Comparison of the disease burden and trends of opioid use disorder between China and the United States from 1990 to 2023

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Author: LIU Hao ¹ JIANG Chenxin ² PENG Qianlan ¹ LI Dan ¹ GONG Qiaoyue ¹ JIN Xiuling ² LIU Rui ¹  SHI Fang ¹

Affiliation: 1.School of Public Health, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China 2.The First Clinical Medical College, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China

Keywords: Disease burden Opioid use disorder Trend analysis Joinpoint regression Decomposition analysis

DOI: 10.12173/j.issn.1005-0698.202603116

Reference: [Liu H, Jiang CX, Peng QL, et al. Comparison of the disease burden and trends of opioid use disorder between China and the United States from 1990 to 2023[J]. Chinese Journal of Pharmacoepidemiology, 2026, 35(9): 978-986.] DOI: 10.12173/j.issn.1005-0698.202603116.[Article in Chinese]  Copied

Abstract
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Abstract

Objective To compare trends in the disease burden of opioid use disorder (OUD) between China and the United States from 1990 to 2023.

Methods Data on incident cases, prevalent cases, deaths, disability-adjusted life years (DALYs), and corresponding rates for OUD in China and the United States from 1990 to 2023 were obtained from the Global Burden of Disease Study 2023 (GBD 2023). Joinpoint regression was used to calculate the average annual percent change (AAPC) in age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) to assess long-term trends. Decomposition analysis was performed to estimate the relative contributions of changes in age structure, population size, and epidemiological changes to the trends in OUD incident cases, prevalent cases, deaths, and DALYs.

Results From 1990 to 2023, the ASIR[AAPC=-1.65%, 95%CI (-1.79%, -1.50%)], ASPR[AAPC=-1.92%, 95%CI (-2.08%, -1.76%)], ASMR[AAPC=-5.95%, 95%CI (-6.63%, -5.26%)], and ASDR[AAPC=-3.35%, 95%CI (-3.66%, -3.03%)] of OUD showed overall decreasing trends in China (P < 0.001), whereas the ASIR[AAPC=5.29%, 95%CI (4.97%, 5.62%)], ASPR[AAPC=6.01%, 95%CI (5.88%, 6.14%)],ASMR[AAPC=8.40%, 95%CI (7.81%, 9.00%)], and ASDR[AAPC=6.99%, 95%CI (6.71%, 7.29%)] of OUD showed overall increasing trends in the United States (P < 0.001). In both countries, OUD incidence was higher in the 20-24-year age group, while prevalence was higher in the 25-29-year age group. Decomposition analysis showed that epidemiological change was the main contributor to changes in the OUD burden in both countries, accounting for 91.86%, 90.56%, 87.04%, and 90.28% to changes in incident cases, prevalent cases, deaths, and DALYs in the United States, respectively; the corresponding contributions in China were -109.95%, -153.92%, -139.22%, and -128.32%.

Conclusions From 1990 to 2023, the overall burden of OUD decreased in China but increased in the United States. Epidemiological change was the main contributor to the changes in OUD burden in both countries. Targeted prevention and intervention strategies should be developed according to the disease burden patterns in the two countries.

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