Frost & Sullivan (Frost & Sullivan, abbreviated as 'Frost & Sullivan') continues to focus on emerging technologies in the research and development of addictive drugs, and has officially released the 'Global and China Addiction Treatment Market research report'.This report is the first multi-dimensional industry analysis of addiction drug treatment, providing the most comprehensive and in-depth analysis in terms of technological development, exploration of addiction mechanisms, and trends in industry development. The report points out that naltrexone long-acting sustained-release implants will become a new direction for addiction treatment, addressing issues such as low efficacy and poor compliance with traditional addiction drugs, and boosting the accelerated development of the addiction treatment market size. Frost & Sullivan looks forward to bringing better treatment options to patients through this innovative drug in the future.
This article delves into the development of the addiction treatment industry, explores addictive behaviors and various mechanisms of addiction, as well as addiction treatment plans that can transform existing treatment protocols and effectively solve patient compliance issues.
Total word count: 3,955, Reading time: 7 minutes
1Addiction behavior: Addiction behavior has become a global issue affecting people's physical and mental health.
Strong drugs, gambling, shopping, and sexual activities can all lead to addictive behaviors. Therefore, addictive behaviors are typically divided into substance addiction and behavioral addiction.
Substance addicts, in order to obtain a certain sense of pleasure or satisfaction or to escape the physical or mental pain caused by substances, continue to use these substances regardless of adverse consequences; behavioral addicts, similarly, in order to obtain or achieve a satisfaction similar to that of substance addiction, compulsively repeat a certain behavior and suffer from physical and psychological adverse consequences.
Clinicians often classify addictive behaviors into substance addiction disorders (including substance dependence, substance misuse, and abuse) and non-substance addiction disorders (also known as impulse control disorders, which refer to psychobehavioral dependence).
01Potential Substance Abuse Populations and Projections
Substance addicts generally suffer from substance dependence or abuse. According to the DSM-5 diagnostic criteria, substance dependence and abuse are combined as a category known as substance use disorders, which include both physical and psychological disorders.
In the absence of a formal diagnosis for addictive behavior, clinicians often use the traditional '3C' classification criteria: 1) Mild to severe craving for addictive behavior; 2) Loss of control over addictive behavior (drug abuse phase); 3) Continuing engagement in addictive behavior despite serious negative consequences (drug dependence phase).
Addictive substances, also known as psychoactive substances, refer to a class of chemicals that can affect the user's emotions, behavior, alter their state of consciousness, and lead to dependence. Common addictive substances include alcohol, tobacco, and drugs. Among them, drugs are a sociological concept referring to substances with strong addictive properties, not for medical use, and prohibited by law. In China, they mainly refer to opioids, cocaine, marijuana, LSD, ketamine, and synthetic drugs.
China lacks large-scale epidemiological surveys on substance addicts. According to diagnostic criteria such as DSM-5 and ICD-10, as well as public information released by the National Chronic Non-communicable Disease Control Center and the SSA (Society for the Study of Addiction), it is believed that populations with severe episodic alcohol use, those with low to high nicotine dependence, and drug users are considered potential substance addicts.
02Analysis of Potential Risk Factors and Related Diseases in Addiction Patients
The report analyzes the potential risk factors for addicted patients. Addiction is a complex disease, and long-term use of certain substances or repetitive behaviors can lead to substance dependence or behavioral dependence. It not only incurs significant health costs and a burden on life but also causes varying degrees of physical and psychological disorders. In addictive behavior, there are many potential risk factors for substance addiction, and the diseases it causes mainly depend on the type of substance used. Different substances cause different types of harm to the human body, including harmful diseases, infectious diseases, acute poisoning, withdrawal syndrome, and psychological disorders, as shown in the following figure:
Analysis of Potential Risk Factors for Substance Abuse
03Analysis of addiction treatment programs
The report takes opioid addiction treatment as an example to analyze the addiction treatment plan, which is a long-term process. Clinicians should confirm the severity of the opioid use disorder in addicts based on the type, dosage, route of use of substances, and previous treatment history for drug addiction, and select the treatment method according to the individual circumstances of the addicts.The addiction treatment process can be divided into three stages: detoxification, rehabilitation, and follow-up care. Among them, the rehabilitation stage is the key phase of the entire addiction treatment, mainly including drug rehabilitation and psycho-behavioral therapy.Drug rehabilitation treatment (also known as antagonist therapy) refers to the use of opioid receptor antagonists to block the effects of opioids, helping addicts completely overcome their addiction and successfully reintegrate into society.
