COMMENTS ON THE REPORTED STATISTICS ON NARCOTIC DRUGS

COMMENTS ON THE REPORTED STATISTICS ON NARCOTIC DRUGS Summry The further overll reduction in globl stocks nd in the production of opium confirm the continuing trend towrds the eventul elimintion of the drug from the interntionl mrket for opite rw mteril. Poppy strw nd concentrte of poppy strw derived from the two min vrieties of poppy strw (the morphine-rich nd thebine-rich vrieties) decresed slightly in 216 compred with 215, nd the mnufcture of morphine remined stble t 422.1 tons, of which round 87 per cent of globl mnufcture ws converted into other nrcotic drugs or into substnces not covered by the 1961 Convention. Of the remining 13 per cent, only 8.6 per cent ws directly consumed for pllitive purposes. English Comments Prt two Deuxième prtie Segund prte The differences in consumption levels between countries continued to be very significnt. In 216, 8 per cent of the world popultion consumed only 14 per cent of the totl mount of morphine used for the mngement of pin nd suffering. Although tht represented n improvement on 214, when 8 per cent of the world popultion consumed 9.5 per cent, the disprity in consumption of nrcotic drugs for pllitive cre continues to be mtter of concern. After some fluctutions in the preceding yers, globl mnufcture of thebine reched the record level of 156 tons in 216, signlling tht the demnd for medicines derived from thebine, fter hving decresed in the pst severl yers, ppers to hve resumed, despite restrictions on prescription drugs recently imposed in the min mrket (the United Sttes of Americ) in response to their buse nd the high number of overdose deths they hve cused. This ws reflected in the fct tht the globl mnufcture of oxycodone nd hydrocodone incresed in 216, while the other semi-synthetic opioids (with the exception of heroin) ll decresed. In the cse of synthetic opioids, globl mnufcture of fentnyl continued to fluctute, decresing to 2.3 tons in 216. The mnufcture of fentnyl nlogues, remifentnil nd sufentnil, lso decresed, while the mnufcture of lfentnil incresed. The mnufcture of dextropropoxyphene nd ketobemidone cesed in 216, nd diphenoxylte continued to be mnufctured in much smller quntities thn in the pst. The mnufcture of pethidine remined t low level, while the mnufcture of tilidine nd trimeperidine continued to fluctute. The mnufcture of methdone continued to increse, s more nd more countries used it in the tretment of opioid dependence. The licit use of cnnbis hs been incresing considerbly since 2. Before 2, licit use ws restricted to scientific reserch nd ws reported only by the United Sttes. Since 2, more nd more countries hve strted to use cnnbis nd cnnbis extrcts for medicl purposes, s well s for scientific reserch. In 2, totl licit production ws 1.4 tons; by 216 it hd incresed to 211.3 tons. Peru hs been the only country to export coc lef for the globl mrket since 2. At the time of prepring this report, Peru hd not provided production dt for 216, but hd reported n export volume of 136 tons, in line with previous yers. 21

22 The other mjor licit producer of coc lef, the Plurintionl Stte of Bolivi, provided informtion to the Bord on the estimted cultivtion (14,75 h) nd preliminry production dt (23,217 tons) for 216. The cultivtion of coc bush in tht country for the chewing of coc lef nd the consumption nd use of coc lef in its nturl stte for culturl nd medicinl purposes, such s prepring infusions, is llowed in ccordnce with the reservtion expressed in 213, when the country recceded to the 1961 Convention, s mended by the 1972 Protocol.

1. The present comments re intended to fcilitte the use of the sttisticl informtion on the licit production, mnufcture, consumption, 1 utiliztion 2 nd stocks of, s well s trde in, opite rw mterils, the min opioids, including synthetic nrcotic drugs under interntionl control, nd cnnbis, coc lef nd cocine tht is presented in the tbles of reported sttistics (see pges 135-256 nd nnexes III nd IV, pges 313-448). Unless otherwise indicted, the comments refer to developments during the period 1997 216. 1 For the purposes of the Single Convention on Nrcotic Drugs of 1961, drug is regrded s consumed when it hs been supplied to ny person or enterprise for retil distribution, medicl use or scientific reserch; nd consumption is construed ccordingly (rt. 1, pr. 2). 2 The prties shll furnish the Interntionl Nrcotics Control Bord (INCB) with sttisticl returns on the utiliztion of nrcotic drugs for the mnufcture of other drugs, of preprtions in Schedule III of the 1961 Convention nd of substnces not covered by the Convention nd on the utiliztion of poppy strw for the mnufcture of drugs. 3. Opium nd poppy strw re the rw mterils obtined from the opium poppy plnt (Ppver somniferum), from which lkloids such s morphine, thebine, codeine nd oripvine re extrcted. Concentrte of poppy strw is product obtined in the process of extrcting lkloids from poppy strw. It is controlled under the 1961 Convention. Detiled informtion on the supply of opite rw mteril nd demnd for opites for medicl nd scientific purposes is provided in prt three of the present publiction. Opite rw mterils 2. The tbles of reported sttistics in prt four nd nnexes IV nd V of the present report contin dt furnished by Governments to the Interntionl Nrcotics Control Bord (INCB) in ccordnce with rticle 2 of the Single Convention on Nrcotic Drugs of 1961 s mended by the 1972 Protocol. The most recent sttisticl dt reflected in the comments re those relting to 216. The filure by some Governments to submit reports or to provide precise nd complete reports my hve bering on the ccurcy of some of the informtion presented below. 3 The most pertinent conclusions nd recommendtions of INCB bsed on the nlysis of sttisticl returns re included in chpter II of its nnul report. 4 3 Detils on the submission of sttisticl reports by individul Governments re contined in nnex I to the present publiction. 4 E/INCB/217/1. production continued to decrese, reching 42.2 tons (4.6 tons in morphine equivlent) in 216. Though imports incresed mrginlly, from 67.7 tons (7.4 tons in morphine equivlent) in 215 to 69.2 tons (7.6 tons in morphine equivlent) in 216, the level ws much lower thn tht of 214 (283.1 tons, or 31.1 tons in morphine equivlent). At the sme time, stocks of opium lso continued to be depleted, decresing from 79.5 tons in 215 to 411 tons (or 45.2 tons in morphine equivlent) in 216 (see figure 1). English Comments Prt two Deuxième prtie Segund prte Opium 4. Opium (lso clled rw opium ) is the ltex obtined by mking incisions on the green cpsules of opium poppy plnts. For sttisticl nd comprison purposes, dt on the production of nd trde in opium re reported t 1 per cent moisture content. When pproprite, the dt on opium re lso expressed in morphine equivlent, 5 in order to enble comprison between opium nd poppy strw. Figure 1 shows the licit production, stocks nd use (consumption nd utiliztion) of opium during the period 1997 216, expressed in morphine equivlent. Not included in the dt on stocks nd use re the mounts of illicitly produced opium tht were seized nd relesed for licit purposes. 5. Opium production ws over 1, tons in 2, but since then production hs followed downwrd trend. There ws n increse in 211, with 789.1 tons in gross weight (86.8 tons in morphine equivlent) but subsequently 5 The morphine or thebine equivlent is clculted by INCB on the bsis of the industril yield of ech lkloid obtined from opium or poppy strw. Lesser lkloids contined in opium or poppy strw tht re convertible into morphine or thebine hve lso been included, djusted by pproprite conversion rtes, whenever the Bord hs been informed of their extrction in commercilly significnt quntities. 25 2 15 1 5 Figure 1. Opium: globl production, stocks nd use (consumption nd utiliztion), b in tons of morphine equivlent, 1997-216 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Utiliztion Stocks Production Stocks s t 31 December of ech yer. b Excluding the utiliztion of seized opium in Irn (Islmic Republic of) nd Mynmr. 23

