Key Substance Use and Mental Health Indicators in the ...

Key Substance Use and

Mental Health Indicators

in the United States:

Results from the 2019 National

Survey on Drug Use and Health

Key Substance Use and Mental Health Indicators in the United States:

Results from the 2019 National Survey on Drug Use and Health

Acknowledgments

This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA),

U.S. Department of Health and Human Services (HHS), under Contract No. HHSS283201700002C with

RTI International. Beth Han was the SAMHSA author. Kathryn Piscopo served as the government project officer

and as the contracting officer representative.

Public Domain Notice

All material appearing in this report is in the public domain and may be reproduced or copied without permission

from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or

distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS.

Electronic Access and Printed Copies

This publication may be downloaded or ordered at . Or call SAMHSA at

1-877-SAMHSA-7 (1-877-726-4727) (English and Espa?ol).

Recommended Citation

Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators

in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No.

PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality,

Substance Abuse and Mental Health Services Administration. Retrieved from

Originating Office

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration,

5600 Fishers Lane, Room 15-E09D, Rockville, MD 20857. For questions about this report, please e-mail

CBHSQrequest@samhsa..

Nondiscrimination Notice

SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color,

national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civiles aplicables y no

discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

U.S. Department of Health and Human Services

Substance Abuse and Mental Health Services Administration

Center for Behavioral Health Statistics and Quality

Populations Survey Branch

Publication Number PEP20-07-01-001

September 2020

Key Substance Use and Mental Health Indicators in the United States:

Results from the 2019 National Survey on Drug Use and Health

September 2020 | iii

Table of Contents

Summary ????????????????????????????????????????????????????????????????????????????????????1

Introduction ????????????????????????????????????????????????????????????????????????????????7

Survey Background ????????????????????????????????????????????????????????????????????7

Data Presentation and Interpretation ??????????????????????????????????????????8

Substance Use in the Past Month ???????????????????????????????????????????????8

Tobacco Use in the Past Month ???????????????????????????????????????????????????9

Cigarette Use ??????????????????????????????????????????????????????????????????????????????10

Daily Cigarette Use ??????????????????????????????????????????????????????????????????????10

Alcohol Use in the Past Month ??????????????????????????????????????????????????12

Any Alcohol Use ??????????????????????????????????????????????????????????????????????????12

Binge Alcohol Use????????????????????????????????????????????????????????????????????????13

Heavy Alcohol Use ???????????????????????????????????????????????????????????????????????13

Underage Alcohol Use ?????????????????????????????????????????????????????????????????14

Kratom Use in the Past Month ??????????????????????????????????????????????????14

Illicit Drug Use in the Past Year ?????????????????????????????????????????????????14

Any Illicit Drug Use ??????????????????????????????????????????????????????????????????????14

Marijuana Use ?????????????????????????????????????????????????????????????????????????????15

Cocaine Use ???????????????????????????????????????????????????????????????????????????????16

Heroin Use ??????????????????????????????????????????????????????????????????????????????????17

Methamphetamine Use ????????????????????????????????????????????????????????????????18

Hallucinogen Use ????????????????????????????????????????????????????????????????????????18

Inhalant Use ????????????????????????????????????????????????????????????????????????????????19

Misuse of Psychotherapeutic Drugs ??????????????????????????????????????????????20

Stimulant Misuse ????????????????????????????????????????????????????????????????????????20

Tranquilizer or Sedative Misuse ????????????????????????????????????????????????????21

Benzodiazepine Misuse ????????????????????????????????????????????????????????????????21

Pain Reliever Misuse ??????????????????????????????????????????????????????????????????22

Opioid Misuse ?????????????????????????????????????????????????????????????????????????????24

Initiation of Substance Use ???????????????????????????????????????????????????????25

Initiation of Cigarette Smoking ?????????????????????????????????????????????????????26

Initiation of Alcohol Use ????????????????????????????????????????????????????????????????26

Initiation of Marijuana Use ????????????????????????????????????????????????????????????27

Initiation of Cocaine Use???????????????????????????????????????????????????????????????28

Initiation of Heroin Use ?????????????????????????????????????????????????????????????????28

Initiation of Methamphetamine Use ???????????????????????????????????????????????29

Initiation of Hallucinogen Use????????????????????????????????????????????????????????29

Initiation of Inhalant Use ???????????????????????????????????????????????????????????????29

