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Key Substance Use and Mental Health Indicators in the United States:
Results from the 2016 National Survey on Drug Use and Health

SAMHSA Authors

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

SAMHSA Project Officer

Peter Tice

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) 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 https://store.samhsa.gov. Or call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español).

Recommended Citation

Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://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 2017

Table of Contents

Summary

Introduction

Survey Background

Data Presentation and Interpretation

Tobacco Use in the Past Month
Cigarette Use
Daily Cigarette Use
Cigar and Pipe Tobacco Use
Smokeless Tobacco Use

Alcohol Use in the Past Month
Any Alcohol Use
Binge Alcohol Use
Heavy Alcohol Use
Underage Alcohol Use

Illicit Drug Use in the Past Month
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

Opioid Misuse in the Past Year
Past Year Opioid Misuse
Past Year Heroin Use
Past Year Pain Reliever Misuse
Misuse of Subtypes of Pain Relievers
Main Reasons for the Last Misuse of Pain Relievers
Source of the Last Pain Reliever That Was Misused

Substance Use Disorders in the Past Year
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
Opioid Use Disorder
Substance Use Disorder (Alcohol or Illicit Drugs)

Substance Use Treatment in the Past Year
Need for Substance Use Treatment
Receipt of Substance Use Treatment

Major Depressive Episode in the Past Year
MDE and MDE with Severe Impairment among Adolescents
MDE and MDE with Severe Impairment among Adults

Mental Illness among Adults in the Past Year
Mental Illness among All Adults
Mental Illness among Adult Age Groups

Mental Health Service Use in the Past Year
Treatment for Depression among Adolescents
Treatment for Depression among Adults
Any Mental Health Service Use among All Adolescents
Any Mental Health Service Use among All Adults
Any Mental Health Service Use among Adults with Mental Illness

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

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

Suicidal Thoughts and Behavior among Adults
Serious Thoughts of Suicide
Suicide Plans
Suicide Attempts

Endnotes

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

Summary

This national report summarizes key findings from the 2016 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. For measures that started a new baseline in 2015, estimates are discussed only for 2016.

Tobacco Use

In 2016, an estimated 51.3 million people aged 12 or older were current cigarette smokers, including 29.7 million who were daily cigarette smokers and 12.2 million who smoked approximately a pack or more of cigarettes per day. Although about 1 in 5 people aged 12 or older were current cigarette smokers, cigarette use generally declined between 2002 and 2016 across all age groups.

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 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, including 65.3 million who reported binge alcohol use in the past month and 16.3 million who reported heavy alcohol use in the past month.

In 2016, about 1 in 5 underage individuals aged 12 to 20 were current alcohol users. About 7.3 million people aged 12 to 20 reported drinking alcohol in the past month, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use. The percentage of underage drinkers in 2016 was lower than the percentages in 2002 through 2014 but was similar to the percentage in 2015. About 2 out of 5 young adults aged 18 to 25 in 2016 were binge alcohol users, and about 1 in 10 were heavy alcohol users.

Illicit Drug Use

In 2016, 28.6 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans overall (10.6 percent) but ranges as high as 1 in 4 for young adults aged 18 to 25. Regardless of age, the illicit drug use estimate for 2016 continues to be driven primarily by marijuana use and the misuse of prescription pain relievers. Among people aged 12 or older, 24.0 million were current marijuana users and 3.3 million were current misusers of prescription pain relievers. Smaller numbers of people were current users of cocaine, hallucinogens, methamphetamine, inhalants, or heroin or were current misusers of prescription tranquilizers, stimulants, or sedatives.

The percentage of people aged 12 or older who were current marijuana users in 2016 was higher than the percentages from 2002 to 2015. In contrast, the percentages among people aged 12 or older have shown little change since 2007 for current use of cocaine, since 2008 for current use of crack cocaine, and since 2014 for current use of heroin. The increase in marijuana use reflects increases in marijuana use among adults aged 26 or older and, to a lesser extent, among young adults aged 18 to 25. Marijuana use among adolescents aged 12 to 17 was lower in 2016 than in most years from 2009 to 2014.

NSDUH also allows for analysis of opioid misuse, which is the use of heroin or the misuse of prescription opioid pain relievers. In 2016, an estimated 11.8 million people misused opioids in the past year, including 11.5 million pain reliever misusers and 948,000 heroin users. Additional information is gathered in NSDUH for the misuse of pain relievers in the past year. Among people aged 12 or older who misused pain relievers in the past year, about 6 out of 10 people indicated that the main reason they misused pain relievers the last time was to relieve physical pain (62.3 percent), and about half (53.0 percent) indicated that they obtained the last pain relievers they misused from a friend or relative.

Substance Use Disorders

In 2016, approximately 20.1 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,1 including 15.1 million people who had an alcohol use disorder and 7.4 million people who had an illicit drug use disorder. Among those who had an illicit drug use disorder, the most common disorder was for marijuana (4.0 million people). An estimated 2.1 million people had an opioid use disorder, which includes 1.8 million people with a prescription pain reliever use disorder and 0.6 million people with a heroin use disorder.

Substance Use Treatment

In 2016, an estimated 21.0 million people aged 12 or older needed substance use treatment. This translates to about 1 in 13 people needing treatment. Among young adults aged 18 to 25, however, about 1 in 7 people needed treatment. 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.2

In 2016, 1.4 percent of people aged 12 or older (3.8 million people) received any substance use treatment in the past year, and 0.8 percent (2.2 million) received substance use treatment at a specialty facility. Only about 1 in 10 people aged 12 or older who needed substance use treatment received treatment at a specialty facility in the past year (10.6 percent).

Major Depressive Episode

In 2016, 12.8 percent of adolescents aged 12 to 17 (3.1 million adolescents) and 10.9 percent of young adults aged 18 to 25 (3.7 million) had a major depressive episode (MDE) during the past year. The percentages of adolescents and young adults in 2016 who had a past year MDE were higher than the corresponding percentages prior to 2015. Percentages of adolescents and young adults with a past year MDE have subsequently shown less change. In contrast, the percentages of adults aged 26 to 49 and those aged 50 or older with a past year MDE have remained stable.

Among the 3.1 million adolescents and 3.7 million young adults in 2016 who had a past year MDE, 1.2 million adolescents (40.9 percent) and 1.6 million young adults (44.1 percent) received treatment for depression. The percentage of adolescents in 2016 with an MDE who received treatment for their depression was similar to the percentages in most prior years. Among young adults, the percentage with an MDE who received treatment for depression was similar to or lower than the percentages in prior years.

Mental Illness among Adults

In 2016, an estimated 44.7 million adults aged 18 or older (18.3 percent) had any mental illness (AMI) in the past year. An estimated 10.4 million adults in the nation had a serious mental illness (SMI) in the past year, representing 4.2 percent of all U.S. adults.3 Although the 2016 percentages of adults with AMI or SMI among adults aged 18 or older were similar to the percentages since 2010, a higher percentage of young adults was experiencing AMI and SMI. The 2016 percentage of young adults with SMI was higher than the percentages in each year since 2008, and the 2016 percentage of young adults with AMI was higher than the percentages in 2008 to 2014.

Mental Health Service Use among Adults

In 2016, an estimated 35.0 million adults aged 18 or older (14.4 percent of adults) received mental health care during the past 12 months. Among the 44.7 million adults with AMI, 19.2 million (43.1 percent) received mental health services in the past year. About 6.7 million of the 10.4 million adults with past year SMI (64.8 percent) received mental health services in the past year. The percentages of adults with AMI or SMI who received mental health care in 2016 were similar to the corresponding percentages in most years from 2008 to 2015.

Co-Occurring MDE and Substance Use among Adolescents

In 2016, 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 (31.7 vs. 13.4 percent). An estimated 333,000 adolescents (1.4 percent of all adolescents) had an SUD and an MDE in the past year. Among adolescents who had a co-occurring MDE and an SUD in the past year, 71.9 percent received either substance use treatment at a specialty facility or mental health services in the past year.

Co-Occurring Mental Illness and Substance Use Disorders among Adults

An estimated 8.2 million adults aged 18 or older (3.4 percent of all adults) had both AMI and SUDs in the past year, and 2.6 million adults (1.1 percent of all adults) had co-occurring SMI and SUDs in the past year. About half of the adults with co-occurring AMI and an SUD in the past year did not receive either mental health care or specialty substance use treatment, and about 1 in 3 adults with co-occurring SMI and an SUD did not receive either type of care.

Suicidal Thoughts and Behavior among Adults

In 2016, an estimated 9.8 million adults aged 18 or older reported they had thought seriously about trying to kill themselves, 2.8 million reported that they had made suicide plans, and 1.3 million made a nonfatal suicide attempt. The percentage of young adults aged 18 to 25 with serious thoughts of suicide was higher in 2016 than in 2008 to 2014. In contrast, similar percentages of adults aged 18 or older, those aged 26 to 49, and those aged 50 or older had serious thoughts of suicide in most years between 2008 and 2016.

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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.

This report summarizes findings for key substance use and mental health indicators from the 2016 National Survey on Drug Use and Health (NSDUH).

This report contains the first set of findings from the 2016 NSDUH for key substance use and mental health indicators in the United States. Comprehensive 2016 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 https://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 2016 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 2016.6

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 sampled 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.

This report is based on data from 67,942 completed interviews from 2016 NSDUH respondents aged 12 or older.

In 2016, screening was completed at 135,188 addresses, and 67,942 completed interviews were obtained, including 17,109 interviews from adolescents aged 12 to 17 and 50,833 interviews from adults aged 18 or older. Weighted response rates for household screening and for interviewing were 77.9 and 68.4 percent, respectively, for an overall response rate of 53.3 percent for people aged 12 or older. The weighted interview response rates were 77.0 percent for adolescents and 67.6 percent for adults.8 Further details about the 2016 NSDUH design and methods can be found on the web at https://www.samhsa.gov/data/.9

Data Presentation and Interpretation

This report focuses on substance use and mental health in the United States based on NSDUH data from 2016 and earlier years.10 Estimates of substance use and substance use treatment are presented for individuals aged 12 or older, adolescents, and adults.11 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.12

One of NSDUH's strengths is the stability in the sample and survey designs. This stability allows for the examination of trends across time. However, the benefit of using NSDUH data to assess trends has to be balanced with the periodic need to revise NSDUH content to address changes in society and emerging issues. Consequently, 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. New baselines were started in 2015 for estimates that were affected by changes to the 2015 NSDUH questionnaire.13,14,15

Trends are presented in this report for estimates from the 2016 NSDUH that are assumed to have remained comparable with estimates from 2015 and prior years.14,15 All trends that are presented in the report compare 2016 estimates with estimates from 3 or more prior years. When new baselines started in 2015, estimates are discussed only for 2016. Trends that are discussed in this report focus on percentages because the percentages take into account changes in the size of the total population and facilitate the comparison of estimates across years.16

Analyses of trends in this report focus on long-term trends in substance use and mental health issues.

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 2016 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.18,19 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.

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Tobacco Use in the Past Month

Tobacco use continues to be the leading cause of preventable death in the United States.20 NSDUH data can be used to estimate the percentage of individuals who used tobacco products and 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. Estimates for smokeless tobacco use since 2015 are not comparable with estimates prior to 2015 because of questionnaire changes in 2015.

The majority of current (i.e., past month) tobacco users in 2016 were current cigarette smokers (Figure 1), as has been the case historically.21 Among current users aged 12 or older of any tobacco product, 66.8 percent smoked cigarettes but did not use other tobacco products, 14.1 percent smoked cigarettes and used some other type of tobacco product, and 19.1 percent used only tobacco products other than cigarettes (Figure 2). This same pattern was observed across the two older age groups in 2016 (young adults aged 18 to 25 and adults aged 26 or older), with most current tobacco users smoking only cigarettes, followed by the use of tobacco products other than cigarettes or the use of both cigarettes and other tobacco products (Table A.5B in Appendix A). Among young adults and adults aged 26 or older who were current users of tobacco products, about 20 percent did not smoke cigarettes (21.6 and 18.1 percent, respectively). In contrast, among adolescents who were current tobacco users, 35.4 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 (24.6 and 24.4 percent, respectively). Among adults aged 26 or older who were current tobacco users, about 1 in 8 (11.8 percent) were current cigarette smokers and current users of other tobacco products.

Figure 1. Numbers of Past Month Tobacco Users among People Aged 12 or Older: 2016

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 tobacco products are not mutually exclusive because people could have used more than one type of tobacco product in the past month.


Figure 2. Type of Past Month Tobacco Use among Current Tobacco Users Aged 12 or Older: Percentages, 2016

Figure 2     D

Cigarette Use

In 2016, an estimated 51.3 million people aged 12 or older were current cigarette smokers (Figure 1). This number corresponds to 19.1 percent of the population being current cigarette smokers (Figure 3). The percentage of people aged 12 or older who smoked cigarettes in the past month was lower in 2016 than in 2002 to 2014, but it was similar to the percentage in 2015. Stated another way, about 1 in 5 people aged 12 or older in 2016 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, research indicates that in 2013, more than a quarter million middle school and high school students (263,000) never smoked a conventional cigarette but used e-cigarettes, which may pertain to products with or without nicotine.22 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 3. Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 3     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 3 Table. Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 19.1
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+ 3.4
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+ 23.5
≥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 20.2

Aged 12 to 17

In 2016, 855,000 adolescents aged 12 to 17 smoked cigarettes in the past month. This number represents 3.4 percent adolescents who were current cigarette smokers (Figure 3). The percentage of adolescents who were past month cigarette smokers declined from 13.0 percent in 2002 (or about 1 in 8 adolescents) to 3.4 percent in 2016 (or fewer than 1 in 20). The percentage of adolescents who were current cigarette smokers in 2016 also was lower than the percentages in each year from 2002 to 2015.

Aged 18 to 25

Among young adults aged 18 to 25 in 2016, 8.1 million individuals smoked cigarettes in the past month. This number of young adults who were current cigarette smokers represents about one quarter of young adults (23.5 percent) (Figure 3). The percentage of young adults who were current cigarette smokers in 2016 was lower than the percentages in 2002 to 2015.

Aged 26 or Older

In 2016, 42.4 million adults aged 26 or older smoked cigarettes in the past month. Stated another way, 1 out of 5 adults aged 26 or older (20.2 percent) were current cigarette smokers in 2016 (Figure 3). The 2016 estimate for current cigarette smoking among adults 26 or older was lower than the estimates from 2002 to 2014, but it was similar to the estimate for 2015.

Daily Cigarette Use

Among the 51.3 million current cigarette smokers aged 12 or older in 2016, 29.7 million were daily cigarette smokers. The 29.7 million daily smokers represent 57.9 percent of current cigarette smokers (Figure 4). Thus, nearly three fifths of current cigarette smokers in 2016 smoked cigarettes daily. The percentage of current smokers aged 12 or older in 2016 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 to 2015 (Table 1).

Figure 4. 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: 2016

Figure 4     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, 2002-2016
Age Group 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 57.9  
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+ 15.0  
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 39.9  
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 62.2  

Among the 29.7 million daily smokers aged 12 or older in 2016, 12.2 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 4 and 5). The percentage of daily smokers aged 12 or older who smoked one or more packs of cigarettes per day was lower in 2016 than the percentages in 2002 to 2011.

Figure 5. Smokers of One or More Packs of Cigarettes per Day among Past Month Daily Cigarette Smokers Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 5     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 5 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, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
* Low precision; no estimate reported.
≥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 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+ 26.2
≥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 43.1

Aged 12 to 17

In 2016, about 129,000 adolescents aged 12 to 17 smoked cigarettes every day in the past month, which represents about 1 in 7 (15.0 percent) adolescents who were current smokers (Table 1). The 2016 percentage was lower than the percentages in 2002 to 2015. The percentage of adolescent daily smokers who smoked one or more packs of cigarettes per day was not reported for 2016 due to low precision (Figure 5).