6. Indi ws the min producer nd only licit exporter of rw opium in 216, ccounting for 23.3 tons (2.5 tons in morphine equivlent) or 55.2 per cent of totl globl production, followed by Chin, with 18.9 tons (2 tons in morphine equivlent), where poppy strw hs replced opium s the min rw mteril used in the mnufcture of lkloids since 2. Together with Chin, other countries produced smller mounts of opium in 216, but exclusively for domestic consumption nd utiliztion. Jpn produced 1.2 kg for reserch purposes. Indi ccounted for 94.5 per cent of exports in 216. 7. Opium exported by Indi contins morphine in concentrtion of 9.5 to 12. per cent, codeine in concentrtion of bout 2.5 per cent nd thebine in concentrtion of 1. to 1.5 per cent. Opium imports from Indi fluctuted in the period 27 216, decresing significntly between 213 nd 215 nd reching 69.2 tons in 216 (see figure 2). The min countries importing opium were Jpn (6 tons, or 86.7 per cent) followed by Frnce (6.5 per cent), Switzerlnd (2.3 per cent), Thilnd (1.8 per cent) nd Spin (1.1 per cent). The United Sttes, which hd been the mjor importer in the pst, reported imports of mrginl quntities of opium from Indi in 215 nd 216, mounting to 1 kg nd 56 kg, respectively. 8. As in previous yers, the bulk of opium ws used for the extrction of lkloids, with only smll mount (23.1 tons, or 2.5 tons in morphine equivlent) being used for Schedule III preprtions. Totl utiliztion of licitly produced opium for the extrction of lkloids followed declining trend during the period under considertion. Utiliztion declined further, from 271.7 tons (29.8 tons in morphine equivlent) in 215 to 145.3 tons (15.9 tons in morphine equivlent) in 216 (excluding the utiliztion of seized opium in the Democrtic People s Republic of Kore nd the Islmic Republic of Irn 6 ). In 216, the min users of opium for the extrction of lkloids were Indi (91.2 tons) nd Jpn (54.1 tons), together ccounting for lmost 1 per cent of the globl totl (see figure 3). In ddition, the Islmic Republic of Irn reported the mnufcture of more thn 464.8 tons (51.1 tons in morphine equivlent), but tht quntity is not included in the globl totl becuse it originted from seizures. The Democrtic People s Republic of Kore continued to report limited cultivtion of opium poppy chrcterized by very low yield, which the competent ntionl uthority ttributed to unfvourble climte conditions nd lck of fertile soil. Detils on the utiliztion of opium for the extrction of lkloids nd the lkloids obtined re provided in tble III. 6 5 4 3 2 1 Figure 3. Opium: utiliztion for the extrction of lkloids, in tons of morphine equivlent, 1997-216 11 1 9 8 7 6 5 4 3 2 1 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 United Sttes Jpn Indi World totl Excluding the utiliztion of seized opium in Irn (Islmic Republic of) nd Mynmr. Figure 2. Opium: imports from Indi, in tons of morphine equivlent, 27-216 27 28 29 21 211 212 213 214 215 216 United Sttes Jpn Irn (Islmic Rep. of) Other countries Note: Amounts imported by the United Sttes decresed significntly, to 1 kg, in 215 nd decresed further, to 56 kg, in 216. 6 In the Islmic Republic of Irn, in ddition to licitly produced opium imported from Indi (in the yers 24, 26, 27, 211 nd 212 only), seized opium is relesed regulrly in lrge quntities for the extrction of lkloids. The yield of lkloids extrcted from seized opium is usully less thn tht from licitly produced opium. 9. While the mjority of opium is used for the extrction of lkloids, opium is lso consumed in some countries in the form of preprtions, minly for the tretment of dirrhoe nd coughs. Most of those preprtions re 24

