Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: A Global Burden of Disease Study
Author Identifier (ORCID)
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.
Keywords
drug use disorders, opioid use disorder, cannabis use disorder, Global Burden of Disease, disability-adjusted life years, epidemiology
Document Type
Journal Article
Date of Publication
2-1-2026
E-ISSN
1546170X
ISSN
10788956
Volume
32
Issue
2
PubMed ID
41545593
Publication Title
Nature Medicine
Publisher
Nature
School
School of Engineering
Funding Information
This study was funded by the Gates Foundation, the Australian National Health and Medical Research Council and the Queensland Department of Health, Australia. This paper was developed as part of the GBD Collaborator Network and GBD Protocol with support from the GBD Secretariat, IHME and the GBD Collaborator Network under the IHME ID: 4251 (GBD 2023 Substance Use Collaborators). This work was supported by the Yonsei Fellowship, funded by Lee Youn Jae (to J.I.S.). This research was supported by the Ministry of Science and ICT (grant nos. RS-2024-00509257 and IITP-2024-RS-2024-00438239 to D.K.Y.) and the Ministry of Health & Welfare (grant no. RS-2025-02220492 to D.K.Y.), South Korea.
Copyright
subscription content
First Page
527
Last Page
544
Recommended Citation
Kang, J., Kim, H. J., Kim, M. S., GBD 2023 Substance Use Collaborators, Shin, J. I., & Yon, D. K. (2026). Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: A Global Burden of Disease Study. Nature Medicine, 32, 527–544. https://doi.org/10.1038/s41591-025-04137-0