Aged 18 to 25

About 3.2 million young adults aged 18 to 25 in 2016 were daily cigarette smokers in the past month, or 39.9 percent of young adults who were current cigarette smokers (Table 1). Thus, about 2 in 5 young adults in 2016 who were current cigarette users smoked cigarettes daily. The percentage of young adult current smokers who smoked cigarettes daily in 2016 was lower than the percentages in years from 2002 to 2014, and it was similar to the percentage in 2015. The percentage of young adult daily smokers who smoked one or more packs of cigarettes per day was lower in 2016 (26.2 percent) than in 2002 to 2008, but it was higher than the percentages in 2013 to 2015 (Figure 5).

Aged 26 or Older

In 2016, about 26.3 million adults aged 26 or older smoked cigarettes every day in the past month, which represents 62.2 percent of the adults aged 26 or older who were current smokers (Table 1). The percentage of current smokers aged 26 or older in 2016 who smoked cigarettes every day was lower than the percentages in 2002 to 2013, but it was similar to the percentages in 2014 and 2015. Despite the decline since 2002, when nearly 70 percent of current smokers aged 26 or older were daily smokers, about three fifths of current smokers in this age group in 2016 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 2016 (43.1 percent) than in 2002 to 2011, but the percentage was stable between 2012 and 2016 (Figure 5).

Cigar and Pipe Tobacco Use

An estimated 12.3 million people aged 12 or older in 2016 were current cigar smokers, and 2.3 million were current pipe tobacco smokers (Figure 1). These numbers correspond to 4.6 percent of the population aged 12 or older who were current cigar smokers (Figure 6) and 0.8 percent who were current pipe tobacco smokers (Figure 7). Among people aged 12 or older, the percentage who were current cigar smokers was lower in 2016 than in 2002 through 2012, but it was similar to the percentages in 2013 to 2015. The percentage of people who were current pipe tobacco smokers in 2016 was similar to the percentages in most years between 2002 and 2015.

Figure 6. Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 6     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 6 Table. Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 4.6
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 1.8
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 8.8
≥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 4.2

Figure 7. Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 7     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 7 Table. Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 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 0.5
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 1.7
≥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 0.7

Aged 12 to 17

Among adolescents aged 12 to 17 in 2016, 448,000 individuals smoked cigars, and 123,000 smoked pipe tobacco in the past month. These numbers indicate that 1.8 percent of adolescents were current cigar smokers (Figure 6) and 0.5 percent were current pipe tobacco smokers in 2016 (Figure 7). A lower percentage of adolescents in 2016 were current cigar smokers than in 2002 to 2013, but the 2016 estimate was similar to the estimates in 2014 and 2015. The estimate for current pipe tobacco smoking among adolescents in 2016 was similar to or slightly lower than the estimates in 2002 to 2015.

Aged 18 to 25

In 2016, 3.0 million young adults aged 18 to 25 smoked cigars, and 573,000 smoked pipe tobacco. These numbers indicate that 8.8 percent of young adults were current cigar smokers (Figure 6) and 1.7 percent were current pipe tobacco smokers in 2016 (Figure 7). The percentage of young adults in 2016 who were current cigar smokers was lower than in 2002 to 2014, but it was similar to the percentage in 2015. The percentage of young adults in 2016 who were current pipe tobacco smokers was greater than the percentages in most years from 2002 to 2008, but the 2016 estimate was similar to the estimates in most years from 2009 to 2015. Although the percentage of young adults who were current pipe tobacco smokers increased relative to the percentages in 2002 to 2007 and was fairly stable after 2007, current smoking of pipe tobacco among young adults in 2016 was less common than the use of other types of tobacco.

Aged 26 or Older

About 8.8 million adults aged 26 or older in 2016 smoked cigars, and 1.6 million smoked pipe tobacco. These numbers correspond to current cigar smoking by 4.2 percent of adults aged 26 or older (Figure 6) and current pipe tobacco smoking by 0.7 percent of adults in this age group (Figure 7). The 2016 estimates for current cigar use among adults aged 26 or older were similar to estimates in 2007 to 2015. The 2016 estimates for current pipe tobacco smoking among adults aged 26 or older were similar to estimates between 2002 and 2015.

Smokeless Tobacco Use

In 2015, questions on snuff and chewing tobacco were combined into a single set of questions about smokeless tobacco, and a moist tobacco powder referred to as snus was added to the question as an example of smokeless tobacco. Consequently, estimates of smokeless tobacco use in 2016 are not comparable with those prior to 2015.

In 2016, an estimated 8.8 million people aged 12 or older in 2016 were current smokeless tobacco users (Figure 1). This number of current smokeless tobacco users corresponds to 3.3 percent of the population aged 12 or older (Figure 8). About 352,000 adolescents aged 12 to 17 used smokeless tobacco in the past month, or 1.4 percent of adolescents. An estimated 1.8 million young adults aged 18 to 25 used smokeless tobacco in the past month, or 5.2 percent of young adults. About 6.6 million adults aged 26 or older used smokeless tobacco in the past month, which represents 3.1 percent of adults in this age group.

Figure 8. Past Month Smokeless Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 8     D

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Alcohol Use in the Past Month

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.23 Until the 2015 NSDUH, the threshold for binge drinking was defined the same for male and females. Consistent with federal definitions24 and other federal data collections, the NSDUH definition for binge alcohol use since 2015 differs 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 unchanged from the threshold prior to 2015. Since 2015, binge alcohol use for females has been 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 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 9). Because of the 2015 changes to the definition of binge alcohol use in NSDUH, overall estimates of binge and heavy alcohol use in 2016 are presented in this report, but these 2016 estimates are not comparable with estimates prior to 2015.25

Figure 9. Current, Binge, and Heavy Alcohol Use among People Aged 12 or Older: 2016

Figure 9     D

Note: Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion.

In 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, 65.3 million reported binge alcohol use in the past month, and 16.3 million reported heavy alcohol use in the past month (Figure 9). Thus, nearly half of current alcohol users reported binge alcohol use (47.8 percent), and 1 in 8 current alcohol users reported heavy alcohol use (11.9 percent). Among binge alcohol users, about 1 in 4 (24.9 percent) were heavy users.

Any Alcohol Use

The estimate of 136.7 million current alcohol users aged 12 or older in 2016 (Figure 9) corresponds to alcohol use in the past month by slightly more than half (50.7 percent) of people aged 12 or older (Figure 10). The 2016 estimate of past month alcohol use was similar to the estimates in most years between 2002 and 2008, but it was lower than the estimates in 2009 to 2015.

Figure 10. Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 10     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 10 Table. Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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+ 50.7
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 9.2
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 57.1
≥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 54.6

Aged 12 to 17

The percentage of adolescents aged 12 to 17 who were current alcohol users was 9.2 percent in 2016 (Figure 10), which corresponds to 2.3 million adolescents in 2016 who drank alcohol in the past month. The percentage of adolescents who were current alcohol users in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015. Although the estimate of current alcohol use among adolescents decreased between 2002 and 2016, about 1 in 11 adolescents were current alcohol users in 2016.

Aged 18 to 25

In 2016, 57.1 percent of young adults aged 18 to 25 were current alcohol users (Figure 10), which corresponds to about 19.8 million young adults. The percentage of young adults in 2016 who drank alcohol in the past month was similar to the percentage in 2015. Although the 2016 estimate was lower than the estimates in 2002 through 2014, about three fifths of young adults were current alcohol users in each year between 2002 and 2016 (ranging from 57.1 to 62.0 percent).

Aged 26 or Older

More than half (54.6 percent) of adults aged 26 or older in 2016 were current alcohol users (Figure 10). This percentage corresponds to about 114.7 million adults in this age group who drank alcohol in the past month. The percentage of adults aged 26 or older in 2016 who were current alcohol users was similar to the percentages in most years from 2002 to 2015. In each year between 2002 and 2016, slightly 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 2016, an estimated 65.3 million people aged 12 or older were binge alcohol users in the past 30 days (Figure 9). This number of people who were current binge drinkers corresponds to about 1 in 4 people aged 12 or older (24.2 percent) (Figure 11). About 1.2 million adolescents aged 12 to 17 were past month binge alcohol users, which corresponds to 4.9 percent of adolescents. Thus, about 1 in 20 adolescents aged 12 to 17 in 2016 were current binge drinkers. An estimated 38.4 percent of young adults aged 18 to 25 were binge alcohol users in the past month, which corresponds to about 13.3 million young adults. Stated another way, about 2 out of 5 young adults in 2016 were current binge alcohol users. About a quarter (24.2 percent) of adults aged 26 or older were current binge alcohol users. This percentage corresponds to about 50.9 million adults in this age group who were binge drinkers.

Figure 11. Past Month Binge and Heavy Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 11     D

Note: Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion.

Heavy Alcohol Use

The estimate of 16.3 million people aged 12 or older in 2016 who were heavy alcohol users in the past month (Figure 9) represents 6.0 percent of the population aged 12 or older (Figure 11). In 2016, 191,000 adolescents aged 12 to 17 were current heavy alcohol users. Stated another way, about 1 out of 125 adolescents (0.8 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 (10.1 percent) were heavy alcohol users in the past month, which corresponds to 3.5 million young adults. An estimated 6.0 percent of adults aged 26 or older in 2016 were current heavy alcohol users. This percentage corresponds to about 12.6 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).26 In 2016, about 7.3 million people aged 12 to 20 reported drinking alcohol in the past month, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use (Figure 12). Thus, about three fifths of underage current drinkers (62.5 percent) were binge alcohol users, and about 1 in 7 were heavy alcohol users (14.7 percent). About one fourth of underage binge alcohol users (23.5 percent) were heavy drinkers.

Figure 12. Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: 2016

Figure 12     D

Note: Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion.

The estimate of 7.3 million underage people in 2016 who reported current alcohol use represents 19.3 percent of 12 to 20 year olds (Figure 13). Among people aged 12 to 20 in 2016, 12.1 percent were binge drinkers, and 2.8 percent were heavy drinkers. The percentage of underage individuals who reported current alcohol use in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015 (Figure 14). Despite these declines over time, about 1 in 5 individuals aged 12 to 20 in 2016 drank alcohol in the past month.

Figure 13. Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: Percentages, 2016

Figure 13     D

Note: Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion.


Figure 14. Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2016

Figure 14     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 14 Table. Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2016
Use 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 19.3

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Illicit Drug Use in the Past Month

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. Because of changes in measurement in 2015 for 7 of the 10 illicit drug categories—hallucinogens, inhalants, methamphetamine, and the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives—estimates of use of any illicit drug and these 7 illicit drug categories in 2016 are not comparable with estimates prior to 2015.

In 2016, an estimated 28.6 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 15). The most commonly used illicit drug in the past month was marijuana, which was used by 24.0 million people aged 12 or older. An estimated 6.2 million people reported misusing psychotherapeutic drugs at least once in the past month, including 3.3 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 2016 were current users of the other illicit drugs shown in Figure 15.27

Figure 15. Numbers of Past Month Illicit Drug Users among People Aged 12 or Older: 2016

Figure 15     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 28.6 million people aged 12 or older who were current illicit drug users in 2016 represent 10.6 percent of the population aged 12 or older (Figures 15 and 16). Stated another way, 1 in 10 individuals aged 12 or older in the United States used illicit drugs in the past month. Approximately 2.0 million adolescents aged 12 to 17 in 2016 were current users of illicit drugs, which represents 7.9 percent of adolescents. Approximately 1 in 4 young adults aged 18 to 25 (23.2 percent) were current users of illicit drugs in 2016. This percentage corresponds to about 8.0 million young adults who were current users of illicit drugs. An estimated 8.9 percent of adults aged 26 or older were current users of illicit drugs, or about 18.6 million adults in this age group.

Figure 16. Past Month Illicit Drug Use among People Aged 12 or Older, by Age Group: 2016

Figure 16     D

Marijuana Use

As noted in the illicit drug use section, an estimated 24.0 million Americans aged 12 or older in 2016 were current users of marijuana (Figure 15). This number of past month marijuana users corresponds to 8.9 percent of the population aged 12 or older (Figure 17). The percentage of people aged 12 or older who were current marijuana users in 2016 was higher than the percentages from 2002 to 2015. 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.

Figure 17. Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 17     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 17 Table. Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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+ 8.9
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 6.5
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 20.8
≥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+ 7.2

Aged 12 to 17

In 2016, 6.5 percent of adolescents aged 12 to 17 were current users of marijuana (Figure 17). This means that approximately 1.6 million adolescents used marijuana in the past month. The percentage of adolescents in 2016 who were current marijuana users was lower than the percentages in most years from 2009 to 2014, but it was similar to the percentage in 2015.

Aged 18 to 25

In 2016, about 1 in 5 young adults aged 18 to 25 (20.8 percent) were current users of marijuana (Figure 17). This means that 7.2 million young adults used marijuana in the past month. The percentage of young adults who were current marijuana users in 2016 was higher than the percentages between 2002 and 2013, but it was similar to the percentages in 2014 and 2015.

Aged 26 or Older

In 2016, 7.2 percent of adults aged 26 or older were current users of marijuana (Figure 17), which represents about 15.2 million adults in this age group. The percentage of adults aged 26 or older who were current marijuana users in 2016 was higher than the percentages in 2002 to 2015.

Misuse of Psychotherapeutic Drugs

NSDUH collects data on four categories of prescription drugs (pain relievers, tranquilizers, stimulants, and sedatives) covering 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." Because the NDSUH prescription drug measures were revised in 2015, the 2016 estimates of prescription drug misuse are not comparable with estimates prior to 2015.

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 2016, an estimated 6.2 million Americans aged 12 or older misused psychotherapeutic drugs at least once in the past month, which represent 2.3 percent of the population aged 12 or older (Figures 18 and 19). Of the four categories of prescription drugs that are presented in this report, prescription pain relievers were the most commonly misused by people aged 12 or older. The 6.2 million people aged 12 or older who misused prescription psychotherapeutic drugs in the past month included 3.3 million who misused prescription pain relievers in that period. Approximately 2.0 million people aged 12 or older misused prescription tranquilizers in the past month. An estimated 1.7 million people aged 12 or older misused prescription stimulants, and 497,000 (0.5 million) misused prescription sedatives in the past month.

Figure 18. Numbers of Past Month Prescription Psychotherapeutic Misusers among People Aged 12 or Older: 2016

Figure 18     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 misusers of different psychotherapeutics are not mutually exclusive because people could have used more than one type of psychotherapeutic in the past month.


Figure 19. Past Month Prescription Psychotherapeutic Misuse among People Aged 12 or Older, by Age Group: 2016

Figure 19     D

An estimated 389,000 adolescents aged 12 to 17 misused psychotherapeutic drugs at least once in the past month, which rounds to the estimate of 0.4 million adolescents shown in Figure 19. Stated another way, about 1 in 60 adolescents (1.6 percent) were current misusers of psychotherapeutic drugs. An estimated 1.6 million young adults aged 18 to 25 were current misusers of psychotherapeutic drugs, which corresponds to 4.6 percent of young adults. There were 4.2 million adults aged 26 or older who were current misusers of psychotherapeutic drugs, or 2.0 percent of adults in this age group.

Pain Reliever Misuse

Overall estimates of current prescription psychotherapeutic drug misuse in 2016 among the population aged 12 or older that were described previously were largely driven by the misuse of prescription pain relievers. In 2016, about half of the current misusers of psychotherapeutic drugs who were aged 12 or older (54.0 percent) reported misusing pain relievers at least once in the past month (Figure 20).

Figure 20. Misuse of Prescription Pain Relievers and Other Prescription Psychotherapeutics among People Aged 12 or Older Who Were Current Misusers of Any Prescription Psychotherapeutics: 2016

Figure 20     D

An estimated 3.3 million people aged 12 or older in 2016 were current misusers of pain relievers, which represents 1.2 percent of the population aged 12 or older (Figures 18 and 21). In 2016, an estimated 239,000 adolescents aged 12 to 17 were current misusers of pain relievers, which corresponds to 1.0 percent of adolescents (Figure 21). An estimated 631,000 young adults aged 18 to 25 misused pain relievers in the past month, which represents 1.8 percent of young adults. An estimated 2.5 million adults aged 26 or older were current misusers of pain relievers, which corresponds to 1.2 percent of adults aged 26 or older.

