Illicit drug use and the burden of disease

There are two major challenges in estimating the burden of disease (BOD) attributable to illicit drug use. These are (1) the poor quality of data on the prevalence of the major types of illicit drug use, namely, cannabis, amfetamine-type stimulants (ATS), opioid, and cocaine use; and (2) the limited epidemiological database from cohort studies of the mortality and morbidity that can be attributed to the use of these drugs. The best available epidemiologically based data on disease burden is that attributable to the use of illicit opioids, which have been shown to increase overall morbidity and mortality from AIDS, overdose, suicide, and trauma. There are strong indications that the stimulants cocaine and ATS contribute to the same causes of death but there are limited longitudinal studies to quantify their contribution. In 2000, illicit opioid use was estimated to contribute to about 200 000 deaths globally. This accounted for 0.8% of the global BOD. Similar estimates have recently been derived using similar methods in Australia. To improve on future estimates of illicit drug-related BOD, better estimates are needed of the prevalence of use of all illicit drugs and better epidemiological data are required on the morbidity and mortality attributable to cannabis, cocaine, and ATS drugs