Conducted annually, the National Survey on Drug Use and Health (NSDUH) provides nationally representative data on the use of tobacco, alcohol, and drugs; substance use disorders; mental health issues; 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 estimates from the 2022 National Survey on Drug Use and Health (NSDUH).
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2022 NSDUH Highlights
Overall Highlights for 2022 NSDUH (PDF)
Highlights for 2022 NSDUH by Race and Ethnicity (PDF)
2022 NSDUH Frequently Asked Questions
General Questions
1. Is the NSDUH data from 2022 comparable with data from 2021?
- Many (but not all) NSDUH estimates from 2022 are comparable with estimates from 2021, as long as updated 2021 estimates, presented in the 2022 Detailed Tables, are used. When the NSDUH moved from in-person only survey administration to a multi-mode approach (with both in-person and web modes), it was determined that mode of administration had an effect on the resulting estimates. The proportion of interviews that were completed in-person was lower in 2021 than it was in 2022, likely due to the COVID-19 pandemic. In response to this, estimates for 2021 were updated using adjusted weights to account for changes in proportions of web vs. in-person interviews. The resulting updated 2021 estimates set the contributions of respondents for each mode to the same proportions as the 2022 estimates, thus removing the potential for bias in estimates of change due to shifts from web to in-person interviewing. See section 3.3.3 of the 2022 NSDUH Methodological Summary and Definitions for more details.
Additionally, necessary changes were made to the survey’s questions for certain outcomes in the 2022 NSDUH, including vaping, substance use treatment, and mental health treatment. Therefore, some outcomes in the 2022 NSDUH are not comparable with the updated 2021 NSDUH data. See What’s New/What’s Changed below for more details.
- Will SAMHSA re-release the 2021 National Report and Detailed Tables due to these revised 2021 estimates?
- SAMHSA has no plans to re-release the 2021 National Report and Detailed Tables, and the 2021 NSDUH National Report and 2021 Detailed Tables do not present this updated data. Therefore, these documents should not be used to compare estimates between 2021 and 2022. The updated 2021 estimates are available in the 2022 Detailed Tables. Consequently, estimates for 2021 listed in the 2022 Detailed Tables may differ slightly from these previously released estimates.
2. Is it appropriate to combine 2022 data with previous years’ data?
- The 2022 NSDUH data may be combined with 2021 data for pooled estimates. When creating pooled estimates, the 2021 updated weights and the 2022 weights should each be divided by the number of years being combined (two, in this case). The pooled estimates should use the new weights for 2021 that have been adjusted to the same mode proportions as the 2022 weights (see answer to FAQ #1).
When the 2022 NSDUH public-use file (PUF) is released, the 2021 PUF will also be updated with adjusted weights to allow for comparison between the two years. The 2021 restricted-use file (RUF) will also include the adjusted weights.
- As with the 2021 NSDUH data, the 2022 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 can be found in chapter 6 of the 2021 Methodological Summary and Definitions report.
3. Is SAMHSA planning to release state-level and substate-level estimates using 2022 data?
- State estimates are generally produced with two years of comparable data and substate estimates are generally produced with three years of comparable data. State estimates using combined 2021 and 2022 data are available here and estimates using combined 2022 and 2023 data will be released in the future. Substate-level estimates will also be released in the future.
4. Did the coronavirus disease 2019 (COVID-19) pandemic affect data collection for the 2022 NSDUH?
- Due to COVID-19, in-person data collection for the 2022 NSDUH was restricted in some areas in January 2022 but was permitted in all areas starting in February 2022. Like 2021, 2022 NSDUH used multimode data collection, in which respondents completed the survey in person or via the web.
What's New/What's Changed
1. Substance Use Treatment and Mental Health Treatment
- Both the substance use treatment and mental health treatment questions underwent considerable revisions in the 2022 NSDUH. The purpose of the updates was to better reflect current approaches to the delivery of treatment services based on extensive literature review, subject matter expert input, and cognitive testing. Due to these changes, 2022 estimates for substance use treatment and mental health treatment should not be compared with estimates from 2021. For this reason, estimates for substance use treatment and mental health treatment in 2021 are not shown in the 2022 NSDUH data products.
