Global burden and trend of substance use disorders, self-harm, and interpersonal violence from 1990 to 2021, with projection to 2040

Background: Alcohol use disorders (AUD), drug use disorders (DUD), interpersonal violence, and self-harm are a major public health concern globally, with high rates of disability, morbidity, and mortality associated with this. To estimate the burden, trends, forecasts, and disparities of AUD, DUD, interpersonal violence, and self-harm among all ages and sexes from 1990 to 2021. Methods: This was a cross-sectional study that used data from the Global Burden of Disease (GBD) 2021 in 204 countries and territories. The incidence, deaths, and disability-adjusted life years (DALYs), projection, and the inequality were estimated for AUD, DUD, interpersonal violence, and self-harm among all age and sex. Finding: In 2021, there were 55.78 million new cases of AUD, 13.61 million new cases of DUD, 29.40 million new cases of interpersonal violence, 5.49 million new cases of self-harm globally, while in 2040 will be 51.98 million of AUD, 13.81 million of DUD, 36.01 million of interpersonal violence, and 10.55 million of self-harm. The burden of age standardized rates of incidence, mortality, and DALYs for AUD, DUD, interpersonal violence, and self-harm were higher in male than in female across all ages. Meanwhile, ages 15-49 have the highest burden of DUD, interpersonal violence, and self-harm, and ages 50-74 have the highest burden of AUD. We also found that 68.45% of attributable deaths due to self-harm and interpersonal violence were related to AUD, and 11.11% related to DUD based on GBD 2021 results. Between 1990 and 2021, both the slope index of inequality and relative concentration index decreased for AUD and interpersonal violence, and increased for DUD and self-harm. Interpretation: Multilevel interventions should be initiated to prevent disease burden related to DUD, interpersonal violence, and self-harm among individuals ages 15-49, and the burden of disease related to AUD among individuals ages 50-75, especially among male. Policy for the management of alcohol and drug use can also simultaneously reduce the social burden of interpersonal violence and self-harm.