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Key Substance Use and Mental Health Indicators in the United States:
Results from the 2015 National Survey on Drug Use and Health

SAMHSA Authors

Jonaki Bose
Sarra L. Hedden
Rachel N. Lipari
Eunice Park-Lee

RTI Authors

Jeremy D. Porter
Michael R. Pemberton

SAMHSA Project Officer

Peter Tice

RTI Project Director

David Hunter

For questions about this report, please e-mail Peter.Tice@samhsa.hhs.gov.


This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by RTI International under Contract No. HHSS283201300001C with SAMHSA, U.S. Department of Health and Human Services (HHS).

Public Domain Notice

All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS.

Electronic Access and Printed Copies

This publication may be downloaded or ordered at http://store.samhsa.gov. Or call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español).

Recommended Citation

Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://www.samhsa.gov/data/

Originating Office

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 15-E09D, Rockville, MD 20857.


September 2016


Table of Contents

Summary

Introduction

Survey Background

Notable 2015 NSDUH Questionnaire Changes

Data Presentation and Interpretation

Illicit Drug Use
Any Illicit Drug Use
Marijuana Use
Misuse of Psychotherapeutic Drugs
Pain Reliever Misuse
Tranquilizer Misuse
Stimulant Misuse
Sedative Misuse
Cocaine Use
Heroin Use
Hallucinogen Use
Inhalant Use
Methamphetamine Use

Tobacco Use
Cigarette Use
Daily Cigarette Use
Cigar and Pipe Tobacco Use
Smokeless Tobacco Use

Alcohol Use
Current Alcohol Use
Binge Alcohol Use
Heavy Alcohol Use
Underage Alcohol Use

Substance Use Disorders in the Past Year
Substance Use Disorder
Alcohol Use Disorder
Illicit Drug Use Disorder
Marijuana Use Disorder
Cocaine Use Disorder
Heroin Use Disorder
Methamphetamine Use Disorder
Pain Reliever Use Disorder
Tranquilizer Use Disorder
Stimulant Use Disorder

Need for Substance Use Treatment

Receipt of Substance Use Treatment

Mental Health Issues and Mental Health Service Use
Mental Illness among Adults
Mental Health Service Use among Adults

Co-Occurring Mental Health Issues and Substance Use Disorders among Adults
Mental Illness and Substance Use Disorders among Adults with a Disorder
Co-Occurring Mental Illness and Substance Use Disorders among Adults in the General Population

Receipt of Services among Adults with Co-Occurring Mental Illness and a Substance Use Disorder

Major Depressive Episode (MDE) and MDE with Severe Impairment among Adults
Treatment for Depression among Adults

Mental Health Service Use among Adolescents
Mental Health Service Use among All Adolescents

MDE and MDE with Severe Impairment among Adolescents
Treatment for Depression among Adolescents

Co-Occurring MDE and Substance Use among Adolescents
Substance Use and Substance Use Disorders among Adolescents with MDE
MDE among Adolescents with a Substance Use Disorder
Co-Occurring MDE and Substance Use Disorder among Adolescents in the General Population

Receipt of Services among Adolescents with Co-Occurring MDE and a Substance Use Disorder

Endnotes

Appendix A: Supplemental Tables of Estimates for Key Substance Use and Mental Health Indicators in the United States

Appendix B: List of Contributors

Report Revision Note:

In this revised report, Figure 37 and its associated text were removed to be consistent with the Office of National Drug Control Policy's National Drug Control Strategy.

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Summary

This national report summarizes key findings from the 2015 National Survey on Drug Use and Health (NSDUH) for indicators of substance use and mental health among people aged 12 years old or older in the civilian, noninstitutionalized population of the United States. Results are provided for the overall category of individuals aged 12 or older as well as by age subgroups. The NSDUH questionnaire underwent a partial redesign in 2015 to improve the quality of the NSDUH data and to address the changing needs of policymakers and researchers with regard to substance use and mental health issues. Trends continue to be presented for estimates that are assumed to have remained comparable with those in earlier years (e.g., marijuana and heroin use trends for 2002 to 2015 and mental health trends typically for 2008 to 2015).

Illicit Drug Use

Changes in measurement for 7 of the 10 illicit drug categories—hallucinogens, inhalants, methamphetamine, and the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives—may have affected the comparability of the measurement of these illicit drugs.1 Therefore, only 2015 estimates are presented for these seven illicit drug categories and for the use of any illicit drug. In 2015, 27.1 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans (10.1 percent). The illicit drug use estimate for 2015 continues to be driven primarily by marijuana use and the misuse of prescription pain relievers, with 22.2 million current marijuana users aged 12 or older (i.e., users in the past 30 days) and 3.8 million people aged 12 or older who reported current misuse of prescription pain relievers. The 2015 estimate of current marijuana users was similar to the estimate in 2014, but it was higher than the estimates from 2002 to 2013. This increase in marijuana use among people aged 12 or older reflects the increase in marijuana use by adults aged 26 or older and, to a lesser extent, the increase in marijuana use among young adults aged 18 to 25.

In 2015, NSDUH adopted a revised definition of prescription drug misuse, which defined misuse as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than told to take a drug; or use in any other way not directed by a doctor. The estimated 3.8 million people aged 12 or older who were current misusers of pain relievers represent 1.4 percent of the population aged 12 or older.

The estimate of current heroin use in 2015 among people aged 12 or older was higher than the estimates in most years between 2002 and 2009, but it was similar to the estimates between 2010 and 2014. Current cocaine use in 2015 was similar to the estimates in most years between 2007 and 2013, but it was higher than the estimate in 2014. The 2015 estimate of crack use was similar to the estimates in most years from 2008 to 2014. There were new baselines in 2015 for hallucinogen, inhalant, and methamphetamine use (0.5, 0.2, and 0.3 percent, respectively, for current use among people aged 12 or older).

Tobacco Use

In 2015, an estimated 52.0 million people aged 12 or older were current cigarette smokers. Although about 1 in 5 people aged 12 or older were current cigarette smokers, cigarette use generally declined between 2002 and 2015 across all age groups. Among the 52.0 million current cigarette smokers in 2015, 30.2 million were daily cigarette smokers, including 12.4 million daily smokers who smoked approximately a pack or more of cigarettes per day.

Alcohol Use

NSDUH collects information on past month alcohol use, binge alcohol use, and heavy alcohol use. For men, binge alcohol use is defined in NSDUH as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. For women, binge drinking is defined as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. Heavy alcohol use is defined as binge drinking on 5 or more days in the past 30 days. In 2015, there were 138.3 million Americans aged 12 or older who reported current use of alcohol, including 66.7 million who reported binge alcohol use in the past month and 17.3 million who reported heavy alcohol use in the past month. Past month binge drinkers and heavy alcohol users represented 24.9 and 6.5 percent of people aged 12 or older, respectively.

Underage alcohol use (i.e., among people aged 12 to 20) and binge and heavy use among young adults aged 18 to 25 are a concern. In 2015, about 7.7 million people aged 12 to 20 reported drinking alcohol in the past month, including 5.1 million who reported binge alcohol use and 1.3 million who reported heavy alcohol use. Among all people aged 12 to 20 in 2015, 13.4 percent were binge drinkers, and 3.3 percent were heavy drinkers. About 2 out of 5 young adults aged 18 to 25 were current binge alcohol users, and 1 out of every 10 young adults were heavy alcohol users.

Substance Use Disorders

In 2015, approximately 20.8 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year,2 including 15.7 million people who had an alcohol use disorder and 7.7 million people who had an illicit drug use disorder. The percentage of people aged 12 or older with an alcohol use disorder (5.9 percent) in 2015 was lower than the percentages in 2002 to 2014. Due to revisions to the NSDUH illicit drug questions, estimates in 2015 for any illicit drug use disorder are not compared with estimates from previous years.

Substance Use Treatment

In 2015, an estimated 21.7 million people aged 12 or older needed substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs), or about 1 in 12 people (8.1 percent). For NSDUH, people are defined as needing substance use treatment if they had an SUD in the past year or if they received substance use treatment at a specialty facility in the past year.3

In 2015, 10.8 percent of people aged 12 or older (2.3 million people) who needed substance use treatment received treatment at a specialty facility in the past year.

Mental Health Issues among Adults

In 2015, an estimated 43.4 million adults aged 18 or older (17.9 percent) had any mental illness (AMI) in the past year. An estimated 9.8 million adults in the nation had a serious mental illness (SMI) in the past year, representing 4.0 percent of all U.S. adults in 2015.4 The percentage of adults with AMI and the percentage of adults with SMI remained stable from 2008 to 2015. In 2015, 6.7 percent of adults aged 18 or older (16.1 million adults) had at least one major depressive episode (MDE) in the past year, and 4.3 percent (10.3 million adults) had an MDE with severe impairment in the past year.5 The percentage of adults who had a past year MDE remained stable between 2005 and 2015.

Mental Health Service Use among Adults

In 2015, an estimated 34.2 million adults (14.2 percent of adults) received mental health care during the past 12 months. Among the 43.4 million adults with AMI, 18.6 million (43.1 percent) received mental health services in the past year. About 6.4 million of the 9.8 million adults with past year SMI (65.3 percent) received mental health services in the past year. The percentage of adults with AMI who received mental health care in 2015 was similar to the percentages in most years from 2008 to 2014.

Co-Occurring Mental Illness and Substance Use Disorders among Adults

An estimated 8.1 million adults (3.3 percent of all adults) had both AMI and SUDs in the past year, and 2.3 million adults (1.0 percent of all adults) had co-occurring SMI and SUDs in the past year. Among the 8.1 million adults with co-occurring AMI and an SUD in the past year, 48.0 percent received either substance use treatment at a specialty facility or mental health care in the past year. Among the 2.3 million adults who had co-occurring SMI and an SUD in the past year, 62.6 percent received either substance use treatment at a specialty facility or mental health care in the past year.

Mental Health Issues among Adolescents

In 2015, 12.5 percent of adolescents aged 12 to 17 (3.0 million adolescents) had an MDE during the past year, and 8.8 percent of adolescents (2.1 million adolescents) had a past year MDE with severe impairment.5 The percentage of adolescents in 2015 who had a past year MDE was higher than the percentages in 2004 to 2014. Among the 3.0 million adolescents in 2015 who had a past year MDE, 1.2 million (39.3 percent) received treatment for depression. This 2015 percentage was similar to the percentages in most years from 2004 to 2014.

Co-Occurring MDE and Substance Use among Adolescents

In 2015, the percentage of adolescents who used illicit drugs in the past year was higher among those with a past year MDE than it was among those without a past year MDE (31.5 vs. 15.3 percent). An estimated 350,000 adolescents in 2015 had an SUD and an MDE in the past year. This number represents 1.4 percent of all adolescents in the United States. Among adolescents who had a co-occurring MDE and an SUD in the past year, 63.1 percent received either substance use treatment at a specialty facility or mental health services in the past year.

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Introduction

Substance use and mental health issues affect millions of adolescents and adults in the United States and contribute heavily to the burden of disease.1,2,3 The National Survey on Drug Use and Health (NSDUH) is the primary source for statistical information on illicit drug use, alcohol use, substance use disorders (SUDs), and mental health issues for the civilian, noninstitutionalized population of the United States. Information on mental health and substance use allows the Substance Abuse and Mental Health Services Administration (SAMHSA) and other policymakers to gauge progress toward improving the health of the nation.

The benefit of using NSDUH data to assess trends across time has to be balanced with the periodic need to revise NSDUH content to address changes in society and emerging issues. Although minor changes may sometimes be made annually, the 2015 NSDUH included a wide array of changes that affected the reporting of trends for many NSDUH estimates.

This report contains one of the first sets of findings from the 2015 NSDUH for key substance use and mental health indicators in the United States. Comprehensive 2015 NSDUH detailed tables that show additional substance use and mental health-related outcomes, including data for various subpopulations covered in NSDUH, are available separately at http://www.samhsa.gov/data/.4

Survey Background

NSDUH is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years old or older.5 The survey is sponsored by SAMHSA within the U.S. Department of Health and Human Services (HHS). The survey covers residents of households and individuals in noninstitutional group quarters (e.g., shelters, boarding houses, college dormitories, migratory workers' camps, halfway houses). The survey excludes people with no fixed address (e.g., homeless people not in shelters), military personnel on active duty, and residents of institutional group quarters, such as jails, nursing homes, mental institutions, and long-term care hospitals.

NSDUH employs a stratified multistage area probability sample that is designed to be representative of both the nation as a whole and for each of the 50 states and the District of Columbia. The 2015 NSDUH annual target sample size of 67,500 interviews was distributed across three age groups, with 25 percent allocated to adolescents aged 12 to 17, 25 percent allocated to young adults aged 18 to 25, and 50 percent allocated to adults aged 26 or older. From 2002 through 2013, the NSDUH sample was allocated equally across these three age groups. Although the sample design changed in 2014, NSDUH had the same total target sample size per year of 67,500 interviews between 2002 and 2015.6

NSDUH is a face-to-face household interview survey that is conducted in two phases: the screening phase and the interview phase. The interviewer conducts a screening of the eligible household with an adult resident (aged 18 or older) in order to determine whether zero, one, or two residents aged 12 or older should be selected for the interview.7 NSDUH collects data using audio computer-assisted self interviewing (ACASI) in which respondents read or listen to the questions on headphones, then enter their answers directly into a NSDUH laptop computer. ACASI is designed for accurate reporting of information by providing respondents with a highly private and confidential mode for responding to questions about illicit drug use, mental health, and other sensitive behaviors. NSDUH also uses computer-assisted personal interviewing (CAPI) in which interviewers read less sensitive questions to respondents and enter the respondents' answers into a NSDUH laptop computer.

In 2015, screening was completed at 132,210 addresses, and 68,073 completed interviews were obtained, including 16,955 interviews from adolescents aged 12 to 17 and 51,118 interviews from adults aged 18 or older. Weighted response rates for household screening and for interviewing were 79.7 and 69.3 percent, respectively, for an overall response rate of 55.2 percent for people aged 12 or older. The weighted interview response rates were 77.7 percent for adolescents and 68.4 percent for adults.8 Further details about the 2015 NSDUH design and methods can be found on the web at http://www.samhsa.gov/data/.9

Notable 2015 NSDUH Questionnaire Changes

The NSDUH questionnaire underwent a partial redesign in 2015 to improve the quality of the NSDUH data and to address the changing needs of policymakers and researchers with regard to substance use and mental health issues. The prescription drug questions were redesigned to shift the focus from lifetime misuse to past year misuse. Additionally, questions were added about any past year prescription drug use rather than just misuse. New methamphetamine questions were added, replacing the methamphetamine questions that were previously asked within the context of prescription stimulants. Substantial changes were also made to questions about smokeless tobacco, binge alcohol use, inhalants, and hallucinogens. These changes led to potential breaks in the comparability of 2015 estimates with estimates from prior years. Consequently, these changes potentially affected overall summary measures, such as illicit drug use, and other measures, such as initiation, SUD, and substance use treatment. Additionally, certain demographic items were changed as part of the partial redesign. Education questions were updated, and new questions were added on disability, English-language proficiency, sexual orientation of adults, and military families.

Due to these changes, only 2015 data are presented for certain estimates until comparability with prior years can be established. Trends will continue to be presented for items that are assumed to have remained comparable with earlier years. Details on the 2015 NSDUH questionnaire changes, reasons for the changes, and implications of the changes for NSDUH data users are included in a brief report on these questionnaire changes, in a report on the design changes for the 2014 and 2015 NSDUHs, and in the methodological summary and definitions report for 2015.10,11,12

Data Presentation and Interpretation

This report focuses on substance use and mental health in the United States based on NSDUH data from 2015 and earlier years.13 Estimates of substance use and substance use treatment are presented for individuals aged 12 or older, adolescents, and adults.14 However, estimates of mental health issues and mental health service use are not presented jointly for individuals aged 12 or older. Rather, these estimates are presented separately for adolescents aged 12 to 17 and adults aged 18 or older because adolescents and adults completed different sets of questions regarding mental health and mental health service utilization.

All estimates (e.g., percentages and numbers) presented in the report are derived from NSDUH survey data that are subject to sampling errors. The estimates have met the criteria for statistical precision. Estimates that do not meet these criteria have been suppressed and are not shown.15 Trend analyses in this report focus on percentages because the percentages take into account any change in the size of the total population and facilitate the comparison of estimates across years.16 This report focuses on long-term trends by comparing percentages in 2015 with percentages in each of the years from 2002 to 2014. Statistical tests also have been conducted for comparisons that appear in the text of the report. Statistically significant differences are described using terms such as "higher," "lower," "increased," or "decreased." Statements use terms such as "similar," "remained steady," or "stable" when a difference is not statistically significant. Analyses of long-term trends in this report summarize whether the 2015 estimates are different from or similar to estimates in most or all previous years,17 while minimizing discussion of anomalous differences between any 2 years that can occur due to these estimates being based on samples.18 Graphics and tables contain estimates that support the statements in this report, and supplementary tables of estimates (including standard errors) are included in Appendix A. Also, Appendix B provides a list of contributors, reviewers, and report production staff who worked on this report.

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Illicit Drug Use

NSDUH obtains information on 10 categories of illicit drugs: marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamine, as well as the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives; see the section on the misuse of psychotherapeutic drugs for the definition of misuse. Estimates of "illicit drug use" reported from NSDUH reflect the data from these 10 drug categories. Changes in measurement for 7 of the 10 illicit drug categories—hallucinogens, inhalants, methamphetamine, and the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives—may have affected the comparability of the measurement of these illicit drugs between 2015 and prior years. Therefore, only 2015 estimates are presented for these seven illicit drug categories. Also, only 2015 estimates are presented for the use of any illicit drug.

In 2015, an estimated 27.1 million Americans aged 12 or older were current (past month) illicit drug users, meaning that they had used an illicit drug during the month prior to the survey interview (Figure 1). The most commonly used illicit drug in the past month was marijuana, which was used by 22.2 million people aged 12 or older. An estimated 6.4 million people reported misusing psychotherapeutic drugs in the past month, including 3.8 million people who were misusers of prescription pain relievers. Thus, the number of current misusers of pain relievers was second to marijuana among specific illicit drugs. Smaller numbers of people in 2015 were current users of the other illicit drugs shown in Figure 1.19

Figure 1. Numbers of Past Month Illicit Drug Users among People Aged 12 or Older: 2015

Figure 1     D

Note: Estimated numbers of people refer to people aged 12 or older in the civilian, noninstitutionalized population in the United States. The numbers do not sum to the total population of the United States because the population for NSDUH does not include people aged 11 years old or younger, people with no fixed household address (e.g., homeless or transient people not in shelters), active-duty military personnel, and residents of institutional group quarters, such as correctional facilities, nursing homes, mental institutions, and long-term care hospitals.

Note: The estimated numbers of current users of different illicit drugs are not mutually exclusive because people could have used more than one type of illicit drug in the past month.

Any Illicit Drug Use

The estimated 27.1 million people aged 12 or older who were current illicit drug users in 2015 (Figure 1) represent 10.1 percent of the population aged 12 or older (Figure 2). Stated another way, 1 in 10 individuals aged 12 or older in the United States used illicit drugs in the past month. Approximately 2.2 million adolescents aged 12 to 17 in 2015 were current users of illicit drugs, which represents 8.8 percent of adolescents. Approximately 1 in 5 young adults aged 18 to 25 (22.3 percent) were current users of illicit drugs in 2015. This percentage corresponds to about 7.8 million young adults in 2015 who were current users of illicit drugs. In 2015, 8.2 percent of adults aged 26 or older were current users of illicit drugs, or about 17.1 million adults in this age group.

Figure 2. Past Month Illicit Drug Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 2     D

Marijuana Use

As noted in the illicit drug use section, an estimated 22.2 million Americans aged 12 or older in 2015 were current users of marijuana (Figure 1). This number of past month marijuana users corresponds to 8.3 percent of the population aged 12 or older (Figure 3). The percentage of people aged 12 or older who were current marijuana users in 2015 was similar to the percentage in 2014, but it was higher than the percentages from 2002 to 2013. This increase in marijuana use among people aged 12 or older reflects the increase in marijuana use by adults aged 26 or older and, to a lesser extent, increases in marijuana use among young adults aged 18 to 25.

Figure 3. Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 3D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 3 Table. Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12   6.2+   6.2+   6.1+   6.0+   6.0+   5.8+   6.1+   6.7+   6.9+   7.0+   7.3+   7.5+   8.4     8.3  
12-17   8.2+   7.9+   7.6     6.8     6.7     6.7     6.7     7.4     7.4     7.9+   7.2     7.1     7.4     7.0  
18-25 17.3+ 17.0+ 16.1+ 16.6+ 16.3+ 16.5+ 16.6+ 18.2+ 18.5+ 19.0   18.7   19.1   19.6   19.8  
≥26   4.0+   4.0+   4.1+   4.1+   4.2+   3.9+   4.2+   4.6+   4.8+   4.8+   5.3+   5.6+   6.6     6.5  

Aged 12 to 17

In 2015, 7.0 percent of adolescents aged 12 to 17 were current users of marijuana (Figure 3). This means that approximately 1.8 million adolescents used marijuana in the past month. The percentage of adolescents in 2015 who were current marijuana users was similar to the percentages in most years between 2004 and 2014.

Aged 18 to 25

In 2015, about 1 in 5 young adults aged 18 to 25 (19.8 percent) were current users of marijuana (Figure 3). This means that 6.9 million young adults used marijuana in the past month. The percentage of young adults who were current marijuana users in 2015 was stable compared with the percentages between 2011 and 2014. However, the 2015 estimate was higher than the estimates in 2002 through 2010.

Aged 26 or Older

In 2015, 6.5 percent of adults aged 26 or older were current users of marijuana (Figure 3), which represents about 13.6 million adults in this age group. The percentage of adults aged 26 or older who were current marijuana users in 2015 was similar to the percentage in 2014, but it was higher than the percentages in 2002 to 2013.

Misuse of Psychotherapeutic Drugs

Because of the changes that were made to the prescription drug questions in 2015, a new baseline started in 2015 for all prescription drug measures. The four categories of prescription drugs (pain relievers, tranquilizers, stimulants, and sedatives) cover numerous medications that currently are or have been available by prescription. NSDUH respondents are asked to report misuse of these drugs, defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than told to take a drug; or use in any other way not directed by a doctor. Misuse of over-the-counter drugs is not included. NSDUH reports combine the four prescription drug groups into a category referred to as "psychotherapeutics." Additional information on the revisions to the NSDUH prescription drug questions are documented in a separate 2015 NSDUH report on prescription drugs.20 The report for prescription drugs also includes new content, such as estimates of any use of prescription drugs (i.e., not just misuse), and motivations for misusing prescription drugs.

In this section, a summary of current misuse of any prescription psychotherapeutic drug is presented first, followed by sections on the current misuse of pain relievers, tranquilizers, stimulants, and sedatives. In 2015, an estimated 6.4 million Americans aged 12 or older were current misusers of psychotherapeutic drugs, which represent 2.4 percent of the population aged 12 or older (Figure 4). An estimated 492,000 adolescents aged 12 to 17 misused psychotherapeutic drugs in the past month. Stated another way, about 1 in 50 adolescents (2.0 percent) were current misusers of psychotherapeutic drugs. An estimated 1.8 million young adults aged 18 to 25 were current misusers of psychotherapeutic drugs, which corresponds to 5.1 percent of young adults. There were 4.1 million adults aged 26 or older who were current misusers of psychotherapeutic drugs, or 2.0 percent of adults in this age group.

Figure 4. Past Month Misuse of Prescription Psychotherapeutics among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 4     D

Pain Reliever Misuse

Overall estimates of current prescription psychotherapeutic drug misuse in 2015 among the population aged 12 or older that were described previously were largely driven by the misuse of prescription pain relievers. In 2015, about three fifths of the current misusers of psychotherapeutic drugs who were aged 12 or older reported misusing pain relievers in the past month (Figure 5).

Figure 5. Misuse of Prescription Pain Relievers and Other Prescription Psychotherapeutics among People Aged 12 or Older Who Were Current Misusers of Any Prescription Psychotherapeutics: 2015

Figure 5     D

An estimated 3.8 million people aged 12 or older in 2015 were current misusers of pain relievers, which represents 1.4 percent of the population aged 12 or older (Figures 5 and 6). In 2015, an estimated 276,000 adolescents aged 12 to 17 were current misusers of pain relievers, which corresponds to 1.1 percent of adolescents (Figure 6). An estimated 829,000 young adults aged 18 to 25 misused pain relievers in the past month, which represents 2.4 percent of young adults. An estimated 2.7 million adults aged 26 or older were current misusers of pain relievers, which corresponds to 1.3 percent of adults aged 26 or older.

Figure 6. Past Month Misuse of Prescription Pain Relievers, Tranquilizers, Stimulants, and Sedatives among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 6     D

Tranquilizer Misuse

An estimated 1.9 million people aged 12 or older in 2015 were current misusers of tranquilizers, which represents 0.7 percent of people aged 12 or older (Figures 1 and 6). In 2015, an estimated 162,000 adolescents aged 12 to 17 were current misusers of tranquilizers, which represents 0.7 percent of adolescents (Figure 6). An estimated 582,000 young adults aged 18 to 25 misused tranquilizers in the past month, which represents 1.7 percent of young adults. In 2015, an estimated 1.1 million adults aged 26 or older were current misusers of tranquilizers, which corresponds to 0.5 percent of adults in this age group.

Stimulant Misuse

In 2015, an estimated 1.7 million people aged 12 or older, or 0.6 percent of this population, were current misusers of stimulants (Figures 1 and 6). About 117,000 adolescents aged 12 to 17 were current misusers of stimulants in 2015, corresponding to about 0.5 percent of adolescents (Figure 6). There were about 757,000 young adults aged 18 to 25 in 2015 who misused stimulants in the past month, which corresponds to about 2.2 percent of young adults in 2015. In 2015, an estimated 779,000 adults aged 26 or older were current misusers of stimulants, which represents 0.4 percent of this age group.

Sedative Misuse

An estimated 446,000 people aged 12 or older were current misusers of sedatives in 2015, which rounds to the 0.4 million people shown in Figure 1. This number represents 0.2 percent of the population aged 12 or older (Figure 6). There were an estimated 21,000 adolescents in 2015 who were current misusers of sedatives (0.1 percent of adolescents). In 2015, an estimated 86,000 young adults aged 18 to 25 misused sedatives in the past month (0.2 percent of young adults). An estimated 340,000 adults aged 26 or older were current misusers of sedatives in 2015 (0.2 percent of adults aged 26 or older).

Cocaine Use

In this report, estimates of the use of cocaine include use of crack cocaine. Estimates also are presented separately for crack use. In 2015, the estimate of about 1.9 million people aged 12 or older who were current users of cocaine (Figure 1) included about 394,000 current users of crack. These numbers correspond to about 0.7 percent of the population aged 12 or older who were current users of cocaine (Figure 7) and 0.1 percent who were current users of crack (Table A.1B in Appendix A). The 2015 estimate for current cocaine use was similar to the estimates in most years between 2007 and 2013, but it was higher than the estimate in 2014. The 2015 estimate of crack use was similar to the estimates in most years from 2008 to 2014. The 2015 estimates of both cocaine and crack use were lower than most of the estimates between 2002 and 2006.

Figure 7. Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 7 D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 7 Table. Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 0.9+ 1.0+ 0.8+ 1.0+ 1.0+ 0.8   0.7   0.7   0.6   0.5+ 0.6   0.6   0.6+ 0.7  
12-17 0.6+ 0.6+ 0.5+ 0.6+ 0.4+ 0.4+ 0.4+ 0.3   0.2   0.3   0.1   0.2   0.2   0.2  
18-25 2.0+ 2.2+ 2.1+ 2.6+ 2.2+ 1.7   1.6   1.4   1.5   1.4   1.1+ 1.1+ 1.4   1.7  
≥26 0.7   0.8+ 0.7   0.8   0.8+ 0.7   0.7   0.6   0.5   0.4+ 0.6   0.5   0.5   0.6  

Aged 12 to 17

There were 53,000 adolescents aged 12 to 17 who were current users of cocaine in 2015. This number who used cocaine represents 0.2 percent of adolescents (Figure 7). The 2015 estimate for current cocaine use among adolescents was similar to the estimates between 2009 and 2014, but the 2015 estimate was lower than the estimates in the years from 2002 to 2008. Where estimates had sufficient precision to be reported, estimates of crack use among adolescents in 2002 to 2015 ranged from less than 0.1 percent to 0.1 percent (Table A.2B in Appendix A).

Aged 18 to 25

An estimated 1.7 percent of young adults aged 18 to 25 were current users of cocaine in 2015 (Figure 7), and 0.1 percent used crack in the past month (Table A.3B in Appendix A). These percentages represent 580,000 young adults who used cocaine, including 39,000 who used crack. The 2015 percentage of young adults who were current cocaine users was lower than the percentages in 2002 through 2006, and it was similar to the percentages in most years between 2007 and 2014. The estimate of current crack use among young adults in 2015 was similar to estimates between 2007 and 2014.

Aged 26 or Older

In 2014, 0.6 percent of adults aged 26 or older were current users of cocaine (Figure 7), and 0.2 percent used crack in the past month (Table A.4B in Appendix A). These percentages represent 1.2 million adults aged 26 or older who currently used cocaine, including 354,000 who currently used crack. The 2015 estimate of current cocaine use among adults aged 26 or older was similar to the estimates from most years between 2002 and 2014. Current use of crack was stable between 2008 and 2015, but the 2015 estimate was lower than the estimates in most years from 2002 to 2007.

Heroin Use

Heroin is a highly addictive opioid that is illegal and has no accepted medical use in the United States. About 329,000 people aged 12 or older were current heroin users in 2015, which rounds to the 0.3 million people shown in Figure 1. This number corresponds to about 0.1 percent of the population aged 12 or older (Figure 8). Because heroin use is not as common as the use of other illicit drugs, monitoring both past month and past year heroin use provides additional context for interpreting the trends. For past year use, 0.3 percent of people aged 12 or older in 2015 had used heroin (Figure 9), which represents about 828,000 people.

