According to the results of recently published research which used new statistical methods to analyze public data on the global health burden due to drug addiction, drug-related deaths have increased approximately 2.2-fold between 1990 and 2021, especially in high-income countries, despite a 6% decrease in cases after correcting for population growth. In addition, the study also showed that the public health burden from drugs was greatest in the US, likely due to the combination of opioids and cocaine and worsening social and healthcare services for individuals who use drugs.
The term ‘drug use disorders’ (DUD), also known as drug addiction, refers to the persistent and relapsing consumption of psychoactive substances despite significant harm to the individual. According to the data published by the UN Office on Drugs and Crime, over 250 million people worldwide used illicit drugs at least occasionally in 2021, and approximately 39.5 million people were affected by DUDs.
“We show that, while the number of new and existing cases of DUD changed little overall between 1990 and 2021, the number of drug-related deaths worldwide has more than doubled, and the total health loss has risen,” said Dr Ning Zhang, professor at Jinshan Hospital of Fudan University in Shanghai, and the study’s corresponding author, in an interview with Frontiers.
The study results show that between 1990 and 2021, new cases of DUD rose by 36%, and total cases increased by 34% to 53.1 million globally. After adjusting for population growth, the global prevalence rate slightly declined by 6%. However, drug-related deaths more than doubled, and mortality rates rose by 31%. The overall health burden, measured in disability-adjusted life years (DALYs), increased by 75%, showing that even with stable prevalence, the global impact of DUD has worsened significantly.
“The surge in deaths is mostly due to systemic gaps in harm reduction and access to treatment. It’s not necessarily new drugs, but the combination of potent substances like opioids and cocaine, along with worsening social and healthcare conditions for existing users, which is responsible,” said Dr. Zhang.
Overall, the results of the study show that countries and regions with higher socio-economic status experienced greater incidence and prevalence of DUD, as well as higher numbers of deaths and lost healthy life-years, compared to lower-income regions. In high-income North America, drug-related deaths rose 11.2-fold between 1990 and 2021, reaching 74,451 deaths that year. The United States recorded the highest prevalence, with 3,821.4 cases per 100,000 people in 2021, while Western Europe saw a 7% increase to 1,201.2 cases per 100,000. The authors also noted that there is no indication these trends will improve in the near future.
“If current patterns continue, deaths will likely remain high – or rise further – in high-income settings unless overdose prevention, treatment coverage, and harm-reduction are rapidly scaled up,” added Dr. Zhang. “Some middle-income regions may keep improving, but places with aging populations or economic stress could see worsening harms without targeted action.”