Alcohol and psychoactive substance use continue to impose a substantial, yet largely preventable, burden on population health in Latin America and the Caribbean (LAC). Alcohol alone is causally linked to more than 200 diseases and health conditions, and WHO estimates that harmful alcohol use caused 2.6 million deaths globally in 2019. In the Americas, alcohol consumption remains around 40% higher than the global average and is characterised by particularly risky drinking patterns. At the same time, drug use disorders are an increasing public health concern in the Region, with PAHO estimating that 17.7 million people in the Americas were living with a drug use disorder in 2021, resulting in nearly 78 000 deaths directly attributable to these disorders (Martinez et al., 2025[1]).
In 2022, total alcohol consumption among people aged 15 and over averaged 5.6 litres of pure alcohol per capita across LAC33, substantially below the OECD average of 8.8 litres (Figure 4.21). Consumption ranged from 1.8 litres in Guatemala to 11.9 litres in Saint Lucia. Other countries with comparatively high levels of consumption included Antigua and Barbuda (9.9 litres), Barbados (9.8), Argentina (9.0) and Brazil (8.2), while Venezuela, Ecuador, Honduras and Haiti also remained below 3 litres per capita. Beer accounted for the largest share of alcohol consumption in LAC on average, followed by spirits, whereas wine consumption remained comparatively low. Beverage preferences nevertheless varied markedly across countries: wine represented a relatively large share of total consumption in Argentina and Uruguay, while spirits accounted for a large proportion of consumption in several Caribbean countries, notably Saint Lucia, Dominica and Saint Vincent and the Grenadines.
Drug poisoning mortality remains much lower in LAC than in OECD countries, although recent increases in some countries warrant attention (Figure 4.22). Across LAC25, the death rate from drug poisoning stood at 0.58 deaths per 100 000 population in 2023, compared with 5.21 in the OECD36. This regional average was slightly below the 2010 level of 0.61, but above the 2019 value of 0.42. In 2023, Grenada recorded the highest reported rate in the region, at 2.38 deaths per 100 000 population, followed by Costa Rica (1.83), Uruguay (1.81), Brazil (1.43) and Trinidad and Tobago (1.42). By contrast, several countries reported rates at or close to zero. Despite the comparatively low absolute levels, the upward movement observed in countries such as Brazil, Costa Rica, Mexico and Uruguay suggests that drug-related mortality is becoming a more visible public health issue in parts of the region.
Alcohol-specific mortality shows a different pattern. Rates are considerably higher than those observed for drug poisoning, and cross-country variation is wide (Figure 4.23). In LAC25, the alcohol-specific death rate was 6.72 per 100 000 population in 2023, below the OECD36 average of 9.45, but only slightly above the 2019 regional level of 6.65 and well below the 2010 level of 8.30. Guatemala reported the highest rate in 2023 (18.21 deaths per 100 000 population), followed by Saint Kitts and Nevis (17.57), Belize (12.81), Mexico (12.49) and Nicaragua (10.91). At the other end of the distribution, the lowest rates were observed in the Dominican Republic (0.90), Panama (1.50), Jamaica (1.69), Antigua and Barbuda (1.72) and Colombia (1.76). Over the longer term, several countries recorded sizeable declines, including Saint Vincent and the Grenadines, Chile, Dominica, Guyana and Nicaragua.
Harmful drinking patterns and high alcohol-specific mortality persist in several countries, despite average alcohol consumption remaining below OECD levels, while drug poisoning mortality, though still low by OECD standards, has increased in some countries. Addressing this burden will require stronger alcohol-control policies, better prevention and early intervention, and wider access to treatment and harm reduction services. Results should be interpreted with caution, especially in small countries, where year-to-year fluctuations may reflect population size, reporting completeness and coding changes.
