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

Jiseung Kang; Hyeon Jin Kim; Min Seo Kim; GBD 2023 Substance Use Collaborators; Jae Il Shin; Hasan Aalruz; Yohannes Habtegiorgis Abate; Nasir Abbas; Mohammadreza Abbasian; Samar Abd ElHafeez; Michael Abdelmasseh; Arash Abdollahi; Mohammad Abdollahi; Meriem Abdoun; Roberto Ariel Abeldaño Zuñiga; Olugbenga Olusola Abiodun; Olumide Abiodun; Richard Gyan Aboagye; Dariush Abtahi; Ibrahim Jatau Abubakar; Bilyaminu Abubakar; Eman Abu-Gharbieh; Salahdein Aburuz; Ahmed Abu-Zaid; Mesafint Molla Adane; Isaac Yeboah Addo; Olumide Thomas Adeleke; Habeeb Omoponle Adewuyi; Temitayo Esther Adeyeoluwa; Kishor Adhikari; Muhammad Sohail Afzal; Saira Afzal; Williams Agyemang-Duah; Aqeel Ahmad; Sajjad Ahmad; Danish Ahmad; Ali Ahmadi; Syed Anees Ahmed; Haroon Ahmed; Muktar Beshir Ahmed; Ayman Ahmed; Mehrunnisha Sharif Ahmed; Mohammed Ahmed Akkaif; Muaaz M. Alajlani; Rasmieh Mustafa Al-Amer; Mohammed Albashtawy; Wafa A. Aldhaleei; Abdelazeem M. Algammal; Fadwa Naji Alhalaiqa; Mohammed Usman Ali; Liaqat Ali; Vikram Niranjan

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

Jiseung Kang
, Hyeon Jin Kim
, Min Seo Kim
, GBD 2023 Substance Use Collaborators
, Jae Il Shin
, Hasan Aalruz
, Yohannes Habtegiorgis Abate
, Nasir Abbas
, Mohammadreza Abbasian
, Samar Abd ElHafeez
, Michael Abdelmasseh
, Arash Abdollahi
, Mohammad Abdollahi
, Meriem Abdoun
, Roberto Ariel Abeldaño Zuñiga
, Olugbenga Olusola Abiodun
, Olumide Abiodun
, Richard Gyan Aboagye
, Dariush Abtahi
, Ibrahim Jatau Abubakar

Bilyaminu Abubakar, Eman Abu-Gharbieh, Salahdein Aburuz, Ahmed Abu-Zaid, Mesafint Molla Adane, Isaac Yeboah Addo, Olumide Thomas Adeleke, Habeeb Omoponle Adewuyi, Temitayo Esther Adeyeoluwa, Kishor Adhikari, Muhammad Sohail Afzal, Saira Afzal, Williams Agyemang-Duah, Aqeel Ahmad, Sajjad Ahmad, Danish Ahmad, Ali Ahmadi, Syed Anees Ahmed, Haroon Ahmed, Muktar Beshir Ahmed, Ayman Ahmed, Mehrunnisha Sharif Ahmed, Mohammed Ahmed Akkaif, Muaaz M. Alajlani, Rasmieh Mustafa Al-Amer, Mohammed Albashtawy, Wafa A. Aldhaleei, Abdelazeem M. Algammal, Fadwa Naji Alhalaiqa, Mohammed Usman Ali, Liaqat Ali, Vikram Niranjan

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	Published - 16 Jan 2026

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Kang, J., Kim, H. J., Kim, M. S., Collaborators, GBD. . S. U., Shin, J. I., Aalruz, H., Abate, Y. H., Abbas, N., Abbasian, M., ElHafeez, S. A., Abdelmasseh, M., Abdollahi, A., Abdollahi, M., Abdoun, M., Zuñiga, R. A. A., Abiodun, O. O., Abiodun, O., Aboagye, R. G., Abtahi, D., ... Niranjan, V. (2026). Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: a Global Burden of Disease Study. Nature Medicine. https://doi.org/10.1038/s41591-025-04137-0

@article{33b936c5e44c47508ee04d23158d3dfb,

title = "Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: 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), 134.4–203.9) 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.",

