Original Article

Global and Cross-Country Inequalities in the Fatal and Non-Fatal Burden Attributable to Drug Use Disorders and Subtypes: Findings from the Global Burden of Disease Study 2021

Abstract

Background: Drug use disorders (DUDs) pose a serious public health threat, exacerbating the worldwide disease burden and resulting in a dramatic rise in fatalities. We aimed to explore the global and cross-country disparities in the fatal and non-fatal burden attributable to DUDs and subtypes by sex and age groups from 1990 to 2021.
Methods: The Global Burden of Disease (GBD) 2021 data were analyzed to estimate the fatal [i.e. mortality and years of life lost (YLL)], non-fatal [i.e. disability-adjusted life years (DALYs), years lived with disability (YLD)] burden, trend attributable to DUDs, subtypes by sex and age groups using the joinpoint regression model across India, China, as well as world between 1990 and 2021.  
Results: Between 1990 and 2021, the age-standardized fatal and non-fatal rates attributable to DUDs significantly increased in India and the world, whereas substantially declined in China. China experienced a 2-fold higher age-standardized DALYs and YLDs rate in 2021, and India observed the fastest (2-fold) upward trend in the age-standardized mortality and YLLs rate attributable to amphetamine use disorders than the world. The trend in YLD rate attributable to DUDs significantly increased in the young age group <20 years in India. The world experienced a significant increasing trend in the fatal rate attributable to DUDs in the middle age group 20-54 years. Overall, females observed remarkable improvement in the fatal and non-fatal burden attributable to DUDs across India, China and the world.
Conclusion: India and the global population experienced rising age-standardized fatal and non-fatal rates due to DUDs—while China demonstrated progress. The trend varied by DUD subtypes, age group, and gender, with amphetamine use disorders disproportionately affecting India and China and females showing improved outcomes across all regions.

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IssueVol 54 No 7 (2025) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v54i7.19156
Keywords
Drug use disorders Mortality Disability-adjusted life years
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How to Cite
1.
Lei Z, Hui L, Anxiu S. Global and Cross-Country Inequalities in the Fatal and Non-Fatal Burden Attributable to Drug Use Disorders and Subtypes: Findings from the Global Burden of Disease Study 2021. Iran J Public Health. 2025;54(7):1493-1503.