Extent of illicit drug use and dependence, and their contribution to the global burden of disease

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• Illicit drugs are drugs for which non-medical use has been prohibited by international drug control treaties for half a century because they are believed to present unacceptable risks of addiction to users.1, 2 International control has since been extended from plant-based drugs—heroin, cocaine, and cannabis—to synthetic drugs, such as amphetamines and methylenedioxymetamfetamine (MDMA), and pharmaceutical drugs such as buprenorphine, methadone, and benzodiazepines (panel 1).

• A classification of harmful drug use needs evidence that substance use is causing physical (eg, organ damage) or psychological harm (eg, drug-induced psychosis).

• a strong desire to take the substance; an impaired control over use; a withdrawal syndrome on cessation or reduction of use; tolerance to the effects of the drug; the need for larger doses to achieve the desired psychological effect; a disproportionate amount of time spent by the user obtaining, using, and recovering from drug use; and continuing to take the drug despite the problems that occur.

• The viruses that cause hepatitis B and hepatitis C infections