included in Schedule III of the 1961 Convention. 7 Globl consumption of opium for those purposes hs fluctuted since 21. In 216, totl consumption incresed to 24.8 tons. The consumption nd utiliztion of opium for the mnufcture of preprtions in Schedule III mounted to totl of 23.1 tons, including 9.5 tons (1 ton in morphine equi vlent) in Chin, 7.3 tons (.8 tons in morphine equivlent) in Frnce nd 5.4 tons (.5 tons in morphine equivlent) in Indi. Thilnd nd Spin reported lower levels of utiliztion (72 kg nd 2 kg, respectively). 1. Globl stocks of opium reched pek in 24 (2,176.2 tons, or 239.3 tons in morphine equivlent) nd then begn to decrese therefter (see figure 1), reching 49.8 tons (53.9 tons in morphine equivlent) in 216. Indi continued to mintin the lrgest stocks of opium (28.2 tons, or 3.8 tons in morphine equivlent, representing 68.1 per cent of the globl totl), followed by Jpn (92 tons, or 1.1 tons in morphine equivlent) nd Chin (22.7 tons, or 2.4 tons in morphine equivlent). 8 The United Sttes lmost totlly eliminted its stock, from 137.2 tons in 212 to 1.2 tons in 216 (from 15 to.1 tons in morphine equivlent). The further overll reductions in globl stocks nd the production of opium confirm the continuing trend towrds the eventul elimintion of the drug. Poppy strw 11. Poppy strw consists of ll prts of the opium poppy plnt fter mowing, except the seeds. Morphine is the predominnt lkloid found in the vrieties of opium poppy plnt cultivted in most producing countries. Commercil cultivtion of the opium poppy plnt with high thebine content strted in the second hlf of the 199s. In the present publiction, poppy strw produced from vrieties of opium poppy plnt rich in morphine is referred to s poppy strw (M), poppy strw produced from vrieties of opium poppy plnt rich in thebine is referred to s poppy strw (T), poppy strw produced from vrieties of opium poppy plnt rich in codeine is referred to s poppy strw (C) nd poppy strw produced from vrieties of opium poppy plnt rich in noscpine is referred to s poppy strw (N). Some of those vrieties contin, in ddition to the min lkloid (morphine, thebine, codeine or noscpine), other lkloids tht cn be extrcted. 7 Preprtions included in Schedule III of the 1961 Convention re exempt from severl control mesures tht re otherwise mndtory for preprtions contining nrcotic drugs, including reporting on their consumption nd interntionl trde. 8 For production of, stocks of nd demnd for opium, see lso prt three of the present publiction, entitled Supply of opite rw mterils nd demnd for opites for medicl nd scientific purposes. 12. The concentrtion of lkloids in poppy strw vries significntly mong the producing countries. Production levels of poppy strw mong those countries cn be compred only by use of common denomintor, which is the morphine or thebine equivlent of the quntity of poppy strw produced in ech country. Commercil cultivtion of the opium poppy plnt with high codeine content strted in Austrli in 21 nd in Frnce in 213. For sttisticl purposes, the quntities of poppy strw produced from tht vriety of opium poppy re recorded under poppy strw (M). Poppy strw produced minly 9 from opium poppy rich in morphine (poppy strw (M)) 13. Although the submission of sttistics on the production of poppy strw is voluntry, most countries cultivting opium poppy plnts for the extrction of lkloids provided such informtion in 216. Globl production of poppy strw (M) expressed in morphine equivlent followed n incresing trend in the two decdes prior to 216. Over the yers, production fluctuted shrply, minly becuse of wether conditions nd in response to the demnd in mnufcturing countries. It reched bout 43 tons in morphine equivlent in 23, decresed to bout 218 tons in 28, but then incresed gin significntly, reching 586 tons in 215, decresing gin, to 463 tons, in 216 (see figure 4). Throughout the two decdes prior to 216, Austrli, Frnce, Spin nd Turkey were the min producer countries. In 216, the leding producer ws Austrli (18 tons in morphine equivlent, ccounting for 38.9 per cent of globl production), followed by Frnce (91 tons in morphine equivlent, or 19.7 per cent), Turkey (63 tons, or 13.6 per cent), Spin (56 tons, or 12.1 per cent) nd Hungry (9 tons, or 1.9 per cent). Other min producers of poppy strw (M) in 216 together ccounted for the remining 13.2 per cent of globl production. In the cse of Austrli nd Frnce, for ccounting purposes, quntities of poppy strw (C) were included in the clcultion of the quntities in morphine equivlent. Such quntities hve become more significnt in recent yers. 14. In 216, the production of opite rw mteril (clculted in morphine equivlent) mostly from poppy strw (M) incresed from 215 levels in Austrli (from 152 to 18 tons) nd in Spin (from 33 to 56 tons), but decresed in Frnce (from 168 to 91 tons) nd Turkey (from 98 to 63 tons) (see figure 4). Chnges in the re cultivted with opium poppy plnt, the mounts of poppy strw (M) hrvested nd the yields obtined in producing countries re shown in tble II. 9 The quntities in morphine equivlent of the morphine nd codeine lkloids contined in other vrieties of poppy strw such s poppy strw (T) nd poppy strw (C) re lso included in the totl production figures in this section, where pplicble. English Comments Prt two Deuxième prtie Segund prte 25

Figure 4. Totl nhydrous morphine lkloid contined in ll poppy strw vrieties: production in min producing countries, in tons of morphine equivlent, 27-216 6 5 4 3 2 1 Figure 5. Totl nhydrous thebine lkloid contined in ll poppy strw vrieties: production in min producing countries, in tons of thebine equivlent, 27-216 4 36 32 28 24 2 16 12 8 4 27 28 29 21 211 212 213 214 215 216 Austrli Frnce Spin 27 28 29 21 211 212 213 214 215 216 Austrli Spin Turkey Hungry Other countries Frnce Other countries 15. Interntionl trde in poppy strw (M) s rw mteril continues to be limited. In 216, Czechi ws the min exporter of poppy strw (M) for the extrction of lkloids, followed by Austrli, Slovki nd Hungry (see nnex IV, tble 1). Czechi, which cultivtes opium poppy plnts primrily for the production of seeds for culinry purposes, produces poppy strw s by-product nd exports it to Slovki, where it is used for the extrction of lkloids. Such poppy strw hs significntly lower morphine content thn poppy strw obtined from opium poppy plnts cultivted for the production of lkloids. In 216, Slovki imported totl of 2,67.7 tons (expressed in gross weight) of poppy strw (M). 16. In 216, the min countries utilizing poppy strw (M) were Turkey (16,55 tons in gross weight), Austrli (6,596.8 tons) nd Frnce (4,5 tons). The United Kingdom of Gret Britin nd Northern Irelnd, Portugl, Slovki, Hungry nd Chin utilized less thn 1, tons. Further detils on the utiliztion of poppy strw (M) for the extrction of lkloids nd the yields obtined re contined in tble IV. Poppy strw produced minly 1 from opium poppy rich in thebine (poppy strw (T)) 17. Austrli nd Frnce strted to report the production of poppy strw (T) to INCB in 1999. Spin reported the 1 The quntities in thebine equivlent of the thebine nd oripvine lkloids contined in other vrieties of poppy strw such s poppy strw (M) nd poppy strw (C) re lso included in the totl production figures in this section, where pplicble. production of poppy strw (T) for the first time in 24. Chin nd Hungry hve reported spordic production in recent yers. More detils on the production of poppy strw (T) cn be found in tble II. 18. Production of poppy strw (T) in the min producing countries during the period 27 216, expressed in thebine equivlent, is shown in figure 5. Totl production decresed from 216 tons in 215 in thebine equivlent to 187 tons in 216. In 216, Austrli remined the leding producer, with 147 tons in thebine equivlent, decrese from 172 tons in 215. It ws followed by Spin, which reported 34 tons in 216, pproximtely the sme level s 215. Frnce reported only 5 tons, pproximtely the sme level s 215 (6 tons). 19. All poppy strw (T) is used in the producing nd mnufcturing countries for the extrction of lkloids. The quntities used, the lkloids obtined from poppy strw (T) nd the yields re shown in tble V. Poppy strw produced from opium poppy rich in codeine (poppy strw (C)) 2. Austrli reported the cultivtion of poppy strw (C) for commercil purposes for the first time in 29 nd Frnce in 213. This new vriety ws cultivted specificlly to meet the high globl demnd for codeine. Its production hs been incresing stedily, from 415 tons (expressed in gross weight) in 21 to 6,76 tons in 215, nd dropped 26

