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.
Quick Facts
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)
- Authors:
- Martinez, Ramon, Zapata, Mario A, Tausch, Amy, Lange, Shannon, Russell, Cayley, Hennis, Anselm, E Souza, Renato Oliveira
- Database ID:
- RTHC-07068
Evidence Hierarchy
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.
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Cite This Study
https://rethinkthc.com/research/RTHC-07068APA
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.