These guidelines contain recommendations on the identification and management of substance use and substance use disorders for health care services which… Cannabis is globally the most commonly used psychoactive substance under international control. The first edition was published in 2013 and summarized the evidence of drug use prevention at the global level.

Defined Daily Dose (DDD)

Quality-assured, safe and effective medicines, vaccines and medicaldevices are fundamental to a functioning health system. Drug dependence treatment and care in the Republic of Serbia Meeting of technical experts on public health responses to cannabis use The publication was invited by resolution 58/5 of the Commission on Narcotic Drugs entitled “Supporting the collaboration of public health and justice… WHO Drug Information provides an overview of topics relating to drug development and regulation that are of current relevance and importance, and includes the lists of proposed and recommended International Nonproprietary Names for Pharmaceutical Substances (INN).

WHO guideline on balanced national controlled medicines policies to ensure medical access and safety

Access to appropriate medications is shown to have substantial impacts on community health and the related economic indicators. Universal health coverage Opioid overdose is easily reversed with the opioid antidote naloxone and with basic life… There is growing concern around the world about drug use and road safety. In 2013, an estimated 181.8 million people aged years… Joint UNESCO, UNODC and WHO publication on education sector responses to substance use in 2017 UNESCO (the United Nations Educational, Scientific and Cultural…

ATC 1st level

Opioid agonist maintenance treatment (OAMT) for people with opioid dependence is proven to be safe and effective in addressing a broad range of health… Other high priority pathogens, such as antibiotic-resistant Neisseria gonorrhoeae and Enterococcus faecium, present unique public health challenges, including persistent infections and resistance to multiple antibiotics, necessitating targeted research and public health interventions. Evidence, including systematic reviews, about treatment of opioid dependence and management of opioid overdose will be presented to the GDG. In the guidelines on community management of opioid overdose, WHO recommends that people who are likely to witness an opioid overdose, including people who use opioids, and their family and friends should be given access to naloxone and training in its use so that they can respond to opioid overdose in an emergency.

Building on the value of the BPPL as a global tool, tailoring the list to country and regional contexts can account for regional variations in pathogen distribution and the AMR burden. Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection moving from critical to high priority in BPPL 2024 mirrors recent reports of decreases in global resistance. Gram-negative bacteria have built-in abilities to find new ways to resist treatment and can pass along genetic material that allows other bacteria to become drug-resistant as well.

In the guidelines, WHO recommends the use of a range of treatment options for opioid dependence. Since 1977, WHO has maintained a list of essentialmedicines as a means to promote health equity around the world. At the same time, antimicrobial resistance is challenging the effectiveness of many commonly used medicines in one of the most concerning threats to global health today. Since then there have been incredible advances in drugs for a wide range of health concerns including disease, mental health and other conditions.

Publications

This Centre is located at the Norwegian Institute of Public Health (NIPH) and the main activities of the Centre are drawn up in an agreement between the WHO Headquarters and the Government of Norway. There are also international differences between PDDs, which can be up to four or five fold higher/lower. When there is a substantial discrepancy between the PDD and the DDD, it is important to take this into consideration when evaluating and interpreting drug utilization figures. The PDD will give the average daily amount of a drug that is actually prescribed. DDDs sometimes need to be reviewed because dosages may change over time, e.g. due to the introduction of new main indications or new research making it necessary to change the DDD. Estimating prevalence of drug use in children is not possible by using crude sales data presented in DDDs owing to the variability of children’s doses.

More than 36 million years of healthy life loss (DALY) were attributable to drug use in 2019. Psychoactive drugs are substances that, when taken in or administered into one’s system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions. English and Spanish versions of the publications are available. Both publications are updated annually and available electronically and in hard copies. The ATC/DDD guidelines and the Index were both published for the first time in the current format in 1990.

WHO drug information provides an overview of topics of current Drug Treatment and Recovery relevance relating to drug development and regulation. The Global status report on alcohol and health and treatment of substance use disorders presents a comprehensive overview of alcohol consumption, alcohol-related… WHO recommends that essential medicines, including those that are controlled, be available to all patients at all times at a price that the individual… Access to medicines is essential for attainment of universal health coverage, which is central to achievement of the health-related Sustainable Development…

• Equal access and the reliable supply of medicines is anongoing goal of WHO and global health delivery systems, the achievement ofwhich is hampered by several factors.
• Working to increase access to essentialpharmaceuticals while limiting the spread of falsified products is at the heart of WHO’s global strategy on medicines.
• When there is a substantial discrepancy between the PDD and the DDD, it is important to take this into consideration when evaluating and interpreting drug utilization figures.
• This report provides a synthesis of the outcomes of the first paediatric drug optimization exercise that was held for Malaria.
• There is growing concern around the world about drug use and road safety.
• It is crucial that people with opioid dependence and those at risk of opioid overdose have access to prevention, harm reduction, treatment, and care, which are of good quality, affordable, ethical and evidence based.