considerbly in 216 to 1,313 tons. Austrli produced 59.6 per cent of poppy strw (C) nd Frnce the remining 4 per cent. Similr proportions were reported for utiliztions nd stocks for both countries. Poppy strw produced from opium poppy rich in noscpine (poppy strw (N)) 21. In recent yers, n increse in the cultivtion of opium poppy rich in noscpine (poppy strw (N)) in some producing countries ws reported. In 216, Hungry ws the min country to report its cultivtion, with totl production of 655 tons (expressed in gross weight). Frnce, the only other country tht cultivted this vriety of poppy strw, produced 23 tons. Poppy strw used for decortive purposes 22. In some countries, the poppy plnt is cultivted for culinry nd decortive purposes, minly Austri, Czechi, Germny, the Netherlnds, Polnd nd Ukrine. Concentrte of poppy strw 23. Most countries using poppy strw for the extrction of lkloids first mnufcture n intermedite product clled concentrte of poppy strw, lthough in some countries morphine or thebine is mnufctured directly from poppy strw in continuous process, which my involve number of other intermedite products (for detils, see tbles IV nd V). Until the second hlf of the 199s, only concentrte of poppy strw contining morphine s the min lkloid ws mnufctured. Since then, concentrte of poppy strw contining minly thebine, oripvine or codeine hs strted to be mnufctured. Concentrte of poppy strw my contin mixture of lkloids, nd more lkloids thn just the principl lkloid my be extrcted in industril processes. The different types of concentrte of poppy strw re referred to by the min lkloid contined in them. 11 24. Since the ctul content of lkloids in concentrte of poppy strw my vry significntly, for purposes of comprison nd for sttisticl purposes, ll dt referring to concentrte of poppy strw re expressed in terms of the quntity of the relevnt nhydrous lkloid contined in the mteril. The quntities of nhydrous morphine lkloid contined in concentrte of poppy strw re referred to s AMA (CPS), those of nhydrous thebine lkloid s ATA (CPS), those of nhydrous oripvine lkloid s AOA (CPS) nd those of nhydrous codeine lkloid s ACA (CPS). The totls of ll the individul lkloids contined in concentrte of poppy strw re exmined below, expressed in terms of 1 per cent of nhydrous lkloid content. 12 Anhydrous morphine lkloid contined in concentrte of poppy strw (AMA (CPS)) 25. AMA (CPS) continues to be the most importnt nd most widely used of the lkloids contined in concentrte of poppy strw. Figure 6 shows the trends in its mnufcture, stocks nd utiliztion during the period 1997 216. 26. Globl mnufcture of AMA (CPS) hs continuously incresed since the 199s, lbeit with some fluctutions between 23 nd 28, reching its highest level ever in 214 (466.3 tons). Its mnufcture decresed in 216 to 357.1 tons. Trends in the mnufcture of AMA (CPS) in the min mnufcturing countries in the period 1997 216 re presented in figure 7. Figure 6. Totl nhydrous morphine lkloid contined in ll vrieties of concentrte of poppy strw: globl mnufcture, stocks nd utiliztion, 1997-216 5 45 4 35 3 25 2 15 1 5 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Utiliztion Stocks Mnufcture Stocks s t 31 December of ech yer. English Comments Prt two Deuxième prtie Segund prte 11 Currently, the following types re trded: () concentrte of poppy strw contining morphine s the min lkloid; (b) concentrte of poppy strw contining thebine s the min lkloid; (c) concentrte of poppy strw contining oripvine s the min lkloid; nd (d) concentrte of poppy strw contining codeine s the min lkloid. 12 The comments on concentrte of poppy strw in the present publiction re not directly comprble with comments on concentrte of poppy strw contined in editions of the present publiction prior to 25, since t tht time, concentrte of poppy strw ws expressed in terms of 5 per cent of the min lkloid contined therein. 27

Figure 7. Totl nhydrous morphine lkloid contined in ll vrieties of concentrte of poppy strw: mnufcture in the min mnufcturing countries, 1997-216 18 16 14 12 1 8 Figure 8. Totl nhydrous morphine lkloid contined in ll vrieties of concentrte of poppy strw: utiliztion for the mnufcture of opites, 1997-216 45 4 35 3 25 2 6 15 4 1 2 5 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Austrli Turkey Frnce Spin Chin United Kingdom 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 United Kingdom Frnce United Sttes Austrli Norwy Chin Other countries World totl 27. Over the previous decde, Austrli nd Turkey were the leding mnufcturers of AMA (CPS). In 216, Turkey reported the lrgest quntity mnufctured (87 tons, or 24.3 per cent of globl mnufcture), followed by Spin nd Frnce (both t 7.9 tons, or 19.8 per cent) nd Austrli (57.8 tons, or 16.2 per cent). Other countries reporting mnufcture of AMA (CPS) for 216 were the United Kingdom (32.6 tons), Belgium (27.2 tons) nd Chin (1.4 tons). 28. After reching record high of 196.6 tons in 215, globl exports of AMA (CPS) incresed further to rech 214.1 in 216. Turkey exported the lrgest quntity of AMA (CPS) in 216 (66.8 tons, or 4.2 per cent), followed by Spin (49.9 tons, or 3 per cent), Austrli the top exporter in previous yers (31.6 tons or 19 per cent), Belgium (17.4 tons, or 1.6 per cent) nd Norwy (12.3 tons, or 7.5 per cent). The United Sttes nd the United Kingdom hve been the leding importers of AMA (CPS), nd together they ccounted for 74.9 per cent of the world totl in 216. Other importing countries were, in descending order, Austrli, Norwy, Jpn, Switzerlnd, the former Yugoslv Republic of Mcedoni, Itly nd Belgium. Further detils on interntionl trde in AMA (CPS) cn be found in nnex IV, tbles 1 nd 2. 29. AMA (CPS) is n intermedite product for the mnufcture of morphine. It is lso used in continuous mnufcturing processes for the mnufcture of codeine. Utiliztion of AMA (CPS) continued n incresing trend Figure 9. Totl nhydrous morphine lkloid contined in ll vrieties of concentrte of poppy strw: stocks, 27-216 22 2 18 16 14 12 1 8 6 4 2 27 28 29 21 211 212 213 214 215 216 Turkey Austrli United Sttes United Kingdom Chin Frnce Spin Belgium Other countries Stocks s t 31 December of ech yer. until 214, but decresed in 215 nd 216 (see figure 8). In 216, totl world utiliztion mounted to 343.4 tons, notble decrese from 428.7 tons in 214. Frnce, t 79.9 tons, ccounted for 23.2 per cent of the globl 28

