2025 National Survey on Drug Use and Health (NSDUH) Releases

• The Center for Behavioral Health Statistics and Quality (CBHSQ) at the Substance Abuse and Mental Health Services Administration (SAMHSA) is a Recognized Statistical Unit under the federal statistical system entrusted with producing data that not only are accurate and timely but 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.
• NSDUH’s study design, data collection, analysis, and reporting always adhere to best practices, including rigorous sampling designs, sound methodologies, and peer review by internal and external statistical entities. SAMHSA’s CBHSQ always applies advanced scientific and statistical methods to produce data that are relevant, valid, reproducible, and protected in accordance with applicable laws and regulations. 
• SAMHSA’s Our Scientific Integrity web page contains more information on the SAMHSA/CBHSQ federal statistical principles.

• Many (but not all) NSDUH estimates from 2025 may be compared with estimates from 2022 to 2024 and with updated 2021 estimates that take into account the proportions of web and in-person interviews. (See Section 2.3.4 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details Coming Soon). 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.
• Information related to variable comparability between 2021 and 2024 can be found in the Variable Crosswalk Chart available with the 2024 Public Use File. The Variable Crosswalk Chart for the 2025 Public Use File will be available on the NSDUH Data Files web page later in 2026.

• The 2025 NSDUH data may be combined with data from 2021 to 2024 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 weights. 
  • See the 2024 NSDUH Public Use File Data Users’ Guide (DUG) for details on the procedures for creating annual average estimates using pooled NSDUH data. SAMHSA expects to release the 2025 DUG on the 2025 NSDUH Methodology Resources page (Coming Soon).

The 2025 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.

• Errors in code used to edit 2022 to 2024 nicotine vaping measures were corrected during processing for 2025 data products, which may result in differences between updated estimates and those previously published. (See Section 3.4.4 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details.) See Section 3.4.4 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details on the measures of nicotine vaping. (Coming Soon)

• A new prediction model based on criteria for mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‑5)¹ was applied to create estimates of AMI and SMI for survey years 2021 to 2025, which may result in differences between estimates in the 2025 data products and those that were previously published. 
• See the Mental Illness among Adults item in What’s New/What’s Changed and Section 3.4.10 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details. (Coming Soon)

¹ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

• The measure of county type for estimates in the 2025 Detailed Tables was updated from the 2013 Rural-Urban Continuum Codes to the 2023 Rural-Urban Continuum Codes developed by the U.S. Department of Agriculture. This update may result in differences between estimates in the 2025 data products and those that were previously published.
• See Section 3.4.17 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details. (Coming Soon)

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

• Because 4 years of comparable data from 2022 to 2025 are available for nicotine vaping, the 2025 NSDUH marks the first year in which trends are presented in NSDUH data products for nicotine vaping.
• NSDUH data products for 2025 also present trends for the use of nicotine products overall (i.e., use of tobacco products or nicotine vaping).
• See the nicotine vaping item in the FAQs for information on changes to the estimates for nicotine vaping in 2022 to 2024. 

• Follow-up questions were added for all specific hallucinogens if respondents refused to answer the corresponding question about lifetime use. Before 2025, these follow-up questions were asked only if respondents refused to answer the questions about lifetime use of lysergic acid diethylamide (LSD), phencyclidine (PCP), or Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]).
• Questions were added for the initiation of use of peyote, mescaline, psilocybin, ketamine, dimethyltryptamine (DMT), alpha-methyltryptamine (AMT), or “Foxy” (5-MeO-DiPT), and Salvia divinorum if respondents reported lifetime use of these specific hallucinogens. Before 2025, initiation questions were asked for only LSD, PCP, and Ecstasy.
• Recency questions were added for peyote and mescaline. Recency questions were available for psilocybin since 2024 and for specific hallucinogens other than psilocybin, peyote, and mescaline before 2021.
• Respondents were given additional opportunities to report the number of days they used any hallucinogen in the past 12 months and past 30 days, if they reported the use of specific hallucinogens in these periods. Before 2025, these questions for the number of days respondents used any hallucinogen in the past 12 months and past 30 days were included for only LSD, PCP, and Ecstasy.
• Investigations suggested that these questionnaire changes did not affect the ability to compare estimates in 2025 for the first use and most recent use of hallucinogens with estimates in 2021 to 2024. Therefore, 2025 NSDUH reports and tables show estimates in 2021 to 2025 for any hallucinogen use in the past year and the past year initiation of any hallucinogen use.
• The 2025 Detailed Tables also show estimates for any hallucinogen use in the lifetime and past month; the frequency of use of any hallucinogen in the past year and past month; the use of LSD, psilocybin, or Ecstasy in the lifetime, past year, and past month; and the past year initiation of use of LSD, psilocybin, or Ecstasy.
• See Section 3.4.1 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details on the measures of hallucinogen use. (Coming Soon)

