Cannabis Is the Second Leading Drug Use Disorder in the Americas, Affecting 5.6 Million People

Cannabis use disorders accounted for 31.5% of all drug use disorders in the Americas in 2021, second only to opioids, with the overall burden of drug disorders rising nearly 5% annually.

Martinez, Ramon et al.·Revista panamericana de salud publica = Pan American journal of public health·2025·Strong EvidenceRetrospective Cohort
RTHC-07068Retrospective CohortStrong Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

In 2021, 17.7 million people in the Americas had drug use disorders, with opioids (42.7%) and cannabis (31.5%) dominating. Drug use disorder deaths reached 77,717 (6.9 per 100,000), higher than global estimates. Age-standardized DALYs increased 4.95% annually, reaching 695 per 100,000. The burden was highest among young adult males.

Key Numbers

17.7 million with drug use disorders (2021). Cannabis: 31.5% (~5.6 million). Opioids: 42.7%. Deaths: 77,717 (6.9/100,000). DALYs: 695/100,000, rising 4.95% annually. 145,515 all-cause deaths attributed to drug use (1.6% of total deaths).

How They Did This

Analysis of Global Burden of Disease Study 2021 estimates across 38 countries in the Americas from 2000 to 2021. Examined morbidity, mortality, and DALYs from opioid, cocaine, amphetamine, cannabis, and other drug use disorders. Trends assessed using average annual percentage change via regression analysis.

Why This Research Matters

Cannabis use disorders affect an estimated 5.6 million people across the Americas (31.5% of 17.7 million). As cannabis legalization expands, understanding the scale of cannabis-specific disorder burden is essential for allocating treatment resources.

The Bigger Picture

The Americas bear a disproportionate share of the global drug use disorder burden. While opioids drive the most deaths, cannabis disorders affect the second-largest population and may be growing as legal access expands.

What This Study Doesn't Tell Us

Global Burden of Disease estimates rely on modeling with inherent uncertainty. Cannabis use disorder diagnosis varies across countries. The study period (2000-2021) includes major policy changes in several countries that may affect reporting and diagnosis rates.

Questions This Raises

  • ?Is the rising cannabis disorder burden driven by increased use, increased diagnosis, or both?
  • ?How do cannabis disorder trends differ between countries with and without legal cannabis?

Trust & Context

Key Stat:
5.6 million people with cannabis use disorders in the Americas
Evidence Grade:
Global Burden of Disease estimates covering 38 countries over 21 years. Strong population-level evidence with inherent modeling uncertainty.
Study Age:
Published in 2025 with data through 2021.
Original Title:
The rising burden of drug use disorders in the Americas, 2000-2021.
Published In:
Revista panamericana de salud publica = Pan American journal of public health, 49, e132 (2025)
Database ID:
RTHC-07068

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

What is a cannabis use disorder?

A clinical diagnosis characterized by problematic cannabis use leading to significant impairment, including inability to cut down, use in dangerous situations, tolerance, withdrawal, and interference with daily responsibilities.

Why are the Americas hit harder than the global average?

Higher rates of drug use, greater availability of potent substances, and opioid epidemic-specific factors in North America contribute to the region having higher drug disorder rates and deaths than the global average.

Read More on RethinkTHC

Cite This Study

RTHC-07068·https://rethinkthc.com/research/RTHC-07068

APA

Martinez, Ramon; Zapata, Mario A; Tausch, Amy; Lange, Shannon; Russell, Cayley; Hennis, Anselm; E Souza, Renato Oliveira. (2025). The rising burden of drug use disorders in the Americas, 2000-2021.. Revista panamericana de salud publica = Pan American journal of public health, 49, e132. https://doi.org/10.26633/RPSP.2025.132

MLA

Martinez, Ramon, et al. "The rising burden of drug use disorders in the Americas, 2000-2021.." Revista panamericana de salud publica = Pan American journal of public health, 2025. https://doi.org/10.26633/RPSP.2025.132

RethinkTHC

RethinkTHC Research Database. "The rising burden of drug use disorders in the Americas, 200..." RTHC-07068. Retrieved from https://rethinkthc.com/research/martinez-2025-the-rising-burden-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.