Trends and cross-country inequalities of alcohol use disorders: findings from the global burden of disease study 2021

BACKGROUND: Alcohol use disorder (AUD) imposes a significant burden on individuals and society. With globalization, transnational alcohol corporations influence policy enforcement and consumer behavior, hindering cost-effective and evidence-based interventions such as reducing alcohol availability and restricting alcohol advertising, as recommended in the World Health Organization (WHO) Best Buys for the prevention and control of noncommunicable diseases (NCDs).This study utilizes the Global Burden of Disease Study 2021 dataset to examine global and regional disparities, offering key insights into the global trends of AUD and addressing critical research gaps. RESULTS: The global age-standardised prevalence of alcohol use disorders among individuals aged 15 years and older decreased from 1,698 per 100,000 in 1990 to 1,335 per 100,000 in 2021, with an average annual percent change of -0.78%. Similarly, the average annual percent change for mortality and disability-adjusted life years were - 0.82% and - 0.83%, respectively. Importantly, the age-standardised decline in alcohol use disorders was more pronounced in females compared to males (prevalence: -0.82% versus - 0.75%; mortality: -1.22% versus - 0.73%; disability-adjusted life years: -0.95% versus - 0.79%). The age-standardised prevalence of alcohol use disorders may remain higher among males until the year 2040. For the older adult groups aged 55 to 74, there was no statistically significant decline in alcohol use disorders mortality rates (Ps ≥ 0.17). Furthermore, countries characterized by a high sociodemographic index did not exhibit a significant reduction in mortality (average annual percent change: 0.02%). Between 1990 and 2021, high levels of alcohol consumption and experiences of childhood sexual abuse were identified as major risk factors for alcohol use disorders. CONCLUSION: Understanding the trends of AUD in the context of globalization is crucial. Given that certain populations continue to experience persistent alcohol-related issues, protecting these groups from the influence of transnational alcohol corporations through effective policy measures such as strengthening regulations on alcohol advertising targeting older adults, and establishing independent regulatory agencies may be a key strategy for reducing the global health burden of AUD.