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National Survey on Drug Use and Health (NSDUH)

2024 National Survey on Drug Use and Health (NSDUH) Releases

Conducted annually, the National Survey on Drug Use and Health (NSDUH) provides nationally representative data on the use of tobacco, alcohol, and illicit drugs; substance use disorders; mental health conditions; suicidal thoughts and behavior; and receipt of substance use and mental health treatment among the civilian, noninstitutionalized population aged 12 or older in the United States. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present national estimates from the 2024 National Survey on Drug Use and Health (NSDUH).

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Frequently Asked Questions

General Questions

  • Our nation relies on the flow of objective, transparent, and credible statistics to inform the decisions of governments, businesses, other organizations, and households. Any loss of trust in the integrity of the federal statistical system and its products can foster uncertainty about the validity of measures used to monitor and assess performance and progress across a range of topics, including health, behavioral health, economics, and law enforcement. Federal Statistical Agencies (or Units) whose principal function is the collection, analysis, and dissemination of information for statistical purposes have set for themselves a high standard of scientific integrity.
  • The Center for Behavioral Health Statistics and Quality (CBHSQ) at the Substance Abuse and Mental Health Services Administration (SAMHSA) is a Recognized Statistical Agency or Unit under the federal statistical system, led by the Office of Management and Budget. Federal Statistical Agencies and Units are entrusted with producing data that not only are accurate and timely, but also are free from political or other undue influence. CBHSQ affirms its commitment to uphold the highest standards of scientific integrity, in alignment with the federal statistical system and related implementing regulations and policies. This commitment is essential for ensuring the credibility, objectivity, and utility of official statistics that inform public policy and research across the United States.
  • Scientific integrity is safeguarded through adherence to technical best practices, including rigorous sampling designs, transparent methodologies, peer review (working with other internal and external statistical entities), and continual methodological innovation. SAMHSA’s CBHSQ always applies advanced scientific and statistical methods to produce data that are relevant, valid, reproducible, and protected in accordance with all confidentiality laws.
  • SAMHSA technical staff in CBHSQ continue to work with the NSDUH contractor to maintain uninterrupted data collection and to produce statistical reports using NSDUH data to inform policy and planning. SAMHSA’s Our Scientific Integrity web page contains more information on the SAMHSA/CBHSQ federal statistical principles.

  • Many (but not all) NSDUH estimates from 2024 may be compared with estimates from 2022 to 2023 and with updated 2021 estimates that take into account the proportions of web and in-person interviews. (See Section 2.3.4 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details.) The 2021 Key Substance Use and Mental Health Indicators report and 2021 Detailed Tables should not be used to compare estimates from 2021 with those from 2022 to 2024 because these 2021 products do not present the updated 2021 estimates.

  • The 2024 NSDUH data may be combined with data from 2021 to 2023 for pooled estimates for most outcomes.
  • If data users wish to create pooled estimates that include data from 2021, the 2021 updated weights should be used. A revised 2021 Public Use File was released in January 2024 with the updated weight
  • The 2024 NSDUH data should not be combined with data from 2020 or prior years for a variety of methodological reasons. A full description of the analyses that were conducted to investigate the effects of methodological changes can be found in Chapter 6 in the 2021 Methodological Summary and Definitions report.
  • Information related to variable comparability between 2021 and 2023 can be found in the Variable Crosswalk Chart available with the 2023 Public Use File. The Variable Crosswalk Chart for the 2024 Public Use File will be available on the NSDUH Data Files web page later in 2025.

  • Work is in progress on a separate series of reports using pooled 2022-2024 NSDUH data to examine in greater depth the associations between characteristics of selected population subgroups (including race and ethnicity) and substance use and mental health indicators. Analyses will adjust for the potential effects of additional demographic and geographic characteristics. Reports in this series will be available on the NSDUH National Releases web page.
  • Additionally, estimates among people in racial or ethnic groups can be found in the 2024 NSDUH Detailed Tables on the NSDUH National Releases web page for selected outcomes.

  • Previously, opioids were defined as heroin or prescription pain relievers. Prescription opioids are a subset of prescription pain relievers. Beginning with the 2024 NSDUH data products, opioids are defined as heroin or prescription opioids.
  • See Section 4.4 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details on the methods for estimating opioid misuse or use and opioid use disorder.

  • The seven-item generalized anxiety disorder (GAD-7) scale is a questionnaire used to screen for generalized anxiety disorder (GAD) and assess symptoms of GAD in the past 2 weeks. This scale was added to the 2024 NSDUH questionnaire in separate sections for adolescents aged 12 to 17 and adults aged 18 or older.

