Drug use disorders are a growing public health concern in the Americas, affecting an estimated 17.7 million people and ranking among the top ten risk factors for death and disability in the region, according to a new study published in the Pan American Journal of Public Health.
The analysis, based on 2021 data from the Global Burden of Disease study, found that nearly 78,000 deaths in the Americas were directly linked to drug use disorders—four times higher than the global average. Opioid use was identified as the primary driver, accounting for more than 75% of all related deaths, with young men disproportionately affected. Disability-adjusted life years (DALYs) from drug use disorders nearly tripled between 2000 and 2021, rising at an average rate of almost 5% per year.
“Drug use disorders are preventable and treatable, yet they are taking an increasing toll on families and communities across our Region,” said PAHO Director Dr. Jarbas Barbosa. He emphasized the urgent need for countries to scale up evidence-based prevention, treatment, and harm reduction services, especially for young people and high-risk populations.
The study highlights regional differences in drug use patterns. In North America, opioid-related disorders—including those linked to potent synthetic opioids such as fentanyl—and amphetamine use have surged. In the Caribbean, Central America, and South America, cannabis and cocaine remain the leading contributors to drug-related health burdens.
Researchers estimate that drug use contributed to 145,515 deaths in 2021 from causes such as opioid overdose, liver cancer, cirrhosis, and suicide. The COVID-19 pandemic appears to have exacerbated these trends, with increases in opioid and amphetamine use linked to crisis-related stress, disrupted health services, and social isolation.
PAHO calls for urgent, integrated action to address the crisis. Recommended measures include expanding access to prevention, treatment, and harm reduction services; integrating substance use care into primary health care and community programs; improving data systems to monitor emerging trends; and adopting gender-responsive strategies, given rising rates among women. Tools such as WHO’s Alcohol Use Disorders Identification Test (AUDIT) and ASSIST screening test are cited as cost-effective methods to reduce harm.
“We must place mental health and substance use care at the center of our health systems,” said Dr. Renato Oliveira E Souza, chief of PAHO’s Mental Health and Substance Use Unit. “Community-based, people-centered services, supported by strong public health leadership, can reverse these trends and save thousands of lives across the Americas.”
