Find reports, tables, and maps for U.S. states based on small area estimation of the 2021-2022 National Surveys on Drug Use and Health (NSDUH).
NSDUH State Result Data Tables
The 2021-2022 NSDUH state data tables provide estimates for 35 measures of substance use and mental health by age group across 37 tables. Due to methodology changes, they cannot be compared to previous years’ estimates. The estimates are based on a small area estimation (SAE) methodology, in which state-level NSDUH survey data of the civilian, noninstitutionalized population aged 12 or older are combined with multiple sources of local data. The age groups available are 12 or older, 12 to 17, 18 or older, 18 to 25, and 26 or older, as well as 12 to 20 for some alcohol measures
The 2021-2022 NSDUH State Prevalence Estimates (PDF, Excel, CSV) provide prevalence (percentage) estimates and 95% confidence intervals by age group.
The 2021-2022 NSDUH Estimated Totals By State (PDF, Excel, CSV) provide the estimated population totals and 95% confidence intervals by age group.
Accompanying p-value tables are also available (Excel, CSV) to help users determine if differences between geographies are statistically significant. There is also a guide to their use.
NSDUH State Result Maps
The 2021-2022 NSDUH National Maps of Prevalence Estimates by State (PDF, HTML) show the 2021-2022 estimates with states sorted into five categories based on the value of the estimate and colored accordingly.
Interactive State Estimates
The Interactive NSDUH State Estimates is an online data tool that displays the prevalence data in a user-friendly format. Use this tool to compare between areas, look at older estimates, or compare the data for related issues.
Regional Barometer Reports
A set of ten user-friendly Barometer Reports are available for each HHS region. Each report has charts and graphs for each indicator that include the percentages for the nation, the region, and the states within that region.
State and Regional Methodology Reports
The 2021-2022 NSDUH: Guide to State Tables and Summary of Small Area Estimation Methodology Report (PDF, HTML) is a guide to the development and presentation of the 2021-2022 state estimates. A summary of the methodology is included, as well as sample sizes, response rates, and population estimates.
The 2021-2022 NSDUH: Other Sources of State-Level Data report provides a brief description of the Behavioral Risk Factor Surveillance System (BRFSS) and compares state-level BRFSS and NSDUH prevalence estimates for alcohol and cigarette use among people aged 18 or older.
2021-2022 NSDUH Frequently Asked Questions
1. How did the coronavirus disease 2019 (COVID-19) pandemic continue to affect data collection for the 2021 and 2022 NSDUH?
- SAMHSA decided to continue with multimode data collection moving forward, meaning that the 2021 and 2022 NSDUH are based on both in-person and web interviews. In-person data collection remained limited to areas with low COVID-19 infection rates in 2021. As COVID-19 infection rates dropped in most areas of the country over the course of 2021, the proportion of web interviews decreased. More than three fourths of interviews in Quarter 1 were completed via the web (76.6 percent). By Quarter 4, fewer than half of the interviews (41.5 percent) were completed that way. Altogether, 54.6 percent of the 2021 interviews, and 31.8 of the 2022 interviews, were completed via the web.
2. Why is it not appropriate to compare estimates from 2021 and 2022 with estimates from 2018-2019 and earlier years?
- In order to assess comparability, we first tested, “Did the mode of data collection (i.e. whether a respondent completed the survey on the web or in-person) influence the estimates?” In other words, “Were there differences between responses from the two modes of collection, and were those differences significant enough to affect whether or not the data from each mode was comparable?”
- We found that estimates based on web interviews are different from estimates based on in-person interviews. First, we found that the demographics of each mode differed significantly. That is to say, the composition of the people answering by web differed from the composition of the people answering in-person (i.e. by gender, race, education, etc.). Secondly, in addition to demographic differences, we also found that in-person respondents were more likely to be users of certain substances and were more likely to have experienced mental health issues. These differences are often called a mode effect because the differences are observed between the two modes of data collection.
3. If more in-person respondents report substance use than web respondents, does that mean that web-based respondents are not accurately reporting their experience?
- Differences in substance use between web respondents and in-person respondents could be due to variability in COVID-19 infection rates in different areas. For example, many respondents could complete the interview only on the web (i.e., those living in areas with high COVID-19 infection rates where in-person data collection was not permissible). If individuals living in these areas are less likely to use substances, overall estimates of substance use in 2021-2022 would be affected given the large proportion of interviews completed on the web.