utiliztion of AMA (CPS), followed by the United Kingdom (74.6 tons, or 21.7 per cent), the United Sttes (68.3 tons, or 19.8 per cent) nd Austrli (4.3 tons, or 11.7 per cent). 3. Globl stocks of AMA (CPS) continued to increse in 216, to 214.1 tons (see figure 9). Austrli, Turkey nd the United Kingdom ech held stocks ccounting for round 16 per cent in 216, followed by Chin (15.6 per cent), the United Sttes (12.3 per cent), Spin (9.28 per cent), Belgium (6.1 per cent), Jpn (2.2 per cent), South Afric (1.9 per cent) nd Norwy (1.2 per cent). Anhydrous thebine lkloid contined in concentrte of poppy strw (ATA (CPS)) 31. Figure 1 provides n overview of the mnufcture, stocks nd utiliztion of ATA (CPS) during the period 27 216. Industril mnufcture of ATA (CPS), which strted in 1998, incresed rpidly before levelling off in 212 nd decresing considerbly to 153.1 tons in 216, from 232.1 tons in 214. The only countries mnufcturing ATA (CPS) in 216 were Austrli, which ccounted for 84.9 per cent of the globl totl, Spin (1.5 per cent) nd Frnce (4.4 per cent). Austrli ws lso the min exporter, ccounting for 11.1 tons, or 87.9 per cent, of globl exports in 216. The United Sttes hs been the leding importer of ATA (CPS) for mny yers; in 216, it ccounted for 99.2 per cent of totl imports. Figure 1. Totl nhydrous thebine lkloid contined in ll vrieties of concentrte of poppy strw: utiliztion, globl mnufcture nd stocks, 27-216 32. ATA (CPS) is n intermedite product for the mnufcture of thebine. Globl utiliztion of ATA (CPS) incresed shrply from 21 to 211, when it peked t 225.9 tons. After tht, it decresed stedily, to 154.9 tons in 215, then incresed gin in 216 to 25.2 tons. This trend reflects the temporry reduction in the demnd for thebine nd of nrcotic drugs obtined from it, such s oxycodone nd hydrocodone (see prs. 53 to 56 below). In 216, the United Sttes continued to be the min user of thebine (ccounting for 73.6 per cent of globl utiliztion); it ws followed by Austrli (2.5 per cent) nd Frnce (4.1 per cent). Globl stocks of ATA (CPS) stood t 113.4 tons in 216. The United Sttes (58.4 tons) nd Austrli (48.4 tons) together ccounted for over 94.3 per cent of globl stocks. Anhydrous oripvine lkloid contined in concentrte of poppy strw (AOA (CPS)) 33. Mnufcture of AOA (CPS) in commercilly usble quntities strted in 1999. Austrli ws the only mnufcturing country in 216, with totl of 31.4 tons. Totl utiliztion of AOA (CPS) in 216 ws low (1.3 tons), representing smll frction of the 21.8 tons in 215. AOA (CPS) ws mnufctured exclusively in Austrli (99.9 per cent). In 216, 1.3 tons were used for the mnufcture of other drugs, mostly by Switzerlnd nd Austrli. Globl stocks of AOA (CPS) hd been fluctuting since 21. In 216, they incresed slightly to 66.8 tons, held exclusively by Austrli (75 per cent) nd the United Sttes (24 per cent). English Comments Prt two Deuxième prtie Segund prte 25 2 15 1 5 27 28 29 21 211 212 213 214 215 216 Utiliztion (United Sttes) Utiliztion (Austrli) Utiliztion (Frnce) Utiliztion (other countries) Globl stocks Globl mnufcture Stocks s t 31 December of ech yer. Anhydrous codeine lkloid contined in concentrte of poppy strw (ACA (CPS)) 34. Mnufcture of ACA (CPS) incresed from 21 until 215, when it reched record 13.7 tons, which ws nerly double the 57.6 tons mnufctured in 214, but then decresed to 56.1 tons in 216. ACA (CPS) is used for the extrction of codeine. The only countries tht mnufctured ACA (CPS) in 216 were Frnce (49.3 per cent of the globl totl), Austrli (3.9 per cent), Spin (1.4 per cent) nd Turkey (9.2 per cent). Globl utiliztion of ACA (CPS) incresed from 31.5 tons in 214 to 79.1 tons in 215, then decresed to 4.7 tons in 216. Frnce ws the min country to utilize ACA (CPS) (52.4 per cent), followed by the United Sttes (35.7 per cent) nd the United Kingdom (9.6 per cent). Globl stocks of ACA (CPS) stood t 19.4 tons in 216, most of which ws held in the United Sttes (14.5 tons), Austrli (2.1 tons), Turkey (1.8 tons), Spin (.6 tons) nd Frnce (.1 tons). 29

Opites nd opioids 35. Opite is the term generlly used to designte drugs derived from opium nd their chemiclly relted derivtives, such s the semi-synthetic lkloids, while opioid is more generl term for both nturl nd synthetic drugs with morphine-like properties, lthough the chemicl structure my differ from tht of morphine. 13 36. Opioids re used mostly for their nlgesic properties to tret severe pin (fentnyl, hydromorphone, methdone, morphine nd pethidine), moderte to severe pin (buprenorphine 14 nd oxycodone) nd mild to moderte pin (codeine, dihydrocodeine nd dextropropoxyphene), s well s to induce or supplement nesthesi (fentnyl nd fentnyl nlogues such s lfentnil nd remifentnil). They re lso used s cough suppressnts (codeine, dihydrocodeine nd, to lesser extent, pholcodine nd ethylmorphine), to tret gstrointestinl disorders, minly dirrhoe (codeine nd diphenoxylte) nd to tret opioid dependence (buprenorphine nd methdone). Nturl lkloids 37. Morphine, codeine, thebine, noscpine, oripvine, ppverine nd nrceine re lkloids contined in opium or poppy strw. Morphine nd codeine re under interntionl control becuse of their potentil for buse, while thebine nd oripvine re under such control becuse of their convertibility into opioids subject to buse. Noscpine, ppverine nd nrceine re not under interntionl control. Morphine is the prototype of nturl opites nd mny opioids nd, becuse of its strong nlgesic potency, it is used s reference prmeter for comprtive purposes. Morphine 38. In the 2-yer period 1997 216, the mnufcture 15 of morphine incresed considerbly from 273.9 tons in 1997. 13 From clinicl point of view, opioids my be clssified ccording to their ctions compred with those of morphine: similr ffinity (gonist), competitive (ntgonist) or mixed (gonist/ntgonist) for the sme receptor sites (the so-clled opioid receptors) in the centrl nd peripherl nervous system. 14 Buprenorphine is controlled under the Convention on Psychotropic Substnces of 1971. Comments on its licit movement re contined in pr. 96 below. 15 In Austrli, Brzil, Chin, Irn (Islmic Republic of), Itly, Norwy, Portugl, Turkey nd the United Kingdom, concentrte of poppy strw is used in continuous industril processes for the mnufcture of other nrcotic drugs, without first seprting morphine. For sttisticl nd comprtive purposes, the theoreticl quntity of morphine involved in such conversions is clculted by INCB nd included in the present publiction in the sttistics on globl mnufcture nd utiliztion of morphine. 5 45 4 35 3 25 2 15 1 5 Figure 11. Morphine: globl mnufcture, stocks, consumption nd utiliztion, 1997-216 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Consumption Utiliztion Stocks Stocks s t 31 December of ech yer. Mnufcture After stbilizing t round 45 tons between 211 nd 214, it decresed to 419.2 tons in 215 nd remined t roughly the sme level (422.1 tons) in 216 (see figure 11). Around 87 per cent of the morphine mnufctured globlly is converted into other nrcotic drugs or into substnces not covered by the 1961 Convention (see prs. 42 nd 43 below). The rest is used directly for medicl purposes (for direct consumption nd in preprtions listed in schedule III), minly for pllitive cre. 39. In 216, the leding morphine mnufcturing country ws the United Kingdom (76.5 tons, or 18.1 per cent of globl mnufcture), followed by Frnce (74.2 tons, or 17.5 per cent), the United Sttes (6.4 tons, or 14.3 per cent), Irn (Islmic Republic of) (57.5 tons, or 13.6 per cent), Austrli (45.5 tons, or 1.7 per cent), Spin (22 tons, or 5.2 per cent) nd Chin (17.3 tons, or 4.1 per cent). Together, these seven countries ccounted for 83.8 per cent of globl mnufcture. Three other countries reported the mnufcture of morphine for 216 in quntities of more thn 1 tons (listed in descending order): Norwy, Jpn nd Slovki. 4. Exports of morphine decresed from 35.4 tons in 215 to 23.5 tons in 216. The min exporting countries in 216 were the United Kingdom (32.6 per cent), Frnce (14.3 per cent), Slovki (12.3 per cent), Germny (11.7 per cent), Switzerlnd (8 per cent) nd Itly (5.6 per cent). Countries tht exported less thn 1 ton, or less thn 3 per 3

