The epidemiology of drug use disorders cross-nationally: Findings from the WHO's World Mental Health Surveys.
Journal: The International journal on drug policy
Volume: 71
Issue:
Year of Publication: 2020
Affiliated Institutions:
National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, Australia. Electronic address: l.degenhardt@unsw.edu.au.
National Drug and Alcohol Research Centre (NDARC), UNSW Sydney, Sydney, Australia.
Department of Epidemiology, Services, and Prevention Research (DESPR), National Institute on Drug Abuse (NIDA), National Institute of Health (NIH), Bethesda, MD, USA.
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand.
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia; Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.
Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA.
College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq.
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
Núcleo de Epidemiologia Psiquiátrica - LIM , Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Brazil.
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA.
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium.
School of Psychology, Ulster University, Londonderry, United Kingdom.
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia; School of Public Health, The University of Queensland, QLD, Australia.
Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands; Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.
Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon.
Wroclaw Medical University, Wroclaw, Poland; University of Lower Silesia, Wroclaw, Poland.
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong.
Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris, Paris, France; Universités Paris Descartes-Paris Diderot, Paris, France; Institut National de la Sante et de la Recherche Medicale (INSERM) UMR-S , Paris, France.
Mental Health Services, Ministry of Health, Jerusalem, Israel.
Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria; University College Hospital, Ibadan, Nigeria.
National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Murcia, Spain.
Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia.
Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
National Institute of Mental Health, National Center for Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia.
Directorate Mental Health, National Center of Public Health and Analyses, Sofia, Bulgaria.
Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
Abstract summary
Illicit drug use and associated disease burden are estimated to have increased over the past few decades, but large gaps remain in our knowledge of the extent of use of these drugs, and especially the extent of problem or dependent use, hampering confident cross-national comparisons. The World Mental Health (WMH) Surveys Initiative involves a standardised method for assessing mental and substance use disorders via structured diagnostic interviews in representative community samples of adults. We conducted cross-national comparisons of the prevalence and correlates of drug use disorders (DUDs) in countries of varied economic, social and cultural nature.DSM-IV DUDs were assessed in 27 WMH surveys in 25 countries. Across surveys, the prevalence of lifetime DUD was 3.5%, 0.7% in the past year. Lifetime DUD prevalence increased with country income: 0.9% in low/lower-middle income countries, 2.5% in upper-middle income countries, 4.8% in high-income countries. Significant differences in 12-month prevalence of DUDs were found across country in income groups in the entire cohort, but not when limited to users. DUDs were more common among men than women and younger than older respondents. Among those with a DUD and at least one other mental disorder, onset of the DUD was usually preceded by the 'other' mental disorder.Substantial cross-national differences in DUD prevalence were found, reflecting myriad social, environmental, legal and other influences. Nonetheless, patterns of course and correlates of DUDs were strikingly consistent. These findings provide foundational data on country-level comparisons of DUDs.
Authors & Co-authors:
Degenhardt Louisa L
Bharat Chrianna C
Glantz Meyer D MD
Sampson Nancy A NA
Scott Kate K
Lim Carmen C W CCW
Aguilar-Gaxiola Sergio S
Al-Hamzawi Ali A
Alonso Jordi J
Andrade Laura H LH
Bromet Evelyn J EJ
Bruffaerts Ronny R
Bunting Brendan B
de Girolamo Giovanni G
Gureje Oye O
Haro Josep Maria JM
Harris Meredith G MG
He Yanling Y
de Jonge Peter P
Karam Elie G EG
Karam Georges E GE
Kiejna Andrzej A
Lee Sing S
Lepine Jean-Pierre JP
Levinson Daphna D
Makanjuola Victor V
Medina-Mora Maria Elena ME
Mneimneh Zeina Z
Navarro-Mateu Fernando F
Posada-Villa José J
Stein Dan J DJ
Tachimori Hisateru H
Torres Yolanda Y
Zarkov Zahari Z
Chatterji Somnath S
Kessler Ronald C RC
Study Outcome
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