Global burden of substance use disorders in adolescents and young adults aged 10-24 years from 1990 to 2021.

Substance use disorders (SUDs) among adolescents and young adults aged 10-24 years represent a major global public health challenge, contributing to various medical conditions and significant disease burden. This study analyzed global, regional, and national estimates of the SUD burden within this demographic from 1990 to 2021. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, we analyzed incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of SUDs among population aged 10-24 years. SUDs in GBD 2021 encompass alcohol and drug use disorders. We calculated age-standardized rates (per 100,000 population) for incidence (ASIR), prevalence (ASPR), mortality (ASMR), and DALYs (ASDR). Health inequalities were assessed using the slope index of inequality (SII) and concentration index. Risk factors were also analyzed. Statistical analyses were performed in R (v4.4.1). In 2021, the global ASIR and ASPR of SUDs among population aged 10-24 years were 614.0 (95% CI 467.6-805.0) and 1557.0 (1234.1-1944.6) per 100,000 population. Substance-specific ASPRs in 2021 included alcohol (651.9, 95% CI 439.0-941.7), cannabis (536.8, 343.5-831.8), opioid use disorders (155.0, 120.0-199.7), etc. The global ASMR and ASDR for SUDs were 1.1 (1.0 to 1.2) and 228.9 (172.4-295.3). From 1990 to 2021, ASIR (average annual percent change [AAPC] - 0.70, 95% CI - 0.71 to - 0.69), ASPR (AAPC - 0.71, - 0.72 to - 0.70), and ASDR (AAPC - 0.60, - 0.63 to - 0.56) declined globally, while ASMR increased (AAPC 0.83, 0.52-1.23). During the COVID-19 pandemic (2019-2021), ASIR and ASPR decreased, ASDR remained stable, and ASMR rose. Substantial disparities were observed across regions and countries and territories. Males, older adolescents, and populations in higher socio-demographic index (SDI) regions exhibited disproportionately higher SUD burden. SUDs impose a significant health burden on adolescents and young adults aged 10-24 years, with distinct demographic and geographic inequities. Evidence-based interventions should prioritize male populations, older age groups, and the high-SDI regions. Lower-SDI regions require enhanced monitoring to address evolving epidemiological trends. Urgent implementation of targeted prevention and treatment strategies is critical to mitigate the impact of SUDs in this vulnerable population.