Despite the dangers associated with heroin use, its use has increased in recent years. The estimate of current heroin use in 2015 among people aged 12 or older was higher than the estimates in most years between 2002 and 2009, but it was similar to the estimates between 2010 and 2014 (Figure 8). However, even when there was a statistically significant difference between the 2015 estimate and prior years, the percentages were approximately the same, except for the estimate in 2014 (0.2 percent). For example, all of these estimates for current heroin use rounded to 0.1 percent. In 2014, the estimate of current heroin use was higher than in all previous years; however, the 2015 estimate does not provide strong support that the increase in 2014 signaled the start of a change in the trend. Future survey years will be useful for monitoring this trend.

The estimate of past year heroin use in 2015 (0.3 percent) was also higher than the estimates for most years between 2002 and 2008, but it was similar to the estimates between 2009 and 2014 (Figure 9). This shift in heroin use among people aged 12 or older reflects changes in heroin use by adults aged 26 or older and, to a lesser extent, smaller increases in heroin use among young adults aged 18 to 25.

Figure 8. Past Month Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 8     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 8 Table. Past Month Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
* Low precision; no estimate reported.
Note: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
≥12 0.1+ 0.1+ 0.1+ 0.1+ 0.1   0.1+ 0.1   0.1+ 0.1   0.1   0.1   0.1   0.2   0.1  
12-17 0.0   0.1   0.1   0.1   0.1   0.0   0.1   0.1   0.0   0.1   *   0.1   0.1   0.0  
18-25 0.1+ 0.1+ 0.1   0.2   0.2   0.1   0.2   0.2   0.3   0.3   0.4   0.3   0.2   0.3  
≥26 0.1   0.0+ 0.1+ 0.0+ 0.1   0.1+ 0.1   0.1+ 0.1   0.1   0.1   0.1   0.2   0.1  

Figure 9. Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 9     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 9 Table. Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 0.2+ 0.1+ 0.2+ 0.2+ 0.2   0.2+ 0.2+ 0.2   0.2   0.2   0.3   0.3   0.3   0.3  
12-17 0.2+ 0.1   0.2+ 0.1   0.1   0.1   0.2   0.1   0.1   0.2+ 0.1   0.1   0.1   0.1  
18-25 0.4+ 0.3+ 0.4+ 0.5   0.4   0.4   0.5   0.5   0.6   0.7   0.8   0.7   0.8   0.6  
≥26 0.1+ 0.1+ 0.1+ 0.1+ 0.2   0.1+ 0.1+ 0.2   0.2   0.2+ 0.2+ 0.2   0.3   0.3  

Aged 12 to 17

In 2015, less than 0.1 percent of adolescents aged 12 to 17 were current heroin users (Figure 8), and 0.1 percent were past year users (Figure 9). These percentages represent 21,000 adolescents who used heroin in the past year, including 5,000 adolescents who were current users of heroin. The percentage of adolescents in 2015 who were current heroin users was similar to available estimates for heroin use in 2002 to 2014. The percentage of adolescents in 2015 who were past year heroin users was similar to the percentages in most years from 2005 through 2014.

Aged 18 to 25

Among young adults aged 18 to 25 in 2015, 0.3 percent were current heroin users (Figure 8), and 0.6 percent were past year users (Figure 9). These percentages represent 217,000 young adults who used heroin in the past year, including 88,000 who were current users of heroin. The percentage of young adults in 2015 who were current heroin users (0.3 percent) was higher than the percentages in 2002 and 2003, and it was similar to the percentages in 2004 through 2014. The percentages of young adults who were past year heroin users were similar between 2005 and 2015 (ranging from 0.4 to 0.8 percent), but the percentage in 2015 (0.6 percent) was higher than the percentages from 2002 through 2004 (ranging from 0.3 to 0.4 percent).

Aged 26 or Older

In 2015, 0.1 percent of adults aged 26 or older were current heroin users (Figure 8), and 0.3 percent were past year users (Figure 9). These percentages represent 591,000 adults aged 26 or older who used heroin in the past year, including 236,000 who were current users of heroin. The percentage of adults aged 26 or older in 2015 who were current heroin users (0.1 percent) was similar to the percentages for most years between 2008 and 2014, but it was higher than the percentages for most years between 2002 and 2007 (ranging from less than 0.1 to 0.1 percent). The percentage of adults aged 26 or older in 2015 who were past year heroin users (0.3 percent) was similar to the percentages for most years between 2009 and 2014, but it was higher than the percentages in most years from 2002 to 2008.

Hallucinogen Use

Several drugs are grouped under the category of hallucinogens, including LSD, PCP, peyote, mescaline, psilocybin mushrooms, "Ecstasy" (MDMA or "Molly"), ketamine, DMT/AMT/"Foxy," and Salvia divinorum.21 The 2015 estimates for hallucinogen use are presented in this section. In 2015, the NSDUH estimate of any hallucinogen use was expanded to include the use of ketamine, DMT/AMT/"Foxy," and Salvia divinorum. Because of this change, estimates of hallucinogen use in 2015 are not compared with estimates in prior years.

In 2015, an estimated 1.2 million people aged 12 or older were current users of hallucinogens (Figure 1), representing 0.5 percent of the population aged 12 or older (Figure 10). An estimated 121,000 adolescents aged 12 to 17 were current users of hallucinogens in 2015, or 0.5 percent of adolescents. In 2015, 1.8 percent of young adults aged 18 to 25 were current users of hallucinogens, which represents 636,000 young adults who used hallucinogens. An estimated 0.2 percent of adults aged 26 or older were current users of hallucinogens in 2015, which represents 482,000 individuals in this age group who were using hallucinogens.

Figure 10. Past Month Hallucinogen Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 10     D

Inhalant Use

Inhalants include a variety of substances, such as nitrous oxide, amyl nitrite, cleaning fluids, gasoline, spray paint, computer keyboard cleaner, other aerosol sprays, felt-tip pens, and glue. Respondents are asked to report the use of inhalants to get high, but not to include accidental inhalation of a substance. In 2015, the NSDUH estimate of inhalant use was expanded to include the use of felt-tip pens or computer keyboard cleaner to get high. Because of this change, estimates of inhalant use in 2015 are not compared with estimates in prior years.

In 2015, approximately 527,000 people aged 12 or older were current users of inhalants, which rounds to the estimate of 0.5 million people shown in Figure 1. This number represents 0.2 percent of the population aged 12 or older (Figure 11). Current use of inhalants in 2015 was more common among adolescents aged 12 to 17 than among people in other age groups. Percentages of people in different age groups who were current users of inhalants in 2015 were 0.7 percent of adolescents, 0.4 percent of young adults aged 18 to 25, and 0.1 percent of adults aged 26 or older (Figure 11). About 175,000 adolescents, 126,000 young adults, and 226,000 adults aged 26 or older were current users of inhalants in 2015.

Figure 11. Past Month Inhalant Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 11     D

Methamphetamine Use

Prior to 2015, questions about methamphetamine use were asked in the context of questions about the misuse of prescription stimulants because methamphetamine is legally available by prescription (Desoxyn®). However, most methamphetamine that is now used in the United States is produced and distributed illicitly rather than through the pharmaceutical industry. Therefore, for 2015, a new set of questions specific to methamphetamine was created and administered separately from the questions about the misuse of prescription stimulants. Because of these changes, estimates of methamphetamine use in 2015 are not compared with estimates from prior years.

In 2015, approximately 897,000 people aged 12 or older were current users of methamphetamine, which rounds to the estimate of 0.9 million people shown in Figure 1. This number represents 0.3 percent of the population aged 12 or older (Figure 12). About 13,000 adolescents aged 12 to 17 were current methamphetamine users in 2015. This number corresponds to about 0.1 percent of adolescents in 2015 being current methamphetamine users. There were about 128,000 young adults aged 18 to 25 in 2015 who used methamphetamine in the past month, which corresponds to about 0.4 percent of young adults (Figure 12). In 2015, an estimated 757,000 adults aged 26 or older used methamphetamine, which represents 0.4 percent of this age group.

Figure 12. Past Month Methamphetamine Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 12     D

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Tobacco Use

Tobacco use continues to be the leading cause of preventable death in the United States. Tobacco use, particularly cigarette smoking, imposes substantial health and financial costs on our nation.22,23 NSDUH data can be used to estimate the percentage of individuals who used tobacco products and, in turn, can be used to monitor changes in use over time. NSDUH asks respondents aged 12 or older about their tobacco use in the 30 days before the interview. Tobacco products include cigarettes, smokeless tobacco (such as snuff, dip, chewing tobacco, or "snus"), cigars, and pipe tobacco. Cigarette use is defined as smoking "part or all of a cigarette." A discussion of the estimates for daily cigarette smoking follows a presentation of the estimates for any current cigarette smoking. Finally, this section presents estimates for current use of cigars, pipe tobacco, and smokeless tobacco.

In 2015, respondents were asked about their use of any smokeless tobacco product (i.e., instead of being asked separately about their use of snuff and chewing tobacco) because data from prior years indicated that respondents had difficulty distinguishing between these types of smokeless tobacco. Due to these changes, estimates of smokeless tobacco use in 2015 are not compared with estimates in prior years.

The majority of current (i.e., past month) tobacco users in 2015 were current cigarette smokers (Figure 13), as has been the case historically.24 Among current users of any tobacco product aged 12 or older in 2015, 66.3 percent smoked cigarettes but did not use other tobacco products, 15.0 percent smoked cigarettes and used some other type of tobacco product, and 18.8 percent used only tobacco products other than cigarettes (Figure 14). This same pattern was observed across the three age groups in 2015 (adolescents aged 12 to 17, young adults aged 18 to 25, and adults aged 26 or older), with most current tobacco use consisting only of cigarette smoking, followed by the use of tobacco products other than cigarettes or the use of both cigarettes and other tobacco products. Among young adults and adults aged 26 or older who were current users of tobacco products, about 20 percent did not smoke cigarettes (19.0 and 18.4 percent, respectively). In contrast, among adolescents who were current tobacco users, 30.3 percent used tobacco products other than cigarettes but did not smoke cigarettes. In addition, about one fourth of adolescents and young adults who were current tobacco users smoked cigarettes and used other tobacco products (26.0 and 23.6 percent, respectively). Among adults aged 26 or older who were current tobacco users, about 1 in 8 (12.7 percent) were current cigarette smokers and current users of other tobacco products.

Figure 13. Past Month Tobacco Use among People Aged 12 or Older: 2015

Figure 13     D

Note: The estimated numbers of current users of different tobacco products are not mutually exclusive because people could have used more than one type of tobacco product in the past month.


Figure 14. Type of Past Month Tobacco Use among Current Tobacco Users Aged 12 or Older: Percentages, 2015

Figure 14     D

Note: The percentages do not add to 100 percent due to rounding.

Cigarette Use

In 2015, an estimated 52.0 million people aged 12 or older were current cigarette smokers (Figure 13). This number corresponds to 19.4 percent of the population being current cigarette smokers (Figure 15). Past month cigarette use among the population aged 12 or older was lower in 2015 than in 2002 to 2014. Stated another way, about 1 in 5 people aged 12 or older in 2015 were current cigarette smokers. In comparison, about 1 in 4 people aged 12 or older were current cigarette smokers in 2002 to 2008 (ranging from 24.0 to 26.0 percent). Although cigarette smoking has declined, some of this decline may reflect the use of electronic vaporizing devices for delivering nicotine, such as e-cigarettes. For example, recent research indicates that more than a quarter million middle school and high school students in 2013 (263,000) never smoked a conventional cigarette but used e-cigarettes.25 Future research on both cigarette use and e-cigarette use is needed to continue monitoring these developments; however, NSDUH does not currently ask direct questions about e-cigarette use.

Figure 15. Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 15     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 15 Table. Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 26.0+ 25.4+ 24.9+ 24.9+ 25.0+ 24.3+ 24.0+ 23.3+ 23.0+ 22.1+ 22.1+ 21.3+ 20.8+ 19.4  
12-17 13.0+ 12.2+ 11.9+ 10.8+ 10.4+   9.9+   9.2+   9.0+   8.4+   7.8+   6.6+   5.6+   4.9+   4.2  
18-25 40.8+ 40.2+ 39.5+ 39.0+ 38.5+ 36.2+ 35.7+ 35.8+ 34.3+ 33.5+ 31.8+ 30.6+ 28.4+ 26.7  
≥26 25.2+ 24.7+ 24.1+ 24.3+ 24.7+ 24.1+ 23.8+ 23.0+ 22.8+ 21.9+ 22.4+ 21.6+ 21.5+ 20.0  

Aged 12 to 17

Among adolescents aged 12 to 17 in 2015, 1.0 million smoked cigarettes in the past month. This number represents 4.2 percent adolescents who were current cigarette smokers (Figure 15). The percentage of adolescents who were past month cigarette smokers declined from 13.0 percent in 2002 (or about 1 in 8 adolescents) to 4.2 percent in 2015 (or fewer than 1 in 20). The percentage of adolescents who were current cigarette smokers in 2015 also was lower than the percentages in each year from 2002 to 2014.

Aged 18 to 25

Among young adults aged 18 to 25 in 2015, 9.3 million smoked cigarettes in the past month. This number of young adults who were current cigarette smokers represents about one quarter of young adults (26.7 percent) (Figure 15). The percentage of young adults who were current cigarette smokers in 2015 was lower than the percentages in 2002 to 2014.

Aged 26 or Older

In 2015, 41.6 million adults aged 26 or older smoked cigarettes in the past month. Stated another way, 1 out of 5 adults aged 26 or older (20.0 percent) were current cigarette smokers in 2015 (Figure 15). The 2015 estimate for current cigarette smoking among adults in this age group was lower than the estimates from 2002 to 2014.

Daily Cigarette Use

Among the 52.0 million current cigarette smokers aged 12 or older in 2015, 30.2 million were daily cigarette smokers. The 30.2 million daily smokers represent 58.1 percent of current cigarette smokers (Figure 16). Thus, about three fifths of current cigarette smokers in 2015 smoked cigarettes daily. The percentage of current smokers aged 12 or older in 2015 who smoked cigarettes daily was lower than the percentages in most years from 2002 to 2012, but it was similar to the percentages in 2013 and 2014 (Table 1).

Figure 16. Daily Cigarette Use among Past Month Cigarette Smokers Aged 12 or Older and Smoking of One or More Packs of Cigarettes per Day among Current Daily Smokers: Percentages, 2015

Figure 16     D

Note: Current daily smokers with unknown data about the number of cigarettes smoked per day were excluded from the pie graph on the right.

Table 1. Daily Cigarette Use among Past Month Cigarette Smokers Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age Group 2002   2003   2004   2005   2006   2007   2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
12 or Older 63.4+ 62.9+ 62.3+ 63.0+ 62.3+ 61.3+ 61.5+ 61.0+ 59.5   60.7+ 60.7+ 59.6   58.8   58.1  
12 to 17 31.8+ 29.7+ 27.6+ 25.8+ 26.5+ 26.4+ 22.3   23.0   22.5   22.7   22.0   19.4   24.1   20.0  
18 to 25 51.8+ 52.7+ 51.6+ 50.1+ 48.8+ 49.2+ 47.8+ 45.3+ 45.8+ 45.3+ 45.1+ 43.1   43.0   42.0  
26 or Older 68.8+ 68.0+ 67.8+ 68.9+ 67.9+ 66.3+ 67.0+ 67.2+ 64.8   66.5+ 66.0+ 64.9   63.3   62.7  

Among the 30.2 million daily smokers aged 12 or older in 2015, 12.4 million reported smoking 16 or more cigarettes per day (i.e., approximately one pack or more per day). Stated another way, about 2 out of 5 daily smokers (41.1 percent) reported smoking a pack or more of cigarettes per day (Figures 16 and 17). The percentage of daily smokers aged 12 or older who smoked one or more packs of cigarettes per day was lower in 2015 than the percentages in 2002 to 2011.

Figure 17. Smokers of One or More Packs of Cigarettes per Day among Past Month Daily Cigarette Smokers Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 17     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 17 Table. Smokers of One or More Packs of Cigarettes per Day among Past Month Daily Cigarette Smokers Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 53.1+ 53.5+ 54.0+ 51.4+ 50.6+ 50.9+ 49.2+ 45.9+ 45.1+ 43.8+ 42.0   41.3   40.3   41.1  
12-17 21.8+ 22.0+ 19.4+ 20.1+ 17.9+ 18.7+ 18.4+ 17.9+ 16.7+ 14.8+ 10.8   11.9   11.9     7.8  
18-25 39.1+ 37.1+ 34.9+ 36.9+ 34.4+ 32.9+ 31.6+ 29.5+ 27.3+ 26.1+ 25.1   22.3   22.5   22.5  
≥26 57.1+ 58.0+ 59.2+ 55.1+ 54.5+ 55.1+ 53.0+ 49.4+ 48.8+ 47.4+ 45.2   44.7   43.3   44.1  

Aged 12 to 17

In 2015, about 208,000 adolescents aged 12 to 17 smoked cigarettes every day in the past month, which represents about one fifth (20.0 percent) of adolescents who were current smokers (Table 1). The 2015 percentage was lower than the percentages in 2002 and 2007, but it was similar to the percentages in 2008 to 2014. The percentage of adolescent daily smokers who smoked one or more packs of cigarettes per day was lower in 2015 (7.8 percent) than in 2002 to 2011 (Figure 17).

Aged 18 to 25

About 3.9 million young adults aged 18 to 25 in 2015 were daily cigarette smokers in the past month, or 42.0 percent of young adults who were current cigarette smokers (Table 1). Thus, about 2 in 5 young adults in 2015 who were current cigarette users smoked cigarettes daily. The percentage of young adult current smokers who smoked cigarettes daily in 2015 was lower than the percentages in years from 2002 to 2012, and it was similar to the percentages in 2013 and 2014. The percentage of young adult daily smokers who smoked one or more packs of cigarettes per day was lower in 2015 (22.5 percent) than in 2002 to 2011 (Figure 17).

Aged 26 or Older

In 2015, about 26.1 million adults aged 26 or older smoked cigarettes every day in the past month, which represents 62.7 percent of the adults aged 26 or older who were current smokers (Table 1). The percentage of current smokers aged 26 or older in 2015 who smoked cigarettes every day was lower than the percentages in most years from 2002 to 2012, but it was similar to the percentages in 2013 and 2014. Despite the decline since 2002, when nearly 70 percent of current smokers aged 26 or older were daily smokers, more than three fifths of current smokers in this age group in 2015 were daily smokers. Among daily smokers aged 26 or older, the percentage who smoked one or more packs of cigarettes per day was lower in 2015 (44.1 percent) than in 2002 to 2011, but the percentage was stable between 2012 and 2015 (Figure 17).

Cigar and Pipe Tobacco Use

An estimated 12.5 million people aged 12 or older in 2015 were current cigar smokers, and 2.3 million were current pipe tobacco smokers (Figure 13). These numbers correspond to 4.7 percent of the population aged 12 or older who were current cigar smokers (Figure 18) and 0.8 percent who were current pipe tobacco smokers (Figure 19). Among people aged 12 or older, the percentage who were current cigar smokers was lower in 2015 than in most years between 2002 and 2012, but it was similar to the percentages in 2013 and 2014. The percentage of people who were current pipe tobacco smokers in 2015 was similar to the percentages in most years between 2002 and 2014.

Figure 18. Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 18     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 18 Table. Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12   5.4+   5.4+   5.7+   5.6+   5.6+   5.4+   5.3+   5.3+   5.2+   5.0     5.2+   4.7     4.5     4.7  
12-17 4.5+   4.5+   4.8+   4.2+   4.1+   4.3+   3.8+   4.0+   3.2+   3.4+   2.6+   2.3     2.1     2.1  
18-25 11.0+ 11.4+ 12.7+ 12.0+ 12.1+ 11.9+ 11.4+ 11.5+ 11.3+ 10.9+ 10.7+ 10.0+   9.7+   8.9  
≥26   4.6     4.5     4.6     4.7     4.6     4.4     4.4     4.4     4.4     4.2     4.5     4.1     3.9     4.3  

Figure 19. Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 19     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 19 Table. Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 0.8   0.7+ 0.8   0.9   0.9   0.8   0.8   0.8   0.8   0.8   1.0   0.9   0.8   0.8  
12-17 0.6+ 0.6+ 0.7+ 0.6+ 0.7+ 0.7+ 0.7+ 0.9+ 0.6+ 0.7+ 0.7+ 0.6+ 0.7+ 0.3  
18-25 1.1+ 0.9+ 1.2+ 1.5   1.3+ 1.2+ 1.4+ 1.8   1.8   1.9   1.8   2.2+ 1.9   1.8  
≥26 0.8   0.6   0.7   0.8   0.9   0.8   0.6   0.7   0.7   0.7   0.9   0.7   0.7   0.8  

Aged 12 to 17

Among adolescents aged 12 to 17 in 2015, 517,000 smoked cigars, and 84,000 smoked pipe tobacco in the past month. These numbers indicate that 2.1 percent of adolescents were current cigar smokers (Figure 18) and 0.3 percent were current pipe tobacco smokers in 2015 (Figure 19). A lower percentage of adolescents in 2015 were current cigar smokers than in 2002 to 2012, although the 2015 estimate was similar to the estimates in 2013 and 2014. The estimate for current pipe tobacco smoking among adolescents in 2015 was lower than the estimates in 2002 to 2014.

Aged 18 to 25

In 2015, 3.1 million young adults aged 18 to 25 smoked cigars, and 0.6 million smoked pipe tobacco. These numbers indicate that 8.9 percent of young adults were current cigar smokers (Figure 18) and 1.8 percent were current pipe tobacco smokers in 2015 (Figure 19). The percentage of young adults in 2015 who were current cigar smokers was lower than in 2002 to 2014. The percentage of young adults in 2015 who were current pipe tobacco smokers was greater than the percentages in most years from 2002 to 2008, but the 2015 estimate was similar to the estimates in most years from 2009 to 2014. Although the percentage of young adults who were current pipe tobacco smokers increased relative to the percentages in 2002 to 2008 and was fairly stable after 2008, current smoking of pipe tobacco among young adults in 2015 was less common than the use of other types of tobacco.

Aged 26 or Older

About 8.9 million adults aged 26 or older in 2015 smoked cigars, and 1.6 million smoked pipe tobacco. These numbers correspond to current cigar smoking by 4.3 percent of adults aged 26 or older (Figure 18) and current pipe tobacco smoking by 0.8 percent of adults in this age group (Figure 19). The 2015 estimates for current cigar use and current pipe tobacco smoking among adults aged 26 or older were similar to estimates between 2002 and 2014.

Smokeless Tobacco Use

As noted previously, questions on snuff and chewing tobacco were combined into a single set of questions about smokeless tobacco in 2015, and a moist tobacco powder referred to as snus was added as an example of smokeless tobacco. This change resulted in a new baseline being established in 2015 for measuring trends in smokeless tobacco use. Consequently, comparisons are not made between estimates of smokeless tobacco use in 2015 and those in prior years.

An estimated 9.0 million people aged 12 or older in 2015 were current smokeless tobacco users (Figure 13). This number of current smokeless tobacco users corresponds to 3.4 percent of the population aged 12 or older (Figure 20). In 2015, about 367,000 adolescents aged 12 to 17 used smokeless tobacco in the past month, or 1.5 percent of adolescents. An estimated 1.9 million young adults aged 18 to 25 used smokeless tobacco in the past month, or 5.4 percent of young adults. About 6.7 million adults aged 26 or older in 2015 used smokeless tobacco in the past month, which represents 3.2 percent of adults in this age group.

Figure 20. Past Month Smokeless Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 20     D

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Alcohol Use

NSDUH asks respondents aged 12 or older about their alcohol use in the 30 days before the interview. Current alcohol use is defined as any use of alcohol in the past 30 days. In addition to asking about any alcohol use, NSDUH collects information on binge alcohol use and heavy alcohol use.26 Consistent with federal definitions27 and other federal data collections, the NSDUH definition for binge alcohol use varies for males and females. Binge drinking for males is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days, which is the same as the definition of binge alcohol use that was applied to males in prior years. For females, binge alcohol use is defined in 2015 as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. The threshold of four or more drinks for females differs from the threshold of five or more drinks that was used in prior years. Heavy alcohol use is defined as binge drinking on 5 or more days in the past 30 days based on the thresholds that were described previously for males and females. Any alcohol use, binge drinking, and heavy drinking are not mutually exclusive categories of use; heavy use is included in estimates of binge and current use, and binge use is included in estimates of current use (Figure 21). Because of these changes to the definition of binge alcohol use in NSDUH, estimates of binge and heavy alcohol use in 2015 are presented in this report, but these 2015 estimates are not compared with estimates from prior years.28

Figure 21. Current, Binge, and Heavy Alcohol Use among People Aged 12 or Older: 2015

Figure 21     D

Note: In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion.

In 2015, 138.3 million Americans aged 12 or older reported current use of alcohol, 66.7 million reported binge alcohol use in the past month, and 17.3 million reported heavy alcohol use in the past month (Figure 21). Thus, nearly half of current alcohol users reported binge alcohol use (48.2 percent), and about 1 in 8 current alcohol users reported heavy alcohol use (12.5 percent). Among binge alcohol users, about 1 in 4 (26.0 percent) were heavy users.

Current Alcohol Use

The estimate of 138.3 million current alcohol users aged 12 or older in 2015 (Figure 21) corresponds to alcohol use in the past month by slightly more than half (51.7 percent) of people aged 12 or older (Figure 22). The 2015 estimate of past month alcohol use was similar to the estimate in 2005 to 2013, but it was lower than the 2014 estimate.

Figure 22. Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 22     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 22 Table. Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 51.0   50.1+ 50.3+ 51.8   51.0   51.2   51.6   51.9   51.8   51.8   52.1   52.2   52.7+ 51.7  
12-17 17.6+ 17.7+ 17.6+ 16.5+ 16.7+ 16.0+ 14.7+ 14.8+ 13.6+ 13.3+ 12.9+ 11.6+ 11.5+   9.6  
18-25 60.5+ 61.4+ 60.5+ 60.9+ 62.0+ 61.3+ 61.1+ 61.8+ 61.4+ 60.7+ 60.2+ 59.6   59.6   58.3  
≥26 53.9+ 52.5+ 53.0+ 55.1   53.7+ 54.1+ 54.7   54.9   54.9   55.1   55.6   55.9   56.5   55.6  

Aged 12 to 17

The percentage of adolescents aged 12 to 17 who were current alcohol users was 9.6 percent in 2015 (Figure 22), which corresponds to 2.4 million adolescents in 2015 who drank alcohol in the past month. The percentage of adolescents who were current alcohol users in 2015 was lower than the percentages in 2002 through 2014. Although the estimate of current alcohol use among adolescents decreased between 2002 and 2015, about 1 in 10 adolescents aged 12 to 17 were current alcohol users in 2015.

Aged 18 to 25

In 2015, 58.3 percent of young adults aged 18 to 25 were current alcohol users (Figure 22), which corresponds to about 20.4 million young adults. The percentage of young adults in 2015 who drank alcohol in the past month was similar to the percentages in 2013 and 2014. Although the 2015 estimate was lower than the estimates in 2002 through 2012, about three fifths of young adults were current alcohol users in each year between 2002 and 2015 (ranging from 58.3 to 62.0 percent).

Aged 26 or Older

More than half (55.6 percent) of adults aged 26 or older in 2015 were current alcohol users (Figure 22). This percentage corresponds to about 115.6 million adults in this age group who drank alcohol in the past month. The percentage of adults aged 26 or older in 2015 who were current alcohol users was higher than the percentages in most years from 2002 to 2007, but it was similar to the percentages in 2008 to 2014. In each year between 2002 and 2015, however, more than half of adults aged 26 or older were current alcohol users (ranging from 52.5 to 56.5 percent).

Binge Alcohol Use

In 2015, an estimated 66.7 million people aged 12 or older were binge alcohol users in the past 30 days (Figure 21). This number of people who were current binge drinkers corresponds to about 1 in 4 people aged 12 or older (24.9 percent) (Figure 23). About 1.4 million adolescents aged 12 to 17 in 2015 were past month binge alcohol users, which corresponds to 5.8 percent of adolescents. Thus, about 1 in 17 adolescents aged 12 to 17 in 2015 were current binge drinkers. An estimated 39.0 percent of young adults aged 18 to 25 in 2015 were binge alcohol users in the past month, which corresponds to about 13.6 million young adults. Stated another way, about 2 out of 5 young adults in 2015 were current binge alcohol users. About a quarter (24.8 percent) of adults aged 26 or older in 2015 were current binge alcohol users. This percentage corresponds to about 51.6 million adults in this age group who were binge drinkers.

Figure 23. Past Month Binge and Heavy Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 23     D

Note: In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion.

Heavy Alcohol Use

The estimate of 17.3 million people aged 12 or older in 2015 who were heavy alcohol users in the past month (Figure 21) represents 6.5 percent of the population aged 12 or older (Figure 23). In 2015, 221,000 adolescents aged 12 to 17 were current heavy alcohol users. Stated another way, about 1 out of 100 adolescents (0.9 percent) engaged in binge drinking on 5 or more days in the past 30 days. About 1 out of every 10 young adults aged 18 to 25 (10.9 percent) were heavy alcohol users in the past month, which corresponds to 3.8 million young adults. An estimated 6.4 percent of adults aged 26 or older in 2015 were current heavy alcohol users. This percentage corresponds to about 13.3 million adults aged 26 or older who were heavy alcohol users in the past month.

Underage Alcohol Use

All 50 states and the District of Columbia currently prohibit possession of alcoholic beverages by individuals younger than 21, and most prohibit underage consumption (i.e., consumption of alcoholic beverages prior to the age of 21).29 In 2015, about 7.7 million people aged 12 to 20 reported drinking alcohol in the past month, including 5.1 million who reported binge alcohol use and 1.3 million who reported heavy alcohol use (Figure 24). Thus, about two thirds of underage current drinkers (65.7 percent) were binge alcohol users, and about 1 in 6 were heavy alcohol users (16.4 percent). About one fourth of underage binge alcohol users (24.9 percent) were heavy drinkers.

