The UN Office on Drugs and Crime on 26th June published a report which says, inter alia, that the non-medical use of prescription drugs is becoming a major threat to public health and law enforcement worldwide with opioids causing the most harm and accounting for 76% of deaths where drug use disorders were implicated. Fentanyl and its analogues remain a problem in North America, while tramadol – an opioid used to treat moderate and moderate-to-severe pain – has become a growing concern in parts of Africa and Asia. Accessibility of fentanyl and tramadol for medical use is vital for treating pain, but traffickers manufacture them illicitly and promote them in illegal markets causing considerable harm to health. The 2018 World Drug Report provides a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine-type stimulants and new psychoactive substances (NPS), as well as their impact on health. It highlights the different drug use patterns and vulnerabilities of particular age and gender groups and highlights the shift in the global drug market.