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Drug-use disorders in the Eastern Mediterranean Region: a glance at GBD 2019 findings

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Abstract

Purpose

The aim of this study is to investigate drug use disorders which are a major cause of Disability Adjusted Life Years (DALYs) in the Eastern Mediterranean Region (EMR).

Methods

This article is a part of the global burden of diseases (GBD), injuries, and risk factors 2019 study. The GBD modeling approach was used to estimate population-level prevalence of drug use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2019.

Results

It is estimated that in 2019 in EMR around 3.4 million people have drug use disorder which has increased by 137% compared to 1990. Also, in 2019, DALY number for drug use disorders was 1217.9 (95% UI: 940.4, 1528.9) thousand years and 7645 (95% UI: 6793.7, 8567.9) deaths occurred. The DALY rate increased 39.6% in the region since1990, whereas the global rate increased by 24.4%. United Arab Emirates, Libya, and Iran were most affected by drug use disorders with the highest rates of age-standardized DALY in EMR in 2019. The most prevalent drug use disorder in the region is opioid use which is accountable for 80% of all drug use disorders DALYs.

Conclusion

Despite many interventions, drug use disorders are still responsible for high rates of DALY in the region which has increased since 1990 in both males and females; more comprehensive policies, better control measures and proper education could reduce the adverse effects.

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Data availability

The datasets for this study can be found in the GHDx (Global Health Data Exchange) result section (https://vizhub.healthdata.org/gbd-results/).

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Acknowledgements

A Fatehizadeh acknowledges support from the Department of Environmental Health Engineering of Isfahan University of Medical Sciences, Isfahan, Iran. S Haque acknowledges support from Jazan University for providing access of Saudi Digital Library for this study. U Saeed acknowledges support from the International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan. AM Samy acknowledges support from Ain Shams University and the Egyptian Fulbright Mission Program. M Tabish acknowledges support from Shaqra University.

GBD Collaborators: Mohsen Abbasi-Kangevari1, Zeinab Abbasi-Kangevari2,1, Mohammad Abdollahi3, Eman Abu-Gharbieh4, Abbas Aghaei5,6, Ali Ahmadi7,8, Marjan Ajami9,10, Yazan Al Thaher11,12, Fadwa Alhalaiqa13, Yousef Alimohamadi14, Sadeq Ali Al-Maweri15, Sami Almustanyir16,17, Mehrdad Amir-Behghadami18,19, Sohrab Amiri20, Jalal Arabloo21, Tahira Ashraf22, Seyyed Shamsadin Athari23, Sina Azadnajafabad1, Nayereh Baghcheghi24, Sara Bagherieh25, Ali Bijani26, Saeid Bitaraf27, Milad Bonakdar Hashemi28, Mahmoud Dibas29, Shirin Djalalinia30, Milad Dodangeh31, Muhammed Elhadi32, Farshad Farzadfar1, Ali Fatehizadeh33, Alireza Feizkhah34, Amir Ghaderi35, Fataneh Ghadirian36, Seyyed-Hadi Ghamari1,2, Mohammad Ghasemi Nour37, Ahmad Ghashghaee38, Ali Gholami39,40, Pouya Goleij41, Mohamad Golitaleb42, Amir Ali Hajebi1, Mehdi Hajiani43, Shafiul Haque44, Ahmed I Hasaballah45, Hamidreza Hasani46, Hossein Hassanian-Moghaddam47,2, Khezar Hayat48,49, Mohammad Heidari50, Mahsa Heidari-Foroozan51,52, Farideh Iravanpour53, Rana Irilouzadian54,55, Haitham Jahrami56,57, Farzad Jalilian58, Elham Jamshidi59,60, Farnaz Kalantar61, Sorour Khateri62, Ali-Asghar Kolahi2, Hamid Reza Koohestani63, Mohammed Kuddus64, Hawraz Ibrahim M Amin65,66, Ata Mahmoodpoor67, Tauqeer Hussain Mallhi68, Yasaman Mansoori69, Borhan Mansouri70, Mahsa Mayeli71, Ritesh G Menezes72, Mahboobeh Meshkat73, Mehdi Mirzaei-Alavijeh58, Yousef Mohammad74, Esmaeil Mohammadi75,76, Fateme Montazeri1,55, Farhad Moradpour6, Majid Motaghinejad77, Shumaila Nargus78, Zuhair S Natto79,80, Muhammad Naveed81, Seyed Aria Nejadghaderi55,51, Hassan Okati-Aliabad82, Shankargouda Patil83,84, Simone Perna85, Sima Rafiei86, Vahid Rahmanian87, Ahmed Mustafa Rashid88, Nazila Rezaei1, Mohsen Rezaeian89, Aly M A Saad90, Basema Saddik91, Umar Saeed92,93, Farhad Saeedi94, Amirhossein Sahebkar95,96, Muhammad Salman97, Abdallah M Samy98,99, Yaser Sarikhani100,101, Mahan Shafie102, Fariba Shahraki-Sanavi82, Masood Ali Shaikh103, Maryam Shayan104,105, Sina Shool106,107, Mohammad Tabish108, Majid Taheri109,110, Hadi Tehrani111, Amir Tiyuri112,113, Razie Toghroli114, Sana Ullah115,116, Sahel Valadan Tahbaz117,118 , Rohollah Valizadeh119, Yasir Waheed120,121, Syed Saoud Zaidi122, Maryam Zamanian123, Iman Zare124, Mohammad Zoladl125

