Cannabis disorder leads globally as legalization correlates with higher rates

This comprehensive global analysis examined drug use disorders across 204 countries from 1990 to 2023, with cannabis use disorder emerging as the most prevalent substance use disorder worldwide. The study found that the global burden of all drug use disorders increased significantly, with age-standardized disability-adjusted life-years rising from 169.3 per 100,000 people in 1990 to 212.0 in 2023—representing a 25% increase. Cannabis use disorder affected 270.8 per 100,000 people globally in 2023, making it more prevalent than opioid use disorder (205.9 per 100,000) and other substance use disorders examined.

The findings reveal a striking correlation between cannabis legalization policies and disorder prevalence. Countries that permit both recreational and medical cannabis use showed higher rates of all types of drug use disorders compared to countries where cannabis remains illegal. High-income countries, particularly the United States, demonstrated both the highest prevalence and burden of drug use disorders globally. While opioid use disorder saw the most dramatic increase—nearly doubling between 1990 and 2023—the widespread nature of cannabis use disorder highlights the need for evidence-based harm reduction strategies.

These results underscore the importance of proactive public health policies as cannabis legalization expands globally. The association between permissive cannabis laws and higher disorder rates suggests that legalization frameworks must include robust prevention, education, and treatment resources. For cannabis users and policymakers alike, this data emphasizes that increased access without adequate support systems may contribute to problematic use patterns, making comprehensive regulatory approaches essential for minimizing harm while respecting individual choice.