Abstract
BACKGROUND: Drug use disorders (DUDs) pose a major global health challenge, with limited comprehensive data across demographic and socioeconomic groups. METHODS: Using data from the Global Burden of Disease (GBD) 2021, we analyzed disability-adjusted life years (DALYs), deaths, prevalence, and incidence of DUDs from 1990 to 2021, stratified by sex, age, country, and Socio-Demographic Index (SDI). Trends were assessed using Joinpoint regression analysis, while cross-inequalities were evaluated through the Slope Index of Inequality (SII) and Concentration Index (CI). Nordpred projected future burden. RESULTS: From 1990 to 2021, DALYs increased by 14.7%. Males and individuals aged 25-29 experienced the highest burden. High-SDI countries recorded the greatest DALYs and deaths. The SII increased from 82.4 in 1990 to 289.24 in 2021, and the CI revealed a disproportionate concentration of DUDs burden in high-SDI countries. Projections suggest that by 2044, DALYs will rise by 12.9 million, mainly due to opioid use disorders. CONCLUSION: The global burden of DUDs has increased significantly with widening health inequalities across SDI levels. Targeted interventions, particularly addressing the opioid crisis, are essential to manage and mitigate future impacts.