The evolving burden of drug use disorders in Mexico: Secondary data analysis from the global burden of disease study 2021.

Abstract

To analyze the burden of disease from drug use disorders (DUD) in Mexico by state from 1990 to 2021 and to assess the association of this burden of disease with the Healthcare Access and Quality Index (HAQI). Secondary data analysis from the GBD-2021 study. The paper analyzes mortality, premature mortality, disability and disability-adjusted life years (DALYs). A log-linear segmented regression model to analyze trends in DUD DALYs over time was used. The information was disaggregated by age-groups and sub-causes, at the national and state levels. DUD mortality increased by 27.9 % over the last three decades. The DUD burden of disease remained stable with DALY rates of 85.8 per 100000 in 1990 and 86.9 in 2021. Males showed mortality rates over four times higher than females. In 2021, DUD premature mortality was higher for males (35.6 vs. 8.2 per 100000 among females), while disability rates were higher for females (70.7 vs. 59.7 among males). The highest DUD DALYs occurred among individuals aged 20-29, with cocaine and opioid use disorders as the leading contributors to the DUD DALYs, with notable differences between males and females. Regionally, the northern states, especially Baja California and Chihuahua, exhibited the highest DUD DALYs, whereas central states like Tlaxcala and the State of Mexico had the lowest. A complex relationship between DUD DALYs and the HAQI was observed. There is also an urgent need for age- and gender-responsive public health strategies, evidence-based harm reduction programs, and comprehensive policy interventions to lessen the impact of DUD in Mexico.