Figure 21. Past Month Prescription Psychotherapeutic Misuse among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 21     D

Tranquilizer Misuse

An estimated 2.0 million people aged 12 or older in 2016 were current misusers of tranquilizers, which represents 0.7 percent of people aged 12 or older (Figures 18 and 21). In 2016, an estimated 121,000 adolescents aged 12 to 17 were current misusers of tranquilizers, which represents 0.5 percent of adolescents (Figure 21). An estimated 536,000 young adults aged 18 to 25 misused tranquilizers in the past month, which represents 1.5 percent of young adults. An estimated 1.3 million adults aged 26 or older were current misusers of tranquilizers, which corresponds to 0.6 percent of adults in this age group.

Stimulant Misuse

In 2016, an estimated 1.7 million people aged 12 or older, or 0.6 percent of this population, were current misusers of stimulants (Figures 18 and 21). About 92,000 adolescents aged 12 to 17 were current misusers of stimulants, corresponding to about 0.4 percent of adolescents (Figure 21). There were about 767,000 young adults aged 18 to 25 who misused stimulants in the past month, which corresponds to about 2.2 percent of young adults. An estimated 876,000 adults aged 26 or older were current misusers of stimulants, which represents 0.4 percent of this age group.

Sedative Misuse

An estimated 497,000 people aged 12 or older were current misusers of sedatives in 2016, which rounds to the 0.5 million people shown in Figure 18. This number represents 0.2 percent of the population aged 12 or older (Figure 21). There were an estimated 23,000 adolescents in 2016 who were current misusers of sedatives (0.1 percent of adolescents). An estimated 50,000 young adults aged 18 to 25 misused sedatives in the past month (0.1 percent of young adults). An estimated 425,000 adults aged 26 or older were current misusers of sedatives (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 2016, the estimate of about 1.9 million people aged 12 or older who were current users of cocaine (Figure 15) included about 432,000 current users of crack. The numbers correspond to about 0.7 percent of the population aged 12 or older who were current users of cocaine (Figure 22) and 0.2 percent who were current users of crack (Table A.7B in Appendix A). The 2016 estimate for current cocaine use was similar to the estimates in most years between 2007 and 2015, but it was lower than the estimates in 2002 to 2006. The 2016 estimate of crack use was similar to the estimates in most years from 2008 to 2015, but it was lower than the estimates in most years between 2002 to 2007.

Figure 22. Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 22     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 22 Table. Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 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 0.1
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 1.6
≥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 0.6

Aged 12 to 17

There were 28,000 adolescents aged 12 to 17 who were current users of cocaine and 3,000 adolescents who were current crack users in 2016. These numbers represent 0.1 percent of adolescents who used cocaine and less than 0.1 percent who used crack (Figure 22). The 2016 estimate for current cocaine use among adolescents was similar to the estimates between 2012 and 2015, but the 2016 estimate was lower than the estimates in 2002 to 2011. Where estimates had sufficient precision to be reported, estimates of crack use among adolescents in 2002 to 2016 ranged from less than 0.1 percent to 0.1 percent (Table A.8B in Appendix A).

Aged 18 to 25

An estimated 1.6 percent of young adults aged 18 to 25 were current users of cocaine in 2016 (Figure 22), and less than 0.1 percent used crack in the past month (Table A.9B in Appendix A). These percentages represent 552,000 young adults who used cocaine, including 15,000 who used crack. The 2016 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 2015. The estimate of current crack use among young adults in 2016 was lower than estimates in 2002 to 2010, but it was similar to the estimates in most years between 2011 and 2015.

Aged 26 or Older

In 2016, 0.6 percent of adults aged 26 or older were current users of cocaine (Figure 22), and 0.2 percent used crack in the past month (Table A.10B in Appendix A). These percentages represent 1.3 million adults aged 26 or older who currently used cocaine, including 414,000 who currently used crack. The 2016 estimates of current cocaine use and current crack use among adults aged 26 or older were similar to the estimates in most years between 2002 and 2015.

Heroin Use

Heroin is a highly addictive opioid that is illegal and has no accepted medical use in the United States. About 475,000 people aged 12 or older were current heroin users in 2016, which rounds to the 0.5 million people shown in Figure 15. This number corresponds to about 0.2 percent of the population aged 12 or older (Figure 23).

Figure 23. Past Month Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 23     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 23 Table. Past Month Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
* Low precision; no estimate reported.
Note: Estimates of less than 0.1 percent round to 0.0 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 0.2
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 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 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 0.2

Despite the dangers associated with heroin use, its use has increased in recent years. The percentage of current heroin users aged 12 or older in 2016 was higher than the percentages in most years between 2002 and 2013, but it was similar to the percentages in 2014 and 2015 (Figure 23). However, even when there was a statistically significant difference between the 2016 estimate and estimates in prior years, the estimates ranged between 0.1 and 0.2 percent.

Aged 12 to 17

In 2016, less than 0.1 percent of adolescents aged 12 to 17 were current heroin users (Figure 23). This percentage represents 3,000 adolescents who were current users of heroin. The percentage of adolescents in 2016 who were current heroin users was similar to available percentages for heroin use in 2007 to 2015 and lower than the percentages in 2003 to 2006.

Aged 18 to 25

Among young adults aged 18 to 25 in 2016, 0.3 percent were current heroin users (Figure 23). This percentage represents 88,000 young adults who were current users of heroin. The percentage of young adults in 2016 who were current heroin users (0.3 percent) was higher than the percentages in 2002 through 2004, and it was similar to the percentages in 2005 through 2015.

Aged 26 or Older

In 2016, 0.2 percent of adults aged 26 or older were current heroin users (Figure 23). This percentage represents 383,000 adults aged 26 or older who were current users of heroin. The percentage of adults aged 26 or older in 2016 who were current heroin users (0.2 percent) was higher than the percentages for most years between 2002 and 2013 (ranging from less than 0.1 to 0.1 percent), but it was similar to the percentages in 2014 and 2015.

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.28 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 the 2015 measurement change, the 2016 estimates of hallucinogen use are not comparable with estimates prior to 2015.

In 2016, an estimated 1.4 million people aged 12 or older were current users of hallucinogens (Figure 15), representing 0.5 percent of the population aged 12 or older (Figure 24). An estimated 114,000 adolescents aged 12 to 17 were current users of hallucinogens, or 0.5 percent of adolescents. An estimated 1.9 percent of young adults aged 18 to 25 were current users of hallucinogens, which represents 668,000 young adults who used hallucinogens. An estimated 0.3 percent of adults aged 26 or older were current users of hallucinogens, which represents 608,000 individuals in this age group who were using hallucinogens.

Figure 24. Past Month Hallucinogen Use among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 24     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 2015 change, the 2016 estimates of inhalant use are not comparable with estimates prior to 2015.

In 2016, approximately 600,000 people aged 12 or older were current users of inhalants, which rounds to the estimate of 0.6 million people shown in Figure 15. This number represents 0.2 percent of the population aged 12 or older (Figure 25). Current use of inhalants in 2016 was more common among adolescents aged 12 to 17 than among people in other age groups. In 2016, 0.6 percent of adolescents, 0.4 percent of young adults aged 18 to 25, and 0.2 percent of adults aged 26 or older were current users of inhalants. About 149,000 adolescents, 121,000 young adults, and 329,000 adults aged 26 or older were current users of inhalants.

Figure 25. Past Month Inhalant Use among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 25     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 2015 measurement changes, the 2016 estimates of methamphetamine use are not comparable with estimates prior to 2015.

In 2016, approximately 667,000 people aged 12 or older were current users of methamphetamine, which rounds to the estimate of 0.7 million people shown in Figure 15. This number represents 0.2 percent of the population aged 12 or older (Figure 26). About 9,000 adolescents aged 12 to 17 were current methamphetamine users. This number corresponds to less than 0.1 percent of adolescents being current methamphetamine users. There were about 65,000 young adults aged 18 to 25 who used methamphetamine in the past month, which corresponds to about 0.2 percent of young adults. An estimated 594,000 adults aged 26 or older used methamphetamine, which represents 0.3 percent of this age group.

Figure 26. Past Month Methamphetamine Use among People Aged 12 or Older, by Age Group: Percentages, 2016

Figure 26     D

Note: Estimates of less than 0.1 percent round to 0.0 percent when shown to the nearest tenth of a percent.

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Opioid Misuse in the Past Year

Opioids are a group of chemically similar drugs that include heroin and prescription pain relievers such as hydrocodone (e.g., Vicodin®), oxycodone (e.g., OxyContin®), and morphine. Opioid misuse includes the misuse of prescription opioid pain relievers or the use of heroin. In 2016, there were 11.8 million past year opioid misusers aged 12 or older in the United States, the vast majority of whom misused prescription pain relievers (Figure 27). Specifically, 11.5 million people aged 12 or older in 2016 misused prescription pain relievers in the past year compared with 948,000 people who used heroin. The majority of prescription pain reliever misusers had misused only prescription pain relievers in the past year but had not used heroin (10.9 million). Approximately 641,000 people had misused prescription pain relievers and also used heroin in the past year. About 307,000 people used heroin in the past year but had not misused prescription pain relievers. Although 5.6 percent of prescription pain reliever misusers also used heroin in the past year, 67.6 percent of heroin users also misused pain relievers in the past year.

Figure 27. Past Year Opioid Misuse among People Aged 12 or Older: 2016

Figure 27     D

Note: Opioid misuse is defined as heroin use or prescription pain reliever misuse.

Past Year Opioid Misuse

This section presents additional 2016 estimates for past year opioid misuse, heroin use, and pain reliever misuse. Because most opioid misuse involves the misuse of prescription pain relievers, this section also provides further details on the misuse of pain relievers in the past year. Specifically, 2016 estimates are presented for the subtypes of prescription pain relievers that people misused, where people obtained the prescription pain relievers that they most recently misused, and the main reason for the most recent misuse of prescription pain relievers in the past year.

In 2016, approximately 11.8 million people aged 12 or older misused opioids in the past year (Figures 27 and 28). This number represents 4.4 percent of the population aged 12 or older. About 891,000 adolescents aged 12 to 17 misused opioids in the past year. This number corresponds to 3.6 percent of adolescents misusing opioids in the past year. About 2.5 million young adults aged 18 to 25 misused opioids in the past year, which corresponds to about 7.3 percent of young adults. An estimated 8.4 million adults aged 26 or older misused opioids in the past year, which represents 4.0 percent of this age group.

Figure 28. Past Year Opioid Misuse among People Aged 12 or Older, by Age Group: 2016

Figure 28     D

Note: Opioid misuse is defined as heroin use or prescription pain reliever misuse.

Past Year Heroin Use

In 2016, an estimated 948,000 people aged 12 or older used heroin in the past year (Figure 27). The estimate of past year heroin use in 2016 (0.4 percent) was higher than the estimates for all years between 2002 and 2013, but it was similar to the estimates in 2014 and 2015 (Figure 29).

Figure 29. Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 29     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 29 Table. Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 0.4
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 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 0.7
≥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 0.3

Aged 12 to 17

In 2016, 0.1 percent of adolescents aged 12 to 17 were past year users (Figure 29). This percentage represents 13,000 adolescents who used heroin in the past year. The percentage of adolescents in 2016 who were past year heroin users was similar to or slightly lower than the percentages in 2002 through 2015.

Aged 18 to 25

Among young adults aged 18 to 25 in 2016, 0.7 percent were past year heroin users (Figure 29). This percentage represents 227,000 young adults who used heroin in the past year. The 2016 percentage of young adults who were past year heroin users was similar to the percentages between 2009 and 2015 (ranging from 0.5 to 0.8 percent), but this percentage in 2016 was higher than the percentages in most years from 2002 through 2008 (ranging from 0.3 to 0.5 percent).

Aged 26 or Older

In 2016, 0.3 percent of adults aged 26 or older were past year heroin users (Figure 29). This percentage represents 708,000 adults aged 26 or older who used heroin in the past year. The percentage of adults aged 26 or older in 2016 who were past year heroin users was similar to the percentages in 2014 and 2015, but it was higher than the percentages in all years from 2002 to 2013.

Past Year Pain Reliever Misuse

In 2016, approximately 11.5 million people misused prescription pain relievers in the past year, representing 4.3 percent of the population aged 12 or older (Figure 30). Among youths aged 12 to 17, 3.5 percent misused prescription pain relievers, corresponding to 881,000 youths. There were about 2.5 million young adults aged 18 to 25 who misused pain relievers in the past year, which corresponds to about 7.1 percent of young adults. An estimated 8.2 million adults aged 26 or older misused pain relievers in the past year, which represents 3.9 percent of this age group.

Figure 30. Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older, by Age Group: 2016

Figure 30     D

Misuse of Subtypes of Pain Relievers

NSDUH asked respondents in 2016 to identify the specific prescription pain relievers that they used in the past year. Names of similar prescription drugs (e.g., Vicodin®, Lortab®, Norco®, Zohydro® ER, and generic hydrocodone) and electronic images of these drugs were presented to respondents to aid them in recalling which prescription pain relievers they used. For each specific pain reliever that respondents reported using in the past 12 months, respondents were asked whether they misused that pain reliever in that period. The specific pain relievers that individuals misused in the past year were categorized into 11 subtypes (i.e., not counting other prescription pain relievers), such as hydrocodone products (Figure 31).

Figure 31. Prescription Pain Reliever Subtypes in the 2016 NSDUH Questionnaire

Figure 31     D

Note: Prescription pain reliever categories shown in the red and blue boxes represent estimates for subtypes that are shown in Table A.12B in Appendix A.
Note: The following drugs in this figure are generic drugs: Hydrocodone, Oxycodone, Tramadol, Extended-Release Tramadol, Codeine Pills, Morphine, Extended-Release Morphine, Fentanyl, Buprenorphine, Buprenorphine Plus Naloxone, Oxymorphone, Extended-Release Oxymorphone, Hydromorphone, Extended-Release Hydromorphone, and Methadone.

This section presents estimates for individuals aged 12 or older. Estimates in this section are not presented for the specific prescription pain relievers that respondents reported misusing due to potential data quality issues. Specifically, respondents may have reported that they misused a brand name drug whose name they recognized (e.g., Vicodin®) when they may have misused a similar drug (e.g., generic hydrocodone). For classification purposes, however, these reports would be equivalent. For example, respondents who reported the misuse of the pain relievers Vicodin® or hydrocodone were classified as misusers of hydrocodone products.

In 2016, the most commonly misused subtype of prescription pain relievers consisted of hydrocodone products, which include Vicodin®, Lortab®, Norco®, Zohydro® ER, and generic hydrocodone (Figure 32). An estimated 6.9 million people aged 12 or older misused these products in the past year, representing 2.6 percent of the population. An estimated 3.9 million people misused oxycodone products in the past year; this number represents 1.4 percent of people aged 12 or older. Oxycodone products include OxyContin®, Percocet®, Percodan®, Roxicodone®, and generic oxycodone. An estimated 0.3 percent of people aged 12 or older misused buprenorphine products in the past year, and 0.1 percent misused methadone.

Figure 32. Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older, by Selected Pain Reliever Subtype: 2016

Figure 32     D

There were 228,000 people who misused prescription fentanyl products in 2016, representing 0.1 percent of the population (Figure 32). Because NSDUH respondents were shown examples of prescription forms of fentanyl, however, this estimate for fentanyl misuse may underrepresent people who misused fentanyl that was illicitly manufactured in clandestine laboratories29 (i.e., as opposed to the misuse of diverted fentanyl that was produced by the pharmaceutical industry). This estimate of fentanyl misuse also may not include people who unknowingly misused fentanyl, such as if heroin was mixed with illicitly manufactured fentanyl.

Main Reasons for the Last Misuse of Pain Relievers

Respondents in the 2016 NSDUH who reported prescription pain reliever misuse in the past year were asked to recall the last prescription pain reliever that they misused in the past year. Respondents were then asked to report their reasons for misusing the prescription pain reliever that last time. Respondents who reported more than one reason for misusing the last prescription pain reliever were asked to report the main reason for pain reliever misuse. If respondents reported only one reason for misusing their last prescription pain reliever, then that reason was their main reason for pain reliever misuse.

