WHO Flags Rising Drug Use Disorders Across the Americas

Drug use disorders are emerging as one of the fastest-growing public health risks in the Americas, driven largely by opioid consumption and affecting millions of people, according to a new study released by the Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO).

The study, published in the Pan American Journal of Public Health and based on data from the Global Burden of Disease 2021 project, estimates that 17.7 million people in the region were living with a drug use disorder in 2021. Nearly 78,000 deaths were directly attributable to these conditions that year, placing the regional mortality rate at roughly four times the global average and positioning drug use among the 10 leading risk factors for death and disability in the Americas.

“Drug use disorders are a preventable and treatable public health problem, but they are having an increasing impact on families and communities across our region,” says Jarbas Barbosa, Director, PAHO. He adds that countries must urgently expand evidence-based prevention, treatment, and harm-reduction services, particularly for young people and populations at higher risk.

According to the analysis, opioid-related disorders account for over 75% of deaths linked directly to drug use disorders in the region. Synthetic opioids, including fentanyl, have played a growing role, particularly in North America. The study also found that drug use disorders disproportionately affect young adults, especially men, although mortality among women has increased over time, signaling a widening impact across population groups.

The burden associated with drug use disorders has risen sharply over the past two decades. Disability-adjusted life years related to these conditions nearly tripled between 2000 and 2021, increasing at an average rate close to 5% per year. Researchers estimate that over 145,000 deaths from all causes in the Americas in 2021 were attributable to drug use, including deaths linked to overdose, liver disease, cirrhosis, and suicide. The findings place drug use alongside hypertension, high body mass index, dietary risks, and tobacco use as major contributors to premature mortality and disability.

PAHO notes that the COVID-19 pandemic coincided with marked increases in opioid- and amphetamine-related disorders, as disruptions in health services, social isolation, and economic stress may have intensified existing vulnerabilities. Renato Oliveira, Head of the Mental Health and Substance Use Unit, PAHO, says the data highlight persistent gaps in prevention, access to treatment, and harm-reduction services across the region.

“We must place mental health and substance use care at the center of our health systems,” Oliveira says, adding that community-based services supported by public health leadership and surveillance systems are critical to reversing current trends.

While the regional picture varies by subregion, the study shows that opioid and stimulant use dominate in North America, while cannabis and cocaine remain leading contributors to drug use disorders in the Caribbean, Central America, and South America. PAHO urges governments to strengthen early prevention programs, expand medication-assisted treatment for opioid use disorders, integrate substance use services into primary care, and improve data systems to track emerging threats such as synthetic opioids and combined drug use.

Mexico’s National Survey on Drug, Alcohol, and Tobacco Consumption 2025 reports that lifetime drug use among people aged 12 to 65 rose to 14.4%, up from 10.3% in 2016, with cannabis remaining the most commonly used illegal substance. Among adults, experimental use of illegal drugs continued to increase, while reported opioid use also rose, partly linked to the nonmedical use of prescription painkillers.

At the same time, the survey documents declines in drug and alcohol use among adolescents, suggesting that prevention efforts may be having an effect in younger populations. However, the data also shows elevated levels of psychological distress, suicidal behavior, and exposure to violence among adolescents, reinforcing concerns about the close links between substance use, mental health, and social risk factors.

Mexican health authorities say these findings underscore the need for integrated approaches that address both substance use and mental health. As part of its response, the Mexican Institute of Social Security (IMSS) has expanded digital prevention and education initiatives, including online courses aimed at adolescents, parents, teachers, and health professionals. Officials say these programs are designed to support early intervention and reduce long-term risks, though they acknowledge that education must be paired with broader access to treatment and community services.

PAHO says tools such as the WHO’s AUDIT and ASSIST screening instruments remain cost-effective strategies for identifying risk and closing treatment gaps. As drug use disorders continue to rise across the Americas, the agency warns that failure to act could further strain health systems and deepen social and economic costs, while coordinated, evidence-based responses could prevent thousands of avoidable deaths in the coming years.