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The lifetime use of illicit drugs is among the lowest in Organisation for Economic Cooperation and Development countries, but harm from alcohol, tobacco, and gambling ranks among the world's highest. Historically, methamphetamine accounted for the majority of drug\u2010related offenses, but the number of people who were apprehended for cannabis offenses in 2023 exceeded the number who were apprehended for stimulants for the first time since 1958. Nevertheless, the lifetime prevalence of illicit drug use among adults remains under ~3%. In contrast, heavy drinking among working\u2010age men, decades of tobacco consumption, and rapid digitalization that has more recently led to a surge in online gambling and gaming disorder have imposed a substantial disease burden. The present review discusses Japan's epidemiology, social impact, policy changes, prevention, and treatment infrastructure of drug\u2010related problems and the latest trends in addiction science and proposes ways to link policy and research. Japan's experience, balancing strict enforcement with health\u2010centered care, may offer lessons for regions that have similar social contexts.<\/jats:p>","DOI":"10.1111\/add.70307","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:39:35Z","timestamp":1767166775000},"page":"1316-1324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Addiction\u2010related problems in Japan: A regional perspective"],"prefix":"10.1111","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-2841","authenticated-orcid":false,"given":"Soichiro","family":"Ide","sequence":"first","affiliation":[{"name":"Addictive Substance Project Tokyo Metropolitan Institute of Medical Science  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Nishitani","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Sumitani","sequence":"additional","affiliation":[{"name":"Department of Pain and Palliative Medicine The University of Tokyo Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masabumi","family":"Minami","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Graduate School of Pharmaceutical Sciences Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Isa","sequence":"additional","affiliation":[{"name":"Department of Neurobiology Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masako","family":"Iseki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Clinic Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Ohkura","sequence":"additional","affiliation":[{"name":"Research and Development Initiative Chuo University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Okamoto","sequence":"additional","affiliation":[{"name":"RIKEN Center for Brain Science  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuro","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Otsuka Pharmaceutical Co., Ltd.  Tokushima Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Sekino","sequence":"additional","affiliation":[{"name":"Graduate School of Agricultural and Life Sciences The University of Tokyo  Tokyo Japan"},{"name":"Institute for Drug Discovery Innovation  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Graduate School of Medical and Dental Sciences Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Kyushu University Faculty of Law  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsumi","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Therapy &amp; Neuropharmacology, Faculty of Pharmaceutical Sciences University of Toyama  Toyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Honjo","sequence":"additional","affiliation":[{"name":"Hitotsubashi University Graduate School of Law  Tokyo Japan"},{"name":"Department of Legal Medicine The University of Osaka Graduate School of Medicine  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"The Institute for Death Control and Prevention The University of Osaka  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Miyakawa","sequence":"additional","affiliation":[{"name":"Division of Systems Medical Science, Center for Medical Science Fujita Health University  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiya","family":"Murai","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Drug Dependence Research National Institute of Mental Health, National Center of Neurology and Psychiatry  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Nakagome","sequence":"additional","affiliation":[{"name":"Department of Psychiatry National Institute of Mental Health, National Center of Neurology and Psychiatry  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8342-0278","authenticated-orcid":false,"given":"Kazutaka","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Addictive Substance Project Tokyo Metropolitan Institute of Medical Science  Tokyo Japan"},{"name":"Department of Neuropsychopharmacology National Institute of Mental Health, National Center of Neurology and Psychiatry  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,30]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"National Police Agency Drug offense statistics for 2023: violations of the Cannabis Control Act and the Stimulants Control Act. 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