The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.
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DOI：
10.1016/s2215-0366(18)30337-7
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发表时间：
2018-12
期刊：
影响因子：
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通讯作者：
GBD 2016 Alcohol and Drug Use Collaborators
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文献类型：
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作者：
GBD 2016 Alcohol and Drug Use Collaborators
酒精和毒品的使用会对社区的健康、经济、生产力和社会方面产生负面影响。我们的目标是使用2016年全球疾病负担、伤害和风险因素研究（GBD）的数据，计算全球和区域酒精、苯丙胺、大麻、可卡因和阿片类药物依赖的流行率估计值，并估计1990年至2016年期间21个地区内195个国家和地区因酒精和药物使用造成的全球疾病负担。在七个超级区域内。我们还旨在研究疾病负担和社会人口指数（SDI）五分位数之间的关联。我们在PubMed、EMBASE和PsycINFO数据库中检索了1980年1月1日至2016年9月7日期间发表的关于酒精和药物使用的原始流行病学研究，没有语言限制，并使用DisMod-MR 2.1（贝叶斯元回归工具）估计物质使用障碍的人群水平患病率。我们将这些估计值与残疾权重相结合，以计算1990-2016年的残疾生活年（YLDs），寿命损失年（YLLs）和残疾调整寿命年（DALLS）。我们还使用了比较评估方法来估计归因于酒精和药物使用的负担作为其他健康结果的风险因素。在全球范围内，酒精使用障碍是所有物质使用障碍中最普遍的，2016年估计有1亿400万例病例（年龄标准化患病率为每10万人1320·8例，95%不确定区间[95%UI] 1181·2-1468·0）。 最常见的药物使用障碍是大麻依赖（2210万例;年龄标准化患病率为每10万人289.7例，95% UI为248.9 - 339.1）和阿片类药物依赖（2680万例;年龄标准化患病率为每10万人353.0例，309.9 - 405.9）。 在全球范围内，2016年，9920万DALLS（95% UI 88·3-111·2）和所有DALLS的4.2%（3.7 - 4.6）可归因于酒精使用，3180万DALLS（27.4 - 36.6）和所有DALLS的1.3%（1.2 - 1.5）可归因于药物使用作为风险因素。因酗酒和吸毒而造成的疾病负担在不同地理位置有很大差异，这一负担大部分是由于吸毒对其他健康结果的影响。总酒精和药物归因的负担和SDI之间的关联观察到相反的模式：酒精归因的负担是最高的国家与低SDI和中高中等SDI，而由于药物的负担增加与较高的S DI水平。酗酒和吸毒是造成全球疾病负担的重要因素。应扩大有效的干预措施，以预防和减少药物使用疾病负担。比尔和梅林达盖茨基金会和澳大利亚国家健康和医学研究理事会。
Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and opioid dependence, and to estimate global disease burden attributable to alcohol and drug use between 1990 and 2016, and for 195 countries and territories within 21 regions, and within seven super-regions. We also aimed to examine the association between disease burden and Socio-demographic Index (SDI) quintiles. We searched PubMed, EMBASE, and PsycINFO databases for original epidemiological studies on alcohol and drug use published between Jan 1, 1980, and Sept 7, 2016, with out language restrictions, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate population-level prevalence of substance 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 1990–2016. We also used a comparative assessment approach to estimate burden attributable to alcohol and drug use as risk factors for other health outcomes. Globally, alcohol use disorders were the most prevalent of all substance use disorders, with 100·4 million estimated cases in 2016 (age-standardised prevalence 1320·8 cases per 100 000 people, 95% uncertainty interval [95% UI] 1181·2–1468·0). The most common drug use disorders were cannabis dependence (22·1 million cases; age-standardised prevalence 289·7 cases per 100 000 people, 95% UI 248·9–339·1) and opioid dependence (26·8 million cases; age-standardised prevalence 353·0 cases per 100 000 people, 309·9–405·9). Globally, in 2016, 99·2 million DALYs (95% UI 88·3–111·2) and 4·2% of all DALYs (3·7–4·6) were attributable to alcohol use, and 31·8 million DALYs (27·4–36·6) and 1·3% of all DALYs (1·2–1·5) were attributable to drug use as a risk factor. The burden of disease attributable to alcohol and drug use varied substantially across geographical locations, and much of this burden was due to the effect of substance use on other health outcomes. Contrasting patterns were observed for the association between total alcohol and drug-attributable burden and SDI: alcohol-attributable burden was highest in countries with a low SDI and middle-high middle SDI, whereas the burden due to drugs increased with higher S DI level. Alcohol and drug use are important contributors to global disease burden. Effective interventions should be scaled up to prevent and reduce substance use disease burden. Bill & Melinda Gates Foundation and Australian National Health and Medical Research Council.