The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSA’s 2018 National Survey on Drug Use and Health (PDF | 1.6 MB) reports that approximately 20.3 million people aged 12 or older had a substance use disorder in the past year.

Alcohol

Data:

• The 2018 National Survey on Drug Use and Health reports that 139.8 million Americans age 12 or older were past month alcohol users, 67.1 million people were binge drinkers in the past month, and 16.6 million were heavy drinkers in the past month.
• About 2.2 million adolescents aged 12 to 17 in 2018 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2018 NSDUH).
• Approximately 14.8 million people age 12 or older had an alcohol use disorder (2018 NSDUH).
• Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions.
• Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily.

Programs/Initiatives:

• STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
• Interagency Coordinating Committee on the Prevention of Underage Drinking
• Talk. They Hear You. – underage drinking media campaign
• Underage Drinking: Myths vs. Facts
• Talking with your College-Bound Young Adult About Alcohol
• Sober Truth on Preventing Underage Drinking (STOP Act) Grants

Relevant links:

• National Association of State Alcohol and Drug Abuse Directors
• Department of Transportation Office of Drug & Alcohol Policy & Compliance
• Alcohol Policy Information Systems Database (APIS)
• National Institute on Alcohol Abuse and Alcoholism

Tobacco

Data:

• Data from the 2018 NSDUH reports that 58.8 million people were current (i.e., past month) tobacco users. Specifically, 47.0 million people aged 12 or older in 2018 were past month cigarette smokers.
• Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States.
• The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes.

Electronic cigarette (e-cigarette) use data:

• Data from the Centers for Disease Control and Prevention’s 2018 National Youth Tobacco Survey indicate a 78 percent increase in current e-cigarette use among high school students and a 49 percent increase among middle school students from 2017 to 2018.
• E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals.

Resources:

• Tips for Teens: Tobacco
• Tips for Teens: E-cigarettes
• Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
• Synar Amendment Program

Links:

• Truth Initiative
• FDA Center for Tobacco Products
• CDC Office on Smoking and Health
• National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
• National Institute on Drug Abuse: E-Cigarettes

Opioids

Data:

• An estimated 808,000 people had used heroin in the past year, based on 2018 NSDUH data.
• In 2018, there were 10.3 million people age 12 or older who misused opioids in the past year. The vast majority of people misused prescription pain relievers (2018 NSDUH).
• An estimated 2.0 million people aged 12 or older had an opioid use disorder based on 2018 NSDUH data.
• Opioid use, specifically injection drug use, is a risk factor for contracting HIV, Hepatitis B, and Hepatitis C. The CDC reports that people who inject drugs accounted for 9 percent of HIV diagnoses in the United States in 2016.
• According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 130 Americans die every day from an opioid overdose.

Resources:

• Medication-Assisted Treatment
• Opioid Overdose Prevention Toolkit
• TIP 63: Medications for Opioid Use Disorder
• Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
• Opioid Use Disorder and Pregnancy
• Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
• The Facts about Buprenorphine for Treatment of Opioid Addiction
• Pregnancy Planning for Women Being Treated for Opioid Use Disorder
• Tips for Teens: Opioids
• Rural Opioid Technical Assistance Grants
• First Responders—Comprehensive Addiction and Recovery Act (FR-CARA) Grant
• Tribal Opioid Response Grants
• Provider’s Clinical Support System - Medication Assisted Treatment Grant Program

Links:

• National Institute on Drug Abuse: Opioids
• National Institute on Drug Abuse: Heroin
• HHS Prevent Opioid Abuse
• Community Anti-Drug Coalitions of America
• Addiction Technology Transfer Center (ATTC) Network
• Prevention Technology Transfer Center (PTTC) Network

Marijuana

Data:

• 2018 NSDUH data indicates that 43.5 million Americans aged 12 or older, 15.9 percent of the population, used marijuana in the past year.
• Approximately 4.4 million people aged 12 or older in 2018 had a marijuana use disorder in the past year (2018 NSDUH).
• Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term.
• Marijuana can have significant health effects on youth and pregnant women.

Resources:

• Know the Risks of Marijuana
• Marijuana and Pregnancy
• Tips for Teens: Marijuana

Relevant links:

• National Institute on Drug Abuse: Marijuana
• Addiction Technology Transfer Centers on Marijuana
• CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

• Methamphetamine—Methamphetamine use has risen in the United States. In 2018, NSDUH data show that approximately 1.9 million people used methamphetamine in the past year. Approximately 1.1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2017. The National Institute on Drug Abuse reports that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.

• Cocaine—In 2018, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 775,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
• Kratom—Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.

Resources:

• Tips for Teens: Methamphetamine
• Tips for Teens: Cocaine
• National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.