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Substance Use Disorder Statistics

April 18, 2022

Table of Contents

In 2020, nearly 60% of people in the United States age 12 or older report using substances, including illicit drug use, alcohol, or tobacco. This represents 162.5 million people. [1]

Drug and alcohol misuse increases the risk for a substance use disorder (SUD). In 2020, over 40 million adults had a SUD, or 14.5% of the US population.[1] 

Alcohol is the most commonly used addictive substance. Opioid drug use, including both illicit drugs like heroin and prescription medications like pain relievers, is a major public health crisis. These drugs are commonly misused, highly addictive, and have a high potential for overdose and death. 

Addiction is treatable. MAT (Medication for Addiction Treatment) has high success rates and can help maintain long-term recovery.

Facts About Substance Use Disorder

In 2020, approximately 18.4 million Americans met criteria for illicit drug use disorder, 28.3 million for alcohol use disorder, and 6.5 million for both.[1] 

Not everyone who uses drugs or alcohol will develop an addiction, as nearly 140 million adults in the United States were current drinkers of alcohol, and close to 60 million used illicit drugs.[1] This means that less than 5% of current alcohol or illicit drug users had a substance use disorder.

Many risk factors increase the odds of developing a substance use disorder, including environmental, social, and biological factors. “Who” will develop a SUD after use is very hard to predict. 

Causes of Addiction

All addictive drugs make neurochemical changes to brain pathways. With regular and repeated use, the brain will expect the substance to create “happy” feelings.When the drug or alcohol is not present in the system, the brain withdraws from these substances, creating various withdrawal symptoms that can range from mild flu like symptoms to as severe as psychosis, respiratory suppression and even death, depending on the substance. 

Addiction is a compulsive need to keep using drugs and/or alcohol despite the consequences. Use continues even when there is a desire to quit. 

Several factors can increase the risk of addiction, including the following:

  • Type of substance used: Some substances are more addictive than others. For example, opioid drugs can quickly make changes to the brain chemistry, which can lead to addiction more easily and faster.
  • Frequency and method of use: The more often a drug or alcohol is used, and with greater frequency, the higher the rate of addiction will be.
  • Environmental factors: Peer pressure, home living situation, and amount of parental supervision can all contribute to substance use and addiction. Exposure to trauma, especially early exposure such as in childhood, raises the odds of addiction and substance misuse later in life. People who have experienced trauma often have rates of substance use disorder that are two to three times that of the general population.[2,3]
  • Age at first use: The brain is not fully developed until a person’s mid-20s. Using mind-altering substances at a young age likely increases the risk for addiction later in life[4]
  • Biology and genetics: Addiction can be as much as 40% to 60% heritable, meaning that there is a large genetic component.[5] When a direct family member has a SUD, the odds of an individual also developing  SUD are greater. . Other biological factors, such as the presence of co-occurring mental health or medical conditions, can also increase the risk for addiction.

Stats on Specific Population Demographics & Addiction

  • Adolescents: Nearly 3% of adolescents between the ages of 12 and 17, or 712,000 teens, had an alcohol use disorder in 2020. Close to 5%, or 1.2 million teens, had an illicit drug use disorder, and 6.3% had a substance use disorder.[1]
  • Young adults/teens: Young adults and teens between the ages of 18 and 25 have the highest rates of substance use disorders, alcohol use disorders, and illicit drug use disorders. Almost 25% of this population had a substance use disorder in 2020 with 15.6% (5.2 million people) diagnosed with an alcohol use disorder and 14.6% (4.9 million people) with an illicit drug use disorder.[1]
  • Adults: Approximately 14% of adults aged 26 and older had a substance use disorder in 2020. This age group has the second-highest rate of alcohol use disorder with 22.4 million adults, or 10.3%, diagnosed in 2020. Approximately 12.3 million adults, 5.6%, had an illicit drug use disorder.
  • Elderly: Rates of substance use disorder typically drop some after young adulthood, but senior citizens are another group for which addiction is common. Close to 1 million older adults ages 65 and older reportedly living with a substance use disorder in 2018.[6] 
  • Men vs. women: Men generally have higher rates of substance abuse and dependence than women do, but both are equally at risk of developing a substance use disorder.[7] Due to higher rates of use and dependence, however, men usually have substance use disorders at higher rates than women, with 3.7% of men and 2.1% of women having a substance use disorder based on data collected from 2015 to 2019.[8]
  • Ethnicity/race: American Indians and Alaska Natives have the highest rates of substance use disorder with nearly 5% of this population having one between 2015 and 2019. The second most common were African Americans at close to 3.5%, then Caucasians at nearly 3%, and Hispanics or Latinos just under this. Asians have the lowest rates at just below 2.5%.[8]
  • Veterans: Close to 1 out of every 10 veterans has a substance use disorder, which is slightly higher than rates in the general population.[9] Rates for male veterans between the ages of 18 and 25 are much higher among veterans.
  • LGBTQ+: Rates of substance misuse and substance use disorders are higher for sexual minority populations with an estimated 20% to 30% of LGBTQ+ individuals believed to have a substance use disorder.[10] Substance use disorders in this population are often more severe and comorbid with mental health issues.