Among people aged 12 or older in 2016 who misused prescription pain relievers in the past year, the most commonly reported reason for their last misuse of a pain reliever was to relieve physical pain (62.3 percent), which is the reason pain relievers are prescribed (Figure 33). Even if the reason for misuse was to relieve physical pain, use without a prescription of one's own or use at a higher dosage or more often than prescribed still constituted misuse. Other commonly reported reasons for the last misuse among people who misused pain relievers in the past year were to feel good or get high (12.9 percent) and to relax or relieve tension (10.8 percent). Less common reasons among past year misusers of pain relievers included to help with feelings or emotions (3.9 percent), to help with sleep (3.3 percent), to experiment or see what the drug was like (3.0 percent), because they were "hooked" or needed to have the drug (2.1 percent), and to increase or decrease the effects of other drugs (0.9 percent). In addition, 0.9 percent of past year misusers of pain relievers reported that some other reason was their main reason.

Figure 33. Main Reason for the Most Recent Prescription Pain Reliever Misuse among People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year: Percentages, 2016

Figure 33     D

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

Source of the Last Pain Reliever That Was Misused

Among people aged 12 or older in 2016 who misused prescription pain relievers in the past year, the most common source for the last pain reliever that was misused was from a friend or relative (Figure 34). More than half (53.0 percent) of people who misused pain relievers in the past year reported that they obtained the pain relievers the last time from a friend or relative. Specifically, 40.4 percent of people who misused pain relievers in the past year obtained pain relievers the last time by getting them from a friend or relative for free, 8.9 percent bought their last pain reliever from a friend or relative, and 3.7 percent took their last pain reliever from a friend or relative without asking. About one third of people who misused pain relievers in the past year (37.5 percent) indicated that they obtained pain relievers the last time through prescription(s) or stole from a health care provider, typically getting the pain relievers through a prescription from one doctor (35.4 percent). About 1 in 16 people who misused pain relievers in the past year (6.0 percent) reported that they bought the last pain reliever they misused from a drug dealer or stranger.

Figure 34. Source Where Pain Relievers Were Obtained for Most Recent Misuse among People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year: Percentages: 2016

Figure 34     D

Note: Respondents with unknown data for Source for Most Recent Misuse or who reported Some Other Way but did not specify a valid way were excluded.
Note: The percentages do not add to 100 percent due to rounding.

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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 2016 estimates for overall SUD (i.e., for alcohol or illicit drugs), any illicit drug use disorder, and SUDs for these specific illicit drugs are not comparable with the estimates from years prior to 2015. The questions did not change for identifying past year users of alcohol, marijuana, cocaine, and heroin. Therefore, estimates of SUDs for these substances in 2016 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 Tables A.15B through A.18B in Appendix A.

Alcohol Use Disorder

Alcohol use disorder was defined as meeting DSM-IV criteria for either dependence or abuse for alcohol. Respondents who used alcohol on 6 or more days in the past 12 months were defined as having dependence if they met three or more of the following seven dependence criteria:

  1. spent a lot of time engaging in activities related to alcohol use,
  2. used alcohol in greater quantities or for a longer time than intended,
  3. developed tolerance,
  4. made unsuccessful attempts to cut down on use,
  5. continued use despite physical health or emotional problems associated with alcohol use,
  6. reduced or eliminated participation in other activities because of alcohol use, and
  7. experienced withdrawal symptoms when cutting back or stopping use.

Respondents who used alcohol on 6 or more days in the past 12 months and did not meet criteria for alcohol dependence were defined as having abuse if they reported one or more of the following:

  1. problems at work, home, and school because of alcohol use;
  2. regularly using alcohol and then doing something physically dangerous;
  3. repeated trouble with the law because of alcohol use; and
  4. continued use of alcohol despite problems with family or friends.

An estimated 15.1 million people aged 12 or older had an alcohol use disorder in 2016, which represents 5.6 percent of people aged 12 or older (Figure 35), or about 1 in 18 people aged 12 or older. The percentage of people aged 12 or older with an alcohol use disorder in 2016 was lower than the percentages in 2002 to 2014, but it was similar to the percentage in 2015.

Figure 35. Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 35     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 35 Table. Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 5.6
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+ 2.0
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 10.7
≥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 5.2

Aged 12 to 17

An estimated 488,000 adolescents aged 12 to 17 in 2016 had a past year alcohol use disorder, or 2.0 percent of adolescents (Figure 35). The percentage of adolescents with an alcohol use disorder in 2016 was lower than the percentages in 2002 to 2015. Although the percentages of adolescents with an alcohol use disorder in 2002 to 2010 were relatively low (ranging from 4.6 to 6.0 percent), the percentage of adolescents in 2016 with an alcohol use disorder was roughly a third to half of these percentages in 2002 to 2010.

Aged 18 to 25

Approximately 3.7 million young adults aged 18 to 25 in 2016 had an alcohol use disorder in the past year. This number of young adults with an alcohol use disorder represents 10.7 percent of young adults (Figure 35). The percentage of young adults with an alcohol use disorder in 2016 was lower than the percentages in 2002 to 2014, but it was similar to the percentage in 2015. Nevertheless, nearly 1 in 9 young adults in 2016 had an alcohol use disorder.

Aged 26 or Older

In 2016, approximately 10.9 million adults aged 26 or older had an alcohol use disorder in the past year, which represents 5.2 percent of the adults in this age group (Figure 35). The percentage of adults aged 26 or older with an alcohol use disorder in 2016 was lower than the percentages in most years from 2002 to 2014, but it was similar to the percentage in 2015.

Illicit Drug Use Disorder

This section presents overall estimates for illicit drug use disorder and then provides SUD estimates for specific illicit drugs. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for one or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). There are seven possible dependence criteria for specific illicit drugs:

  1. spent a lot of time engaging in activities related to use of the drug,
  2. used the drug in greater quantities or for a longer time than intended,
  3. developed tolerance to the drug,
  4. made unsuccessful attempts to cut down on use of the drug,
  5. continued to use the drug despite physical health or emotional problems associated with use,
  6. reduced or eliminated participation in other activities because of use of the drug, and
  7. experienced withdrawal symptoms when respondents cut back or stopped using the drug.

For most illicit drugs, dependence is defined as meeting three or more of these seven criteria. However, experiencing withdrawal symptoms is not included as a criterion for some illicit drugs based on DSM-IV criteria. For these substances, dependence is defined as meeting three or more of the first six criteria.

Respondents who used (or misused) a specific illicit drug in the past 12 months and did not meet the dependence criteria for that drug were defined as having abuse were defined as meeting the abuse criteria for that drug if they reported one or more of the following:

  1. problems at work, home, and school because of use of the drug;
  2. regularly using the drug and then doing something physically dangerous;
  3. repeated trouble with the law because of use of the drug; and
  4. continued use of the drug despite problems with family or friends.

Application of these criteria is discussed briefly in the respective SUD sections for specific illicit drugs. Detailed definitions for SUDs for specific illicit drugs also can be found in a glossary of key definitions for the 2016 NSDUH.9

In 2016, an estimated 7.4 million people aged 12 or older had an illicit drug use disorder (Figure 36). This number represents 2.7 percent of people aged 12 or older. An estimated 3.2 percent of adolescents aged 12 to 17 had an illicit drug use disorder, or about 789,000 adolescents. Approximately 2.4 million young adults aged 18 to 25 had an illicit drug use disorder in the past year, which represents 7.0 percent of young adults. Approximately 4.2 million adults aged 26 or older had an illicit drug use disorder in the past year, which represents 2.0 percent of adults aged 26 or older.

Figure 36. Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 36     D

Marijuana Use Disorder

Marijuana use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of marijuana, including health problems, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who used marijuana on 6 or more days in the past 12 months were categorized as having a marijuana use disorder if they met the DSM-IV criteria for either dependence or abuse for marijuana. Dependence and abuse criteria for illicit drugs (including marijuana) were described previously.

Approximately 4.0 million people aged 12 or older in 2016 had a marijuana use disorder in the past year, which represents 1.5 percent of people aged 12 or older (Figure 37). The 2016 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 2015.

Figure 37. Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 37     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 37 Table. Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 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 2.3
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 5.0
≥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 0.8

Aged 12 to 17

In 2016, 2.3 percent of adolescents aged 12 to 17 had a marijuana use disorder in the past year (Figure 37), or about 584,000 adolescents. The percentage of adolescents with a marijuana use disorder in 2016 was lower than the percentages in 2002 to 2013, but it was similar to the percentages in 2014 and 2015.

Aged 18 to 25

Approximately 1.7 million young adults aged 18 to 25 in 2016 had a marijuana use disorder in the past year, or 5.0 percent of young adults (Figure 37). The percentage of young adults with a marijuana use disorder in 2016 was lower than the percentages in 2002 through 2006, but it was similar to the percentages in most years from 2007 to 2015.

Aged 26 or Older

In 2016, approximately 1.7 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 37). The 2016 percentage of adults aged 26 or older with a marijuana use disorder was similar to the percentages in all years between 2002 and 2015.

Cocaine Use Disorder

Cocaine use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of cocaine, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who used cocaine or crack in the past 12 months were categorized as having a cocaine use disorder if they met the DSM-IV criteria for either dependence or abuse for cocaine. Dependence and abuse criteria for illicit drugs (including cocaine) were described previously.

About 867,000 people aged 12 or older in 2016 had a cocaine use disorder in the past year. This number of people with a cocaine use disorder represents 0.3 percent of the population aged 12 or older (Figure 38). The percentage of the population aged 12 or older with a cocaine use disorder remained fairly stable between 2010 and 2016. However, the percentage in 2016 was lower than the percentages in 2002 to 2009.

Figure 38. Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 38     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 38 Table. Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 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 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 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 0.6
≥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 0.3

Aged 12 to 17

An estimated 0.1 percent of adolescents aged 12 to 17 in 2016 had a cocaine use disorder in the past year (Figure 38), or about 29,000 adolescents. The percentage of adolescents with a cocaine use disorder in 2016 was lower than the percentages in 2002 to 2008, but it was similar to the percentages in 2009 to 2015.

Aged 18 to 25

Approximately 215,000 young adults aged 18 to 25 in 2016 had a cocaine use disorder in the past year. This number represents 0.6 percent of young adults (Figure 38). Similar to the pattern for adolescents aged 12 to 17, the percentage of young adults with a cocaine use disorder in 2016 was lower than the percentages in 2002 to 2009, but it was similar to the percentages in 2010 to 2015.

Aged 26 or Older

In 2016, approximately 623,000 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 38). The percentage of adults aged 26 or older with a cocaine use disorder in 2016 was lower than the percentages in 2002 to 2008, but it remained steady when compared with the percentages in most years between 2009 and 2015.

Heroin Use Disorder

Heroin use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of heroin, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who used heroin in the past 12 months were categorized as having a heroin use disorder if they met the DSM-IV criteria for either dependence or abuse for heroin. Dependence and abuse criteria for illicit drugs (including heroin) were described previously.

About 626,000 people aged 12 or older in 2016 had a heroin use disorder. This number of people with a heroin use disorder represents 0.2 percent of people aged 12 or older (Figure 39). The percentage of people aged 12 or older with a heroin use disorder in 2016 was higher than the percentages in 2002 to 2010 (0.1 percent), but it was similar to the percentages in 2011 to 2015.

Figure 39. Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016

Figure 39     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 39 Table. Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016
Age 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Estimates of less than 0.1 percent round to 0.0 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 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 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 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 0.2

Aged 12 to 17

Less than 0.1 percent of adolescents aged 12 to 17 in 2016 had a heroin use disorder in the past year (Figure 39), which corresponds to about 1,000 adolescents. The percentage of adolescents with a heroin use disorder in 2016 was lower than the estimates in most years from 2002 to 2014, but it was similar to the percentage in 2015.

Aged 18 to 25

Approximately 152,000 young adults aged 18 to 25 in 2016 had a heroin use disorder in the past year, which represents 0.4 percent of young adults (Figure 39). The percentage of young adults with a heroin use disorder in 2016 was greater than the percentages in 2002 to 2007, but it was similar to the percentages in 2008 to 2015.

Aged 26 or Older

In 2016, approximately 473,000 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 39). Between 2002 and 2016, 0.1 to 0.2 percent of adults aged 26 or older had a heroin use disorder in the past year. The 2016 estimate was higher than the estimates in 2002 to 2012, but it remained steady when compared with the percentages between 2013 and 2015.

Methamphetamine Use Disorder

With the addition of questions about methamphetamine use in 2015 that were separate from questions about the misuse of prescription stimulants, questions also were added in 2015 about SUD symptoms that respondents attributed specifically to their use of methamphetamine. Consequently, estimates for methamphetamine use disorder are available for 2015 and 2016 but are not available prior to 2015. Also, methamphetamine use disorder does not include stimulant use disorder, which is measured and reported separately.

Methamphetamine use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of methamphetamine, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who used methamphetamine in the past 12 months were categorized as having a methamphetamine use disorder if they met the DSM-IV criteria for either dependence or abuse for methamphetamine. Dependence and abuse criteria for illicit drugs (including methamphetamine) were described previously.

In 2016, an estimated 684,000 people aged 12 or older had a methamphetamine use disorder. This number represents about 0.3 percent of people aged 12 or older (Table A.15B in Appendix A). Less than 0.1 percent of adolescents aged 12 to 17 in 2016 had a methamphetamine use disorder in the past year (Table A.16B), which represents about 10,000 adolescents. Approximately 135,000 young adults aged 18 to 25 and 539,000 adults aged 26 or older in 2016 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.17B) and 0.3 percent of adults aged 26 or older (Table A.18B).

Pain Reliever Use Disorder

Pain reliever use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of pain relievers, including health problems, physical withdrawal, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who misused pain relievers in the past 12 months were categorized as having a pain reliever use disorder if they met the DSM-IV criteria for either dependence or abuse for pain relievers. Dependence and abuse criteria for illicit drugs (including pain relievers) were described previously.

In 2016, an estimated 1.8 million people aged 12 or older had a pain reliever use disorder, which represents 0.7 percent of people aged 12 or older (Figure 40). An estimated 0.6 percent of adolescents aged 12 to 17 had a pain reliever use disorder in the past year, which represents about 152,000 adolescents. Approximately 291,000 young adults aged 18 to 25 and 1.3 million adults aged 26 or older had a pain reliever use disorder in the past year. These numbers of adults with a pain reliever use disorder correspond to 0.8 percent of young adults and 0.6 percent of adults aged 26 or older.

Figure 40. Pain Reliever Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 40     D

Tranquilizer Use Disorder

Tranquilizer use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of tranquilizers, including health problems, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who misused tranquilizers in the past 12 months were categorized as having a tranquilizer use disorder if they met the DSM-IV criteria for either dependence or abuse for tranquilizers. Dependence and abuse criteria for illicit drugs (including tranquilizers) were described previously.

In 2016, an estimated 618,000 people aged 12 or older had a tranquilizer use disorder. This number represents 0.2 percent of people aged 12 or older (Table A.15B in Appendix A). An estimated 0.3 percent of adolescents aged 12 to 17 had a tranquilizer use disorder in the past year (Table A.16B), which represents about 86,000 adolescents. Approximately 188,000 young adults aged 18 to 25 and 343,000 adults aged 26 or older had a tranquilizer use disorder in the past year. These numbers correspond to 0.5 percent of young adults (Table A.17B) and 0.2 percent of adults aged 26 or older (Table A.18B).

Stimulant Use Disorder

Stimulant use disorder occurs when someone experiences clinically significant impairment caused by the recurrent use of prescription stimulants, including health problems, persistent or increasing use, and failure to meet major responsibilities at work, school, or home. NSDUH respondents who misused stimulants in the past 12 months were categorized as having a stimulant use disorder if they met the DSM-IV criteria for either dependence or abuse for stimulants. Dependence and abuse criteria for illicit drugs (including stimulants) were described previously. (As noted in the section on methamphetamine use disorder, respondents who met criteria for methamphetamine use disorder do not necessarily have a stimulant use disorder.)

