Zhu David T, Kwon Ye In Christopher, Lai Alan, Park Andrew Min-Gi, Barnes Andrew J, Chapman Derek A
Medical Scientist Training Program, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States.
Department of Health Policy, School of Public Health, Virginia Commonwealth University, Richmond, Virginia, United States.
PLoS One. 2025 Aug 21;20(8):e0328276. doi: 10.1371/journal.pone.0328276. eCollection 2025.
Drug use disorders (DUDs) represent a major global health challenge, leading to substantial morbidity and mortality, while also being compounded by social and structural barriers. In this study, we examined global epidemiological trends in DUDs over the past three decades to inform clinical and public health responses. We extracted data on the incidence, deaths, and disability-adjusted life years (DALYs) attributable to DUDs from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study between 1990 and 2021. Age-standardized incidence (ASIR), mortality (ASMR), and DALY rates per 100,000 population were calculated. The analysis focused on four DUDs-opioid, amphetamine, cocaine, and cannabis use disorders-and further stratified rates by sex, Socio-demographic Index (SDI), countries, and world regions. In 2021, there were 13.6 (95% UI, 11.6-15.7) million new cases, 137,278 (95% UI, 129,269-146,181) deaths, and 15.6 (95% UI, 12.8-18.1) million DALYs attributed to DUDs. Between 1990 and 2021, the ASIR decreased by 8.1%, while the ASMR and DALY rates rose by 30.8% and 14.8%, respectively. Opioid use disorder accounted for the highest ASIR (169.4 [95% UI, 145.1-195.0] per 100,000), ASMR (1.7 [95% UI, 1.6-1.8] per 100,000), and age-standardized DALY rate (191.0 [95% UI, 156.1-222.8] per 100,000) in 2021. Sex and geographical variations were notable, with males and world regions like high-income North America, Australasia, and Eastern/Western Europe showing disproportionately higher rates. Overall, these findings highlight rising mortality and morbidity rates despite a modest decline in incidence, underscoring the need for tailored public health interventions, advancing harm reduction programs, and expanding access to treatment.
药物使用障碍（DUDs）是一项重大的全球健康挑战，会导致大量发病和死亡，同时还受到社会和结构障碍的影响。在本研究中，我们考察了过去三十年中DUDs的全球流行病学趋势，以为临床和公共卫生应对措施提供参考。我们从《2021年全球疾病、伤害及风险因素负担研究》中提取了1990年至2021年间归因于DUDs的发病率、死亡人数和伤残调整生命年（DALYs）数据。计算了每10万人口的年龄标准化发病率（ASIR）、死亡率（ASMR）和DALY率。分析聚焦于四种DUDs——阿片类药物、苯丙胺、可卡因和大麻使用障碍——并按性别、社会人口指数（SDI）、国家和世界区域进一步分层计算发病率。2021年，归因于DUDs的新发病例有1360万（95%不确定区间，1160万 - 1570万），死亡137278例（95%不确定区间，129269 - 146181例），DALYs为1560万（95%不确定区间，1280万 - 1810万）。1990年至2021年间，ASIR下降了8.1%，而ASMR和DALY率分别上升了30.8%和14.8%。2021年，阿片类药物使用障碍的ASIR最高（每10万人中169.4例[95%不确定区间，145.1 - 195.0例]），ASMR（每10万人中1.7例[95%不确定区间，1.6 - 1.8例]），年龄标准化DALY率（每10万人中191.0例[95%不确定区间，156.1 - 222.8例]）。性别和地域差异显著，男性以及高收入的北美、澳大拉西亚和东欧/西欧等世界区域的发病率尤其高。总体而言，这些发现凸显了尽管发病率略有下降，但死亡率和发病率仍在上升，强调了需要采取针对性的公共卫生干预措施、推进减少伤害计划以及扩大治疗可及性。