ATC 2nd level

Millennium Development Goal 8E aims for affordable access to essential medicines.Essential medicines, as defined by WHO, are those that “satisfy… This report provides a synthesis of the outcomes of the first paediatric drug optimization exercise that was held for Malaria. The PADO for epilepsy exercise aimed to support the identification of short- and long term priorities for epilepsy medicines for the paediatric age group,… WHO’s 6th Virtual cGMP Training Marathon concludes, reinforcing global manufacturing capacities Public expenditure ranges widely between nations, from under 20% of totalhealthcare costs in high-income countries to up to 66% in low-income countries. The price of medicine remains the largest impediment toaccess and the economic impact of pharmaceuticals is substantial.

ATC 3rd& 4th levels

High prices, misuse of drugs and poor or unreliabledrug quality contribute to this issue. However, globalized trade can undermine regulation, and in resource-limited settings especially, incidence of substandard or falsified medicines is growing. Today there are thousands of drugs on the market able to prevent, treat and lessen the impact of ailments that would have been fatal just a few generations ago. 1st WHO Forum on alcohol, drugs and addictive behaviours 2nd WHO Forum on alcohol, drugs and addictive behaviours

Prescribed Daily Dose (PDD)

These include reduction in non-medical opioid use, mortality and morbidity (including due to opioid overdose, HIV and viral hepatitis), lowering risk of crime and incarceration, better retention in treatment, quality of life and overall wellbeing. To address the issue, WHO has published guidelines for the psychosocially assisted pharmacological treatment of opioid dependence (2009) and community management of opioid overdose (2014). While some 64 million people globally are estimated to live with drug use disorders, access to treatment remains very limited, with less than 10% having access to it. It is crucial that people with opioid dependence and those at risk of opioid overdose have access to prevention, harm reduction, treatment, and care, which are of good quality, affordable, ethical and evidence based. The list provides guidance on the development of new and necessary treatments to stop the spread of antimicrobial resistance (AMR). These include opioid agonist maintenance treatment (or OAMT) with medicines such as methadone and buprenorphine, pharmacological treatment with opioid antagonists (such as naltrexone) as well as psychosocial support.

This feedback helps WHO develop high-quality guidelines that reflect diverse perspectives and respond to the needs of communities worldwide. To ensure transparency and inclusivity, WHO invites members of the public and interested organizations to review the biographies of the GDG members and provide feedback. GDG members were selected by WHO technical staff based on their technical expertise, their role as end-users (e.g., programme managers and healthcare providers), and their representation of affected communities. In the choice of treatment, WHO recommends OAMT to be used for most patients as the intervention with strongest evidence of effectiveness for variety of outcomes.

The updated BPPL incorporates new evidence and expert insights to guide research and development (R&D) for new antibiotics and promote international coordination to foster innovation. AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to medicines, making people sicker and increasing the risk of disease spread, illness and deaths. “Together, we can preserve the effectiveness of life-saving antimicrobial drugs and accelerate progress toward ending these epidemics.”

• DDDs provide a fixed unit of measurement independent of price, currencies, package size and strength enabling the researcher to assess trends in drug utilization and to perform comparisons between population groups.
• This limits comparisons of drug consumption at an international level.
• Target 3.5 of UN Sustainable Development Goal 3 sets out a commitment by governments to strengthen the prevention and treatment of substance abuse.
• The price of medicine remains the largest impediment toaccess and the economic impact of pharmaceuticals is substantial.
• This is crucial for mitigating AMR’s impact on public health and the economy.
• Medium priority pathogens include Group A and B Streptococci (both new to the 2024 list), Streptococcus pneumoniae, and Haemophilus influenzae, which present a high disease burden.