  • The GAD-7 is a screening tool, not a diagnostic instrument. Although a high score on the GAD-7 may suggest the presence of generalized anxiety symptoms, it cannot be used to estimate whether people would meet diagnostic criteria for GAD. According to criteria from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders,* for a GAD diagnosis, a person must experience excessive anxiety and worry on most days for at least 6 months, accompanied by at least three specified symptoms for adults and at least one specified symptom for children.

    * American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596 

  • State estimates are generally produced with 2 years of comparable data, and substate estimates are generally produced with 3 years of comparable data.
  • State estimates that will use combined 2023 and 2024 data are expected to be released by early 2026. Please check the NSDUH State Releases web page for the release of 2023-2024 state-level estimates.
  • Substate-level estimates that will use combined data from 2023 to 2025 are expected to be released around summer 2027. Please check the NSDUH Substate Releases web page for the release of 2023-2025 substate estimates.

What's New/What's Changed

This section lists notable changes for the 2024 NSDUH. See the 2024 Methodological Summary and Definitions (Coming Soon) report on the 2024 NSDUH Methodology Resources web page for more information about methods for the 2024 NSDUH. A summary of notable changes to the 2024 NSDUH questionnaire is available in Section 2.2.2 in the 2024 Methodological Summary and Definitions report. A full list of questionnaire changes is available as part of the 2024 NSDUH Questionnaire. 

  • The criteria for suppressing (i.e., not publishing) unreliable estimates from NSDUH were simplified for the 2024 NSDUH data products. Consequently, 2024 NSDUH data products may publish estimates for 2021-2023 that were suppressed in prior years’ data products. Future NSDUH reports also will use these new suppression criteria, even if they do not present estimates from 2024.
  • See Section 3.2.2 in the 2024 Methodological Summary and Definitions (Coming soon) report on the 2024 NSDUH Methodology Resources web page for more details on suppression criteria for the 2024 NSDUH.

  • Since the start of multimode data collection, 2024 marked the first year in which 4 years of data were available for reporting trends.
  • Linear trend testing for outcomes of interest with four comparable NSDUH data points was resumed for the 2024 NSDUH Annual National Report.
    • Linear trend testing for the 2024 NSDUH Annual National Report indicates whether estimates have decreased, increased, or showed no change across the overall period from 2021 to 2024.
    • See the 2019 Statistical Inference Report for additional details on how to compute linear trend tests.
  • For tables in the 2024 Detailed Tables that show 4 years of data, pairwise statistical testing was conducted between estimates in 2024 and corresponding estimates that could be compared in 2021-2023. Tables show places where estimates in 2024 differ significantly from the corresponding estimates in 2021-2023.
  • See Section 3.2.3 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details on testing for statistical significance in NSDUH.

  • Questions were added to estimate the most recent use of psilocybin mushrooms if respondents reported lifetime use of this hallucinogen.
  • Investigations suggested that the addition of this new question for the most recent use of psilocybin mushrooms did not affect the ability to compare estimates in 2024 for the use of hallucinogens in the past year with estimates in 2021-2023. 

  • Respondents were asked to report the use of inhalants “for fun or to get high.” In prior years, respondents were asked to report the use of inhalants “for kicks or to get high.”
  • This change in the questionnaire wording appeared to have affected the reporting of the use of inhalants in the past year, especially among adolescent respondents aged 12 to 17. Therefore, the 2024 NSDUH reports and tables present estimates for the use of inhalants for 2024 only.
  • This change in the questionnaire wording appeared to have affected the reporting of the use of inhalants in the past year, especially among adolescent respondents aged 12 to 17. Therefore, the 2024 NSDUH reports and tables present estimates for the use of inhalants for 2024 only.
  • This questionnaire change did not affect the comparability of estimates between 2024 and 2021-2023 for the use of any illicit drug or for inhalant use disorder in the past year.
  • See Section 3.4.1 in the 2024 Methodological Summary and Definitions (Coming Soon) report on the 2024 NSDUH Methodology Resources web page for more details on changes to the questions for inhalants in the 2024 NSDUH.

