Dr Kamran Niaz is a public health physician with postgraduate training in public health, specialising in epidemiology. He is currently working as an epidemiologist in the Research Branch of the United Nations Office on Drugs and Crime (UNODC).
Over the past 30 years, mainly working with UNODC and based in different countries, his main focus of work has been on epidemiology of substance use and HIV and AIDS among people who use drugs.
Over the years, he has led the design and implementation of population-based surveys, studies and assessments on drug use and health consequences in a number of low- and middle-income countries. Since 2010, he has been among the main contributors to the UNODC flagship publication, the World Drug Report, contributing to the development of global and regional estimates on drug-related indicators. For the World Drug Report, he also authored analyses on drug use and health, policy developments, and the outcomes of regulatory changes related to certain controlled substances.
The World Drug Report (WDR) 2025 emphasises the diversification of drug markets and behaviours globally. Which of these trends are most significant for Europe at present?
Kamran Niaz: The most significant trends are: the emerging mix of both conventional and synthetic drugs, including new psychoactive substance (NPS); an increase in trafficking and seizures of cocaine, with rising availability and high purity levels, leading to more problem cocaine use and increased treatment demand, including for crack cocaine; a remaining hub of amphetamine and MDMA production and a major market for use; cannabis products with higher THC content than decades ago are becoming more common, alongside increased availability and use of synthetic cannabinoids, resulting in more cannabis use disorders and treatment needs; ketamine spreading from recreational settings to regular users, causing increasing harms; and the spread of other NPS, including netzines, in different locations.
The report highlights adolescence as a particularly sensitive period for substance use. Why does starting early have such enduring impacts on young people’s lives?
Kamran Niaz: The adolescent brain is developing along with physical and psychological development. Early initiation of drugs, and regular use, seemingly disrupts the trajectory of normal brain development and has adverse effects on cognitive functions such as attention, learning and memory. Although the causal pathways are complex, in addition to somatic harms to the brain and to the respiratory and other systems, early intensive cannabis use, as an example, brings with it a range of social and educational issues, including limited academic achievement and subsequent economic problems.
In high-income regions like Europe, some substance use, like cannabis, among teens is declining, yet new risky behaviours are emerging. What explains this shift?
Kamran Niaz: Apart from alcohol and tobacco use, which have shown a long-term decline, the main decline in drug use among adolescents is in cannabis use. Nevertheless, there is an increase in the use of e-cigarettes and vaping, including vaping cannabis. Also, the use of other drugs such as cocaine, amphetamine, MDMA or NPS (mainly synthetic cannabinoids) has not shown a decline. Most importantly, there is an increase in the non-medical use of pharmaceutical drugs, more among girls than boys, including tranquillisers, pain killers and ADHD medications. To top this, there is also an increase in the risk or addictive gambling and gaming behaviours among European adolescents.
Is there evidence connecting social media use with drug-related behaviours among young Europeans?
Kamran Niaz: Not per se in Europe. There is a growing trend of use of social media among young people in most parts of the world, Adolescents in Europe, as in other regions, have a high use of and exposure to a range of social media and gaming platforms where they are likely to be exposed, among other contents, to drug-related contents where drug related behaviours may be promoted and normalized that may then influence the adolescents to experiment with drugs. Young people, and not necessarily only adolescents, can also encounter online marketing of drugs, with social media or gaming platforms used to advertise different drugs – cannabis, MDMA, and synthetic drugs – as well as through encrypted messaging, to facilitate their delivery.
The report observes strong links between mental health, stress, and substance use. How are these connections influencing the behaviour of Europe’s younger generations?
Kamran Niaz: There is an association between drug use disorders and mental health disorders reported in scientific literature in general, and not just limited to Europe. It would be quite speculative to describe such associations between substance use disorders and mental health disorders among young people in a particular region.
AI and digital innovation are transforming numerous aspects of health policy. How do you perceive the potential role of AI in understanding or preventing risky behaviours among youth?
Kamran Niaz: AI and social media platforms, like many other health promotion interventions, can also be used for indicative and targeted prevention among adolescents and young people.
Ultimately, with prevention efforts varying across countries, what should Europe focus on in the next decade to safeguard adolescents from substance use and emerging digital threats?
In general, this requires more targeted, age- and gender-sensitive prevention interventions, with increasing use of AI and digital platforms accessible to young people.