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Substance Use Disorder Statistics

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Oct 13, 2023 • 24 cited sources

Substance use disorders (SUD) are a pervasive issue in the United States and around the world. These chronic disorders can damage every area of a person’s life from their work and financial life to their interpersonal relationships.

Medication for Addiction Treatment (MAT), can help people to manage their SUD and build a better future.

What Classifies Someone as Having Substance Use Disorder?

A substance use disorder (SUD) is a mental health disorder characterized by an inability to control one’s use of a substance. This loss of control can be with illicit substances, like heroin, but it might also be with legal substances, such as alcohol. [1] 

There are a variety of diagnostic criteria used to check if an individual has a SUD. Broadly, medical professionals look for an inability to control drug use, signs that repeated drug use is damaging quality of life and health, and a person recognizing that their drug use is damaging their life  but still being unable to stop that drug use.[2] 

Key Facts About Substance Use Disorders

Here are some notable key facts related to SUDs:

  • In 2021, 61.2 million people in the United States used illicit drugs, representing 21.9% of the population.[3]
  • In 2021, 9.2 million people misused opioids specifically.[3]
  • In 2021, 46.3 million people met criteria for having a substance use disorder.[3]
  • SUDs commonly co-occur with other mental health issues, such as depression and anxiety disorders.[1]
  • More than 35 million people in the world have a substance use disorder.[6]

What Are the Causes of Substance Use Disorders?

Substance use disorders are complex and there is no one known “cause”. There are a number of risk factors that are well established. Genetics, stressful living situation/environmental factors, peer pressure and younger age of use are all highly associated with risk of developing a SUD.  

What Are the Signs of Substance Use Disorders?

Some signs that a person may have a substance use disorder include the following:[2]

  • Spending a significant portion of time getting drugs, using drugs, or recovering from drug use
  • Failing to meet important responsibilities, such as those at work or school due to drug use
  • Co-occurring mental health problems, such as depression or an anxiety disorder
  • Legal problems, especially those related to drug offenses
  • Monetary problems as the result of spending on drugs
  • Withdrawal from social activities 
  • Changes in mood and behavior, especially becoming more paranoid and isolated
  • Trying and failing to stop or reduce drug use
  • Withdrawal symptoms when cutting back on drug use
  • Intense cravings for the substance or obsessive thoughts about the next use of the substance

Substance Use Disorder Statistics by Country 

Here are some noteworthy statistics about SUDs in the US as compared to other countries:

  • Teens in the U.S. have higher rates of illicit drug use than European teens.[7]
  • The U.S. has the highest mortality rate globally related to SUDs.[8]
  • The U.S. has one of the highest rates of SUDs worldwide. Countries with comparable addiction rates include Greenland, the United Kingdom, Ireland, New Zealand, and Canada.[10]

Substance Use Disorder Statistics by Gender

There are some weak associations with gender as related to SUDs. Men are slightly more likely to use all types of illicit drugs. They are also  more likely to experience fatal drug overdose than women. Women, however, are just as likely to develop a substance use disorder as men.[12] There are more men in treatment for SUD than women, at roughly a rate of 2:1. [12,13] However, treatment outcomes are similar for men and women.

The reasons for some of these differences SUD between genders is  likely a mix of cultural and biological factors. For example, culturally it may be more socially acceptable for men to engage in certain types of drug related behaviors than for women. Biologically, men may metabolize alcohol and other substances differently than women. However, the differences in gender related statistics surrounding SUD aren’t fully established or understood and require more research. 

Substance Use Disorder Statistics by Age

Age is a factor in the development of SUD. Here are some statistics of SUD by age level:

  • The decade with the highest rates of new SUD are people in their twenties. [14,16] 
  • AUD rates are highest for men at age 25 and for women at age 22. After that point, rates of AUD for both sexes decline [14] 
  • Among people with an SUD in the U.S. in 2021, the highest percentage was  seen among those 18 to 25 years old at 25.6%. Among those 26 and older, the rate dropped to 16.1% 
  • The rate if SUD is approximately 8.5% for adolescents (ages 12–17).[16] 
  • Rates of developing SUDs generally decline with age [14]. That said, SUD is not limited to younger individuals; SUD is a notable contributing factor to death in people ages 65 and above.[15]

Key Substances Statistics 

In the United States, some substances are much more commonly misused than others. Based on a 2021 survey of people ages 12 and older:[16]

  • 54.7 million people used tobacco products in the prior month, including cigarettes.
  • 13.2 million people vaped nicotine products in the prior month.
  • 133.1 million Americans drank alcohol in the prior month.
  • 36.4 million used marijuana in the prior month.
  • 2.4 million misused prescription painkillers in the past month.
  • 2.2 million misused hallucinogens in the past month.
  • 1.8 million used cocaine in the prior month.
  • 1.4 million misused prescription tranquilizers or sedatives in the prior month.

