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Background <p>Drug use disorders (DUD) pose a serious threat to the health of women of childbearing age (15–49&#xa0;years), and their disease burden has not been systematically assessed at the global level. This study aimed to analyze the trends in the disease burden of DUD among women of childbearing age worldwide from 1990 to 2021, the distribution by specific substance, and its relationship with socio-economic development levels, and the relationship between drug use and health status.</p> Methods <p>Using the 2021 Global Burden of Disease (GBD) data, we obtained the incidence and disability-adjusted life years (DALYs) and calculated the age-standardized rates (ASR) of DUD among women of childbearing age in 204 countries and territories worldwide. The estimated annual percentage change (EAPC) was used to assess temporal trends. Socio-economic disparities and health system performance were examined using the Socio-demographic Index (SDI) and efficiency frontier analysis. Furthermore, integrating NHANES 2013–2018 data, the relationship between drug use and self-reported health status was analyzed using multivariable ordered logistic regression.</p> Results <p>In 2021, the global age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) for DUD among women of childbearing age were 265.9 per 100,000 (95% UI: [265.7—266.1]) and 241.8 per 100,000 (95% UI:[241.5—242.0]), respectively. The burden was highly concentrated in high-SDI countries (such as the United States, Canada, Australia), where ASIR and ASDR were significantly higher than in low- and middle-SDI countries, and most showed an increasing trend (EAPC for ASIR = 0.82, 95% UI: [0.70—0.94]; EAPC for ASDR = 4.35, 95% UI: [3.93—4.77]). Opioid use disorder (OUD) was the leading cause of the disease burden, accounting for 74.14% of DALYs. The age distribution showed a bimodal pattern, with incidence peaks at 20–24 and 35–39&#xa0;years, while the DALY peak was delayed until 25–29&#xa0;years. NHANES analysis revealed that after adjusting for socio-economic confounders, drug use was significantly associated with poorer health status (OR = 1.36, 95% CI: 1.15–1.62, <i>P</i> &lt; 0.001).</p> Conclusion <p>The burden of DUD among women of childbearing age shows significant socio-economic and geographical inequalities, with high-income countries facing a persistently growing crisis related to opioids and amphetamines. The true health impact of substance use becomes apparent only after adjusting for socio-economic factors. The results call for strengthened screening and early intervention in high-burden countries, the development of gender-sensitive drug policies, and improved risk communication and treatment accessibility.</p>

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Global burden and socioeconomic correlates of drug use disorders in women of childbearing age: insights from GBD and NHANES

  • 期刊论文

  • 发表日期：

    2026年3月26日

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  • Dingwen Xu,
  • Jingjing Li,
  • Huishen Yan,
  • Zhe Yang

摘要

Background

Drug use disorders (DUD) pose a serious threat to the health of women of childbearing age (15–49 years), and their disease burden has not been systematically assessed at the global level. This study aimed to analyze the trends in the disease burden of DUD among women of childbearing age worldwide from 1990 to 2021, the distribution by specific substance, and its relationship with socio-economic development levels, and the relationship between drug use and health status.

Methods

Using the 2021 Global Burden of Disease (GBD) data, we obtained the incidence and disability-adjusted life years (DALYs) and calculated the age-standardized rates (ASR) of DUD among women of childbearing age in 204 countries and territories worldwide. The estimated annual percentage change (EAPC) was used to assess temporal trends. Socio-economic disparities and health system performance were examined using the Socio-demographic Index (SDI) and efficiency frontier analysis. Furthermore, integrating NHANES 2013–2018 data, the relationship between drug use and self-reported health status was analyzed using multivariable ordered logistic regression.

Results

In 2021, the global age-standardized incidence rate (ASIR) and age-standardized DALY rate (ASDR) for DUD among women of childbearing age were 265.9 per 100,000 (95% UI: [265.7—266.1]) and 241.8 per 100,000 (95% UI:[241.5—242.0]), respectively. The burden was highly concentrated in high-SDI countries (such as the United States, Canada, Australia), where ASIR and ASDR were significantly higher than in low- and middle-SDI countries, and most showed an increasing trend (EAPC for ASIR = 0.82, 95% UI: [0.70—0.94]; EAPC for ASDR = 4.35, 95% UI: [3.93—4.77]). Opioid use disorder (OUD) was the leading cause of the disease burden, accounting for 74.14% of DALYs. The age distribution showed a bimodal pattern, with incidence peaks at 20–24 and 35–39 years, while the DALY peak was delayed until 25–29 years. NHANES analysis revealed that after adjusting for socio-economic confounders, drug use was significantly associated with poorer health status (OR = 1.36, 95% CI: 1.15–1.62, P < 0.001).

Conclusion

The burden of DUD among women of childbearing age shows significant socio-economic and geographical inequalities, with high-income countries facing a persistently growing crisis related to opioids and amphetamines. The true health impact of substance use becomes apparent only after adjusting for socio-economic factors. The results call for strengthened screening and early intervention in high-burden countries, the development of gender-sensitive drug policies, and improved risk communication and treatment accessibility.