Temporal trends and future projections of amphetamine use disorder in China and the United States: findings from the Global Burden of Disease Study 2023.

Background: Amphetamine use disorder (AUD) is a growing public health concern, yet comparative evidence on long-term trends and future burden in China and the United States remains limited due to differing drug policy and sociocultural contexts.Objectives: To compare sex-specific long-term trends and future burden of AUD in China and the United States.Methods: Data on incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2023 were obtained from the Global Burden of Disease 2023 study for males and females. Given known sex differences in substance use burden, analyses were stratified by sex. Joinpoint regression, age - period - cohort (APC) analysis, and autoregressive integrated moving average (ARIMA) models were applied to assess trends and project rates through 2038.Results: Males had consistently higher age-standardized incidence rate (ASIR) and age-standardized disability-adjusted life year rate (ASDR) than females in both countries. In 2023, ASDR among males and females were 51.92 and 30.73 per 100,000 in China, compared with 175.38 and 82.82 per 100,000 in the United States, respectively. China showed significant declining trends in ASIR and ASDR (average annual percent change [AAPC] -1.38% and -1.67%, both p < .05), whereas the United States showed increasing trends (AAPC 1.03% and 4.26%, both p < .05). APC analysis showed declining cohort effects in China but increasing risks among recent U.S. cohorts. Projections suggested continued increases among U.S. males.Conclusions: AUD burden declined in China but increased in the United States. Strengthening prevention and treatment strategies may help reduce future burden.