Figure 12. Morphine: percentge shre of totl export, by country, 27-216 Percentge 1 9 8 7 6 5 4 3 2 1 27 28 29 21 211 212 213 214 215 216 United Kingdom Austrli Frnce Netherlnds Denmrk Slovki Germny United Sttes Itly Switzerlnd Other countries Figure 13. Morphine: distribution of consumption, 216 Cnd (.6%) 6.8% Europe (11.7%) 25.4% Austrli nd New Zelnd (.5%) 2.6% Jpn (2%).6% Other countries (8.1%) 14% United Sttes (5.1%) 5.6% Note: Percentges in prentheses refer to shre of the totl popultion of ll countries tht submitted dt on morphine. English Comments Prt two Deuxième prtie Segund prte cent, were, in descending order, Hungry, Polnd, Austrli, Spin, Austri, Irn (Islmic Republic of) nd Denmrk (see figure 12). The min importing countries in 216 were Germny (4.5 tons, or 2.3 per cent), Austri nd Frnce (both t 3 tons, or 13.9 per cent), the United Kingdom (2.1 tons, or 9.6 per cent), Cnd (1.4 tons, or 6.4 per cent), nd Switzerlnd (1.1 ton, or 5.1 per cent). Other countries imported less thn 1 ton. Further detils on exports nd imports of morphine cn be found in nnex IV, tbles 3 nd 4. 41. The mount of morphine used for direct consumption stood t 4.2 per cent in 1997 but since then hs doubled, reching 8.6 per cent in 216. Despite the increse, mny countries continued to report hving difficulties procuring morphine medictions. 42. The differences in consumption levels between countries continued to be very significnt (see figure 13 nd tble XIV), owing to vrious economic, knowledge, regultory nd other fctors influencing the use of morphine for the tretment of pin. Although most countries nd territories reported morphine consumption in 216, mny people still hd limited ccess to the drug. In 216, 8 per cent of the world popultion consumed only 14 per cent of the totl mount of morphine used for the mngement of pin nd suffering. Although tht represented n improvement over 214, when 8 per cent of the world popultion consumed 9.5 per cent, the disprity in consumption of nrcotic drugs for pllitive cre continues to be mtter of concern. The remining 86 per cent of the totl consumption of morphine, excluding pre prtions included in Schedule III of the 1961 Convention, continued to be concentrted in smll number of countries locted minly in Western Europe nd North Americ. Among them, in 216 the United Sttes hd the highest consumption (18.3 tons), followed by Cnd (2.4 tons), Austri, Chin nd Frnce (ll three t 1.8 tons), Germny (1.6 tons) nd the United Kingdom (1 ton). 43. In some countries, morphine is used for the mnufcture of preprtions included in Schedule III of the 1961 Convention. In 216, the countries using morphine for tht purpose in significnt quntities were Chin (7.6 tons), the United Kingdom (6 tons) nd Itly (1.2 tons). 44. The lrgest shre of morphine is used for conversion into other opites, such s codeine ethylmorphine nd pholcodine (see tble VI), lthough it is importnt to note tht codeine is incresingly obtined directly from opium poppy rich in codeine. The mounts utilized for conversion into other opites, which fluctuted t bout 2 tons per yer until the beginning of the 199s, incresed stedily until 212, but decresed significntly in 215 nd remined reltively stble in 216, t 342 tons. Morphine is lso used for the mnufcture of substnces not controlled under the 1961 Convention, such s noroxymorphone nd pomorphine. The quntity of morphine utilized for tht purpose fluctuted considerbly in the period 1997 216 nd reched 2.1 tons in 216, most of which ws used by Frnce nd the United Kingdom. 31

