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. 2025 Jun 13:34:e32.
doi: 10.1017/S2045796025100085.

Global, regional, and national trends and burden of opioid use disorder in individuals aged 15 years and above: 1990 to 2021 and projections to 2040

Shuailei Wang  1 , Yumiao He  1 , Yuguang Huang  1
Affiliations

Global, regional, and national trends and burden of opioid use disorder in individuals aged 15 years and above: 1990 to 2021 and projections to 2040

Shuailei Wang et al. Epidemiol Psychiatr Sci. .

Abstract

Aim: Opioid use disorder (OUD) is a medical condition associated with problematic opioid use, leading to addiction and severe life impairments. This research delivers an in-depth evaluation of OUD burden and trends at global, regional and national levels.

Methods: This study analysed the global burden of OUD from 1990 to 2021 using data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study. Key metrics included age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs), disaggregated by gender, age, region, country and socio-demographic index (SDI) quintiles. The average annual percentage change described trends, while the age-period-cohort model evaluated age, period and cohort effects. A Bayesian Age-period-cohort model predicted future OUD trends from 2022 to 2040.

Results: In 2021, the global burden of OUD remained substantial, with a total of 16,164,876 cases and a prevalence of 154.59 cases per 100,000 population (95% uncertainty interval [UI]: 131.06-181.26). In 2021, the global incidence of OUD reached 1,942,525 cases (95% UI: 1,643,342-2,328,363), and its global mortality reached 99,555 deaths (95% UI: 92,948-108,050), with DALYs amounting to 11,218,519 (95% UI: 9,188,658-13,159,551). Regionally, high SDI regions, particularly in the High-income North America, exhibited the greatest burden. Among countries, the United States faced the most severe burden and increase, with the highest prevalence (2014.62 per 100,000), incidence (151.84 per 100,000), mortality (15.37 per 100,000) and DALYs (1594.63 per 100,000), and all APPC values exceeding 5%. Males aged 20-39 years were the most affected demographic. However, forecasts indicate that the OUD burden among females will significantly increase over the next 20 years, with the prevalence and incidence expected to rise by 39% and 49%, respectively.

Conclusions: The global burden of OUD has statistically significantly increased from 1990 to 2021. There are marked disparities across regions, countries and SDI levels. High-SDI regions, particularly High-income North America, bear the heaviest burden, with young males (aged 20-39 years) being the most affected groups. However, caution should be exercised regarding the female population, as the number of affected individuals is rapidly increasing.

Keywords: disability-adjusted life years; epidemiology; global burden of disease; opioid use disorder; prevalence.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Burden of opioid use disorder for age-standardized prevalence, incidence, mortality and disability-adjusted life years from 1990 to 2021.
Figure 2.
Figure 2.
Prevalent cases and crude prevalence (a), deaths cases and crude mortality (b) of opioid use disorder by sex and SDI regions in 1990 and 2021. SDI, socio-demographic index.
Figure 3.
Figure 3.
Global maps of opioid use disorder prevalence (a) and disability-adjusted life years (b) rates across all ages in 2021.
Figure 4.
Figure 4.
Global trends of age-specific, period-based and cohort-based effects on opioid use disorder prevalence (a, c, e) and DALYs (b, d, f). DALYs, disability-adjusted life years.
Figure 5.
Figure 5.
Future forecasts of global opioid use disorder burden for age-standardized prevalence, incidence, mortality and disability-adjusted life years.
See this image and copyright information in PMC

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