In 2016, an estimated 540,000 people aged 12 or older had a stimulant use disorder in the past year. This number of people with a stimulant use disorder represents 0.2 percent of people aged 12 or older (Table A.15B in Appendix A). An estimated 0.2 percent of adolescents aged 12 to 17 had a stimulant use disorder in the past year (Table A.16B), which represents about 56,000 adolescents. Approximately 170,000 young adults aged 18 to 25 and 315,000 adults aged 26 or older had a stimulant use disorder in the past year. These numbers correspond to 0.5 percent of young adults (Table A.17B) and 0.1 percent of adults aged 26 or older (Table A.18B).

Opioid Use Disorder

Opioids include two categories of drugs: heroin and opioid prescription pain relievers. NSDUH collects dependence and abuse information for these two categories of drugs. A respondent was classified as having an opioid use disorder if he or she met DSM-IV criteria for heroin use disorder or pain reliever use disorder, as described previously.

In 2016, an estimated 2.1 million people aged 12 or older had an opioid use disorder, or 0.8 percent of people aged 12 or older (Figure 41). An estimated 0.6 percent of adolescents aged 12 to 17 in 2016 had an opioid use disorder in the past year, which represents about 153,000 adolescents. About 392,000 young adults aged 18 to 25 had an opioid use disorder in the past year. This number corresponds to 1.1 percent of young adults. An estimated 1.6 million adults aged 26 or older had an opioid use disorder, which corresponds to 0.8 percent of adults in this age group.

Figure 41. Opioid Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 41     D

Note: Opioid use disorder is defined as meeting DSM-IV criteria for heroin use disorder or pain reliever use disorder in the past 12 months.

Substance Use Disorder (Alcohol or Illicit Drugs)

NSDUH's overall estimates of SUD include people who met the DSM-IV criteria for either dependence or abuse for alcohol or illicit drugs. In 2016, approximately 20.1 million people aged 12 or older had an SUD in the past year, including 15.1 million people who had an alcohol use disorder and 7.4 million people who had an illicit drug use disorder (Figure 42). Among the 7.4 million people aged 12 or older who had an illicit drug use disorder, the most common disorders were for marijuana (4.0 million people) and prescription pain relievers (1.8 million people). Smaller numbers of people in 2016 had disorders related to their use of cocaine, methamphetamine, or heroin or related to their misuse of prescription stimulants.

Figure 42. Numbers of People Aged 12 or Older with a Past Year Substance Use Disorder: 2016

Figure 42     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.

An estimated 2.3 million people aged 12 or older had both an alcohol use disorder and an illicit drug use disorder in the past year (Figure 43). Thus, among people aged 12 or older in 2016 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 9 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 43. 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): 2016

Figure 43     D

The 20.1 million people who had SUDs in 2016 (Figure 42) represent 7.5 percent of people aged 12 or older (Figure 44). This percentage of people in 2016 who had SUDs corresponds to about 1 in 13 people aged 12 or older. An estimated 1.1 million adolescents aged 12 to 17 had SUDs in 2016, which represents 4.3 percent of adolescents. In 2016, 5.2 million young adults aged 18 to 25 had SUDs. This number represents 15.1 percent of young adults. An estimated 13.8 million adults aged 26 or older in 2016 had SUDs, which represents 6.6 percent of adults in this age group. Stated another way, about 1 in 23 adolescents, 1 in 7 young adults, and 1 in 15 adults aged 26 or older had an SUD in the past year.

Figure 44. Substance Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 44     D

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Substance Use Treatment in the Past Year

Substance use treatment services are intended to help people address problems associated with their substance use. NSDUH provides two measures related to substance use treatment: (a) the need for substance use treatment and (b) the receipt of substance use treatment. The substance use treatment estimates in this section are presented for 2016 but are not considered to be comparable with estimates prior to 2015 because changes in the measurement of substance use may have affected the group of respondents who were asked the substance use treatment questions. Also, estimates of the need for substance use treatment in 2016 are not comparable with estimates prior to 2015 because of the noncomparability of several SUD estimates in 2016 with those prior to 2015.

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 facility32 in the past year.33,34

In 2016, an estimated 21.0 million people aged 12 or older needed substance use treatment. Stated another way, about 1 in 13 people aged 12 or older (7.8 percent) needed substance use treatment (Figure 45).34 About 1.1 million adolescents aged 12 to 17 needed treatment for a substance use problem in the past year, representing 4.4 percent of adolescents. About 5.3 million young adults aged 18 to 25 needed treatment for a substance use problem in the past year, representing 15.5 percent of young adults. Stated another way, about 1 in 7 young adults needed substance use treatment. About 14.5 million adults aged 26 or older needed substance use treatment in the past year, which represents 6.9 percent of adults in this age group.

Figure 45. Need for Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 45     D

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 alcohol or illicit drug use or for medical problems associated with the use of alcohol or illicit drugs. NSDUH collects information on the receipt of any substance use treatment and the receipt of substance use treatment at a specialty facility. The categories of any substance use treatment and treatment at a specialty facility are not mutually exclusive categories of use; substance use treatment at a specialty facility is included in estimates of any substance use treatment. Receipt of any substance use treatment includes treatment that was received in the past year at any location, such as a hospital (inpatient), rehabilitation facility (outpatient or inpatient), mental health center, emergency room, private doctor's office, prison or jail, or a self-help group (e.g., such as Alcoholics Anonymous or Narcotics Anonymous). Receipt of substance use treatment at a specialty facility is defined as substance use treatment that 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. This section presents estimates of the receipt of any substance use treatment among all people aged 12 or older, receipt of specialty substance use treatment among people aged 12 or older, and receipt of specialty substance use treatment among people aged 12 or older who needed substance use treatment in the past year.

In 2016, approximately 3.8 million people aged 12 or older received any substance use treatment in the past year, or 1.4 percent of people aged 12 or older (Figure 46). Among adolescents aged 12 to 17, 180,000 received any substance use treatment in the past year, or 0.7 percent of adolescents. An estimated 624,000 young adults aged 18 to 25 received any substance use treatment in the past year; this number represents 1.8 percent of young adults receiving any substance use treatment. About 3.0 million adults aged 26 or older received any substance use treatment in the past year, or 1.4 percent of adults in this age group.

Figure 46. Received Any Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 46     D

Approximately 2.2 million people aged 12 or older in 2016 received substance use treatment at a specialty facility, or 0.8 percent of the population aged 12 or older (Figure 47). Among adolescents aged 12 to 17, 89,000 (0.4 percent) received substance use treatment at a specialty facility. An estimated 383,000 young adults aged 18 to 25 received substance use treatment at a specialty facility; this number represents 1.1 percent of young adults receiving substance use treatment at a specialty facility. About 1.8 million adults aged 26 or older received substance use treatment at a specialty facility in the past year, or 0.8 percent of adults in this age group.

Figure 47. Received Specialty Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016

Figure 47     D

The estimated 2.2 million people aged 12 or older in 2016 who received substance use treatment at a specialty facility in the past year also represents 10.6 percent of the people who needed treatment (Figure 48). Among people in specific age groups who needed substance use treatment, 8.2 percent of adolescents aged 12 to 17, 7.2 percent of young adults aged 18 to 25, and 12.1 percent of adults aged 26 or older received substance use treatment at a specialty facility in the past year. These percentages represent 89,000 adolescents, 383,000 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 48. 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: 2016

Figure 48     D

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Major Depressive Episode in the Past Year

Mental disorders, such as major depressive episode (MDE), 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. Adults and 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. NSDUH uses different age-adapted questions based on using the diagnostic criteria from DSM-IV to ask adults and adolescents about their experiences with MDE.30 Stated another way, some wordings of depression questions for adolescents were designed to make them more developmentally appropriate for youths.35

NSDUH also collects data on impairment in four major life activities or role domains because of an MDE in the past year. These four domains are defined separately for adults aged 18 or older and youths aged 12 to 17 to reflect the different roles associated with the two age groups. 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.36 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.37 Given the differences in item wording, estimates of MDE and MDE with severe impairment are provided separately for adults and adolescents. NSDUH has measured adolescent MDE since 2004 and adolescent MDE with severe impairment since 2006. NSDUH has measured adult MDE since 2005 and adult MDE with severe impairment since 2009.

MDE and MDE with Severe Impairment among Adolescents

In 2016, 12.8 percent of adolescents aged 12 to 17 (3.1 million adolescents) had an MDE during the past year, and 9.0 percent of adolescents (2.2 million adolescents) had a past year MDE with severe impairment (Figure 49). Thus, adolescents in 2016 who had an MDE with severe impairment represented more than two thirds (70.5 percent) of adolescents who had a past year MDE.38

Figure 49. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: 2016

Figure 49     D

Note: Youth respondents with unknown past year MDE data or unknown impairment data were excluded.
Note: The percentages do not add to 100 percent due to rounding.

The percentage of adolescents aged 12 to 17 in 2016 who had a past year MDE was higher than the percentages in 2004 to 2014, but it was similar to the estimate in 2015 (Figure 50). The percentage of adolescents in 2016 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 2016 estimate for MDE with severe impairment among adolescents was similar to the estimates in 2014 and 2015.

Figure 50. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2016

Figure 50     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 50 Table. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2016
MDE Status 04 05 06 07 08 09 10 11 12 13 14 15 16
N/A = not available.
+ Difference between this estimate and the 2016 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 12.8
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 9.0

MDE and MDE with Severe Impairment among Adults

In 2016, 6.7 percent of adults aged 18 or older (16.2 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 51). Adults in 2016 who had an MDE with severe impairment represented nearly two thirds (64.0 percent) of adults who had a past year MDE.38

Figure 51. Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Adults Aged 18 or Older: 2016

Figure 51     D

Note: Adult respondents with unknown past year MDE data or unknown impairment data were excluded.
Note: The percentages do not add to 100 percent due to rounding.

The percentage of adults 18 or older who had a past year MDE remained stable between 2005 and 2016 (Figure 52). The percentage of adults with a past year MDE with severe impairment also remained stable between 2009 and 2016 (Figure 53).

Figure 52. Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2016

Figure 52     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 52 Table. Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2016
>Age Group 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 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 10.9
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 7.4
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 4.8

Figure 53. Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2016

Figure 53     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 53 Table. Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2016
Age Group 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 4.3
18 to 25 5.2+ 5.2+ 5.2+ 5.8+ 5.7+ 6.0+ 6.5 7.0
26 to 49 4.8 4.7 5.2 5.1 4.9 4.6 4.9 4.7
50 or Older 2.6 3.5 2.9 3.4 3.2 3.5 3.0 3.0

Aged 18 to 25

In 2016, an estimated 3.7 million young adults aged 18 to 25 had a past year MDE, or 10.9 percent of young adults (Figure 52). The percentage of young adults with a past year MDE was greater in 2016 than in 2005 to 2014, but it was similar to the percentage in 2015.

An estimated 2.4 million young adults aged 18 to 25 in 2016 had a past year MDE with severe impairment, or 7.0 percent of young adults (Figure 53). The percentage of young adults with a past year MDE with severe impairment was greater in 2016 than in 2009 to 2014, but it was similar to the percentage in 2015.

Aged 26 to 49

In 2016, an estimated 7.2 million adults aged 26 to 49 had a past year MDE, or 7.4 percent of adults in this age group (Figure 52). The percentage of adults aged 26 to 49 in 2016 who had a past year MDE was similar to the corresponding percentages in 2005 to 2015.

An estimated 4.6 million adults aged 26 to 49 in 2016 had a past year MDE with severe impairment, or 4.7 percent of adults in this age group (Figure 53). The percentage of adults aged 26 to 49 in 2016 who had a past year MDE with severe impairment was similar to the percentages in 2009 to 2015.

Aged 50 or Older

In 2016, an estimated 5.3 million adults aged 50 or older had a past year MDE, or 4.8 percent of adults in this age group (Figure 52). The percentage of adults aged 50 or older in 2016 who had a past year MDE was similar to the corresponding percentages in 2005 to 2015.

An estimated 3.3 million adults aged 50 or older in 2016 had a past year MDE with severe impairment, or 3.0 percent of adults in this age group (Figure 53). The percentage of adults aged 50 or older in 2016 who had a past year MDE with severe impairment was similar to the percentages in 2009 to 2015.

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Mental Illness among Adults in the Past Year

NSDUH provides estimates of any mental illness (AMI) and serious mental illness (SMI) for adults aged 18 or older.39 The NSDUH interview does not include questions or methods for estimating the occurrence of mental disorders among adolescents other than whether adolescents had an MDE. Therefore, NSDUH does not include any measure for adolescents that is equivalent to AMI or SMI of any mental illness for adults.

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).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.40

Mental Illness among All Adults

In 2016, an estimated 44.7 million adults aged 18 or older had AMI in the past year (Figure 54). This number represents 18.3 percent of adults in the United States. An estimated 10.4 million adults in the nation had SMI in the past year, and 34.3 million adults had AMI excluding SMI in the past year. The number of adults with SMI represents 4.2 percent of adults in 2016, and the number of adults with AMI excluding SMI represents 14.0 percent of adults. Among adults with AMI in the past year, 23.2 percent had SMI, and 76.8 percent did not have SMI.41,42

Figure 54. Any Mental Illness (AMI), Serious Mental Illness (SMI), and AMI Excluding SMI in the Past Year among Adults Aged 18 or Older: 2016

Figure 54     D

In 2016, the percentages of adults with AMI and adults who had AMI excluding SMI were similar to the percentages from 2008 to 2015 (Figures 55 and 57). The percentage of adults in 2016 with SMI was similar to the percentages from 2010 to 2015 but higher than the percentages in 2008 and 2009 (Figure 56).

Figure 55. Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 55     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 55 Table. Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 18.3
18 to 25 18.5+ 18.0+ 18.1+ 18.5+ 19.6+ 19.4+ 20.1+ 21.7 22.1
26 to 49 20.7 21.6 20.9 20.3 21.2 21.5 20.4 20.9 21.1
50 or Older 14.1 14.5 15.1 15.0 15.8 15.3 15.4 14.0 14.5

Figure 56. Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 56     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 56 Table. Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 4.2
18 to 25 3.8+ 3.3+ 3.9+ 3.8+ 4.1+ 4.2+ 4.8+ 5.0+ 5.9
26 to 49 4.8+ 4.9 5.2 5.0 5.2 5.3 4.9 5.0 5.3
50 or Older 2.5 2.5 3.0 2.8 3.0 3.2 3.1 2.8 2.7

Figure 57. Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 57     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 57 Table. Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 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 14.0
18 to 25 14.8+ 14.6+ 14.1+ 14.8+ 15.5 15.2+ 15.3 16.7 16.2
26 to 49 16.0 16.7+ 15.7 15.3 16.0 16.2 15.5 15.9 15.8
50 or Older 11.6 12.0 12.2 12.3 12.8 12.1 12.3 11.1 11.8

Mental Illness among Adult Age Groups

Aged 18 to 25

In 2016, an estimated 7.6 million young adults aged 18 to 25 (22.1 percent) had AMI in the past year (Figure 55), and an estimated 2.0 million young adults (5.9 percent) had SMI in the past year (Figure 56). An estimated 5.6 million young adults (16.2 percent) had AMI excluding SMI in the past year (Figure 57).

Percentages of young adults aged 18 to 25 in 2016 who had AMI, SMI, or AMI excluding SMI were greater than the corresponding percentages in most or all years from 2008 to 2013. The percentage of young adults in 2016 who had AMI was greater than the percentages from 2008 to 2014, but it was similar to the percentage in 2015. The estimate of SMI among young adults in 2016 was higher than the estimates in all years between 2008 and 2015. The 2016 percentage of young adults with AMI excluding SMI was higher than the percentages in most years between 2008 and 2013, but it was similar to the percentages in 2014 and 2015.

Aged 26 to 49

In 2016, 20.9 million adults aged 26 to 49 (21.1 percent) had AMI in the past year (Figure 55), and an estimated 5.3 million adults aged 26 to 49 (5.3 percent) had SMI in the past year (Figure 56). An estimated 15.6 million adults aged 26 to 49 (15.8 percent) had AMI excluding SMI in the past year (Figure 57). Estimates of AMI, SMI, and AMI excluding SMI among adults aged 26 to 49 in 2016 were similar to the estimates in most years between 2008 and 2015.