Addiction Stats for Specific Substances

  • Cocaine: In 2020, 1.3 million people, or 0.5%, had a cocaine use disorder.[1]
  • Heroin: Nearly 700,000 people ages 12 and older in the United States, 0.2%, had a heroin use disorder in 2020.[1]
  • Prescription drugs: Nearly 2.5 million (0.8%) American adults had a prescription pain reliever use disorder in 2020, while 1.2 million (0.4%) had a prescription tranquilizer or sedative use disorder, and 758,000 (0.3%) had a prescription stimulant use disorder.[1]
  • Opioids: Approximately 2.7 million people (1%) of American adults had an opioid use disorder in 2020.[1]
  • Marijuana: Just over 5%, or 14.2 million people met criteria for marijuana use disorder in 2020.
  • Methamphetamine: About 1.5 million people or 0.6% of the U.S. adult population met criteria for a methamphetamine use disorder in 2020.[1]
  • Alcohol: More than 10% of U.S. adults met criteria for alcohol use disorder in 2020, which represents nearly 30 million individuals.[1] Alcohol use disorder is the most common SUD.
    Benzodiazepines: More than 5 million people (based on 2015–2016 national surveys) misused benzodiazepines in the past year. Of this population, 0.2% met criteria for benzodiazepine use disorder.[11]
  • Nicotine: Around 20% of the population has a nicotine use disorder with lifetime rates approaching 30%.[12]
  • Hallucinogens: Just over 2.5%, or just over 7 million people, used a hallucinogen in 2020.[1] These drugs are rarely considered physically addictive; however, they have many risks of use.

Addiction Treatment Statistics

Close to 15% (41.1 million) of adults ages 12 and older in the United States needed substance use disorder treatment in a specialized facility, but only 1.4% (4 million) received necessary treatment in 2020.[1] Treatment was broken down according to type:

  • Outpatient rehab: 1.8 million
  • Self-help groups: 1.8 million
  • Outpatient mental health clinic: 1.4 million
  • Inpatient rehab: 1.1 million
  • Private doctor’s office: 1.1 million
  • Inpatient in a hospital: 801,000
  • Emergency room: 732,000
  • Jail or prison: 181,000

The majority of people receiving treatment were adults ages 26 and older with 3.4 million receiving help, followed by young adults between the ages of 18 and 25 (445,000 people). Only 6.5% of people with a substance use disorder in 2020 received specialty addiction treatment.[1]

Addiction Stats by State

States with the highest rates of substance use disorder (between 8.68% and 12.60%) based on 2017 and 2018 national surveys are as follows:[13]

  • Alaska
  • Oregon
  • Maine
  • Montana
  • Colorado
  • New Hampshire
  • Vermont 
  • Massachusetts
  • South Dakota

States with rates between 7.79% and 8.67% include:[13]

  • Washington
  • Nevada
  • Oklahoma
  • Louisiana
  • North Dakota
  • Iowa
  • Wisconsin
  • Rhode Island
  • Connecticut
  • Delaware

States with substance use disorder rates between 7.13% and 7.78% are:

  • California
  • Idaho
  • New Mexico
  • Nebraska
  • Arkansas
  • Michigan
  • Missouri
  • Illinois
  • South Carolina
  • New York
  • Ohio

The following states have substance use disorder rates between 6.70% and 7.12%:[13]

  • Arizona
  • Kansas
  • Minnesota
  • Kentucky
  • Indiana
  • Virginia
  • Pennsylvania
  • Alabama
  • Hawaii
  • Wyoming

The states with the lowest rates of substance abuse, between 6.01% and 6.69%, are:[13]

  • Texas
  • Florida
  • Georgia
  • Mississippi
  • Tennessee
  • North Carolina
  • West Virginia
  • New Jersey
  • Maryland
  • Utah

