Facts and Figures

The bare facts

• 76.3 million persons with alcohol use disorders worldwide.
• At least 15.3 million persons who have drug use disorders.
• Injecting drug use reported in 136 countries, of which 93 report HIV infection among this population.
• For every dollar invested in drug treatment, 7 dollars are saved in health and social costs.

The global burden

Psychoactive substance use poses a significant threat to the health, social and economic fabric of families, communities and nations. The extent of worldwide psychoactive substance use is estimated at 2 billion alcohol users, 1.3 billion smokers and 185 million drug users.

Disability Adjusted Life Years (DALY) are calculated by adding the years of life lost due to premature mortality and the years of life lost due to living with disability. The years of life lost due to disability are determined from morbidity, where each disease has been given a certain disability weight, which is multiplied with the time spent with that disease, to arrive at the years of life lost due to disability.

In an initial estimate of factors responsible for the global burden of disease, tobacco, alcohol and illicit drugs contributed together 12.4% of all deaths worldwide in the year 2000. Looking at the percentage of total years of life lost due to these substances, it has been estimated that they account for 8.9%.

The disease burden in Disability Adjusted Life Years (DALYs) is significantly higher in Europe and the Western Pacific than in Africa and the Eastern Mediterranean. Also the share of the burden for the different substances varies, tobacco is the largest burden in Europe and South-East Asia while alcohol poses the largest burden in Africa, the Americas, and Western Pacific.

The level of economic development in countries also plays an important role. The burden from psychoactive substance use is higher in the developed countries than especially in the high mortality developing countries. The sex ratio for the attributable deaths of psychoactive substance use varies from 80% male for tobacco and illicit drug use and 90% for alcohol. With regard to DALYs it is between 77 and 85% for all substances. The largest proportion of DALYs is on males in the developed countries, where psychoactive substance use accounts for 33.4% of all DALYs.

One of the differences between these three categories of psychoactive substances is the fact that they inflict their disease burden on different age groups. Illicit drug use inflicts its mortality burden earliest in life, alcohol also mainly (65%) before the age of 60, while 70% of the tobacco deaths occur after the age of 60.