Aged 50 or Older

In 2016, an estimated 16.1 million adults aged 50 or older (14.5 percent) had AMI in the past year (Figure 55), and an estimated 3.0 million adults aged 50 or older (2.7 percent) had SMI in the past year (Figure 56). An estimated 13.1 million adults aged 50 or older (11.8 percent) had AMI excluding SMI in the past year (Figure 57).

The 2016 estimate of AMI among adults aged 50 or older was similar to the estimates between 2008 and 2015. The percentages of adults aged 50 or older with past year SMI and AMI excluding SMI in 2016 were also similar to the percentages in 2008 to 2015.

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Mental Health Service Use in the Past Year

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 who reported seeing or talking to a health professional or taking prescribed medication for their depression were defined as having received treatment for their depression in the past year.43 Estimates of treatment for depression among adolescents are presented for 2004 to 2016 among adolescents with MDE and for 2006 to 2016 among adolescents with MDE with severe impairment.

Of the 3.1 million adolescents aged 12 to 17 with past year MDE in 2016, an estimated 1.2 million youths received treatment for depression. Stated another way, 40.9 percent of youths who had a past year MDE received treatment for depression (Figure 58). The 2016 percentage was similar to the percentages in most years from 2004 to 2015.

Figure 58. Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2016

Figure 58     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 58 Table. Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2016
MDE Status 04 05 06 07 08 09 10 11 12 13 14 15 16
N/A = not available.
+ Difference between this estimate and the 2016 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 40.9
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 46.7

In 2016, about 1.0 million youths aged 12 to 17 who had a past year MDE with severe impairment received treatment for depression, or 46.7 percent of youths who had a past year MDE with severe impairment. The percentage of adolescents with an MDE with severe impairment in 2016 who received treatment for depression was similar to the percentages in most years from 2006 to 2015.

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.43 Estimates of treatment for depression among adults are presented for 2009 to 2016 for adults with an MDE and adults with an MDE with severe impairment.

Of the 16.2 million adults aged 18 or older in 2016 who had a past year MDE, 10.6 million received treatment for depression, or 65.3 percent of adults who had a past year MDE (Figure 59). The percentage of adults with a past year MDE who received treatment for depression in 2016 was similar to the percentages in most years between 2009 and 2015.

Figure 59. Received Treatment in the Past Year for Depression among Adults Aged 18 or Older with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2016

Figure 59     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 59 Table. Received Treatment in the Past Year for Depression among Adults Aged 18 or Older with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2016
MDE Status 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
MDE 64.3 68.2 68.1 68.0 68.6+ 68.6+ 67.2 65.3
MDE with Severe
   Impairment
71.5 72.9 73.7 73.1 76.4+ 73.7 72.7 72.2

Among the 10.3 million adults in 2016 who had a past year MDE with severe impairment, 7.5 million received treatment for depression, or 72.2 percent of adults with a past year MDE with severe impairment. The percentage of adults with an MDE with severe impairment in 2016 who received treatment for depression was similar to the percentages in most years from 2009 to 2015.

Aged 18 to 25

Of the 3.7 million young adults aged 18 to 25 with a past year MDE, about 1.6 million received treatment for depression in the past year, or 44.1 percent of young adults with a past year MDE. The percentage of young adults with MDE in 2016 who received treatment for depression was similar to or lower than the percentages in 2009 to 2014 (Table A.24B in Appendix A).

In 2016, 1.2 million of the young adults aged 18 to 25 with a past year MDE with severe impairment received treatment for depression in the past year, or about half (51.3 percent). The percentage of young adults with an MDE with severe impairment in 2016 who received treatment for depression was similar to the percentages in most years from 2009 to 2015.

Aged 26 to 49

In 2016, about 4.9 million of the 7.2 million adults aged 26 to 49 with a past year MDE received treatment for depression in the past year, or about two thirds of the adults in this age group who had a past year MDE (67.4 percent) (Table A.24B). The percentage of adults aged 26 to 49 with a past year MDE in 2016 who received treatment for depression was similar to the percentages in 2009 to 2015.

In 2016, 3.4 million adults aged 26 to 49 with a past year MDE with severe impairment received treatment for depression in the past year, or about three fourths of adults in this age group who had a past year MDE with severe impairment (74.3 percent). The percentage of adults in this age group with an MDE with severe impairment in 2016 who received treatment for depression was similar to the percentages in 2009 to 2015.

Aged 50 or Older

Of the 5.3 million adults aged 50 or older with a past year MDE, about 4.1 million received treatment for depression in the past year. The percentage of adults aged 50 or older with an MDE who received treatment for depression (77.3 percent) was similar to the percentages in 2009 to 2015 (Table A.24B).

In 2016, 2.8 million of the 3.3 million adults aged 50 or older with a past year MDE with severe impairment received treatment for depression in the past year, or 84.1 percent of adults in this age group with a past year MDE with severe impairment. The percentage of adults in this age group with an MDE with severe impairment in 2016 who received treatment for depression was similar to the percentages in 2009 to 2015.

Any Mental Health Service Use among All Adolescents

In addition to asking youths about treatment for depression, NSDUH includes questions for adolescents aged 12 to 17 that ask about any receipt of services for emotional and behavioral problems (i.e., not just depression) that were not caused by substance use. 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 the following settings: (a) specialty mental health settings;44 (b) education settings (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) general medical settings (care from a pediatrician or family physician for emotional or behavioral problems); (d) juvenile justice settings (services for an emotional or behavioral problem in a detention center, prison, or jail); or (e) child welfare settings (foster care or therapeutic foster care).

As noted previously, the NSDUH interview does not include questions or methods for estimating the occurrence of mental disorders among adolescents other than whether adolescents had an MDE. Therefore, NSDUH does not include any measure for adolescents that is equivalent to AMI or SMI for adults. Consequently, this section focuses on mental health care among all adolescents.

In 2016, the following numbers and percentages 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 60):

Figure 60. Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: 2016

Figure 60     D

Note: Mental health service for youths aged 12 to 17 is defined as having received treatment/counseling for emotional or behavioral problems not caused by substance use.
Note: Nonspecialty settings do not include youths who received mental health services in the past year from a juvenile justice setting.

In addition, 1.5 million youths aged 12 to 17 (6.2 percent) received mental health services in both specialty and nonspecialty settings (i.e., an education, general medical, or child welfare setting). The percentage of youths who received mental health services in both specialty and nonspecialty settings in 2016 was higher than the estimates in 2009 to 2011, but it was similar to the percentages in 2012 to 2015 (Table A.25B in Appendix A).

The percentage of adolescents in 2016 who received mental health services in a specialty mental health setting in the past 12 months (14.7 percent) was higher than the percentages in 2009 to 2015, which ranged from 12.0 to 13.7 percent (Figure 61). The percentages of youths aged 12 to 17 in 2016 who received mental health services in an education setting (13.1 percent), a general medical setting (2.9 percent), a child welfare setting (0.4 percent), and a juvenile justice setting (0.2 percent) were similar to the corresponding percentages in most years from 2009 to 2015.

Figure 61. Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: Percentages, 2009-2016

Figure 61     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service for youths aged 12 to 17 is defined as having received treatment/counseling for emotional or behavioral problems not caused by substance use.
Note: Nonspecialty settings do not include youths who received mental health services in the past year from a juvenile justice setting.

Figure 61 Table. Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: Percentages, 2009-2016
Source 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service for youths aged 12 to 17 is defined as having received treatment/counseling for emotional or behavioral problems not caused by substance use.
Note: Nonspecialty settings do not include youths who received mental health services in the past year from a juvenile justice setting.
Specialty Mental Health Setting 12.0+ 12.1+ 12.6+ 12.7+ 13.6+ 13.7+ 13.3+ 14.7
Education Setting 12.1+ 12.4 11.9+ 12.9 13.0 13.2 13.2 13.1
General Medical Setting 2.5 2.5 2.5 2.5 2.8 2.9 2.7 2.9
Child Welfare Setting 0.4 0.4 0.6 0.4 0.4 0.4 0.3 0.4
Juvenile Justice Setting 0.4+ 0.3 0.4+ 0.3 0.2 0.3 0.2 0.2
Specialty and Nonspecialty Settings 5.0+ 5.3+ 5.4+ 5.7 6.1 5.9 5.7 6.2

Any Mental Health Service Use among All 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. Unlike questions about treatment for depression that were discussed previously, general questions for the receipt of treatment or counseling for mental health issues among adults do not ask specifically about treatment for a particular mental disorder. Consequently, references in this section to treatment or counseling for any problem with emotions, nerves, or mental health are described broadly as "mental health service use." This section compares the 2016 estimates of mental health service use with estimates from 2002 to 2015 for the entire adult population. The next section presents estimates of mental health service use for adults with mental illness.

In 2016, an estimated 35.0 million adults aged 18 or older (14.4 percent of adults) received mental health services during the past 12 months (Figure 62). The estimate of 14.4 percent of adults aged 18 or older in 2016 who received mental health services in the past 12 months was greater than the estimates in most years between 2002 and 2011, but it was similar to the estimates in 2012 to 2015.

Figure 62. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2016

Figure 62     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.

Figure 62 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2016
Service 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.
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 14.4
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 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 6.9
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 12.0

Aged 18 to 25

In 2016, 4.4 million young adults aged 18 to 25 used mental health services in the past year. This number represents 12.9 percent of young adults receiving mental health services in 2016 (Table A.26B in Appendix A). The percentage of young adults in 2016 who received mental health services in the past year was higher than the percentages in most years from 2002 to 2015.

Aged 26 to 49

In 2016, 15.2 million adults aged 26 to 49 used mental health services in the past year. This number represents 15.4 percent of adults aged 26 to 49 (Table A.26B). The 2016 estimate of the receipt of mental health services among adults in this age group was higher than estimates from 2004 to 2008, but it was similar to the estimates from 2009 to 2015.

Aged 50 or Older

In 2016, 15.4 million adults aged 50 or older used mental health services in the past year. This number represents 14.0 percent of adults aged 50 or older (Table A.26B). The 2016 estimate of the receipt of mental health services among adults in this age group was higher than the estimates in 2002 to 2006, but it was similar to the estimates in most years from 2007 to 2015.

Any Mental Health Service Use among Adults with Mental Illness

NSDUH data may also be used to assess mental health service use among adults with AMI or SMI. In 2016, among the 44.7 million adults with AMI, 19.2 million (43.1 percent) received mental health services in the past year (Figure 63). About 6.7 million of the 10.4 million adults with past year SMI (64.8 percent) received mental health services in the past year (Figure 64).

Figure 63. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2016

Figure 63     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.

Figure 63 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2016
Service Type 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.
Any Mental Health Services 40.9 40.2+ 42.4 40.8+ 41.0 44.7 44.7 43.1 43.1
Inpatient 3.7 3.2 2.7 3.3 3.0 3.3 3.8 3.4 3.3
Outpatient 24.1 22.5+ 23.4 24.0 22.4+ 24.4 24.3 25.4 24.5
Prescription Medication 35.5 34.8+ 36.9 35.6 35.3 38.9 38.7 36.7 37.1

Figure 64. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2016

Figure 64     D

Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.

Figure 64 Table. Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2016
Service Type 2008 2009 2010 2011 2012 2013 2014 2015 2016
Note: Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health.
Any Mental Health Services 65.7 66.5 67.5 64.9 62.9 68.5 68.5 65.3 64.8
Inpatient 8.6 8.6 6.7 8.8 6.2 8.3 8.8 7.0 7.6
Outpatient 46.2 44.6 42.5 44.1 39.0 46.9 44.2 43.6 42.6
Prescription Medication 59.7 61.1 61.0 58.2 57.8 62.1 61.4 57.3 58.0

The percentage of adults with AMI in 2016 who received mental health care in the past year (43.1 percent) was similar to the percentages in most years from 2008 to 2015 (Figure 63). The percentage of adults with SMI in 2016 who received mental health services in the past year (64.8 percent) also was similar to the estimates in 2008 to 2015 (Figure 64). In any given year, about two thirds of adults with past year SMI received mental health services in the past year. Stated another way, however, about one third of adults with SMI in any given year did not receive mental health services.

Aged 18 to 25

In 2016, 2.7 million young adults aged 18 to 25 with AMI used mental health services in the past year, including 1.0 million young adults with SMI. These numbers of young adults who used mental health services represent 35.1 percent of young adults with AMI in the past year and 51.5 percent of those with SMI (Table A.27B in Appendix A). The percentage of young adults with AMI in 2016 who received mental health care was higher than estimates in 2008 and 2009, but it was similar to the percentages in most years from 2010 to 2015. The percentage of young adults with SMI in 2016 who received mental health services in the past year was similar to the estimates from 2008 to 2015.

Aged 26 to 49

In 2016, 9.0 million adults aged 26 to 49 with AMI used mental health services in the past year, including 3.5 million adults in this age group with SMI. These numbers of adults in this age group who received mental health services in the past year correspond to 43.1 percent of those with AMI and 66.1 percent of those with SMI (Table A.27B). The percentage of adults aged 26 to 49 with AMI in 2016 who received mental health care in the past year was similar to the percentages from 2008 to 2015. The percentage of adults aged 26 to 49 with SMI who received mental health services in the past year also remained steady from 2008 to 2016.

Aged 50 or Older

In 2016, 7.5 million adults aged 50 or older with AMI used mental health services in the past year, including 2.2 million adults in this age group with SMI. These numbers of adults aged 50 or older who used mental health services represent nearly half of those with AMI (46.8 percent) and nearly three fourths of those with SMI (71.5 percent) (Table A.27B). The percentage of adults aged 50 or older with AMI in 2016 who received mental health care in the past year was similar to the percentages from 2008 to 2015. The percentage of adults aged 50 or older with SMI in 2016 who received mental health services in the past year also remained steady compared with estimates from 2008 to 2015.

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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 (i.e., illicit drug use disorder or alcohol use disorder) among adolescents aged 12 to 17. Estimates of co-occurring MDE and SUDs are presented among all adolescents. Additionally, this section presents estimates of having a past year MDE among adolescents with SUDs. This section also presents estimates of substance use and SUDs among adolescents with an MDE. Because of the 2015 changes to the SUD estimates, the 2016 estimates of co-occurring MDE and SUD are not comparable with estimates from years prior to 2015.

An estimated 333,000 adolescents aged 12 to 17 in 2016 had an SUD and an MDE in the past year. This number represents 1.4 percent of adolescents in the United States (Figure 65). An estimated 278,000 adolescents in 2016 (1.1 percent of adolescents) had an SUD and an MDE with severe impairment in the past year.

Figure 65. Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) Status among Youths Aged 12 to 17: Percentages, 2016

Figure 65     D

MDE among Adolescents with a Substance Use Disorder

The 333,000 adolescents in 2016 who had a co-occurring MDE and an SUD in the past year represent about one third (33.0 percent) of the 1.1 million adolescents who had a past year SUD (Figure 66 and Table A.29B). Among adolescents without a past year SUD, 11.9 percent (2.8 million adolescents) had an MDE in the past year.

Figure 66. Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) among Youths Aged 12 to 17: Numbers in Millions, 2016

Figure 66     D

Note: Youth respondents with unknown MDE data were excluded.

Substance Use and Substance Use Disorders among Adolescents with MDE

Estimates of illicit drug use among adolescents that were previously described in this report focused on use in the past month (i.e., current use). Because MDE estimates are for the past year, however, this section focuses mainly on co-occurring MDE and substance use in the past year among adolescents. In 2016, 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 (31.7 vs. 13.4 percent) (Figure 67). Youths with a past year MDE in 2016 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.

Figure 67. Past Year Illicit Drug Use among Youths Aged 12 to 17, by Past Year Major Depressive Episode (MDE) Status: Percentages, 2016

Figure 67     D

Unlike the illicit drug use estimates described previously, NSDUH estimates of daily cigarette smoking and heavy alcohol use are available only for the past month. Among adolescents aged 12 to 17 in 2016, 0.9 percent of those with a past year MDE were daily cigarette smokers in the past month compared with 0.4 percent of those without a past year MDE (Table A.30B in Appendix A). In addition, 1.7 percent of adolescents aged 12 to 17 with a past year MDE were heavy alcohol drinkers in the past month compared with 0.6 percent of those without a past year MDE.

