Rates of Co-Occurring Mental and Substance Use Disorders
Mental and substance use conditions often co-occur.
- Over 8.9 million persons have co-occurring disorders; that is they have both a mental and substance use disorder.
- Only 7.4 percent of individuals receive treatment for both conditions with 55.8 percent receiving no treatment at all.
Prevalence information on co-occurring disorders is available through a number of sources. Summary statistics are provided below from the following three reports:
- National Survey on Drug Use and Health (NSDUH)
- National Comorbidity Survey Replication (NCS-R)
- Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions
For more resources see the annotated bibliography.
Below are summary statistics from the 2009 National Survey on Drug Use and Health (NSDUH) on the number of individuals in the United States experiencing co-occurring mental and substance use disorders.
Adults with any type of mental illness in the past year — 45.1 million
- Adults with any mental illness and co-occurring substance use dependence — 4 percent of all adults
- Adults with any mental illness who used cigarettes in past month — 37 percent compared to 22 percent of adults with no mental illness who smoked cigarettes
- Adults with serious mental illness who smoked cigarettes — 47 percent or compared to 22 percent of adults with no mental illness who smoked cigarettes
- Adults with any mental illness who reported binge alcohol use(5 or more drinks)- 30 percent compared to 24 percent of adults with no mental illness who reported binge drinking
- Adults with any mental illness who report heavy alcohol use — 10 percent compared to 7 percent for adults without mental illness
Adults with serious mental illness — 11 million
- Adults with serious mental illness and substance use dependence — 2.8 million (25.7 percent of all adults with serious mental illness)
- Adults with any mental illness and substance use dependence — 9.8 million (19.7 percent of all adults with any mental illness)
- Among the 2.8 million adults with co-occurring SMI and substance use disorder, 62 percent received substance use or mental health treatment and 38 percent did not receive any treatment.
Adults with substance use disorder — 20.8 million
- Among adults with substance use disorder, 42.8 percent(8.9 million) had co-occurring mental illness
Access to treatment
- Among the 8.9 million adults with any mental illness and a substance use disorder, 44 percent received substance use treatment or mental health treatment in the past year, 13.5 percent received both mental health treatment and substance use treatment, and 37.6 percent did not receive any treatment.
Below are summary statistics from the 2001-2003 National Comorbidity Survey Replication (NCS-R) on the number of individuals in the United States experiencing comorbid conditions.
Co-morbidity of physical health problems and co-occurring disorders
- 68 percent of adults with mental disorder also had one or more medical conditions
- 58 percent of adult population has medical conditions; 29 percent of adults with medical conditions have a comorbid mental disorder
- Medical conditions may lead to mental disorders, or mental disorders may lead to medical conditions.
Below are summary statistics from Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions. This report examined Medicaid data to determine what is known about highest-need, highest-cost beneficiaries.
Among Medicaid beneficiaries with disabilities
- 45 percent were found to be diagnosed with three or more chronic conditions
- Costs for beneficiaries with three or more chronic conditions represented 75 percent of total spending for all beneficiaries with disabilities.
- More than half of disabled Medicaid enrollees with psychiatric conditions also had claims for diabetes, cardiovascular disease or pulmonary disease
- Of the most expensive group of beneficiaries, 24 percent had psychiatric conditions, cardiovascular disease and central nervous disorders
Poverty is also found to be correlated with the co-occurrence of medical and behavioral health conditions. Adults with mental illness/substance use disorders are twice as likely to have incomes less than 150% of poverty level as adults without either disorder.