Commentary: From Global Consensus to Local Action: China’s Strategic Response to Emerging Drug Use Trends

The recognition of drug use as a global challenge requiring coordinated international response began with the first international conference on narcotic drugs held in Shanghai in 1909. Throughout the 20th century, three pivotal United Nations (UN) conventions on drug control (1961, 1971, and 1988) established the legal and institutional framework for a comprehensive multilateral system addressing prevention and enforcement. The creation of the United Nations Office on Drugs and Crime (UNODC) in 1997 further underscored the widespread nature of drug-related challenges confronting societies worldwide (1-2).

As nations develop more sophisticated approaches to addressing global drug challenges, international surveillance data continue to underscore both the magnitude of the problem and the critical importance of prevention strategies. The global population using drugs has reached 292 million in 2022, representing a 20% increase over the past decade (3). Particularly concerning is the finding that cannabis use prevalence among adolescents aged 15–16 years exceeds that of adults worldwide (3). It was estimated that 84 million adults aged 15–64 in Europe had used cannabis at least once, including approximately 15.3 million young adults aged 15–34 based on the European Drug Report 2023. (4). Similarly, in 2022, an estimated 70.3 million individuals aged 12 or older in the United States reported illicit drug use within the past year, with peak prevalence occurring among young adults aged 18 to 25. These statistics demonstrate the urgent need for targeted prevention investments, particularly among youth populations (5).

China has actively contributed to and responded to these global drug control initiatives. The Anti-Drug Law of the People’s Republic of China (6) was enacted in 2007, establishing a comprehensive triadic strategy that encompasses prevention, punishment, and rehabilitation. Following the law’s implementation, the number of newly identified drug users increased steadily, reaching its peak in 2015 (Figure 1). However, a series of national initiatives — including the “People’s War on Drugs,” the “Sword Action” (Liangjian Project), and the deployment of “Skynet” surveillance systems — led to a significant decrease in newly identified drug users. This decline was particularly pronounced during and after the COVID-19 pandemic, when the number of newly found drug users experienced a sharp drop (Figure 1).

Figure 1. 

Trends in newly identified drug users in China, 2007–2022.

Note: Data from 2007 to 2013 were sourced from the Drug Abuse Population Estimation in the Key Cities of the Ministry of Public Security, while data from 2014 to 2022 were obtained from the respective annual editions of the Drug Situation in China report.

The theme of this year’s International Day Against Drug Abuse and Illicit Trafficking — “The evidence is clear: invest in prevention, Break the cycle, Stop Organized Crime” (7) — underscores the public health nature of the drug problem and emphasizes the critical importance of preventive measures (Figure 2). The evolution of these annual themes reflects a fundamental shift in global attitudes toward drug policy. From 1996 to 2009, themes primarily emphasized the dangers and harmful consequences of drug use. The second stage (2010 to 2015) began treating the drug problem as a public health issue rather than solely a criminal justice matter. Since 2016, the focus has shifted toward prevention, early intervention, and youth-centered strategies, reflecting a more comprehensive and evidence-based approach to drug policy.

Figure 2. 

Official themes of the International Day Against Drug Abuse and Illicit Trafficking (World Drug Day), 1996–2025.

Note: Data sourced from United Nations publications.

Nevertheless, emerging risks continue to challenge existing frameworks. Recent cases of adolescent substance abuse involving compounds not yet under formal regulatory control, such as nitrous oxide and etomidate, have been documented across China (8). Since January 2021, Guangzhou in Guangdong Province has implemented targeted enforcement measures against nitrous oxide distribution, resulting in 46 investigated cases by June 2022 (9). These novel psychoactive substances present distinct challenges due to their accessibility through online platforms, ambiguous legal classification, and limited public awareness — particularly among adolescents. In response to these evolving threats, the Ministry of Justice issued a national directive in early 2025 emphasizing “intensified drug prevention campaigns targeting adolescents” (10). Through strategic investments in early education programs, enhanced cross-sector collaboration, and implementation of evidence-based policy frameworks, China is proactively adapting its approach to address the dynamic landscape of emerging drug-related risks.