Among the 3.1 million adolescents aged 12 to 17 in 2016 who had a past year MDE, a total of 333,000 adolescents (10.8 percent) had a past year SUD. In contrast, among adolescents without a past year MDE, 676,000 (3.2 percent) had an SUD in the past year (Figure 66 and Table A.29B in Appendix A).

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

This section presents data from the 2016 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 333,000 adolescents in 2016 who had a co-occurring MDE and an SUD in the past year, 239,000 received either substance use treatment at a specialty facility or mental health services in the past year. This number of adolescents who received mental health care or specialty substance use treatment corresponds to 71.9 percent of adolescents who had a co occurring MDE and an SUD (Table A.31B in Appendix A). Stated another way, however, nearly a quarter of adolescents with both an MDE and an SUD in the past year did not receive either type of service. Among adolescents with a co-occurring MDE and an SUD in 2016, 4.6 percent received both mental health care and specialty substance use treatment, and 65.8 percent received only mental health care. An estimated 1.5 percent of adolescents with a co occurring MDE and an SUD received only specialty substance use treatment.

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

The coexistence of both a mental disorder among adults 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, percentages of adults with co occurring disorders can be estimated. This section presents findings on mental disorders (i.e., AMI and SMI) that co-occurred with SUDs (i.e., alcohol use disorder or illicit drug use disorder) among adults aged 18 or older in the United States. Because of the 2015 changes to SUD estimates, the 2016 estimates of co-occurring mental disorders and SUDs among adults are not comparable with estimates prior to 2015.

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

As noted previously, 44.7 million adults aged 18 or older in 2016 had AMI in the past year, including 10.4 million who had SMI. In addition, 19.0 million adults had a past year SUD. Among these adults in 2016 who had either AMI or SUDs in the past year, 8.2 million had both AMI and SUDs (Figure 68). This number of adults with AMI and SUDs corresponds to 3.4 percent of adults (Table A.32B in Appendix A). An estimated 2.6 million adults aged 18 or older had co-occurring SMI and SUDs in the past year (Figure 69), which corresponds to 1.1 percent of adults.

Figure 68. Past Year Substance Use Disorder (SUD) and Mental Illness among Adults Aged 18 or Older: Numbers in Millions, 2016

Figure 68     D


Figure 69. Past Year Substance Use Disorder (SUD) and Serious Mental Illness (SMI) among Adults Aged 18 or Older: Numbers in Millions, 2016

Figure 69     D

Aged 18 to 25

In 2016, 7.6 million young adults aged 18 to 25 had AMI in the past year, and 5.2 million had a past year SUD. Among young adults who had either AMI or SUDs, 2.1 million had both AMI and SUDs in the past year. This number of adults with both AMI and SUDs corresponds to 6.1 percent of young adults (Table A.32B). An estimated 711,000 young adults had co-occurring SMI and SUDs in the past year, which corresponds to 2.1 percent of young adults.

Aged 26 to 49

In 2016, 20.9 million adults aged 26 to 49 had AMI in the past year, and 9.3 million had a past year SUD. Among aged 26 to 49 who had either AMI or SUDs, 4.5 million had both AMI and SUDs in the past year. This number of adults aged 26 to 49 with both AMI and SUDs corresponds to 4.5 percent of adults in this age group (Table A.32B). An estimated 1.4 million adults aged 26 to 49 in 2016 had co-occurring SMI and SUDs in the past year, which corresponds to 1.4 percent of adults in this age group.

Aged 50 or Older

In 2016, 16.1 million adults aged 50 or older had AMI in the past year, and 4.5 million had a past year SUD. Among adults aged 50 or older who had either AMI or SUDs, 1.7 million had both AMI and SUDs in the past year. This number of adults aged 50 or older with both AMI and SUDs corresponds to 1.5 percent of adults in this age group (Table A.32B). An estimated 496,000 adults aged 50 or older in 2016 had co-occurring SMI and SUDs in the past year, which corresponds to 0.4 percent of adults in this age group.

Mental Illness among Adults with a Substance Use Disorder

In 2016, among the 19.0 million adults with a past year SUD, 8.2 million (43.3 percent) had AMI in the past year (Figure 68 and Table A.33B in Appendix A). In contrast, among adults without a past year SUD, 16.1 percent (36.4 million adults) had AMI in the past year.

Among the 19.0 million adults who had a past year SUD, 2.6 million (13.8 percent) also had SMI in the past year (Figure 69). In contrast, among adults without a past year SUD, 3.4 percent (7.7 million adults) had SMI in the past year.

Aged 18 to 25

In 2016, among the 5.2 million young adults aged 18 to 25 with a past year SUD, 2.1 million (40.6 percent) had AMI in the past year (Table A.33B). In contrast, among young adults without a past year SUD, 18.8 percent (5.5 million adults) had AMI in the past year.

In 2016, among the 5.2 million adults aged 18 to 25 with a past year SUD, 711,000 (13.6 percent) had SMI in the past year. In contrast, among young adults without a past year SUD, 4.5 percent (1.3 million adults) had SMI in the past year.

Aged 26 to 49

Among the 9.3 million adults aged 26 to 49 with a past year SUD, 4.5 million (47.9 percent) had AMI in the past year (Table A.33B). Among adults aged 26 to 49 without a past year SUD, 18.3 percent (16.4 million adults) had AMI in the past year.

Among the 9.3 million adults aged 26 to 49 with a past year SUD, 1.4 million (15.3 percent) had SMI in the past year. Among adults aged 26 to 49 without a past year SUD, 4.3 percent (3.9 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 (37.0 percent) had AMI in the past year (Table A.33B). Among adults aged 50 or older without a past year SUD, 13.6 percent (14.5 million adults) had AMI in the past year.

Among the 4.5 million adults aged 50 or older with a past year SUD, 496,000 (11.0 percent) had SMI in the past year. Among adults aged 50 or older without a past year SUD, 2.4 percent (2.6 million adults) had SMI in the past year.

Substance Use Disorders among Adults with Mental Illness

The 8.2 million adults with AMI who met the criteria for an SUD in the past year represent 18.5 percent of the 44.7 million adults with AMI (Figure 70). In contrast, 5.4 percent of adults who did not have past year AMI (10.8 million adults) met the criteria for an SUD (Table A.34B in Appendix A and Figure 68). The 2.6 million adults with SMI who met the criteria for an SUD in the past year represent 25.4 percent of the 10.4 million adults with SMI (Figure 71). In contrast, 7.0 percent of adults who did not have past year SMI (16.4 million adults) met the criteria for SUD (Figure 69).

Figure 70. Past Year Substance Use Disorder among Adults Aged 18 or Older with Any Mental Illness in the Past Year, by Age Group: 2016

Figure 70     D


Figure 71. Past Year Substance Use Disorder among Adults Aged 18 or Older with Serious Mental Illness in the Past Year, by Age Group: 2016

Figure 71     D

Aged 18 to 25

In 2016, about 2.1 million young adults aged 18 to 25 with AMI had a past year SUD. This number of young adults with a past year SUD represents 27.8 percent of young adults with AMI (Figure 70). Among young adults with SMI, about 711,000 (34.9 percent) had an SUD (Figure 71). Among young adults with no mental illness, about 3.1 million (11.6 percent) had an SUD.

Aged 26 to 49

Among adults aged 26 to 49 in 2016 with AMI, about 4.5 million had an SUD. This number of adults with a past year SUD represents 21.3 percent of adults aged 26 to 49 with AMI (Figure 70). Among adults aged 26 to 49 with SMI, about 1.4 million (26.9 percent) had an SUD (Figure 71). Among adults aged 26 to 49 with no mental illness, about 4.9 million (6.2 percent) had an SUD.

Aged 50 or Older

In 2016, about 1.7 million adults aged 50 or older with AMI had an SUD. This number of adults with a past year SUD presents 10.3 percent of adults aged 50 or older with AMI (Figure 70). Among adults aged 50 or older with SMI, 496,000 (16.3 percent) had an SUD (Figure 71). Among adults aged 50 or older with no mental illness, about 2.8 million (3.0 percent) had an SUD.

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 services or specialty substance use treatment among adults with an SUD who have co-occurring AMI and co occurring SMI. Because of the 2015 questionnaire changes for substance use and SUDs that were described previously, the 2016 NSDUH estimates of the receipt of services among adults with co-occurring mental disorders and SUDs are not comparable with estimates prior to 2015.

Among the 8.2 million adults with co-occurring AMI and an SUD in the past year, 48.1 percent received either substance use treatment at a specialty facility45 or mental health care in the past year (Figure 72). In other words, however, about half of the adults with co-occurring AMI and an SUD in the past year did not receive either type of service.46 An estimated 6.9 percent of adults with these co occurring disorders received both mental health care and specialty substance use treatment, 38.2 percent received only mental health care, and 2.9 percent received only specialty substance use treatment.

Figure 72. Receipt of Mental Health Services and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older with Past Year Mental Illness and Substance Use Disorders: Percentages, 2016

Figure 72     D

Note: Mental health service 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 2.6 million adults who had co-occurring SMI and an SUD in the past year, 65.6 percent received either substance use treatment at a specialty facility or mental health care in the past year (Figure 73). Stated another way, however, 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, 12.0 percent received both mental health care and specialty substance use treatment, 51.2 percent received only mental health care, and 2.3 percent received only specialty substance use treatment.

Figure 73. Receipt of Mental Health Services and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2016

Figure 73     D

Note: Mental health service 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.

Aged 18 to 25

Among young adults aged 18 to 25 in 2016 who had co-occurring AMI and an SUD in the past year, 42.0 percent received substance use treatment at a specialty facility or mental health care in the past year (Table A.35B in Appendix A). Among young adults who had co-occurring AMI and an SUD, 35.1 percent received only mental health care, 3.8 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 2016, 55.7 percent received either mental health care or specialty substance treatment, 3.8 percent received both mental health care and specialty substance use treatment, 49.6 percent received only mental health care, and 2.3 percent received only specialty substance use treatment in the past year.

Aged 26 to 49

Among adults aged 26 to 49 in 2016 who had co-occurring AMI and an SUD in the past year, 47.9 percent received mental health care or substance use treatment at a specialty facility in the past year (Table A.35B). Among adults 26 to 49 who had co-occurring AMI and an SUD, 37.0 percent received only mental health care, 8.0 percent received both mental health care and specialty substance use treatment, and 2.8 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 2016, 69.0 percent received either mental health care or specialty substance treatment, 12.7 percent received both mental health care and specialty substance use treatment, 54.1 percent received only mental health care, and 2.2 percent received only specialty substance use treatment in the past year.

Aged 50 or Older

Among adults aged 50 or older in 2016 who had co-occurring AMI and an SUD in the past year, 56.3 percent received mental health care or substance use treatment at a specialty facility in the past year (Table A.35B). Among adults aged 50 or older who had co-occurring AMI and an SUD, 45.1 percent received only mental health care, 8.1 percent received both mental health care and specialty substance use treatment, and 3.0 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.12

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Suicidal Thoughts and Behavior among Adults

Suicide is an important public health problem in the United States and a tragedy for all involved—the individuals and their families, friends, neighbors, colleagues, and communities. Although deaths from suicide average to about 100 people each day,47 individuals who die from suicide represent a fraction of those who consider or attempt suicide.48 Out of every 31 adults in 2008 to 2011 in the United States who attempted suicide in the past 12 months, there was 1 death by suicide.49 Individuals are likely to have thought about suicide before attempting suicide. NSDUH has collected information on past year suicidal thoughts and behavior among adults aged 18 or older in the United States since 2008.

NSDUH respondents aged 18 or older were asked if at any time during the past 12 months they had thought seriously about trying to kill themselves. Adults who had serious thoughts of suicide in the past 12 months were asked whether they made a plan to kill themselves or tried to kill themselves in that period.

In 2016, 9.8 million adults aged 18 or older (4.0 percent) reported they had thought seriously about trying to kill themselves (Figures 74 and 75). Of the 9.8 million adults with serious thoughts of suicide, 2.8 million reported that they had made suicide plans, and 1.3 million made a nonfatal suicide attempt. Among the 1.3 million adults aged 18 or older who attempted suicide in the past year, 1.0 million reported making suicide plans, and 0.3 million did not make suicide plans.50 Stated another way, about one fourth of adults who had serious thoughts of suicide made suicide plans, and about 1 in 7 adults who had serious thoughts of suicide made a suicide attempt.

Figure 74. Suicidal Thoughts, Plans, and Attempts in the Past Year among Adults Aged 18 or Older: Numbers in Millions, 2016

Figure 74     D


Figure 75. Suicidal Thoughts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 75     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 75 Table. Suicidal Thoughts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
18 or Older 3.7 3.7 3.8 3.7+ 3.9 3.9 3.9 4.0 4.0
18 to 25 6.8+ 6.1+ 6.7+ 6.8+ 7.2+ 7.4+ 7.5+ 8.3 8.8
26 to 49 4.0 4.3 4.1 3.7+ 4.2 4.0 4.0 4.1 4.2
50 or Older 2.3 2.3 2.6 2.6 2.4 2.7 2.7 2.6 2.4

Serious Thoughts of Suicide

The estimated 9.8 million adults aged 18 or older in 2016 who had serious thoughts of suicide in the past year (Figure 74) represent 4.0 percent of adults aged 18 or older (Figure 75). The percentage of adults aged 18 or older in 2016 who had serious thoughts of suicide was similar to the percentages in most years between 2008 and 2015.

Aged 18 to 25

An estimated 3.0 million young adults aged 18 to 25 in 2016 had serious thoughts of suicide in the past year, which represents 8.8 percent of young adults (Figure 75). The percentage of young adults with serious thoughts of suicide was higher in 2016 than the percentages in 2008 to 2014 but was similar to the percentage in 2015.

Aged 26 to 49

In 2016, 4.2 million adults aged 26 to 49 had serious thoughts of suicide in the past year, or 4.2 percent of adults in this age group (Figure 75). The percentage of adults aged 26 to 49 with serious thoughts of suicide was stable in most years between 2008 and 2016.

Aged 50 or Older

In 2016, 2.6 million adults aged 50 or older had serious thoughts of suicide in the past year, which represents 2.4 percent of adults in this age group (Figure 75). The percentage of adults aged 50 or older with serious thoughts of suicide remained stable from 2008 to 2016.

Suicide Plans

The estimated 2.8 million adults in 2016 who made suicide plans in the past year (Figure 74) represent 1.1 percent of adults aged 18 or older (Figure 76). The percentage of adults aged 18 or older who made suicide plans remained stable between 2008 and 2016.

Figure 76. Suicide Plans in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 76     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 76 Table. Suicide Plans in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
18 or Older 1.0 1.0 1.1 1.0 1.1 1.1 1.1 1.1 1.1
18 to 25 2.0+ 2.0+ 1.9+ 1.9+ 2.4+ 2.5 2.3+ 2.7 2.9
26 to 49 1.1 1.0+ 1.0+ 1.1 1.3 1.3 1.1 1.1+ 1.3
50 or Older 0.7 0.6 0.9+ 0.7 0.6 0.6 0.7+ 0.7 0.5

Aged 18 to 25

In 2016, about 981,000 young adults aged 18 to 25 made suicide plans in the past year, which corresponds to 2.9 percent of young adults (Figure 76). The percentage of young adults in 2016 who made suicide plans was higher than the percentages in most years from 2008 to 2014, but it was similar to the percentage in 2015.

Aged 26 to 49

In 2016, about 1.3 million adults aged 26 to 49 made suicide plans in the past year, which represents 1.3 percent of adults in this age group (Figure 76). The percentage of adults in this age group who made suicide plans in the past year was similar to or slightly higher than the percentages in 2008 through 2015.

Aged 50 or Older

In 2016, about 504,000 adults aged 50 or older made suicide plans in the past year, which represents 0.5 percent of adults aged 50 or older (Figure 76). The percentage of adults aged 50 or older in 2016 who made suicide plans in the past year was similar to the percentages in most years from 2008 to 2015.

