title: The global epidemiology and burden of psychostimulant dependence: findings from the Global Burden of Disease Study 2010.
abstract: OBJECTIVE
  To estimate the global prevalence of cocaine and amphetamine dependence and the burden of disease attributable to these disorders.
  
  
  METHODS
  An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years (DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010.
  
  
  RESULTS
  In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million amphetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for amphetamines. There were 37.6 amphetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between amphetamines and cocaine in the geographic distribution of crude DALYs. Over half of amphetamine dependence DALYs were in Asian regions (52%), whereas almost half of cocaine dependence DALYs were in the Americas (44%, with 23% in North America High Income).
  
  
  CONCLUSIONS
  Dependence upon psychostimulants is a substantial contributor to global disease burden; the contribution of cocaine and amphetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, 2052, Australia; Melbourne School of Population and Global Health, University of Melbourne, 3053, Australia. Electronic address: l.degenhardt@unsw.edu.au.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane 4074, Australia; School of Population Health, University of Queensland, Herston 4006, Australia.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Baxter
authors.affiliation: Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane 4074, Australia; School of Population Health, University of Queensland, Herston 4006, Australia.
authors.forename: Yong Yi
authors.initials: YY
authors.lastname: Lee
authors.affiliation: University of Queensland Centre for Clinical Research, University of Queensland, Brisbane 4006, Australia; National Addiction Centre, Kings College, London, England, United Kingdom.
authors.forename: Wayne
authors.initials: W
authors.lastname: Hall
authors.affiliation: School of Population Health, University of Queensland, Herston 4006, Australia; InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Sydney 2113, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney 2065, Australia.
authors.forename: Grant E
authors.initials: GE
authors.lastname: Sara
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Johns
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Flaxman
authors.affiliation: Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Brisbane 4074, Australia; School of Population Health, University of Queensland, Herston 4006, Australia.
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Whiteford
authors.affiliation: Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
authors.forename: Theo
authors.initials: T
authors.lastname: Vos
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D017281:Cost of Illness; D005260:Female; D014943:Global Health / Q000191:economics*; D006801:Humans; D008297:Male; D012042:Registries; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants
keywords: Amphetamines; Burden of disease; Cocaine; Epidemiology; Psychostimulants