- There could be differences between web respondents and in-person respondents for reasons other than underreporting of substance use among web respondents. For example, some people prefer to complete an interview via web, while others prefer to complete an interview in person. Adult web respondents in NSDUH have completed higher levels of education, on average, than their in-person counterparts; people with higher educational levels are less likely to smoke cigarettes and are more likely to have access to the Internet. Weighting the data to match the demographic characteristics of the population controls for educational differences between web and in-person respondents.
4. What are the benefits of multimode data collection?
- Offering a web mode enables collecting data from individuals who may not have otherwise completed an interview. For example, some individuals will complete an interview only on the web because they will not allow strangers in their homes. Some individuals’ only option is to complete the interview on the web because they live in areas inaccessible to field interviewers, such as gated communities, or they live in areas where in-person data collection is not permissible due to high COVID-19 infection rates.
- Likewise, offering an in-person mode enables collecting data from individuals who would not otherwise complete an interview. For example, some individuals’ only option is to complete an interview in person because they do not have a computer, a Smart phone, or a tablet or do not have Internet or a cellular data plan. Some individuals choose to complete an interview only in person due to a lack of computer proficiency or discomfort with entering personal information online.
5. Why are estimates on treatment outcomes based on only 2022 data?
- In 2022, major revisions were made to the drug treatment and mental health service utilization sections of the survey to better reflect the current state of treatment services and their delivery. Because the new measures are not comparable to the measures used in 2021, these estimates were based on 2022 data alone.
6. Why did the 2021 NSDUH ask substance use disorder (SUD) questions of all past year users of prescription drugs?
- SUDs are characterized by impairment caused by the recurrent use of alcohol or other drugs (or both), including health problems, disability, and failure to meet major responsibilities at work, school, or home. SUD questions in the 2021 NSDUH assessed the presence of an SUD in the past 12 months based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5).* NSDUH respondents were classified as having an SUD if they met 2 or more of up to 11 applicable criteria in a 12-month period.
- DSM-5 SUD criteria apply to any use of prescription drugs, not just misuse. People who use but do not misuse prescription drugs could therefore meet SUD criteria. It is important for individuals who are using prescription drugs to receive ongoing medical monitoring, even if individuals are not misusing the prescription drugs. For these reasons, respondents in the 2021 NSDUH who reported any use of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past 12 months were asked corresponding SUD questions.
*American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
7. Are there differences in SUD criteria for misusers of prescription drugs and for users but not misusers of prescription drugs?
- The number of applicable DSM-5 criteria for classifying respondents as having a prescription drug use disorder depends on whether respondents misused prescription drugs or whether they used prescription drugs in the past year but did not misuse them. Respondents who misused prescription drugs in the past year were classified as having a prescription drug use disorder if they met 2 or more of 11 DSM-5 SUD criteria. Respondents who used prescription drugs in the past year but did not misuse them were classified as having a prescription drug use disorder if they met two or more of nine criteria. Two criteria (tolerance and withdrawal) do not apply to respondents who used but did not misuse these prescription drugs in the past year; tolerance and withdrawal can occur as normal physiological adaptations when people use these prescription drugs appropriately under medical supervision.˚
˚Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry, 170(8), 834-851. https://doi.org/10.1176/appi.ajp.2013.12060782
8. How did asking SUD questions of all past year users of prescription drugs affect SUD estimates?
- Asking SUD questions in 2021 of all past year users of prescription drugs more than doubled the estimated numbers of people who had prescription drug use disorders, compared with the estimated numbers based only on people who misused prescription drugs in the past year.
- Asking SUD questions of all past year users of prescription drugs also tended to capture data from people with mild SUDs, defined as having two or three SUD criteria for a given substance.
- In contrast, asking SUD questions of all past year users of prescription drugs had less effect on SUD estimates for aggregate SUD measures that included substances other than prescription drugs. For example, 20.0 million people aged 12 or older in 2021 were estimated to have an illicit drug use disorder in the past year (including use of marijuana, cocaine, heroin, hallucinogens, inhalants, or methamphetamine and misuse of prescription drugs). The estimate increased for any drug use disorder to 24.0 million people when data included past year users of prescription drugs, or an increase of about 20 percent.
Please direct any questions regarding the data included in these reports to CBHSQRequest@samhsa.hhs.gov.
People searching for treatment for mental or substance use disorders can find treatment by visiting FindTreatment.gov or by calling SAMHSA’s National Helpline, 1-800-662-HELP (4357). Reporters with questions should send inquiries to media@samhsa.hhs.gov.