Stats on Overdose Deaths

In 2019, there were more than 70,000 drug overdose deaths in the United States, 70% attributable to opioids[14] Since 1999, at least 841,000 people have died from a drug overdose. Synthetic opioids(heroin, oxycodone, fentanyl) made up almost three-quarters of the nearly 50,000 opioid overdose deaths in 2019.[14] 

Opioid overdose death rates are on the rise. Overdose rates involving psychostimulants such as methamphetamine are up as well, particularly in the Northeast where they increased by over 40% between 2018 and 2019.[14]

Statistics on Addiction & Mental Health

Mental health issues, substance abuse, and addiction are often intertwined. As many as one out of every four adults in the United States with a serious mental health problem also has a SUD[15] People with depression, anxiety disorders, personality disorders, and schizophrenia commonly also have issues with SUD.

In 2020, approximately 17 million people in the United States, or 6.7% of the adult population, had both a SUD and a concurrent mental illness of any type. Approximately 5.7 million of those people - 2.2% - had a “serious” mental illness .[1] Mental health conditions increase the risk of a SUD and vice versa.

Stats on the Consequences of Substance Use Disorder 

Substance use disorder has a wide range of potential consequences from legal troubles to physical ones. The following issues can arise:

  • Contracting an infectious disease: Injecting drugs raises the risk of transmitting communicable diseases such as HIV and hepatitis C (HCV). Rates of both are rising with more and more people developing substance use disorders. Between 2012 and 2017, newly diagnosed HIV infections spiked by 4%,  particularly among injection drug users. Rates of HCV tripled between 2010 and 2017.[16]
  • Criminal actions: About 65% of inmates in U.S. prisons and jails, 1.5 million individuals, have a SUD.[17] Many committed crimes while under the influence of drugs or alcohol or committed a crime for the purposes of trying to obtain drugs.
  • Suicidal behaviors: Alcohol and drug use increase the risk for suicidal ideations, and addiction is arisk factor for suicide. More than 20% of all non-traffic injury deaths involving alcohol intoxication were suicides, studies show.[18]
  • Driving while intoxicated: This can lead to accidents and fatalities. More than 1 million people in the United States are arrested each year for driving while intoxicated.[19] Nearly a third of all traffic-related deaths in 2014 were alcohol-relate Almost 30 million people in the U.S. ages 16 or older drove under the influence of alcohol in 2014, while more than 10 million did so under the influence of drugs.[19]
  • Homelessness: Somewhere between 25% and 40% of the homeless population in the United States has a SUD[20] Drug and alcohol misuse and addiction can increase the risk of homelessness

Substance Use Disorder Stats FAQs

What percent of people have a substance use disorder?

In 2020, approximately 14.5% of the U.S. population ages 12 and older had a substance use disorder.[1]

What is the most common substance use disorder?

Alcohol use disorder is the most common substance use disorder. In 2020, 28.3 million adults had an alcohol use disorder compared to 18.4 million with a drug use disorder.[1]

How many different types of substance use disorders are there?

There are as many types of SUD as there are substances to misuse. Some of the more common ones are alcohol use disorder, cocaine use disorder, methamphetamine use disorder, opioid use disorder (which could include heroin use disorder, oxycodone use disorder, etc.)  

Where are substance use disorders the most common?

Methamphetamine and tobacco use are common in rural areas, while prescription drug abuse and heroin abuse are found in areas ranging from large cities to small towns. Alcohol addiction is common across the country. Some of the highest rates of substance use disorders are found in Alaska, Oregon, Maine, Vermont, Montana, Colorado, New Hampshire, Massachusetts, and South Dakota.[13]

Which demographic is most frequently impacted by substance use disorders?

Young adults between the ages of 18 and 25 have the highest rates of substance use disorders at 5.2 million people and nearly a quarter of this population. Alaskan Natives and American Indians, as well as sexual minorities, people with co-occurring mental health issues, men, and veterans, have higher rates of substance use disorders than other demographics.[1]

How often do substance use disorders and mental health issues intersect?

Around half of all people with a mental health disorder also have issues with SUDand vice versa.[21] People with anxiety disorders, depression, schizophrenia, and personality disorders have high rates of substance abuse and addiction as well. Approximately 17 million people in the United States in 2020 had both a substance use disorder and any form of mental illness.[1]

What are some common consequences of addiction?

