Substance use and the Sustainable Development Goals: will development bring greater problems?

Purpose: The United Nations has adopted a set of 17 interlocking Sustainable Development Goals (SDGs) for 2015–2030. This commentary discusses how alcohol and other drugs have been dealt with and discussed in the context of the Goals, and issues raised by the relationship and history of how alcohol and other drug use and problems relate to development. Material and methods: A cross-section of discussions of alcohol and drugs in the context of the SDGs is considered, and evidence considered on the relationship and history of alcohol and drug use and problems to development. Results: While alcohol and narcotic drugs are mentioned in the SDG Targets, there has been little consideration of what effects attaining the goals may have on levels of alcohol and other drug consumption and problems. In cross-sectional comparisons, there are higher average levels of consumption of alcohol and controlled drugs in richer societies, and among richer than poorer individuals. But the harm per unit of use tends to be lower for richer individuals, and in richer societies. We consider how these two contrary trends may apply with socioeconomic development, given that development has often brought increases in substance use, and societal responses to limit the harms are often delayed by a generation or more, often resulting in ‘long waves’ of consumption and associated harms. Conclusions: To take alcohol and other drugs coherently into account in the Sustainable Development Goals, along with recognising that they are marketable and sometimes useful products, and thus involved to some extent in economic development, there needs to be action at national and international levels which recognises their double-sided nature—including market controls on commercial products to channel and limit availability and minimise harm.