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Americans Struggling With Addiction, Mental Health, SAMHSA Survey Shows

— Biden administration highlights need for better access to treatment

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The Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of its on Tuesday, which showed that nearly one in five Americans ages 12 and older reported having a substance use disorder in the past year, and roughly one in four adults reported having a mental illness.

While the nation has made "progress," there's still more work to be done, said Rahul Gupta, MD, MPH, MBA, director of the Office of National Drug Control Policy, during a call with reporters on Monday. "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 ... We need to close this gap and we need to make sure that everyone who needs treatment can get it."

In a recent , the Biden administration called for $1.55 billion to improve and expand treatments for substance use disorder, overdose prevention measures, and recovery support services, as well as more than $1.2 billion to "crack down on drug trafficking," a from HHS noted.

The NSDUH captures nationally representative, self-reported data on substance use disorders and mental health conditions, including suicidal thoughts and behaviors, and use of substance use and mental health treatment.

Looking at the on past month substance use, about 60% of adolescents and adults 12 and older used alcohol (48.7%), tobacco (18.1%), or an illicit drug (16.5%), or vaped nicotine (8.3%). Among adolescents, 7.3% of those ages 12 to 17 used tobacco or vaped nicotine in the past month.

In 2022, 48.7 million adolescents and adults reported a substance use disorder in the past year, including 29.5 million with alcohol use disorder, 27.2 million with a drug use disorder, and 8 million with both.

Of the 137.4 million current alcohol users 12 and older, 44.5% were "past month binge drinkers." The share of people who engaged in binge drinking in the past month was highest among those ages 18 to 25, at 29.5%, followed by adults ages 26 and older at 22.6%. Of adolescents 12 to 17, 3.2% reported binge drinking.

Marijuana was the most commonly used illicit drug (22%), with young adults ages 18 to 25 making up the highest percentage of marijuana users (38.2%). Of the 8.9 million people who misused opioids in the past year, 8.5 million misused prescription painkillers, and 1 million misused heroin. In addition, 991,000 people misused prescription fentanyl or used illegally made fentanyl.

Importantly, Miriam Delphin-Rittmon, PhD, the Assistant Secretary for Mental Health and Substance Use, said 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."

Among the more "promising" findings, she pointed out that 21.3 million adults who believe they had a substance use disorder considered themselves to be in recovery or to have recovered.

Furthermore, Gupta noted that, as a result of targeted efforts by the Biden administration, the rate of overdose deaths in the U.S. "flattened" in 2022 and 2023 compared with 2019 to 2021, when "sharp increases" were observed.

Looking at mental health conditions, 59.3 million, or 23.1%, of adults reported any mental illness in the past year. Five percent of adults had serious suicidal thoughts, 1.5% made a suicide plan, and 0.6% attempted suicide.

White and multiracial adults were more likely than Black, Hispanic, or Asian adults to receive mental health treatment at any time in the past year, Delphin-Rittmon noted.

As for adolescents ages 12 to 17, 4.8 million experienced a major depressive episode in the past year; 13.4% had serious thoughts of suicide, 6.5% made a suicide plan, and 3.7% attempted suicide.

Asked about the still-concerning trends despite the COVID pandemic subsiding, Delphin-Rittmon said people continue to experience its "ripple effects." CDC data have also indicated that mental health challenges persist among young women and youth, she added, while other studies have highlighted the effects of social media and bullying on kids' mental health.

She stressed that additional analyses will be needed to identify trends and drivers of the patterns observed in the survey.

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    Shannon Firth has been reporting on health policy as app's Washington correspondent since 2014. She is also a member of the site's Enterprise & Investigative Reporting team.