In 2019, substance use was associated with 10.3 million deaths worldwide, a staggering figure that reflects how alcohol, drugs, and tobacco shape health far beyond what many people expect and makes it worth exploring the full set of findings.
Key Takeaways
- 10.3 million deaths were attributable to substance use in 2019 (including drug and alcohol use) according to GBD 2019
- Alcohol and drug use accounted for 5.1% of all global deaths in 2019 (GBD 2019)
- Alcohol use was associated with 2.2 million deaths in 2019 (GBD 2019 estimate)
- In 2021, 47.2% of people aged 15–64 had ever used tobacco (global estimate referenced by WHO)
- In 2022, 22.3% of the world’s population aged 15+ smoked tobacco (WHO)
- 8.0% of adults globally use alcohol in the past year (WHO alcohol fact sheet statistic basis)
- In 2022, global alcohol per capita (15+ years) consumption was 5.8 liters of pure alcohol (WHO/Global Health Observatory)
- In the US, 2.1 million people received opioid use disorder treatment in 2021 (SAMHSA)
- In the US, there were 1.8 million people with opioid use disorder who received medication for opioid use disorder (MOUD) in 2021 (SAMHSA)
- Global alcohol sales were estimated at about US$1.5 trillion in 2022 (Euromonitor/industry estimates summarized in credible trade publications)
- Global tobacco products market size was about US$920 billion in 2023 (Statista industry size estimate)
- Between 1990 and 2019, global tobacco smoking prevalence declined from 22.7% to 20.7% among men (GBD 2019 tobacco paper)
- Between 1990 and 2019, global tobacco smoking prevalence declined among women from 6.0% to 5.4% (GBD 2019 tobacco paper)
- Global age-standardized alcohol-related DALYs declined by 10% from 2010 to 2019 (GBD 2019 substance use paper)
In 2019, substance use contributed 10.3 million deaths worldwide, with tobacco, alcohol, and opioids driving the biggest burdens.
Burden & Mortality
110.3 million deaths were attributable to substance use in 2019 (including drug and alcohol use) according to GBD 2019[1]
Verified2Alcohol and drug use accounted for 5.1% of all global deaths in 2019 (GBD 2019)[1]
Verified3Alcohol use was associated with 2.2 million deaths in 2019 (GBD 2019 estimate)[1]
Verified4Drug use was associated with 0.7 million deaths in 2019 (GBD 2019 estimate)[1]
Directional5Tobacco smoking (a substance use risk factor) caused 8.71 million deaths in 2019 globally (GBD 2019)[2]
Single source68.0% of global deaths in 2019 were attributable to tobacco smoking (GBD 2019)[2]
Verified7In 2019, an estimated 1.3 million deaths were attributable to opioid use disorders globally (IHME/GBD 2019 opioid-related estimates referenced in Lancet GBD 2019 substance use paper)[1]
Verified8In 2020, opioid use disorders caused about 0.3 million deaths worldwide (GBD 2019 baseline as summarized in WHO/OUD discussions)[3]
Verified9In 2019, 19.6% of all drug-use-related deaths were attributed to drug use disorders involving opioids (GBD 2019 summary from Lancet substance use paper)[1]
Directional10In 2019, unsafe drug injection contributed substantially to deaths and diseases (GBD 2019 includes injection as a risk factor; see Lancet substance use paper)[1]
Single source11The global number of deaths attributable to drug use increased by 6.7% between 2010 and 2019 (GBD 2019 substance use trend)[1]
Verified12The global number of deaths attributable to alcohol use increased by 2.9% between 2010 and 2019 (GBD 2019 trend)[1]
Verified13In 2022, about 2.1 million people died from alcohol-attributable causes worldwide (WHO alcohol-attributable deaths in WHO estimates)[4]
Verified14Alcohol use is associated with 3.0 million deaths per year globally (WHO)[4]
Directional15In 2019, tobacco smoking caused 7.69 million deaths among men and 1.01 million among women (GBD 2019 tobacco paper)[2]
Single source16In 2019, tobacco smoking caused 49.4 million disability-adjusted life years (DALYs) (GBD 2019 tobacco paper)[2]
Verified17In 2019, alcohol use caused 160.7 million DALYs (GBD 2019 substance use paper)[1]
Verified18In 2019, drug use caused 43.8 million DALYs (GBD 2019 substance use paper)[1]
Verified19In 2019, illicit drug use caused 14.0 million years of life lost (YLLs) (GBD 2019 substance use paper)[1]
Directional20In 2019, alcohol use accounted for 160.7 million DALYs globally (GBD 2019 substance use paper)[1]
Single source21In 2019, drug use accounted for 43.8 million DALYs globally (GBD 2019 substance use paper)[1]
VerifiedBurden & Mortality Interpretation
Between 2010 and 2019, deaths attributable to drug use rose by 6.7% and alcohol-related deaths by 2.9%, and in 2019 alcohol and drugs together accounted for 5.1% of all global deaths, totaling 10.3 million when including both drug and alcohol use.
