Global, Regional, and National Burdens Attributable to Drug Use Across 204 Countries and Territories Between 1990 and 2021: The Global Burden of Disease Study 2021.

Objectives: Diseases, injuries, and death attributable to drug use are a major global public health problem.

Methods: This was a cross-sectional study that used data from the Global Burden of Diseases (GBD) 2021. Data on years of life lost (YLLs), years lived with disability (YLDs), disability adjusted life years (DALY), and deaths from HIV/AIDS, acute hepatitis B, acute hepatitis C, cirrhosis, liver cancer, drug use disorders, and self-harm attributable to drug use in 204 countries and territories from 1990 to 2021 were retrieved from the GBD 2021.

Results: Globally, drug use accounted for 463.4 thousand deaths, 18.0 million YLLs, 9.6 million YLDs, and 27.7 million DALYs in 2021. Globally, 0.96% of all DALYs (95% uncertainty intervals 0.85% to 1.07%) were attributable to drug use in 2021, and 71.82% of age-standardized rates of DALYs attributed to drug use disorders were due to opioid use disorders. High-income North America (2117.6), Eastern Europe (911.1), and Australasia (559.4) had the highest DALYs attributable to drug use in 2021. Globally there was not a nonsignificant annual trend [estimated annual percentage change (EAPC) 0.16, 95% CI: -0.16 to 0.47] in age-standardised DALYs attributable to drug use from 1990 to 2021; however, there were regional increases during this period, with the largest increases seen in High-income North America (4.83, 4.52 to 5.14), Western sub-Saharan Africa (1.84, -0.79 to 4.55), and Eastern Europe (1.07, 0.21 to 1.93).

Conclusions: Burdens attributable to drug use were high and continued to grow rapidly in some regions, particularly high-income North America.