In This Article

The United States faces a complex and evolving crisis when it comes to substance use disorders (SUDs). These disorders affect people across demographics. It destroys lives and strains families, communities, and healthcare systems.

Understanding the shocking scale of this problem, along with its risk factors, is crucial for creating prevention and treatment programs that save lives.

• Nearly 50 million Americans experienced a substance use disorder in the past year.
• Despite the widespread need, only a tiny fraction (9.1%) of those with co-occurring mental health issues and SUDs receive treatment for both conditions.
• Over 70% of individuals with alcohol abuse or dependence never receive treatment.
• Suicidal thoughts are alarmingly common, affecting over 13 million US adults and 3.4 million adolescents in the past year.
• Addiction doesn’t discriminate: heroin use has increased across all income levels in recent years.

This article draws on the most recent and reliable data sources available. By focusing on up-to-the-minute information, we gain the clearest possible picture of the challenges and the best ways to address them.

Prevalence of Substance Use Disorders by Drug Type

Substance use disorders (SUDs) affect a significant portion of the US population. In 2022, the numbers reveal the varying prevalence of different substance-related disorders:

Overall Substance Use Disorders

• An estimated 48.7 million Americans aged 12 or older had a substance use disorder (SUD) in the past year.

Alcohol Use Disorder (AUD)

• Alcohol use disorders were the most common, affecting 29.5 million people.

Drug Use Disorder (DUD)

• 27.2 million people had a drug use disorder.
• Of those with DUD, 8.0 million also had an alcohol use disorder, highlighting the overlap between the two.

Illicit Drug Use

• Around 70.3 million people aged 12 or older used illicit drugs in the past year.
• Marijuana was the most common illicit drug, used by 61.9 million people (22.0% of those aged 12+).

Mental Health & Substance Use

• Mental health issues are closely linked to SUDs. Nearly 1 in 4 adults (59.3 million) experienced any mental illness (AMI) in the past year.
• Among adolescents (12-17), 19.5% (4.8 million) experienced a major depressive episode (MDE) in the past year.

Suicidal Thoughts & Behaviors

Suicidal thoughts are concerningly common, especially linked to mental health struggles:

• 1 in 20 US adults (13.2 million) had serious suicidal thoughts in the past year.
• Over 1 in 8 adolescents (13.4% or 3.4 million) had serious suicidal thoughts in the past year.

These statistics show the widespread impact of substance use disorders. It’s crucial to address both substance use and mental health needs, as they often go hand-in-hand.

Age and Gender Differences in Addiction Rates

Substance use and addiction rates vary significantly based on both age and gender.  Here’s a breakdown of the key trends:

Gender Differences

Males vs. Females

Generally, men are more likely to use illicit drugs and have higher rates of alcohol use/dependence. However:

• Women are equally likely to develop substance use disorders (SUDs).
• Women may be more prone to cravings and relapse, impacting their recovery process.

Specific Substances

• Marijuana: Use is lower among females, but they may experience different effects.
• Alcohol: Men have historically had higher AUD rates, but this gap is narrowing.
• Prescription Drugs: Women are more likely to overdose or seek emergency care due to prescription drug misuse.
• Stimulants: Abuse rates are similar, but women may start using earlier and experience stronger cravings.

Age Differences

• Adolescents: Alcohol use rates are surprisingly similar for boys and girls aged 12-17.
• Young Adults: Females aged 12-20 may have slightly higher rates of alcohol misuse than males.
• Older Adults: Women 65+ have significantly higher rates of prescription painkiller addiction than their male peers.

Treatment & Recovery Considerations

• Gender-Specific Care: Treatment programs tailored to the unique needs of men or women can be more effective.
• Telescoping Effect: Women often progress from substance use to dependence more quickly than men, impacting treatment approaches.

Socioeconomic Factors and Addiction Risk

Socioeconomic status plays a significant role in addiction risk. Here’s how factors like income, education, and social circumstances contribute:

Income & Addiction

• Smoking is much more common among low-income individuals than those with high incomes.
• Contrary to stereotypes, higher income levels are linked to increased alcohol and drug use among teens and young adults.