Figure 24. Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: 2015

Figure 24     D

Note: In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion.

The estimate of 7.7 million underage people in 2015 who reported current alcohol use represents 20.3 percent of 12 to 20 year olds (Figure 25). Among all people aged 12 to 20 in 2015, 13.4 percent were binge drinkers, and 3.3 percent were heavy drinkers. The percentage of underage individuals who reported current alcohol use in 2015 was lower than the percentages in 2002 through 2014 (Figure 26). Despite these declines over time, about 1 in 5 individuals aged 12 to 20 in 2015 drank alcohol in the past month.

Figure 25. Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: Percentages, 2015

Figure 25     D

Note: In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion.


Figure 26. Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2015

Figure 26     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 26 Table. Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2015
Use 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Current 28.8+ 29.0+ 28.7+ 28.2+ 28.4+ 28.0+ 26.5+ 27.2+ 26.2+ 25.1+ 24.3+ 22.7+ 22.8+ 20.3

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Substance Use Disorders in the Past Year

Substance use disorders (SUDs) represent clinically significant 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. NSDUH includes a series of questions to estimate the percentage of the population aged 12 or older who had SUDs in the past 12 months. Respondents were asked questions about SUDs if they previously reported use in the past 12 months of alcohol or illicit drugs. Illicit drugs include marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, and the misuse of prescription psychotherapeutic drugs (i.e., pain relievers, tranquilizers, stimulants, and sedatives). These SUD questions classify people as having an SUD in the past 12 months and are based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM IV).30,31

Because of changes that were described previously to the questions for the use of hallucinogens, inhalants, and methamphetamine and the misuse of prescription drugs, the sets of respondents who were asked the SUD questions for those drugs in 2015 could have differed from the corresponding sets of respondents who were asked these SUD questions in prior years. Consequently, the 2015 SUD estimates for those drugs are not comparable with the estimates from prior years. Also, questions were added in 2015 about SUD symptoms that respondents attributed specifically to their use of methamphetamine; prior to 2015, past year methamphetamine users were asked about SUD symptoms for the misuse of prescription stimulants. In addition, these changes are assumed to have affected the comparability of the overall SUD measures in 2015 with those prior to 2015 for illicit drugs and for any substance (i.e., illicit drugs or alcohol). Thus for these measures, the 2015 estimates are not compared with estimates from prior years. Because the questions did not change for alcohol, marijuana, cocaine, and heroin, estimates of SUDs for these substances in 2015 are assumed to have remained comparable with estimates from earlier years.

This section presents estimates for the most common SUDs among the population aged 12 or older. Estimates of less common SUDs are not discussed in this report (e.g., inhalant use disorder) but are available in Table A.12B in Appendix A.

Substance Use Disorder

In 2015, approximately 20.8 million people aged 12 or older had an SUD in the past year, including 15.7 million people who had an alcohol use disorder and 7.7 million people who had an illicit drug use disorder (Figure 27). An estimated 2.7 million people aged 12 or older had both an alcohol use disorder and an illicit drug use disorder in the past year (Figure 28). Thus, among people aged 12 or older in 2015 who had an SUD in the past year, nearly 3 out of 4 had an alcohol use disorder, and about 1 out of 3 had an illicit drug use disorder. About 1 in 8 people aged 12 or older who had SUDs in the past year had both an alcohol use disorder and an illicit drug use disorder.

Figure 27. Numbers of People Aged 12 or Older with a Past Year Substance Use Disorder: 2015

Figure 27     D

Note: Estimated numbers of people refer to people aged 12 or older in the civilian, noninstitutionalized population in the United States. The numbers do not sum to the total population of the United States because the population for NSDUH does not include people aged 11 years old or younger, people with no fixed household address (e.g., homeless or transient people not in shelters), active-duty military personnel, and residents of institutional group quarters, such as correctional facilities, nursing homes, mental institutions, and long-term care hospitals.

Note: The estimated numbers of people with substance use disorders are not mutually exclusive because people could have use disorders for more than one substance.


Figure 28. Alcohol Use Disorder and Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older with a Past Year Substance Use Disorder (SUD): 2015

Figure 28     D

Of the 7.7 million people aged 12 or older who had a past year SUD related to their use of illicit drugs, 4.0 million had a past year disorder related to their use of marijuana, and 2.0 million people had a disorder related to their misuse of prescription pain relievers (Figure 27). Smaller numbers of people in 2015 had disorders in the past year related to their use of cocaine or heroin.

The 20.8 million people who had SUDs in 2015 (Figure 27) represent 7.8 percent of people aged 12 or older (Figure 29). This percentage of people in 2015 who had SUDs corresponds to about 1 in 13 people aged 12 or older. An estimated 1.2 million adolescents aged 12 to 17 had SUDs in 2015, which represents 5.0 percent of adolescents, or about 1 in 20 adolescents. In 2015, 5.3 million young adults aged 18 to 25 had SUDs; this number of young adults with SUDs represents 15.3 percent of young adults, or about 1 in 7 young adults. An estimated 14.2 million adults aged 26 or older in 2015 had SUDs, which represents 6.9 percent of adults aged 26 or older, or about 1 in 15 adults in this age group.

Figure 29. Substance Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 29     D

Alcohol Use Disorder

The 15.7 million people aged 12 or older who had an alcohol use disorder in 2015 (Figures 27 and 28) represent 5.9 percent of people aged 12 or older (Figure 30), or about 1 in 17 people aged 12 or older. The percentage of people aged 12 or older with an alcohol use disorder in 2015 was lower than the percentages in 2002 to 2014.

Figure 30. Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 30     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 30 Table. Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12   7.7+   7.5+   7.8+   7.7+   7.7+   7.5+   7.4+   7.5+   7.1+   6.5+   6.8+   6.6+   6.4+   5.9  
12-17   5.9+   5.9+   6.0+   5.5+   5.4+   5.4+   4.9+   4.6+   4.6+   3.8+   3.4+   2.8     2.7     2.5  
18-25 17.7+ 17.2+ 17.4+ 17.5+ 17.6+ 16.9+ 17.4+ 16.1+ 15.7+ 14.4+ 14.3+ 13.0+ 12.3+ 10.9  
≥26   6.2+   6.0+   6.3+   6.2+   6.2+   6.2+   6.0+   6.3+   5.9     5.4     5.9+   6.0+   5.9     5.4  

Aged 12 to 17

There were 623,000 adolescents aged 12 to 17 in 2015 with a past year alcohol use disorder, or 2.5 percent of adolescents (Figure 30). The percentage of adolescents with an alcohol use disorder in 2015 was lower than the percentages in 2002 to 2012, but it was similar to the percentages in 2013 and 2014. In particular, the percentage of adolescents in 2015 with an alcohol use disorder was roughly half the percentages in 2002 to 2008 (ranging from 4.9 to 6.0 percent).

Aged 18 to 25

Approximately 3.8 million young adults aged 18 to 25 in 2015 had an alcohol use disorder in the past year. This number of young adults with an alcohol use disorder represents 10.9 percent of young adults (Figure 30). The percentage of young adults with an alcohol use disorder in 2015 was lower than the percentages in 2002 to 2014. Nevertheless, about 1 in 9 young adults in 2015 had an alcohol use disorder.

Aged 26 or Older

In 2015, approximately 11.3 million adults aged 26 or older had an alcohol use disorder in the past year, which represents 5.4 percent of the adults in this age group (Figure 30). The percentage of adults aged 26 or older with an alcohol use disorder in 2015 was lower than the percentages in most years from 2002 to 2013, but it was similar to the percentage in 2014.

Illicit Drug Use Disorder

The 7.7 million people aged 12 or older who had an illicit drug use disorder in 2015 (Figures 27 and 28) represent 2.9 percent of people aged 12 or older (Figure 31). An estimated 3.4 percent of adolescents aged 12 to 17 had an illicit drug use disorder in 2015, or about 855,000 adolescents. Approximately 2.5 million young adults aged 18 to 25 in 2015 had an illicit drug use disorder in the past year, which represents 7.2 percent of young adults. In 2015, approximately 4.4 million adults aged 26 or older had an illicit drug use disorder in the past year, which represents 2.1 percent of adults aged 26 or older.

Figure 31. Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 31     D

Marijuana Use Disorder

The approximately 4.0 million people aged 12 or older in 2015 who had a marijuana use disorder in the past year (Figure 27) represent 1.5 percent of people aged 12 or older (Figure 32). The 2015 percentage of the population aged 12 or older with a marijuana use disorder was lower than the percentages in most years between 2002 and 2010 and was similar to the percentages in 2011 to 2014.

Figure 32. Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 32     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 32 Table. Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 1.8+ 1.8+ 1.9+ 1.7+ 1.7+ 1.6   1.7+ 1.7+ 1.8+ 1.6   1.7   1.6   1.6   1.5  
12-17 4.3+ 3.8+ 3.9+ 3.6+ 3.4+ 3.1+ 3.4+ 3.4+ 3.6+ 3.5+ 3.2+ 2.9   2.7   2.6  
18-25 6.0+ 5.9+ 6.0+ 5.9+ 5.7   5.6   5.6   5.6   5.7   5.7   5.5   5.4   4.9   5.1  
≥26 0.8   0.7   0.8   0.7   0.8   0.7   0.8   0.8   0.9   0.7   0.8   0.8   0.9   0.8  

Aged 12 to 17

In 2015, 2.6 percent of adolescents aged 12 to 17 had a marijuana use disorder in the past year (Figure 32), or about 651,000 adolescents. The percentage of adolescents with a marijuana use disorder in 2015 was lower than the percentages in 2002 to 2012, but it was similar to the percentages in 2013 and 2014.

Aged 18 to 25

Approximately 1.8 million young adults aged 18 to 25 in 2015 had a marijuana use disorder in the past year, or 5.1 percent of young adults (Figure 32). The percentage of young adults with a marijuana use disorder in 2015 was lower than the percentages in 2002 through 2005, but it was similar to the percentages in 2006 to 2014.

Aged 26 or Older

In 2015, approximately 1.6 million adults aged 26 or older had a marijuana use disorder in the past year, or 0.8 percent of adults in this age group (Figure 32). The 2015 percentage of adults aged 26 or older with a marijuana use disorder was similar to the percentages in all years between 2002 and 2014.

Cocaine Use Disorder

About 896,000 people aged 12 or older in 2015 had a cocaine use disorder in the past year, which rounds to the 0.9 million people shown in Figure 27. This number of people with a cocaine use disorder represents 0.3 percent of the population aged 12 or older (Figure 33). The percentage of the population aged 12 or older with a cocaine use disorder remained stable between 2010 and 2015. However, the percentage in 2015 was lower than the percentages in 2002 to 2009.

Figure 33. Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 33     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 33 Table. Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
≥12 0.6+ 0.6+ 0.7+ 0.6+ 0.7+ 0.6+ 0.6+ 0.4+ 0.4   0.3   0.4   0.3   0.3   0.3  
12-17 0.4+ 0.3+ 0.4+ 0.4+ 0.4+ 0.4+ 0.3+ 0.2   0.1   0.2   0.2   0.1   0.1   0.1  
18-25 1.2+ 1.2+ 1.4+ 1.5+ 1.3+ 1.4+ 1.2+ 0.9+ 0.7   0.6   0.6   0.7   0.5   0.7  
≥26 0.6+ 0.6+ 0.6+ 0.5+ 0.6+ 0.6+ 0.5+ 0.4   0.4   0.3   0.4   0.3   0.3   0.3  

Aged 12 to 17

An estimated 0.1 percent of adolescents aged 12 to 17 in 2015 had a cocaine use disorder in the past year (Figure 33), or about 31,000 adolescents. The percentage of adolescents with a cocaine use disorder in 2015 was lower than the percentages in 2002 to 2008, but it was similar to the percentages in 2009 to 2014.

Aged 18 to 25

Approximately 229,000 young adults aged 18 to 25 in 2015 had a cocaine use disorder in the past year. This number represents 0.7 percent of young adults (Figure 33). Similar to the pattern for adolescents aged 12 to 17, the percentage of young adults with a cocaine use disorder in 2015 was lower than the percentages in 2002 to 2009, but it was similar to the percentages in 2010 to 2014.

Aged 26 or Older

In 2015, approximately 637,000 adults aged 26 or older had a cocaine use disorder in the past year, which represents 0.3 percent of adults in this age group (Figure 33). The percentage of adults aged 26 or older with a cocaine use disorder in 2015 was lower than the percentages in 2002 to 2008, but it remained steady when compared with the percentages between 2009 and 2014.

Heroin Use Disorder

About 591,000 people aged 12 or older in 2015 had a heroin use disorder, which rounds to the 0.6 million people shown in Figure 27. This number of people with a heroin use disorder represents 0.2 percent of people aged 12 or older (Figure 34). The percentage of people aged 12 or older with a heroin use disorder in 2015 was higher than the percentages in 2002 to 2010 (0.1 percent), but it was similar to the percentages in 2011 to 2014.

Figure 34. Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015

Figure 34     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 34 Table. Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015
Age 02   03   04   05   06   07   08   09   10   11   12   13   14   15  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Note: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
≥12 0.1+ 0.1+ 0.1+ 0.1+ 0.1+ 0.1+ 0.1+ 0.1+ 0.1+ 0.2   0.2   0.2   0.2   0.2  
12-17 0.1   0.0   0.1   0.0   0.0   0.0   0.1   0.1   0.0   0.1+ 0.1   0.0   0.1   0.0  
18-25 0.2+ 0.1+ 0.2+ 0.3+ 0.2+ 0.2+ 0.3   0.3   0.3   0.4   0.5   0.5   0.5   0.4  
≥26 0.1+ 0.1+ 0.1+ 0.1+ 0.1   0.1+ 0.1+ 0.1   0.1+ 0.1   0.1   0.2   0.2   0.2  

Aged 12 to 17

Less than 0.1 percent of adolescents aged 12 to 17 in 2015 had a heroin use disorder in the past year (Figure 34), which corresponds to about 6,000 adolescents. The percentage of adolescents with a heroin use disorder remained stable from 2002 to 2015.

Aged 18 to 25

Approximately 155,000 young adults aged 18 to 25 in 2015 had a heroin use disorder in the past year, which represents 0.4 percent of young adults (Figure 34). The percentage of young adults with a heroin use disorder in 2015 was greater than the percentages in 2002 to 2007, but it was similar to the percentages in 2008 to 2014.

Aged 26 or Older

In 2015, approximately 430,000 adults aged 26 or older had a heroin use disorder in the past year, which represents 0.2 percent of adults in this age group (Figure 34). Between 2002 and 2015, 0.1 to 0.2 percent of adults aged 26 or older had a heroin use disorder in the past year. The 2015 estimate was higher than the estimates in most years between 2002 and 2010, but it remained steady when compared with the percentages between 2011 and 2014.

Methamphetamine Use Disorder

Questions were added in 2015 about SUD symptoms that respondents attributed specifically to their use of methamphetamine. Prior to 2015, past year methamphetamine users were asked about SUD symptoms for the misuse of prescription stimulants. An estimated 872,000 people aged 12 or older had a methamphetamine use disorder in 2015.32 This number represents about 0.3 percent of people aged 12 or older (Table A.12B in Appendix A). An estimated 0.1 percent of adolescents aged 12 to 17 in 2015 had a methamphetamine use disorder in the past year (Table A.13B), which represents about 22,000 adolescents. Approximately 156,000 young adults aged 18 to 25 and 694,000 adults aged 26 or older in 2015 had a methamphetamine use disorder in the past year. Adults with a methamphetamine use disorder correspond to 0.4 percent of young adults aged 18 to 25 (Table A.14B) and 0.3 percent of adults aged 26 or older (Table A.15B).

Pain Reliever Use Disorder

The estimated 2.0 million people aged 12 or older in 2015 who had a pain reliever use disorder (Figure 27) represents 0.8 percent of people aged 12 or older (Figure 35). An estimated 0.5 percent of adolescents aged 12 to 17 in 2015 had a pain reliever use disorder in the past year, which represents about 122,000 adolescents. Approximately 427,000 young adults aged 18 to 25 and 1.5 million adults aged 26 or older in 2015 had a pain reliever use disorder in the past year. These numbers of adults with a pain reliever use disorder correspond to 1.2 percent of young adults and 0.7 percent of adults aged 26 or older.

Figure 35. Pain Reliever Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015

Figure 35     D

Tranquilizer Use Disorder

In 2015, an estimated 688,000 people aged 12 or older had a tranquilizer use disorder. This number represents 0.3 percent of people aged 12 or older (Table A.12B in Appendix A). An estimated 0.3 percent of adolescents aged 12 to 17 in 2015 had a tranquilizer use disorder in the past year (Table A.13B), which represents about 77,000 adolescents. Approximately 234,000 young adults aged 18 to 25 and 376,000 adults aged 26 or older in 2015 had a tranquilizer use disorder in the past year. These numbers correspond to 0.7 percent of young adults (Table A.14B) and 0.2 percent of adults aged 26 or older (Table A.15B).

Stimulant Use Disorder

An estimated 426,000 people aged 12 or older had a stimulant use disorder in 2015, which rounds to the estimate of 0.4 million people in Figure 27.32 This number of people with a stimulant use disorder represents 0.2 percent of people aged 12 or older (Table A.12B in Appendix A). An estimated 0.2 percent of adolescents aged 12 to 17 in 2015 had a stimulant use disorder in the past year (Table A.13B in Appendix A), which represents about 38,000 adolescents. Approximately 159,000 young adults aged 18 to 25 and 229,000 adults aged 26 or older in 2015 had a stimulant use disorder in the past year. These numbers correspond to 0.5 percent of young adults (Table A.14B) and 0.1 percent of adults aged 26 or older (Table A.15B).

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Need for Substance Use Treatment

NSDUH includes questions that are used to identify people who needed substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs) in the past year. For NSDUH, people are defined as needing substance use treatment if they had an SUD in the past year or if they received substance use treatment at a specialty facility33 in the past year.34,35 Because of the previously described effects of the questionnaire changes on the comparability of SUD estimates between 2015 and prior years, the 2015 estimates of the need for substance use treatment are not compared with estimates from prior years.

In 2015, an estimated 21.7 million people aged 12 or older needed substance use treatment, which means that about 1 in 12 people (8.1 percent) needed substance use treatment (Figure 36).35 About 1.3 million adolescents aged 12 to 17 in 2015 needed treatment for a substance use problem in the past year, representing 5.1 percent of adolescents. About 5.4 million young adults aged 18 to 25 in 2015 needed treatment for a substance use problem in the past year, representing 15.5 percent of young adults. Stated another way, about 1 in 6 young adults needed substance use treatment. In 2015, about 15.0 million adults aged 26 or older needed substance use treatment in the past year. This number represents 7.2 percent of adults in this age group.

Figure 36. Need for Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2015

Figure 36     D

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Receipt of Substance Use Treatment

NSDUH respondents who used alcohol or illicit drugs in their lifetime are asked whether they ever received substance use treatment, and those who received substance use treatment in their lifetime are asked whether they received treatment in the 12 months prior to the survey interview (i.e., the past year). Substance use treatment refers to treatment or counseling received for illicit drug or alcohol use or for medical problems associated with the use of illicit drugs or alcohol. NSDUH collects information on the receipt of substance use treatment at a specialty facility. Receipt of substance use treatment at a specialty facility is defined as substance use treatment a respondent received at a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center. People could report receiving treatment at more than one location.

As previously described, the changes to the questions for the use of hallucinogens, inhalants, and methamphetamine and the misuse of prescription drugs also had the potential to affect the group of respondents in 2015 who answered questions about their receipt of substance use treatment. Investigations with future years of NSDUH data will help to assess whether these changes ultimately affected the comparability of NSDUH estimates for the receipt of substance use treatment between 2015 and prior years. For this report, however, the 2015 estimates of the receipt of substance use treatment are not compared with estimates from prior years.

Report Revision Note:

In this revised report, Figure 37 and its associated text were removed to be consistent with the Office of National Drug Control Policy's National Drug Control Strategy.

In 2015, 10.8 percent of people aged 12 or older (2.3 million people) who needed substance use treatment received treatment at a specialty facility in the past year (Figure 38). Among people in specific age groups in 2015 who needed substance use treatment, 6.3 percent of adolescents aged 12 to 17, 7.7 percent of young adults aged 18 to 25, and 12.3 percent of adults aged 26 or older received substance use treatment at a specialty facility in the past year. These percentages represent 80,000 adolescents, 417,000 young adults, and 1.8 million adults aged 26 or older who needed substance use treatment and received treatment at a specialty facility in the past year.

Figure 38. Received Specialty Substance Use Treatment in the Past Year among People Aged 12 or Older Who Needed Substance Use Treatment in the Past Year, by Age Group: 2015

Figure 38     D

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Mental Health Issues and Mental Health Service Use

Mental disorders are generally characterized by changes in mood, thought, or behavior. They can make carrying out daily activities difficult and can impair an individual's ability to work or function in school, interact with family, and fulfill other major life functions. As noted in this report's survey background section, unlike what is done in the substance use questions, NSDUH uses different age-adapted questions to collect mental health information for adults and adolescents. Therefore, this section presents mental health estimates separately for adults and adolescents.

Mental Illness among Adults

NSDUH provides estimates of any mental illness (AMI) and serious mental illness (SMI) for adults aged 18 or older.36 An adult with AMI was defined as having any mental, behavioral, or emotional disorder in the past year that met DSM-IV criteria (excluding developmental disorders and SUDs).30 Adults with AMI were defined as having SMI if they had any mental, behavioral, or emotional disorder that substantially interfered with or limited one or more major life activities. AMI and SMI are not mutually exclusive categories; adults with SMI are included in estimates of adults with AMI. Adults with AMI who do not meet the criteria for having SMI are categorized as having AMI excluding SMI. This section includes past year estimates of adults with AMI, SMI, and AMI excluding SMI.37

In 2015, an estimated 43.4 million adults aged 18 or older had AMI in the United States (Figure 39). This number represents 17.9 percent of all adults in the United States. An estimated 9.8 million adults in the nation had SMI in the past year, and 33.7 million adults had AMI excluding SMI in the past year. The number of adults with SMI represents 4.0 percent of all U.S. adults in 2015, and the number of adults with AMI excluding SMI represents 13.9 percent of all adults. Among adults with AMI in the past year, 22.5 percent had SMI and 77.5 percent did not have SMI.38,39 In 2015, the percentages of adults with AMI, adults with SMI, and adults who had AMI excluding SMI were similar to the percentages from 2008 to 2014 (Figures 40, 41, and 42).

Figure 39. Any Mental Illness (AMI), Serious Mental Illness (SMI), and AMI Excluding SMI in the Past Year among Adults Aged 18 or Older: 2015

Figure 39     D


Figure 40. Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015

Figure 40     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 40 Table. Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015
Age Group 2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
18 or Older 17.7   18.1   18.1   17.8   18.6   18.5   18.1   17.9  
18 to 25 18.5+ 18.0+ 18.1+ 18.5+ 19.6+ 19.4+ 20.1+ 21.7  
26 to 49 20.7   21.6   20.9   20.3   21.2   21.5   20.4   20.9  
50 or Older 14.1   14.5   15.1   15.0   15.8+ 15.3+ 15.4+ 14.0  

Figure 41. Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015

Figure 41     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 41 Table. Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015
Age Group 2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
18 or Older 3.7   3.7   4.1   3.9   4.1   4.2   4.1   4.0  
18 to 25 3.8+ 3.3+ 3.9+ 3.8+ 4.1+ 4.2+ 4.8   5.0  
26 to 49 4.8   4.9   5.2   5.0   5.2   5.3   4.9   5.0  
50 or Older 2.5   2.5   3.0   2.8   3.0   3.2   3.1   2.8  

Figure 42. Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015

Figure 42     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 42 Table. Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015
Age Group 2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
18 or Older 14.0   14.4   14.0   13.9   14.5   14.2   14.0   13.9  
18 to 25 14.8+ 14.6+ 14.1+ 14.8+ 15.5+ 15.2+ 15.3+ 16.7  
26 to 49 16.0   16.7   15.7   15.3   16.0   16.2   15.5   15.9  
50 or Older 11.6   12.0   12.2   12.3   12.8+ 12.1   12.3+ 11.1  

Aged 18 to 25

In 2015, an estimated 7.6 million young adults aged 18 to 25 (21.7 percent) had AMI in the past year (Figure 40), and an estimated 1.8 million young adults (5.0 percent) had SMI in the past year (Figure 41). An estimated 5.8 million young adults (16.7 percent) had AMI excluding SMI in the past year (Figure 42). With one exception, the percentages of young adults in 2015 who had AMI, SMI, and AMI excluding SMI were greater than the percentages from 2008 to 2014. However, similar percentages of young adults had SMI in 2014 and 2015.

Aged 26 to 49

In 2015, 20.6 million adults aged 26 to 49 (20.9 percent) had AMI in the past year (Figure 40), and an estimated 4.9 million adults aged 26 to 49 (5.0 percent) had SMI in the past year (Figure 41). An estimated 15.7 million adults aged 26 to 49 (15.9 percent) had AMI excluding SMI in the past year (Figure 42). Estimates of AMI, SMI, and AMI excluding SMI among adults aged 26 to 49 in 2015 were similar to the estimates in all years between 2008 and 2014.

Aged 50 or Older

In 2015, an estimated 15.3 million adults aged 50 or older (14.0 percent) had AMI in the past year (Figure 40), and an estimated 3.1 million adults aged 50 or older (2.8 percent) had SMI in the past year (Figure 41). An estimated 12.1 million adults aged 50 or older (11.1 percent) had AMI excluding SMI in the past year (Figure 42).

The estimate of AMI among adults aged 50 or older was lower in 2015 than the estimates between 2012 and 2014, but it was similar to the estimates between 2008 and 2011. The percentage of adults aged 50 or older with past year SMI in 2015 was similar to the percentages in 2008 to 2014. Although the percentage of adults aged 50 or older with past year AMI excluding SMI was lower in 2015 than in 2012 or 2014, the 2015 estimate was similar to the percentages in most years since 2008.

Mental Health Service Use among Adults

Adults are asked whether they received treatment or counseling for any problem with emotions, "nerves," or mental health in the past year in any inpatient or outpatient setting or if they used prescription medication in the past year for a mental or emotional condition. All adults are asked these questions about their use of mental health services (i.e., not just those with mental illness). Respondents are asked not to include treatment for their use of alcohol or illicit drugs. The questions about the receipt of treatment or counseling for mental health issues do not ask specifically about treatment for a particular mental disorder. Consequently, references to treatment or counseling for any problem with emotions, nerves, or mental health are described broadly as "mental health service use."

Although the collection of data for making estimates of AMI and SMI began in 2008, NSDUH has included questions on mental health service use among adults since 2002. Therefore, this section compares the 2015 estimates of mental health service use with estimates from 2002 to 2014 for the entire adult population. This section also compares the 2015 estimates of mental health service use with estimates from 2008 to 2014 for adults with AMI and adults with SMI.

In 2015, an estimated 34.2 million adults aged 18 or older (14.2 percent of adults) received mental health care during the past 12 months (Figure 43). Among the 43.4 million adults with AMI, 18.6 million (43.1 percent) received mental health services in the past year (Figure 44). About 6.4 million of the 9.8 million adults with past year SMI (65.3 percent) received mental health services in the past year (Figure 45).

Figure 43. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015

Figure 43     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 43 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015
Service 02 03 04 05 06 07 08 09 10 11 12 13 14 15
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental Health Services 13.0+ 13.2+ 12.8+ 13.0+ 12.9+ 13.3+ 13.5   13.4+ 13.8   13.6   14.5   14.6   14.8+ 14.2  
Inpatient   0.7+   0.8     0.9     1.0     0.7+   1.0     0.9     0.8     0.8     0.8     0.8     0.9     1.0     0.9  
Outpatient   7.4     7.1     7.1     6.8     6.7     7.0     6.8     6.4+   6.6     6.7     6.6     6.6     6.7     7.1  
Prescription Medication 10.5+ 10.9+ 10.5+ 10.7+ 10.9+ 11.2   11.4   11.3   11.7   11.5   12.4   12.5+ 12.6+ 11.8  

Figure 44. Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2015

Figure 44     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 44 Table. Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2015
Service Type 2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental Health Services 40.9   40.2+ 42.4   40.8+ 41.0   44.7   44.7   43.1  
Inpatient   3.7     3.2     2.7+   3.3     3.0     3.3     3.8     3.4  
Outpatient 24.1   22.5+ 23.4+ 24.0   22.4+ 24.4   24.3   25.4  
Prescription Medication 35.5   34.8   36.9   35.6   35.3   38.9   38.7+ 36.7  

Figure 45. Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2015

Figure 45     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 45 Table. Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2015
Service Type 2008   2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Any Mental Health Services 65.7   66.5   67.5   64.9   62.9   68.5   68.5   65.3  
Inpatient   8.6     8.6     6.7     8.8     6.2     8.3     8.8     7.0  
Outpatient 46.2   44.6   42.5   44.1   39.0+ 46.9   44.2   43.6  
Prescription Medication 59.7   61.1   61.0   58.2   57.8   62.1+ 61.4+ 57.3  

The estimate of 14.2 percent of adults aged 18 or older in 2015 who received mental health care in the past 12 months was similar to the estimates in most years from 2010 to 2014, but it was greater than the estimates in most years between 2002 and 2009 (Figure 43). The percentage of adults with AMI who received mental health care in 2015 (43.1 percent) was similar to the percentages in most years from 2008 to 2014 (Figure 44). However, higher percentages of adults with AMI received mental health services in the past year in 2013 and 2014 (44.7 percent in each year) compared with the corresponding percentages of adults in most years from 2008 to 2011. The percentage of adults with SMI who received mental health services in the past year remained relatively steady across years between 2008 and 2015 (Figure 45).

