Global health. The current scenario and future perspectives

197 13. A comprehensive look at drug policy from a global perspective José Francisco Cumsille Garib Introduction For the purposes of this article, we will use the term “drugs” to refer to those substances (outside of pharmacological use) of natural or synthetic origin that have an effect on the central nervous system and can, therefore, alter and/or modify psychic and emotional activity and bodily functioning. These substances, whether legal or illegal in a particular country, can cause dependence. In accordance with this, emphasis will be placed on one of the most used legal substances like alcohol, as well as illegal drugs like marijuana (although it is currently legal in some countries), cocaine and other substances. Special mention will be given to what is happening in some countries with certain analgesic substances derived from poppies that are used pharmacologically but also diverted into an illegal market. Although this chapter is focused on analyzing the relationship between drugs and health, other consequences surrounding the drug phenomenon that directly impact people’s health must not be overlooked. The following sections present a conceptual framework for the drug phenomenon in the Americas, a description of indicators regarding drug consumption, challenges faced in the region and some final reflections aimed at fostering an informed debate on public policies related to these matters. Conceptual Framework The drug phenomenon has a long history in human civilization. It is not a new topic, however, its consequences have changed over time, mainly due to responses implemented. When we talk about the drug phenomenon globally and on our hemisphere, our first reflection is about identifying the drug problem and we ask ourselves “What is the drug problem?”. Does such a problem exist globally? This seems important for several reasons: first because we have focused policies towards substance control by dividing them into two groups - legal and illegal - thus developing differential responses accordingly. Second, and particularly concerning illegal substances, we have developed a set of common measures for countries under the assumption that they all share the same problem. However, evidence shows that the various activities associated with this phenomenon - production, trade and drug consumption - generate different types of