The Thirty-third report presents recommendations from the Expert Committee on Drug Dependence which is responsible for reviewing information on dependence-producing drugs and assessing the need for international control by the UN Commission on Narcotic Drugs. It is important to balance the need for preventing diversion of therapeutic substances with abuse potential against the need to ensure access for therapeutic use. WHO has developed a formal procedure for its review of dependence-producing psychoactive substances which is described in the first part of the report.

This is followed by a critical review of five psychoactive substances (amfepramone, amineptine, buprenorphine, delta-9-tetrahydrocannabinol and tramadol). The report also discusses the substances that were pre-reviewed by the Committee, four of which (ketamine, zopiclone, butorphanol and khat) were recommended for critical review at a future meeting. The final section discusses the problems of the terminology used in reporting abuse-related adverse drug reactions and describes how confusion affects the reporting of adverse effects using as an example the selective serotonin reuptake inhibitors (SSRIs).

WHO Expert Committee on Drug Dependence. Thirtythird report. WHO Technical Report Series, No. 915 (2003). Available from: Marketing and Dissemination, World Health organization, 1211 Geneva 27, Switzerland. e-mail: bookorders@who.int