Comprehensive epidemiological assessment of global opioid use disorders over the past three decades

Global burden of opioid use disorders (OUD) has risen substantially, posing major socioeconomic challenges. Cross-spatiotemporal disease burden comparison using data sourced from Global Burden of Disease 2021. We comprehensively assessed OUD’s epidemiological burden using multiple metrics and the socio-demographic index (SDI), estimated annual percentage changes (EAPCs), and integrated estimates through Bayesian meta-regression. Disability-adjusted life years (DALYs) of OUD demonstrated a significant upward trend. Specifically, DALYs of OUD increased from 5,415,249 (95%UI: 4,242,001 to 6,437,812) in 1990 to 11,218,519 (95%UI: 9,188,658 to 13,159,551) in 2021. Over these three decades, burden of OUD shifted considerably across regions with different SDI, with the highest burden transitioning from high-middle SDI regions to high SDI regions, where age-standardized DALY rate in 2021 was 587.41 (95%UI: 484.84 to 680.69). While males had a higher overall burden, females bore a disproportionate burden at older ages, and their deaths rose sharply over 30 years, narrowing the gap with males. Global burden of OUD is rising, especially in high-income countries. Despite higher prevalence in males, female mortality has increased over the past three decades. This study provides crucial evidences for policy and resource allocation in high-burden areas and calls for multinational collaboration.