45. Globl stocks of morphine stood t 154.1 tons in 216, slight decrese from 215 (157.3 tons). The lrgest stocks were held by the United Sttes (54.3 tons, or 35.2 per cent of globl stocks), followed by Frnce (33.7 tons, or 21.8 per cent), Hungry (16.5 tons, or 1.7 per cent), Jpn (14.6 tons, or 9.1 per cent), Switzerlnd (9.1 tons, or 5.9 per cent) nd the United Kingdom (6.3 tons, or 4.1 per cent). 45 4 35 Figure 14. Codeine: globl mnufcture, stocks, consumption nd utiliztion, 1997-216 Codeine 46. Codeine is nturl lkloid of the opium poppy plnt, but most of the codeine currently being mnufctured is obtined from morphine through semi-synthetic process. As reported bove, there hs been n increse in the cultivtion of the opium poppy vriety tht is rich in codeine, nd in the mnufcture of ACA (CPS), which is used for the extrction of codeine. Codeine is used minly for the mnufcture of preprtions in Schedule III of the 1961 Convention, while smller quntity is used for the mnufcture of other nrcotic drugs, such s dihydrocodeine nd hydrocodone. The trends in globl mnufcture, consumption, utiliztion nd stocks of codeine during the period 1997 216 re shown in figure 14. 47. Globl mnufcture of codeine incresed since 1997 nd reched pek of 411.8 tons in 212. Since then, globl mnufcture hs been decresing, dropping to 323.2 tons in 216, lmost the sme level s 28. The min mnufcturing countries were Frnce (66.8 tons, or 2.6 per cent), the United Kingdom (56.8 tons, or 17.5 per cent), the United Sttes (55.1 tons, or 17 per cent), nd Austrli (37.9 tons, or 11.7 per cent). The Islmic Republic of Irn (from seized opium), Spin, Norwy, Jpn, Indi, Chin, South Afric nd Slovki, in descending order, mnufctured smller quntities (see figure 15). In recent yers, vrious ntionl nd regionl orgniztions nd regultory bodies hve issued wrnings relted to codeine use nd the occurrence of dverse effects in children. Such wrnings might hve been prtly responsible for the decrese in mnufcture. 48. Stocks vilble globlly continued to drop in 216. At 318.2 tons in 214, they decresed to 284.4 tons in 215, then further to 266 tons in 216. The countries keeping significnt quntities of codeine in stock were Indi (44.1 tons, or 16.6 per cent), Frnce (41.5 tons, or 15.6 per cent), the United Sttes (4.3 tons, or 15.1 per cent), the United Kingdom (38.1 tons, or 14.3 per cent), Austrli (15.5 tons, or 5.8 per cent), Cnd (12.7 tons, or 4.7 per cent) nd Jpn (11.5 tons, or 4.3 per cent). A number of countries reported stocks of codeine below 1 tons. 49. In 216, world exports of codeine mirrored the decresing trend in mnufcturing, flling to 127.9 tons from 157 tons in 215, fr from the pek t 176.4 tons 3 25 2 15 1 5 45 4 35 3 25 2 15 1 5 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Frnce United Kingdom United Sttes Austrli Norwy Figure 15. Codeine: mnufcture, 1997-216 Jpn Consumption Mnufcture Stocks s t 31 December of ech yer. Hungry Indi Spin Utiliztion Stocks Irn (Islmic Rep. of) World totl recorded in 212 (see figure 16). Frnce continued to be the leding exporting country for codeine in 216, exporting 37.2 tons, or 29.1 per cent of the globl totl, followed by the United Kingdom (25 tons, or 19.6 per cent), Austrli (23.6 tons, or 18.4 per cent), Norwy (1.1 tons, or 7.9 per cent), Spin (6.6 tons, or 5.2 per cent) the United Sttes (5.7 tons or 4.5 per cent) nd Switzerlnd (5.4 tons, or 4.2 per cent). 32

18 16 14 12 1 8 6 4 2 Figure 16. Codeine: exports, 1997-216 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Frnce Austrli United Kingdom Hungry Irn (Islmic Rep. of) Slovki Norwy Spin Switzerlnd World totl Figure 17. Codeine: utiliztion for the mnufcture of preprtions listed in Schedule III of the 1961 Convention, 216 2.5% Hungry 2.6% Cnd 4% Germny 4.7% Chin Irn (Islmic Rep. of) 8.1% Viet Nm 2.5% Frnce 9.4% Norwy 2.2% Brzil 2% United Sttes 14.4% Other countries 15.6% Indi 16.2% United Kingdom 15.8% 5. The min countries importing codeine in 216 were Indi (25.9 tons), Germny (17.5 tons), Cnd (14.6 tons), Itly (7 tons), Viet Nm (6.1 tons) nd Hungry (5.7 tons). More detils on the interntionl trde in codeine cn be found in nnex IV, tbles 3 nd 4. 51. In 216, codeine used for the mnufcture of preprtions listed in Schedule III ccounted for 96.1 per cent of the globl consumption 16 of codeine. The use of codeine for tht purpose grew from 162.9 tons in 1996 to 278.9 tons in 216 (see figure 14). Countries reporting the utiliztion of codeine for the mnufcture of such preprtions re not necessrily the countries in which those preprtions re consumed. The countries mnufcturing those preprtions in lrger quntities for subsequent export re reflected in figure 17. 52. In 216, globl consumption (including Schedule III preprtions) stood t 29 tons (see figure 14). The min countries reporting dt in tht respect were Indi (45.5 tons), the United Kingdom (44.2 tons), the United Sttes (4.5 tons), Frnce (26.5 tons), Irn (Islmic Republic of) (22.8 tons), Germny (13.2 tons) nd Cnd (13 tons). Other countries with level of codeine consumption below 1 tons were Hungry, Chin, Viet Nm, Norwy, Brzil, South Afric, Austrli nd Itly. Other countries reported consumption below 4 tons. 53. Utiliztion of codeine for the mnufcture of other nrcotic drugs, minly dihydrocodeine nd hydrocodone, incresed stedily until reching its highest level in 27 (81.8 tons). Utiliztion hs grdully declined nd stood t 44 tons in 216. Of the mount reported for 216, 15 tons were used in the United Sttes, 12 tons in Jpn, 11.6 tons in the United Kingdom, 3.5 tons in Itly nd 1.5 tons in Slovki. Thebine 54. Until the 199s, thebine ws mnufctured minly from opium; since 1999, it hs been obtined primrily from poppy strw. Thebine my lso be obtined through the conversion of oripvine or from semi-synthetic opioids, such s hydrocodone. Thebine itself is not used in therpy, but it is n importnt strting mteril for the mnufcture of number of opioids, minly codeine, dihydrocodeine, etorphine, hydrocodone, oxycodone nd oxymorphone (ll of which re substnces controlled under the 1961 Convention) nd buprenorphine (which is substnce controlled under the Convention on Psychotropic Substnces of 1971), 17 s well s of substnces not under interntionl control, such s the derivtives nloxone, nltrexone, nlorphine nd nlbuphine. 55. Globl mnufcture of thebine hs incresed shrply since the lte 199s, s consequence of the growing 16 Globl consumption is term used by INCB to reflect the totl of the mount of drug tht is directly consumed nd the mount tht is utilized for the mnufcture of preprtions listed in Schedule III of the 1961 Convention. 17 United Ntions, Trety Series, vol. 119, No. 14956. English Comments Prt two Deuxième prtie Segund prte 33

