GPH 81: Public Health Aspects of Illicit Psychoactive Drug Use

Illicit psychoactive drug use is a significant contributor to global morbidity and mortality. Although its overall burden is smaller than that attributable to tobacco or alcohol, illicit drug use generates substantial health, social, and economic consequences - including overdose deaths, infectious disease transmission, mental health disorders, and social disruption.This episode explores:• Global prevalence patterns of cannabis, opioids, cocaine, and amphetamine-type stimulants• Drug-related mortality and disability-adjusted life years (DALYs)• Geographic variation in production, trafficking, and consumption• Injection drug use and the transmission of HIV and hepatitis• Overdose epidemiology and the opioid crisis• The neurobiology of dependence and relapse• Harm reduction strategies (needle exchange, opioid substitution therapy)• Prevention, treatment, and policy responses• The intersection of drug use, incarceration, and social inequityIllicit drug use is shaped not only by individual vulnerability but by structural forces - production economies, trafficking routes, criminal justice systems, and social marginalization. Public health responses increasingly recognize that punitive approaches alone are insufficient.The episode highlights the importance of evidence-based harm reduction, treatment accessibility, and integrated policy approaches that address both individual behaviour and structural determinants.────────────────────────────Key Takeaways• Illicit drug use contributes significantly to global morbidity and mortality• Cannabis is the most widely used illicit drug globally• Opioid use is strongly associated with overdose and infectious disease transmission• Harm reduction strategies reduce HIV, hepatitis, and overdose risk• Substance use disorders are chronic, relapsing conditions• Criminal justice responses have population health consequences• Public health frameworks prioritize prevention, treatment, and structural reform This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe