The burden of mental disorders attributable by cocaine use: Global Burden of Diseases Study in Brazil, 1990 and 2019

Crepalde, Rayce dos Santos; Bonadiman, Cecília Silva Costa; Malta, Deborah Carvalho; Naghavi, Mohsen; Melo, Ana Paula Souto

doi:10.1590/0037-8682-0320-2021

Brasil

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Major Article • Rev. Soc. Bras. Med. Trop. 55 (suppl 1) • 2022 • https://doi.org/10.1590/0037-8682-0320-2021 linkcopy

The burden of mental disorders attributable by cocaine use: Global Burden of Diseases Study in Brazil, 1990 and 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

INTRODUCTION: Brazil is an important consumer market for cocaine. However, the consequences of this consumption and the pattern of distribution of the estimates are still poorly studied in the Brazilian states. The Global Burden of Disease study - 2019 (GBD-2019) has enabled us to describe and analyze indicators of mental disorders (MD) attributable by cocaine use in Brazil and its states, in 1990 and 2019.

METHODS: A descriptive study of the burden of cocaine use disorders, using prevalence, age-standardized mortality rate (ASMR), years of life lost (YLL) due to premature death, years lived with disabilities (YLD), and disability adjusted life years (DALY), which accounts for YLL+YLD.

RESULTS: Brazil ranks 8^th as DALYs due to cocaine use disorder in the world (42.83/100.000; 95% uncertainty intervals [95% UI]: 35.28 to 61.43). Significant increases have occurred in the age-standardized rate prevalence (ASRP), ASMR, DALY, YLD, and YLL, in Brazil and its states, between 1990 and 2019. The ASRP in 2019 was 2.7-fold higher for men (278.60/100.000; 95% UI: 208.20 to 374.39) in comparison to women (104.01/100.000; 95% UI: 76.70 to 143.02). There is a predominance of YLD in the composition of DALYs; however, the YLL had the biggest increases between 1990 and 2019.

CONCLUSIONS: The high rate of DALYs and the increase in mortality rates show the need to scale up effective interventions to prevent and reduce the burden of disease attributable to cocaine use disorder, which is a preventable cause of death and disability.

Keywords: Cocaine; Descriptive epidemiology; Mortality; Disability adjusted life years; Brazil

	1990		2019		Percentage of chance in the number of cases 1990 to 2019	Percentage of chance in the ASRP 1990 to 2019
	Number of cases	Age-standardized prevalence rate	Number of cases	Age-standardized prevalence rate
Male	135 795	181.34	314 385	278.60	132*	54*
Male	(97 403 to 188 685)	(132.76 to 246.67)	(234 880 to 422 536)	(208.20 to 374.39)	(105 to 164)	(37 to 73)
Female	68 371	89.00	122 045	104.01	79*	17*
Female	(49 999 to 95 910)	(66.42 to 122.02)	(90 625 to 167 170)	(76.70 to 143.02)	(68 to 93)	(11 to 23)
Both sexes	204 165	134.27	436 430	190.28	114*	42*
Both sexes	(147 448 to 282 872)	(98.91 to 182.28)	(329 015 to 580 991)	(142.29 to 255.93)	(94 to 137)	(30 to 57)

STATE	ASMR 2019	Percentage of change in the ASMR 1990 to 2019*	DALY 2019	Percentage of change in the DALY 1990 to 2019*	YLD 2019	Percentage of change in the YLD 1990 to 2019*	YLL 2019	Percentage of change in the YLL 1990 to 2019*
Acre	0.48	333	57.20	134	31.83	67	25.37	378
	(0.41 to 0.57)	(245 to 451)	(30.98 to 57.97)	(90 to 200)	(18.58 to 48.55)	(33 to 111)	(20.88 to 30.58)	(271 to 528)
Alagoas	0.20	350	34.47	73	24.18	35	10.29	415
	(0.16 to 0.24)	(250 to 499)	(32.82 to 56.81)	(44 to 116)	(13.67 to 37.46)	(10 to 67)	(8.39 to 12.68)	(295 to 600)
Amapá	0.27	335	37.99	82	23.46	31	14.52	391
	(0.23 to 0.32)	(250 to 438)	(23.54 to 47.81)	(48 to 130)	(13.24 to 36.63)	(6 to 59)	(12.01 to 17.37)	(282 to 525)
Amazonas	1.52	315	113.27	220	30.88	66	82.39	388
	(1.27 to 1.84)	(225 to 424)	(92.29 to 139.05)	(158 to 306)	(17.69 to 48.91)	(33 to 112)	(67.53 to 102.19)	(274 to 538)
Bahia	0.23	131	34.89	55	24.07	35	10.82	134
	(0.19 to 0.28)	(77 to 199)	(34.00 to 63.54)	(31 to 86)	(13.57 to 37.75)	(10 to 67)	(8.58 to 13.18)	(78 to 212)
Ceará	0.19	584	33.82	78	24.02	35	9.80	677
	(0.15 to 0.24)	(394 to 852)	(25.02 to 49.20)	(46 to 126)	(13.67 to 38.12)	(10 to 67)	(7.69 to 12.49)	(451 to 1026)
Distrito Federal	0.60	166	60.18	108	29.59	57	30.60	201
	(0.5 to 0.73)	(109 to 239)	(19.70 to 42.03)	(74 to 152)	(16.99 to 46.06)	(28 to 97)	(24.80 to 37.58)	(133 to 288)
Espírito Santo	0.44	276	52.02	110	29.11	50	22.91	321
	(0.37 to 0.53)	(203 to 361)	(32.37 to 56.00)	(72 to 163)	(16.71 to 44.32)	(22 to 86)	(18.56 to 27.93)	(232 to 427)
Goiás	0.33	232	41.36	85	24.11	35	17.25	284
	(0.26 to 0.40)	(154 to 328)	(29.71 to 56.25)	(53 to 130)	(14.04 to 37.56)	(12 to 67)	(13.53 to 21.57)	(190 to 403)
Maranhão	0.33	232	39.51	75	23.66	32	15.84	232
	(0.26 to 0.40)	(131 to 382)	(27.66 to 51.11)	(44 to 118)	(13.91 to 36.99)	(10 to 62)	(12.43 to 19.76)	(129 to 3.84)
Mato Grosso	0.41	247	47.05	96	26.04	41	21.01	287
	(0.34 to 0.48)	(173 to 348)	(28.90 to 53.79)	(64 to 143)	(14.99 to 40.09)	(13 to 74)	(17.41 to 25.5)	(196 to 434)
Mato Grosso do Sul	0.39	200	43.16	81	23.25	30	19.90	232
	(0.33 to 0.47)	(141 to 266)	(42.93 to 74.84)	(52 to 122)	(13.4 to 36.13)	(5 to 63)	(16.39 to 24.42)	(160 to 311)
Minas Gerais	0.42	348	59.5	156	36.83	92	22.68	469
	(0.35 to 0.51)	(258 to 461)	(28.45 to 54.26)	(107 to 227)	(21.55 to 57.37)	(52 to 144)	(18.45 to 28.00)	(348 to 630)
Pará	0.14	217	29.45	49	22.54	26	6.91	253
	(0.11 to 0.16)	(152 to 291)	(24.38 to 48.42)	(25 to 84)	(12.79 to 34.66)	(4 to 53)	(5.53 to 8.30)	(174 to 349)
Paraíba	0.26	511	39.81	98	26.03	43	13.78	590
	(0.22 to 0.32)	(385 to 685)	(22.24 to 45.64)	(61 to 152)	(14.93 to 40.17)	(16 to 80)	(11.20 to 16.94)	(427 to 812)
Paraná	0.31	285	41.07	91	24.66	37	16.41	372
	(0.26 to 0.37)	(212 to 372)	(43.83 to 80.52)	(58 to 140)	(14.33 to 37.91)	(13 to 68)	(13.27 to 20.02)	(270 to 493)
Pernambuco	0.17	230	32.5	62	23.61	34	8.89	265
	(0.15 to 0.21)	(167 to 311)	(29.69 to 54.56)	(36 to 100)	(13.5 to 37.35)	(8 to 68)	(7.34 to 10.80)	(189 to 369)
Piauí	0.42	554	46.91	127	24.95	40	21.96	675
	(0.35 to 0.50)	(409 to 744)	(25.11 to 48.79)	(82 to 197)	(14.39 to 38.68)	(16 to 73)	(17.76 to 26.70)	(475 to 933)
Rio de Janeiro	0.43	317	48.57	115	25.2	40	23.36	405
	(0.36 to 0.51)	(240 to 407)	(31.13 to 57.59)	(77 to 175)	(14.4 to 38.95)	(14 to 72)	(19.22 to 28.34)	(305 to 526)
Rio Grande do Norte	0.15	430	32.38	71	24.14	37	8.24	541
	(0.12 to 0.19)	(307 to 587)	(44.48 to 73.63)	(41 to 117)	(14.06 to 37.34)	(12 to 70)	(6.45 to 10.47)	(380 to 755)
Rio Grande do Sul	0.32	218	43.01	88	26.83	46	16.19	261
	(0.27 to 0.39)	(163 to 295)	(31.34 to 57.02)	(58 to 129)	(15.24 to 41.47)	(21 to 81)	(13.43 to 19.45)	(192 to 355)
Rondônia	0.32	204	42.77	83	26.3	40	16.47	258
	(0.26 to 0.38)	(134 to 311)	(22.15 to 46.21)	(54 to 126)	(15.24 to 40.53)	(16 to 71)	(13.38 to 20.10)	(168 to 411)
Roraima	0.58	220	57.41	109	27.2	41	30.21	272
	(0.49 to 0.68)	(157 to 302)	(35.25 to 61.92)	(74 to 162)	(15.51 to 43.21)	(12 to 76)	(24.78 to 35.95)	(188 to 390)
Santa Catarina	0.24	210	35.46	94	22.59	52	12.87	262
	(0.20 to 0.29)	(151 to 283)	(36.87 to 62.77)	(63 to 145)	(12.77 to 35.88)	(23 to 93)	(10.43 to 15.98)	(188 to 362)
São Paulo	0.35	244	47.00	73	29.16	29	17.84	326
	(0.29 to 0.42)	(174 to 330)	(23.47 to 47.60)	(45 to 114)	(16.84 to 45.73)	(5 to 56)	(14.67 to 21.77)	(233 to 447)
Sergipe	0.22	337	35.57	78	23.7	34	11.87	419
	(0.18 to 0.27)	(237 to 464)	(45.33 to 77.69)	(47 to 125)	(13.62 to 36.95)	(9 to 63)	(9.50 to 14.56)	(288 to 583)
Tocantins	0.36	516	42.52	105	24.4	34	18.12	600
	(0.29 to 0.43)	(374 to 696)	(38.86 to 68.16)	(67 to 161)	(13.86 to 38.38)	(11 to 64)	(14.66 to 22.25)	(428 to 831)
Brazil	0.32	278	42.83	95	25.82	43	17.01	343
	(0.30 to 0.35)	(245 to 321)	(35.28 to 61.43)	(70 to 128)	(15.1 to 39.36)	(29 to 59)	(15.63 to 18.71)	(299 to 401)

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[TFN1] * Differences were considered statistically significant. The values in parentheses are 95% uncertainty intervals (95% UI).