ORIGINAL RESEARCH article
Front. Public Health
Sec. Substance Use Disorders and Behavioral Addictions
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1655575
Global Trends and Inequalities in the Burden of Drug Use Disorders: A Comprehensive Analysis from 1990 to 2021 with Future Projections
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
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Background: Drug use disorders (DUDs) pose a major global health challenge, with limited comprehensive data across demographic and socioeconomic groups. Methods: Using data from the Global Burden of Disease (GBD)2021, we analyzed disability-adjusted life years (DALYs), deaths, prevalence, and incidence of DUDs from 1990 to 2021, stratified by sex, age, country, and Socio-Demographic Index (SDI). Trends were assessed using Joinpoint regression analysis, while cross-inequalities were evaluated through the Slope Index of Inequality (SII) and Concentration Indxe (CI). Nordpred projected future burden. Results: From 1990 to 2021, DALYs increased by 14.7%. Males and individuals aged 25-29 experienced the highest burden. High-SDI countries recorded the greatest DALYs and deaths. The SII increased from 82.4 in 1990 to 289.24 in 2021, and the CI revealed a disproportionate concentration of DUDs burden in high-SDI countries. Projections suggest that by 2044, DALYs will rise by 12.9 million, mainly due to opioid use disorders. Conclusion: The global burden of DUDs has increased significantly with widening health inequalities across SDI levels. Targeted interventions, particularly addressing the opioid crisis, are essential to manage and mitigate future impacts.
Keywords: drug use disorders, Global burden, opioid epidemic, health inequality, public health intervention
Received: 03 Jul 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Zhou, He, Yang, Wang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xuehan Li, xuehanli@scu.edu.cn
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