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

GBD 2023 Substance Use Collaborators

doi:10.1038/s41591-025-04137-0

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

GBD 2023 Substance Use Collaborators

Department of Social Sciences

Korea University
Massachusetts General Hospital
Kyung Hee University
Broad Institute
An-Najah National University
Medical University of Warsaw
Southern University of Science and Technology
Harvard University
Xi'an Jiaotong University
Huazhong University of Science and Technology
Johns Hopkins University
Al-Azhar University
University of Hail
University of Catania
Hodeidah University
University of Maiduguri
Wuhan University
University of Toyama
Juntendo University
The University of Hong Kong
Xuzhou Medical University
Manipal Academy of Higher Education
Kaduna State University
Universitas Aisyiyah Bandung
Rajarata University of Sri Lanka
Capital Medical University
Universidade de São Paulo
Haramaya University
National University of Sciences and Technology Pakistan
Széchenyi István University
University of Belgrade
Icahn School of Medicine at Mount Sinai
University of Southampton
University of Edinburgh
Kermanshah University of Medical Sciences
UKK Institute
Tampere University
Jazan University
KU Leuven
University of Bahrain
University of Nizwa
University of Karachi
University of Houston
University of Medical Sciences
Wake Forest University
University of Development
Dalhousie University
University of Crete
University of Leicester
Leicestershire Partnership NHS Trust
ALS Vietnam
University of Medicine and Pharmacy at Ho Chi Minh City
University of Massachusetts Dartmouth
Saveetha Institute of Medical and Technical Sciences (Deemed to be University)
NOVA University Lisbon
Hospital CUF Tejo
University of South Australia
Debre Markos University
Amrita Vishwa Vidyapeetham

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Journal	Nature Medicine
DOIs	https://doi.org/10.1038/s41591-025-04137-0
Publication status	Accepted/In press - 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Access to Document

10.1038/s41591-025-04137-0

Cite this

@article{284f3d4d783b448883bcad8ffd2e9b0f,

title = "Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990{\textendash}2023: a Global Burden of Disease Study",

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{\textendash}203.9) per 100,000 people in 1990 to 212.0 (95\% UI, 179.2{\textendash}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{\textendash}350.0) per 100,000 people) and opioid use disorder (205.9 (95\% UI, 178.7{\textendash}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.",

author = "\{GBD 2023 Substance Use Collaborators\} and Jiseung Kang and Kim, \{Hyeon Jin\} and Kim, \{Min Seo\} and Zyoud, \{Sa{\textquoteright}ed H.\} and Magdalena Zieli{\'n}ska and Bin Zhu and Anthony Zhong and Jingya Zhang and Haijun Zhang and Zeariya, \{Mohammed G.M.\} and Aurora Zangh{\`i} and Fathiah Zakham and Hadiza Yusuf and Chuanhua Yu and Naohiro Yonemoto and Paul Yip and Dehui Yin and Renjulal Yesodharan and Yahaya, \{Zwanden Sule\} and Angga Wilandika and Wickramasinghe, \{Nuwan Darshana\} and Shu Wang and Wang, \{Yuan Pang\} and Walde, \{Mandaras Tariku\} and Yasir Waheed and Vujcic, \{Isidora S.\} and Manish Vinayak and Verras, \{Georgios Ioannis\} and Siavash Vaziri and Vasankari, \{Tommi Juhani\} and Joe Varghese and Eynde, \{Jef Van den\} and Vaithinathan, \{Asokan Govindaraj\} and Atta Ullah and Saeed Ullah and Udoakang, \{Aniefiok John\} and Munkhtuya Tumurkhuu and Tualeka, \{Abdul Rohim\} and Tsermpini, \{Evangelia Eirini\} and Aristidis Tsatsakis and Tsai, \{Alexander C.\} and Tromans, \{Samuel Joseph\} and Duc, \{Nguyen Tran Minh\} and Tran, \{Thang Huu\} and Tovani-Palone, \{Marcos Roberto\} and Marco Torrado and Jovana Todorovic and Tiruye, \{Tenaw Yimer\} and Thankappan, \{Kavumpurathu Raman\} and Nuno Ferreira",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Nature America, Inc. 2026.",

year = "2026",

doi = "10.1038/s41591-025-04137-0",

language = "English",

journal = "Nature Medicine",

issn = "1078-8956",

publisher = "Nature Research",

}

TY - JOUR

T1 - Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023

T2 - a Global Burden of Disease Study

AU - GBD 2023 Substance Use Collaborators

AU - Kang, Jiseung

AU - Kim, Hyeon Jin

AU - Kim, Min Seo

AU - Zyoud, Sa’ed H.

AU - Zielińska, Magdalena

AU - Zhu, Bin

AU - Zhong, Anthony

AU - Zhang, Jingya

AU - Zhang, Haijun

AU - Zeariya, Mohammed G.M.

AU - Zanghì, Aurora

AU - Zakham, Fathiah

AU - Yusuf, Hadiza

AU - Yu, Chuanhua

AU - Yonemoto, Naohiro

AU - Yip, Paul

AU - Yin, Dehui

AU - Yesodharan, Renjulal

AU - Yahaya, Zwanden Sule

AU - Wilandika, Angga

AU - Wickramasinghe, Nuwan Darshana

AU - Wang, Shu

AU - Wang, Yuan Pang

AU - Walde, Mandaras Tariku

AU - Waheed, Yasir

AU - Vujcic, Isidora S.

AU - Vinayak, Manish

AU - Verras, Georgios Ioannis

AU - Vaziri, Siavash

AU - Vasankari, Tommi Juhani

AU - Varghese, Joe

AU - Eynde, Jef Van den

AU - Vaithinathan, Asokan Govindaraj

AU - Ullah, Atta

AU - Ullah, Saeed

AU - Udoakang, Aniefiok John

AU - Tumurkhuu, Munkhtuya

AU - Tualeka, Abdul Rohim

AU - Tsermpini, Evangelia Eirini

AU - Tsatsakis, Aristidis

AU - Tsai, Alexander C.

AU - Tromans, Samuel Joseph

AU - Duc, Nguyen Tran Minh

AU - Tran, Thang Huu

AU - Tovani-Palone, Marcos Roberto

AU - Torrado, Marco

AU - Todorovic, Jovana

AU - Tiruye, Tenaw Yimer

AU - Thankappan, Kavumpurathu Raman

AU - Ferreira, Nuno

PY - 2026

Y1 - 2026

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/105028015563

U2 - 10.1038/s41591-025-04137-0

DO - 10.1038/s41591-025-04137-0

M3 - Article

C2 - 41545593

AN - SCOPUS:105028015563

SN - 1078-8956

JO - Nature Medicine

JF - Nature Medicine

ER -

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

Abstract

UN SDGs

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