- The 2022 NSDUH defined substance use treatment as treatment received in the past year for the use of alcohol or drugs in an inpatient location; in an outpatient location; via telehealth; or in a prison, jail, or juvenile detention center; or the receipt of medication-assisted treatment (MAT) for alcohol use or opioid use. The 2022 NSDUH also collected information on the receipt of other services, including substance use services from any of the following: a support group, a peer support specialist or recovery coach who works with a substance use treatment program or other treatment provider, services in an emergency room or emergency department, or detoxification or withdrawal support services from a healthcare professional. These other services were not classified as “substance use treatment.” However, they were included in a separate aggregate measure created to cover the receipt of substance use treatment or other services.
- In addition, SAMHSA historically has included substance use treatment at a “specialty facility” in the past. With the changes to the questionnaire in 2022, the term “specialty facility” was dropped from 2022 NSDUH data products. In 2022, respondents were classified as needing substance use treatment if they had a substance use disorder in the past year or received treatment for their alcohol or drug use through inpatient treatment or counseling, outpatient treatment or counseling, medication-assisted treatment, telehealth treatment, or treatment received in a prison, jail, or juvenile detention center.
- The 2022 NSDUH defined mental health treatment as receipt of treatment or counseling for any problem with mental health, emotions, or behavior in the past year. Respondents were asked to report whether they received mental health treatment in the past 12 months in an inpatient location; in an outpatient location; through the use of prescription medication; via telehealth treatment; or in a prison, jail, or juvenile detention center. The 2022 NSDUH also collected information on the receipt of other mental health services, including participation in a support group, being seen in an emergency room or emergency department, or receiving help from a peer support specialist or recovery coach who works with a mental health treatment program or other treatment provider. These other services were not classified as “mental health treatment.” However, they were included in a separate aggregate measure created to cover the receipt of mental health treatment or other services.
- Sections 3.4.5 and 3.4.6 of the 2022 NSDUH Methodological Summary and Definitions discuss changes made to the substance use treatment and mental health treatment sections of the 2022 NSDUH questionnaire.
2. Nicotine Vaping and Marijuana Vaping
- Starting with the 2022 NSDUH, questions on vaping of nicotine were included in the nicotine section of the questionnaire instead of in the later emerging issues section. These changes affected the comparability of estimates of nicotine vaping between 2021 and 2022. For this reason, estimates for nicotine vaping in 2021 are not shown in the 2022 NSDUH data products.
- Additionally, questions about marijuana vaping were added to the marijuana section of the 2022 NSDUH questionnaire (marijuana vaping questions were previously only asked in the emerging issues section). The questions about marijuana vaping in the marijuana use section of the questionnaire were used to create the 2022 marijuana vaping estimates. Because questions on lifetime marijuana vaping are not asked in the marijuana section of the 2022 questionnaire, the estimates for lifetime marijuana vaping are not available for the 2022 NSDUH. Because of these changes to how marijuana vaping was measured for the 2022 NSDUH, estimates for marijuana vaping are not comparable between 2021 and 2022, and estimates for marijuana vaping in 2021 are not shown in the 2022 NSDUH data products.
- See section 3.4.11 of the 2022 NSDUH Methodological Summary and Definitions for details on changes made to the nicotine vaping measure in 2022, and 3.4.15 for more information on the marijuana vaping measure in 2022.
3. Modes of Marijuana Use
- Recognizing that many people use marijuana in another way besides smoking or vaping, starting with the 2022 NSDUH, questions were added to the marijuana section of the questionnaire to assess the different ways that respondents used marijuana. The complete list of modes of marijuana in the survey questions include smoking; vaping; dabbing waxes, shatter, or concentrates; eating or drinking; putting drops, strips, lozenges, or sprays in their mouth or under their tongue; applying lotion, cream, or patches to their skin; or taking pills. Respondents were also given an opportunity to describe other ways that they may have used marijuana that do not appear on the list.
- See section 3.4.15 of the 2022 NSDUH Methodological Summary and Definitions for details on data collection and management for these measures.
4. Illegally Made Fentanyl
- Starting with the 2022 NSDUH, questions were added to the emerging issues section of the questionnaire to assess the use of illegally made fentanyl (IMF). Because the questions about IMF came after the questions assessing substance use disorder and substance use treatment, it is not possible to assess SUDs or substance use treatment that arose solely from the use of IMF.
- Because data on IMF were not available in prior NSDUH years, some summary drug measures, such as illicit drug use and opioid misuse, did not include IMF in prior years. To enable comparisons with 2021, these measures also did not include IMF in 2022. However, new measures were produced in 2022 that included the use of IMF. These new measures included the use and misuse of fentanyl (i.e., pharmaceutical fentanyl or IMF) and the use and misuse of opioids including IMF.
- See section 4.3.4, 4.3.7, and 4.3.8 of the 2022 NSDUH Methodological Summary and Definitions for details on data collection and management for these measures as well as a discussion of which summary measures of opioids include IMF and which do not.
- It should be noted that because people who used IMF may have been unaware that they used it, caution must be taken in interpreting estimates of IMF use; these estimates are most likely an underestimate of true IMF use.
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 2022 NSDUH data. All reported indicators meet rigorous criteria for statistical precision. The 2022 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)
- 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
Estimates are presented by age group and by race/ethnicity for selected measures.
Also view slides based on the figures in the Annual National Report: Key Substance Use and Mental Health Indicators in the United States (PDF | PPT).
2022 NSDUH Companion Infographic
This infographic is a visual representation of key findings from the 2022 NSDUH national report. It covers selected indicators of substance use, substance use disorders, mental health issues, suicidality, and recovery from substance use problems or mental health issues among the U.S. population aged 12 or older.
Highlighted Population Slides
The 2022 NSDUH Highlighted Population Slides are a collection of slide decks underlining substance use and mental health for particular populations in the United States. Within each slide deck, selected estimates are presented overall, by age group, and for selected sub-populations. The slides for the following populations are available:
American Indian and Alaska Native Population (AIAN) (PDF | PPT).
Asian Population (PDF | PPT).
Black or African American Population (PDF | PPT).
Female Population (PDF | PPT).
Hispanic or Latino Population (PDF | PPT).
Lesbian, Gay, or Bisexual (LGB) Adult Population (PDF | PPT).
Multiracial Population (PDF | PPT).
Native Hawaiian and Other Pacific Islander Population (NHOPI) (PDF | PPT).
Veteran Population (PDF | PPT).
Detailed Tables
The 2022 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, treatment, and the perceived effects of the Coronavirus Disease 2019 (COVID-19) pandemic, along with some other miscellaneous health topics. The tables include estimates from 2021 and 2022 where appropriate, including statistical tests of differences between the two years. The 2021 estimates presented in these detailed tables are based on weights that were adjusted to allow for comparison with 2022. As a result, the NSDUH estimates for 2021 presented in the 2022 Detailed Tables may be different from the 2021 estimates previously published elsewhere. Please refer to the Methodological Summary and Definitions report for more information on the NSDUH survey.
Sections of the 2022 Detailed Tables:
Please refer to the related README file for instructions on how to use the Table of Contents and download files for faster viewing.
Methodology
The 2022 Methodological Summary and Definitions report summarizes the information users need to properly interpret NSDUH estimates related to substance use and mental health. This report accompanies the annual detailed tables and provides information on overall methodology, key definitions for measures and terms used in 2022 NSDUH reports and tables, along with some analysis of these measures and of the survey as a whole. The report is organized into five chapters:
- Chapter 1 is an introduction to the report.
- Chapter 2 describes the survey, including information about the sample design; data collection procedures and questionnaire changes; and key aspects of data processing, such as development of analysis weights.
- Chapter 3 presents technical details on the statistical methods and measurement, such as suppression criteria for unreliable estimates, statistical testing procedures, revised estimates for 2021 to account for data collection mode, and measurement issues for selected substance use and mental health measures.
- Chapter 4 covers special methodological topics related to prescription psychotherapeutic drugs.
- Chapter 5 describes other sources of data on substance use and mental health issues, including data sources for populations outside the NSDUH target population.
- Appendix A is a glossary that covers key definitions for use as a resource with the 2022 NSDUH reports and detailed tables.
- Appendix B provides a list of contributors to the report.
Additional methodological reports and materials are available from the 2022 Methodological Resource Book.