Aged 18 to 25

In 2015, 4.0 million young adults aged 18 to 25 used mental health services in the past year, including 2.4 million young adults with AMI. The 2.4 million young adults with AMI who used mental health services include 887,000 young adults with SMI. Among all adults aged 18 to 25 in 2015, 11.7 percent used mental health services in the past year. Among young adults with AMI in the past year, 32.0 percent used mental health services (Table A.18B in Appendix A). Among young adults with SMI, 50.7 percent used mental health services.

Aged 26 to 49

In 2015, 15.1 million adults aged 26 to 49 used mental health services in the past year, including 8.9 million adults aged 26 to 49 with AMI. The 8.9 million adults aged 26 to 49 with AMI who used mental health services include 3.2 million adults aged 26 to 49 with SMI. In 2015, 15.3 percent of all adults aged 26 to 49 used mental health services in the past year. Among adults in this age group, 43.3 percent of those with AMI and 66.1 percent with SMI used mental health services in the past year (Table A.18B in Appendix A).

Aged 50 or Older

In 2015, 15.1 million adults aged 50 or older used mental health services in the past year, including 7.3 million adults aged 50 or older with AMI. The 7.3 million adults aged 50 or older with AMI who used mental health services include 2.2 million adults aged 50 or older with SMI. In 2015, 13.9 percent of all adults aged 50 or older used mental health services in the past year. Nearly half (48.3 percent) of adults aged 50 or older with AMI used mental health services (Table A.18B in Appendix A). Nearly three fourths (72.2 percent) of adults aged 50 or older with SMI used mental health services in the past year.

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Co-Occurring Mental Health Issues and Substance Use Disorders among Adults

The coexistence of both a mental disorder and an SUD is referred to as co-occurring disorders. Because NSDUH data allow estimates to be made for the presence of a mental disorder (as defined by AMI and SMI) and SUDs, it is possible to estimate the percentages of adults with co-occurring disorders. This section presents findings on mental disorders (i.e., AMI, SMI, and major depressive episode [MDE]) co-occurring with SUDs (i.e., illicit drug use disorder or alcohol use disorder) among adults aged 18 or older in the United States. Because of the potential effects of the 2015 questionnaire changes on SUD estimates that were described previously, the 2015 estimates of co-occurring mental disorders and SUDs among adults are not compared with estimates from prior years.

Mental Illness and Substance Use Disorders among Adults with a Disorder

In 2015, among the 19.6 million adults with a past year SUD, 8.1 million (41.2 percent) had AMI in the past year (Figure 46). In contrast, among adults without a past year SUD, 15.8 percent (35.4 million adults) had AMI in the past year. The 8.1 million adults with AMI who met the criteria for an SUD in the past year represent 18.6 percent of the 43.4 million adults with AMI (Figure 47). In contrast, 5.8 percent of adults who did not have past year AMI (11.5 million adults) met the criteria for an SUD (Table A.23B in Appendix A).

Figure 46. Past Year Substance Use Disorder (SUD) and Mental Illness among Adults Aged 18 or Older: 2015

Figure 46     D


Figure 47. Past Year Substance Use Disorder among Adults Aged 18 or Older with Any Mental Illness in the Past Year, by Age Group: 2015

Figure 47     D

Among the 19.6 million adults aged 18 or older in 2015 who had a past year SUD, 2.3 million (11.9 percent) also had SMI in the past year (Figure 48). The 2.3 million adults with SMI who met the criteria for an SUD in the past year represent 23.8 percent of the 9.8 million adults with SMI (Figure 49).

Figure 48. Past Year Substance Use Disorder (SUD) and Serious Mental Illness (SMI) among Adults Aged 18 or Older: 2015

Figure 48     D


Figure 49. Past Year Substance Use Disorder among Adults Aged 18 or Older with Serious Mental Illness in the Past Year, by Age Group: 2015

Figure 49     D

Aged 18 to 25

In 2015, among the 5.3 million young adults aged 18 to 25 with a past year SUD, 2.1 million (38.7 percent) had AMI in the past year (Table A.22B in Appendix A). In contrast, among young adults without a past year SUD, 18.6 percent (5.5 million adults) had AMI in the past year.

In 2015, among the 5.3 million adults aged 18 to 25 with a past year SUD, 593,000 (11.1 percent) had SMI in the past year. In contrast, among young adults without a past year SUD, 3.9 percent (1.2 million adults) had SMI in the past year.

Aged 26 to 49

Among the 9.7 million adults aged 26 to 49 with a past year SUD, 4.3 million (44.1 percent) had AMI in the past year (Table A.22B). Among adults aged 26 to 49 without a past year SUD, 18.3 percent (16.3 million adults) had AMI in the past year.

Among the 9.7 million adults aged 26 to 49 with a past year SUD, 1.3 million (13.5 percent) had SMI in the past year. Among adults aged 26 to 49 without a past year SUD, 4.0 percent (3.6 million adults) had SMI in the past year.

Aged 50 or Older

Among the 4.5 million adults aged 50 or older with a past year SUD, 1.7 million (38.0 percent) had AMI in the past year (Table A.22B). Among adults aged 50 or older without a past year SUD, 12.9 percent (13.5 million adults) had AMI in the past year.

Among the 4.5 million adults aged 50 or older with a past year SUD, 422,000 (9.3 percent) had SMI in the past year. Among adults aged 50 or older without a past year SUD, 2.6 percent (2.7 million adults) had SMI in the past year.

Co-Occurring Mental Illness and Substance Use Disorders among Adults in the General Population

Prior sections described the percentage of adults with mental illness among the subpopulation of adults who had a past year SUD or described the percentage of adults with an SUD among the subpopulation of adults with mental illness. This section presents findings on the percentages of adults who had co-occurring SUDs and mental illness among all adults in the United States. This type of presentation helps to provide further context for discussions of co-occurring disorders. Although the numbers of adults in the population who had co-occurring disorders are the same as those that were presented in previous sections, the percentages presented in this section are based on the total population of adults.

In 2015, the estimate of 8.1 million adults aged 18 or older who had both mental illness and SUDs in the past year corresponds to 3.3 percent of all adults (Table A.24B in Appendix A). The estimate of 2.3 million adults aged 18 or older in 2015 who had co-occurring SMI and SUDs in the past year corresponds to 1.0 percent of all adults.

Aged 18 to 25

In 2015, the estimate of 2.1 million adults aged 18 to 25 who had both mental illness and SUDs in the past year corresponds to 5.9 percent of all young adults (Table A.24B). The estimate of 593,000 adults aged 18 to 25 in 2015 who had co-occurring SMI and SUDs in the past year corresponds to 1.7 percent of all young adults.

Aged 26 to 49

In 2015, the estimate of 4.3 million adults aged 26 to 49 who had both mental illness and SUDs in the past year corresponds to 4.3 percent of all adults aged 26 to 49 (Table A.24B). The estimate of 1.3 million adults aged 26 to 49 in 2015 who had co-occurring SMI and SUDs in the past year corresponds to 1.3 percent of all adults aged 26 to 49.

Aged 50 or Older

In 2015, the estimate of 1.7 million adults aged 50 or older who had both mental illness and SUDs in the past year corresponds to 1.6 percent of all adults aged 50 or older (Table A.24B). The estimate of 422,000 adults aged 50 or older in 2015 who had co-occurring SMI and SUDs in the past year corresponds to 0.4 percent of all adults aged 50 or older.

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Receipt of Services among Adults with Co-Occurring Mental Illness and a Substance Use Disorder

This section presents data on the receipt of mental health care or specialty substance use treatment among adults with an SUD who have co-occurring AMI and co-occurring SMI.33 The 2015 NSDUH estimates of the receipt of services among adults with co-occurring mental disorders and SUDs are not compared with estimates from prior years because of the potential effects of the 2015 questionnaire changes on SUD estimates that were described previously.

Among the 8.1 million adults with co-occurring AMI and an SUD in the past year, approximately 48.0 percent received either mental health care or substance use treatment at a specialty facility in the past year (Figure 50). In other words, about half of the adults with co-occurring AMI and an SUD in the past year did not receive either type of service.40 An estimated 6.8 percent of adults with co-occurring disorders received both mental health care and specialty substance use treatment, 36.7 percent received only mental health care, and 4.4 percent received only specialty substance use treatment.

Figure 50. Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Mental Illness and Substance Use Disorders: Percentages, 2015

Figure 50     D

Note: Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use.

Note: The percentages do not add to 100 percent due to rounding.

Among the 2.3 million adults who had co-occurring SMI and an SUD in the past year, 62.6 percent received either substance use treatment at a specialty facility or mental health care in the past year (Figure 51). Stated another way, about 1 in 3 adults with co-occurring SMI and an SUD did not receive either type of care in the past year. Among adults with co-occurring SMI and an SUD, 11.0 percent received both mental health care and specialty substance use treatment, 47.4 percent received only mental health care, and 4.2 percent received only specialty substance use treatment.

Figure 51. Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2015

Figure 51     D

Note: Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use.

Aged 18 to 25

Among young adults aged 18 to 25 in 2015 who had co-occurring AMI and an SUD in the past year, 35.2 percent received mental health care or substance use treatment at a specialty facility in the past year (Table A.25B in Appendix A). Among young adults who had co-occurring AMI and an SUD, 26.5 percent received only mental health care, 5.4 percent received both mental health care and specialty substance use treatment, and 3.1 percent received only specialty substance use treatment in the past year. Among young adults with co-occurring SMI and an SUD in 2015, 53.1 percent received either mental health care or specialty substance treatment, 9.3 percent received both mental health care and specialty substance use treatment, 41.6 percent received only mental health care, and 2.2 percent received only specialty substance use treatment in the past year.

Aged 26 to 49

Among adults aged 26 to 49 in 2015 who had co-occurring AMI and an SUD in the past year, 50.5 percent received mental health care or substance use treatment at a specialty facility in the past year (Table A.25B). Among adults 26 to 49 who had co-occurring AMI and an SUD, 37.6 percent received only mental health care, 7.6 percent received both mental health care and specialty substance use treatment, and 5.3 percent received only specialty substance use treatment in the past year. Among adults aged 26 to 49 with co-occurring SMI and an SUD in 2015, 68.0 percent received either mental health care or specialty substance treatment, 12.4 percent received both mental health care and specialty substance use treatment, 49.0 percent received only mental health care, and 6.6 percent received only specialty substance use treatment in the past year.

Aged 50 or Older

Among adults aged 50 or older in 2015 who had co-occurring AMI and an SUD in the past year, 57.1 percent received mental health care or substance use treatment at a specialty facility in the past year (Table A.25B). Among adults aged 50 or older who had co-occurring AMI and an SUD, 46.8 percent received only mental health care, 6.6 percent received both mental health care and specialty substance use treatment, and 3.6 percent received only specialty substance use treatment in the past year. Estimates for the receipt of services among adults aged 50 or older with co-occurring SMI and an SUD were not reported because of low precision.15

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Major Depressive Episode (MDE) and MDE with Severe Impairment among Adults

NSDUH also provides estimates of having a past year MDE among adults. MDE is defined using the diagnostic criteria from the DSM-IV.30 Adults were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth.41 Adults were defined as having an MDE with severe impairment if their depression caused severe problems with their ability to manage at home, manage well at work, have relationships with others, or have a social life.42

In 2015, 6.7 percent of adults aged 18 or older (16.1 million adults) had at least one MDE in the past year, and 4.3 percent of adults (10.3 million adults) had an MDE with severe impairment in the past year (Figure 52). Adults in 2015 who had an MDE with severe impairment represent nearly two thirds (64.0 percent) of adults who had a past year MDE.43

Figure 52. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Adults Aged 18 or Older: 2015

Figure 52     D

Note: Adult respondents with unknown past year MDE data or unknown impairment data were excluded.

The percentage of adults who had a past year MDE remained stable between 2005 and 2015 (Figure 53). The percentage of adults with a past year MDE with severe impairment also remained stable between 2009 and 2015 (Figure 54).

Figure 53. Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2015

Figure 53     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 53 Table. Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2015
Age Group 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
18 or Older   6.6     6.5     6.7     6.5     6.6     6.8     6.6     6.9     6.7     6.6     6.7  
18 to 25   8.8+   8.1+   8.0+   8.4+   8.0+   8.3+   8.3+   8.9+   8.7+   9.3+ 10.3  
26 to 49   7.6     7.7     7.6     7.4     7.6     7.5     7.7     7.6     7.6     7.2     7.5  
50 or Older   4.5     4.5     5.2     4.8     4.9     5.6     4.8     5.5     5.1     5.2     4.8  

Figure 54. Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2015

Figure 54     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 54 Table. Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2015
Age Group 2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
18 or Older 4.0   4.2   4.2   4.5   4.3   4.3   4.3  
18 to 25 5.2+ 5.2+ 5.2+ 5.8+ 5.7+ 6.0   6.5  
26 to 49 4.8   4.7   5.2   5.1   4.9   4.6   4.9  
50 or Older 2.6   3.5   2.9   3.4   3.2   3.5   3.0  

Aged 18 to 25

In 2015, an estimated 3.6 million young adults aged 18 to 25 had a past year MDE, or 10.3 percent of young adults (Figure 53). The percentage of young adults with a past year MDE was greater in 2015 than in 2005 to 2014.

In 2015, an estimated 2.2 million young adults aged 18 to 25 had a past year MDE with severe impairment, or 6.5 percent of young adults (Figure 54). The percentage of young adults with a past year MDE with severe impairment was greater in 2015 than in 2009 to 2013, but it was similar to the percentage in 2014.

Aged 26 to 49

In 2015, an estimated 7.3 million adults aged 26 to 49 had a past year MDE, or 7.5 percent of adults in this age group (Figure 53). The percentage of adults aged 26 to 49 in 2015 who had a past year MDE was similar to the corresponding percentages in 2005 to 2014.

In 2015, an estimated 4.8 million adults aged 26 to 49 had a past year MDE with severe impairment, or 4.9 percent of adults in this age group (Figure 54). The percentage of adults aged 26 to 49 in 2015 who had a past year MDE with severe impairment was similar to the percentages in 2009 to 2014.

Aged 50 or Older

In 2015, an estimated 5.2 million adults aged 50 or older had a past year MDE, or 4.8 percent of adults in this age group (Figure 53). The percentage of adults aged 50 or older in 2015 who had a past year MDE was similar to the corresponding percentages in 2005 to 2014.

In 2015, an estimated 3.2 million adults aged 50 or older had a past year MDE with severe impairment, or 3.0 percent of adults in this age group (Figure 54). The percentage of adults aged 50 or older in 2015 who had a past year MDE with severe impairment was similar to the percentages in 2009 to 2014.

Treatment for Depression among Adults

Adults who had met the criteria for having a past year MDE were asked whether they had received treatment for their depression in the past year. Treatment for depression in adults is defined as seeing or talking to a health professional or other professional or using prescription medication for depression in the past year.44

In 2015, an estimated 67.2 percent of adults aged 18 or older who had a past year MDE received treatment for depression (Figure 55). This percentage represents 10.8 million adults with a past year MDE who received treatment for depression. The percentage of adults with a past year MDE who received treatment for depression remained stable between 2009 and 2015. Among adults who had a past year MDE with severe impairment, 7.5 million, or 72.7 percent, received treatment for depression. The percentage of adults with an MDE with severe impairment in 2015 who received treatment for depression was similar to the percentages in most years from 2009 to 2014.

Figure 55. Received Treatment in the Past Year for Depression among Adults Aged 18 or Older with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2015

Figure 55     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 55 Table. Received Treatment in the Past Year for Depression among Adults Aged 18 or Older with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2015
MDE Status 2009   2010   2011   2012   2013   2014   2015  
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
MDE 64.3   68.2   68.1   68.0   68.6   68.6   67.2  
MDE with Severe Impairment 71.5   72.9   73.7   73.1   76.4+ 73.7   72.7  

Aged 18 to 25

In 2015, 1.7 million young adults aged 18 to 25 with a past year MDE received treatment for depression in the past year. Among young adults, the percentage of adults with MDE in 2015 who received treatment for depression (46.8 percent) was similar to the percentages in 2009 to 2014 (Table A.20B in Appendix A).

In 2015, 1.2 million young adults aged 18 to 25 with a past year MDE with severe impairment received treatment for depression in the past year. Among young adults, the percentage of adults with MDE with severe impairment in 2015 who received treatment for depression (52.0 percent) was similar to the percentages in 2009 to 2014.

Aged 26 to 49

In 2015, 4.9 million adults aged 26 to 49 with a past year MDE received treatment for depression in the past year. Among adults aged 26 to 49, the percentage of adults with MDE in 2015 who received treatment for depression (67.4 percent) was similar to the percentages in 2009 to 2014 (Table A.20B).

In 2015, 3.4 million adults aged 26 to 49 with a past year MDE with severe impairment received treatment for depression in the past year. Among adults aged 26 to 49, the percentage of adults with MDE with severe impairment in 2015 who received treatment for depression (72.0 percent) was similar to the percentages in 2009 to 2014.

Aged 50 or Older

In 2015, 4.2 million adults aged 50 or older with a past year MDE received treatment for depression in the past year. Among adults aged 50 or older, the percentage of adults with MDE in 2015 who received treatment for depression (80.9 percent) was similar to the percentages in 2009 to 2014 (Table A.20B).

In 2015, 2.8 million adults aged 50 or older with a past year MDE with severe impairment received treatment for depression in the past year. Among adults aged 50 or older, the percentage of adults with MDE with severe impairment in 2015 who received treatment for depression (87.9 percent) was similar to the percentages in 2009 to 2014.

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Mental Health Service Use among Adolescents

In addition to asking youths about substance use, NSDUH includes questions for adolescents aged 12 to 17 that ask about the receipt of services for emotional and behavioral problems that were not caused by substance use. As discussed earlier, these questions differ for adolescents and adults. The youth mental health service utilization section of the interview asks respondents aged 12 to 17 whether they received any treatment or counseling within the 12 months prior to the interview for problems with emotions or behavior in several settings: (a) the specialty mental health setting (inpatient or outpatient care); (b) the education setting (talked with a school social worker, psychologist, or counselor about an emotional or behavioral problem; participated in a program for students with emotional or behavioral problems while in a regular school; or attended a school for students with emotional or behavioral problems); (c) the general medical setting (care from a pediatrician or family physician for emotional or behavioral problems); (d) the juvenile justice setting (services for an emotional or behavioral problem in a detention center, prison, or jail); or (e) the child welfare setting (foster care or therapeutic foster care).

The NSDUH interview currently does not include questions or methods for estimating the occurrence of mental disorders among adolescents other than whether adolescents had an MDE. Therefore, a NSDUH measure of any mental disorder does not exist for adolescents. Consequently, this section focuses on mental health care among all adolescents. Some estimates of mental health service use among youths in this report may differ from estimates in reports prior to the 2014 NSDUH due to changes in the definition of mental health service use.45

Mental Health Service Use among All Adolescents

In 2015, the following numbers of adolescents aged 12 to 17 received mental health services in the past 12 months in specific settings for problems with emotions or behaviors (Figure 56):

Figure 56. Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: Percentages and Numbers (in Thousands), 2015

Figure 56     D

Note: Nonspecialty settings do not include youths who received mental health care in the past year from a juvenile justice setting.

In addition, 1.4 million youths aged 12 to 17 received mental health services in both specialty and nonspecialty settings (i.e., an education, general medical, or child welfare setting).

These numbers correspond to the following percentages of all adolescents aged 12 to 17 (Figure 56):

The percentage of adolescents in 2015 who received mental health services in a specialty mental health setting in the past 12 months (13.3 percent) was higher than the percentages in 2002, 2003, 2009, and 2010, which ranged from 11.8 to 12.4 percent (Table A.30B in Appendix A). However, the 2015 estimate was similar to the estimates in all other years. The percentage of youths aged 12 to 17 in 2015 who received mental health services in an education setting (13.2 percent) was similar to the percentages in most years from 2009 to 2014. The percentage of youths in 2015 who received mental health services in a general medical setting (2.7 percent) was similar to the percentages in most years from 2002 to 2014. The percentage of youths in 2015 who received mental health services in a juvenile justice setting (0.2 percent) was similar to the percentages in most years from 2009 to 2014.

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MDE and MDE with Severe Impairment among Adolescents

Although NSDUH does not have an overall measure of mental illness among adolescents aged 12 to 17, the survey provides estimates of having a past year MDE for this age group. MDE is defined using the diagnostic criteria from DSM-IV.30 Similar to adults, adolescents were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth. However, some wordings to the questions for adolescents were designed to make them more developmentally appropriate for youths.46 Adolescents were defined as having an MDE with severe impairment if their depression caused severe problems with their ability to do chores at home, do well at work or school, get along with their family, or have a social life.47

In 2015, 12.5 percent of adolescents aged 12 to 17 (3.0 million adolescents) had an MDE during the past year, and 8.8 percent of adolescents (2.1 million adolescents) had a past year MDE with severe impairment (Figure 57). Adolescents in 2015 who had an MDE with severe impairment represent more than two thirds (70.7 percent) of adolescents who had a past year MDE.43

Figure 57. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: 2015

Figure 57     D

Note: Youth respondents with unknown past year MDE data or unknown impairment data were excluded.

The percentage of adolescents aged 12 to 17 in 2015 who had a past year MDE was higher than the percentages in 2004 to 2014 (Figure 58). The percentage of adolescents in 2015 who had a past year MDE with severe impairment was higher than the percentages in 2006 to 2013, which ranged from 5.5 to 7.7 percent. However, the 2015 estimate was similar to the estimate in 2014.

Figure 58. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2015

Figure 58     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 58 Table. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2015
MDE Status 2004   2005   2006   2007   2008   2009   2010   2011   2012   2013   2014   2015  
N/A = not available.
+ Difference between this estimate and the 2015 estimate is statistically significant at the 05 level.
MDE   9.0+   8.8+   7.9+   8.2+   8.3+   8.1+   8.0+   8.2+   9.1+ 10.7+ 11.4+ 12.5  
MDE with Severe Impairment N/A   N/A     5.5+   5.5+   6.0+   5.8+   5.7+   5.7+   6.3+   7.7+   8.2     8.8  

Treatment for Depression among Adolescents

Adolescents who had met the criteria for having a past year MDE were asked whether they had received treatment for their depression in the past year. Adolescents were defined as having received treatment for their depression in the past year if they reported seeing or talking to a health professional or taking prescribed medication for their depression.44

An estimated 1.2 million youths aged 12 to 17 in 2015 who had a past year MDE received treatment for depression, or 39.3 percent of youths who had a past year MDE (Figure 59). This 2015 percentage was similar to the percentages in most years from 2004 to 2014. Among youths who had a past year MDE with severe impairment, 945,000 (44.6 percent) received treatment for depression. The percentage of adolescents with MDE with severe impairment in 2015 who received treatment for depression was similar to the percentages in most years from 2006 to 2014.

Figure 59. Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2015

Figure 59     D

+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.

Figure 59 Table. Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2015
MDE Status 2004   2005   2006   2007   2008   2009   2010   2011   2012   2013   2014   2015  
N/A = not available.
+ Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
MDE 40.3   37.8   38.8   39.0   37.7   34.6+ 37.8   38.4   37.0   38.1   41.2   39.3  
MDE with Severe Impairment N/A   N/A   46.5   43.9   42.6   38.8+ 41.1   43.5   41.0   45.0   44.7   44.6  

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Co-Occurring MDE and Substance Use among Adolescents

This section describes co-occurring MDE and substance use and co-occurring MDE and SUDs among adolescents aged 12 to 17. Specifically, estimates of substance use and SUDs are presented among adolescents with an MDE, and estimates of having a past year MDE are presented among those with SUDs. Estimates of co-occurring MDE and SUDs also are presented among all adolescents. Because of the potential effects of the 2015 questionnaire changes on SUD estimates that were described previously, the 2015 estimates of co-occurring MDE and SUD are not compared with estimates from prior years.

Substance Use and Substance Use Disorders among Adolescents with MDE

In 2015, the percentage of adolescents aged 12 to 17 who used illicit drugs in the past year was higher among those with a past year MDE than it was among those without a past year MDE (31.5 vs. 15.3 percent) (Figure 60). Youths with a past year MDE in 2015 also were more likely than those without an MDE to be users of marijuana, misusers of prescription psychotherapeutic drugs (i.e., pain relievers, tranquilizers, stimulants, and sedatives), users of inhalants, and users of hallucinogens in the past year. Although estimates of past month illicit drug use among adolescents were previously mentioned in this report, this section of the report focuses on estimates of past year illicit drug use among adolescents (Figure 60).

Figure 60. Past Year Illicit Drug Use among Youths Aged 12 to 17, by Past Year Major Depressive Episode: Percentages, 2015

Figure 60     D

Among adolescents aged 12 to 17 in 2015, 1.8 percent of those with a past year MDE were daily cigarette smokers in the past month compared with 0.7 percent of those without a past year MDE (Table A.33B in Appendix A). In addition, 1.7 percent of adolescents aged 12 to 17 with a past year MDE and 0.8 percent of those without a past year MDE were heavy alcohol drinkers in the past month.

Among the 3.0 million adolescents aged 12 to 17 in 2015 who had a past year MDE, a total of 350,000 adolescents (11.6 percent) had a past year SUD. In contrast, among adolescents without a past year MDE, 854,000 (4.0 percent) had an SUD in the past year (Figure 61 and Table A.28B in Appendix A).

Figure 61. Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) in the Past Year among Youths Aged 12 to 17: 2015

Figure 61     D

Note: Youth respondents with unknown MDE data were excluded.

MDE among Adolescents with a Substance Use Disorder

An estimated 350,000 adolescents aged 12 to 17 in 2015 had a co-occurring MDE and an SUD in the past year. This number of adolescents with a co-occurring MDE and an SUD represents 29.1 percent of the 1.2 million adolescents who had a past year SUD. Among adolescents without a past year SUD, 11.6 percent (2.7 million adolescents) had an MDE in the past year (Figure 61 and Table A.28B).

Co-Occurring MDE and Substance Use Disorder among Adolescents in the General Population

The previous section presented findings among adolescents who had an MDE or an SUD. This section presents findings on co-occurring SUD and MDE among all adolescents aged 12 to 17.

The estimated 350,000 adolescents aged 12 to 17 in 2015 who had an SUD and an MDE in the past year represent 1.4 percent of all adolescents in the United States (Figure 62). An estimated 303,000 adolescents in 2015 (1.2 percent of adolescents) had an SUD and an MDE with severe impairment in the past year.

Figure 62. Past Year Substance Use Disorder (SUD), Major Depressive Episode (MDE), MDE with Severe Impairment, Co-Occurring SUD and MDE, and Co-Occurring SUD and MDE with Severe Impairment among Youths Aged 12 to 17: Percentages, 2015

Figure 62     D

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Receipt of Services among Adolescents with Co-Occurring MDE and a Substance Use Disorder

This section presents data from NSDUH on the receipt of mental health care or specialty substance use treatment among adolescents aged 12 to 17 who had a co-occurring MDE and an SUD. Among the 350,000 adolescents who had a co-occurring MDE and an SUD in the past year, 63.1 percent received either substance use treatment at a specialty facility or mental health services in the past year (Table A.29B in Appendix A). Stated another way, more than one third of adolescents with both an MDE and an SUD in the past year did not receive either type of treatment. Among adolescents with a co-occurring MDE and an SUD, 3.8 percent received both mental health care and specialty substance use treatment, and 59.4 percent received only mental health care. The percentage of adolescents with a co-occurring MDE and an SUD who received only specialty substance use treatment is not reported because of low precision.15

Summary Footnotes

1 NSDUH obtains information on the following 10 categories of drugs: marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamine, as well as the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives. Estimates of "illicit drug use" reported from NSDUH reflect the use of drugs in any of these 10 categories.

2 People who met the criteria for dependence or abuse for alcohol or illicit drugs in the past 12 months based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM IV), were defined as having an SUD. See the following reference: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author.

3 Specialty treatment refers to substance use treatment at a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center.

4 Adults with AMI were defined as having any mental, behavioral, or emotional disorder in the past year that met DSM-IV criteria (excluding developmental disorders and SUDs). Adults with AMI were defined as having SMI if they had any mental, behavioral, or emotional disorder that substantially interfered with or limited one or more major life activities. See footnote 2 for the reference for the DSM-IV criteria.

5 Based on DSM-IV criteria, adults and youths were defined as having an MDE if they had a period of 2 weeks or longer in the past 12 months when they experienced a depressed mood or loss of interest or pleasure in daily activities, and they had at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth. Some wordings to the questions for adolescents were designed to make them more developmentally appropriate for youths. Adults and youths were defined as having an MDE with severe impairment if their depression caused severe problems in carrying out life activities in four developmentally appropriate role domains. For adults, these domains were the ability to manage at home, manage well at work, have relationships with others, or have a social life. For youths, these domains were the ability to do chores at home, do well at work or school, get along with their family, or have a social life. See footnote 2 for the reference for the DSM-IV criteria.

Endnotes

1. World Health Organization. (2013). Mental health action plan 2013-2020. Retrieved from http://www.who.int/mental_health/publications/action_plan/en/

2. Reeves, W. C., Strine, T. W., Pratt, L. A., Thompson, W., Ahluwalia, I., Dhingra, S. S., McKnight-Eily, L. R., Harrison, L., D'Angelo, D. V., Williams, L., Morrow, B., Gould, D., & Safran, M. A. (2011). Mental illness surveillance among adults in the United States. Morbidity and Mortality Weekly Report CDC Surveillance Summaries, 60 (Suppl. 3), 1-29.

3. Murray, C. J. L., & Lopez, A. D. (2013). Measuring the global burden of disease. New England Journal of Medicine, 369, 448-457. doi:10.1056/NEJMra1201534

4. This report occasionally presents estimated numbers of people with a specific characteristic (e.g., estimated numbers of substance users). Some of these estimated numbers are not included in figures or tables in the report but may be found in the detailed tables for the 2015 NSDUH available at http://www.samhsa.gov/data/.