Staging of addiction treatment
2Drug addiction: Long-acting sustained-release implants could become a new direction in drug addiction treatment
Traditional substitution therapies, mainly consisting of methadone and buprenorphine, can effectively reduce the spread of diseases but still have high dependence rates. They provide little help in alleviating physical and psychological dependence, and cannot achieve the goal of eradicating addiction. At the same time, methadone and buprenorphine, as psychoactive substances, still have significant side effects on the human body and have insurmountable clinical deficiencies. Naltrexone, as an antagonist drug, prevents the binding of opioid substances to opioid receptors in the brain, disrupting the latent dependent memories that patients have formed, and ultimately helping them overcome their mental dependence on drugs. Due to poor compliance with oral naltrexone medication, long-acting sustained-release implants of naltrexone will produce better therapeutic effects.
01Analysis of the Hazards and Losses Caused by Drugs
The use of drugs without medical supervision can pose serious health risks and lead to potential drug use disorders. Drug use disorders, especially those that are untreated, can significantly increase an individual's incidence of illness and mortality risk, thereby causing damage to individuals, families, society, education, career, or other important functional areas.
Drug use disorders are closely linked to reduced personal efficiency, unnatural deaths, increased health support needs, waste of social order management resources, decreased social welfare, and other social harms. According to the World Drug Report 2022 released by the World Health Organization, the report finds that the social losses caused by opioid abuse are the most severe.
02Global and China's Drug Use Population Size and Projections
Among the global population aged 15-64, about 1 in every 18 people has used drugs within the past 12 months.
According to the type of drug, cannabis use increased significantly in 2021, remaining the most commonly used drug globally in terms of both users and frequency. At the same time, the use of amphetamine-type drugs rose in 2021. The number of opioid users and their frequency remained stable. Drugs such as cocaine and ecstasy showed a different downward trend compared to previous years, possibly due to public place closures and quarantine policies caused by the pandemic.
Overall, the prevalence of drugs and the number of drug users globally increased in 2021 compared to 2020. The trend in global drug use from 2017 to 2021 showed a U-shape, growing from 271 million to 297 million people, with an annual compound growth rate of about 2.28%. In the future, global drug use is expected to show a stable growth trend. It is estimated that the global number of drug users will reach 332 million in 2026, with an annual compound growth rate of about 2.26% during this period.
03Analysis of Drug Addiction Mechanisms
Almost all drugs directly or indirectly increase the dopamine level between ventral tegmental synapses. The addictive substances in drugs increase the impulses of dopamine neurons in the ventral tegmental area of the midbrain, leading to increased dopamine release in the ventral tegmental nucleus and other regions of the brain, forming a reward circuit. While completing the reward process, the brain associates drug stimulation information with the euphoria produced by dopamine and matches it with stored memories, thus forming an 'addiction memory'.
After drug withdrawal, dependence memory is still in a latent stage. When re-exposed to the drug environment, dependence memory is reactivated, which is the direct cause of relapse. The nucleus accumbens, as an important hub in the process of dependence formation, plays two roles: on one hand, it forms dependence memory through changes in synaptic plasticity, and on the other hand, it reinforces dependence memory through the reward mechanism.
The report takes opioid drugs as an example to analyze the drug addiction mechanism.Opioid substances have the highest affinity for μ-opioid receptors on neurons in the ventral tegmental area of the midbrain after entering the human body. Opioid receptors prevent the release of γ-aminobutyric acid (GABA) from neurons through four pathways of response. GABA inhibits the release of dopamine from neurons located within the ventral tegmental nucleus, and a decrease in GABA leads to an increase in dopamine levels, thereby activating the reward circuit mechanism.