• Respondents in 2025 were asked to report the use of inhalants “to get high.” 
  • Before 2024, respondents were asked to report the use of inhalants “for kicks or to get high.” 
  • In 2024, respondents were asked to report the use of inhalants “for fun or to get high.”
• This change in the questionnaire wording affected the reporting of the use of inhalants in 2025 in a way that was different from reporting in prior years. Therefore, the 2025 NSDUH data products present estimates for the use of inhalants for 2025 only.
• This questionnaire change did not affect the comparability of estimates between 2025 and 2021 to 2024 for inhalant use disorder in the past year.
• See Section 3.4.2 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details on changes to the questions for inhalants in the 2025 NSDUH. (Coming Soon)

• Changes to the questions for inhalants in 2025 also affected estimates of illicit drug use in the lifetime and past year among adolescents aged 12 to 17.
• As in 2024, the changes to the inhalant questions for 2025 affected estimates of the use of illicit drugs other than marijuana in the lifetime, past year, and past month among all age groups.
• Therefore, the 2025 Detailed Tables show only 2025 estimates of illicit drug use in the lifetime and past year among people aged 12 to 17 or 12 to 20, including estimates among adolescents aged 12 to 13, 14 to 15, or 16 to 17. The 2025 Detailed Tables show only 2025 estimates of illicit drugs other than marijuana among any age groups for the past year and past month.
• Trends from 2021 to 2025 for illicit drug use in the past year also were evaluated for the 2025 Key Substance Use and Mental Health Indicators report. Trends for the use of illicit drugs in the past year excluding inhalants were the same as the trends for any use of illicit drugs including inhalants. Therefore, the change to the question for inhalants in 2025 was assumed not to have affected overall trends from 2021 to 2025 for any illicit drug use in the past year. 
• The 2025 Key Substance Use and Mental Health Indicators report does not present estimates for the use of illicit drugs other than marijuana.

• Because 4 years of comparable data from 2022 to 2025 are available for IMF use, the 2025 NSDUH marks the first year in which trends are presented in NSDUH data products for IMF use.
• The 2025 Key Substance Use and Mental Health Indicators report does not present estimates for the misuse of any fentanyl product (i.e., misuse of prescription fentanyl or use of IMF) because findings from the 2024 NSDUH indicated that most people who misused any fentanyl product had used IMF. See the 2024 Key Substance Use and Mental Health Indicators report.
• Recall that IMF is not included in measures of the use of any illicit drug or use of illicit drugs other than marijuana because questions about IMF were asked in a later section of the interview and were not included in the questionnaire until 2022.

• In 2025, questions about the perceived risk of harm for use of specific substances were revised to be asked only of adolescent respondents aged 12 to 17. These estimates in 2025 among adolescents can be compared with estimates from prior years, but estimates are no longer available for people aged 12 or older or adults aged 18 or older.
• For adult respondents aged 18 or older in 2025, the first questions in the risk and availability section of the NSDUH questionnaire were for the perceived availability of selected illicit drugs. 
  • Because of this questionnaire change, the estimates of the perceived availability of drugs among adults aged 18 or older in 2025 are not comparable with estimates from prior years. 
  • These estimates of the perceived availability of drugs in 2025 also are not comparable with estimates from prior years among the total population aged 12 or older and among people aged 12 to 20. 
  • However, these estimates of the perceived availability of drugs remain comparable with those in prior years among adolescents aged 12 to 17.
• The order of remaining questions in the risk and availability section for 2025 was the same for adolescents and adults. Consequently, estimates based on those remaining questions are comparable between 2025 and prior years for all age groups.
• Starting with the 2025 Detailed Tables, separate estimates for “don’t know” also are shown for the perceived risk of substance use and perceived availability of drugs. 
  • In prior years, respondents who answered these questions as “don’t know” were excluded from the analysis. 
  • Respondents in 2025 who broke off the interview before reaching these questions, refused to answer, or were logically inferred to have “bad data” continued to be excluded from the analyses. 
  • See Section 3.3.2 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for a discussion on how procedures for handling missing data may bias estimates. (Coming Soon)
  • Because of the change in how the “don’t know” responses were handled for 2025, estimates for 2024 in the 2025 Detailed Tables for the perceived great risk of harm from drug use and perceived availability of drugs may differ from the estimates for 2024 that were published in the 2024 Detailed Tables.

