The rising burden of drug use disorders in the Americas, 2000-2021

Drug use disorders - preventable and treatable conditions - are a challenging and growing public health threat in the Region of the Americas. This study aims to provide a comprehensive analysis of the levels and trends of the burden of these disorders across countries in the Americas.

This study analyzed morbidity, mortality and disease burden from drug use disorders, including opioid, cocaine, amphetamine, cannabis and other drug use disorders, across 38 countries in the Americas from 2000 to 2021. Using estimates from the Global Burden of Disease Study in 2021, trends were assessed using the average annual percentage change, estimated through regression analysis.

In 2021, 17.7 million (95% uncertainty interval [UI]: 15.9 to 19.9 million) people in the Americas were living with these disorders, mainly opioid use disorders (42.7%) and cannabis use disorders (31.5%). Drug use disorders accounted for 77 717 deaths (95% UI: 70 414 to 86 270) or 6.9 deaths (95% UI: 6.3 to 7.6) per 100 000 population, which was higher than the global estimates. Rates of age-standardized disability-adjusted life years from drug use disorders increased annually by 4.95%, reaching 695.36 years (95% UI: 583.45 to 807.69) per 100 000 population, higher than the global estimate. The burden of these disorders was consistently higher among male young adults. Regionwide in 2021, 145 515 (95% UI: 132 710 to 159 080) all-cause deaths (1.6%, 95% UI: 1.4 to 1.7% of total deaths) were attributed to drug use, primarily deaths from opioid use disorders, cirrhosis and liver cancer.

Drug use disorders are a major and growing public health challenge in the Americas, driven mainly by opioid use disorders in young adults and the rise in these disorders among women. Urgent, evidence-based responses are needed that target high-risk populations, expand treatment and harm reduction, and strengthen data systems. Tailored strategies informed by national contexts and global frameworks can reduce avoidable deaths and improve population health.