Opioid addiction mechanism
04Global and China's Opioid Substance Rehabilitation Treatment Potential Market Size
According to the China Drug Situation Report, in 2021, the number of registered opioid users in China was 556,000. According to data released by the National Narcotics Control Commission, the hidden population of opioid abuse in China is about 861,800 people. Considering the affordability of addicts, it is estimated that the potential market size for opioid detoxification treatment in China in 2021 was about 16.763 billion yuan. At the same time, based on the global opioid use figures released by the WHO, as well as addiction rates and voluntary drug rehabilitation rates, it is estimated that the potential market size for global opioid detoxification treatment in 2021 was about 176.654 billion yuan.
Global and China's Opioid Substance Rehabilitation Treatment Potential Market Size
3Alcohol addiction: There is a lack of drugs for treating alcohol addiction in China, and the market demand urgently needs to be met.
At the current stage, China does not have any approved drugs for alcohol dependence treatment. The drug market in this area is still blank, and patients with alcohol dependence can only choose psychotherapy and behavioral therapy. Currently, only two drugs for alcohol dependence treatment have entered the clinical trial phase: Sankyo Pharma's naltrexone implant (under development) and Huaxi United Technology's calcium acatate enteric-coated tablets (Phase I clinical trial, but since entering clinical trials in 2014, there has been no new progress).
01Analysis of the Definition of Alcohol Use Disorder
Alcohol use disorder is a condition characterized by impaired ability to stop or control alcohol consumption. Alcohol use disorders often include risky drinking, alcohol abuse, and alcohol dependence, with alcohol abuse being the precursor to alcohol dependence.
02The scale and prediction of alcohol dependence among the Chinese population
Different from the Western culture of drinking, Chinese wine culture has become a social, political, and artistic phenomenon.The frequency of alcohol consumption among Chinese people shows a trend of increasing first and then decreasing with age. Among current drinkers, excessive drinking, frequent drinking (more than 5 days a week), and binge drinking have reached epidemic levels. As the proportion of the population aged 15 and above in China and the prevalence of alcohol dependence increase year by year, the number of alcohol-dependent individuals in China has grown from 2.865 million in 2017 to 3.581 million in 2021. It is estimated that the number of alcohol-dependent individuals in China will grow at a compound annual growth rate of 6.29% to reach 4.858 million by 2026.
03Analysis of Alcohol Dependence-Related Hazards
The report analyzes the related hazards of alcohol dependence. Alcohol dependence and related issues are among the top global public health problems, ranking second only to cardiovascular disease and malignant tumors. The hazards caused by alcohol dependence can be further divided into physical diseases and mental disorders. The effects of alcohol on the body can be acute or chronic. Acute effects mainly manifest as acute gastritis, vascular hemorrhage, etc., while chronic effects refer to organ damage caused by long-term alcohol consumption exceeding the liver's metabolic capacity, primarily affecting organs such as the brain, heart, liver, pancreas, and digestive tract; mental disorders caused by alcohol include acute alcohol poisoning, alcohol withdrawal symptoms, alcoholic epilepsy, alcoholic hallucinations, and alcohol withdrawal delirium, among others.
04Market Scale and Forecast of Alcohol Dependence Drug Treatment Demand in China
Alcohol-dependent patients have long been seeking effective addiction treatment to overcome the troubles of alcoholism. However, there are currently no approved drugs in China for the treatment of alcohol dependence. Based on the prices and dosages of drugs that have been approved for marketing overseas, such as disulfiram, naltrexone, and calcium acetylcarnitine, the market demand for alcohol-dependent drug treatment in China was about 33.975 billion yuan in 2021, with a compound annual growth rate of 15.07% from 2017 to 2021. Driven by China's large population with alcohol dependence and the unmet clinical needs for addiction treatment, the potential market size for alcohol-dependent drug treatment in China will further grow, expected to reach 68.985 billion yuan by 2026, with a compound annual growth rate of 15.22% from 2021 to 2026.
