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Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: a Global Burden of Disease Study

Journal: Nature Medicine (1078-8956)Year: 2026Volume: Issue:
Heidari M.aHeidari M.a Kim M.S. Zyoud S.H. Zielińska M. Zhu B. Zeariya M.G.M. Zanghi A. Zakham F.Yusuf, Hadiza Yu C. Yonemoto N.Yip, PaulYin, DehuiYesodharan, RenjulalYahaya, Zwanden SuleWilandika, Angga Wickramasinghe N.D. Wang S.Wang, Yuan-Pang Walde M.T. Waheed Y.Vujcic, Isidora S. Vinayak M. Verras G.-I. Vaziri S. Vasankari T.J.Varghese, JoeEynde, Jef Van den Vaithinathan A.G. Ullah A. Ullah S. Udoakang A.J. Tumurkhuu M. Tualeka A.R. Tsermpini E.E.Tsatsakis, AristidisTsai, Alexander C. Tromans S.J. Tran Minh Duc N. Tran T.H. Tovani-Palone M.R.Torrado, MarcoTodorovic, Jovana Tiruye T.Y. Thankappan K.R. Teramoto M. Temsah M.-H. Temsah R.M.H.Tefera, Yonas Getaye Tareke M. Tan K.-K. Tampa M. Tabatabaei S.M. Tabarés-Seisdedos R. Damavandi P.T. Szarpak L. Swain C.K. Suresh V. Suleman M.Subramaniyan, VetriselvanStein, Dan J. Sreeramareddy C.T. Soyiri I.N. Soriano J.B. Soraneh S. Soboka M.Sobia, Farrukh Skryabina A.A.Skryabin, Valentin Yurievich Singh S. Singh H. Singh P. Singh B.Singh, Jasvinder A. Silva L.M.L.R. Silva J.P.Sigfusdottir, Inga Dora Siddig E.E.Shrestha, Roman Shrestha S. Shorofi S.A. Shittu A. Shetty P.H. Shetty P.K. Shetty M.Sheidaei, AliSharma, Vishal Sharma U. Sharma M.Rad, Javad Sharifi Sharifan A. Shamsutdinova A.Shams-Beyranvand, Mehran Sham S.Shakeri, Alireza Shaikh M.A. Shahwan M.J. Shahid S.Shaheen, Amira A. Shafie M.Shabani, MohammadSha’aban, Abubakar Seylani A. Sethi Y.Sendekie, Ashenafi KibretSchwebel, David C. Saylan M. Sawhney M. Satpathy M. Sarode G.S. Sarode S.C. Sarikhani Y. Saqib M.A.N. Santric-Milicevic M.M. Samy A.M. Salum G.A. Salihu D. Saleh M.A.Salami, Afeez Abolarinwa Sajid M.R.Sahoo, Pragyan Monalisa Sahebkar A.Sagar, Rajesh Saeed U. Saeb M.R. Sadeghi M. Saddik B.A. Sabet C.J.de Andrade Ruela, GuilhermeRoy, Shubhanjali Rout H.S. Ross A.G. Root K.T.Rony, Moustaq Karim KhanRohilla, Ravi Roever L. Rhee T.G. Rezaeian M. Rezaei N. Rawaf D.L. Rautalin I. Rauniyar S.K. Rathish D. Rasouli-Saravani A.Rani, Smitha Rancic N. Ramasamy S.K. Ramadan M.Ramadan, Mahmoud Mohammed Rajpoot P.L.Rajabi, Rayan Rahmani A.M. Rahman M. Rahman M.H.U. Rahman M.A. Rahimi-Movaghar A.Rahimibarghani, Sarvenaz Rahim F. Qattea I. Puvvula J. Prates E.J.S.Prabhu, Disha Pourshams A. Poluru R. Plotnikov E.Phillips, Michael R. Philip A.K. Pham H.N. Perna S. Pereira M. Pereira M.O. Pereira G. Peprah P. Peden A.E.Toroudi, Hamidreza Pazoki Pawar S. Patil S. Patel J. Patel S.K. Passera R.Pashaei, AvaPark, Sungchul Parikh R.R. Parekh U. Pardhan S. Papadopoulou P. Pantazopoulos I. Panos G.D. Pandi-Perumal S.R. Pandey A. Katare D.P. Panda S.K. Palma-Alvarez R.F.F. Padubidri J.R. Mahesh Padukudru P.A. Ouyahia A. Osuagwu U.L. Ortiz-Prado E. Orish V.N. Ordak M.Bali, Ahmed Omar Oluwafemi Y.D.D. Oliveira G.M.M. Okeke S.R.Ofakunrin, Akinyemi O. D. Oduro M.S. Odetokun I.A. Obamiro K.O. Oancea B. Nzoputam C.I. Nzoputam O.J. Nri-Ezedi C.A. Noor S.T.A. Nnyanzi L.A. Niranjan V. Nikoobar A. Nguyen P.T. 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Krishnamoorthy Y. Krishnamoorthy V. Krishna V. Krishan K. Laxminarayana S.L.K. Kostev K.Koscik, Michal Koohestani H.R. Kolahi A.