Cannabis Use Disorder Is Now the World's Most Prevalent Drug Use Disorder

In 2023, cannabis use disorder was the most prevalent drug use disorder globally (age-standardized prevalence 270.8 per 100,000), followed by opioid use disorder (205.9). Countries permitting both recreational and medical cannabis had higher prevalence rates for all types of drug use disorders compared to countries where cannabis was illegal.

Analysis of Global Burden of Disease Study 2023 data covering 204 countries and territories from 1990-2023, examining trends in prevalence, disability-adjusted life-years, and burden of amphetamine, cannabis, cocaine, and opioid use disorders.

Published in Nature Medicine, this comprehensive global analysis reveals that cannabis use disorder has become the world's most common drug use disorder, with legalization policies associated with higher rates across all substance categories.

This Nature Medicine study reframes the global drug burden: while opioids dominate harm narratives, cannabis use disorder is actually more prevalent — and the data suggest legalization has unintended consequences across substance categories.

GBD estimates rely on modeling with data quality varying across countries; cross-country comparisons confounded by reporting differences; association between legal status and DUD prevalence doesn't prove causation; diagnostic criteria may vary across cultures.