The consequences of addiction can involve virtually every area of life. SUD can create a wide range of emotional, physical, and social issues, including trouble with the law and jail time, overdose, contraction of infectious diseases, increased mental health or medical issues, loss of job and home, increased rate of accidents and injuries, and suicidal behaviors.

What is the treatment gap between people who need addiction treatment and those who receive it?

There is a massive gap between the 41.1 million American adults who need treatment for a substance use disorder and the 4 million who receive it. This means that at least37.1 million people who could benefit from substance abuse treatment are not currently getting the treatment they deserve.[1]

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 she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf. October 2021. Accessed April 2022.
  2. Substance Use, Childhood Traumatic Experience, and Posttraumatic Stress Disorder in an Urban Civilian Population. Depression & Anxiety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/. December 2010. Accessed April 2022.
  3. Making the Connection: Trauma and Substance Abuse. The National Child Traumatic Stress Network. https://www.nctsn.org/sites/default/files/resources/making_the_connection_trauma_substance_abuse.pdf. June 2008. Accessed April 2022.
  4. Age at First Use and Later Substance Use Disorder: Shared Genetic and Environmental Pathways for Nicotine, Alcohol, and Cannabis. Journal of Abnormal Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061603/. August 2016. Accessed April 2022.
  5. Human Genetics of Addiction: New Insights and Future Directions. Current Psychology Reports. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5983372/. March 2018. Accessed April 2022.
  6. Substance Use in Older Adults DrugFacts. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/publications/drugfacts/substance-use-in-older-adults-drugfacts. July 2020. Accessed April 2022.
  7. Sex and Gender Differences in Substance Use. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use. April 2020. Accessed April 2022.
  8. Racial/Ethnic Differences in Substance Use, Substance Use Disorders, and Substance Use Treatment Utilization Among People Aged 12 or Older (2015-2019). Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/report/racialethnic-differences-substance-use. October 2021. Accessed April 2022.
  9. Substance Use and Military Life DrugFacts. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/publications/drugfacts/substance-use-military-life. October 2019. Accessed April 2022.
  10. LGBT Substance Use: Beyond Statistics. Social Work Today. https://www.socialworktoday.com/archive/070714p8.shtml.  July/August 2014. Accessed April 2022.
  11. Research Suggests Benzodiazepine Use is High While Use Disorder Rates Are Low. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/news-events/science-highlight/research-suggests-benzodiazepine-use-high-while-use-disorder-rates-are-low. October 2018. Accessed April 2022.
  12. The Epidemiology of DSM-5 Nicotine Use Disorder: Results from the National Epidemiological Survey on Alcohol and Related Conditions-III. Journal of Clinical Psychiatry. https://pubmed.ncbi.nlm.nih.gov/27135834/. October 2016. Accessed April 2022.
  13. 2017-2018 National Survey on Drug Use and Health National Maps of Prevalence Estimates, by State. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/report/2017-2018-nsduh-national-maps-prevalence-estimates-state. Accessed April 2022.
  14. Drug Overdose Deaths. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/drugoverdose/deaths/index.html. February 2022. Accessed April 2022.
  15. Mental Health and Substance Use Co-Occurring Disorders. MentalHealth.gov. https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders. March 2022. Accessed April 2022.
  16. Infectious Diseases and Injection Drug Use: Public Health Burden and Response. The Journal of Infectious Diseases. https://academic.oup.com/jid/article/222/Supplement_5/S213/5900585. September 2020. Accessed April 2022.
  17. Online Only: Report Finds Most U.S. Inmates Suffer from Substance Abuse or Addiction. The Nation’s Health. https://www.thenationshealth.org/content/40/3/E11. April 2010. Accessed April 2022.
  18. Does Alcohol and Other Drug Abuse Increase the Risk for Suicide? U.S. Department of Health & Human Services (HHS). https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-alcohol-increase-risk-of-suicide/index.html. May 2008. Accessed April 2022.
  19. Driving Under the Influence of Alcohol and Illicit Drugs. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/data/sites/default/files/report_2688/ShortReport-2688.html. December 2016. Accessed April 2022. 
  20. Fact Check: Is Most Homelessness Tied to Drugs and Alcohol? Voice of San Diego. https://voiceofsandiego.org/2017/11/09/fact-check-homelessness-tied-drugs-alcohol/. November 2017. Accessed April 2022.
  21. Medication Frequently Asked Questions. National Alliance on Mental Illness (NAMI). https://www.nami.org/FAQ/Treatment-Referrals-FAQ/How-can-I-get-help-for-my-substance-abuse-issue-an. 2022. Accessed April 2022.

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