Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 19;24(1):1639.
doi: 10.1186/s12889-024-19142-0.

Burden of drug use disorders in the United States from 1990 to 2021 and its projection until 2035: results from the GBD study

Tongchao Zhang #  1   2 , Lin Sun #  3 , Xiaolin Yin  1   2 , Hui Chen  1   2 , Lejin Yang  4 , Xiaorong Yang  5   6
Affiliations

Burden of drug use disorders in the United States from 1990 to 2021 and its projection until 2035: results from the GBD study

Tongchao Zhang et al. BMC Public Health. .

Abstract

Background: Drug use disorders (DUDs) have emerged as one of the most significant public health crises, exerting a substantial influence on both community health and socio-economic progress. The United States (US) also suffers a heavy burden, it is necessary to figure out the situation from multiple perspectives and take effective measures to deal with it. Therefore, using the data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2021, we evaluated this topic.

Methods: Annual data on DUDs-related burden were collected from the GBD study 2021. We calculated the indicator of estimated annual percentage change (EAPC) to evaluate the changing trend of burden. The Bayesian model for age-period-cohort was introduced to forecast the burden.

Results: In 2021, the number and age-standardized rate of prevalence were particularly prominent, with 12,146.95 thousand and 3821.43 per 100,000, respectively. Higher burden was also observed in males, 15-45 years old populations, and opioid use disorders subtype. From 1990 to 2021, the DUDs-related burden increased in the US and all states, especially in West Virginia; and the national death-related burden with the highest increase (EAPC = 7.96). Other significant inverse associations were seen between EAPC, age-standardized rates, and socio-demographic index (SDI). Moreover, in the next 14 years, the projected DUDs burden remains exigent.

Conclusions: The burden of DUDs in the US is heavy and has been enlarging. This study proposes that greater attention should be paid to the strategies in males, the younger population, opioid use disorders, and low-SDI states implemented by decision-makers to achieve goals such as reducing burden.

Keywords: Death; Disability-adjusted life years; Drug use disorders; Incidence; The United States; Epidemiology; Global Burden of Disease; Prevalence; Projection; Trends.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Age-standardized rates of drug use disorders-related burden in 2021 and the temporal trends from 1990 to 2021 by states in the US. A ASIR in 2021; B EAPC in ASIR from 1990 to 2021; C ASPR in 2021; D EAPC in ASPR from 1990 to 2021; E ASMR in 2021; F EAPC in ASMR from 1990 to 2021; G ASDR in 2021; and H EAPC in ASDR from 1990 to 2021. ASIR: age-standardized incidence rate; ASPR: age-standardized prevalence rate; ASMR: age-standardized mortality rate; ASDR: age-standardized DALYs rate; EAPC: estimated annual percentage change
Fig. 2
Fig. 2
Age-specific numbers and rates of drug use disorders-related burden by sex and subtype in 2021 in the US. A age-specific numbers and rates of incidence; B age-specific numbers and rates of prevalence; C age-specific numbers and rates of deaths; and D age-specific numbers and rates of DALYs. The bar plots represented the numbers; the line plots and their shade represented the rates and their 95%UIs. DALYs: disability-adjusted life years; UI: uncertainty interval
Fig. 3
Fig. 3
The age-specific changing trends in drug use disorders-related burden by sex from 1990 to 2021 in the US and the world. A age-specific EAPCs of incidence rates; B age-specific EAPCs of prevalence rates; C age-specific EAPCs of death rates; and D age-specific EAPCs of DALYs rates. The error bar represented the EAPCs and their 95%CIs. CI: confidential interval; DALYs: disability-adjusted life years; EAPC: estimated annual percentage change
Fig. 4
Fig. 4
The influence factors of the EAPCs of drug use disorders-related burden in the US. A ASIR in 1990 and EAPC in ASIR; B SDI in 2021 and EAPC in ASIR; C ASPR in 1990 and EAPC in ASPR; D SDI in 2021 and EAPC in ASPR; E ASMR in 1990 and EAPC in ASMR; F SDI in 2021 and EAPC in ASMR; G ASDR in 1990 and EAPC in ASDR; H SDI in 2021 and EAPC in ASDR. The circle represented the state, and the size of the circle represented the number. The r or ρ indices and P values were evaluated by Pearson or Spearman rank analysis. The blue line and its shade were fitted by LOESS. ASIR: age-standardized incidence rate; ASPR: age-standardized prevalence rate; ASMR: age-standardized mortality rate; ASDR: age-standardized DALYs rate; EAPC: estimated annual percentage change; SDI: socio-demographic index
Fig. 5
Fig. 5
Changing trend and prediction rate of drug use disorders-related burden from 2022 to 2035 in the US. A ASIR from 1990 to 2035; B ASPR from 1990 to 2035; C ASMR from 1990 to 2035; D ASDR from 1990 to 2035. ASIR: age-standardized incidence rate; ASPR: age-standardized prevalence rate; ASMR: age-standardized mortality rate; ASDR: age-standardized DALYs rate. Shading represented a 1% decrease and increase interval based on the rate of 2021
See this image and copyright information in PMC

References

    1. Shen J, Hua G, Li C, Liu S, Liu L, Jiao J. Prevalence, incidence, deaths, and disability-adjusted life-years of drug use disorders for 204 countries and territories during the past 30 years. Asian J Psychiatr. 2023;86:103677. doi: 10.1016/j.ajp.2023.103677. - DOI - PubMed
    1. Pan Z, Zhang J, Cheng H, Bu Q, Li N, Deng Y, et al. Trends of the incidence of drug use disorders from 1990 to 2017: an analysis based on the Global Burden of Disease 2017 data. Epidemiol Psychiatr Sci. 2020;29:e148. doi: 10.1017/S2045796020000657. - DOI - PMC - PubMed
    1. Lu W, Xu L, Goodwin RD, Muñoz-Laboy M, Sohler N. Widening gaps and disparities in the treatment of adolescent alcohol and drug use disorders. Am J Prev Med. 2023;64(5):704–715. doi: 10.1016/j.amepre.2023.01.036. - DOI - PubMed
    1. Wilcox HC, Conner KR, Caine ED. Association of alcohol and drug use disorders and completed suicide: an empirical review of cohort studies. Drug Alcohol Depend. 2004;76 Suppl:S11–S19. doi: 10.1016/j.drugalcdep.2004.08.003. - DOI - PubMed
    1. Swendsen JD, Merikangas KR. The comorbidity of depression and substance use disorders. Clin Psychol Rev. 2000;20(2):173–189. doi: 10.1016/S0272-7358(99)00026-4. - DOI - PubMed

Publication types