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2021 National Survey on Drug Use and Health Data Released

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Medically Reviewed By: Diana Vo, LMFT

December 15, 2023

Table of Contents

HHS (U.S. Department of Health and Human Services) and SAMHSA (Substance Abuse and Mental Health Services Administration) released the latest findings from NSDUH 2021.

NSDUH (National Survey on Drug Use and Health) is an annual survey that addresses the following issues:

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  • Drug use (illicit drugs and prescription medications)
  • Alcohol use
  • Addiction
  • Engagement with addiction treatment

The 2021 report includes estimates of substance abuse and mental health markers by age group, race, and ethnicity.

NSDUH 2021 is the most comprehensive report to date and the findings show that over 46 million over-12s in the U.S. were addicted to drugs or alcohol in 2021.

National Survey on Drug Use and Health

The federal government has conducted NSDUH since 1971. The report is considered a primary source of statistical data on substance abuse and mental health issues in the U.S. civilian population aged 12 and older.

NSDUH measures:

  • Use of prescription drugs, illicit drugs, alcohol, and tobacco
  • Substance use disorder
  • Treatment for substance abuse
  • Major depressive episodes
  • Mental health disorders
  • Treatment for mental health conditions
  • Perceived recovery from addiction and mental health issues

NSDUH 2020 vs NSDUH 2021

SAMHSA suggests that the findings of NSDUH 2021 are not comparable with estimates from previous surveys due to methodological changes to the way data is collected.

During the pandemic of 2020, researchers used web interviews to supplement in-person interviews when collecting data. Researchers concluded that estimates based on online interviews differ from those based on face-to-face interviews. Weighting data fails to account for these differences in data collection.

Despite these differences in data collection, though, one thing is abundantly clear: addiction in the United States continues to rise.

  • In 2019, 20 million U.S. citizens were addicted to drugs or alcohol.
  • In 2020, 40 million U.S. citizens were addicted to drugs or alcohol.
  • In 2021, 26 million U.S. citizens were addicted to drugs or alcohol.

The most disturbing of these increases is the doubling of the number of U.S. citizens with addictions from 2019 to 2020 as the pandemic created unprecedented stress for most people. At the time, SAMHSA explained this huge increase by stating that the criteria used to diagnose addictions changed from the criteria in DSM-IV to the criteria in DSM-5. It is worth noting that SAMHSA claimed in 2020 that “the impact of methodological changes is likely to be minor”.

Whatever the reasons, the abuse of alcohol and drugs are impacting tens of millions of U.S. citizens and their families. Just how bad is this problem?

NSDUH 2021 Highlights

NSDUH 2021 reports on many areas of drug use, alcohol use, and mental health issues.

These are some key findings for substance abuse and addiction in the form of substance use disorder:

  • 61.2 million U.S. over-12s reported using illicit drugs in 2020.
  • Marijuana was the most common drug of abuse, with over 52 million people reporting past-year use.
  • Among young adults aged 18 to 25, almost two in five reported using illicit drugs in 2020. One in three of the same demographic reported past-year marijuana use.
  • 9.2 million U.S. over-12s reported misusing opioids in 2020.
  • 46.3 million over-12s satisfied DSM-5-TR criteria for substance use disorder in 2020. This translates to almost 17% of the U.S, population with a diagnosable addiction.
  • 29.5 million U.S. over-12s met the DSM criteria for alcohol use disorder (alcoholism) in 2020.
  • 24 million over-12s were diagnosed with a drug addiction in 2020.

Substance use disorder in 2020 was most prevalent among young adults aged 18 to 25.

In 2020, only 6% of those diagnosed with substance use disorders obtained treatment at a specialist facility. Most people who did not engage with addiction treatment did not feel that they required professional help.

These are some key findings for co-occurring disorders – addictions and mental health conditions that present simultaneously:

  • 13.5% of 18-25s met the criteria for both substance use disorder and AMI (any mental illness).
  • Almost one in three U.S. adults had either a mental health disorder or a substance use disorder in 2020.
  • 46% of 18-25s were diagnosed with either a mental health disorder or a substance use disorder in 2020.
  • The prevalence of co-occurring disorder (dual diagnosis) was highest among multiracial adults in the U.S.

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Joseph Gilmore has been in the addiction industry for three years with experience working for facilities all across the country. Connect with Joe on LinkedIn.

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