Objective　Opioid　use　disorders　(OUDs)　have　become　a　significant　global　public　health　challenge.　Despite　extensive　research　on　the　opioid　crisis,　the　trends　in　incidence　and　regional　disparities　remain　inadequately　understood.　Methods　Data　were　obtained　from　the　Global　Burden　of　Disease　2021,　covering　204　countries　and　territories.　OUDs　incidence　cases　and　rates　per　100,000　population　were　analyzed　over　the　study　period.　Trends　were　evaluated　using　the　estimated　annual　percentage　Results　Globally,　OUDs　cases　increased　by　49.25%　from　1,301,551　(95%　uncertainty　interval　[UI]:　1,077,634　to　1,598,053)　in　1990　to　1,942,525　(95%　UI:　1,643,342　to　2,328,363)　in　2021.　The　incidence　rate　in　2021　was　24.62　per　100,000　population,　with　an　EAPC　of　-0.25　(95%　confidence　interval:　-0.39　to　-0.1).　Males　had　slightly　higher　rates　than　females　(25.39　vs.　23.84　per　100,000).　Individuals　aged　15-49　years　carried　the　highest　burden,　while　older　age　groups　showed　the　largest　increases　in　cases.　High-income　North　America　reported　the　highest　incidence　rate　in　2021　(123.28　per　100,000)　and　the　largest　case　increase　(425.34%).　Among　countries,　the　United　States　had　the　highest　incidence　rate　increase　(EAPC:　5.55),　while　Switzerland　experienced　the　largest　decline　(EAPC:　-4.33).　A　moderate　positive　correlation　was　identified　between　2021　incidence　rates　and　socio-demographic　development　(rho=0.382,　p＜0.001).　Conclusion　This　study　highlights　substantial　global　variability　in　OUDs　trends,　with　significant　differences　across　regions,　sexes,　age　groups,　and　countries.　Findings　emphasize　the　need　for　tailored　prevention　and　treatment　strategies.