Alcohol Remains the Primary Driver of Treatment Admissions in the U.S., followed by Methamphetamines and Heroin

A recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA) provides a comprehensive look at substance use disorder (SUD) treatment across the United States, including who is entering treatment, what substances are most commonly involved, and what services are being utilized.

Drawing on data from the Treatment Episode Data Set (TEDS), the annual report captures admissions and discharges among individuals ages 12 and older receiving treatment at facilities licensed or certified by Single State Agencies (SSAs). The report includes episode-level data—meaning each record reflects a treatment episode rather than a unique individual, as some people may have multiple admissions within a year.

TEDS also reports substance use trends, demographics, treatment types and duration, and key outcomes such as housing stability, employment, criminal justice involvement, social support, and abstinence. The dataset presents aggregate data from 2019-2023, which includes more than 8.25 million admissions and 7.38 million discharges, offering a broader view of trends over time.

This 2025 report presents data from 2023 and includes over 1.62 million admissions and 1.47 million discharges.

Key Findings:

• Alcohol remains the leading substance for treatment admissions. In 2023, 35.7% of admissions were for alcohol use, followed by methamphetamine (14.2%), heroin (13.3%), other opiates/synthetics (13.2%), marijuana/hashish use (9.3%), cocaine (6.8%), and other substances (2%).

• Outpatient care was the most common treatment setting. Admission rates were highest in non-intensive outpatient services (41.5%), followed by residential detoxification services (12.8%), intensive outpatient services (11.0%), medications for opioid use disorder (MOUD) outpatient services (10.5%), short-term residential rehabilitation services (10.1%), and long-term residential rehabilitation services (6.7%).

Additional Findings:

• Age: Admissions and discharges were highest among individuals aged 21-34 years (35.1% and 35.4%) and 35-44 years (29.3% and 29.7%), respectively.

• Gender: 65.3% of admissions and 65.6% of discharges were male, while females accounted for 34.7% of admissions and 34.4% of discharges.

• Employment Status: 43.7% of admissions were unemployed, 30.4% were not in the labor force, and 25.8% were employed.

• Arrests: 93.1% of admissions had no arrests in the past 30 days, 5.7% had one arrest, and 1.2% had two or more arrests.

• Criminal Justice Referrals: 38.6% of admissions were referred through probation or parole, 16.3% through state or federal court, 12.6% through other recognized legal entities, 12.0% through DUI/DWI, 10.4% through formal adjudication processes, 3.9% through diversionary programs, 3.5% through other criminal justice referrals, and 2.7% through prison.

• Self-Help Group Attendance: 78.7% of admissions reported no attendance at self-help groups in the past 30 days, 5.1% reported attending self-help groups 1-3 times, 3.3% reported attending self-help groups 4-7 times, 8.5% reported attending self-help groups 8-30 times, and 4.4% reported some attendance in the past month, however the frequency was unknown.

• State Concentration: Ten states accounted for 63.9% of admissions to treatment services: Arizona, New York, Maryland, California, New Jersey, Colorado, Michigan, Minnesota, Oregon, and Massachusetts.

• Reasons for Discharge: 42.6% completed treatment, 25.1% were transferred to further treatment, 22.0% dropped out, 4.8% were discharged for other reasons, 4.1% were terminated, 1.1% were incarcerated, and 0.3% died.

Read the Report

To see how these trends have evolved over time, see our previous summary of SAMHSA’s 2024 TEDS report.

The Report

Substance Abuse and Mental Health Services Administration. (2025). Treatment Episode Data Set (TEDS) 2023: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies. Publication No. PEP25-07-014. https://www.samhsa.gov/data/report/2023-teds-annual-report