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

Publication ,  Journal Article
Kang, J; Kim, HJ; Kim, MS; GBD 2023 Substance Use Collaborators; Shin, JI; Yon, DK
Published in: Nat Med
February 2026

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.

Duke Scholars

Published In

Nat Med

DOI

EISSN

1546-170X

Publication Date

February 2026

Volume

32

Issue

2

Start / End Page

527 / 544

Location

United States

Related Subject Headings

  • Substance-Related Disorders
  • Prevalence
  • Opioid-Related Disorders
  • Marijuana Abuse
  • Male
  • Immunology
  • Humans
  • Global Health
  • Global Burden of Disease
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kang, J., Kim, H. J., Kim, M. S., GBD 2023 Substance Use Collaborators, Shin, J. I., & Yon, D. K. (2026). Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study. Nat Med, 32(2), 527–544. https://doi.org/10.1038/s41591-025-04137-0
Kang, Jiseung, Hyeon Jin Kim, Min Seo Kim, GBD 2023 Substance Use Collaborators, Jae Il Shin, and Dong Keon Yon. “Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study.Nat Med 32, no. 2 (February 2026): 527–44. https://doi.org/10.1038/s41591-025-04137-0.
Kang J, Kim HJ, Kim MS, GBD 2023 Substance Use Collaborators, Shin JI, Yon DK. Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study. Nat Med. 2026 Feb;32(2):527–44.
Kang, Jiseung, et al. “Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study.Nat Med, vol. 32, no. 2, Feb. 2026, pp. 527–44. Pubmed, doi:10.1038/s41591-025-04137-0.
Kang J, Kim HJ, Kim MS, GBD 2023 Substance Use Collaborators, Shin JI, Yon DK. Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990-2023: a Global Burden of Disease Study. Nat Med. 2026 Feb;32(2):527–544.

Published In

Nat Med

DOI

EISSN

1546-170X

Publication Date

February 2026

Volume

32

Issue

2

Start / End Page

527 / 544

Location

United States

Related Subject Headings

  • Substance-Related Disorders
  • Prevalence
  • Opioid-Related Disorders
  • Marijuana Abuse
  • Male
  • Immunology
  • Humans
  • Global Health
  • Global Burden of Disease
  • Female