1Non-communicable Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran; 2Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran; 4Clinical Sciences Department, University of Sharjah, Sharjah, United Arab Emirates; 5Department of Epidemiology and Biostatistics, Kurdistan University of Medical Sciences, Sanandaj, Iran; 6Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran; 7Department of Epidemiology and Biostatistics, Shahrekord University of Medical Sciences, Shahrekord, Iran; 8Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 9Department of Food and Nutrition Policy and Planning Research, National Institute of Nutrition, Tehran, Iran; 10National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 11Faculty of Pharmacy, Philadelphia University, Amman, Jordan; 12School of Pharmacy, Cardiff University, Cardiff, UK; 13Professor at Department of Clinical Affairs, College of Nursing, QU Health, Qatar University, Doha, Qatar; 14Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; 15College of Dental Medicine, Qatar University, Doha, Qatar; 16College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; 17Ministry of Health, Riyadh, Saudi Arabia; 18Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 19Department of Health Service Management, Iranian Center of Excellence in Health Management, Tabriz, Iran; 20Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran; 21Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran; 22University Institute of Radiological Sciences and Medical Imaging Technology, The University of Lahore, Lahore, Pakistan; 23Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran; 24Department of Nursing, Saveh University of Medical Sciences, Saveh, Iran; 25School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran; 26Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, Iran; 27Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; 28Urology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 29Research Unit, Sulaiman Al Rajhi University, Qassim, Saudi Arabia; 30Development of Research and Technology Center, Ministry of Health and Medical Education, Tehran, Iran; 31School of Medicine, Iran University of Medical Sciences, Tehran, Iran; 32Faculty of Medicine, University of Tripoli, Tripoli, Libya; 33Department of Environmental Health Engineering, Isfahan University of Medical Sciences, Isfahan, Iran; 34Department of Social Medicine and Epidemiology, Guilan University of Medical Sciences, Rasht, Iran; 35Department of Addiction Studies, Kashan University of Medical Sciences, Kashan, Iran; 36Psychiatric Nursing and Management Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 37E-Learning Center, Mashhad University of Medical Sciences, Mashhad, Iran; 38School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran; 39Department of Epidemiology and Biostatistics, Neyshabur University of Medical Sciences, Neyshabur, Iran; 40Non-Communicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran; 41Department of Genetics, Sana Institute of Higher Education, Sari, Iran; 42Department of Nursing, Arak University of Medical Sciences, Arak, Iran; 43School of Medicine, Shiraz, Iran; 44Research and Scientific Studies Unit, Jazan University, Jazan, Saudi Arabia; 45Department of Zoology and Entomology, Al Azhar University, Cairo, Egypt; 46Department of Ophthalmology, Iran University of Medical Sciences, Karaj, Iran; 47Department of Clinical Toxicology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 48Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore, Pakistan; 49Department of Pharmacy Administration and Clinical Pharmacy, Xian Jiaotong University, Xian, China; 50Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran; 51Department of Epidemiology, Non-Communicable Diseases Research Center (NCDRC), Tehran, Iran; 52Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 53Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 54Burn Research Center, Iran University of Medical Sciences, Tehran, Iran; 55School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 56College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 57Ministry of Health, Ministry of Health, Manama, Bahrain; 58Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 59Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 60Division of Pulmonary Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland; 61Department of Pharmaceutical Sciences, Faran Shimi Pharmaceutical Company, Tehran, Iran; 62School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran; 63Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran; 64Department of Biochemistry, College