5. In this report, terms such as "Americans," "people in this country," "general population," or similar terms are used broadly to refer to the civilian, noninstitutionalized population that is covered by NSDUH. Although some people in the general population of the United States are outside of the civilian, noninstitutionalized population, information from the 2010 census suggests that the civilian, noninstitutionalized population includes at least 97 percent of the total U.S. population. See the following reference: Lofquist, D., Lugaila, T., O'Connell, M., & Feliz, S. (2012, April). Households and families: 2010 (C2010BR-14, 2010 Census Briefs). Retrieved from https://www.census.gov/prod/cen2010/briefs/c2010br-14.pdf

6. Details about the sample design, weighting, and interviewing results for the 2015 NSDUH are provided in Sections A.1, A.3.4, and B.3.1 of CBHSQ (2016). In particular, Tables A.1 and A.2 in CBHSQ (2016) provide sample design information on the targeted numbers of completed interviews by state and by age group, respectively. See the following reference: Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from http://www.samhsa.gov/data/

7. The screening procedure involves listing all household members in order to determine whether zero, one, or two individuals aged 12 or older should be selected for the interview.

8. Overall response rates are not calculated for adolescents or adults because the screening response rate is not specific to age groups.

9. See the CBHSQ (2016) reference in endnote 6.

10. Center for Behavioral Health Statistics and Quality. (2016). 2015 National Survey on Drug Use and Health: Summary of the effects of the 2015 NSDUH questionnaire redesign: Implications for data users. Retrieved from http://www.samhsa.gov/data/

11. Center for Behavioral Health Statistics and Quality. (2015, August). National Survey on Drug Use and Health: 2014 and 2015 redesign changes. Retrieved from http://www.samhsa.gov/data/

12. See Section C in CBHSQ (2016). See endnote 6 for the reference.

13. Trend data are presented for 2002 to 2015. Methodological changes to the survey in 2002 affect the comparability of the 2002 to 2015 estimates with estimates from prior surveys, including the addition of a $30 incentive to respondents and the change in the survey's name from the National Household Survey on Drug Abuse (NHSDA) to NSDUH. For more details, see Appendix C in the following report for the 2004 NSDUH: Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (HHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

14. Estimates presented in this report have been weighted to reflect characteristics of the civilian, noninstitutionalized population aged 12 or older in the United States. The calculation of NSDUH weights for analysis includes a step that yields weights that are consistent with population totals obtained from the U.S. Census Bureau based on the most recently available decennial census.

15. For a discussion of the criteria for suppressing (i.e., not publishing) unreliable estimates, see Section B.2.2 in CBHSQ (2016). See endnote 6 for the reference.

16. If the number of people in the population with a characteristic of interest has increased (e.g., the number of substance users) simply because the size of the overall population has increased, then the percentages will control for the increases both in the number of people with the characteristic of interest and the total number of people in the population.

17. The term "most years" is used when the 2015 estimate is either similar to or significantly different from the estimates in the majority of prior years. However, estimates may not follow the overall pattern in up to 3 nonsequential years for estimates that are available in 2002 to 2015 and in up to 1 or 2 nonsequential years for mental health estimates that are available in 2008 (or 2009) to 2015.

18. Anomalous differences between 2 years of data usually "correct" themselves with 1 or 2 additional years of data.

19. The estimated numbers of current users of different illicit drugs are not mutually exclusive because people could have used more than one type of illicit drug in the past month.

20. Hughes, A., Williams, M. R., Lipari, R. N., Bose, J., Copello, E. A. P., & Kroutil, L. A. (2016, September). Prescription drug use and misuse in the United States: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review. Retrieved from http://www.samhsa.gov/data/

21. LSD = lysergic acid diethylamide; PCP = phencyclidine; MDMA = methylenedioxy-methamphetamine; DMT = dimethyltryptamine; AMT = alpha-methyltryptamine; Foxy = N, N-diisopropyl-5-methoxytryptamine (5-MeO-DIPT). Definitions for these hallucinogens also are included in Section D of CBHSQ (2016). See endnote 6 for the reference.

22. U.S. Department of Health and Human Services. (2014, January). The health consequences of smoking—50 years of progress: A report of the Surgeon General, 2014. Retrieved from http://www.surgeongeneral.gov/library/reports/50-years-of-progress/

23. Adhikari, B., Kahende, J., Malarcher, A., Pechacek, T., & Tong, V. (2008). Smoking-attributable mortality, years of potential life lost, and productivity losses—United States, 2000-2004. Morbidity and Mortality Weekly Report, 57(45), 1226-1228.

24. Center for Behavioral Health Statistics and Quality. (2014). Results from the 2013 National Survey on Drug Use and Health: Summary of national findings (HHS Publication No. SMA 14-4863, NSDUH Series H-48). Retrieved from http://www.samhsa.gov/data/

25. Bunnell, R. E., Agaku, I. T., Arrazola, R. A., Apelberg, B. J., Caraballo, R. S., Corey, C. G., Coleman, B. N., Dube, S. R., & King, B. A. (2015). Intentions to smoke cigarettes among never-smoking US middle and high school electronic cigarette users: National Youth Tobacco Survey, 2011-2013. Nicotine & Tobacco Research, 17, 228 235. doi:10.1093/ntr/ntu166

26. In NSDUH, a "drink" is defined as a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. Times when respondents only had a sip or two from a drink are not considered to be alcohol consumption.

27. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking that brings blood alcohol concentration (BAC) levels to 0.08 grams per deciliter (g/dL). This typically occurs after four drinks for women and five drinks for men in about 2 hours. See the following two references:

National Institute on Alcohol Abuse and Alcoholism. (2004, Winter). NIAAA council approves definition of binge drinking. NIAAA Newsletter, 3, 3. Retrieved from http://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf

National Institute on Alcohol Abuse and Alcoholism. (2016). Drinking levels defined. Retrieved from http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking

28. The threshold for determining binge alcohol use for females was lowered from five or more drinks on an occasion for the 2014 and earlier NSDUHs to four or more drinks on an occasion for the 2015 NSDUH to ensure consistency with federal definitions and other federal data collection programs. The threshold for males in 2015 remained at five or more drinks on an occasion. New baselines began in 2015 for estimates of binge and heavy alcohol use for females and for binge and heavy alcohol use for the overall population (both genders). Estimates from 2002 to 2015 for binge and heavy alcohol use among males are available in the 2015 NSDUH detailed tables.

29. Alcohol Policy Information System, National Institute on Alcohol Abuse and Alcoholism. (2015, December 23). State profiles of underage drinking laws. Retrieved from http://www.alcoholpolicy.niaaa.nih.gov/state_profiles_of_underage_drinking_laws.html

30. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author.

31. The DSM-IV criteria for SUDs include separate criteria for dependence or abuse. Individuals who met the criteria for abuse for a given substance (e.g., alcohol) did not meet the criteria for dependence for that substance. For more information, see Section B.4.3 and the definitions for abuse and dependence in Section D of CBHSQ (2016). See endnote 6 for the reference.

32. Respondents in 2015 who had a methamphetamine use disorder were not classified as having a disorder related to their misuse of prescription stimulants unless they also reported misuse of prescription stimulants in the past year and sufficient SUD symptoms in order to be defined as having a stimulant use disorder.

33. Specialty treatment refers to substance use treatment at a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center. This NSDUH definition historically has not considered emergency rooms, private doctors' offices, prisons or jails, and self-help groups to be specialty substance use treatment facilities.

34. The NSDUH definition of the need for treatment does not explicitly indicate the need for treatment at a specialty facility. People who had an SUD in the past year can be considered to need some form of assistance for their problems with substance use. However, individuals who met DSM-IV criteria for abuse but not dependence may not necessarily need treatment at a specialty facility (see endnote 30 for the DSM-IV reference). For more information about the DSM-IV criteria for having an SUD, see Section B.4.3 and the definitions for abuse and dependence in Section D of CBHSQ (2016). See endnote 6 for the reference.

35. Because there were 20.8 million people aged 12 or older in 2015 with an SUD in the past year, about 96 percent of the people in 2015 who needed treatment for a substance use problem were defined as such because they had an SUD in the past year, regardless of whether they received substance use treatment at a specialty facility.

36. In order to generate estimates of AMI and SMI in the United States, SAMHSA designed and implemented the Mental Health Surveillance Study (MHSS). Over the 5-year period from 2008 to 2012, a subsample of adults was selected from the main study to participate in a follow-up telephone interview that obtained a detailed mental health assessment administered by trained mental health clinicians. The MHSS interview used the Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). A prediction model created from clinical interview data that were collected from 2008 to 2012 was applied to data from the 2008 to 2015 NSDUHs to produce estimates of AMI for the entire NSDUH adult sample in these years. See the following reference: First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York, NY: New York State Psychiatric Institute, Biometrics Research.

37. Details about the definitions and estimation methods for mental illness estimates are provided in Section B.4.7 and Section D of CBHSQ (2016). See endnote 6 for the reference.

38. In this section, estimated numbers or percentages of adults with SMI and the corresponding estimates for adults who had AMI without SMI may not sum to the overall estimates for adults with AMI because of rounding.

39. Percentages shown in Figure 39 may differ from percentages that are calculated from the estimated numbers of people because the estimated numbers are rounded.

40. Percentages for the receipt of specific types of services do not sum to the total percentage who received any type of service due to rounding.

41. The specific questions used to measure MDE and a discussion of measurement issues are included in Section B.4.8 of CBHSQ (2016). See endnote 6 for the reference.

42. Adults were first asked whether they ever had a period in their lifetime lasting several days or longer when any of the following was true for most of the day: (a) feeling sad, empty, or depressed; (b) feeling discouraged about how things were going in their lives; or (c) losing interest in most things they usually enjoy. Adults who reported any of these problems were asked further questions about having an MDE in their lifetime, including whether they had at least five of nine symptoms in the same 2-week period in their lifetime; at least one of the symptoms needed to be having a depressed mood or loss of interest or pleasure in daily activities. Those who had lifetime MDE were asked if they had a period of time in the past 12 months when they felt depressed or lost interest or pleasure in daily activities for 2 weeks or longer, and they reported that they had some of their other lifetime MDE symptoms in the past 12 months. These adults were defined as having past year MDE. Data on MDE in the past year for adults are available in NSDUH since 2005. Data on MDE with severe impairment for adults are available since 2009.

43. Percentages shown in Figure 52 and in Figure 57 (which is discussed later in the report) may differ from percentages that are calculated from the estimated numbers of people because the estimated numbers are rounded. Also, respondents with unknown information for past year MDE or MDE with severe impairment were excluded.

44. Health professionals include general practitioners or family doctors; other medical doctors (e.g., cardiologist, gynecologist, urologist); psychologists; psychiatrists or psychotherapists; social workers; counselors; other mental health professionals (e.g., mental health nurse or other therapist where type is not specified); and nurses, occupational therapists, or other health professionals.

45. Youth mental health service questions were revised in 2009 to include updates to the questions about services in the education setting (i.e., school system). A new question on mental health service utilization in the juvenile justice setting also was added in 2009. In addition, the definition of mental health service use among youths was revised for the 2014 survey. The child welfare setting was redefined as a separate service category instead of being included as part of inpatient services under specialty mental health services.

46. Adolescents were first asked whether they ever had a period in their lifetime lasting several days or longer when any of the following was true for most of the day: (a) feeling sad, empty, or depressed; (b) feeling very discouraged or hopeless about how things were going in their lives; or (c) losing interest and becoming bored with most things they usually enjoy. Adolescents who reported any of these problems were asked further questions about having an MDE in their lifetime, including whether they had at least five of nine symptoms in the same 2-week period in their lifetime; at least one of the symptoms needed to be having a depressed mood or loss of interest or pleasure in daily activities. Unlike questions for adults, adolescents who reported gaining weight without trying were asked if this occurred because they were growing. Those who had lifetime MDE were asked if they had a period of time in the past 12 months when they felt depressed or lost interest or pleasure in daily activities for 2 weeks or longer, and they reported that they had some of their other lifetime MDE symptoms in the past 12 months. These adolescents were defined as having past year MDE.

47. Questions measuring adolescents' impairment in carrying out life activities because of MDE were added to the survey in 2006.


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Appendix A: Supplemental Tables of Estimates for Key Substance Use and Mental Health Indicators in the United States

