Research Report: New Data on Alcohol and Substance Use Disorder (AUD/SUD)

Every year, the National Institutes of Health (NIH) collaborate with various public and private entities, including the Center for Behavioral Health Statistics (CBHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to conduct the National Survey on Drug Use and Health (NSDUH), an annual publication that estimates the rates of substance use disorder, alcohol use disorder, and mental health disorders in general population of the U.S.

The survey is important for a variety of reasons, including but not limited to:

1. Large sample size – over 70,000 respondents each year – allows scientists to make population-level generalizations about drug use and health. That means, based on the data in the NSDUH, researchers can say things like “In 2021, 16.5% of adults over age 18 had a substance use disorder.”
2. The generalizations allowed by the data enable providers, policy makers, and people in the general public to understand the current state of drug use and health in the U.S.
3. Annual publication allows everyone – laypeople, providers, and policymakers alike – to identify trends in drug use and health. For instance, we can learn whether rates of addiction or overdose increased or decreased, compared to previous years.

We use data from the NSDUH to inform our treatment practices and create evidence-based, factual articles and blog posts like this one. We share the latest data so patients and families have access to the most recent, reliable, verified facts and figures about topics that are important to them.

In this article, we’ll share new data from the 2022 National Survey on Drug Use and Health, published in November, 2023. While it may be frustrating to arrive at 2024 and only recently have access to verified data for 2022, taking time is essential: researchers compile, study, restudy, revise, and review the data before publication.

Why?

They have to get it right.

They have to get it right because policymakers use this data to allocate funding, assign priorities, and write rules, guidelines, and laws related to substance use and substance use treatment. In addition, they have to get it right because people’s lives – and billions of dollars every year – are at stake.

With that said, let’s take a look at the top-line data on addiction from the 2022 NSDUH.

The 2022 NSDUH: Prevalence of Alcohol and Substance Use Disorder

There’s another thing to mention about the 2022 NSDUH before we proceed. This year, they used the updated criteria from the Diagnostic and Statistical Manual of Mental Disorders, Volume 5 (DSM-5) for substance use disorder diagnosis, rather than a combination of criteria from the DSM-IV and DSM-V.

Here’s the new, standardized criteria for diagnosing substance use disorder.

DSM-V: How to Identify SUD

1. The substance is often taken in larger amounts or over a longer period than intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control substance use.
3. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects.
4. There is a craving, or a strong desire or urge, to use the substance.
5. There is recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home.
6. There is continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance.
7. Important social, occupational, or recreational activities are given up or reduced because of substance use.
8. There is recurrent substance use in situations in which it is physically hazardous.
9. Substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. There is a need for markedly increased amounts of the substance to achieve intoxication or the desired effect, or markedly diminished effect with continued use of the same amount of the substance (i.e., tolerance).
11. For substances other than hallucinogens and inhalants that have a withdrawal criterion, there are two components of withdrawal symptoms, either of which meet the overall criterion for withdrawal symptoms:
    • There is a required number of withdrawal symptoms that occur when substance use is cut back or stopped following a period of prolonged use.
    • The substance or a related substance is used to get over or avoid withdrawal symptoms

Interpreting the answers:

Survey respondents who answered “yes” to two or more of the 11 questions above met criteria for substance use disorder (SUD) and were therefore included in the total prevalence estimates for 2022.

Let’s get to the data.

Substance Use Disorder and Alcohol Use Disorder in 2022

Here’s what the new data shows.

Alcohol and Substance Use Disorder, by Substance, Adults 18+

Any SUD:

• 2021: 44.3 million
• 2022: 46.4 million

Drug Use Disorder, excluding alcohol:

• 2021: 15.6 million
• 2022: 17.7 million

Alcohol Use Disorder, excluding drugs:

• 2021: 21.8 million
• 2022: 21 million

Marijuana:

• 2021: 15.3 million
• 2022: 17.6 million

Cocaine:

• 2021: 1.4 million
• 2022: 1.4 million

Heroin:

• 2021: 989,000
• 2022: 898,000

Methamphetamine:

• 2021: 1.6 million
• 2022: 1.8 million

Opioids:

• 2021: 5.3 million
• 2022: 5.8 million

Pain Relievers (Prescription):

• 2021: 4.7 million
• 2022: 5.3 million

Stimulants (Prescription):

• 2021: 1.2 million
• 2022: 1.5 million

Tranquilizers/Sedatives (Prescription):

• 2021: 1.6 million
• 2022: 1.7 million

In places we see increases, we understand we need to increase our efforts to support people with those diagnoses.

We also ask ourselves why.

In the data above, we can see we need to increase our efforts with regards to methamphetamine addiction (increased), opioid addiction (increased), prescription pain medication addiction (increased), and prescription stimulant addiction (increased). Drug use disorder overall increased, which means, overall, we have to redouble our efforts to help those in need.

We also see that marijuana use disorder increased, which is logical, given the recent nationwide movement toward legalization: that may be the why behind that increase.

With regards to the why behind increased opioid, methamphetamine, and pain reliever addiction, they why is not as clear as with marijuana. However, stress associated with the pandemic, which persisted through 2020 and 2021 – remember, most of us didn’t get a vaccine before May 2021 – may explain these increases, alongside the increased risk of addiction related to the presence of fentanyl in substances of misuse, including amphetamines and illicitly produced sedatives and tranquilizers.

Moving Forward: Our Work in 2024

Based on this data, we’re ready to increase our efforts supporting people with opioid use disorder and stimulant use disorder – including methamphetamine – with our full array of SUD treatment options. We’ll focus on offering traditional treatment and support, robust harm reduction efforts, and an ongoing commitment to offering medication-assisted treatment (MAT) with medications for opioid use disorder (MOUD) to people with opioid use disorder (OUD).

That’s our New Year’s Resolution: to continue offering the latest and best evidence-based addiction treatment available.