafe sex Blood pressure Blood pressure 3 Unsafe water Tobacco (4.0%) Alcohol (9.2%) 4 Indoor smoke Underweight Cholesterol 5 Zinc deficiency Body mass index Body mass index 6 Iron deficiency Cholesterol Low fruit & veg intake 7 Vitamin A deficiency Low fruit & veg intake Physical inactivity 8 Blood pressure Indoor smoke - solid fuels Illicit drugs (1.8%) 9 Tobacco (2.0%) Iron deficiency Unsafe sex 10 Cholesterol Unsafe water Iron deficiency 11 Alcohol Unsafe sex Lead exposure 12 Low fruit & veg intake Lead exposure Child sexual abuse

  9. World Deaths in 2000 attributable to selected leading risk factors Number of deaths (000s)

  10. World Disease burden (DALYs) in 2000 attributable to selected leading risk factors Number of Disability-Adjusted Life Years (000s)

  11. World Disease burden (DALYs) in 2000 attributable to Addictive Substances related Risks Number of Disability-Adjusted Life Years (000s)

  12. World Deaths in 2000 attributable to Addictive Substances related Risks Number of deaths (000s)

  13. World Deaths in 2000 attributable to Addictive Substances related Risks Number of deaths (000s)

  14. WHO Regions Deaths in 2000 attributable to selected leading risk factors Number of deaths (000s)

  15. WHO Regions Disease burden (DALYs) in 2000 attributable to selected leading risk factors Number of Disability-Adjusted Life Years (000s)

  16. Burden of disease attributable to addictive substances related risks: ALCOHOL (% DALYs in each subregion) Proportion of DALYs attributable to selected risk factor <0.5% 0.5-0.9% 1-1.9% 2-3.9% 4-7.9% 8-15.9%

  17. Burden of disease attributable to addictive substances related risks: TOBACCO (% DALYs in each subregion) Proportion of DALYs attributable to selected risk factor <0.5% 0.5-0.9% 1-1.9% 2-3.9% 4-7.9% 8-15.9%

  18. Burden of disease attributable to addictive substances related risks: ILLICIT DRUGS (% DALYs in each subregion) Proportion of DALYs attributable to selected risk factor <0.5% 0.5-0.9% 1-1.9% 2-3.9%

  19. Conclusions • The burden of licit and illicit drug problems is increasingly evident. • From a public health perspective tobacco and alcohol use carry much higher burdens that illicit drug use. • Alcohol and drug polices need to address the relative harms of these substances. • In the management of psychoactive substance problems (prevention and treatment) more attention should be paid to epidemiologic evidence and developments in neuroscience.

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