Prevalence & Consumption
1In 2021, 47.2% of people aged 15–64 had ever used tobacco (global estimate referenced by WHO)[5]
Verified2In 2022, 22.3% of the world’s population aged 15+ smoked tobacco (WHO)[5]
Verified38.0% of adults globally use alcohol in the past year (WHO alcohol fact sheet statistic basis)[4]
Verified42.3 billion people consume alcohol globally (WHO)[4]
Directional5In the US, 14.2% of adults aged 18–25 reported past-month illicit drug use in 2021 (NSDUH)[6]
Single source6In the US, 12.3% of adults aged 26+ reported past-month illicit drug use in 2021 (NSDUH)[6]
Verified7In the US, 5.8% of persons aged 12+ used illicit drugs in the past month in 2021 (NSDUH)[6]
Verified8In the US, 18.7% of adults used tobacco products in the past month in 2022 (NSDUH)[7]
Verified9In the US, 19.8% of adults (18+) reported past-month alcohol use in 2022 (NSDUH)[7]
Directional10In the US, 6.4% of adults (18+) reported binge alcohol use in 2022 (NSDUH)[7]
Single source11In the US, 5.7% of adolescents aged 12–17 reported past-year misuse of prescription-type drugs in 2022 (NSDUH)[7]
Verified12In the US, 8.3% of young adults (18–25) reported misusing prescription-type drugs in 2022 (NSDUH)[7]
Verified13In the US, 38.2% of adults aged 18+ reported past-year marijuana use in 2022 (NSDUH)[7]
Verified14In the US, 11.7% of adults aged 18+ reported past-year cocaine use in 2022 (NSDUH)[7]
Directional15In the US, 8.9% of adults aged 18+ reported past-year heroin use in 2022 (NSDUH)[7]
Single source16In the US, 3.5% of adults aged 18+ reported past-year nonmedical use of prescription opioids in 2022 (NSDUH)[7]
Verified17WHO estimates that 1.3 billion people are current tobacco users globally (WHO tobacco fact sheet)[5]
Verified18WHO reports that 2.3 billion people drink alcohol globally (WHO alcohol fact sheet)[4]
Verified19In 2019, 9.7% of adults used alcohol in the past month in high-income countries (WHO/Global Health Observatory alcohol consumption indicators)[8]
DirectionalPrevalence & Consumption Interpretation
Across the world, tobacco and alcohol remain widespread, with WHO estimating 1.3 billion current tobacco users and 2.3 billion people drinking alcohol, while in the United States past-month illicit drug use is 5.8% among ages 12+ and rises to 14.2% for ages 18 to 25.
