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A New Report Looks at Substance Use Trends in the U.S. in 2019

Updated: Nov 17, 2020

The 2019 National Survey on Drug Use and Health Finds Declines in Opioid Use Disorders but Rises in Marijuana, Methamphetamine Use, and Mental Illness

The Substance Abuse and Mental Health Services Administration (SAMHSA) recently released results from the 2019 National Survey on Drug Use and Health (NSDUH). The report finds declines in the misuse of prescription pain medication, alcohol use, and cigarettes, but increases in marijuana use and methamphetamine use, along with an increase in mental illness.

Conducted annually for individuals over the age of 12 in the U.S., the NSDUH based its findings on over 67,000 interviews that capture changes in substance use and substance use disorders (SUD) over time. Overall, the NSDUH finds, the number of Americans with an SUD has held steady in recent years, as 20.4 million people had one in 2019. But the topline continuity masks changes in the composition of substance use.

Prescription pain medication misuse fell from 4.7 percent in 2015 to 3.5 percent in 2019, according to the findings. The amount of people with an opioid use disorder also fell across that time period, from 2.4 million people to 1.6 million. Heroin initiation decreased by 57 percent from 2018.

Past year tobacco use declined between 2002-2019, from 26 percent to around 17 percent, and past year cocaine use fell from 2.5 percent to 2 percent in these years. The number of individuals with an alcohol use disorder (AUD) also declined by 2.4 percent in the same span, from 18.1 million people to 14.5 million. It remains the most common form of SUD and most commonly used substance, with 139.7 million people drinking in the past month, of whom 65.8 million are binge drinkers.

Past year methamphetamine use rose from 0.5 percent to 0.8 percent from 2018 to 2019, and hallucinogen use increased from 0.8 percent to 1.5 percent between 2015 and 2019. While the number of individuals with a marijuana use disorder declined from 2002 by 1.5 percent among adolescents between 12 and 17, the figures rose for adults 26 or older, from 1.4 million people in 2002 to 2.2 million in 2019. In that latter group, daily marijuana use in the past year increased from 4.5 million people to 7.3 million between 2016-2019. Marijuana use over the past year rose from 11 percent to 17.5 percent since 2002.

The number of individuals needing SUD treatment, 15.6 million, was similar to recent years. And 4.2 million people received treatment in 2019 (1.5 percent), and 2.6 million (1 percent) received it at a specialty facility.

Mental illness increased from 17.7 percent to 20.6 percent between 2008 and 2019. 9.5 million people 18 or older had both an SUD and a mental illness, a 0.5 percent increase from 2015.

“This year’s National Survey on Drug Use and Health has some very encouraging news: The number of Americans with opioid use disorder dropped substantially, and fewer young adults are abusing heroin and other substances,” commented Health and Human Services (HHS) Secretary Alex Azar. “Increases in marijuana and methamphetamine use and in serious mental illness are very concerning, and we expect that these challenges will be exacerbated by this year’s pandemic.”

The full report is available here.


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