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Data Source

2023 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 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 national estimates from the 2023 National Survey on Drug Use and Health (NSDUH).

Jump to: HighlightsAnnual National ReportDetailed Tables Methodology

Companion Infographic Reports

For the 2023 NSDUH release, two companion infographic reports are provided. Both offer user-friendly, visual representations of findings.

They cover selected indicators of substance use, substance use disorders, mental health issues, suicidality, and recovery from substance use problems or mental health issues among the civilian, noninstitutionalized U.S. population aged 12 or older.

2023 NSDUH Frequently Asked Questions

General Questions

1. Are NSDUH data from 2023 able to be compared with data from 2021 and 2022?

  • Many (but not all) NSDUH estimates from 2023 may be compared with estimates from 2022 and updated 2021 estimates that take into account the proportions of web and in-person interviews. Selected updated 2021 estimates are available in the 2022 Detailed Tables and in the 2023 Companion Infographic Report. Additionally, the 2021 Public Use File and Restricted Use File have been revised to allow data users to produce updated estimates for 2021. 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 or 2023 because these 2021 products do not present the updated estimates. SAMHSA provides more information about NSDUH restricted use files.
  • The 2021 estimates were updated because the mode of administration had an effect on the resulting estimates when NSDUH moved from in-person only to a multimode approach (with both in-person and web modes). Estimates for 2021 were updated using adjusted weights to account for changes in proportions of web versus in-person interviews between years. The resulting updated 2021 estimates set the contributions of respondents for each mode to targeted proportions of 30% of interviews being completed via the web and 70% being completed in person.
    • Adjustment to these targeted proportions also was included as part of the 2022 and 2023 weighting procedures to remove the potential for bias in the comparison of estimates across years due to changes in the proportions of interviews that were completed in each mode.
    • See section 2.3.4 of the 2023 Methodological Summary and Definitions report for more details.

2. Why does SAMHSA not use the term “trends” to compare estimates from 2021 to 2023 in the 2023 Companion Infographic Report?

  • SAMHSA has indicated in the 2023 Companion Infographic Report that statistical tests for overall trends from the baseline year to the current year will not be conducted until at least four comparable NSDUH data points are available.
  • Although the 2023 Companion Infographic Report compares estimates between years for 2021, 2022, and 2023, SAMHSA does not consider comparisons involving only 3 years of data to be sufficient for drawing conclusions about longer-term trends for substance use and mental health outcomes.

3. Is it appropriate to combine 2023 data with previous years’ data?

  • The 2023 NSDUH data may be combined with 2022 data or with data from 2021 and 2022 for pooled estimates.
    • If data users wish to create pooled estimates that include data from 2021, the 2021 updated weights should be used (see response to FAQ #1 ). A revised 2021 NSDUH Public Use File was released in January 2024 with the updated weight. A revised 2021 Restricted Use File also is available with the updated weight.
    • See the 2022 Statistical Inference Report (SIR) for details on the procedures for creating annual average estimates using pooled NSDUH data. SAMHSA expects to release the 2023 SIR in early 2025 as part of the 2023 Methodological Resource Book.
  • As with the 2021 and 2022 NSDUH data, the 2023 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 of the 2021 Methodological Summary and Definitions report.
  • Some estimates should not be compared between years because of changes in the NSDUH questionnaire in 2022 and 2023. Information related to variable comparability between 2021 and 2022 can be found in the Variable Crosswalk Chart available with the 2022 Public Use File. The Variable Crosswalk Chart for the 2023 Public Use File will be available later in 2024.

4. Is SAMHSA planning to release state-level and substate-level estimates using 2023 data?

  • 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 using combined 2022 and 2023 data are expected to be released later in 2024. Substate-level estimates using combined data from 2021 to 2023 are expected to be released in 2025.

What's New/What's Changed

This section lists notable changes for the 2023 NSDUH. A full list of questionnaire changes is available as part of the 2023 NSDUH Questionnaire. Also, see the 2023 Methodological Summary and Definitions report for more information about methods for the 2023 NSDUH.

1. Front-End Demographics

  • Questions about sex, Hispanic origin, and race that are used to create estimates for reports and tables were moved to this new section from the core demographics section, which was interviewer administered for in-person respondents in 2022.
  • The question about respondents’ sex from 2022 was also revised to ask about sex assigned at birth instead of asking whether respondents were male or female.
  • Investigation of the effects of changes to the questions for sex, Hispanic origin, and race led SAMHSA to conclude that substance use and mental health estimates in 2023 by sex and by race/ethnicity may be compared with corresponding estimates from 2021 and 2022.
  • New questions were included to ask about respondents’ gender identity. Consequently, estimates for gender identity do not exist for prior years.

2. Sexual Attraction and Identity

  • Beginning in 2023, questions about sexual attraction and identity were asked of all respondents. Before 2023, these questions were asked only of adults aged 18 or older.
  • The question about sexual identity was also revised to be more inclusive. Additional response choices were provided, and respondents could specify other terms that they use to describe their sexual identity. Therefore, estimates of sexual identity among adults should not be compared between 2023 and prior years.

3. Medication-Assisted Treatment

  • Questions that measured medication-assisted treatment (MAT) for alcohol and opioid use were removed from the emerging issues section
  • Since 2022, NSDUH has used MAT questions that were added to the alcohol and drug treatment section to estimate the receipt of MAT. Questions for the receipt of MAT from this section did not change for 2023. Therefore, estimates for the receipt of MAT from the alcohol and drug treatment section may be compared between 2022 and 2023.

4. Modes of Marijuana Use

  • Beginning in 2023, all variables for the ways in which respondents used marijuana in the past year and past month (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; taking pills; or some other way) were statistically imputed to replace missing data. For estimates of modes of marijuana use that were presented in 2022 NSDUH reports and tables, only the variables for marijuana vaping were statistically imputed.
  • For the 2023 NSDUH, these revised methods were also applied to produce imputed variables for all modes of marijuana use for 2022, including revised marijuana vaping variables. Therefore, the 2022 estimates for modes of marijuana use in the 2023 Detailed Tables may differ from previously published estimates. However, the revised 2022 estimates for modes of marijuana use may be compared with estimates in 2023.

2023 NSDUH Highlights

Overall Highlights for 2023 NSDUH (PDF)

Highlights for 2023 NSDUH by Race and Ethnicity (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 2023 NSDUH data. All reported indicators meet rigorous criteria for statistical precision. The 2023 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).

Detailed Tables

The 2023 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 2022 and 2023 where appropriate, including statistical tests of differences between the two years. Please refer to the Methodological Summary and Definitions report for more information on the NSDUH survey.

Sections of the 2023 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 2023 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 National Report and provides information on overall methodology, key definitions for measures and terms used in 2023 NSDUH reports and tables, along with some analysis of these measures and of the survey as a whole. The report is organized into four 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, and measurement issues for selected substance use and mental health measures.
  • Chapter 4 covers special methodological topics related to prescription psychotherapeutic drugs.

Additional methodological reports and materials are available from the 2023 Methodological Resource Book.