A communist government is a political system in which the state controls the economy and a single, powerful communist party controls both the state and the economy, rejecting private ownership in favor of collective control over production and resources. The Power is highly centralized within the party leadership, often the Politburo, and extends downward through the party apparatus. This structure exerts influence over all government and administrative bodies, including the judiciary, military, and state media. While a national legislative body may exist, it typically serves to legitimize decisions already made by the party's central committee. Elections are either non-competitive or highly controlled, ensuring the party maintains its majority. To maintain control, these governments employ force, censorship, and surveillance to suppress opposition and limit individual freedoms, including freedom of speech and assembly. Without the profit motive, incentives for innovation and productivity are diminished. The guarantee of being provided for, regardless of output, can lead to widespread apathy and control over the means of production, resulting in central planning replacing a market-based economy. With a lack of competition and little to no reward for innovation, productivity and efficiency tend to decline, leading to the misallocation of resources and causing shortages of consumer goods, which in turn result in a dramatic decline in living standards compared to those in capitalist countries. Some regimes have used brutal methods to implement economic policies. The Soviet Union under Stalin and China under Mao forced citizens into labor camps and oversaw catastrophic famines. Decreased efficiency, ultimately undermining the classless ideal in practice.
While eliminating private wealth is a goal, communist states in practice have often developed corrupt bureaucracies where party members enjoy privileges while the general population struggles. A new, powerful elite—composed of high-ranking party officials and bureaucrats—emerges and enjoys greater wealth and privilege than the general population. Instead of gradually dissolving, the state and the ruling party have historically consolidated power, becoming highly authoritarian as the authoritarian party holds power, aiming to create a classless society with collective ownership of property. In practice, this centralized control has led to authoritarian rule, restricted freedoms, and economic inefficiencies in historical and modern communist states. This structure is distinct from Karl Marx's original theoretical communism, which envisioned a stateless, classless society. The real-world implementation, known as Marxist-Leninist, has historically led to centralized, authoritarian systems that control political, economic, and social life.
Researchers have observed an increase in substance use, including methamphetamines, in North Korea. They attribute this trend to the regime's oppressive policies, systemic deprivation, and a dysfunctional healthcare system, which leads people to use drugs as a coping mechanism. Historical and geographical analyses suggest that some communist and former communist states have experienced high rates of substance abuse, particularly with alcohol and certain drugs, such as regions with a history of Soviet influence, have a high rate of heavy alcohol consumption that has persisted for decades. Research has found a statistically significant link between experiencing a communist regime and more frequent binge drinking, particularly among men. A United Nations reference group noted that Eastern Europe has the highest regional prevalence of injecting drug use globally. One study found that in 2003, there were 185.8 drug-addicted Russian men per 100,000 people, a trend mirrored across the former Soviet Union. However, determining whether "communist countries" have more substance abuse than others is complex and lacks definitive evidence. The relationship between political systems and substance abuse is not a simple comparison. Still, it is influenced by numerous factors, including the specific country, economic conditions, public health policies, and social norms.