Education & Parental Influence

• Low parental education levels correlate with an increased risk of heroin use in children.
• Students who skip school (truancy) are far more likely to experiment with or become addicted to heroin.

Socioeconomic Disparities

• People in the lowest income brackets are more likely to report problems associated with substance abuse.
• Lower socioeconomic status dramatically increases the risk of alcohol-related death and opioid addiction.

Unexpected Trends

• Heroin use has increased across all income groups in the US.
• Upper-middle-class youth face a surprisingly high risk of drug and alcohol addiction.

Poverty, Marginalization, & Substance Use

• Poverty and social disadvantage create a cycle where substance use becomes both a cause and a consequence of hardship.

Addiction doesn’t discriminate based on socioeconomic status.  Effective prevention and treatment must address the unique challenges faced by people from all backgrounds.

Co-occurring Mental Health Disorders and Addiction

People can struggle with both substance use disorders (SUDs) and mental health conditions, known as co-occurring disorders or dual diagnoses. Here’s a look at how prevalent this is:

Prevalence of Co-occurring Disorders

• 7.7 million US adults experience co-occurring mental health and substance use disorders.
• Of adults with SUDs, 37.9% also have a mental illness. Among adults with a mental illness, 18.2% have a co-occurring SUD.
• Over 60% of teens in substance use treatment programs also meet the criteria for a mental health disorder.

Treatment & Barriers

• Only 9.1% of people with co-occurring disorders receive treatment for both conditions.
• Common reasons for not seeking help include cost (cited by 52.2% of those needing mental health care) and not being ready to stop using substances (38.4%).

Specific Conditions

• SUDs frequently co-occur with anxiety disorders like generalized anxiety, panic disorder, and PTSD.
• Depression, bipolar disorder, and other mood disorders are also highly prevalent alongside substance use disorders.

Additional Statistics

• Co-occurring serious mental illness (SMI) and SUDs in young adults (18-25) rose from 1.7% in 2015 to 2.8% in 2019.
• Of those with heroin use disorder, over 66% are nicotine-dependent, and significant percentages struggle with alcohol or cocaine addiction.
• People with co-occurring disorders are much more likely to be arrested, highlighting the complex challenges they face.

Global Perspective

• Studies across cultures show high rates (50-80%) of psychiatric conditions among people with drug use disorders.

The significant overlap between mental health and addiction underscores the need for treatment that addresses both conditions simultaneously.

Treatment Rates and Barriers to Accessing Care

Despite the importance of treatment, many individuals with mental health and substance use disorders never receive the help they need. Here’s a look at the numbers:

Treatment Rates

• Co-occurring Disorders: Only 9.1% of the 7.7 million adults with co-occurring disorders receive treatment for both conditions.
• Substance Use Disorders (SUDs): Treatment gaps are wide, with the vast majority (78.1%) of individuals with alcohol abuse/dependence going untreated.
• Mental Health Disorders: Over half of people with conditions like depression, anxiety disorders, and bipolar disorder do not receive treatment.

Barriers to Accessing Care

There are various barriers to accessing proper care for SUD treatment. Closing the treatment gap requires addressing these obstacles:

• Cost & Insurance: High costs and inadequate insurance coverage prevent many from seeking care (37% for mental health, 31% for SUD treatment).
• Provider Shortages: Lack of mental health professionals, especially in rural areas, limits access.
• Stigma: Fear of judgment or confidentiality concerns deter individuals from seeking help.
• Lack of Awareness: People may not know what resources exist or how to recognize signs of needing help.
• Systemic Issues: Long waitlists, fragmented care systems, and socioeconomic factors like poverty create additional barriers.

Summary

Substance use disorders (SUDs) are a widespread problem in the US. It affects nearly 50 million people. This crisis cuts across all demographics and has devastating consequences for individuals, families, and communities.

Alarmingly, despite the need, treatment rates remain low. Only a tiny fraction receive help, especially for co-occurring mental health issues.

We must strive for improved access to treatment programs that address both substance use and mental health needs. Considering the unique challenges different populations face will lead to more effective solutions.