Global health. The current scenario and future perspectives

200 Regarding these previous figures, it is necessary to mention three aspects, which are described later in more detail. The first refers to great diversity in consumption magnitude among regions and subregions. The second is related to the use of cannabis, which accounts for half or more than half of mentioned figures. And third, perhaps the most relevant, is the situation regarding opioid use which currently generates a major health problem in several countries while also spreading to several others. To better describe these two situations, Table 1 provides estimates for past-year prevalence rates (%) for three substances in 2020: cannabis (including marijuana and resin), cocaine (including cocaine hydrochloride, crack cocaine, base paste and other designations) and opioids (including opiates and pharmaceutical opioids). Table 1. Estimation of past-year prevalence (%) for cannabis, opioids and cocaine use, population aged 15 to 64, globally and by region, 2020. Region Cannabis Opioids Cocaine Africa 6.54 1.23 0.27 Americas 9.81 1.76 1.69 Asia 1.97 1.16 0.07 Europe 5.41 0.67 0.96 Oceania 12.00 2.44 2.7 Global 4.12 1.21 0.42 Source: Own elaboration based on data available at https://dataunodc.un.org . Considering the prevalence of any substance in the last year as a reference for 2020, which is 5.6%, the first conclusion is that cannabis use (past-year prevalence of 4.1%) represents a very relevant proportion of drug use. The second fact is the great variability by region. Indeed, the estimate of past-year cannabis prevalence varies from 1.97% in Asia to 12% in Oceania. The same counts for opioid use (0.67% in Europe to 2.44% in Oceania) and cocaine use (from 0.07% in Asia to 2.7% in Oceania). For the three substances described the estimate for the American region far exceeds the global average. Is our region homogeneous? Let us first analyze the variability between subregions within the region of the Americas. According to the UNODC report, the estimate for the past- year prevalence of 9.81% for cannabis use ranges from 3% in Central America to 16.6% in North America. Something similar happens with other substances. To review drug consumption variability at a country level within our region, we will examine the Report on Drug Use in the Americas published by the Inter-American Drug Observatory (OID), Inter-American