Table A.1B – Types of Illicit Drug Use in the Past Month among Individuals Aged 12 or Older
Drug 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
LSD = lysergic acid diethylamide; PCP = phencyclidine.
**Low precision; no estimate reported.
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level. Rounding may make the estimates appear identical.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 10.1  (0.17)
Marijuana 6.2* (0.14) 6.2* (0.14) 6.1* (0.15) 6.0* (0.15) 6.0* (0.15) 5.8* (0.14) 6.1* (0.15) 6.7* (0.16) 6.9* (0.16) 7.0* (0.16) 7.3* (0.17) 7.5* (0.17) 8.4  (0.16)   8.3  (0.15)
Cocaine 0.9* (0.05) 1.0* (0.06) 0.8* (0.05) 1.0* (0.06) 1.0* (0.06) 0.8  (0.06) 0.7  (0.05) 0.7  (0.05) 0.6  (0.04) 0.5* (0.04) 0.6  (0.05) 0.6  (0.05) 0.6* (0.04)   0.7  (0.05)
Crack 0.2* (0.03) 0.3* (0.04) 0.2  (0.03) 0.3* (0.04) 0.3* (0.04) 0.2* (0.03) 0.1  (0.02) 0.2  (0.03) 0.1  (0.02) 0.1* (0.02) 0.2  (0.04) 0.1  (0.02) 0.1  (0.02)   0.1  (0.02)
Heroin 0.1* (0.02) 0.1* (0.01) 0.1* (0.02) 0.1* (0.01) 0.1  (0.03) 0.1* (0.02) 0.1  (0.02) 0.1* (0.01) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.2  (0.02)   0.1  (0.02)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc   0.5  (0.03)
LSD 0.0* (0.01) 0.1* (0.01) 0.1* (0.01) 0.0* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1* (0.01) 0.1  (0.02)   0.1  (0.01)
PCP 0.0* (0.01) 0.0* (0.01) 0.0  (0.01) 0.0  (0.01) 0.0  (0.00) 0.0  (0.01) 0.0  (0.00) 0.0  (0.01) 0.0  (0.01) 0.0  (0.00) 0.0  (0.00) 0.0  (0.01) **  (**)   0.0  (0.00)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc   0.2  (0.02)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc   0.2  (0.02)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc   0.3  (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc   2.4  (0.08)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc   1.4  (0.06)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc   0.7  (0.04)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc   0.6  (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc   0.2  (0.02)
Table A.2B – Types of Illicit Drug Use in the Past Month among Youths Aged 12 to 17
Drug 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
LSD = lysergic acid diethylamide; PCP = phencyclidine.
**Low precision; no estimate reported.
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level. Rounding may make the estimates appear identical.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 8.8  (0.27)
Marijuana 8.2* (0.24) 7.9* (0.24) 7.6  (0.23) 6.8  (0.22) 6.7  (0.21) 6.7  (0.22) 6.7  (0.22) 7.4  (0.24) 7.4  (0.25) 7.9* (0.24) 7.2  (0.22) 7.1  (0.23) 7.4  (0.27) 7.0  (0.24)
Cocaine 0.6* (0.07) 0.6* (0.06) 0.5* (0.06) 0.6* (0.06) 0.4* (0.05) 0.4* (0.05) 0.4* (0.05) 0.3  (0.05) 0.2  (0.05) 0.3  (0.05) 0.1  (0.03) 0.2  (0.04) 0.2  (0.04) 0.2  (0.05)
Crack 0.1* (0.03) 0.1* (0.03) 0.1* (0.02) 0.1* (0.03) 0.0* (0.02) 0.1* (0.02) 0.0  (0.01) 0.0  (0.02) 0.0  (0.01) 0.0  (0.01) **  (**) 0.0  (0.01) 0.0  (0.02) 0.0  (0.01)
Heroin 0.0  (0.02) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.0  (0.01) 0.1  (0.03) 0.1  (0.02) 0.0  (0.01) 0.1  (0.03) **  (**) 0.1  (0.02) 0.1  (0.02) 0.0  (0.01)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5  (0.07)
LSD 0.2  (0.05) 0.2  (0.04) 0.2  (0.03) 0.1  (0.03) 0.1  (0.03) 0.1  (0.03) 0.2  (0.04) 0.1  (0.03) 0.2  (0.04) 0.1  (0.03) 0.1* (0.02) 0.2  (0.04) 0.3  (0.06) 0.2  (0.05)
PCP 0.1  (0.02) 0.1  (0.02) 0.0  (0.02) 0.1  (0.02) 0.0  (0.02) 0.0  (0.02) 0.1  (0.02) 0.1  (0.02) 0.0  (0.01) 0.0  (0.01) 0.0  (0.01) 0.0  (0.01) 0.0  (0.01) 0.0  (0.02)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.04)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7  (0.08)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.02)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 2.0  (0.15)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.1  (0.11)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7  (0.09)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5  (0.07)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.03)
Table A.3B – Types of Illicit Drug Use in the Past Month among Young Adults Aged 18 to 25
Drug 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
LSD = lysergic acid diethylamide; PCP = phencyclidine.
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level. Rounding may make the estimates appear identical.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 22.3  (0.42)
Marijuana 17.3* (0.36) 17.0* (0.37) 16.1* (0.37) 16.6* (0.37) 16.3* (0.35) 16.5* (0.37) 16.6* (0.37) 18.2* (0.38) 18.5* (0.38) 19.0  (0.39) 18.7  (0.39) 19.1  (0.39) 19.6  (0.45) 19.8  (0.40)
Cocaine   2.0* (0.12)   2.2* (0.13)   2.1* (0.13)   2.6* (0.15)   2.2* (0.13)   1.7  (0.12)   1.6  (0.12)   1.4  (0.11)   1.5  (0.11)   1.4  (0.12)   1.1* (0.09)   1.1* (0.10)   1.4  (0.11)   1.7  (0.14)
Crack   0.2  (0.03)   0.2  (0.04)   0.3* (0.04)   0.3* (0.05)   0.2* (0.04)   0.2  (0.03)   0.2  (0.03)   0.1  (0.03)   0.2  (0.05)   0.1  (0.02)   0.1  (0.03)   0.1  (0.03)   0.1  (0.03)   0.1  (0.04)
Heroin   0.1* (0.03)   0.1* (0.02)   0.1  (0.03)   0.2  (0.03)   0.2  (0.04)   0.1  (0.03)   0.2  (0.04)   0.2  (0.04)   0.3  (0.05)   0.3  (0.06)   0.4  (0.06)   0.3  (0.05)   0.2  (0.05)   0.3  (0.05)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc   1.8  (0.14)
LSD   0.1* (0.03)   0.2* (0.04)   0.3* (0.04)   0.2* (0.04)   0.2* (0.04)   0.2* (0.04)   0.3* (0.05)   0.3* (0.05)   0.3* (0.05)   0.3* (0.04)   0.3* (0.05)   0.3* (0.05)   0.3* (0.05)   0.6  (0.08)
PCP   0.0* (0.02)   0.1* (0.03)   0.1* (0.02)   0.0  (0.02)   0.0  (0.02)   0.0* (0.02)   0.0  (0.01)   0.0  (0.01)   0.0  (0.01)   0.0  (0.02)   0.0* (0.01)   0.0  (0.01)   0.0  (0.01)   0.0  (0.00)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc   0.9  (0.10)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc   0.4  (0.06)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc   0.4  (0.07)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc   5.1  (0.21)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc   2.4  (0.13)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc   1.7  (0.13)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc   2.2  (0.15)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc   0.2  (0.05)
Table A.4B – Types of Illicit Drug Use in the Past Month among Adults Aged 26 or Older
Drug 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
LSD = lysergic acid diethylamide; PCP = phencyclidine.
**Low precision; no estimate reported.
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level. Rounding may make the estimates appear identical.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 8.2  (0.19)
Marijuana 4.0* (0.16) 4.0* (0.16) 4.1* (0.17) 4.1* (0.17) 4.2* (0.17) 3.9* (0.16) 4.2* (0.18) 4.6* (0.18) 4.8* (0.19) 4.8* (0.19) 5.3* (0.20) 5.6* (0.20) 6.6  (0.18) 6.5  (0.17)
Cocaine 0.7  (0.07) 0.8* (0.08) 0.7  (0.06) 0.8  (0.07) 0.8* (0.08) 0.7  (0.08) 0.7  (0.06) 0.6  (0.07) 0.5  (0.05) 0.4* (0.05) 0.6  (0.07) 0.5  (0.06) 0.5  (0.05) 0.6  (0.06)
Crack 0.3* (0.04) 0.3* (0.05) 0.2  (0.03) 0.3* (0.05) 0.3* (0.05) 0.3* (0.04) 0.2  (0.03) 0.2  (0.04) 0.2  (0.03) 0.1  (0.02) 0.2  (0.05) 0.2  (0.03) 0.2  (0.03) 0.2  (0.03)
Heroin 0.1  (0.02) 0.0* (0.01) 0.1* (0.02) 0.0* (0.01) 0.1  (0.04) 0.1* (0.02) 0.1  (0.02) 0.1* (0.02) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.1  (0.02) 0.2  (0.03) 0.1  (0.02)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.03)
LSD 0.0* (0.01) 0.0* (0.00) 0.0* (0.01) 0.0* (0.00) 0.0  (0.01) 0.0  (0.02) **  (**) 0.0  (0.01) **  (**) 0.0  (0.01) 0.0  (0.01) 0.0  (0.02) 0.1  (0.02) 0.0  (0.01)
PCP 0.0  (0.01) **  (**) 0.0  (0.01) 0.0  (0.01) **  (**) 0.0  (0.01) **  (**) 0.0  (0.01) 0.0  (0.01) **  (**) 0.0  (0.01) 0.0  (0.01) **  (**) 0.0  (0.00)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.02)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.02)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4  (0.04)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 2.0  (0.09)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.3  (0.07)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5  (0.05)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4  (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.03)
Table A.5B – Heroin Use in the Past Year among Individuals Aged 12 or Older
Age 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOTAL 0.2* (0.02) 0.1* (0.02) 0.2* (0.02) 0.2* (0.02) 0.2  (0.03) 0.2* (0.02) 0.2* (0.02) 0.2  (0.03) 0.2  (0.03) 0.2  (0.03) 0.3  (0.03) 0.3  (0.03) 0.3  (0.03) 0.3  (0.03)
12-17 0.2* (0.04) 0.1  (0.03) 0.2* (0.04) 0.1  (0.03) 0.1  (0.03) 0.1  (0.02) 0.2  (0.04) 0.1  (0.03) 0.1  (0.03) 0.2* (0.05) 0.1  (0.04) 0.1  (0.03) 0.1  (0.03) 0.1  (0.03)
18-25 0.4* (0.05) 0.3* (0.04) 0.4* (0.05) 0.5  (0.06) 0.4  (0.06) 0.4  (0.06) 0.5  (0.06) 0.5  (0.06) 0.6  (0.07) 0.7  (0.07) 0.8  (0.08) 0.7  (0.08) 0.8  (0.09) 0.6  (0.08)
26 or Older 0.1* (0.03) 0.1* (0.02) 0.1* (0.03) 0.1* (0.02) 0.2  (0.04) 0.1* (0.03) 0.1* (0.03) 0.2  (0.04) 0.2  (0.04) 0.2* (0.03) 0.2* (0.04) 0.2  (0.03) 0.3  (0.03) 0.3  (0.04)
Table A.6B – Tobacco Product and Alcohol Use in the Past Month among Individuals Aged 12 or Older
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOBACCO PRODUCTS 30.4* (0.35) 29.8* (0.34) 29.2* (0.33) 29.4* (0.35) 29.6* (0.35) 28.7* (0.34) 28.4* (0.35) 27.7* (0.33) 27.5* (0.34) 26.5* (0.33) 26.7* (0.34) 25.5* (0.32) 25.2* (0.28) 23.9  (0.26)
Cigarettes 26.0* (0.34) 25.4* (0.33) 24.9* (0.32) 24.9* (0.32) 25.0* (0.33) 24.3* (0.33) 24.0* (0.32) 23.3* (0.32) 23.0* (0.31) 22.1* (0.32) 22.1* (0.32) 21.3* (0.30) 20.8* (0.26) 19.4  (0.25)
Daily Cigarette Smoking1 63.4* (0.66) 62.9* (0.67) 62.3* (0.63) 63.0* (0.62) 62.3* (0.59) 61.3* (0.65) 61.5* (0.70) 61.0* (0.68) 59.5  (0.71) 60.7* (0.71) 60.7* (0.71) 59.6  (0.73) 58.8  (0.59) 58.1  (0.64)
Smoked 1+ Packs of
   Cigarettes per Day2
53.1* (0.91) 53.5* (0.82) 54.0* (0.87) 51.4* (0.86) 50.6* (0.85) 50.9* (0.88) 49.2* (0.94) 45.9* (0.98) 45.1* (0.94) 43.8* (0.90) 42.0  (0.94) 41.3  (1.00) 40.3  (0.83) 41.1  (0.87)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc   3.4  (0.11)
Cigars   5.4* (0.15)   5.4* (0.14)   5.7* (0.13)   5.6* (0.15)   5.6* (0.14)   5.4* (0.14)   5.3* (0.15)   5.3* (0.14)   5.2* (0.14)   5.0  (0.14)   5.2* (0.15)   4.7  (0.14)   4.5  (0.11)   4.7  (0.12)
Pipe Tobacco   0.8  (0.07)   0.7* (0.06)   0.8  (0.06)   0.9  (0.06)   0.9  (0.07)   0.8  (0.07)   0.8  (0.06)   0.8  (0.06)   0.8  (0.06)   0.8  (0.06)   1.0  (0.07)   0.9  (0.06)   0.8  (0.05)   0.8  (0.05)
ALCOHOL 51.0  (0.42) 50.1* (0.39) 50.3* (0.40) 51.8  (0.40) 51.0  (0.39) 51.2  (0.41) 51.6  (0.39) 51.9  (0.38) 51.8  (0.39) 51.8  (0.39) 52.1  (0.39) 52.2  (0.41) 52.7* (0.33) 51.7  (0.32)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 24.9  (0.27)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   6.5  (0.14)
Table A.7B – Tobacco Product and Alcohol Use in the Past Month among Youths Aged 12 to 17
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOBACCO PRODUCTS 15.2* (0.33) 14.4* (0.32) 14.4* (0.32) 13.1* (0.31) 12.9* (0.29) 12.4* (0.30) 11.5* (0.28) 11.8* (0.29) 10.7* (0.28) 10.0* (0.27)   8.6* (0.25)   7.8* (0.24)   7.0* (0.25)   6.0  (0.23)
Cigarettes 13.0* (0.30) 12.2* (0.29) 11.9* (0.30) 10.8* (0.28) 10.4* (0.26)   9.9* (0.27)   9.2* (0.25)   9.0* (0.26)   8.4* (0.26)   7.8* (0.24)   6.6* (0.22)   5.6* (0.20)   4.9* (0.21)   4.2  (0.20)
Daily Cigarette Smoking1 31.8* (1.03) 29.7* (1.06) 27.6* (1.13) 25.8* (1.12) 26.5* (1.19) 26.4* (1.16) 22.3  (1.11) 23.0  (1.17) 22.5  (1.29) 22.7  (1.28) 22.0  (1.33) 19.4  (1.35) 24.1  (1.89) 20.0  (1.84)
Smoked 1+ Packs of
   Cigarettes per Day2
21.8* (1.61) 22.0* (1.68) 19.4* (1.80) 20.1* (1.87) 17.9* (1.94) 18.7* (2.14) 18.4* (2.08) 17.9* (2.12) 16.7* (2.24) 14.8* (1.97) 10.8  (1.88) 11.9  (2.47) 11.9  (2.52)   7.8  (2.51)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc   1.5  (0.10)
Cigars   4.5* (0.19)   4.5* (0.17)   4.8* (0.18)   4.2* (0.18)   4.1* (0.16)   4.3* (0.18)   3.8* (0.16)   4.0* (0.16)   3.2* (0.15)   3.4* (0.16)   2.6* (0.13)   2.3  (0.13)   2.1  (0.13)   2.1  (0.14)
Pipe Tobacco   0.6* (0.06)   0.6* (0.07)   0.7* (0.08)   0.6* (0.07)   0.7* (0.07)   0.7* (0.08)   0.7* (0.07)   0.9* (0.09)   0.6* (0.07)   0.7* (0.07)   0.7* (0.07)   0.6* (0.07)   0.7* (0.08)   0.3  (0.06)
ALCOHOL 17.6* (0.32) 17.7* (0.33) 17.6* (0.32) 16.5* (0.32) 16.7* (0.32) 16.0* (0.34) 14.7* (0.32) 14.8* (0.32) 13.6* (0.33) 13.3* (0.31) 12.9* (0.31) 11.6* (0.29) 11.5* (0.33)   9.6  (0.29)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   5.8  (0.23)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   0.9  (0.10)
Table A.8B – Tobacco Product and Alcohol Use in the Past Month among Young Adults Aged 18 to 25
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOBACCO PRODUCTS 45.3* (0.48) 44.8* (0.48) 44.6* (0.50) 44.3* (0.48) 44.0* (0.49) 41.9* (0.50) 41.4* (0.47) 41.6* (0.50) 40.9* (0.49) 39.5* (0.49) 38.1* (0.47) 37.0* (0.49) 35.0* (0.54) 33.0  (0.48)
Cigarettes 40.8* (0.48) 40.2* (0.47) 39.5* (0.49) 39.0* (0.47) 38.5* (0.48) 36.2* (0.49) 35.7* (0.45) 35.8* (0.48) 34.3* (0.47) 33.5* (0.47) 31.8* (0.47) 30.6* (0.46) 28.4* (0.53) 26.7  (0.46)
Daily Cigarette Smoking1 51.8* (0.72) 52.7* (0.69) 51.6* (0.72) 50.1* (0.73) 48.8* (0.77) 49.2* (0.76) 47.8* (0.81) 45.3* (0.80) 45.8* (0.80) 45.3* (0.86) 45.1* (0.88) 43.1  (0.83) 43.0  (0.91) 42.0  (1.02)
Smoked 1+ Packs of
   Cigarettes per Day2
39.1* (0.93) 37.1* (0.88) 34.9* (0.86) 36.9* (0.93) 34.4* (0.93) 32.9* (0.92) 31.6* (0.91) 29.5* (0.92) 27.3* (0.94) 26.1* (0.97) 25.1  (0.90) 22.3  (0.90) 22.5  (1.16) 22.5  (1.11)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc   5.4  (0.22)
Cigars 11.0* (0.27) 11.4* (0.26) 12.7* (0.30) 12.0* (0.28) 12.1* (0.29) 11.9* (0.28) 11.4* (0.29) 11.5* (0.29) 11.3* (0.30) 10.9* (0.29) 10.7* (0.27) 10.0* (0.29)   9.7* (0.30)   8.9  (0.27)
Pipe Tobacco   1.1* (0.08)   0.9* (0.08)   1.2* (0.09)   1.5  (0.11)   1.3* (0.10)   1.2* (0.10)   1.4* (0.10)   1.8  (0.12)   1.8  (0.12)   1.9  (0.14)   1.8  (0.11)   2.2* (0.14)   1.9  (0.13)   1.8  (0.13)
ALCOHOL 60.5* (0.53) 61.4* (0.50) 60.5* (0.51) 60.9* (0.51) 62.0* (0.51) 61.3* (0.52) 61.1* (0.49) 61.8* (0.52) 61.4* (0.50) 60.7* (0.54) 60.2* (0.49) 59.6  (0.53) 59.6  (0.56) 58.3  (0.53)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 39.0  (0.51)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 10.9  (0.33)
Table A.9B – Tobacco Product and Alcohol Use in the Past Month among Adults Aged 26 or Older
Substance 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOBACCO PRODUCTS 29.9* (0.44) 29.3* (0.41) 28.5* (0.41) 29.0* (0.43) 29.4* (0.43) 28.6* (0.42) 28.4* (0.44) 27.3* (0.40) 27.2* (0.42) 26.3* (0.41) 27.0* (0.42) 25.7* (0.40) 25.8* (0.33) 24.5  (0.32)
Cigarettes 25.2* (0.42) 24.7* (0.41) 24.1* (0.39) 24.3* (0.39) 24.7* (0.40) 24.1* (0.40) 23.8* (0.41) 23.0* (0.39) 22.8* (0.38) 21.9* (0.39) 22.4* (0.40) 21.6* (0.38) 21.5* (0.32) 20.0  (0.31)
Daily Cigarette Smoking1 68.8* (0.87) 68.0* (0.86) 67.8* (0.80) 68.9* (0.79) 67.9* (0.74) 66.3* (0.83) 67.0* (0.86) 67.2* (0.84) 64.8  (0.86) 66.5* (0.88) 66.0* (0.85) 64.9  (0.88) 63.3  (0.72) 62.7  (0.76)
Smoked 1+ Packs of
   Cigarettes per Day2
57.1* (1.12) 58.0* (0.99) 59.2* (1.05) 55.1* (1.02) 54.5* (1.00) 55.1* (1.06) 53.0* (1.10) 49.4* (1.16) 48.8* (1.09) 47.4* (1.05) 45.2  (1.09) 44.7  (1.15) 43.3  (0.93) 44.1  (0.98)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc   3.2  (0.13)
Cigars   4.6  (0.18)   4.5  (0.18)   4.6  (0.17)   4.7  (0.18)   4.6  (0.18)   4.4  (0.16)   4.4  (0.18)   4.4  (0.18)   4.4  (0.17)   4.2  (0.18)   4.5  (0.19)   4.1  (0.17)   3.9  (0.12)   4.3  (0.14)
Pipe Tobacco   0.8  (0.09)   0.6  (0.07)   0.7  (0.08)   0.8  (0.08)   0.9  (0.09)   0.8  (0.09)   0.6  (0.07)   0.7  (0.07)   0.7  (0.07)   0.7  (0.07)   0.9  (0.09)   0.7  (0.07)   0.7  (0.06)   0.8  (0.06)
ALCOHOL 53.9* (0.53) 52.5* (0.49) 53.0* (0.51) 55.1  (0.51) 53.7* (0.49) 54.1* (0.52) 54.7  (0.50) 54.9  (0.48) 54.9  (0.48) 55.1  (0.49) 55.6  (0.48) 55.9  (0.50) 56.5  (0.39) 55.6  (0.38)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 24.8  (0.32)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   6.4  (0.17)
Table A.10B – Type of Tobacco Product Use among Past Month Tobacco Users Aged 12 or Older
Tobacco Product Use Total 12 to 17 18 to 25 26 or Older
NOTE: Estimates shown are percentages with standard errors included in parentheses.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Cigarette Use Only 66.3  (0.60) 43.6  (2.06) 57.4  (0.83) 68.9  (0.70)
Cigarette Use Plus Some Other Type of Tobacco Product 15.0  (0.40) 26.0  (1.77) 23.6  (0.69) 12.7  (0.46)
Tobacco Product Use Other Than Cigarettes Only 18.8  (0.49) 30.3  (1.86) 19.0  (0.72) 18.4  (0.59)
Table A.11B – Alcohol Use in Past Month among Individuals Aged 12 to 20, by Gender
Alcohol Use/Gender 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
TOTAL                            
Alcohol 28.8* (0.39) 29.0* (0.41) 28.7* (0.39) 28.2* (0.41) 28.4* (0.42) 28.0* (0.46) 26.5* (0.40) 27.2* (0.43) 26.2* (0.41) 25.1* (0.47) 24.3* (0.48) 22.7* (0.40) 22.8* (0.46) 20.3  (0.42)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 13.4  (0.36)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   3.3  (0.20)
MALE                            
Alcohol 29.6* (0.52) 29.9* (0.53) 29.6* (0.55) 28.9* (0.53) 29.2* (0.54) 28.5* (0.57) 27.1* (0.53) 28.5* (0.58) 28.1* (0.55) 25.6* (0.54) 24.7* (0.61) 23.0* (0.51) 22.8* (0.60) 19.8  (0.53)
Binge Alcohol Use 21.8* (0.48) 21.7* (0.49) 22.1* (0.52) 21.3* (0.51) 21.3* (0.49) 21.2* (0.51) 19.3* (0.47) 20.6* (0.53) 19.7* (0.50) 17.5* (0.47) 16.5* (0.52) 15.8* (0.45) 15.4* (0.53) 13.4  (0.46)
Heavy Alcohol Use   8.1* (0.29)   7.9* (0.29)   8.2* (0.34)   7.6* (0.32)   7.9* (0.35)   7.8* (0.34)   7.0* (0.31)   7.0* (0.36)   6.7* (0.32)   5.6* (0.29)   5.2* (0.31)   4.6* (0.25)   4.3  (0.28)   3.6  (0.26)
FEMALE                            
Alcohol 28.0* (0.50) 28.1* (0.57) 27.8* (0.51) 27.5* (0.54) 27.5* (0.56) 27.4* (0.59) 25.8* (0.53) 25.8* (0.55) 24.0* (0.53) 24.6* (0.65) 24.0* (0.59) 22.5* (0.54) 22.9* (0.61) 20.8  (0.57)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 13.3  (0.48)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc   3.0  (0.24)
Table A.12B – Substance Use Disorder for Specific Substances in the Past Year among Individuals Aged 12 or Older
Past Year Use Disorder 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 2.9  (0.08)
Marijuana 1.8* (0.07) 1.8* (0.06) 1.9* (0.07) 1.7* (0.06) 1.7* (0.06) 1.6  (0.06) 1.7* (0.06) 1.7* (0.06) 1.8* (0.07) 1.6  (0.06) 1.7  (0.07) 1.6  (0.07) 1.6  (0.06) 1.5  (0.05)
Cocaine 0.6* (0.05) 0.6* (0.05) 0.7* (0.05) 0.6* (0.04) 0.7* (0.05) 0.6* (0.05) 0.6* (0.04) 0.4* (0.04) 0.4  (0.04) 0.3  (0.03) 0.4  (0.05) 0.3  (0.03) 0.3  (0.03) 0.3  (0.03)
Heroin 0.1* (0.02) 0.1* (0.02) 0.1* (0.02) 0.1* (0.01) 0.1* (0.03) 0.1* (0.02) 0.1* (0.02) 0.1* (0.03) 0.1* (0.02) 0.2  (0.02) 0.2  (0.03) 0.2  (0.02) 0.2  (0.02) 0.2  (0.02)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.01)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0  (0.01)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.3  (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0  (0.05)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.8  (0.04)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3  (0.02)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.02)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.01)
ALCOHOL 7.7* (0.18) 7.5* (0.16) 7.8* (0.17) 7.7* (0.16) 7.7* (0.17) 7.5* (0.17) 7.4* (0.16) 7.5* (0.17) 7.1* (0.16) 6.5* (0.15) 6.8* (0.16) 6.6* (0.16) 6.4* (0.14) 5.9  (0.13)
BOTH ILLICIT DRUGS
   AND ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0  (0.05)
ILLICIT DRUGS OR
   ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 7.8  (0.15)
Table A.13B – Substance Use Disorder for Specific Substances in the Past Year among Youths Aged 12 to 17
Past Year Use Disorder 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 3.4  (0.17)
Marijuana 4.3* (0.18) 3.8* (0.15) 3.9* (0.16) 3.6* (0.16) 3.4* (0.16) 3.1* (0.14) 3.4* (0.16) 3.4* (0.16) 3.6* (0.16) 3.5* (0.16) 3.2* (0.16) 2.9  (0.15) 2.7  (0.16) 2.6  (0.15)
Cocaine 0.4* (0.07) 0.3* (0.05) 0.4* (0.05) 0.4* (0.05) 0.4* (0.05) 0.4* (0.05) 0.3* (0.05) 0.2  (0.04) 0.1  (0.03) 0.2  (0.04) 0.2  (0.04) 0.1  (0.02) 0.1  (0.03) 0.1  (0.04)
Heroin 0.1  (0.02) 0.0  (0.01) 0.1  (0.03) 0.0  (0.01) 0.0  (0.01) 0.0  (0.01) 0.1  (0.02) 0.1  (0.02) 0.0  (0.01) 0.1* (0.04) 0.1  (0.03) 0.0  (0.02) 0.1  (0.03) 0.0  (0.01)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3  (0.06)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.04)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.1  (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9  (0.09)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5  (0.07)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3  (0.06)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.03)
ALCOHOL 5.9* (0.20) 5.9* (0.20) 6.0* (0.20) 5.5* (0.20) 5.4* (0.19) 5.4* (0.19) 4.9* (0.20) 4.6* (0.20) 4.6* (0.20) 3.8* (0.18) 3.4* (0.16) 2.8  (0.14) 2.7  (0.17) 2.5  (0.15)
BOTH ILLICIT DRUGS
   AND ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0  (0.10)
ILLICIT DRUGS OR
   ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 5.0  (0.20)
Table A.14B – Substance Use Disorder for Specific Substances in the Past Year among Young Adults Aged 18 to 25
Past Year Use Disorder 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc   7.2  (0.26)
Marijuana   6.0* (0.20)   5.9* (0.20)   6.0* (0.23)   5.9* (0.22)   5.7  (0.21)   5.6  (0.21)   5.6  (0.22)   5.6  (0.22)   5.7  (0.22)   5.7  (0.21)   5.5  (0.23)   5.4  (0.22)   4.9  (0.22)   5.1  (0.21)
Cocaine   1.2* (0.09)   1.2* (0.09)   1.4* (0.10)   1.5* (0.10)   1.3* (0.10)   1.4* (0.10)   1.2* (0.10)   0.9* (0.08)   0.7  (0.08)   0.6  (0.07)   0.6  (0.08)   0.7  (0.08)   0.5  (0.07)   0.7  (0.08)
Heroin   0.2* (0.04)   0.1* (0.03)   0.2* (0.04)   0.3* (0.04)   0.2* (0.04)   0.2* (0.04)   0.3  (0.05)   0.3  (0.05)   0.3  (0.05)   0.4  (0.06)   0.5  (0.06)   0.5  (0.07)   0.5  (0.07)   0.4  (0.06)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc   0.3  (0.05)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc   0.0  (0.02)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- --   0.4  (0.07)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc   2.0  (0.14)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc   1.2  (0.11)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc   0.7  (0.08)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc   0.5  (0.06)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc   0.1  (0.02)
ALCOHOL 17.7* (0.36) 17.2* (0.34) 17.4* (0.37) 17.5* (0.37) 17.6* (0.37) 16.9* (0.35) 17.4* (0.35) 16.1* (0.35) 15.7* (0.37) 14.4* (0.34) 14.3* (0.33) 13.0* (0.35) 12.3* (0.34) 10.9  (0.32)
BOTH ILLICIT DRUGS
   AND ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc   2.9  (0.16)
ILLICIT DRUGS OR
   ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 15.3  (0.37)
Table A.15B – Substance Use Disorder for Specific Substances in the Past Year among Adults Aged 26 or Older
Past Year Use Disorder 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 2.1  (0.09)
Marijuana 0.8  (0.07) 0.7  (0.06) 0.8  (0.07) 0.7  (0.06) 0.8  (0.07) 0.7  (0.07) 0.8  (0.06) 0.8  (0.07) 0.9  (0.08) 0.7  (0.06) 0.8  (0.07) 0.8  (0.08) 0.9  (0.06) 0.8  (0.05)
Cocaine 0.6* (0.06) 0.6* (0.06) 0.6* (0.06) 0.5* (0.05) 0.6* (0.07) 0.6* (0.06) 0.5* (0.05) 0.4  (0.05) 0.4  (0.05) 0.3  (0.04) 0.4  (0.06) 0.3  (0.04) 0.3  (0.04) 0.3  (0.04)
Heroin 0.1* (0.02) 0.1* (0.02) 0.1* (0.03) 0.1* (0.02) 0.1  (0.03) 0.1* (0.02) 0.1* (0.02) 0.1  (0.03) 0.1* (0.03) 0.1  (0.03) 0.1  (0.03) 0.2  (0.03) 0.2  (0.03) 0.2  (0.03)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0  (0.01)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0  (0.01)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.3  (0.04)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9  (0.06)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7  (0.05)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2  (0.03)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.02)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1  (0.01)
ALCOHOL 6.2* (0.22) 6.0* (0.20) 6.3* (0.21) 6.2* (0.19) 6.2* (0.20) 6.2* (0.20) 6.0* (0.19) 6.3* (0.20) 5.9  (0.20) 5.4  (0.18) 5.9* (0.19) 6.0* (0.19) 5.9  (0.16) 5.4  (0.15)
BOTH ILLICIT DRUGS
   AND ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7  (0.05)
ILLICIT DRUGS OR
   ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 6.9  (0.17)
Table A.16B – Need for and Receipt of Treatment for an Illicit Drug or Alcohol Problem in the Past Year among Individuals Aged 12 or Older
Demographic Characteristic Aged 12 or
Older,
Numbers1
Percentage
among
Individuals
Aged 12 or
Older2
Aged 12-17,
Numbers1
Percentage
among
Youths
Aged
12-172
Aged 18-25,
Numbers1
Percentage
among
Adults
Aged
18-252
Aged 26 or
Older,
Numbers1
Percentage
among
Adults
Aged 26 or
Older2
1 Estimates shown are numbers in thousands with standard errors included in parentheses.
2 Estimates shown are percentages with standard errors included in parentheses.
3 Respondents were classified as needing treatment for an illicit drug or alcohol problem if they met the criteria for illicit drug or alcohol use disorder as defined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) or received treatment for illicit drug or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or mental health center).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
Needed Treatment for Illicit Drug
   or Alcohol Problem3
21,664  (403)   8.1  (0.15) 1,266  (51) 5.1  (0.20) 5,422  (130) 15.5  (0.37) 14,976  (369)   7.2  (0.18)
Received Treatment for Illicit Drug
   or Alcohol Problem at a Specialty
   Facility among Individuals Who Needed
   Illicit Drug or Alcohol Use Treatment
  2,346  (136) 10.8  (0.58)      80  (12) 6.3  (0.96)    417    (38)   7.7  (0.67)   1,849  (128) 12.3  (0.78)
Table A.17B – Level of Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group
Mental Illness/Age Group 2008 2009 2010 2011 2012 2013 2014 2015
AMI = any mental illness; SMI = serious mental illness.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2015.
AMI 17.7  (0.30) 18.1  (0.31) 18.1  (0.30) 17.8  (0.30) 18.6  (0.31) 18.5  (0.31) 18.1  (0.23) 17.9  (0.25)
18-25 18.5* (0.34) 18.0* (0.32) 18.1* (0.35) 18.5* (0.37) 19.6* (0.35) 19.4* (0.36) 20.1* (0.39) 21.7  (0.38)
26-49 20.7  (0.42) 21.6  (0.43) 20.9  (0.42) 20.3  (0.43) 21.2  (0.44) 21.5  (0.45) 20.4  (0.34) 20.9  (0.34)
50 or Older 14.1  (0.59) 14.5  (0.54) 15.1  (0.55) 15.0  (0.53) 15.8* (0.55) 15.3* (0.52) 15.4* (0.40) 14.0  (0.42)
SMI   3.7  (0.14)   3.7  (0.14)   4.1  (0.16)   3.9  (0.14)   4.1  (0.14)   4.2  (0.16)   4.1  (0.12)   4.0  (0.12)
18-25   3.8* (0.16)   3.3* (0.15)   3.9* (0.17)   3.8* (0.17)   4.1* (0.17)   4.2* (0.18)   4.8  (0.21)   5.0  (0.21)
26-49   4.8  (0.21)   4.9  (0.22)   5.2  (0.23)   5.0  (0.22)   5.2  (0.23)   5.3  (0.25)   4.9  (0.18)   5.0  (0.18)
50 or Older   2.5  (0.24)   2.5  (0.23)   3.0  (0.27)   2.8  (0.22)   3.0  (0.25)   3.2  (0.26)   3.1  (0.19)   2.8  (0.20)
AMI EXCLUDING SMI 14.0  (0.27) 14.4  (0.27) 14.0  (0.27) 13.9  (0.26) 14.5  (0.28) 14.2  (0.27) 14.0  (0.21) 13.9  (0.22)
18-25 14.8* (0.31) 14.6* (0.29) 14.1* (0.31) 14.8* (0.33) 15.5* (0.33) 15.2* (0.33) 15.3* (0.35) 16.7  (0.36)
26-49 16.0  (0.38) 16.7  (0.38) 15.7  (0.37) 15.3  (0.37) 16.0  (0.38) 16.2  (0.40) 15.5  (0.29) 15.9  (0.30)
50 or Older 11.6  (0.54) 12.0  (0.50) 12.2  (0.49) 12.3  (0.48) 12.8* (0.50) 12.1  (0.48) 12.3* (0.37) 11.1  (0.37)
Table A.18B – Type of Mental Health Service Received in the Past Year among Adults Aged 18 or Older, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/Mental Health
Service Received1/Age Group
2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service use information were excluded.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Respondents could indicate multiple service sources; thus, these response categories are not mutually exclusive.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2015.
ANY MENTAL ILLNESS                
Mental Health Service Use 40.9  (0.93) 40.2* (0.86) 42.4  (0.89) 40.8* (0.82) 41.0  (0.82) 44.7  (0.91) 44.7  (0.72) 43.1  (0.72)
18-25 30.3  (0.94) 32.0  (0.97) 32.6  (0.93) 32.9  (0.98) 34.5  (0.96) 34.7* (0.98) 33.6  (1.05) 32.0  (0.91)
26-49 41.4  (1.09) 40.8  (1.10) 43.3  (1.07) 41.1  (1.09) 42.0  (1.10) 43.5  (1.15) 44.2  (0.83) 43.3  (0.89)
50 or Older 45.2  (2.26) 42.8* (1.92) 45.1  (1.93) 43.6* (1.75) 42.4* (1.67) 50.5  (1.95) 49.9  (1.48) 48.3  (1.54)
Inpatient   3.7  (0.51)   3.2  (0.29)   2.7* (0.25)   3.3  (0.31)   3.0  (0.28)   3.3  (0.29)   3.8  (0.26)   3.4  (0.26)
18-25   3.5  (0.39)   4.1  (0.45)   3.3  (0.35)   3.9  (0.40)   3.8  (0.39)   4.2  (0.40)   3.7  (0.37)   4.3  (0.42)
26-49   2.9  (0.38)   3.7  (0.43)   2.8  (0.38)   2.9  (0.38)   2.3  (0.30)   3.3  (0.37)   3.7  (0.34)   3.1  (0.31)
50 or Older   5.2  (1.42)   2.1  (0.50)   2.1  (0.44)   3.5  (0.63)   3.6  (0.65)   2.9  (0.60)   3.9  (0.56)   3.5  (0.59)
Outpatient 24.1  (0.78) 22.5* (0.74) 23.4* (0.78) 24.0  (0.74) 22.4* (0.68) 24.4  (0.84) 24.3  (0.61) 25.4  (0.63)
18-25 18.9  (0.80) 20.3  (0.80) 19.9  (0.82) 20.9  (0.84) 21.9  (0.84) 21.0  (0.82) 21.3  (0.92) 20.6  (0.82)
26-49 26.0  (0.89) 23.6* (0.90) 24.9  (0.92) 25.1  (0.98) 23.6* (0.89) 24.3  (0.99) 25.8  (0.71) 26.1  (0.77)
50 or Older 23.5  (1.85) 21.9* (1.63) 22.8  (1.63) 23.8  (1.60) 21.0* (1.40) 26.1  (1.83) 23.9  (1.26) 27.0  (1.41)
Prescription Medication 35.5  (0.91) 34.8  (0.82) 36.9  (0.90) 35.6  (0.82) 35.3  (0.79) 38.9  (0.91) 38.7* (0.71) 36.7  (0.71)
18-25 23.3  (0.84) 25.3  (0.88) 25.5  (0.89) 25.3  (0.92) 26.8* (0.88) 27.2* (0.90) 25.5  (1.00) 24.3  (0.85)
26-49 35.9  (1.07) 35.3  (1.08) 37.7  (1.07) 35.6  (1.05) 37.1  (1.10) 37.7  (1.11) 38.0  (0.81) 36.4  (0.86)
50 or Older 40.8  (2.25) 38.1* (1.84) 40.7  (1.94) 39.8  (1.77) 36.7* (1.65) 45.5  (1.92) 45.3  (1.46) 43.2  (1.49)
SERIOUS MENTAL ILLNESS                
Mental Health Service Use 65.7  (1.76) 66.5  (1.68) 67.5  (1.67) 64.9  (1.70) 62.9  (1.65) 68.5  (1.78) 68.5  (1.33) 65.3  (1.33)
18-25 45.9  (2.28) 55.0  (2.20) 53.7  (2.32) 52.1  (2.27) 53.1  (2.14) 54.0  (2.30) 53.9  (2.13) 50.7  (2.14)
26-49 67.2  (2.08) 64.5  (2.06) 67.4  (2.05) 63.6  (2.20) 63.5  (2.27) 68.4  (2.29) 66.2  (1.72) 66.1  (1.68)
50 or Older 73.2  (4.33) 76.1  (3.74) 74.0  (3.74) 73.2  (3.60) 66.3  (3.62) 74.9  (3.51) 79.2  (2.59) 72.2  (3.09)
Inpatient   8.6  (1.29)   8.6  (0.98)   6.7  (0.77)   8.8  (1.11)   6.2  (0.77)   8.3  (0.93)   8.8  (0.85)   7.0  (0.71)
18-25   7.9  (1.18) 11.4  (1.81)   8.1  (1.06)   8.0  (1.19)   8.5  (1.18) 10.3  (1.27)   8.2  (1.05)   8.9  (1.17)
26-49   6.9  (1.19)   9.7  (1.44)   7.0  (1.04)   8.0  (1.17)   4.8  (0.82)   8.4  (1.22)   8.0  (0.93)   7.3  (0.95)
50 or Older 12.4  (3.65)   4.9  (1.47)   5.5  (1.50) 10.8  (2.61)   7.3  (1.90)   7.3  (1.93) 10.2  (2.07)   5.5  (1.51)
Outpatient 46.2  (1.86) 44.6  (1.97) 42.5  (1.89) 44.1  (1.78) 39.0* (1.68) 46.9  (1.97) 44.2  (1.39) 43.6  (1.44)
18-25 33.0  (2.05) 38.6  (2.27) 36.2  (2.30) 37.2  (2.20) 35.8  (2.08) 37.3  (2.13) 39.2  (2.12) 36.0  (2.10)
26-49 48.2  (2.23) 43.8  (2.21) 42.9  (2.13) 42.8  (2.17) 40.3  (2.23) 47.1  (2.33) 43.8  (1.74) 44.8  (1.78)
50 or Older 49.0  (4.66) 49.0  (4.74) 44.6  (4.48) 49.7  (4.14) 38.2  (3.62) 50.7  (4.21) 47.3  (3.15) 46.0  (3.25)
Prescription Medication 59.7  (1.81) 61.1  (1.77) 61.0  (1.80) 58.2  (1.80) 57.8  (1.65) 62.1* (1.91) 61.4* (1.42) 57.3  (1.43)
18-25 35.9  (2.12) 43.4  (2.22) 44.0  (2.31) 41.0  (2.22) 45.5  (2.09) 46.2* (2.21) 42.4  (2.02) 40.0  (2.03)
26-49 60.1  (2.22) 59.5  (2.17) 61.2  (2.15) 57.2  (2.26) 58.7  (2.25) 60.7  (2.42) 60.1  (1.79) 58.2  (1.78)
50 or Older 71.5  (4.32) 72.6  (4.00) 68.4  (4.10) 68.1  (3.76) 61.9  (3.66) 71.3  (3.74) 72.9  (2.89) 65.6  (3.27)
Table A.19B – Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group
MDE/Age Group 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Impairment is based on the Sheehan Disability Scale (SDS) role domains, which measure the impact of a disorder on an adult's life. Impairment is defined as the highest severity level of role impairment across four domains: (1) home management, (2) work, (3) close relationships with others, and (4) social life. Ratings ≥ 7 on a 0 to 10 scale were considered Severe Impairment. Respondents with unknown impairment data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2005-2015.
MDE   6.6  (0.19)   6.5  (0.18)   6.7  (0.18)   6.5  (0.18)   6.6  (0.18)   6.8  (0.19)   6.6  (0.18)   6.9  (0.19)   6.7  (0.19)   6.6  (0.15)   6.7  (0.15)
18-25   8.8* (0.26)   8.1* (0.23)   8.0* (0.24)   8.4* (0.25)   8.0* (0.24)   8.3* (0.25)   8.3* (0.25)   8.9* (0.27)   8.7* (0.26)   9.3* (0.29) 10.3  (0.28)
26-49   7.6  (0.27)   7.7  (0.29)   7.6  (0.26)   7.4  (0.27)   7.6  (0.26)   7.5  (0.27)   7.7  (0.28)   7.6  (0.27)   7.6  (0.29)   7.2  (0.21)   7.5  (0.21)
50 or Older   4.5  (0.32)   4.5  (0.29)   5.2  (0.34)   4.8  (0.35)   4.9  (0.32)   5.6  (0.35)   4.8  (0.30)   5.5  (0.34)   5.1  (0.31)   5.2  (0.24)   4.8  (0.26)
MDE WITH SEVERE IMPAIRMENT1 -- -- -- --   4.0  (0.14)   4.2  (0.15)   4.2  (0.15)   4.5  (0.15)   4.3  (0.15)   4.3  (0.12)   4.3  (0.12)
18-25 -- -- -- --   5.2* (0.20)   5.2* (0.21)   5.2* (0.20)   5.8* (0.21)   5.7* (0.22)   6.0  (0.24)   6.5  (0.23)
26-49 -- -- -- --   4.8  (0.21)   4.7  (0.21)   5.2  (0.23)   5.1  (0.23)   4.9  (0.24)   4.6  (0.17)   4.9  (0.17)
50 or Older -- -- -- --   2.6  (0.23)   3.5  (0.28)   2.9  (0.24)   3.4  (0.28)   3.2  (0.25)   3.5  (0.21)   3.0  (0.21)
Table A.20B – Receipt of Treatment for Depression in the Past Year among Adults Aged 18 or Older with Major Depressive Episode (MDE) or MDE with Severe Impairment in the Past Year
MDE 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year treatment data, unknown past year MDE data, and/or past year impairment data were excluded.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Impairment is based on the Sheehan Disability Scale (SDS) role domains, which measure the impact of a disorder on an adult‘s life. Impairment is defined as the highest severity level of role impairment across four domains: (1) home management, (2) work, (3) close relationships with others, and (4) social life. Ratings ≥ 7 on a 0 to 10 scale were considered Severe Impairment. Respondents with unknown impairment data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2009-2015.
MDE 64.3  (1.31) 68.2  (1.25) 68.1  (1.24) 68.0  (1.24) 68.6  (1.22) 68.6  (1.03) 67.2  (1.08)
18-25 47.0  (1.57) 48.7  (1.57) 47.8  (1.64) 49.8  (1.52) 50.8  (1.50) 49.5  (1.64) 46.8  (1.58)
26-49 64.8  (1.72) 68.1  (1.69) 68.1  (1.74) 68.8  (1.75) 66.7  (1.80) 67.9  (1.36) 67.4  (1.36)
50 or Older 73.8  (2.83) 78.4  (2.55) 80.0  (2.50) 76.8  (2.52) 81.3  (2.64) 80.8  (2.04) 80.9  (2.32)
MDE WITH SEVERE IMPAIRMENT1 71.5  (1.49) 72.9  (1.47) 73.7  (1.44) 73.1  (1.47) 76.4* (1.36) 73.7  (1.19) 72.7  (1.22)
18-25 51.2  (1.95) 53.9  (1.94) 54.2  (2.08) 55.5  (1.89) 56.8  (1.80) 55.3  (2.02) 52.0  (1.98)
26-49 72.4  (1.97) 74.2  (1.89) 74.1  (1.96) 73.7  (2.14) 74.4  (2.12) 72.3  (1.68) 72.0  (1.63)
50 or Older 84.4  (3.20) 81.4  (3.01) 85.0  (3.00) 82.4  (2.91) 90.8  (2.48) 85.9  (2.17) 87.9  (2.26)
Table A.21B – Received Mental Health Services or Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older, by Substance Use Disorder (SUD) Status and Major Depressive Episode (MDE) Status and Age Group
Past Year SUD Status/MDE Status/
Age Group
Mental Health Service Use1 or
Substance Use Treatment at a
Specialty Facility
Mental Health Service Use1 but
Not Substance Use Treatment at a
Specialty Facility
Substance Use Treatment at a
Specialty Facility
but Not Mental Health Service
Use1
Mental Health Service Use1 and
Substance Use Treatment at a
Specialty Facility
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents with unknown information on mental health service use were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
SUD AND MDE 56.7  (2.24) 45.1  (2.26)   3.1  (0.69)   8.5  (1.15)
18-25 41.9  (2.77) 33.2  (2.58)   2.6  (0.98)   6.1  (1.26)
26-49 63.2  (2.88) 48.7  (3.00)   4.4  (1.18) 10.1  (1.77)
50 or Older       **  (**)       **  (**)       **  (**)       **  (**)
SUD AND NO MDE 22.5  (0.94) 16.1  (0.84)   3.9  (0.41)   2.5  (0.36)
18-25 16.5  (1.03) 11.1  (0.87)   3.1  (0.45)   2.3  (0.42)
26-49 22.9  (1.22) 15.5  (1.02)   4.7  (0.61)   2.7  (0.53)
50 or Older 28.3  (2.85) 22.7  (2.56)   3.1  (1.04)   2.5  (0.91)
MDE AND NO SUD 57.5  (1.31) 56.3  (1.31)   0.2  (0.07)   1.1  (0.31)
18-25 39.5  (1.61) 38.7  (1.59)   0.3  (0.19)   0.5  (0.28)
26-49 58.4  (1.59) 57.0  (1.59)   0.2  (0.13)   1.2  (0.44)
50 or Older 66.5  (2.86) 65.3  (2.87)       **  (**)   1.2  (0.66)
NO SUD AND NO MDE 10.7  (0.22) 10.4  (0.22)   0.2  (0.03)   0.1  (0.02)
18-25   7.8  (0.29)   7.6  (0.28)   0.1  (0.04)   0.1  (0.04)
26-49 11.5  (0.27) 11.0  (0.27)   0.3  (0.04)   0.1  (0.03)
50 or Older 10.8  (0.38) 10.6  (0.38)   0.2  (0.05)   0.0  (0.02)
Table A.22B – Level of Mental Illness in the Past Year among Adults Aged 18 or Older, by Past Year Substance Use Disorder Status and Age Group
Level of Mental Illness/SUD Status Total 18 to 25 26 to 49 50 or Older
AMI = any mental illness; SMI = serious mental illness, SUD = substance use disorder.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
AMI        
SUD 41.2  (0.97) 38.7  (1.16) 44.1  (1.32) 38.0  (2.81)
No SUD 15.8  (0.25) 18.6  (0.40) 18.3  (0.34) 12.9  (0.41)
SMI        
SUD 11.9  (0.59) 11.1  (0.74) 13.5  (0.84)   9.3  (1.57)
No SUD   3.3  (0.12)   3.9  (0.20)   4.0  (0.17)   2.6  (0.19)
AMI EXCLUDING SMI        
SUD 29.4  (0.89) 27.5  (1.10) 30.7  (1.24) 28.7  (2.57)
No SUD 12.5  (0.22) 14.7  (0.37) 14.3  (0.30) 10.4  (0.36)
Table A.23B – Substance Use Disorder in the Past Year among Adults Aged 18 or Older, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness Total 18 to 25 26 to 49 50 or Older
AMI = any mental illness; SMI = serious mental illness.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
AMI 18.6  (0.51) 27.2  (0.88) 20.8  (0.73) 11.3  (0.98)
SMI 23.8  (1.14) 33.8  (1.90) 26.7  (1.53) 13.6  (2.19)
AMI Excluding SMI 17.1  (0.57) 25.2  (0.99) 19.0  (0.83) 10.7  (1.07)
No Mental Illness   5.8  (0.15) 12.0  (0.39)   7.0  (0.25)   3.0  (0.21)
Table A.24B – Co-Occurring Substance Use Disorder and Mental Illness Status in the Past Year among Adults Aged 18 or Older, by Age Group
SUD and Mental Illness Total 18 to 25 26 to 49 50 or Older
AMI = any mental illness; SMI = serious mental illness, SUD = substance use disorder.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
SUD and AMI   3.3  (0.10)   5.9  (0.21)   4.3  (0.17)   1.6  (0.15)
SUD and SMI   1.0  (0.05)   1.7  (0.12)   1.3  (0.09)   0.4  (0.07)
SUD and AMI Excluding SMI   2.4  (0.09)   4.2  (0.19)   3.0  (0.14)   1.2  (0.13)
Table A.25B – Received Mental Health Services or Substance Use Treatment at a Specialty Facility in the Past Year among Adults Aged 18 or Older with Past Year Substance Use Disorder, by Past Year Level of Mental Illness and Age Group
Level of Mental Illness/Age Group Mental Health Service Use1
or Substance Use Treatment at
a Specialty Facility
Mental Health Service Use1
but Not Substance Use
Treatment at a Specialty
Facility1
Substance Use Treatment at
a Specialty Facility but Not
Mental Health Service Use1
Mental Health Service Use1
and Substance Use
Treatment at a Specialty
Facility
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents with unknown information on mental health service use were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
ANY MENTAL ILLNESS 48.0  (1.58) 36.7  (1.57)   4.4  (0.59)   6.8  (0.71)
18-25 35.2  (1.85) 26.5  (1.68)   3.1  (0.69)   5.4  (0.89)
26-49 50.5  (2.02) 37.6  (1.93)   5.3  (0.86)   7.6  (1.05)
50 or Older 57.1  (4.73) 46.8  (4.65)   3.6  (1.67)   6.6  (1.92)
SERIOUS MENTAL ILLNESS 62.6  (2.59) 47.4  (2.77)   4.2  (1.09) 11.0  (1.55)
18-25 53.1  (3.54) 41.6  (3.51)   2.2  (1.01)   9.3  (1.95)
26-49 68.0  (3.25) 49.0  (3.53)   6.6  (1.87) 12.4  (2.24)
50 or Older       **  (**)       **  (**)       **  (**)       **  (**)
Table A.26B – Major Depressive Episode (MDE), MDE with Severe Impairment in the Past Year, Co-Occurring Substance Use Disorder (SUD) and Past Year MDE, and Co-Occurring SUD and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17
MDE/Age Group 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
* Difference between estimate and 2015 estimate is statistically significant at the .05 level.
1 Impairment is based on the Sheehan Disability Scale (SDS) role domains, which measure the impact of a disorder on a youth's life. Impairment is defined as the highest severity level of role impairment across four domains: (1) chores at home, (2) school or work, (3) close relationships with family, and (4) social life. Ratings ≥ 7 on a 0 to 10 scale were considered Severe Impairment. Respondents with unknown impairment data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2004-2015.
MDE 9.0* (0.25) 8.8* (0.25) 7.9* (0.24) 8.2* (0.25) 8.3* (0.25) 8.1* (0.24) 8.0* (0.24) 8.2* (0.24) 9.1* (0.26) 10.7* (0.30) 11.4* (0.32) 12.5  (0.33)
MDE with Severe
   Impairment1
-- -- 5.5* (0.20) 5.5* (0.20) 6.0* (0.22) 5.8* (0.20) 5.7* (0.20) 5.7* (0.19) 6.3* (0.22)   7.7* (0.26)   8.2  (0.27)   8.8  (0.28)
MDE and SUD nc nc nc nc nc nc nc nc nc nc nc   1.4  (0.11)
MDE with Severe
   Impairment and SUD1
-- -- nc nc nc nc nc nc nc nc nc   1.2  (0.10)
Table A.27B – Receipt of Treatment for Depression in the Past Year among Youths Aged 12 to 17 with Major Depressive Episode (MDE) or MDE with Severe Impairment in the Past Year
MDE 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year treatment data, unknown past year MDE data, and/or past year impairment data were excluded.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Impairment is based on the Sheehan Disability Scale (SDS) role domains, which measure the impact of a disorder on a youth's life. Impairment is defined as the highest severity level of role impairment across four domains: (1) chores at home, (2) school or work, (3) close relationships with family, and (4) social life. Ratings ≥ 7 on a 0 to 10 scale were considered Severe Impairment. Respondents with unknown impairment data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2004-2015.
MDE 40.3  (1.38) 37.8  (1.42) 38.8  (1.60) 39.0  (1.52) 37.7  (1.48) 34.6* (1.52) 37.8  (1.51) 38.4  (1.47) 37.0  (1.34) 38.1  (1.35) 41.2  (1.42) 39.3  (1.40)
MDE with Severe
   Impairment1
-- -- 46.5  (1.95) 43.9  (1.90) 42.6  (1.73) 38.8* (1.83) 41.1  (1.80) 43.5  (1.79) 41.0  (1.66) 45.0  (1.61) 44.7  (1.67) 44.6  (1.63)
Table A.28B – Substance Use Disorder (SUD) and Past Year Major Depressive Episode (MDE) among Youths Aged 12 to 17, by SUD and MDE Status
Outcome SUD No SUD MDE No MDE
da = does not apply.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
SUD 100.0  (0.00) da   11.6  (0.86)     4.0  (0.21)
MDE   29.1  (2.04) 11.6  (0.33) 100.0  (0.00) da
Table A.29B – Received Mental Health Services or Substance Use Treatment at a Specialty Facility among Youths Aged 12 to 17, by Substance Use Disorder (SUD) Status and Major Depressive Episode (MDE) Status
Past Year SUD Status/MDE Status/
Age Group
Mental Health Service Use1 or
Substance Use Treatment at a
Specialty Facility
Mental Health Service Use1 but Not
Substance Use Treatment at a
Specialty Facility1
Substance Use Treatment at a
Specialty Facility
but Not Mental Health Service Use1
Mental Health Service Use1 and
Substance Use Treatment at a
Specialty Facility
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Respondents with unknown information on mental health service use were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
SUD and MDE 63.1  (3.80) 59.4  (3.87)       **  (**)   3.8  (1.29)
SUD and No MDE 33.0  (2.46) 29.2  (2.41)   1.3  (0.61)   2.4  (0.74)
MDE and No SUD 48.0  (1.50) 47.7  (1.50)   0.0  (0.01)   0.3  (0.13)
No SUD and No MDE 18.2  (0.42) 18.1  (0.42)   0.1  (0.02)   0.1  (0.02)
Table A.30B – Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17
Source of Mental Health
Service
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown receipt of mental health service information were excluded.
NOTE: Respondents could indicate multiple service sources; thus, these response categories are not mutually exclusive.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
1 Respondents who did not report their school enrollment status, who reported not being enrolled in school in the past 12 months, or who reported being home-schooled were not asked about receipt of mental health service use from this source; however, respondents who reported not being enrolled in school in the past 12 months were classified as not having received mental health services from this source.
2 These services were often provided by psychiatrists, psychologists, social workers, or counselors who work for the court system.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2015.
SPECIALTY MENTAL
HEALTH SERVICE
11.8* (0.28) 12.4* (0.28) 13.4  (0.31) 13.4  (0.30) 13.0  (0.29) 12.4  (0.31) 12.7  (0.29) 12.0* (0.30) 12.1* (0.30) 12.6  (0.31) 12.7  (0.28) 13.6  (0.32) 13.7  (0.34) 13.3  (0.32)
Outpatient 10.8* (0.27) 11.3  (0.27) 12.1  (0.30) 12.1  (0.29) 11.7  (0.29) 11.2* (0.29) 11.5  (0.29) 10.9* (0.29) 10.9* (0.28) 11.5  (0.30) 11.5  (0.27) 12.5  (0.31) 12.7  (0.33) 12.0  (0.31)
Inpatient or Residential
   (Overnight or Longer Stay)
  2.1* (0.12)   2.2* (0.13)   2.5  (0.14)   2.5  (0.14)   2.4  (0.14)   2.3  (0.13)   2.2* (0.13)   2.1* (0.13)   2.2* (0.13)   2.1* (0.13)   2.2* (0.13)   2.3  (0.14)   2.5  (0.15)   2.6  (0.15)
NONSPECIALTY SERVICE -- -- -- -- -- -- -- 14.2* (0.33) 14.5  (0.32) 14.2* (0.31) 15.0  (0.30) 15.0  (0.33) 15.4  (0.35) 15.2  (0.35)
Education1 -- -- -- -- -- -- -- 12.1* (0.30) 12.4  (0.29) 11.9* (0.28) 12.9  (0.29) 13.0  (0.32) 13.2  (0.33) 13.2  (0.34)
General Medicine                            
Pediatrician or Other Family
   Doctor
  2.7  (0.13)   2.9  (0.15)   3.4* (0.15)   3.2* (0.17)   2.8  (0.14)   2.8  (0.14)   2.9  (0.14)   2.5  (0.14)   2.5  (0.14)   2.5  (0.14)   2.5  (0.13)   2.8  (0.15)   2.9  (0.15)   2.7  (0.16)
Juvenile Justice                            
Juvenile Detention Center,
   Prison, or Jail2
-- -- -- -- -- -- --   0.4* (0.06)   0.3  (0.05)   0.4* (0.06)   0.3  (0.05)   0.2  (0.04)   0.3  (0.05)   0.2  (0.04)
Child Welfare                            
Foster Care or Therapeutic
   Foster Care
  0.6* (0.06)   0.7* (0.08)   0.6* (0.07)   0.6* (0.07)   0.5* (0.07)   0.5  (0.05)   0.5* (0.06)   0.4  (0.05)   0.4  (0.06)   0.6* (0.07)   0.4  (0.05)   0.4  (0.05)   0.4  (0.06)   0.3  (0.05)
SPECIALTY MENTAL
HEALTH SERVICES
AND EDUCATION,
GENERAL MEDICINE,
OR CHILD WELFARE
SERVICES1
-- -- -- -- -- -- --   5.0* (0.20)   5.3  (0.20)   5.4  (0.20)   5.7  (0.20)   6.1  (0.21)   5.9  (0.23)   5.7  (0.21)
Table A.31B – Reasons for Receiving Most Recent Mental Health Service in the Past Year among Youths Aged 12 to 17 Who Received Specialty Mental Health Services in the Past Year
Reason for Receipt of Mental Health Service1/Number of Visits Specialty Mental Health Service2
(2015)
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown receipt of mental health service information were excluded.
1 Respondents were asked the reasons for the last time they received mental health care from each of the reported mental health services and could indicate multiple reasons for the last time they received mental health care; thus, these response categories are not mutually exclusive.
2 Specialty Mental Health Services include mental health services received at either an outpatient or inpatient setting. Outpatient services include mental health services from a (1) private therapist, psychologist, psychiatrist, social worker, or counselor; (2) mental health clinic or center; (3) partial day hospital or day treatment program; or (4) in-home therapist, counselor, or family preservation worker. Inpatient services include mental health services from an overnight or longer stay in a (1) hospital or (2) residential treatment center.
3 The Received Mental Health Services row represents all youths who received mental health services regardless of whether a reason is known.
4 Respondent reported in the other-specify question that he or she has been diagnosed with a mental or neurological disorder as a reason for having received mental health services. This reason is one of the most commonly reported other reasons for having received mental health services.
5 Respondents with unknown or invalid responses to the other-specify question on Some Other Reason for receiving mental health services were classified as not having received mental health services for Some Other Reason.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
RECEIVED MENTAL HEALTH SERVICES3 13.3  (0.32)
Thought about Killing Self or Tried to Kill Self 31.3  (1.34)
Felt Depressed 58.4  (1.38)
Felt Very Afraid and Tense 28.6  (1.25)
Had Eating Problems 12.8  (0.93)
Had Other Diagnosed Mental/Neurological Disorder4   3.0  (0.46)
Broke Rules and "Acted Out" 19.8  (1.16)
Had Trouble Controlling Anger 15.1  (1.00)
Got into Physical Fights   3.6  (0.53)
Had Problems with Home/Family 25.0  (1.25)
Had Problems with Friends 11.6  (0.86)
Had Problems with People Other Than Family/Friends   9.3  (0.81)
Had Problems at School 19.2  (1.10)
Some Other Reason5 11.0  (0.89)
Table A.32B – Type of Treatment Received in the Past Year for Depression among Youths Aged 12 to 17 with a Past Year Major Depressive Episode (MDE)
Type of Treatment 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year treatment data and/or unknown past year MDE data were excluded.
* Difference between this estimate and the 2015 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2004-2015.
SAW OR TALKED TO A HEALTH
PROFESSIONAL OR USED
PRESCRIPTION MEDICATION
38.7  (1.35) 35.9  (1.40) 35.9  (1.54) 37.0  (1.51) 36.3  (1.45) 33.0* (1.51) 35.8  (1.48) 36.3  (1.45) 36.0  (1.35) 36.9  (1.35) 39.6  (1.42) 37.9  (1.37)
Saw or Talked to a Health Professional Only 19.3  (1.21) 18.6  (1.19) 20.9  (1.30) 18.6  (1.17) 20.2  (1.22) 18.5  (1.19) 19.4  (1.22) 19.9  (1.20) 19.6  (1.10) 20.4  (1.10) 20.0  (1.19) 19.8  (1.12)
Used Prescription Medication and Did Not See
   or Talk to a Health Professional
  3.4  (0.47)   2.7  (0.45)   2.4  (0.47)   2.7  (0.52)   3.0  (0.48)   2.4  (0.47)   3.0  (0.63)   2.6  (0.50)   2.4  (0.40)   3.7  (0.65)   2.8  (0.50)   2.9  (0.47)
Saw or Talked to a Health Professional and Used
   Prescription Medication
15.5  (1.03) 14.1  (1.02) 12.3  (0.98) 15.3  (1.10) 12.8  (1.00) 11.9* (0.99) 13.2  (0.95) 13.6  (0.97) 13.7  (0.97) 12.3* (0.86) 16.4  (1.07) 14.8  (0.94)
Table A.33B – Substance Use in the Past Year and Past Month among Youths Aged 12 to 17, by Past Year Major Depressive Episode (MDE)
Substance Total1 MDE No MDE
**Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
1 Estimates in the Total column represent all youths aged 12 to 17, including those with unknown past year MDE information.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2015.
PAST YEAR USE      
Illicit Drugs 17.5  (0.37) 31.5  (1.28) 15.3  (0.38)
Marijuana 12.6  (0.32) 22.3  (1.16) 11.1  (0.33)
Cocaine   0.6  (0.08)   1.1  (0.29)   0.5  (0.08)
Crack   0.0  (0.01)       **  (**)   0.0  (0.01)
Heroin   0.1  (0.03)   0.2  (0.09)   0.1  (0.03)
Hallucinogens   2.1  (0.15)   4.2  (0.58)   1.7  (0.15)
LSD   1.0  (0.10)   2.1  (0.42)   0.8  (0.11)
PCP   0.1  (0.04)   0.1  (0.06)   0.1  (0.05)
Ecstasy   0.8  (0.09)   1.5  (0.32)   0.7  (0.10)
Inhalants   2.7  (0.16)   6.4  (0.70)   2.2  (0.15)
Methamphetamine   0.2  (0.04)   0.5  (0.22)   0.1  (0.03)
Misuse of Psychotherapeutics   5.9  (0.23) 12.2  (0.91)   4.9  (0.23)
Pain Relievers   3.9  (0.19)   7.8  (0.75)   3.3  (0.19)
Tranquilizers   1.6  (0.13)   3.4  (0.45)   1.3  (0.14)
Stimulants   2.0  (0.14)   5.5  (0.67)   1.4  (0.13)
Sedatives   0.4  (0.06)   0.8  (0.24)   0.3  (0.06)
PAST MONTH USE      
Daily Cigarette Use   0.8  (0.09)   1.8  (0.40)   0.7  (0.08)
Heavy Alcohol Use   0.9  (0.10)   1.7  (0.40)   0.8  (0.10)

