UNODC. Global SMART Update 2019, Vol. 21 (The non-medical Use of Opioids)

The Global SMART Update is designed to provide regular brief reports on emerging patterns and trends of the global synthetic drug situation. 

The current issue provides insight into the non-medical use of opioids, which presents a significant concern for public health, safety and law enforcement authorities worldwide. In the past years, the non-medical use of potent opioids such as fentanyl and its analogues have been reported mainly from North America, as well as from Asia, Europe and Oceania. Often sold as heroin or prescription medicines, these substances have contributed to the unprecedented number of recent opioid overdose deaths. The non-medical use of tramadol, an opioid analgesic, continues to increase in parts of Africa and the Middle East with reported adverse health effects. The rapidly emerging crisis which has resulted in significant harm to human health and welfare, including fatalities, calls for a coordinated, comprehensive and multidisciplinary response. (UNODC, März 2019)

https://www.unodc.org/documents/scientific/Global_SMART_21_web.pdf