Worldwide, alcohol and tobacco cause much more death, disability and addiction than illegal drugs, according to a new review.
The review analyzed data from 2015 on global drug use — both overall and in 21 different regions — using data from the World Health Organization, the United Nations Office on Drugs and Crime, and the Institute for Health Metrics and Evaluation, as well as other sources. The researchers examined both the prevalence of drug use as well as the “health burden,” in the form of death and disability tied to drugs.
The researchers found that, worldwide, an estimated 18 percent of people reported “heavy” alcohol use in the last month (heavy use corresponds to more than 60 grams of alcohol, or about four standard drinks, on one occasion). In addition, 15 percent reported daily tobacco smoking, 3.8 percent reported marijuana use in the past year, 0.77 percent reported amphetamine use in the past year, 0.37 percent reported non-medical opioid use in the past year and 0.35 percent reported cocaine use in the past year.
Some of the highest levels of alcohol consumption were in Central, Eastern and Western Europe, where the per-capita consumption was 11 to 12 liters (about 3 gallons) of pure alcohol a year, compared with about 6 liters (1.5 gallons) a year per capita worldwide. These regions also had the highest levels of daily tobacco smoking, with around 21 to 24 percent of those populations reporting daily smoking, according to the review. [Here’s How Much Alcohol Is OK to Drink in 19 Countries]
Regarding addiction, an estimated 63 million people worldwide were dependent on alcohol in 2015, with about 843 cases of alcohol dependence per 100,000 people. For comparison, about 20 million people were dependent on marijuana (260 cases per 100,000 people) and 17 million were dependent on opioids (220 cases per 100,000 people) in 2015.
However, the rates of marijuana and opioid dependence were almost threefold higher in the United States and Canada (a region called “high-income North America” in the report) than in the rest of the world, with an estimated 749 cases of marijuana dependence and 650 cases of opioid dependence per 100,000 people.
Tobacco smoking was tied to the greatest rate of death. For every 100,000 deaths in 2015, 110 were tied to tobacco, while just 33 were related to alcohol and seven to illegal drug use.
The researchers also calculated how many years of life were lost by people who died from drug use, or who were living with disability from drug use (which together were called “disability-adjusted life years,” or DALYs). They found that tobacco smoking cost the human population 171 million DALYs, compared with 85 million DALYs for alcohol and 28 million DALYs for illegal drug use.
“Alcohol use and tobacco smoking are far more prevalent than illicit substance use, globally and in most regions,” the researchers wrote in the May 11 issue of the journal Addiction.
And tobacco smoking accounted for most of the health burden due to drugs, they said. Still, the health toll of illegal drugs may be underestimated because available data on these drugs is limited.
For example, some countries and regions (including Africa, the Caribbean, Latin America and Asia) have little or no data on substance use and its associated health burden, the researchers said.
“Better standardized and rigorous methods for data collection, collation and reporting are needed to assess more accurately” the disease burden from substance use worldwide,” the researchers said.