Cannabis Use Disorder Is the Leading Cause of Drug Use Disorder Prevalence Worldwide

Cannabis use disorder leads all five drug use disorder categories in age-standardized prevalence rates globally. Opioid use disorder has the highest disability and mortality rates. The burden of drug use disorders is significantly greater in high-SDI (high-income) areas, with income inequality exacerbating uneven distribution of disability-adjusted life years.

Analysis of Global Burden of Disease (GBD) 2021 data examining incidence, prevalence, mortality, and DALYs for drug use disorders. Decomposition analysis for age, gender, and SDI effects. Health inequality analysis using slope index and concentration index.

Establishing that cannabis use disorder is the most prevalent drug use disorder globally provides important context for legalization debates and healthcare resource allocation.

The concentration of drug use disorder burden in high-income regions challenges the perception that substance use disorders are primarily a developing-world problem. The finding that income inequality worsens the distribution highlights structural determinants of addiction.

GBD estimates rely on available data that varies greatly by country and region. Cannabis use disorder diagnostic criteria have changed over time. Some countries have minimal surveillance data. Cannot distinguish between cannabis use and cannabis use disorder in many settings.