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46.3 Million in US Met Criteria for SUD Diagnosis in 2021

In 2021, 46.3 million people aged 12 or older in the US—about 16.5% of the nation’s population—met the applicable DSM-5 criteria for having a substance use disorder. Of those, 94% did not receive any treatment. The findings come from the 2021 National Survey on Drug Use and Health (NSDUH), which was released this week by the US Department of Health and Human Services’ (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA).

The survey has been published annually since 1971, although SAMHSA cautioned that estimates in the latest edition should not be compared with past years because the COVID-19 pandemic forced changes to its data collecting methods.

With selected estimates by race, ethnicity, and age group, the NDSUH provides a window into Americans’ experiences with mental health conditions, substance use, and their pursuit of treatment. This year’s report included the following findings from within the past year:

  • 61.2 million people at least 12 years of age used illicit drugs. Marijuana, the most commonly used substance, was used by 52.5 million.
  • 9.2 million misused opioids.
  • Of the 46.3 million Americans with a substance use disorder (SUD), 29.5 million were classified as having an alcohol use disorder and 24 million were classified as having a drug use disorder. Individuals between the ages of 18 and 25 had the highest rate of SUD of any age group.
  • 1 in 5 adolescents had a major depressive episode within the past year, nearly 75% of which had symptoms consistent with severe impairment.
  • Nearly 1 in 4 adults at least 18 years old, as well as 1 in 3 adults aged 18 to 25, had a past-year mental illness. Adults with serious mental illness reported higher rates of treatment.
  • 13.5% of adults between the ages of 18 and 25 had both a mental illness and SUD. Nearly 1 in 3 adults reported having either an SUD or any mental illness in the past year.
  • 12.3 million adults had serious thoughts of suicide within the past year.
  • 72% adults who have ever had a substance use disorder and 66.5% of adults with a mental health issue consider themselves to be recovering or in recovery.

“As the findings make clear, millions of Americans young and old faced mental health and substance use challenges—sometimes both at once—during the second year of the pandemic,” HHS Secretary Xavier Becerra said in a news release. “As we work to improve behavioral health across the nation, HHS is committed to ensuring that all people facing mental health or substance use challenges are connected to appropriate services and supports.” 

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