The Negative Effects of Alcohol and Substance Use Disorders in China Part 2

Macroeconomic costs and fiscal pressure

At the macro level, the economic costs of AUD/SUD span direct medical spending, social care, law-enforcement and criminal-justice expenses, and indirect losses from reduced labor supply and productivity. Studies synthesizing regional data and attributable risk assessments show that alcohol and other modifiable behavioral risks make a measurable contribution to societal costs in Chinese cities and provinces (Qu et al., 2021). Lost productivity (reduced output, early retirement, deaths in working ages) often composes the largest share of societal cost estimates (Cui et al., 2025). Even where precise national GDP-level loss estimates vary by methodology, convergent evidence indicates that rising substance-related morbidity and mortality has quantifiable negative effects on growth and household incomes — especially in younger cohorts where years of potential life and work are lost (Ma et al., 2020). That fiscal burden falls partly on public health budgets (treatment, hospital care, prevention programs) and partly on employers and families, increasing socioeconomic inequality (Rehm, 2019).

Mental-health consequences and co-morbidities

AUD and SUDs are tightly linked with mental-health disorders. Comorbidity with depression, anxiety, psychotic disorders, and PTSD is common and bidirectional: psychiatric illness increases risk of substance misuse, and substance misuse exacerbates psychiatric symptoms and suicide risk (An et al., 2025). In China, mental and substance use disorders accounted for millions of DALYs in recent national estimates, with depressive disorders a leading contributor (Ma et al., 2020). The combined burden complicates care pathways — people with co-occurring disorders typically need integrated treatment, yet services are fragmented and treatment coverage low (Cui et al., 2025). The human cost here is profound: higher chronicity of illness, impaired family functioning, increased stigma, and elevated suicide risk among people with untreated comorbid conditions (Nature Medicine, 2023).

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Concrete statistics to anchor the discussion

• National surveys and epidemiologic analyses report high overall drinking rates. Some studies find weighted drinking rates around 41% overall, with a stark gender gap: male drinking rates often above 60% compared to under 20% among women (Cheng et al., 2015).
• Methamphetamine cases documented in surveillance rose from about 62,000 in 2008 to over 623,000 by 2015, concentrated in major urban regions (Qu et al., 2021).
• Mental-health and substance-use disorders together contributed tens of millions of DALYs nationwide in 2019, highlighting the scale of lost health and productivity (Ma et al., 2020).

Policy implications and recommendations

To blunt these harms, China needs a multipronged approach: strengthen early prevention (public awareness, alcohol policy measures like pricing and restricted availability), scale up evidence-based treatment (expand medication-assisted approaches, integrate addiction care into primary and mental-health services), and invest in workforce training for addiction and dual-diagnosis care (Cui et al., 2025). Surveillance and better data are essential: timely, regional monitoring of alcohol and drug trends allows targeted interventions in high-risk urban and migrant populations (An et al., 2025). Finally, workplace-focused programs (screening, brief interventions, employer-supported rehabilitation) can protect productivity while reducing stigma (Qu et al., 2021). Internationally validated policy mixes — taxes, advertising controls, screening and brief interventions, and treatment scale-up — have good evidence for reducing population harms, and tailoring these to China’s socio-cultural and health-system context should be a public-policy priority (Rehm, 2019; Nature Medicine, 2023).

Conclusion

Alcohol use disorder and other substance use disorders are not only medical or moral issues; they are structural problems that stress China’s health system, reduce workforce capacity, impose measurable economic costs, and amplify mental-health needs. Addressing them requires coordinated public-health policy, investment in treatment and rehabilitation, better surveillance, and workplace and community interventions. Doing so will reduce avoidable illness, protect economic productivity, and improve population mental health — benefits that extend far beyond the individuals directly affected.

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