Figure 18. Thebine: globl mnufcture, utiliztion nd stocks, 1997-216 Figure 19. Thebine: utiliztion for the mnufcture of opioids, 1997-216 16 14 12 1 8 6 4 2 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Stocks Mnufcture Utiliztion 13 12 11 1 9 8 7 6 5 4 3 2 1 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 United Sttes Frnce United Kingdom Other countries Stocks s t 31 December of ech yer. demnd for oxycodone nd other drugs nd substnces tht my be derived from it. In 216, fter some fluctutions in the preceding yers, globl mnufcture of thebine reched record level of 156 tons (see figure 18). The demnd for medicines derived from thebine, fter decresing in the pst yers, ppers to hve resumed, despite restrictions on prescription drugs recently imposed in the min mrket (the United Sttes) in response to their buse nd the high number of overdose deths they hve cused. With 72.5 tons, or 46.4 per cent, in 216, the United Sttes resumed its position s the min mnufcturer, hving lost tht position in 215. It ws followed by Austrli (39.8 tons, or 25.5 per cent) nd Spin (37.5 tons, or 24 per cent). Minor mnufcturing countries were, in descending order, Frnce, Jpn, Chin, Slovki, Hungry nd Indi. Exports declined from 77.7 tons in 215 to 64.1 tons in 216. The min exporting countries in 216 were Austrli (36.2 tons) nd Spin (26.6 tons). Switzerlnd, Denmrk nd the United Kingdom exported quntities below 1 ton. The min countries importing thebine were Frnce (46.7 per cent), the United Kingdom (42.3 per cent), Czechi (4.4 per cent) nd Denmrk (2.6 per cent). 56. Following the min mnufcturing trend, the utiliztion of thebine for the mnufcture of other nrcotic drugs incresed to 111.5 tons in 216 (see figure 19 nd tble VII). The United Sttes ws the min country to use thebine during the 2-yer period 1997 216. In 216, the United Sttes ccounted for 58.8 per cent of globl use for tht purpose, followed by Frnce (24 per cent) nd the United Kingdom (14.2 per cent). The quntity of thebine reported s hving been used for the mnufcture of substnces not covered under the 1961 Convention (minly buprenorphine) fluctuted during the 1-yer period 27 216: in 216, it reched 24.8 tons, the highest mount ever reported. Switzerlnd, the United Kingdom nd Czechi, in descending order, ccounted for 84.6 per cent of the world totl. 57. After n overll fluctuting upwrd trend in the period since 1996, globl stocks of thebine remined stble in 216 t 89 tons. Mjor stocks were held in the United Sttes (26.52 tons), Spin (21.1 tons), Frnce (14.2 tons), the United Kingdom (12.2 tons), Austrli (5.5 tons), Switzerlnd (3.2 tons) nd Jpn (2.4 tons). Oripvine 58. In 27, oripvine ws included in Schedule I of the 1961 Convention. Since 24, the mount of oripvine mnufctured hs fluctuted between 6 nd 25 tons. In 216, combined totl of 21.3 tons were mnufctured in only three countries: the United Sttes (14 tons), Spin (6.3 tons) nd Switzerlnd (1 ton). The use of oripvine in significnt quntities for the mnufcture of other drugs ws reported in 216 by the United Sttes (16 tons) nd Switzerlnd (1.1 tons). The drugs mnufctured were minly hydromorphone, oxymorphone nd buprenorphine. In 216, globl stocks of oripvine mounted to 18.1 tons, of which 76.3 per cent ws held in Spin, 14.9 per cent in the United Sttes nd 8.5 per cent in Switzerlnd. 34

Semi-synthetic opioids 59. Semi-synthetic opioids re mde by mens of reltively simple chemicl modifictions of nturl opites such s morphine, codeine nd thebine. Some exmples of such derivtives re dihydrocodeine, ethylmorphine, heroin, hydrocodone, oxycodone nd pholcodine. Some of the min mnufcturers hve reported tht lrge losses occur during the processing of some semi-synthetic opioids. 18 Those mnufcturing losses ccount for the difference between the totl quntities of hydrocodone nd oxycodone mnufctured nd those consumed, which re reflected in figures 22 nd 23. Dihydrocodeine 6. Globl mnufcture of dihydrocodeine fluctuted between 27.1 nd 35.7 tons in the 2-yer period 1997 216. In 216, the quntity mnufctured worldwide stood t 28.9 tons (see figure 2). The min countries mnufcturing significnt quntities continued to be Jpn (12 tons), the United Kingdom (11.1 tons) nd Itly (3.4 tons), together ccounting for 91 per cent of totl mnufcture in 216. Globl exports of dihydrocodeine mounted to 7.8 tons in 216. The min exporting country ws Itly (42.7 per cent), followed, in descending order, by the United Kingdom (21.6 per cent), Frnce (15.9 per cent), Slovki (11.6 per cent) nd Hungry (4.4 per cent). In 216, the Republic of Kore ws the leding importing country for dihydrocodeine (3.1 tons). Other mjor importers were the United Kingdom (2 tons), Colombi (.6 ton), Hong Kong, Chin (.3 ton) nd Itly (.2 ton). 61. Dihydrocodeine is consumed minly in the form of preprtions included in Schedule III of the 1961 Convention, which ccounted for 81.7 per cent of totl consumption in 216, decrese from 92 per cent in 215. In 216, mnufcture of dihydrocodeine reched 28.9 tons. The min user countries for dihydrocodeine, in descending order, were Jpn, the United Kingdom nd the Republic of Kore, together ccounting for 88.5 per cent of totl globl utiliztion (consumption nd utiliztion for the mnufcture of preprtions in Schedule III). In 216, globl stocks of dihydrocodeine mounted to 24.7 tons; mjor stocks were held in Jpn (11.1 tons) nd the United Kingdom (6.2 tons). 4 35 3 25 2 15 1 5 Figure 2. Dihydrocodeine: globl mnufcture, consumption nd stocks, 1997-216 97 98 99 1 2 3 4 5 6 7 8 9 1 11 12 13 14 15 16 Stocks Mnufcture Consumption Stocks s t 31 December of ech yer. Ethylmorphine 62. The mnufcture of ethylmorphine showed n overll downwrd trend over the 2-yer period 1997 216 nd ws stble t round 1 ton for severl yers. In 216, the totl quntity mnufctured ws 1 ton, down from 1.4 tons in the previous yer nd much lower thn the pek of 4.6 tons reched in 1997. Frnce ws the only mnufcturing country in 216 nd ws lso the leding exporting country (415 kg), ccounting for over 86 per cent of globl exports. The lrgest importer in 216 ws Sweden, which imported 5.6 per cent of totl production. Belgium imported 25.2 per cent, while Finlnd, Polnd nd Hong Kong, Chin imported quntities smller thn 1 per cent. Ethylmorphine is consumed minly in the form of preprtions listed in Schedule III of the 1961 Convention (bout 92.5 per cent of totl consumption). Globl utiliztion (consumption nd mnufcture of preprtions in Schedule III) reched 984 kg in 216. The min consuming countries in 216 were Sweden (3.3 per cent of the world totl), Frnce (26.8 per cent), Indi (14.9 per cent) nd Belgium (12.7 per cent). In 216, globl stocks of ethylmorphine totlled 2.2 tons; the lrgest holders of stocks were Frnce, Indi nd Belgium, ll three with 29 per cent of globl stocks. English Comments Prt two Deuxième prtie Segund prte 18 Mnufcturing losses re those occurring: () during the process of refining drug; (b) during the process of trnsformtion of drug into its slts, isomers, esters nd ethers, s pplicble ccording to the Schedules; nd (c) during the mnufcture of preprtions other thn those included in Schedule III. They my lso be due to the chemicl decomposition of drug, lekge, evportion, qulity requirements or ccidents. Heroin 63. Over the pst 2 yers, the licit mnufcture of heroin verged 6 kg, with peks of over 1 ton in 23, 212 nd 216. In 216, totl of 1.1 tons ws mnufctured, 35