• Questions about risk and protective factors in the youth experiences section for adolescents aged 12 to 17 also underwent the following changes for 2025:
  • Questions were removed that asked respondents about the likelihood of them smoking a cigarette; perceptions of how many of respondents’ peers were smoking cigarettes, using marijuana/cannabis products, or drinking alcohol; and how respondents’ parents would feel about respondents smoking cigarettes, using marijuana/cannabis products, or drinking alcohol.
  • A new question was added at the end of January 2025 about whether respondents spoke with at least one parent in the past year about the dangers of substance use.
• The addition or deletion of questions did not affect the comparability of other measures for risk and protective factors among adolescents from the youth experiences section.
• Because the question about whether respondents spoke with at least one parent in the past year about the dangers of substance use was not included at the beginning of data collection in 2025, not all adolescents were asked this question. Therefore, the 2025 Detailed Tables do not show estimated numbers in thousands corresponding to this question, but the tables show percentages.
• Starting with the 2025 Detailed Tables, separate estimates for “don’t know” also are shown for feelings about peers’ substance use. 
  • In prior years, respondents who answered these questions as “don’t know” were excluded from the analysis. 
  • Respondents in 2025 who broke off the interview before reaching these questions, refused to answer, or were logically inferred to have “bad data” continued to be excluded from the analyses. 
  • See Section 3.3.2 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for a discussion on how procedures for handling missing data may bias estimates. (Coming Soon)
  • Because of the change in how the “don’t know” responses were handled for 2025, estimates for 2024 in the 2025 Detailed Tables for feelings about peers’ substance use may differ from the estimates for 2024 that were published in the 2024 Detailed Tables.

• As noted in the 2024 FAQs, the questions for alcohol and drug treatment changed for 2024. These changes also affected estimates for 2025.
  • 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.
  • In June 2024, additional changes were made to introductory text for treatment at inpatient and outpatient locations and to response choices for each inpatient or outpatient location to emphasize that the treatment was for alcohol or drug use.
  • The 2025 NSDUH was the first full year for both changes to the questions for the receipt of substance use treatment in inpatient and outpatient locations.
• Together, these changes reduced the number of respondents who did not report the specific substances for which they received inpatient or outpatient treatment and reduced the estimates of any inpatient or outpatient treatment and any substance use treatment in the past year.
• Because of the additional changes in June 2024, the 2025 estimates of substance use treatment overall, estimates of inpatient treatment, and estimates of outpatient treatment are not comparable with estimates from prior years. Estimates in 2025 for the need for substance use treatment and the perceived unmet need for substance use treatment also are not comparable with estimates from prior years.
• Questions for the receipt of medication for alcohol use disorder (MAUD), medication for opioid use disorder (MOUD), treatment via telehealth, and treatment in a prison, jail, or juvenile detention center have not changed since 2022. These substance use treatment measures are comparable for 2022 through 2025.
• The 2025 Key Substance Use and Mental Health Indicators report includes new estimates for the receipt of other services in the past year to help with substance use (i.e., support services from a support group or from a peer support specialist or recovery coach, services in an emergency room, withdrawal management services, or treatment with overdose reversal medicine such as Narcan^® or naloxone), including any receipt of other services, receipt of substance use treatment and other services, and receipt of other services but not substance use treatment. In addition, the report includes new estimates for people with an SUD in the past year who did not receive any services to help with their substance use (i.e., substance use treatment or other services).

