According to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA), almost 20% of Americans ages 12 and older reported having a substance use disorder in the last year, and around 25% of adults reported having a mental illness. Here are the key findings.

Tactics to build a stronger behavioral health system

Survey details and key findings

Since 1971, SAMHSA has conducted the National Survey on Drug Use and Health (NSDUH), which collects self-reported substance use and mental health information from Americans ages 12 and older. The survey measures include:

• The use of alcohol, tobacco, prescription drugs, and illegal drugs
• Rates of substance use disorder and substance use treatment
• Major depressive episodes, suicidal thoughts and behaviors, and other symptoms of mental illness or mental healthcare
• Recovery from substance use and mental health disorders

In the 2022 NSDUH, researchers found that 59.8% of individuals ages 12 and older reported using tobacco products, vapes, alcohol, or illicit drugs in the past month. Almost 50% of respondents in this group said they drank alcohol, 18.1% used tobacco products, 8.3% vaped nicotine, 16.5% used an illicit drug.

In 2022, 70.3 million people ages 12 and older, or 24.9% of respondents, said they had used illicit drugs in the past year. Marijuana was the most used illicit drug, with 22% of respondents saying they had used it in the past year. Young adults ages 18 to 25 made up the highest percentage of marijuana users at 38.2%.

In total, 48.7 million people ages 12 and older reported a substance use disorder in the past year, with 29.5 million reporting an alcohol use disorder, 27.2 million reporting a drug use disorder, and 8 million reporting both.

Around a quarter of adults ages 18 and older (23.1%) reported having any mental illness in the past year. Around 5% of adults also reported having serious thoughts of suicide in the past year, and 1.5% said they made a suicide plan. Less than one percent (0.6%) said they had attempted suicide in the last year.

Among adolescents ages 12 to 17, 19.5% said they had a major depressive episode in 2022. In addition, 13.4% of adolescents said they had serious thoughts of suicide in the last year, while 6.5% made any suicide plans, and 3.7% attempted suicide.

Commentary

According to Rahul Gupta, director of the Office of National Drug Control Policy, the United States has made "progress" on substance use and mental health issues in the last few years. He said targeted efforts by the Biden administration "flattened" the rate of overdose deaths in 2022 and 2023 after "sharp increases" were observed from 2019 to 2021.

HHS Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon also noted that the survey data showed "no difference by racial and ethnic groups in the percentage of people who receive substance use treatment in the past year among people who needed it." Another "promising" finding was that 21.3 million adults who believed they had a substance use disorder said they were either in recovery or have recovered.

However, Gupta also noted that there is still more work that needs to be done. "There are currently more than 48 million Americans struggling with substance use disorders, and three out of every four are not getting the treatment they need," Gupta said. "… We need to close this gap and we need to make sure that everyone who needs treatment can get it."

People are still experiencing the "ripple effects" of the COVID-19 pandemic, Delphin-Rittmon said. Currently, CDC data shows that young women and younger individuals are facing persistent mental health challenges. Studies have shown that social media and bullying have also had a negative effect on children's mental health.

According to Delphin-Rittmon, additional analyses are needed to identify the trends and drivers of patterns found in the 2022 NSDUH.

"To tackle the behavioral health crisis in this nation, we need to fully understand the issues surrounding mental health and substance use, and the impact they have on people and communities," said HHS Deputy Secretary Andrea Palm. (Firth, MedPage Today, 11/14; SAMHSA press release, 11/13; SAMHSA 2022 NSDUH releases, accessed 11/17)