Amala’s story: how to prevent antimicrobial resistance

WHO updates guidelines on opioid dependence treatment and overdose prevention The UNGASS marked a shift in the overall drug policy discourse to highlight the public health and human rights dimensions of the world drug problem and to achieve a better balance between supply reduction and public health measures. About 296 million people aged had used psychoactive drugs in 2021 and about 39.5 million people are estimated to be affected by drug use disorders (harmful pattern of drug use or drug dependence). Psychoactive drugs have different degrees of restriction of availability, depending on their risks to health and therapeutic usefulness, and classified according to a hierarchy of schedules at both national and international levels. This is crucial for mitigating AMR’s impact on public health and the economy. The critical priority pathogens, such as gram-negative bacteria resistant to last-resort antibiotics, and Mycobacterium tuberculosis resistant to the antibiotic rifampicin, present major global threats due to their high burden, and ability to resist treatment and spread resistance to other bacteria.

Changes to the index are made annually and a cumulative list including all ATC and DDD alterations made since 1982 is available  here . For drugs where the recommended dosage differs for different indications (e.g. antipsychotics) it is important that diagnosis is linked to the prescribed daily dose given. The PDD can be determined from studies of prescriptions, medical or pharmacy records, and it is important to relate the PDD to the diagnosis on which the drug is used.

WHO guideline on balanced national controlled medicines policies to ensure medical access and safety:…

In 2022, approximately 60 million people globally engaged in non-medical opioid use, including the use of drugs like heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances. Currently, WHO is convening a guideline development group (GDG) for update of both guidelines with an aim to improve availability and access to treatment of opioid dependence and reduce the number of deaths from opioid overdose by providing evidence-based recommendations on the psychosocially assisted pharmacological treatment and interventions on prevention and management of opioid overdose. WHO announces development of updated guidelines for the psychosocially assisted pharmacological treatment of opioid dependence and community management of opioid overdose

WHO Drug Information – Volume 39, No. 3

The system has fourteen main anatomical or pharmacological groups (1st level). In Hanoi, WHO’s collaboration provides a rosy picture of health Digital version of Essential Medicines list  (eEML) launched Promoting rational use of medicines Strengthening access to essential medicines

Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence (2009) In many ATC main groups, pharmacological groups have been assigned on the 2nd, 3rd and 4th levels allowing drugs with several therapeutic uses to be included, without specifying the main indication. Tanzania making steady progress in access to essential medicines and health products as new challenges emerge

For example, low strength finasteride tablets used for treatment of baldness are classified under D11AX Other dermatologicals and the high strength tablets used for benign prostatic hyperplasia (BPH) are classified under G04C Drugs used in BPH. For example, calcium channel blockers are classified in the pharmacological group C08 (see classification of verapamil below), which avoids specifying whether the main indication is coronary heart disease or hypertension. Medicinal substances are classified according to their main therapeutic use on the basic principle of only one ATC code for each medicinal product (as defined by route of administration and in some cases strength).

The World Medicines Situation 2011- Access to controlled medicines, 3rd edition

Guidelines and recommendations concerning medicines, biologicals, vaccines, medical devices, herbals and related products WHO Drug Information is a quarterly journal providing an overview of topics relating to medicines development and regulation which is targeted to a wide audience of health professionals and policy makers. It is estimated that worldwide there are almost 14.8 million people who inject drugs, of whom 15.2% live with HIV and 38.8% – with hepatitis C. Production, distribution, sale or non-medical use of many psychoactive drugs is either controlled or prohibited outside legally sanctioned channels by law.

Anatomical Therapeutic Chemical (ATC) Classification

For enquiries, please send an e-mail to It presents a range of perspectives on how current challenges impact the manufacture, prescribing and access of medicines throughout the world and introduces newly-released guidance documents. Latest lists of proposed and recommended International Nonproprietary Names for Pharmaceutical Substances (INN) are also included. Over 3 million annual deaths due to alcohol and drug use, majority among men UN Commission approves WHO recommendations to place psychoactive substances under international control

DDDs provide a fixed unit of measurement independent of price, currencies, package size and strength enabling the researcher to assess trends in drug utilization and to perform comparisons between population groups. An operational handbook accompanies the guidelines, providing practical advice for large-scale implementation. Primarily aimed at health policymakers and National TB Programme (NTP) managers, they also support healthcare providers and technical organizations engaged in TB care. WHO’s work on antimicrobial resistance For example, antibiotic-resistant Mycoplasma genitalium, which is not included in the list, is an increasing concern in some parts of the world.

Revisions of the Essential Medicines lists

DDDs are normally assigned based on use in adults.For medical products approved for use in children, the dose recommendations will differ based on age and body weight. The DDDs are allocated to drugs by the WHO Drug Treatment and Recovery Collaborating Centre in Oslo, working in close association with the WHO International Working Group on Drug Statistics Methodology. This limits comparisons of drug consumption at an international level. Drug consumption can be expressed in cost, number of units, number of prescriptions or by the physical quantity of drugs.

