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 Alexander C. Tsai Samuel Joseph Tromans Aristidis Tsatsakis Atta Ullah Masayuki Teramoto Mohamad Hani Temsah Reem Temsah Yonas Getaye Tefera Vinay Suresh Vetriselvan Subramaniyan Dan J. Stein Chandrashekhar T. Sreeramareddy Joan B. Soriano Roman Shrestha Sunil Shrestha Pavanchand H. Shetty Premalatha K. ShettyS Minale Tareke Seyed Afshin Shorofi Soroush Soraneh Amin Sharifan Ujjawal Sharma Manoj Sharma Javad Sharifi Rad Alfiya Shamsutdinova Ireneous N. Soyiri Aminu Shittu Sunder Sham Anthony Zhong Jingya Zhang Haijun Zhang Mohammed G.M. Zeariya Aurora Zanghì Marcos Roberto Tovani-Palone Jovana Todorovic Marco Torrado Tenaw Yimer Tiruye Kavumpurathu Raman Thankappan 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 Nuwan Darshana Wickramasinghe Yuan Pang Wang Mandaras Tariku Walde Isidora S. Vujcic Shu Wang Asokan Govindaraj Vaithinathan Saeed Ullah Nguyen Tran Minh Duc Thang Huu Tran Mircea Tampa Seyyed Mohammad Tabatabaei Rafael Tabarés-Seisdedos Lukasz Szarpak Chandan Kumar Swain Payam Tabaee Damavandi Alireza Shakeri Masood Ali Shaikh Aniefiok John Udoakang Matiwos Soboka Mehran Shams-Beyranvand Y. Waheed Farrukh Sobia Anna Aleksandrovna Skryabina Valentin Yurievich Skryabin Surjit Singh Fathiah Zakham Hadiza Yusuf Zwanden Sule Yahaya Harmanjit Singh Sa’ed H. Zyoud Asokan Govindaraj Vaithinathan Paramdeep Singh Shu Wang Ker Kan Tan Pavanchand H. Shetty Premalatha K. ShettyS Marco Torrado

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

Alexander C. Tsai

35362700200

Samuel Joseph Tromans

56925199300

Aristidis Tsatsakis

35596169100

Atta Ullah

57216146674

Masayuki Teramoto

57222309775

Mohamad Hani Temsah

56115852000

Reem Temsah

57222065893

Yonas Getaye Tefera

56043059700

Vinay Suresh

58111941200

Vetriselvan Subramaniyan

56721233900

Dan J. Stein

59810528900

Chandrashekhar T. Sreeramareddy

57212263335

Joan B. Soriano

58319978200

Roman Shrestha

60341987200

Sunil Shrestha

56453947500

Pavanchand H. Shetty

60007114400

Premalatha K. ShettyS

60342263700

Minale Tareke

57191823514

Seyed Afshin Shorofi

35086976700

Soroush Soraneh

57377347800

Amin Sharifan

57224116591

Ujjawal Sharma

55145355700

Manoj Sharma

55468811500

Javad Sharifi Rad

59951141600

Alfiya Shamsutdinova

6507538546

Ireneous N. Soyiri

15052406400

Aminu Shittu

16418068900

Sunder Sham

58031551200

Anthony Zhong

57886452300

Jingya Zhang

58396283600

Haijun Zhang

57217088114

Mohammed G.M. Zeariya

57269857400

Aurora Zanghì

57189760694

Marcos Roberto Tovani-Palone

56644977900

Jovana Todorovic

7003376825

Marco Torrado

60341804400

Tenaw Yimer Tiruye

57194055872

Kavumpurathu Raman Thankappan

57202955435

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

Nuwan Darshana Wickramasinghe

55326938000

Yuan Pang Wang

8576812100

Mandaras Tariku Walde

57851610900

Isidora S. Vujcic

55957120100

Shu Wang

59877855000

Asokan Govindaraj Vaithinathan

58547317600

Saeed Ullah

57218515071

Nguyen Tran Minh Duc

57199622107

Thang Huu Tran

58158086500

Mircea Tampa

55324899600

Seyyed Mohammad Tabatabaei

55935372700

Rafael Tabarés-Seisdedos

6602981102

Lukasz Szarpak

55053599400

Chandan Kumar Swain

58956745000

Payam Tabaee Damavandi

57218312541

Alireza Shakeri

57218867854

Masood Ali Shaikh

57203122601

Aniefiok John Udoakang

57217492763

Matiwos Soboka

56588050100

Mehran Shams-Beyranvand

57193608415

Y. Waheed

35303643700

Farrukh Sobia

28367950100

Anna Aleksandrovna Skryabina

57218875198

Valentin Yurievich Skryabin

57226830981

Surjit Singh

55740397100

Fathiah Zakham

37064030100

Hadiza Yusuf

57191630259

Zwanden Sule Yahaya

57196374777

Harmanjit Singh

57215069796

Sa’ed H. Zyoud

58486874500

Asokan Govindaraj Vaithinathan

58309502900

Paramdeep Singh

57202809996

Shu Wang

57216923903

Ker Kan Tan

16745396700

Pavanchand H. Shetty

56366875300

Premalatha K. ShettyS

13608971500

Marco Torrado

55515638000