The Negative Effects of Alcohol and Substance Use Disorders in China Part 1

Alcohol use disorder (AUD) and other substance use disorders (SUDs) are often framed as individual problems, but in China they represent a major and growing public health challenge with wide social and economic consequences. Patterns of drinking and drug use have changed in recent decades: overall alcohol consumption and the prevalence of harmful drinking have risen for many groups, while stimulant and synthetic drug use (notably methamphetamine) have shown steep increases in reported cases (Cheng et al., 2015; Qu et al., 2021). These trends raise urgent concerns about strain on health services, lost productivity, fiscal costs, and the mental health burden on individuals, families, and communities (An et al., 2025).

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Impact on the health care system

First, the clinical burden is large and rising. Alcohol contributes to a broad spectrum of physical illnesses — from liver disease and cardiovascular problems to cancers and injury — and also to mental and behavioral disorders (Rehm, 2019). Global Burden of Disease analyses show that alcohol-attributable disease burden in China increased substantially between 1990 and recent years; alcohol-related disorders and other SUDs together account for millions of disability-adjusted life years (DALYs) (Ma et al., 2020). This translates into more hospital admissions, longer outpatient follow-ups, and greater need for specialist addiction and psychiatric services at a time when China’s mental-health system is still scaling up. The mismatch between demand and specialized services (e.g., evidence-based AUD/SUD treatment, integrated addiction–mental health care) amplifies pressure on general hospitals and primary care (Cui et al., 2025).

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Beyond volume, AUD/SUD care is costly and complex. Acute presentations (overdoses, alcohol-related trauma, withdrawal syndromes) require emergency care and sometimes intensive care; chronic complications (cirrhosis, heart disease) require long-term management and expensive procedures (Nature Medicine, 2023). Treatment gaps are substantial: many people with AUD/SUD do not receive evidence-based medical or psychosocial treatments, increasing downstream costs and avoidable morbidity (Ma et al., 2020). The need for workforce training, specialist clinics, and community rehabilitation services creates both one-time investment needs and recurring operational costs for the health system (Cui et al., 2025).

Effects on employment and productivity

AUD and SUDs also reduce workforce participation and productivity. Problematic drinking and drug use increase absenteeism, presenteeism (reduced performance while at work), workplace accidents, and early exit from the labor force. In China’s rapidly urbanizing labor market — where many industries rely on large workforces and migrant labor — these effects have outsized implications. Regions with rising stimulant use have reported concentrated impacts among working-age adults, which disproportionately influences productive capacity (Qu et al., 2021). For example, documented methamphetamine use cases rose dramatically from about 62,000 in 2008 to over 623,000 by 2015 in one analysis, concentrated in major urban and industrial agglomerations — areas critical to national economic output (Cheng et al., 2015). The cumulative effect is fewer productive work years, lower firm output, and higher employer costs (Cui et al., 2025).

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References

An, J., Wang, Q., Bai, Z., Du, X., Yu, D., Mo, X., & others. (2025). Global burden and trend of substance use disorders, self-harm, and interpersonal violence from 1990 to 2021, with projection to 2040. BMC Public Health, 25, Article 1632. https://doi.org/10.1186/s12889-025-22814-0

Cheng, H. G., Deng, F., Xiong, W., & Phillips, M. R. (2015). Prevalence of alcohol use disorders in mainland China: A systematic review. Addiction, 110(5), 761–774. https://doi.org/10.1111/add.12876

Cui, X., Liu, K., Ji, Y., Han, S., & Cheng, Y. (2025). Global trends in the burden of alcohol use disorders in the working-age population from 1990 to 2021 and projections for the next 20 years. Frontiers in Public Health, 13, Article 1616343. https://doi.org/10.3389/fpubh.2025.1616343

Ma, C., Yu, S., Huang, Y., Liu, Z., Wang, Q., Chen, H., & Zhang, T. (2020). Burden of mental and substance use disorders — China, 1990–2019. China CDC Weekly, 2(40), 771–777. https://doi.org/10.46234/ccdcw2020.219

Nature Medicine. (2023). Alcohol consumption and risks of more than 200 diseases: A comprehensive analysis. Nature Medicine, 29(6), 1235–1244. https://doi.org/10.1038/s41591-023-02383-8

Qu, X., Zhang, T., & Yu, S. (2021). The burden of alcohol use disorders in China and its regions: 1990–2017. Journal of Global Health, 11, 04060. https://doi.org/10.7189/jogh.11.04060

Rehm, J. (2019). Global burden of alcohol use disorders and alcoholic liver disease. Biomolecules, 9(10), 99. https://doi.org/10.3390/biom910099