Appendix B: List of Contributors

This National Survey on Drug Use and Health (NSDUH) report was prepared by the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), and by RTI International (a registered trademark and a trade name of Research Triangle Institute), Research Triangle Park, North Carolina. Work by RTI was performed under Contract No. HHSS283201300001C.

This report was drafted by SAMHSA and reviewed at RTI. Production of the report at SAMHSA was managed by Rachel N. Lipari. SAMHSA contributors, listed alphabetically, include Rebecca Ahrnsbrak, Barbara Forsyth, Jonaki Bose, Sarra L. Hedden, Art Hughes, Joel Kennet, Rachel N. Lipari, Grace Medley, Dicy Painter, Eunice Park-Lee, Kathryn Piscopo, Peter Tice (Project Officer), and Matthew R. Williams.

Contributors and reviewers at RTI, listed alphabetically, include Kevin Adams, Jennifer Cooney, Elizabeth A. P. Copello, Misty S. Foster, Rebecca A. Granger, David Hunter (Project Director), Larry A. Kroutil, Dexter McNutt, Lisa E. Packer, Michael R. Pemberton, Jeremy D. Porter, Ana Saravia, and Kathryn Spagnola.

Also at RTI, report and web production staff, listed alphabetically, include Teresa F. Bass, Debbie F. Bond, Wallace A. Campbell, Kimberly H. Cone, Valerie Garner, August Gering, E. Andrew Jessup, Farrah Bullock Mann, Daniel Occoquan, Brenda K. Porter, Pamela Couch Prevatt, Margaret A. Smith, Richard S. Straw, and Pamela Tuck.

HHS Publication No. SMA 16-4984
2016
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
www.samhsa.gov


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Long Descriptions – Figures

Long description, Figure 1: Figure 1 is titled "Numbers of Past Month Illicit Drug Users among People Aged 12 or Older: 2015." It is a pie chart with an accompanying bar graph, where the pie chart shows the percentage and number of people with no past month illicit drug use and the percentage and number of people with past month illicit drug use. The bar graph breaks down the people with past month illicit drug use by showing the number of people in millions on the horizontal axis and 10 types of illicit drugs on the vertical axis. Two notes are below the figure, the first of which says, "Estimated numbers of people refer to people aged 12 or older in the civilian, noninstitutionalized population in the United States. The numbers do not sum to the total population of the United States because the population for NSDUH does not include people aged 11 years old or younger, people with no fixed household address (e.g., homeless or transient people not in shelters), active-duty military personnel, and residents of institutional group quarters, such as correctional facilities, nursing homes, mental institutions, and long-term care hospitals." The second note says, "The estimated numbers of current users of different illicit drugs are not mutually exclusive because people could have used more than one type of illicit drug in the past month."

For the pie chart, the number and percentage of people aged 12 or older with no past month illicit drug use in 2015 were 240.6 million people and 89.9 percent, respectively. The number and percentage of people with past month illicit drug use were 27.1 million people and 10.1 percent, respectively.

For the bar graph in descending order, of the 27.1 million people with past month illicit drug use in 2015:

The number of people who had used marijuana in the past month was 22.2 million.

The number of people who had misused prescription pain relievers in the past month was 3.8 million.

The number of people who had used cocaine in the past month was 1.9 million.

The number of people who had misused prescription tranquilizers in the past month was 1.9 million.

The number of people who had misused prescription stimulants in the past month was 1.7 million.

The number of people who had used hallucinogens in the past month was 1.2 million.

The number of people who had used methamphetamine in the past month was 0.9 million.

The number of people who had used inhalants in the past month was 0.5 million.

The number of people who had misused prescription sedatives in the past month was 0.4 million.

The number of people who had used heroin in the past month was 0.3 million.

Long description end. Return to Figure 1.

Long description, Figure 2: Figure 2 is titled "Past Month Illicit Drug Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month illicit drug use is shown on the vertical axis.

The percentage of people aged 12 or older who were past month illicit drug users was 10.1 percent.

The percentage of youths aged 12 to 17 who were past month illicit drug users was 8.8 percent.

The percentage of young adults aged 18 to 25 who were past month illicit drug users was 22.3 percent.

The percentage of adults aged 26 or older who were past month illicit drug users was 8.2 percent.

Long description end. Return to Figure 2.

Long description, Figure 3: Figure 3 is titled "Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month marijuana use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 3.

Long description, Figure 4: Figure 4 is titled "Past Month Misuse of Prescription Psychotherapeutics among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month misuse of prescription psychotherapeutic drugs is shown on the vertical axis.

The percentage of people aged 12 or older who were past month misusers of prescription psychotherapeutics was 2.4 percent.

The percentage of youths aged 12 to 17 who were past month misusers of prescription psychotherapeutics was 2.0 percent.

The percentage of young adults aged 18 to 25 who were past month misusers of prescription psychotherapeutics was 5.1 percent.

The percentage of adults aged 26 or older who were past month misusers of prescription psychotherapeutics was 2.0 percent.

Long description end. Return to Figure 4.

Long description, Figure 5: Figure 5 is titled "Misuse of Prescription Pain Relievers and Other Prescription Psychotherapeutics among People Aged 12 or Older Who Were Current Misusers of Any Prescription Psychotherapeutics: 2015." It is a pie chart, with the following written below the chart: "6.4 Million Current Misusers of Prescription Psychotherapeutics." The pie chart shows the number in millions and the percentage who were current misusers of prescription pain relievers, as well as the number in millions and the percentage who were current misusers of prescription psychotherapeutics excluding prescription pain relievers.

Of the 6.4 million current misusers of psychotherapeutic drugs in 2015, 3.8 million people (59.3 percent) were current misusers of prescription pain relievers, and 2.6 million (40.7 percent) were current misusers of prescription psychotherapeutics excluding prescription pain relievers.

Long description end. Return to Figure 5.

Long description, Figure 6: Figure 6 is titled "Past Month Misuse of Prescription Pain Relievers, Tranquilizers, Stimulants, and Sedatives among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the four categories of prescription drugs are shown on the horizontal axis and the percentage of people aged 12 or older using these drugs in the past month is shown on the vertical axis. The four categories of prescription drugs are (1) pain relievers, (2) tranquilizers, (3) stimulants, and (4) sedatives. For each type of prescription drug, the figure shows four bars representing four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older).

For prescription pain relievers in 2015, 1.4 percent of people aged 12 or older misused them, 1.1 percent of youths aged 12 to 17 misused them, 2.4 percent of young adults aged 18 to 25 misused them, and 1.3 percent of adults aged 26 or older misused them.

For prescription tranquilizers in 2015, 0.7 percent of people aged 12 or older misused them, 0.7 percent of youths aged 12 to 17 misused them, 1.7 percent of young adults aged 18 to 25 misused them, and 0.5 percent of adults aged 26 or older misused them.

For prescription stimulants in 2015, 0.6 percent of people aged 12 or older misused them, 0.5 percent of youths aged 12 to 17 misused them, 2.2 percent of young adults aged 18 to 25 misused them, and 0.4 percent of adults aged 26 or older misused them.

For prescription sedatives in 2015, 0.2 percent of people aged 12 or older misused them, 0.1 percent of youths aged 12 to 17 misused them, 0.2 percent of young adults aged 18 to 25 misused them, and 0.2 percent of adults aged 26 or older misused them.

Long description end. Return to Figure 6.

Long description, Figure 7: Figure 7 is titled "Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month cocaine use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 7.

Long description, Figure 8: Figure 8 is titled "Past Month Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month heroin use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. A note below the figure states, "Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent." Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 8.

Long description, Figure 9: Figure 9 is titled "Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past year heroin use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 9.

Long description, Figure 10: Figure 10 is titled "Past Month Hallucinogen Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month use of hallucinogens is shown on the vertical axis.

The percentage of people aged 12 or older who were past month hallucinogen users was 0.5 percent.

The percentage of youths aged 12 to 17 who were past month hallucinogen users was 0.5 percent.

The percentage of young adults aged 18 to 25 who were past month hallucinogen users was 1.8 percent.

The percentage of adults aged 26 or older who were past month hallucinogen users was 0.2 percent.

Long description end. Return to Figure 10.

Long description, Figure 11: Figure 11 is titled "Past Month Inhalant Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month use of inhalants is shown on the vertical axis.

The percentage of people aged 12 or older who were past month inhalant users was 0.2 percent.

The percentage of youths aged 12 to 17 who were past month inhalant users was 0.7 percent.

The percentage of young adults aged 18 to 25 who were past month inhalant users was 0.4 percent.

The percentage of adults aged 26 or older who were past month inhalant users was 0.1 percent.

Long description end. Return to Figure 11.

Long description, Figure 12: Figure 12 is titled "Past Month Methamphetamine Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month use of methamphetamine is shown on the vertical axis.

The percentage of people aged 12 or older who were past month methamphetamine users was 0.3 percent.

The percentage of youths aged 12 to 17 who were past month methamphetamine users was 0.1 percent.

The percentage of young adults aged 18 to 25 who were past month methamphetamine users was 0.4 percent.

The percentage of adults aged 26 or older who were past month methamphetamine users was 0.4 percent.

Long description end. Return to Figure 12.

Long description, Figure 13: Figure 13 is titled "Past Month Tobacco Use among People Aged 12 or Older: 2015." It is a pie chart with an accompanying bar graph, where the pie chart shows the percentage and number of people with no past month tobacco use and the percentage and number of people with past month tobacco use. The bar graph breaks down the people with past month tobacco use by showing the number of people in millions on the horizontal axis and four types of tobacco on the vertical axis. A note below the figure says, "The estimated numbers of current users of different tobacco products are not mutually exclusive because people could have used more than one type of tobacco product in the past month."

For the pie chart, the number and percentage of people aged 12 or older with no past month tobacco use in 2015 were 203.7 million people and 76.1 percent, respectively. The number and percentage of people with past month tobacco use were 64.0 million people and 23.9 percent, respectively.