Initiation of Prescription Stimulant Misuse ?????????????????????????????????????30

Initiation of Prescription Tranquilizer or Sedative Misuse ?????????????????30

Initiation of Prescription Pain Reliever Misuse ????????????????????????????????31

Perceived Risk from Substance Use ?????????????????????????????????????????32

Perceived Risk from Substance Use among Adolescents ????????????????33

Perceived Risk from Substance Use among Young Adults ???????????????33

Perceived Risk from Substance Use among Adults Aged

26 or Older ????????????????????????????????????????????????????????????????????????????33

Age Comparisons for Perceived Risk from Substance Use ??????????????34

Substance Use Disorders in the Past Year ????????????????????????????????34

Alcohol Use Disorder ???????????????????????????????????????????????????????????????????35

Illicit Drug Use Disorder????????????????????????????????????????????????????????????????35

Marijuana Use Disorder????????????????????????????????????????????????????????????????36

Cocaine Use Disorder ??????????????????????????????????????????????????????????????????37

Heroin Use Disorder ?????????????????????????????????????????????????????????????????????37

Methamphetamine Use Disorder???????????????????????????????????????????????????38

Prescription Stimulant Use Disorder ??????????????????????????????????????????????38

Prescription Tranquilizer or Sedative Use Disorder ??????????????????????????39

Prescription Pain Reliever Use Disorder ?????????????????????????????????????????39

Opioid Use Disorder ?????????????????????????????????????????????????????????????????????40

Substance Use Disorder (Alcohol or Illicit Drugs) ????????????????????????????40

Major Depressive Episode in the Past Year ???????????????????????????????41

MDE and MDE with Severe Impairment among Adolescents ??????????42

MDE and MDE with Severe Impairment among Adults ????????????????????42

Any Mental Illness among Adults in the Past Year ????????????????????43

Serious Mental Illness among Adults in the Past Year ??????????????44

Co?Occurring MDE and SUD among Adolescents??????????????????????45

Substance Use among Adolescents with MDE ??????????????????????????45

Co?Occurring Mental Health Issues and SUD among Adults ?????46

Co?Occurring AMI and SUD ??????????????????????????????????????????????????????????46

Co?Occurring SMI and SUD ??????????????????????????????????????????????????????????47

Substance Use among Adults, by Mental Illness Status ???????????47

Suicidal Thoughts and Behavior among Adults ?????????????????????????48

Had Serious Thoughts of Suicide ??????????????????????????????????????????????????48

Made a Suicide Plan ????????????????????????????????????????????????????????????????????49

Attempted Suicide ???????????????????????????????????????????????????????????????????????50

Substance Use Treatment in the Past Year ???????????????????????????????50

Need for Substance Use Treatment ???????????????????????????????????????????????50

Receipt of Substance Use Treatment ????????????????????????????????????????????51

Perceived Need for Substance Use Treatment ????????????????????????????????53

Reasons for Not Receiving Substance Use Treatment ????????????????????54

Medication?Assisted Treatment for Alcohol Use or Opioid Misuse ????55

iv | September 2020

Key Substance Use and Mental Health Indicators in the United States:

Results from the 2019 National Survey on Drug Use and Health

Mental Health Service Use in the Past Year ??????????????????????????????55

Treatment for Depression among Adolescents ???????????????????????????????55

Treatment for Depression among Adults ????????????????????????????????????????56

Any Mental Health Service Use among Adolescents ???????????????????????57

Any Mental Health Service Use among Adults ????????????????????????????????58

Any Mental Health Service Use among Adults with AMI ??????????????????59

Any Mental Health Service Use among Adults with SMI ??????????????????60

Perceived Unmet Need for Mental Health Services

among Adults with Mental Illness ????????????????????????????????????????????60

Receipt of Services for Co?Occurring Substance Use

Disorder and Mental Health Issues ???????????????????????????????????????????63

Receipt of Services among Adolescents with a

Co?Occurring SUD and an MDE ??????????????????????????????????????????????63

Receipt of Services among Adults with a Co?Occurring

SUD and AMI ??????????????????????????????????????????????????????????????????????????63

Receipt of Services among Adults with a Co?Occurring

SUD and SMI ??????????????????????????????????????????????????????????????????????????64

Perceived Recovery ??????????????????????????????????????????????????????????????????65