author = "Jiseung Kang and Kim, \{Hyeon Jin\} and Kim, \{Min Seo\} and Collaborators, \{GBD 2023 Substance Use\} and Shin, \{Jae Il\} and Hasan Aalruz and Abate, \{Yohannes Habtegiorgis\} and Nasir Abbas and Mohammadreza Abbasian and ElHafeez, \{Samar Abd\} and Michael Abdelmasseh and Arash Abdollahi and Mohammad Abdollahi and Meriem Abdoun and Zu{\~n}iga, \{Roberto Ariel Abelda{\~n}o\} and Abiodun, \{Olugbenga Olusola\} and Olumide Abiodun and Aboagye, \{Richard Gyan\} and Dariush Abtahi and Abubakar, \{Ibrahim Jatau\} and Bilyaminu Abubakar and Eman Abu-Gharbieh and Salahdein Aburuz and Ahmed Abu-Zaid and Adane, \{Mesafint Molla\} and Addo, \{Isaac Yeboah\} and Adeleke, \{Olumide Thomas\} and Adewuyi, \{Habeeb Omoponle\} and Adeyeoluwa, \{Temitayo Esther\} and Kishor Adhikari and Afzal, \{Muhammad Sohail\} and Saira Afzal and Williams Agyemang-Duah and Aqeel Ahmad and Sajjad Ahmad and Danish Ahmad and Ali Ahmadi and Ahmed, \{Syed Anees\} and Haroon Ahmed and Ahmed, \{Muktar Beshir\} and Ayman Ahmed and Ahmed, \{Mehrunnisha Sharif\} and Akkaif, \{Mohammed Ahmed\} and Alajlani, \{Muaaz M.\} and Al-Amer, \{Rasmieh Mustafa\} and Mohammed Albashtawy and Aldhaleei, \{Wafa A.\} and Algammal, \{Abdelazeem M.\} and Alhalaiqa, \{Fadwa Naji\} and Ali, \{Mohammed Usman\} and Liaqat Ali and Vikram Niranjan",

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

year = "2026",

month = jan,

day = "16",

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

language = "English",

journal = "Nature Medicine",

issn = "1078-8956",

}

Kang, J, Kim, HJ, Kim, MS, Collaborators, GBDSU, Shin, JI, Aalruz, H, Abate, YH, Abbas, N, Abbasian, M, ElHafeez, SA, Abdelmasseh, M, Abdollahi, A, Abdollahi, M, Abdoun, M, Zuñiga, RAA, Abiodun, OO, Abiodun, O, Aboagye, RG, Abtahi, D, Abubakar, IJ, Abubakar, B, Abu-Gharbieh, E, Aburuz, S, Abu-Zaid, A, Adane, MM, Addo, IY, Adeleke, OT, Adewuyi, HO, Adeyeoluwa, TE, Adhikari, K, Afzal, MS, Afzal, S, Agyemang-Duah, W, Ahmad, A, Ahmad, S, Ahmad, D, Ahmadi, A, Ahmed, SA, Ahmed, H, Ahmed, MB, Ahmed, A, Ahmed, MS, Akkaif, MA, Alajlani, MM, Al-Amer, RM, Albashtawy, M, Aldhaleei, WA, Algammal, AM, Alhalaiqa, FN, Ali, MU, Ali, L & Niranjan, V 2026, 'Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: a Global Burden of Disease Study', Nature Medicine. https://doi.org/10.1038/s41591-025-04137-0

TY - JOUR

T1 - Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: a Global Burden of Disease Study

AU - Kang, Jiseung

AU - Kim, Hyeon Jin

AU - Kim, Min Seo

AU - Collaborators, GBD 2023 Substance Use

AU - Shin, Jae Il

AU - Aalruz, Hasan

AU - Abate, Yohannes Habtegiorgis

AU - Abbas, Nasir

AU - Abbasian, Mohammadreza

AU - ElHafeez, Samar Abd

AU - Abdelmasseh, Michael

AU - Abdollahi, Arash

AU - Abdollahi, Mohammad

AU - Abdoun, Meriem

AU - Zuñiga, Roberto Ariel Abeldaño

AU - Abiodun, Olugbenga Olusola

AU - Abiodun, Olumide

AU - Aboagye, Richard Gyan

AU - Abtahi, Dariush

AU - Abubakar, Ibrahim Jatau

AU - Abubakar, Bilyaminu

AU - Abu-Gharbieh, Eman

AU - Aburuz, Salahdein

AU - Abu-Zaid, Ahmed

AU - Adane, Mesafint Molla

AU - Addo, Isaac Yeboah

AU - Adeleke, Olumide Thomas

AU - Adewuyi, Habeeb Omoponle

AU - Adeyeoluwa, Temitayo Esther

AU - Adhikari, Kishor

AU - Afzal, Muhammad Sohail

AU - Afzal, Saira

AU - Agyemang-Duah, Williams

AU - Ahmad, Aqeel

AU - Ahmad, Sajjad

AU - Ahmad, Danish

AU - Ahmadi, Ali

AU - Ahmed, Syed Anees

AU - Ahmed, Haroon

AU - Ahmed, Muktar Beshir

AU - Ahmed, Ayman

AU - Ahmed, Mehrunnisha Sharif

AU - Akkaif, Mohammed Ahmed

AU - Alajlani, Muaaz M.

AU - Al-Amer, Rasmieh Mustafa

AU - Albashtawy, Mohammed

AU - Aldhaleei, Wafa A.

AU - Algammal, Abdelazeem M.

AU - Alhalaiqa, Fadwa Naji

AU - Ali, Mohammed Usman

AU - Ali, Liaqat

AU - Niranjan, Vikram

PY - 2026/1/16

Y1 - 2026/1/16

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 - http://dx.doi.org/10.1038/s41591-025-04137-0

U2 - 10.1038/s41591-025-04137-0

DO - 10.1038/s41591-025-04137-0

M3 - Article

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

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