Drug Use in Sub-Saharan Africa
Attributable deaths from drug use across 48 countries in Sub-Saharan Africa.
View all Sub-Saharan Africa| # | Country | Attributable Deaths |
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Drug Use is a modifiable risk factor tracked by the IHME Global Burden of Disease Study. The attributable deaths shown here represent the estimated number of deaths in Sub-Saharan Africa that could be prevented if exposure to this risk factor were eliminated or reduced to optimal levels. Risk factor attribution uses comparative risk assessment methodology, and a single death may be partially attributed to multiple risk factors.
Drug use disorders — encompassing opioid, stimulant, cannabis, and other substance use disorders — directly cause approximately 170,000 deaths per year, with opioid overdose accounting for roughly three-quarters of drug death mortality. The opioid crisis in North America has been particularly devastating, with synthetic opioids (fentanyl and its analogues) driving record overdose deaths exceeding 100,000 per year in the United States alone. Globally, an estimated 296 million people used drugs in 2021. Injecting drug use is a major driver of HIV and hepatitis C transmission. While North America and Europe bear the highest absolute burden of drug overdose deaths, methamphetamine use is a growing concern in East and Southeast Asia, and tramadol misuse is rising in West Africa. Drug use disorders are chronic relapsing conditions influenced by genetic vulnerability, childhood adversity, mental health comorbidities, social environment, and drug availability. Criminalisation and stigma impede access to treatment and harm reduction in many settings. Sub-Saharan Africa faces the world's most acute health challenges, with the youngest population of any region, the highest burden of infectious diseases, and health systems constrained by limited financing and workforce shortages. In Sub-Saharan Africa, drug use mortality is broadly in line with global averages, though the region's young demographic profile and high infectious disease burden shape the overall mortality landscape.
Harm reduction — needle and syringe programmes, opioid agonist therapy (methadone, buprenorphine), naloxone distribution for overdose reversal, and supervised consumption facilities — saves lives and reduces HIV and hepatitis transmission. Evidence-based addiction treatment includes medication-assisted treatment, cognitive-behavioural therapy, and contingency management. Prescription drug monitoring programmes and opioid prescribing guidelines aim to prevent iatrogenic addiction. Addressing social determinants — housing, employment, mental health services — is essential for sustained recovery.
The mortality estimates presented on this page are derived from the Global Burden of Disease (GBD) study, produced by the Institute for Health Metrics and Evaluation (IHME). The GBD synthesizes data from vital registration systems, verbal autopsies, cancer registries, and surveillance networks across more than 200 countries and territories. Death rates are expressed per 100,000 population and are age-standardized, which adjusts for differences in age structure between populations so that comparisons across countries and over time reflect genuine differences in mortality risk rather than demographic composition.
The dataset typically covers the period from 1990 to 2023, although availability varies by country and cause. When interpreting the figures for drug use in Sub-Saharan Africa, note that higher age-standardized rates indicate a greater mortality burden independent of whether a country's population is older or younger. Trends over time reveal whether public health interventions, economic development, and health system improvements have reduced or increased the toll of this condition in the region.
Risk factor attribution in the GBD framework uses counterfactual analysis and population attributable fractions (PAFs). A PAF estimates the proportion of deaths that would not have occurred if exposure to a given risk factor had been at its theoretical minimum level. Because multiple risk factors can contribute to a single death, attributable fractions across all risk factors may sum to more than 100%. The figures for drug use in Sub-Saharan Africa reflect the estimated mortality burden that could be averted through complete elimination of this risk exposure.