Endnotes ???????????????????????????????????????????????????????????????????????????????????67

Appendix A: Special Tables of Estimates for Substance

Use and Mental Health Indicators in the United States??????????? A?1

Appendix B: Selected 2019 Detailed Tables That

Support Estimates for Key Substance Use and Mental

Health Indicators in the United States ???????????????????????????????????? B?1

Key Substance Use and Mental Health Indicators in the United States:

Results from the 2019 National Survey on Drug Use and Health

Summary

This report summarizes key findings from the 2019 National

Survey on Drug Use and Health (NSDUH) for national

indicators of substance use and mental health among the

civilian, noninstitutionalized population aged 12 or older in

the United States. In this report, overall statements use terms

such as ¡°increased,¡± ¡°decreased,¡± or ¡°declined¡± to describe

a trend from the baseline year to 2019 that was statistically

significant (at the .05 level) based on results of linear or

quadratic trend tests. Pairwise t tests also were conducted to

compare the estimates in 2019 with corresponding estimates

in prior years.

Substance Use

? Among people aged 12 or older in 2019, 60.1 percent

(or 165.4 million people) used a substance (i.e., tobacco,

alcohol, kratom, or an illicit drug) in the past month. In

particular, 50.8 percent (or 139.7 million people) drank

alcohol in the past month, 21.1 percent (or 58.1 million

people) used a tobacco product in the past month, and

13.0 percent (or 35.8 million people) used an illicit drug

in the past month. In addition, 0.3 percent (or 825,000

people) used kratom in the past month.

Tobacco Use

? Among people aged 12 or older in 2019 who used

any tobacco product in the past month, 65.3 percent

smoked cigarettes but did not use other tobacco

products, 13.8 percent smoked cigarettes and used

some other type of tobacco product, and 21.0 percent

used only noncigarette tobacco products (i.e., other

tobacco products but not cigarettes). Thus, most of the

past month tobacco users in the United States were

cigarette users.

? Among past month tobacco product users in 2019, the

percentage who used only cigarettes increased with age

(35.4 percent of adolescents aged 12 to 17, 49.6 percent

of young adults aged 18 to 25, and 68.5 percent of

adults aged 26 or older), but the percentage who used

only noncigarette tobacco products decreased with age

(39.6 percent of adolescents, 27.9 percent of young

adults, and 19.5 percent of adults aged 26 or older).

September 2020 | 1

? Among people aged 12 or older, the percentage who were

past month cigarette users declined from 26.0 percent

(or 61.1 million people) in 2002 to 16.7 percent (or

45.9 million people) in 2019.

? Among past month cigarette smokers aged 12 or older,

the percentage who smoked cigarettes daily declined

from 63.4 percent in 2002 (or 38.7 million people) to

58.4 percent (or 26.8 million people) in 2019.

Alcohol Use

? Among the 139.7 million current alcohol users aged 12

or older in 2019, 65.8 million people (47.1 percent) were

past month binge drinkers. Among past month binge

drinkers, 16.0 million people (24.4 percent of current

binge drinkers and 11.5 percent of current alcohol users)

were past month heavy drinkers.

? Among adolescents aged 12 to 17, the percentage who

were past month alcohol users declined from 17.6 percent

(or 4.4 million people) in 2002 to 9.4 percent (or

2.3 million people) in 2019. The percentage who were

past month binge alcohol users declined from 5.8 percent

(or 1.4 million people) in 2015 to 4.9 percent (or

1.2 million people) in 2019.

? Among young adults aged 18 to 25, the percentage who

were past month alcohol users declined from 61.4 percent

(or 19.5 million people) in 2003 to 54.3 percent (or

18.3 million people) in 2019. The percentage who

were past month binge alcohol users declined from

39.0 percent (or 13.6 million people) in 2015 to

34.3 percent (or 11.6 million people) in 2019.

? Among people aged 12 to 20, the percentage who were

past month alcohol users declined from 28.8 percent

(or 10.7 million people) in 2002 to 18.5 percent (or

7.0 million people) in 2019. The percentage who

were past month binge alcohol users declined from

13.4 percent (or 5.1 million people) in 2015 to

11.1 percent (or 4.2 million people) in 2019, and the

percentage who were past month heavy alcohol users

declined from 3.3 percent (or 1.3 million people) in 2015

to 2.2 percent (or 825,000 people) in 2019.

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