Abstract

Background: Use of psychoactive substances is contributing to the burden of disease and to a worsening socioeconomic problems in Ethiopia. Drug use and trafficking are highly complex problems which require a multisectoral and coordinated response. Generally drug control policy should address demand, supply and risk of drug use related problems. Despite the implementation of comprehensive national drug control master plan since 2017, the trend of licit and illicit drug use is increasing in Ethiopia.

Objective: The objective of this review was to answer the question why illicit drug use is increasing in Ethiopia by using economics perspective of drug use control policy.

Methods: We have included nine countries from developed and developing regions, to review drug control policy options and their impacts on drug use related problems in respective countries.

Findings: Our review revealed that zero tolerance laws are not effective in controlling and/or reducing drugs use problems. On other hand decriminalization approaches addressing demand, supply and risk of drug use have reduced drug use associated problems in selected countries except Ethiopia and Colorado. Total budget allocated for demand reduction is only 34.2% of total national drug control budget. Khat, alcohol and tobacco are available at low price at every corner of the country. Khat is used as a source of revenue generation by government and society. The ease of access and availability of Khat is contributing to cascades of drug use related problems and there is no clear law against Khat use and cultivation in the country.

Conclusion: In conclusion, national drug control policy movement towards 2030 goal (i.e. having drug use free generation) is challenged by commercialization of Khat; low budget allocation to demand reduction measures and lack of long term plan for substituting Khat cultivation with alternative economic sectors.

Recommendations: Based our review we forward the following recommendations to the responsible authorities to; increase investing in demand reduction measures; develop long term plan for substituting Khat with alternative revenue source for the country and create attractive teaching learning environment including recreational centers for students in school is important to retain students in school during school hours and reduce exposure time to triggers of unhealthy behaviors.