of Medicine, University of Hail, Saudi Arabia; 65Chemistry Department, Salahaddin University-Erbil, Erbil, Iraq; 66Department of Medical Biochemical Analysis, Cihan University-Erbil, Erbil, Iraq; 67Department of Anesthesiology and Critical Care, Tabriz University of Medical Sciences, Tabriz, Iran; 68Department of Clinical Pharmacy, Jouf University, Sakaka, Saudi Arabia; 69Shiraz University of Medical Sciences, Shiraz, Iran; 70Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; 71School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 72Forensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 73Department Biology, Isfahan University of Medical Sciences, Isfahan, Iran; 74Internal Medicine Department, King Saud University, Riyadh, Saudi Arabia; 75Tehran University of Medical Sciences, Tehran, Iran; 76Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran; 77Chronic Respiratory Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 78University Institute of Public Health, The University of Lahore, Lahore, Pakistan; 79Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia; 80Department of Health Policy and Oral Epidemiology, Harvard University, Boston, MA, USA; 81Department of Biotechnology, University of Central Punjab, Lahore, Pakistan; 82Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran; 83College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT, USA; 84Centre of Molecular Medicine and Diagnostics (COMManD), Saveetha University, Chennai, India; 85Department of Biology, University of Bahrain, Sakir, Bahrain; 86Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; 87Department of Public Health, Torbat Jam Faculty of Medical Sciences, Torbat Jam, Iran; 88Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan; 89Department of Epidemiology and Biostatistics, Rafsanjan University of Medical Sciences, Rafsanjan, Iran; 90Cardiovascular Department, Zagazig University, Zagazig, Egypt; 91Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates; 92Multidisciplinary Laboratory Foundation University School of Health Sciences (FUSH), Foundation University, Islamabad, Pakistan; 93International Center of Medical Sciences Research (ICMSR), Islamabad, Pakistan; 94Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran; 95Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; 96Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; 97Department of Pharmacy Practice, The University of Lahore, Lahore, Pakistan; 98Department of Entomology, Ain Shams University, Cairo, Egypt; 99Medical Ain Shams Research Institute, Ain Shams University, Cairo, Egypt; 100Department of Public Health, Jahrom University of Medical Sciences, Jahrom, Iran; 101Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 102Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran; 103Independent Consultant, Karachi, Pakistan; 104Department of Pharmacology, Tehran University of Medical Sciences, Tehran, Iran; 105Ophthalmic Research Center (ORC), Shahid Beheshti University of Medical Sciences, Tehran, Iran; 106Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 107Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; 108Department of Pharmacology, Shaqra University, Shaqra, Saudi Arabia; 109Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran; 110Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 111Department of Health Education and Health Promotion, Mashhad University of Medical Sciences, Mashhad, Iran; 112Department of Epidemiology and Biostatistics, Birjand University of Medical Sciences, Birjand, Iran; 113Department of Epidemiology and Biostatistics, Iran University of Medical Sciences, Tehran, Iran; 114 Department of community medicine, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran; 115Department of Zoology, University of Education, Lahore, Pakistan; 116Division of Science and Technology, University of Education, Lahore, Lahore, Pakistan; 117Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran; 118Department of Microbiology, Islamic Azad University, Tehran, Iran; 119Urmia University of Medical Sciences, Urmia, Iran; 120Office of Research, Innovation, and Commercialization (ORIC), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, Pakistan; 121Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Lebanon; 122Department of Pharmaceutics, Dow University of Health Sciences, Karachi, Pakistan; 123Department of Epidemiology, Arak University of Medical Sciences, Arak, Iran; 124Research and Development Department, Sina Medical Biochemistry Technologies, Shiraz, Iran; 125Department of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran

Funding

The funders of this study had no role in study design, data collection, data analysis, data interpretation, or the writing of the report.

Author information

Author notes

  1. Ali Amirkafi and Faezeh Mohammadi equally contributed first authors.

  2. Christopher J. L. Murray, Mohsen Naghavi, and Ali H. Mokdad are senior authors.

Authors and Affiliations

  1. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran

    Ali Amirkafi, Faezeh Mohammadi, Arash Tehrani-Banihashemi & Maziar Moradi-Lakeh

  2. Occupational Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran

    Faezeh Mohammadi

  3. Department of Community and Family Medicine, Iran University of Medical Sciences, Tehran, Iran

    Arash Tehrani-Banihashemi

  4. Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA

    Christopher J. L. Murray, Mohsen Naghavi & Ali H. Mokdad

  5. Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA

    Christopher J. L. Murray, Mohsen Naghavi & Ali H. Mokdad

Authors
  1. Ali Amirkafi
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  2. Faezeh Mohammadi
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  3. Arash Tehrani-Banihashemi
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  4. Maziar Moradi-Lakeh
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  5. Christopher J. L. Murray
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  6. Mohsen Naghavi
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  7. Ali H. Mokdad
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Consortia

GBD Collaborators

  • Mohsen Abbasi-Kangevari
  • , Zeinab Abbasi-Kangevari
  • , Mohammad Abdollahi
  • , Eman Abu-Gharbieh
  • , Abbas Aghaei
  • , Ali Ahmadi
  • , Marjan Ajami
  • , Yazan Al Thaher
  • , Fadwa Alhalaiqa
  • , Yousef Alimohamadi
  • , Sadeq Ali Al-Maweri
  • , Sami Almustanyir
  • , Mehrdad Amir-Behghadami
  • , Sohrab Amiri
  • , Jalal Arabloo
  • , Tahira Ashraf
  • , Seyyed Shamsadin Athari
  • , Sina Azadnajafabad
  • , Nayereh Baghcheghi
  • , Sara Bagherieh
  • , Ali Bijani
  • , Saeid Bitaraf
  • , Milad Bonakdar Hashemi
  • , Mahmoud Dibas
  • , Shirin Djalalinia
  • , Milad Dodangeh
  • , Muhammed Elhadi
  • , Farshad Farzadfar
  • , Ali Fatehizadeh
  • , Alireza Feizkhah
  • , Amir Ghaderi
  • , Fataneh Ghadirian
  • , Seyyed-Hadi Ghamari
  • , Mohammad Ghasemi Nour
  • , Ahmad Ghashghaee
  • , Ali Gholami
  • , Pouya Goleij
  • , Mohamad Golitaleb
  • , Amir Ali Hajebi
  • , Mehdi Hajiani
  • , Shafiul Haque
  • , Ahmed I. Hasaballah
  • , Hamidreza Hasani
  • , Hossein Hassanian-Moghaddam
  • , Khezar Hayat
  • , Mohammad Heidari
  • , Mahsa Heidari-Foroozan
  • , Farideh Iravanpour
  • , Rana Irilouzadian
  • , Haitham Jahrami
  • , Farzad Jalilian
  • , Elham Jamshidi
  • , Farnaz Kalantar
  • , Sorour Khateri
  • , Ali-Asghar Kolahi
  • , Hamid Reza Koohestani
  • , Mohammed Kuddus
  • , Hawraz Ibrahim M. Amin
  • , Ata Mahmoodpoor
  • , Tauqeer Hussain Mallhi
  • , Yasaman Mansoori
  • , Borhan Mansouri
  • , Mahsa Mayeli
  • , Ritesh G. Menezes
  • , Mahboobeh Meshkat
  • , Mehdi Mirzaei-Alavijeh
  • , Yousef Mohammad
  • , Esmaeil Mohammadi
  • , Fateme Montazeri
  • , Farhad Moradpour
  • , Majid Motaghinejad
  • , Shumaila Nargus
  • , Zuhair S. Natto
  • , Muhammad Naveed
  • , Seyed Aria Nejadghaderi
  • , Hassan Okati-Aliabad
  • , Shankargouda Patil
  • , Simone Perna
  • , Sima Rafiei
  • , Vahid Rahmanian
  • , Ahmed Mustafa Rashid
  • , Nazila Rezaei
  • , Mohsen Rezaeian
  • , Aly M. A. Saad
  • , Basema Saddik
  • , Umar Saeed
  • , Farhad Saeedi
  • , Amirhossein Sahebkar
  • , Muhammad Salman
  • , Abdallah M. Samy
  • , Yaser Sarikhani
  • , Mahan Shafie
  • , Fariba Shahraki-Sanavi
  • , Masood Ali Shaikh
  • , Maryam Shayan
  • , Sina Shool
  • , Mohammad Tabish
  • , Majid Taheri
  • , Hadi Tehrani
  • , Amir Tiyuri
  • , Razie Toghroli
  • , Sana Ullah
  • , Sahel Valadan Tahbaz
  • , Rohollah Valizadeh
  • , Yasir Waheed
  • , Syed Saoud Zaidi
  • , Maryam Zamanian
  • , Iman Zare
  •  & Mohammad Zoladl

Contributions

Please see appendix (pp 18–19) for more detailed information about individual author contributions to the research, divided into the following categories: managing the overall research enterprise; writing the first draft of the manuscript; primary responsibility for applying analytical methods to produce estimates; primary responsibility for seeking, cataloguing, extracting, or cleaning data; designing or coding figures and tables; providing data or critical feedback on data sources; developing methods or computational machinery; providing critical feedback on methods or results; drafting the manuscript or revising it critically for important intellectual content; and managing the estimation or publications process.

Corresponding author

Correspondence to Maziar Moradi-Lakeh.

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Conflict of interest

The authors declare no financial or non-financial competing interests.

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Supplementary file1 (DOCX 82 KB)

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Amirkafi, A., Mohammadi, F., Tehrani-Banihashemi, A. et al. Drug-use disorders in the Eastern Mediterranean Region: a glance at GBD 2019 findings. Soc Psychiatry Psychiatr Epidemiol (2023). https://doi.org/10.1007/s00127-023-02587-w

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