The global epidemiology and burden of psychostimulant dependence: findings from the Global Burden of Disease Study 2010.

Abstract

AIMS:

To estimate the global prevalence of cocaine and amphetamine dependence and the burden of disease attributable to these disorders.

METHODS:

An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years (DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010.

RESULTS:

In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million amphetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for amphetamines. There were 37.6 amphetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between amphetamines and cocaine in the geographic distribution of crude DALYs. Over half of amphetamine dependence DALYs were in Asian regions (52%), whereas almost half of cocaine dependence DALYs were in the Americas (44%, with 23% in North America High Income).

CONCLUSION:

Dependence upon psychostimulants is a substantial contributor to global disease burden; the contribution of cocaine and amphetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden.

• Authors: Louisa Degenhardt, Amanda J Baxter, Yong Yi Lee, Wayne Hall, Grant E Sara, Nicole Johns, Abraham Flaxman, Harvey A Whiteford, Theo Vos
• Journal: Drug and alcohol dependence (Drug Alcohol Depend) Vol. 137 Pg. 36-47 (Apr 01 2014) ISSN: 1879-0046 [Electronic] Ireland
• PMID: 24559607 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Central Nervous System Stimulants

Topics

• Adult
• Bayes Theorem
• Central Nervous System Stimulants (adverse effects)
• Cost of Illness
• Female
• Global Health (economics)
• Humans
• Male
• Registries
• Substance-Related Disorders (diagnosis, economics, epidemiology)
• Young Adult