-A. Kondlahalli S.K.M. Kisa A. Kim Y.J. Kifle Z.D. Khokhar M. Khatatbeh M.M. Khatatbeh H. Khatab K. Khan A. Khan M.J.Khalid, Asaad Khajuria H. Kayode G.A. Katikireddi S.V. Karimi S.E. Karimi Y. Kapoor N. Kantar R.S. Kanmodi K.K. Kanmiki E.W. Kamath A. Kamarajah S.K.Kalan, Ebbie Kadashetti V. Kabir Z. K V. Jozwiak J.J. Joshua C.E. Joseph N.Moghadam, Mohammad Mehdi JohariJi, Zixiang Jayasinghe R.D.Yengejeh, Reza Jalilzadeh Jaka S. Jairoun A.A. Jain A. Jahrami H. Jacob L. Islam M.R. Islam S.M.S. Irham L.M. Iravanpour F. Inok A. Immurana M. Ikiroma A. Huang J. Hu C. Hostiuc M. Hostiuc S.Hossain, Mohammad Bellal Hezam K.Hedna, Khedidja Hasnain M.S. Hasaballah A.I. Haro J.M. Handanagic S. Hammoud A. Haghmorad D. Haddadi R. Gutiérrez-Murillo R.S. Gupta S. Gupta B. Gupta A.K. Gunturu S. Gudeta M.D. Guan S.-Y. Grada A.Girmay, Alem Abera Gil A.U. Ghalichi L. 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Chattu V.K.Chang, Jung-Chen Chandika R.M. Chakraborty C. Caye A. Castelpietra G. Castaldelli-Maia J.M. Carvalho M. Capodici A.Cao, Chao Camera L.A. Calina D. Barsbay M.Ç. Butt Z.A. Bustanji Y. Burns R.A. Brunoni A.R. Bouaoud S.Borges, Guilherme Boloor A. Boachie M.K.Biswas, Monirujjaman Bintoro B.S. Bhatti G.K. Bhatti J.S. Bhaskar S. Bhagavathula A.S. Beyene K.A. Bermudez A.N.C. Bemanalizadeh M. Behnam B. Bastan M.-M. Bashiri A. Barrow A. Barqawi H.J. Bardhan M.Baran, Mehmet Firat Banach M. Baig A.A. Bai R.Bahreini, Razieh Bagheri N. Baghcheghi N. Azzam A.Y. Ayana L.A.A. Aujayeb A. Atreya A. Athari S.S.Aslam, Muhammad Shahzad Ashraf T. Asghari-Jafarabadi M. Artamonov A.A. Arooj M. Armocida B. Areda D.Ardani, Irfan Araújo A.M. Arabloo J.Anuoluwa, Boluwatife Stephen Anuoluwa I.A. Antony C.M.Antonio, Carl Abelardo T. Anil A. Amusa G.A.Amrollahi-Sharifabadi, Mohammad Amiri S. Al-Zyoud W.A. Alzoubi K.H. Aly H. Al-Worafi Y.M. Al-Wardat M. Alvis-Guzman N. Thaher Y.A. Al-Tammemi A.B. Alshahrani N.Z. Alrousan S.M. Al-Rifai R.H. Alrawashdeh A.Al-Jabi, Samah W. Alif S.M.Ali, Mohammad Daud Ali S.S. Ali L. Ali M.U. Alhalaiqa F.N. Algammal A.M. Aldhaleei W.A. Albashtawy M. Al-Amer R.M.Alajlani, Muaaz M. Akkaif M.A.Ahmed, Mehrunnisha Sharif Ahmed A. Ahmed M.B.Ahmed, HaroonAhmed, Syed Anees Ahmadi A. Ahmad D. Ahmad S. Ahmad A. Agyemang-Duah W. Afzal S. Afzal M.S. Adhikari K. Adeyeoluwa T.E. Adewuyi H.O.Adeleke, Olumide Thomas Addo I.Y. Adane M.M. Abu-Zaid A. Aburuz S. Abu-Gharbieh E. Abubakar B. Jatau A.I. Abtahi D. Aboagye R.G. Abiodun O. Abiodun O.O. Zuñiga R.A.A. Abdoun M.Abdollahi, Mohammad Abdollahi A. Abdelmasseh M. ElHafeez S.A. Abbasian M.Abbas, Nasir Abate Y.H. Abualruz H.Il Shin, JaeShin, Jae Il Yon D.K.
GreenDOI:10.1038/s41591-025-04137-0Language: English

Abstract

Drug use disorders (DUDs) are emerging global public health challenges. Here we investigated the global and regional estimates of the prevalence and burden of DUDs, including amphetamine, cannabis, cocaine and opioid use disorders, from 1990 to 2023 for 204 countries and territories by using the Global Burden of Disease Study 2023. Overall, trends in global age-standardized disability-adjusted life-years of DUDs increased from 169.3 (95% uncertainty interval (95% UI), 134.4–203.9) per 100,000 people in 1990 to 212.0 (95% UI, 179.2–245.6) in 2023. In 2023, both prevalence and burden of DUDs were higher in high-income countries, particularly in the USA. The most prevalent DUDs in 2023 were cannabis use disorder (age-standardized prevalence, 270.8 (95% UI, 201.7–350.0) per 100,000 people) and opioid use disorder (205.9 (95% UI, 178.7–235.0)). Particularly, opioid use disorder showed a nearly twofold increase in prevalence and burden between 1990 and 2023. In 2023, compared with countries where cannabis use was illegal, countries permitting both recreational and medical cannabis use had higher prevalence rates for all types of DUDs. Proactive and effective policies are essential to mitigate the increasing global burden of DUDs. © The Author(s), under exclusive licence to Springer Nature America, Inc. 2026.