Open access. Comment. The systematic analysis of the global burden of disease attributable to alcohol and drug use from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 20161 published in The Lancet Psychiatry, is the most comprehensive and systematic global estimate to date of the adverse health effects of substance use. The GBD 2016 Alcohol and Drug Use Collaborators systematically analysed data on the epidemiology of alcohol and drug use and prevalence of these use disorders, and used disability weights to estimate disability-adjusted life-years. The estimates include the burden attributable to alcohol and drug use as risk factors for a variety of health conditions.