In Cape Verde, substance use is publicly visible but statistically elusive. The gap exposes how limited data, stigma, and informal markets distort the picture.

Some months ago I wanted to investigate substance use in Cape Verde, an African republic consisting of a group of islands. Before starting, I expected a familiar journalistic process: gather relevant data, speak to experts, triangulate lived experience with statistics, and build a careful picture of cause and effect. Instead, I ran into a more fundamental problem. The numbers didn’t seem to align with what I was seeing, and the people who might explain substance use linked to Cape Verdean culture and history were largely unavailable or unwilling to speak.

At night, the signs of substance (ab)use are hard to ignore. Walking through parts of Mindelo after dark, it’s typical to be approached by people asking for coins or a drink. Some seem unsteady, shaking slightly, speaking incoherently, or lingering in the same places night after night. Their preference is often grogue: the strong, locally produced sugarcane rum and one of the cheapest forms of alcohol available.

Yet, as a journalist I know all too well: lived visibility alone does not prove the scale of a national problem, and public presence is not the same as prevalence. That’s why my mind came up with the question that any reporter would ask next: what do the numbers say?

And that’s where the story got complicated.

What the data suggests

When I first pulled figures from the World Bank, the WHO, and Our World in Data, I thought I’d made a mistake. Cape Verde didn’t stand out. Reported rates of alcohol consumption and substance use disorders were moderate compared to global averages.

In 2021, according to Our World In Data, the estimated share of the population with a drug use disorder was 3.7% in the United States, 1.7% in the United Kingdom, and 0.9% in Brazil. In Cape Verde, it was estimated at just 0.3%.

Alcohol consumption data show an even sharper contrast. According to the Our World In Data, which based data on WHO’s Global Health Observatory, Cape Verde recorded an estimated 1.1 liters of pure alcohol per person aged 15 or older per year in 2021. In comparison, consumption was estimated at 37.7 liters in the United States, 11.0 in the United Kingdom, and 4.9 in Brazil. On paper, alcohol consumption in this republic in the Atlantic off the coast of West Africa appears exceptionally low.

A population-based analysis from March 2025, using the 2020 WHO STEPS survey, found that among adults living with hypertension in Cape Verde, about 69% reported lifetime alcohol consumption and nearly 23% of drinkers met criteria for an alcohol use disorder. These figures – based on structured health interviews in a defined subpopulation – contrast with the low per-capita alcohol volumes reported in international development indicators and highlight how different data sources grab different slices of reality.

What these numbers are built on

Most of these figures capture alcohol that enters the formal economy: production, imports, sales, and taxation documented through official channels. A significant part of Cape Verde’s alcohol economy, however, operates outside those systems. Locally produced spirits like grogue are inexpensive, informally distributed, and often consumed without any interaction with regulatory frameworks. From a data perspective, this means consumption can occur without leaving a paper trail. The WHO estimates that globally around 21% of alcohol consumption is unrecorded, with substantially higher shares in lower-income settings.

Mortality data indicate similar limitations. WHO Global Health Estimates, processed by Our World in Data, attribute roughly one death per 100,000 people in Cape Verde in 2020 to alcohol and drug use disorders, compared to 32.9 in the United States, 11 in the United Kingdom, and 4.9 in Brazil. These figures manifest how deaths are classified, not necessarily how harm manifests. Deaths are only attributed to substance use disorders when those conditions are explicitly filed as the underlying cause. The WHO cautions that low reported mortality often reveals gaps in surveillance rather than low harm.

Signals without certainty

The contrast remains striking. On the street, substance use feels visible and persistent. In the data, it comes out muted. That gap is not just confusing; it is structurally revealing.

To get a better grasp of what might be behind the (lack of) data, and of substance use in Cape Verde in general, I contacted historians, psychologists, researchers, and social scientists who have written about Cape Verde’s colonial history, migration patterns, intergenerational trauma, and health outcomes. I told them, for example, that I wanted to understand how substance use might be shaped by long-term social dynamics. Most declined, some didn’t respond. Others expressed discomfort speaking on the topic. For a journalist, this silence matters.

Public concern does surface intermittently. In July 2025, Cape Verde’s Minister of Health, Jorge Figueiredo, reaffirmed that combating alcohol abuse is a political, health, and social priority. Other official references largely date back to 2019, when the United Nations Office on Drugs and Crime (UNODC) reported that drug use in Cape Verde had increased by 30% since 2009, a conclusion based on improved data availability rather than new nationwide surveys. UNODC figures for Cape Verde for most recent years aren’t publicly available.

What can – and cannot – be said

After reading these reports, I let the story simmer for a while, not knowing what to make of it. Journalism 101: a story where the numbers don’t seem to match the hypothesis is simply not a story. But then it came to me: this story isn’t about proving that substance use in Cape Verde is higher than anywhere else, or about discussing cultural causes, nor about drawing direct causal links between alcohol, drugs, and broader health outcomes. Based on existing data, such claims cannot be responsibly made. 

So what can be said? It’s the following: substance use exists in a context where it is poorly measured, unevenly monitored, and socially stigmatized. WHO data from 2024 reveal that cirrhosis of the liver is among the leading causes of death in Cape Verde, particularly among men, while ischaemic heart disease is the leading cause of death overall. Clinical studies present a strong overlap between hypertension and lifetime alcohol use. The WHO identifies alcohol as a major risk factor for cardiovascular disease, liver disease, and stroke. These outcomes are consistent with alcohol-related harm.

However, causality cannot be confirmed when there’s no reliable national data on consumption patterns, frequency, and intensity. The divide between lived experience and official numbers is therefore not proof of exaggeration or denial. It is evidence of absence: of data, sustained research, and transparent public discussion.

That absence has consequences. Without further in-depth and quantitative data, policymakers struggle to design effective interventions, and funding is harder to justify. Without research, communities rely on informal responses and street-level consensus. Substance use becomes widely recognized, but rarely measured, and rarely addressed.

This is why the story matters, because it shows how impossible conclusions currently are, and why that impossibility itself should be treated as a warning sign.