For the bar graph in descending order, of the 64.0 million people with past month tobacco use in 2015:

The number of past month users for cigarettes was 52.0 million people.

The number of past month users for cigars was 12.5 million people.

The number of past month users for smokeless tobacco was 9.0 million people.

The number of past month users for pipe tobacco was 2.3 million people.

Long description end. Return to Figure 13.

Long description, Figure 14: Figure 14 is titled "Type of Past Month Tobacco Use among Current Tobacco Users Aged 12 or Older: Percentages, 2015." It is a pie chart that shows the percentages of people who used only cigarettes, cigarettes and some other type of tobacco product, and non-cigarette tobacco products. A note below the chart says, "The percentages do not add to 100 percent due to rounding."

Of the people who used tobacco products in the past month in 2015, 66.3 percent only used cigarettes, 15.0 percent used cigarettes and some other type of tobacco product, and 18.8 percent used non-cigarette tobacco products.

Long description end. Return to Figure 14.

Long description, Figure 15: Figure 15 is titled "Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month cigarette use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 15.

Long description, Figure 16: Figure 16 is titled "Daily Cigarette Use among Past Month Cigarette Smokers Aged 12 or Older and Smoking of One or More Packs of Cigarettes per Day among Current Daily Smokers: Percentages, 2015." It shows two connected pie charts. The pie chart on the left is the larger of the two. The larger pie chart shows the number in millions and the percentage who were less than daily smokers, as well as the number in millions and the percentage who were daily smokers. For daily smokers, the smaller pie chart shows the number in millions and the percentage who smoked less than a pack a day, as well as the number in millions and the percentage who smoked one or more packs per day. A note below the figure says, "Current daily smokers with unknown data about the number of cigarettes smoked per day were excluded from the pie graph on the right."

The larger pie chart shows the following: In 2015, 21.8 million people and 41.9 percent of past month smokers were less than daily smokers, and 30.2 million people and 58.1 percent of past month smokers were daily smokers.

The smaller pie chart shows the following: Of the daily smokers in 2015, 17.8 million people and 58.9 percent smoked less than a pack per day, and 12.4 million people and 41.1 percent smoked one or more packs per day.

Long description end. Return to Figure 16.

Long description, Figure 17: Figure 17 is titled "Smokers of One or More Packs of Cigarettes per Day among Past Month Daily Cigarette Smokers Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of smokers of one or more packs of cigarettes per day among past month daily cigarette smokers is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 17.

Long description, Figure 18: Figure 18 is titled "Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month cigar use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 18.

Long description, Figure 19: Figure 19 is titled "Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month pipe tobacco use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 19.

Long description, Figure 20: Figure 20 is titled "Past Month Smokeless Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past month use of smokeless tobacco is shown on the vertical axis.

The percentage of people aged 12 or older who were past month smokeless tobacco users was 3.4 percent.

The percentage of youths aged 12 to 17 who were past month smokeless tobacco users was 1.5 percent.

The percentage of young adults aged 18 to 25 who were past month smokeless tobacco users was 5.4 percent.

The percentage of adults aged 26 or older who were past month smokeless tobacco users was 3.2 percent.

Long description end. Return to Figure 20.

Long description, Figure 21: Figure 21 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 or Older: 2015." It is a three-circle diagram, where the smallest inner circle represents the number in millions of people who were heavy alcohol users. The smallest inner circle for heavy alcohol users is entirely inside of the second smallest inner circle, which represents the number in millions of people who were binge alcohol users. The second smallest inner circle for binge alcohol users is entirely inside of the largest circle, which represents the number in millions of people who were current alcohol users (i.e., past month drinkers). Thus, all heavy alcohol users are both binge alcohol users and current alcohol users, and all binge alcohol users are current alcohol users. In addition, the area within the second smallest inner circle but outside of the smallest inner circle represents people who were binge alcohol users but not heavy alcohol users. Also, the area within the largest circle but outside the second smallest inner circle represents people who were current alcohol users but not binge alcohol users. A note below the figure says, "In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion."

Of the 138.3 million people aged 12 or older in 2015 who were current alcohol users, 66.7 million were binge alcohol users, who made up 48.2 percent of all current alcohol users. There were 17.3 million people aged 12 or older who were heavy alcohol users, who made up 26.0 percent of all binge alcohol users and 12.5 percent of all current alcohol users.

Long description end. Return to Figure 21.

Long description, Figure 22: Figure 22 is titled "Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month alcohol use is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 22.

Long description, Figure 23: Figure 23 is titled "Past Month Binge and Heavy Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older) are shown on the horizontal axis and the percentage of people who were binge and heavy alcohol users in the past month is shown on the vertical axis. For each age group, the figure shows a bar representing binge alcohol use and a bar representing heavy alcohol use. A note below the figure says, "In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion."

Among people aged 12 or older in 2015, 24.9 percent were binge alcohol users, and 6.5 percent were heavy alcohol users.

Among youths aged 12 to 17 in 2015, 5.8 percent were binge alcohol users, and 0.9 percent were heavy alcohol users.

Among young adults aged 18 to 25 in 2015, 39.0 percent were binge alcohol users, and 10.9 percent were heavy alcohol users.

Among adults aged 26 or older in 2015, 24.8 percent were binge alcohol users, and 6.4 percent were heavy alcohol users.

Long description end. Return to Figure 23.

Long description, Figure 24: Figure 24 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: 2015." It is a three-circle diagram, where the smallest inner circle represents the number in millions of people who were heavy alcohol users. The smallest inner circle for heavy alcohol users is entirely inside of the second smallest inner circle, which represents the number in millions of people who were binge alcohol users. The second smallest inner circle for binge alcohol users is entirely inside of the largest circle, which represents the number in millions of people who were current alcohol users (i.e., past month drinkers). Thus, all heavy alcohol users are both binge alcohol users and current alcohol users, and all binge alcohol users are current alcohol users. In addition, the area within the second smallest inner circle but outside of the smallest inner circle represents people who were binge alcohol users but not heavy alcohol users. Also, the area within the largest circle but outside the second smallest inner circle represents people who were current alcohol users but not binge alcohol users. A note below the figure says, "In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion."

Of the 7.7 million people aged 12 to 20 in 2015 who were current alcohol users, 5.1 million were binge alcohol users, who made up 65.7 percent of all current alcohol users. There were 1.3 million people aged 12 to 20 who were heavy alcohol users, who made up 24.9 percent of all binge alcohol users and 16.4 percent of all current alcohol users.

Long description end. Return to Figure 24.

Long description, Figure 25: Figure 25 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: Percentages, 2015." It is a bar graph, where the types of alcohol use (current, binge, and heavy) are shown on the horizontal axis and the percentage for past month use of alcohol is shown on the vertical axis. A note below the figure says, "In 2015, the threshold for determining binge alcohol use for females changed from five or more drinks on an occasion to four or more drinks on an occasion."

The percentage of past month current alcohol use among people aged 12 to 20 was 20.3 percent.

The percentage of past month binge alcohol use among people aged 12 to 20 was 13.4 percent.

The percentage of past month heavy alcohol use among people aged 12 to 20 was 3.3 percent.

Long description end. Return to Figure 25.

Long description, Figure 26: Figure 26 is titled "Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past month current alcohol use is shown on the vertical axis. A line shows current alcohol use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 26.

Long description, Figure 27: Figure 27 is titled "Numbers of People Aged 12 or Older with a Past Year Substance Use Disorder: 2015." It is a pie chart with an accompanying bar graph, where the pie chart shows the percentage and number of people with no past year substance use disorder and the percentage and number of people with a past year substance use disorder. The bar graph breaks down the people with a past year substance use disorder by showing the number of people in millions on the horizontal axis and eight types of substances on the vertical axis. Two notes are below the figure, the first of which says, "Estimated numbers of people refer to people aged 12 or older in the civilian, noninstitutionalized population in the United States. The numbers do not sum to the total population of the United States because the population for NSDUH does not include people aged 11 years old or younger, people with no fixed household address (e.g., homeless or transient people not in shelters), active-duty military personnel, and residents of institutional group quarters, such as correctional facilities, nursing homes, mental institutions, and long-term care hospitals." The second note says, "The estimated numbers of people with substance use disorders are not mutually exclusive because people could have use disorders for more than one substance."

For the pie chart, the number and percentage of people aged 12 or older with no past year substance use disorder in 2015 were 246.9 million people and 92.2 percent, respectively. The number and percentage of people with a past year substance use disorder were 20.8 million people and 7.8 percent, respectively.

For the bar graph in descending order, of the 20.8 million people with a past year substance use disorder in 2015:

The number of people who had an alcohol use disorder in the past year was 15.7 million.

The number of people who had an illicit drug use disorder in the past year was 7.7 million.

The number of people who had a marijuana use disorder in the past year was 4.0 million.

The number of people who had a prescription pain reliever disorder in the past year was 2.0 million.

The number of people who had a cocaine use disorder in the past year was 0.9 million.

The number of people who had a methamphetamine use disorder in the past year was 0.9 million.

The number of people who had a heroin use disorder in the past year was 0.6 million.

The number of people who had a prescription stimulant disorder in the past year was 0.4 million.

Long description end. Return to Figure 27.

Long description, Figure 28: Figure 28 is titled "Alcohol Use Disorder and Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older with a Past Year Substance Use Disorder (SUD): 2015." It is a Venn diagram with the following written below the diagram: "20.8 Million People Aged 12 or Older with Past Year SUDs." The Venn diagram shows overlapping larger and smaller circles. The larger circle on the left represents the people who had a past year alcohol use disorder. The smaller circle on the right represents people who had a past year illicit drug use disorder. The intersection of the two circles represents people who had both a past year alcohol use disorder and a past year illicit drug use disorder. In addition, the area of the larger circle that does not intersect with the smaller circle represents people who had an alcohol use disorder only. Also, the area of the smaller circle that does not intersect with the larger circle represents people who had an illicit drug use disorder only.

Of the 20.8 million people aged 12 or older in 2015 with past year SUDs, 15.7 million had an alcohol use disorder, which was 75.6 percent of the people with an SUD. There were 7.7 million people who had an illicit drug use disorder, which was 37.2 percent of the people with an SUD. There also were 2.7 million people who had both alcohol and illicit drug use disorders, which was 12.8 percent of the people with SUDs. In addition, 13.1 million people had an alcohol use disorder only, and 5.1 million people had an illicit drug use disorder only.

Long description end. Return to Figure 28.

Long description, Figure 29: Figure 29 is titled "Substance Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past year substance use disorder is shown on the vertical axis.

The percentage of people aged 12 or older who had a substance use disorder in the past year was 7.8 percent.

The percentage of youths aged 12 to 17 who had a substance use disorder in the past year was 5.0 percent.

The percentage of young adults aged 18 to 25 who had a substance use disorder in the past year was 15.3 percent.

The percentage of adults aged 26 or older who had a substance use disorder in the past year was 6.9 percent.

Long description end. Return to Figure 29.

Long description, Figure 30: Figure 30 is titled "Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past year alcohol use disorder is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 30.

Long description, Figure 31: Figure 31 is titled "Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past year illicit drug use disorder is shown on the vertical axis.

The percentage of people aged 12 or older who had an illicit drug use disorder in the past year was 2.9 percent.

The percentage of youths aged 12 to 17 who had an illicit drug use disorder in the past year was 3.4 percent.

The percentage of young adults aged 18 to 25 who had an illicit drug use disorder in the past year was 7.2 percent.

The percentage of adults aged 26 or older who had an illicit drug use disorder in the past year was 2.1 percent.

Long description end. Return to Figure 31.

Long description, Figure 32: Figure 32 is titled "Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past year marijuana use disorder is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 32.

Long description, Figure 33: Figure 33 is titled "Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past year cocaine use disorder is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 33.

Long description, Figure 34: Figure 34 is titled "Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage for past year heroin use disorder is shown on the vertical axis. For each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older), there is a line showing use over the years 2002 through 2015. A note below the figure states, "Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent." Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 34.

Long description, Figure 35: Figure 35 is titled "Pain Reliever Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2015." It is a bar graph, where the age groups are shown on the horizontal axis and the percentage for past year pain reliever use disorder is shown on the vertical axis.

The percentage of people aged 12 or older who had a pain reliever use disorder in the past year was 0.8 percent.

The percentage of youths aged 12 to 17 who had a pain reliever use disorder in the past year was 0.5 percent.

The percentage of young adults aged 18 to 25 who had a pain reliever use disorder in the past year was 1.2 percent.

The percentage of adults aged 26 or older who had a pain reliever use disorder in the past year was 0.7 percent.

Long description end. Return to Figure 35.

Long description, Figure 36: Figure 36 is titled "Need for Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of people in thousands, the horizontal axis on the right shows the percentages that correspond to the number of people, and the shared vertical axis shows the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older).

There were 21,664,000 people aged 12 or older in 2015 who needed substance use treatment in the past year, or 8.1 percent of those 12 or older.

There were 1,266,000 youths aged 12 to 17 who needed substance use treatment in the past year, or 5.1 percent of youths.

There were 5,422,000 young adults aged 18 to 25 who needed substance use treatment in the past year, or 15.5 percent of young adults.

There were 14,976,000 adults aged 26 or older who needed substance use treatment in the past year, or 7.2 percent of those 26 or older.

Long description end. Return to Figure 36.

Long description, Figure 38: Figure 38 is titled "Received Specialty Substance Use Treatment in the Past Year among People Aged 12 or Older Who Needed Substance Use Treatment in the Past Year, by Age Group: 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of people in thousands, the horizontal axis on the right shows the percentages that correspond to the number of people, and the shared vertical axis shows the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older).

Among those who needed substance use treatment in the past year:

There were 2,346,000 people aged 12 or older in 2015 who received specialty substance use treatment in the past year, or 10.8 percent of those 12 or older.

There were 80,000 youths aged 12 to 17 who received specialty substance use treatment in the past year, or 6.3 percent of youths.

There were 417,000 young adults aged 18 to 25 who received specialty substance use treatment in the past year, or 7.7 percent of young adults.

There were 1,849,000 adults aged 26 or older who received specialty substance use treatment in the past year, or 12.3 percent of those 26 or older.

Long description end. Return to Figure 38.

Long description, Figure 39: Figure 39 is titled "Any Mental Illness (AMI), Serious Mental Illness (SMI), and AMI Excluding SMI in the Past Year among Adults Aged 18 or Older: 2015." It is a pie chart, with the following written below the chart: "43.4 Million Adults with AMI in the Past Year (17.9% of All Adults)." The pie chart shows the number in millions and the percentage of all adults who had AMI excluding SMI in the past year, as well as the number in millions and the percentage of all adults who had SMI in the past year. The pie chart also shows the percentages of adults with AMI within each of these two categories.

Of the 43.4 million adults in 2015 with AMI in the past year, 33.7 million adults had AMI excluding SMI. This represents 13.9 percent of all adults and 77.5 percent of adults with AMI. Also, 9.8 million adults had SMI, which represents 4.0 percent of all adults and 22.5 percent of adults with AMI.

Long description end. Return to Figure 39.

Long description, Figure 40: Figure 40 is titled "Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with any mental illness in the past year is shown on the vertical axis. For each of the four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older), there is a line showing the percentage with any mental illness over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 40.

Long description, Figure 41: Figure 41 is titled "Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with serious mental illness in the past year is shown on the vertical axis. For each of the four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older), there is a line showing the percentage with serious mental illness over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 41.

Long description, Figure 42: Figure 42 is titled "Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with any mental illness excluding serious mental illness in the past year is shown on the vertical axis. For each of the four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older), there is a line showing the percentage with any mental illness excluding serious mental illness over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 42.

Long description, Figure 43: Figure 43 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage receiving mental health services in the past year is shown on the vertical axis. For each of the four types of mental health services (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage receiving mental health services over the years 2002 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 43.

Long description, Figure 44: Figure 44 is titled "Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with any mental illness receiving mental health care in the past year is shown on the vertical axis. For each of the four types of mental health care (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage with any mental illness receiving mental health care over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 44.

Long description, Figure 45: Figure 45 is titled "Type of Mental Health Care Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with serious mental illness receiving mental health care in the past year is shown on the vertical axis. For each of the four types of mental health care (any mental health services, inpatient, outpatient, and prescription medication), there is a line showing the percentage with serious mental illness receiving mental health care over the years 2008 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 45.

Long description, Figure 46: Figure 46 is titled "Past Year Substance Use Disorder (SUD) and Mental Illness among Adults Aged 18 or Older: 2015." It is a Venn diagram that shows overlapping larger and smaller circles. The smaller circle on the left represents adults who had an SUD in the past year. The larger circle on the right represents adults who had mental illness in the past year. The intersection of the two circles represents adults who had both an SUD and mental illness. In addition, the area of the smaller circle that does not intersect with the larger circle represents adults who had an SUD but no mental illness. Also, the area of the larger circle that does not intersect with the smaller circle represents adults who had mental illness but no SUD.

The number of adults aged 18 or older in 2015 with a past year SUD was 19.6 million, including 11.5 million with an SUD and no mental illness. The number of adults who had mental illness was 43.4 million, including 35.4 million with a mental illness and no SUD. There were 8.1 million adults who had both an SUD and mental illness.

Long description end. Return to Figure 46.

Long description, Figure 47: Figure 47 is titled "Past Year Substance Use Disorder among Adults Aged 18 or Older with Any Mental Illness in the Past Year, by Age Group: 2015." It is a bar graph, where four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older) are shown on the horizontal axis and the percentage with substance use disorder in the past year is shown on the vertical axis.

The percentage of adults aged 18 or older with any mental illness in the past year who also had substance use disorder in the past year was 18.6 percent.

The percentage of adults aged 18 to 25 with any mental illness in the past year who also had substance use disorder in the past year was 27.2 percent.

The percentage of adults aged 26 to 49 with any mental illness in the past year who also had substance use disorder in the past year was 20.8 percent.

The percentage of adults aged 50 or older with any mental illness in the past year who also had substance use disorder in the past year was 11.3 percent.

Long description end. Return to Figure 47.

Long description, Figure 48: Figure 48 is titled "Past Year Substance Use Disorder (SUD) and Serious Mental Illness (SMI) among Adults Aged 18 or Older: 2015." It is a Venn diagram that shows overlapping larger and smaller circles. The larger circle on the left represents adults who had an SUD in the past year. The smaller circle on the right represents adults who had SMI in the past year. The intersection of the two circles represents adults who had both an SUD and SMI. In addition, the area of the larger circle that does not intersect with the smaller circle represents adults who had an SUD but no SMI. Also, the area of the smaller circle that does not intersect with the larger circle represents adults who had SMI but no SUD.

The number of adults aged 18 or older in 2015 with a past year SUD was 19.6 million, including 17.3 million who had an SUD and no SMI. The number of adults who had SMI was 9.8 million, including 7.4 million who had SMI and no SUD. There were 2.3 million adults who had both an SUD and SMI.

Long description end. Return to Figure 48.

Long description, Figure 49: Figure 49 is titled "Past Year Substance Use Disorder among Adults Aged 18 or Older with Serious Mental Illness in the Past Year, by Age Group: 2015." It is a bar graph, where four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older) are shown on the horizontal axis and the percentage with substance use disorder in the past year is shown on the vertical axis.

The percentage of adults aged 18 or older with serious mental illness in the past year who also had substance use disorder in the past year was 23.8 percent.

The percentage of adults aged 18 to 25 with serious mental illness in the past year who also had substance use disorder in the past year was 33.8 percent.

The percentage of adults aged 26 to 49 with serious mental illness in the past year who also had substance use disorder in the past year was 26.7 percent.

The percentage of adults aged 50 or older with serious mental illness in the past year who also had substance use disorder in the past year was 13.6 percent.

Long description end. Return to Figure 49.

Long description, Figure 50: Figure 50 is titled "Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Mental Illness and Substance Use Disorders: Percentages, 2015. It is a pie chart, with the following written below the chart: "8.1 Million Adults with Co-Occurring Mental Illness and Substance Use Disorders." Also, two notes are below the figure, the first of which says, "Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use." The second note says, "The percentages do not add to 100 percent due to rounding." The pie chart shows the percentage of adults for each type of mental health care and specialty substance use treatment.

Of the 8.1 million adults with co-occurring mental illness and substance use disorders, 52.0 percent had no treatment, 36.7 percent had mental health care only, 4.4 percent had specialty substance use treatment only, and 6.8 percent had mental health care and specialty substance use treatment.

Long description end. Return to Figure 50.

Long description, Figure 51: Figure 51 is titled "Receipt of Mental Health Care and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older Who Had Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2015. It is a pie chart, with the following written below the chart: "2.3 Million Adults with Co-Occurring Serious Mental Illness and Substance Use Disorders." Also, a note below the chart says, "Mental health care is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health. Specialty substance use treatment refers to treatment at a hospital (inpatient only), rehabilitation facility (inpatient or outpatient), or mental health center in order to reduce or stop drug or alcohol use, or for medical problems associated with drug or alcohol use." The pie chart shows the percentage of adults for each type of mental health care and specialty substance use treatment.

Of the 2.3 million adults with co-occurring serious mental illness and substance use disorders, 37.4 percent had no treatment, 47.4 percent had mental health care only, 4.2 percent had specialty substance use treatment only, and 11.0 percent had mental health care and specialty substance use treatment.

Long description end. Return to Figure 51.

Long description, Figure 52: Figure 52 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Adults Aged 18 or Older: 2015." It is a pie chart, with the following written below the chart: "16.1 Million Adults with a Past Year MDE (6.7% of All Adults)." Also, a note below the chart says, "Adult respondents with unknown past year MDE data or unknown impairment data were excluded." The pie chart shows the number in millions and the percentage of adults who had an MDE with severe impairment in the past year, as well as the number in millions and the percentage of adults who had an MDE without severe impairment in the past year. The pie chart also shows the percentages of adults who had an MDE within each of these two categories.

Of the 16.1 million adults with an MDE in the past year, 10.3 million adults had an MDE with severe impairment. This represents 4.3 percent of all adults and 64.0 percent of adults with an MDE. Also, 5.8 million adults had an MDE without severe impairment, which represents 2.4 percent of all adults and 36.0 percent of adults with an MDE.

Long description end. Return to Figure 52.

Long description, Figure 53: Figure 53 is titled "Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults with a major depressive episode in the past year is shown on the vertical axis. For each of the four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older), there is a line showing the percentage with a major depressive episode over the years 2005 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 53.

Long description, Figure 54: Figure 54 is titled "Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults with a major depressive episode with severe impairment in the past year is shown on the vertical axis. For each of the four age groups (18 or older, 18 to 25, 26 to 49, and 50 or older), there is a line showing the percentage with a major depressive episode with severe impairment over the years 2009 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 54.

Long description, Figure 55: Figure 55 is titled "Received Treatment in the Past Year for Depression among Adults Aged 18 or Older with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults who received treatment for depression is shown on the vertical axis. One line shows the percentage with a major depressive episode who received treatment for depression, and the other line shows the percentage with a major depressive episode with severe impairment who received treatment for depression over the years 2009 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 55.

Long description, Figure 56: Figure 56 is titled "Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: Percentages and Numbers (in Thousands), 2015." It consists of two bar graphs with two horizontal axes and one shared vertical axis. The horizontal axis on the left shows the number of youths in thousands. The horizontal axis on the right shows the percentages that correspond to the number of youths. The shared vertical axis shows six sources of mental health services: (1) specialty mental health setting, (2) education setting, (3) general medical setting, (4) child welfare setting, (5) juvenile justice setting, and (6) specialty and nonspecialty settings. A note below the figure says, "Nonspecialty settings do not include youths who received mental health care in the past year from a juvenile justice setting."

There were 3,253,000 youths aged 12 to 17 in 2015 who received mental health services in a specialty mental health setting in the past year, or 13.3 percent of youths.

There were 3,206,000 youths who received mental health services in an education setting in the past year, or 13.2 percent of youths.

There were 668,000 youths who received mental health services in a general medical setting in the past year, or 2.7 percent of youths.

There were 79,000 youths who received mental health services in a child welfare setting in the past year, or 0.3 percent of youths.

There were 53,000 youths who received mental health services in a juvenile justice setting in the past year, or 0.2 percent of youths.

There were 1,408,000 youths who received mental health services in both specialty and nonspecialty settings in the past year, or 5.7 percent of youths.

Long description end. Return to Figure 56.

Long description, Figure 57: Figure 57 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: 2015." It is a pie chart, with the following written below the chart: "3.0 Million Youths with a Past Year MDE (12.5% of All Youths)." Also, a note below the figure says, "Youth respondents with unknown past year MDE data or unknown impairment data were excluded." The pie chart shows the number in millions and the percentage of youths who had an MDE with severe impairment in the past year, as well as the number in millions and the percentage of youths who had an MDE without severe impairment in the past year. The pie chart also shows the percentages of youths who had an MDE within each of these two categories.

Of the 3.0 million youths aged 12 to 17 in 2015 with an MDE in the past year, 2.1 million youths had an MDE with severe impairment. This represents 8.8 percent of all youths and 70.7 percent of youths with an MDE. Also, 0.9 million youths had an MDE without severe impairment, which represents 3.6 percent of all youths and 29.3 percent of youths with an MDE.

Long description end. Return to Figure 57.

Long description, Figure 58: Figure 58 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of youths with major depressive episode or major depressive episode with severe impairment in the past year is shown on the vertical axis. One line shows the percentage with a major depressive episode over the years 2004 through 2015, and the other line shows the percentage with a major depressive episode with severe impairment over the years 2006 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 58.

Long description, Figure 59: Figure 59 is titled "Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2015." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of youths who received treatment for depression is shown on the vertical axis. One line shows the percentage with a major depressive episode who received treatment for depression over the years 2004 through 2015, and the other line shows the percentage with a major depressive episode with severe impairment who received treatment for depression over the years 2006 through 2015. Tests of statistical significance at the .05 level were performed between 2015 and each of the previous years listed; significant results are indicated where appropriate. An accessible table of the estimates in the line graph is located below this figure.

Long description end. Return to Figure 59.

Long description, Figure 60: Figure 60 is titled "Past Year Illicit Drug Use among Youths Aged 12 to 17, by Past Year Major Depressive Episode: Percentages, 2015." It is a bar graph, where five categories of illicit drug use in the past year are shown on the horizontal axis and the percentage of youths aged 12 to 17 using these drugs in the past year is shown on the vertical axis. The five categories of illicit drugs are (1) illicit drugs, (2) marijuana, (3) psychotherapeutics (misuse), (4) inhalants, and (5) hallucinogens. For each type of illicit drug, the figure shows three bars. The first shows the percentage among all youths aged 12 to 17. The second shows the percentage among youths who had a major depressive episode in the past year. The third shows the percentage among youths who did not have a major depressive episode in the past year.

Among all youths aged 12 to 17 in 2015, 17.5 percent used illicit drugs in the past year. Corresponding percentages for illicit drug use in the past year were 31.5 percent among youths who had a past year major depressive episode and 15.3 percent among youths who did not have a past year major depressive episode.

Among all youths aged 12 to 17, 12.6 percent used marijuana in the past year. Corresponding percentages for marijuana use in the past year were 22.3 percent among youths who had a past year major depressive episode and 11.1 percent among youths who did not have a past year major depressive episode.

Among all youths aged 12 to 17, 5.9 percent reported misuse of psychotherapeutics in the past year. Corresponding percentages for misuse of psychotherapeutics in the past year were 12.2 percent among youths who had a past year major depressive episode and 4.9 percent among youths who did not have a past year major depressive episode.

Among all youths aged 12 to 17, 2.7 percent used inhalants in the past year. Corresponding percentages for use of inhalants in the past year were 6.4 percent among youths who had a past year major depressive episode and 2.2 percent among youths who did not have a past year major depressive episode.

Among all youths aged 12 to 17, 2.1 percent used hallucinogens in the past year. Corresponding percentages for use of hallucinogens in the past year were 4.2 percent among youths who had a past year major depressive episode and 1.7 percent among youths who did not have a past year major depressive episode.

Long description end. Return to Figure 60.

Long description, Figure 61: Figure 61 is titled "Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) in the Past Year among Youths Aged 12 to 17: 2015." It is a Venn diagram with a note below the figure that says, "Youth respondents with unknown MDE data were excluded." The Venn diagram shows overlapping larger and smaller circles. The smaller circle on the left represents youths who had an SUD in the past year. The larger circle on the right represents youths who had an MDE in the past year. The intersection of the two circles represents youths who had an MDE and an SUD. In addition, the area of the smaller circle that does not intersect with the larger circle represents youths who had an SUD but no MDE. Also, the area of the larger circle that does not intersect with the smaller circle represents youths who had an MDE but no SUD.

The number of youths aged 12 to 17 in 2015 with a past year SUD was 1.2 million, including 0.9 million who had an SUD and no MDE. The number of youths with a past year MDE was 3.0 million, including 2.7 million who had an MDE and no SUD. There were 0.4 million who had both an MDE and an SUD.

Long description end. Return to Figure 61.

Long description, Figure 62: Figure 62 is titled "Past Year Substance Use Disorder (SUD), Major Depressive Episode (MDE), MDE with Severe Impairment, Co-Occurring SUD and MDE, and Co-Occurring SUD and MDE with Severe Impairment among Youths Aged 12 to 17: Percentages, 2015." It is a bar graph, where SUD, MDE, MDE with severe impairment, co-occurring SUD and MDE, and co-occurring SUD and MDE with severe impairment are shown on the horizontal axis and the percentages in the past year are shown on the vertical axis.

The percentage of youths aged 12 to 17 with an SUD in the past year was 5.0 percent.

The percentage of youths aged 12 to 17 with an MDE in the past year was 12.5 percent.

The percentage of youths aged 12 to 17 with an MDE with severe impairment in the past year was 8.8 percent.

The percentage of youths aged 12 to 17 with a co-occurring SUD and an MDE in the past year was 1.4 percent.

The percentage of youths aged 12 to 17 with a co-occurring SUD and an MDE with severe impairment in the past year was 1.2 percent.

Long description end. Return to Figure 62.

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