  • Beginning in 2024, respondents who selected “other” when reporting any use of prescription pain relievers in the past 12 months were asked to specify the names of up to five pain relievers that they used.
  • Respondents could be identified who used only over-the-counter (OTC) drugs or nonprescription drugs, or who used only nonopioid prescription pain relievers in the past 12 months.
    • Respondents who used only OTC drugs or nonprescription drugs were logically inferred not to have used prescription pain relievers in the past 12 months.
    • Because additional respondents could be identified for 2024 who used only OTC drugs or nonprescription drugs, estimates in 2024 for any use of prescription pain relievers in the past year are not comparable with corresponding estimates in 2021-2023.
  • In addition, respondents who used only nonopioid prescription pain relievers were logically inferred not to have used prescription opioids in the past 12 months.
  • See Chapter 4 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details on how this change to the pain relievers screener affected estimates for the 2024 NSDUH.

  • In 2024, questions changed that asked respondents aged 12 to 17 how they thought their parents would feel about them using specific substances and how respondents felt about their peers using these substances.
    • Two new response options were added, and the order of response options was reversed.
    • In addition, respondents were asked about parental disapproval of them smoking cigarettes every day and how they felt about their peers smoking cigarettes every day. In prior years, these questions pertained to smoking one or more packs of cigarettes every day.
  • The question also changed in 2024 for parents limiting the amount of time that respondents aged 12 to 17 spent watching or using electronic devices.
    • Respondents were asked how often their parents limited the amount of time spent with television, tablets, smartphones, computers, or video games.
    • In prior years, the question asked only about parents limiting the amount of time that respondents watched television.
  • Due to these changes, estimates using 2024 data are not comparable with corresponding estimates using 2021-2023 data.

  • New follow-up questions were added in 2024 for respondents who reported that they received treatment in an inpatient or outpatient location, but they did not report any substances for which they received treatment. These respondents were given a second opportunity to specify the substances for which they received inpatient or outpatient treatment or to enter “None” if they did not receive treatment.
  • Starting in June 2024, additional changes were made to introductory text for treatment at inpatient and outpatient locations and in response choices for each inpatient or outpatient location to emphasize that the treatment was for alcohol or drug use.
  • Because of the additional changes in 2024, 2024 estimates of substance use treatment overall, estimates of inpatient treatment, and estimates of outpatient treatment are not comparable with estimates from prior years.
  • See Section 3.4.8 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details on changes to the questions for substance use treatment in the 2024 NSDUH.

  • Starting in June 2024, additional changes were made to introductory text for treatment at inpatient and outpatient locations and in response choices for each inpatient or outpatient location to emphasize that the treatment was for mental health, emotions, or behavior.
  • Because of the additional changes in 2024, 2024 estimates of the receipt of mental health treatment overall, estimates of inpatient treatment, and estimates of outpatient treatment are not comparable with estimates from prior years.
  • See Section 3.4.10 in the 2024 Methodological Summary and Definitions report on the 2024 NSDUH Methodology Resources web page for more details on changes to the questions for mental health treatment in the 2024 NSDUH.

 

Highlights

Overall Highlights for 2024 NSDUH (PDF)

Annual National Report

Key Substance Use and Mental Health Indicators in the United States

NSDUH’s latest annual report shows indicators of substance use and mental health in the United States based on NSDUH data from 2021 to 2024. All reported indicators meet rigorous criteria for statistical precision. The 2024 Key Substance Use and Mental Health Indicators report summarizes the following:

  • Substance use (tobacco, alcohol, vaping, marijuana, and other illicit drug use, as well as the use and misuse of prescription drugs)
  • Initiation of substance use by type
  • Substance use disorders (SUDs)
  • Symptoms of generalized anxiety disorder
  • Major depressive episode (MDE), any mental illness, and serious mental illness
  • Mental illness and MDE co-occurring with substance use and SUDs
  • Suicidal thoughts, plans, and attempts
  • Substance use treatment and mental health treatment
  • Recovery among adults

Estimates are presented by age group for selected measures.

Detailed Tables

The 2024 NSDUH Detailed Tables present national estimates of substance use, mental health, and treatment in the United States. They present indicators for youths aged 12 to 17 and adults aged 18 or older (separately or combined) on drug, alcohol, and tobacco use, risk and availability of substance use, substance initiation, substance use disorder (SUD), mental illness and major depressive episode, suicidality, and treatment, along with some other miscellaneous health topics. The tables include estimates from 2023 and 2024 where appropriate, including statistical tests of differences between the two years.

2024 NSDUH Detailed Tables
HTML Files (ZIP | 2.54 MB)
README (PDF | 160.28 KB)
Clickable Table of Contents (HTM | 65.39 KB)

Last Updated: 9/8/2025