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

Muhammad Suleman Masood Ali Shaikh Jiseung Kang Sa’ed H. Zyoud Chuanhua Yu Naohiro Yonemoto Manish Vinayak Georgios Ioannis Verras Siavash Vaziri Hyeon Jin Kim Min Seo Kim Magdalena Zielińska Bin Zhu Paul Yip Dehui Yin Renjulal Yesodharan Tommi Juhani Vasankari Joe Varghese Jef Van den Eynde Munkhtuya Tumurkhuu Abdul Rohim Tualeka Evangelia Eirini Tsermpini Aristidis Tsatsakis Alexander C. Tsai Samuel Joseph Tromans Atta Ullah Masayuki Teramoto Mohamad Hani Temsah Reem Temsah Yonas Getaye Tefera Minale Tareke Vinay Suresh Vetriselvan Subramaniyan Dan J. Stein Chandrashekhar T. Sreeramareddy Ireneous N. Soyiri Joan B. Soriano Soroush Soraneh Roman Shrestha Sunil Shrestha Pavanchand H. Shetty Premalatha K. ShettyS Seyed Afshin Shorofi Aminu Shittu Ujjawal Sharma Manoj Sharma Javad Sharifi Rad Amin Sharifan Alfiya Shamsutdinova Sunder Sham Anthony Zhong Jingya Zhang Haijun Zhang Mohammed G.M. Zeariya Aurora Zanghì Fathiah Zakham Hadiza Yusuf Zwanden Sule Yahaya Marcos Roberto Tovani-Palone Marco Torrado Jovana Todorovic Tenaw Yimer Tiruye Kavumpurathu Raman Thankappan Ker Kan Tan Baljinder Singh Jasvinder A. Singh Luís Manuel Lopes Rodrigues Silva João Pedro Silva Inga Dora Sigfusdottir Emmanuel Edwar Siddig Mahabalesh Shetty Ali Sheidaei Vishal Sharma Angga Wilandika Asokan Govindaraj Vaithinathan Shu Wang Nuwan Darshana Wickramasinghe Yuan Pang Wang Mandaras Tariku Walde Isidora S. Vujcic Saeed Ullah Aniefiok John Udoakang Thang Huu Tran Nguyen Tran Minh Duc Mircea Tampa Seyyed Mohammad Tabatabaei Rafael Tabarés-Seisdedos Payam Tabaee Damavandi Lukasz Szarpak Chandan Kumar Swain Matiwos Soboka Mehran Shams-Beyranvand Alireza Shakeri Masood Ali Shaikh Y. Waheed Farrukh Sobia Anna Aleksandrovna Skryabina Valentin Yurievich Skryabin Surjit Singh Harmanjit Singh Paramdeep Singh Sa’ed H. Zyoud Asokan Govindaraj Vaithinathan Shu Wang Pavanchand H. Shetty Marco Torrado Premalatha K. ShettyS

Publication Name: Nature Medicine

Publication Date: 2026-02-01

Volume: 32

Issue: 2

Page Range: 527-544

Description:

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.

Open Access: Yes

DOI: 10.1038/s41591-025-04137-0

Authors - 107

Muhammad Suleman

57196800921

Masood Ali Shaikh

56673685600

Jiseung Kang

57216638349

Sa’ed H. Zyoud

60338330400

Chuanhua Yu

57208140344

Naohiro Yonemoto

57204947657

Manish Vinayak

58199948600

Georgios Ioannis Verras

57226630938

Siavash Vaziri

24460825100

Hyeon Jin Kim

58065396200

Min Seo Kim

57203591936

Magdalena Zielińska

58491440100

Bin Zhu

57195958809

Paul Yip

58808132500

Dehui Yin

55881605800

Renjulal Yesodharan

57202021490

Tommi Juhani Vasankari

57200592416

Joe Varghese

57372145200

Jef Van den Eynde

57953280500

Munkhtuya Tumurkhuu

59156725100

Abdul Rohim Tualeka

36447791600

Evangelia Eirini Tsermpini

55967275100

Aristidis Tsatsakis

35596169100

Alexander C. Tsai

35362700200

Samuel Joseph Tromans

56925199300

Atta Ullah

57216146674

Masayuki Teramoto

57222309775

Mohamad Hani Temsah

56115852000

Reem Temsah

57222065893

Yonas Getaye Tefera

56043059700

Minale Tareke

57191823514

Vinay Suresh

58111941200

Vetriselvan Subramaniyan

56721233900

Dan J. Stein

59810528900

Chandrashekhar T. Sreeramareddy

57212263335

Ireneous N. Soyiri

15052406400

Joan B. Soriano

58319978200

Soroush Soraneh

57377347800

Roman Shrestha

60341987200

Sunil Shrestha

56453947500

Pavanchand H. Shetty

60007114400

Premalatha K. ShettyS

60342263700

Seyed Afshin Shorofi

35086976700

Aminu Shittu

16418068900

Ujjawal Sharma

55145355700

Manoj Sharma

55468811500

Javad Sharifi Rad

59951141600

Amin Sharifan

57224116591

Alfiya Shamsutdinova

6507538546

Sunder Sham

58031551200

Anthony Zhong

57886452300

Jingya Zhang

58396283600

Haijun Zhang

57217088114

Mohammed G.M. Zeariya

57269857400

Aurora Zanghì

57189760694

Fathiah Zakham

37064030100

Hadiza Yusuf

57191630259

Zwanden Sule Yahaya

57196374777

Marcos Roberto Tovani-Palone

56644977900

Marco Torrado

60341804400

Jovana Todorovic

7003376825

Tenaw Yimer Tiruye

57194055872

Kavumpurathu Raman Thankappan

57202955435

Ker Kan Tan

16745396700

Baljinder Singh

55769747784

Jasvinder A. Singh

7404421736

Luís Manuel Lopes Rodrigues Silva

11838952800

João Pedro Silva

57204703526

Inga Dora Sigfusdottir

57195363778

Emmanuel Edwar Siddig

55879555400

Mahabalesh Shetty

7005020142

Ali Sheidaei

56071455800

Vishal Sharma

57988338000

Angga Wilandika

57465682500

Asokan Govindaraj Vaithinathan

58547317600

Shu Wang

59877855000

Nuwan Darshana Wickramasinghe

55326938000

Yuan Pang Wang

8576812100

Mandaras Tariku Walde

57851610900

Isidora S. Vujcic

55957120100

Saeed Ullah

57218515071

Aniefiok John Udoakang

57217492763

Thang Huu Tran

58158086500

Nguyen Tran Minh Duc

57199622107

Mircea Tampa

55324899600

Seyyed Mohammad Tabatabaei

55935372700

Rafael Tabarés-Seisdedos

6602981102

Payam Tabaee Damavandi

57218312541

Lukasz Szarpak

55053599400

Chandan Kumar Swain

58956745000

Matiwos Soboka

56588050100

Mehran Shams-Beyranvand

57193608415

Alireza Shakeri

57218867854

Masood Ali Shaikh

57203122601

Y. Waheed

35303643700

Farrukh Sobia

28367950100

Anna Aleksandrovna Skryabina

57218875198

Valentin Yurievich Skryabin

57226830981

Surjit Singh

55740397100

Harmanjit Singh

57215069796

Paramdeep Singh

57202809996

Sa’ed H. Zyoud

58486874500

Asokan Govindaraj Vaithinathan

58309502900

Shu Wang

57216923903

Pavanchand H. Shetty

56366875300

Marco Torrado

55515638000

Premalatha K. ShettyS

13608971500