This list beganwith 208 identified medicines and has grown to include 460 differentpharmaceuticals. WHO works with partners and Member States to strengthen regulation,including post-marketing surveillance, and to eliminate substandard andfalsified medicines. They are thelargest public expenditure on health after personal costs in many low-incomecountries, and the expense is a major cause of household impoverishment anddebt.

• Medicinal substances are classified according to their main therapeutic use on the basic principle of only one ATC code for each medicinal product (as defined by route of administration and in some cases strength).
• At the same time, antimicrobial resistance is challenging the effectiveness of many commonly used medicines in one of the most concerning threats to global health today.
• Drug dependence treatment and care in the Republic of Serbia

WHO updates guidelines on opioid dependence treatment and overdose prevention

The new framework proposes a unified approach to prevent the emergence and spread of resistance and reduce its impact through integrated, people-centred strategies. Without urgent, coordinated action, it could lead to increased new infections and treatment failures and higher preventable morbidity and mortality, and undermine global elimination goals. Drug resistance is a major challenge to prevention and treatment efforts. Such drugs are usually only given one code and this may be a problem for users in countries where other uses are predominant. Substandard and falsified medical products This second review of the world medicines situation (first published in 1988 as The WorldDrug Situation) presents the available evidence on global production,…

Medicinal products containing two or more active ingredients are regarded as combinations in the ATC classification system and given different ATC codes from the product with a single component (one active ingredient). This will often give several classification alternatives and the main indication is decided by the WHO International Working Group for Drug Statistics Methodology on the basis of available literature and a qualified assumption of the most prevalent indication worldwide. The challenge occurs when a medicinal product (same strength and route of administration) is approved and used for two or more equally important indications, and the main therapeutic use differs from one country to another.

Poster: We urgently need more effective medicines

In resolution S-30/1, the General Assembly adopted the outcome document of the special session on the world drug problem entitled “Our joint commitment to effectively addressing and countering the world drug problem”. Target 3.5 of UN Sustainable Development Goal 3 sets out a commitment by governments to strengthen the prevention and treatment of substance abuse. Since its creation, WHO has played an important role within the UN system in addressing the world drug problem.

Despite this transition, investment in R&D and other prevention and control strategies for CRPA remains important, given its significant burden in some regions. The fact that third-generation cephalosporin-resistant Enterobacterales are listed as a standalone item within the critical priority category emphasizes their burden and need for targeted interventions, especially in low- and middle-income countries. Changes between the 2017 and 2024 lists “Antimicrobial resistance jeopardizes our ability to effectively treat high burden infections, such as tuberculosis, leading to severe illness and increased mortality rates,” said Dr Jérôme Salomon, WHO’s Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases. These pathogens require increased attention, especially in vulnerable populations including paediatric and elderly populations, particularly in resource-limited settings. Medium priority pathogens include Group A and B Streptococci (both new to the 2024 list), Streptococcus pneumoniae, and Haemophilus influenzae, which present a high disease burden.

• Since its creation, WHO has played an important role within the UN system in addressing the world drug problem.
• Digital version of Essential Medicines list  (eEML) launched
• Psychoactive drugs are substances that, when taken in or administered into one’s system, affect mental processes, e.g. perception, consciousness, cognition or mood and emotions.
• Meeting of technical experts on public health responses to cannabis use

Publications

High priority pathogens, such as Salmonella and Shigella, are of particularly high burden in low- and middle-income countries, along with Pseudomonas aeruginosa and Staphylococcus aureus, which pose significant challenges in healthcare settings. The Framework builds on WHO’s Global health sector strategies and aligns with the Sustainable Development Goals and the Global Action Plan on Antimicrobial Resistance. “Drug resistance threatens decades of progress in HIV, hepatitis and STI control. It emphasizes antimicrobial stewardship, stronger surveillance systems, and equitable access to high-quality prevention, diagnosis and treatment services for HIV, hepatitis B and C and STIs.

Although it was not designed as a global standard, the listnow acts as a guide for the procurement and supply of medicines at the nationaland local level. Universal health coverage can only be achieved when thereis affordable access to safe, effective and quality medicines and healthproducts. Equal access and the reliable supply of medicines is anongoing goal of WHO and global health delivery systems, the achievement ofwhich is hampered by several factors. Working to increase access to essentialpharmaceuticals while limiting the spread of falsified products is at the heart of WHO’s global strategy on medicines.