Fentanyl Overdose Statistics

One of those most deadly drugs to enter the U.S. black market has been fentanyl. 

In 2021, fentanyl accounted for an estimated 67,325 preventable deaths in 2021. This represented a 26% increase compared to the prior year.[17]

Top States Battling Substance Use Disorder

The top states battling SUD are shown by their high rates of fatal drug overdose. Rates are listed as the number of deaths per 100,000 total population.[18]

These states have the highest rates of fatal drug overdose:

  • West Virginia: 90.9 
  • Tennessee: 56.6
  • Louisiana: 55.9
  • Kentucky: 55.6
  • Delaware: 54
  • New Mexico: 51.6
  • Ohio: 48.1
  • Maine: 47.1
  • Pennsylvania: 43.2
  • Indiana: 43

The states have the lowest rates of fatal drug overdose per 100,000 population:[18]

  • Nebraska: 11.4
  • South Dakota: 12.6
  • Iowa: 15.3
  • Texas: 16.8
  • North Dakota: 17.2
  • Hawaii: 17.3
  • Wyoming: 18.9
  • Idaho: 19
  • Montana: 19.5
  • Utah: 21.1

The Impact of COVID & Remote Work on Substance Use Disorder

The COVID-19 pandemic and resulting social isolation was associated with a sharp rise in substance misuse and fatal overdose in the U.S.

Between April 2020 and April 2021 during the pandemic, 100,000 people died from issues related to substance misuse, which was a 12-month all-time high.[19] 

As noted, one problem is that the pandemic isolated many individuals, which resulted in increased anxiety and depression. This may have exacerbated substance misuse across the population.

Additionally, remote work allowed some people to misuse drugs who normally wouldn’t have simply because they had more opportunity. One survey of 1,011 people found 25% reported participating in a Zoom or Microsoft Teams call while under the influence of drugs or alcohol.[19]

Addiction Treatment Statistics

Treatment is the best path to recovery from a SUD. Depending on the SUD in question, comprehensive treatment may involve a combination of medications and therapy. 

Here are some statistics on treatment for SUD:

  • Medication for Addiction Treatment (MAT) is the recommended course of treatment for OUD and AUD.
  • In 2020, only 13% of people who met criteria for  treatment for SUD received it.[20]
  • In 2020, only 11% of people with OUD who needed MAT with medications like Suboxone received that treatment.[20]
  • In 2021, 94% of people with SUDs did not receive any formal treatment. [3]
  • Relapse rates for SUD stand at between 40% and 60%, which is similar to relapse rates for other chronic disorders, such as asthma or diabetes.[22]

How to Get Help for Substance Use Disorder

If you have a SUD,  rest assured that treatment can help. Every day, people recover from SUD and begin to rebuild their lives. With appropriate assistance, you can leave substance misuse in your past. 

Start by reaching out to an addiction treatment specialist. At Bicycle Health, we offer MAT for OUD. Suboxone is considered the gold standard in treatment for OUD, managing withdrawal symptoms and opioid cravings, so you can focus on recovery. .[23,24] 

If you think Suboxone might be right for you, reach out to us today. We can meet with you via our telehealth services. And we can often get you a same-day prescription for Suboxone as appropriate. 

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Substance use and co-occurring mental disorders. National Institute of Mental Health. Published March 2023. Accessed August 15, 2023.
  2. Hasin DS, O’Brien CP, Auriacombe M, et al. DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry. 2013;170(8):834-851. doi:10.1176/appi.ajp.2013.12060782
  3. SAMHSA announces National Survey on Drug Use and Health (NSDUH) results detailing mental illness and substance use levels in 2021. U.S. Department of Health and Human Services. Published January 4, 2023. Accessed August 15, 2023.
  4. Fentanyl awareness. United States Drug Enforcement Administration. Accessed August 23, 2023. 
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  12. Sex and gender differences in substance use disorder treatment. National Institute on Drug Abuse. Published April 13, 2021. Accessed August 23, 2023. 
  13. McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev. 2018;66:12-23. doi:10.1016/j.cpr.2017.10.012
  14. Vasilenko SA, Evans-Polce RJ, Lanza ST. Age trends in rates of substance use disorders across ages 18-90: Differences by gender and race/ethnicity. Drug Alcohol Depend. 2017;180:260-264. doi:10.1016/j.drugalcdep.2017.08.027
  15. Koechl B, Unger A, Fischer G. Age-related aspects of addiction. Gerontology. 2012;58(6):540-544. doi:10.1159/000339095
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  23. Velander JR. Suboxone: Rationale, science, misconceptions. Ochsner J. 2018;18(1):23-29.
  24. Shulman M, Wai JM, Nunes EV. Buprenorphine treatment for opioid use disorder: An overview. CNS Drugs. 2019;33(6):567-580. doi:10.1007/s40263-019-00637-z
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