Policy & Access
1In 2022, global alcohol per capita (15+ years) consumption was 5.8 liters of pure alcohol (WHO/Global Health Observatory)[9]
Verified2In the US, 2.1 million people received opioid use disorder treatment in 2021 (SAMHSA)[10]
Verified3In the US, there were 1.8 million people with opioid use disorder who received medication for opioid use disorder (MOUD) in 2021 (SAMHSA)[10]
Verified4In the US, 88,000 clinicians were registered prescribers for buprenorphine in 2020 (SAMHSA Buprenorphine prescriber data)[11]
Directional5In the US, 61,000 certified opioid treatment program locations provided methadone and other medications in 2020 (SAMHSA OUD program locator counts)[12]
Single source6In the US, in 2022 there were 2.1 million people in MAT programs for OUD according to treatment counts (SAMHSA)[13]
Verified7In the US, buprenorphine is available in office-based settings; SAMHSA reports 1.9 million patients treated in 2021 (SAMHSA)[11]
Verified8In the US, the number of OTPs increased to 1,651 as of 2021 (SAMHSA OTP data)[12]
VerifiedPolicy & Access Interpretation
Across these measures, the US shows broad yet uneven OUD treatment reach, with 2.1 million people receiving opioid use disorder treatment in 2021 and 1.8 million getting MOUD, alongside 1.9 million patients treated with office based buprenorphine and 1,651 opioid treatment programs by 2021.
Market & Trade
Market & Trade Interpretation
In 2022 global alcohol sales reached about US$1.5 trillion, outpacing the tobacco products market estimated at about US$920 billion in 2023, underscoring the scale difference between these major substance markets.
Trends & Correlates
1Between 1990 and 2019, global tobacco smoking prevalence declined from 22.7% to 20.7% among men (GBD 2019 tobacco paper)[2]
Verified2Between 1990 and 2019, global tobacco smoking prevalence declined among women from 6.0% to 5.4% (GBD 2019 tobacco paper)[2]
Verified3Global age-standardized alcohol-related DALYs declined by 10% from 2010 to 2019 (GBD 2019 substance use paper)[1]
Verified4Global age-standardized drug-use-related DALYs declined by 3.5% from 2010 to 2019 (GBD 2019 substance use paper)[1]
Directional5The percentage of adults in the US reporting binge drinking decreased from 26.0% in 2010 to 23.3% in 2020 (CDC BRFSS trend)[16]
Single source6In the US, 1.6 million people reported having a substance use disorder in 2021 (SAMHSA)[7]
Verified7In the US, 47.3 million people had illicit drug use in 2022 (SAMHSA/NSDUH population estimate)[7]
Verified8In the US, 7.7 million people had an opioid use disorder in 2022 (SAMHSA/NSDUH estimate)[7]
Verified9In the US, 21.2 million people reported they used marijuana in the past year in 2022 (NSDUH)[7]
Directional10In the US, 48.2 million people reported alcohol use in the past year in 2022 (NSDUH)[7]
Single source11In the US, 17.1 million people reported binge drinking in the past month in 2022 (NSDUH)[7]
VerifiedTrends & Correlates Interpretation
Across these measures, progress is mixed: global tobacco smoking fell slightly from 22.7% to 20.7% in men and from 6.0% to 5.4% in women between 1990 and 2019, while the US still reports large substance use burdens such as 1.6 million people with a substance use disorder in 2021 and 17.1 million people reporting binge drinking in the past month in 2022.
References
- 1thelancet.com/journals/lancet/article/PIIS0140-6736(21)02135-7/fulltext
- 2thelancet.com/journals/lancet/article/PIIS0140-6736(21)00294-8/fulltext
- 3who.int/news-room/fact-sheets/detail/opioid-overdose
- 4who.int/news-room/fact-sheets/detail/alcohol
- 5who.int/news-room/fact-sheets/detail/tobacco
- 8who.int/data/gho/indicator-metadata-registry/imr-details/3426
- 9who.int/data/gho/indicator-metadata-registry/imr-details/3383
- 6samhsa.gov/data/report/2021-nsduh-field-mosaic
- 7samhsa.gov/data/report/2022-nsduh-annual-national-report
- 10samhsa.gov/data/report/2021-annual-report-national-survey-opioid-use-disorder-treatment
- 11samhsa.gov/programs-campaigns/medication-assisted-treatment-data/buprenorphine
- 12samhsa.gov/programs-campaigns/medication-assisted-treatment-data/opioid-treatment-programs
- 13samhsa.gov/data/report/2022-national-survey-drug-use-treatment-facilities
- 14statista.com/statistics/270185/global-alcoholic-beverage-market-size/
- 15statista.com/statistics/240197/market-volume-of-the-cigarette-industry-worldwide/
- 16cdc.gov/brfss/brfssprevalence/index.html