Regional perspectives: Substance use related problems in Ethiopia.

Ethiopia, with a population exceeding 130 million, presents a complex landscape for understanding substance use disorders. The country's diverse cultural heritage, varying regional practices, and evolving socioeconomic conditions create unique factors of substance use that differ markedly from global trends. Traditional substances like khat and locally brewed alcohols exist alongside emerging threats from cannabis, injecting drug use, and other illicit substances. This paper describes the epidemiology, societal impact, and policy responses to alcohol, tobacco, khat, and other psychoactive substances in Ethiopia. The interplay between economic interests, cultural practices, and public health imperatives creates a complex drug policy environment requiring nuanced, evidence-based approaches that balance harm reduction with sociocultural realities.