See Section 3.4.9 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details. (Coming Soon)

• A Mental Illness Calibration Study (MICS) was conducted as part of the 2023 and 2024 NSDUHs.
• The primary goal of the MICS was to update and recalibrate NSDUH’s mental illness prediction models by transitioning from using criteria for mental disorders in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‑IV)² to using criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM‑5).³
  • In the MICS, specially trained clinicians conducted follow-up clinical interviews with a sample of adult NSDUH respondents by telephone or videoconference.
• Clinical interview data from the MICS were used to fit a statistical model to predict the likelihood of adults aged 18 or older having mental illness. The prediction model was applied to all adult respondents in the 2021 to 2025 surveys. Consequently, the measures of mental illness among adults are comparable in 2021 to 2025.
• As noted in the mental illness item in the FAQs, estimates of mental illness for survey years 2021 to 2024 in the 2025 NSDUH data products may differ from previously published estimates for those years.
• See Section 3.4.10 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details. (Coming Soon)

² American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.).

³ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

• As noted in the 2024 FAQs, the questions for treatment at inpatient and outpatient locations and in response choices for each inpatient or outpatient location were changed in June 2024 to emphasize that the treatment was for mental health, emotions, or behavior. The 2025 NSDUH was the first full year for these changes to the questions for the receipt of mental health treatment in inpatient and outpatient locations.
• Because of these changes in June 2024, 2025 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. 
• The 2025 Key Substance Use and Mental Health Indicators report includes new estimates for the receipt of other services in the past year to help with mental health (i.e., support services from a support group or from a peer support specialist or recovery coach or services in an emergency room), including any receipt of other services, receipt of mental health treatment and other services, and receipt of other services but not mental health treatment. In addition, the report includes new estimates for people with mental health conditions in the past year who did not receive any services to help with their mental health (i.e., mental health treatment or other services).
• See Section 3.4.11 in the 2025 Methodological Summary and Definitions report on the 2025 NSDUH Methodology Resources web page for more details. (Coming Soon)

• New questions about nonsuicidal self-harm were added to the youth experiences section of the questionnaire for adolescent respondents aged 12 to 17.
• Respondents were asked whether, during the past 12 months, they intentionally harmed themselves without trying to kill themselves, such as by cutting, burning, or bruising themselves. In addition to the standard “Yes” and “No” response options, adolescents could select “I’m not sure” or “I don’t want to answer” when answering the question.
• The 2025 Detailed Tables (see Tables 7.36-7.37) and Key Substance Use and Mental Health Indicators report include estimates for nonsuicidal self-harm among adolescents.

• The 2025 NSDUH questionnaire included new questions for adults aged 18 or older about symptoms of sleep disturbance in the past 30 days.
• Respondents were asked two separate questions about how often they had trouble falling asleep in the past 30 days and how often they had trouble staying asleep in the past 30 days. Possible response choices were the following: (1) never, (2) some days, (3) most days, and (4) every day, in addition to respondents having other options for answering the question as “don’t know” and “refused.” Respondents were classified as having symptoms of sleep disturbance if they reported having trouble falling asleep or staying asleep on most days or every day in the past 30 days. 
• Respondents were asked how often they took any medication to help them fall asleep or stay asleep in the past 30 days, including either prescription or over-the-counter medications. Possible response choices were the following: (1) never, (2) some days, (3) most days, and (4) every day, in addition to respondents having other options for answering the question as “don’t know” and “refused.”
• The 2025 Detailed Tables (see Tables 8.38-8.40) included estimates for adults having symptoms of sleep disturbance and estimates for adults who took any medication at least once in the past 30 days to help them fall asleep or stay asleep.

• The 2025 NSDUH questionnaire included new questions for adults aged 18 or older about chronic pain in the past 3 months. 
• Respondents were asked how often they had pain in the past 3 months. Possible response choices were the following: (1) never, (2) some days, (3) most days, and (4) every day, in addition to respondents having other options for answering the question as “don’t know” and “refused.” Respondents were classified as having chronic pain if they reported having pain on most days or every day in the past 3 months.
• Respondents were asked how often their pain limited life or work activities in the past 3 months. Possible response choices were the following: (1) never, (2) some days, (3) most days, and (4) every day, in addition to respondents having other options for answering the question as “don’t know” and “refused.” Respondents were classified as having high-impact chronic pain if they reported having pain that limited their life or work activities on most days or every day in the past 3 months.
• The 2025 Detailed Tables (see Tables 8.41-8.44) included estimates for adults having chronic pain and high-impact chronic pain in the past 3 months.