This 2026 Nature Medicine study presents the most comprehensive analysis to date of global trends in drug use disorders (DUDs)—including amphetamine, cannabis, cocaine, and opioid use disorders—across 204 countries from 1990 to 2023. Using Global Burden of Disease (GBD 2023) data, the authors show a substantial and continued rise in the global burden of DUDs, with disability‑adjusted life years (DALYs) increasing from 169.3 per 100,000 people in 1990 to 212.0 in 2023. Opioid use disorder (OUD) accounted for the highest burden worldwide, nearly doubling over the study period, particularly in high‑income countries such as the United States and Canada. Cannabis use disorder was the most prevalent but contributed the least to the overall burden.
The study highlights strong associations between different DUDs, especially between opioid and amphetamine or cannabis disorders—indicating widespread polydrug use. Countries permitting recreational and medical cannabis use had significantly higher prevalence rates of all DUD categories than countries where cannabis remains illegal.
For FORUT’s ADD Programme, the findings reinforce key concerns: the urgent need for comprehensive, prevention‑oriented drug policies. As the authors noted, a comprehensive strategy, including taxation and regulation of recreational drugs, opioid substitution therapy, distribution of naloxone, needle exchange programs, and regulation of telehealth prescriptions, is essential to mitigate the increasing burden of DUDs.
Recommended citation:
Kang, J., Kim, H. J., Kim, M. S., et al. (2026). Global burden of amphetamine, cannabis, cocaine and opioid use in 204 countries, 1990–2023: A Global Burden of Disease Study. Nature Medicine, 32(2), 527-544. https://doi.org/10.1038/s41591-025-04137-0