Suicide Attempts

The estimated 1.3 million adults aged 18 or older in 2016 who attempted suicide in the past year (with or without first making suicide plans) (Figure 74) represent 0.5 percent of all adults (Figure 77). The percentage of adults aged 18 or older who attempted suicide remained stable between 2008 and 2016.

Figure 77. Suicide Attempts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016

Figure 77     D

+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.

Figure 77 Table. Suicide Attempts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
+ Difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
18 or Older 0.5 0.5 0.5 0.5 0.6 0.6 0.5 0.6 0.5
18 to 25 1.2+ 1.1+ 1.2+ 1.2+ 1.5 1.3+ 1.2+ 1.6 1.8
26 to 49 0.4 0.5 0.4 0.5 0.5 0.6 0.5 0.5 0.5
50 or Older 0.3 0.2 0.3 0.3 0.3 0.3 0.2 0.3 0.2

Aged 18 to 25

In 2016, about 616,000 young adults aged 18 to 25 in 2016 attempted suicide in the past year. This number represents 1.8 percent of young adults (Figure 77). The percentage of young adults who attempted suicide was higher in 2016 than the percentages in most years from 2008 to 2014, but it was similar to the percentage in 2015.

Aged 26 to 49

In 2016, about 496,000 adults aged 26 to 49 attempted suicide in the past year, which represents 0.5 percent of adults in this age group (Figure 77). The percentages of adults aged 26 to 49 who attempted suicide in the past year were stable from 2008 to 2016.

Aged 50 or Older

In 2016, about 208,000 adults aged 50 or older attempted suicide in the past year, which represents 0.2 percent of adults in that age group (Figure 77). The percentages of adults aged 50 or older who attempted suicide in the past year were stable from 2008 to 2016.

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Summary Footnotes

1 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.

2 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.

3 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 1 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. https://doi.org/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 2016 NSDUH available at https://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 2016 NSDUH are provided in Sections A.1, A.3.4, and B.3.1 of CBHSQ (2017). In particular, Tables A.1 and A.2 in CBHSQ (2017) 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. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://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. Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

10. Trend data are presented for 2002 to 2016. Methodological changes to the survey in 2002 affect the comparability of the 2002 to 2016 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.

11. 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.

12. For a discussion of the criteria for suppressing (i.e., not publishing) unreliable estimates, see Section B.2.2 in CBHSQ (2017). See the following reference: Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/.

13. 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 https://www.samhsa.gov/data/

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

15. Details about the questionnaire changes for 2015 and their effects on the comparability of estimates are provided in Section C of CBHSQ (2016). 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 https://www.samhsa.gov/data/

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 2016 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 2016 and in up to 1 or 2 nonsequential years for mental health estimates that are available in 2008 (or 2009) to 2016.

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

19. Some tables in Appendix A present 2015 and 2016 estimates and statistical comparisons for measures that started new baselines in 2015. However, caution is advised in drawing conclusions based on only these 2 years of data because both sets of estimates are based on samples of respondents.

20. 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 https://www.surgeongeneral.gov/library/reports/50-years-of-progress/

21. 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 https://www.samhsa.gov/data/

22. 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. https://doi.org/10.1093/ntr/ntu166

23. 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.

24. 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 https://pubs.niaaa.nih.gov/publications/Newsletter/winter2004/Newsletter_Number3.pdf

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

25. 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 2016 for binge and heavy alcohol use among males are available in the 2016 NSDUH detailed tables at https://www.samhsa.gov/data/.

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

27. 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.

28. 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 (2017). See the following reference: Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

29. Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016). Increases in drug and opioid overdose deaths—United States, 2000-2014. Morbidity and Mortality Weekly Report, 64(50-51), 1378-1382. https://doi.org/10.1111/ajt.13776

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 (2017). See the following reference: Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

32. 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.

33. 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. 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 (2017). See the following references:

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

Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

34. Because there were 20.1 million people aged 12 or older in 2016 with an SUD in the past year, about 96 percent of the people in 2016 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.

35. 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.

36. 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.

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

38. Percentages shown in Figure 49 and in Figure 51 (which is discussed for adults in the next section of 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.

39. 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.

40. Details about the definitions and estimation methods for mental illness estimates are provided in Section B.4.7 and Section D of CBHSQ (2017). 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 definitions for the settings where youths received services. See the following reference: Center for Behavioral Health Statistics and Quality. (2017). 2016 National Survey on Drug Use and Health: Methodological summary and definitions. Retrieved from https://www.samhsa.gov/data/

41. 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.

42. Percentages shown in Figure 54 may differ from percentages that are calculated from the estimated numbers of people because the estimated numbers are rounded.

43. 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.

44. The specialty mental health setting includes services in outpatient or inpatient settings. Outpatient services include those from (a) a private therapist, psychologist, psychiatrist, social worker, or counselor; (b) a mental health clinic or center; (c) a partial day hospital or day treatment program; or (d) an in-home therapist, counselor, or family preservation worker. Inpatient or residential specialty mental health services in which adolescents stayed overnight or longer include services in a hospital or a residential treatment center.

45. A specialty facility refers to a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or outpatient), or a mental health center.

46. 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.

47. National Center for Injury Prevention and Control. (2016). Suicide: Facts at a glance 2015. Retrieved from https://www.cdc.gov/violenceprevention/pdf/Suicide-DataSheet-a.pdf

48. Crosby, A. E., Han, B., Ortega, L. A. G., Parks, S. E., & Gfroerer, J. (2011, October 21). Suicidal thoughts and behaviors among adults aged ≥18 years—United States, 2008-2009. Morbidity and Mortality Weekly Report Surveillance Summaries, 60(13), 1-22.

49. Han, B., Kott, P. S., Hughes, A., McKeon, R., Blanco, C., & Compton, W. M. (2016). Estimating the rates of deaths by suicide among adults who attempt suicide in the United States. Journal of Psychiatric Research, 77, 125 133. https://doi.org/10.1016/j.jpsychires.2016.03.002

50. The estimate for the number of adults aged 18 or older in 2016 who attempted suicide (regardless of whether they made a suicide plan) is presented in the 2016 detailed tables at https://www.samhsa.gov/data/. However, the estimates for the numbers of adults who attempted suicide and made a plan or who attempted suicide without making a plan were made specifically for this report and are not included in the 2016 detailed tables.


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

Table A.1B – 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 2016
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 2016 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, 2002-2016.
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) 23.5 (0.27)
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) 19.1 (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) 57.9 (0.66)
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) 41.1 (0.89)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc 3.4 (0.11) 3.3 (0.10)
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) 4.6 (0.11)
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) 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) 50.7 (0.31)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 24.9 (0.27) 24.2 (0.26)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 6.5* (0.14) 6.0 (0.14)
Table A.2B – 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 2016
** Low precision; no estimate reported.
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 2016 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, 2002-2016.
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) 5.3 (0.21)
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) 3.4 (0.18)
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) 15.0 (1.64)
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) 1.4 (0.11)
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) 1.8 (0.12)
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) 0.5 (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) 9.2 (0.30)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 5.8* (0.23) 4.9 (0.22)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9 (0.10) 0.8 (0.09)
Table A.3B – 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 2016
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 2016 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, 2002-2016.
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) 30.0 (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) 23.5 (0.47)
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) 39.9 (1.03)
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) 26.2 (1.42)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc 5.4 (0.22) 5.2 (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) 8.8 (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) 1.7 (0.12)
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) 57.1 (0.55)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 39.0 (0.51) 38.4 (0.54)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 10.9 (0.33) 10.1 (0.32)
Table A.4B – 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 2016
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 2016 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, 2002-2016.
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) 24.6 (0.33)
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) 20.2 (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) 62.2 (0.75)
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) 43.1 (1.00)
Smokeless Tobacco nc nc nc nc nc nc nc nc nc nc nc nc nc 3.2 (0.13) 3.1 (0.12)
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) 4.2 (0.13)
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) 0.7 (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) 54.6 (0.38)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 24.8 (0.32) 24.2 (0.32)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 6.4 (0.17) 6.0 (0.17)
Table A.5B – Type of Tobacco Product Use among Past Month Tobacco Users Aged 12 or Older, by Age Group
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, 2016.
Only Cigarettes 66.8 (0.55) 40.0 (1.88) 54.0 (0.90) 70.0 (0.65)
Cigarettes and Some Other Type of Tobacco Product 14.1 (0.38) 24.6 (1.62) 24.4 (0.75) 11.8 (0.44)
Only Noncigarette Tobacco Products 19.1 (0.46) 35.4 (1.88) 21.6 (0.79) 18.1 (0.54)
Table A.6B – Alcohol Use in the Past Month among Individuals Aged 12 to 20
Alcohol Use 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
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 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
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) 19.3 (0.45)
Binge Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 13.4* (0.36) 12.1 (0.35)
Heavy Alcohol Use nc nc nc nc nc nc nc nc nc nc nc nc nc 3.3* (0.20) 2.8 (0.17)
Table A.7B – 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 2016
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.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 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, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 10.1* (0.17) 10.6 (0.18)
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) 8.9 (0.16)
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) 0.7 (0.04)
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) 0.2 (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) 0.2 (0.02)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.03) 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) 0.1 (0.02)
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) 0.0 (0.00)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.02) 0.2 (0.02)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.02) 0.2 (0.02)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3* (0.03) 0.2 (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 2.4 (0.08) 2.3 (0.08)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.4 (0.06) 1.2 (0.06)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.04) 0.7 (0.04)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.6 (0.04) 0.6 (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.02) 0.2 (0.03)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.5 (0.06) 1.4 (0.06)
Table A.8B – 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 2016
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.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 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, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 8.8* (0.27) 7.9 (0.26)
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) 6.5 (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) 0.1 (0.03)
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) 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) 0.0 (0.01)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.07) 0.5 (0.06)
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) 0.2 (0.04)
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) 0.0 (0.01)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.04) 0.1 (0.03)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.08) 0.6 (0.07)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.02) 0.0 (0.01)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 2.0* (0.15) 1.6 (0.12)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.1 (0.11) 1.0 (0.09)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.09) 0.5 (0.07)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.07) 0.4 (0.06)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.03) 0.1 (0.03)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.1 (0.11) 1.0 (0.09)
Table A.9B – 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 2016
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.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 22.3 (0.42) 23.2 (0.43)
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) 20.8 (0.42)
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) 1.6 (0.13)
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) 0.0 (0.02)
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) 0.3 (0.05)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 1.8 (0.14) 1.9 (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) 0.6 (0.07)
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) 0.9 (0.10)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4 (0.06) 0.4 (0.07)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4* (0.07) 0.2 (0.04)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 5.1 (0.21) 4.6 (0.21)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 2.4* (0.13) 1.8 (0.13)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.7 (0.13) 1.5 (0.12)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 2.2 (0.15) 2.2 (0.17)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.05) 0.1 (0.03)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 2.5* (0.14) 2.0 (0.14)
Table A.10B – 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 2016
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.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 8.2* (0.19) 8.9 (0.21)
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) 7.2 (0.19)
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) 0.6 (0.05)
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) 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) 0.2 (0.03)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.03) 0.3 (0.04)
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) 0.1 (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) 0.0 (0.00)
Ecstasy nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.02) 0.1 (0.02)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.02) 0.2 (0.03)
Methamphetamine nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4 (0.04) 0.3 (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 2.0 (0.09) 2.0 (0.09)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.3 (0.07) 1.2 (0.07)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.05) 0.6 (0.05)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.4 (0.04) 0.4 (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.03) 0.2 (0.03)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.3 (0.08) 1.3 (0.08)
Table A.11B – Opioid Misuse in the Past Year among Individuals Aged 12 or Older, by Age Group
Opioid Misuse Status/Age Group 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
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 2016 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, 2002-2016.
OPIOID MISUSE (HEROIN USE OR PAIN
RELIEVER MISUSE)
nc nc nc nc nc nc nc nc nc nc nc nc nc 4.7* (0.12) 4.4 (0.11)
12-17 nc nc nc nc nc nc nc nc nc nc nc nc nc 3.9 (0.19) 3.6 (0.17)
18-25 nc nc nc nc nc nc nc nc nc nc nc nc nc 8.7* (0.27) 7.3 (0.27)
26 or Older nc nc nc nc nc nc nc nc nc nc nc nc nc 4.2 (0.14) 4.0 (0.13)
HEROIN USE 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) 0.4 (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) 0.1 (0.02)
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) 0.7 (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) 0.3 (0.04)
PAIN RELIEVER MISUSE nc nc nc nc nc nc nc nc nc nc nc nc nc 4.7* (0.11) 4.3 (0.11)
12-17 nc nc nc nc nc nc nc nc nc nc nc nc nc 3.9 (0.19) 3.5 (0.17)
18-25 nc nc nc nc nc nc nc nc nc nc nc nc nc 8.5* (0.26) 7.1 (0.27)
26 or Older nc nc nc nc nc nc nc nc nc nc nc nc nc 4.1 (0.14) 3.9 (0.13)
Table A.12B – Misuse of Pain Relievers in the Past Year among Individuals Aged 12 or Older, by Pain Reliever Subtype
Pain Reliever Subtype Numbers1 Percentages2
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 Includes hydrocodone products (Vicodin®, Lortab®, Norco®, Zohydro® ER, generic hydrocodone, or other similar products); oxycodone products (OxyContin®, Percocet®, Percodan®, Roxicodone®, generic oxycodone, or other similar products); tramadol products (Ultram®, Ultram® ER, Ultracet®, generic tramadol, generic extended-release tramadol, or other similar products); codeine products (Tylenol® with codeine 3 or 4, generic codeine pills, or other similar products); morphine products (Avinza®, Kadian®, MS Contin®, generic morphine, generic extended-release morphine, or other similar products); fentanyl products (Duragesic®, Fentora®, generic fentanyl, or other similar products); buprenorphine products (Suboxone®, generic buprenorphine, generic buprenorphine plus naloxone, or other similar products); oxymorphone products (Opana®, Opana® ER, generic oxymorphone, generic extended-release oxymorphone, or other similar products); meperidine products (Demerol® or other similar products); hydromorphone products (Dilaudid® or generic hydromorphone, Exalgo® or generic extended-release hydromorphone, or other similar products); methadone products (methadone or other similar products); or any other prescription pain reliever. Over-the-counter drugs are not included.
4 Includes misuse of pain relievers containing other active ingredients. A small number of respondents who reported misuse of "any other prescription pain reliever" corresponding only to the specific pain reliever categories shown in the table are included in estimates for Any Other Prescription Pain Reliever and are also included in the relevant pain reliever subtype category.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
MISUSE OF ANY PAIN RELIEVER3 11,517 (286) 4.3 (0.11)
Hydrocodone Products 6,924 (220) 2.6 (0.08)
Oxycodone Products 3,905 (162) 1.4 (0.06)
Tramadol Products 1,591 (108) 0.6 (0.04)
Codeine Products 2,767 (146) 1.0 (0.05)
Morphine Products 536 (58) 0.2 (0.02)
Fentanyl Products 228 (35) 0.1 (0.01)
Buprenorphine Products 712 (65) 0.3 (0.02)
Oxymorphone Products 302 (40) 0.1 (0.01)
Demerol® 95 (40) 0.0 (0.01)
Hydromorphone Products 239 (44) 0.1 (0.02)
Methadone 346 (52) 0.1 (0.02)
Any Other Prescription Pain Reliever4 793 (78) 0.3 (0.03)
Table A.13B – Main Reasons for Pain Reliever Misuse for the Last Episode of Misuse among Individuals Aged 12 or Older Who Misused Pain Relievers in the Past Year
Main Reason for Misuse Past Year Misusers of Pain Relievers
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown information for their main reason for misuse were excluded from the analysis, including respondents who reported some other reason but had unknown data in their write-in responses.
NOTE: Responses to the Some Other Reason category for one drug type may fall into a response category that is asked only for another drug type (e.g., "to relieve physical pain" for tranquilizer misuse).
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
Relieve Physical Pain 62.3 (1.24)
Relax or Relieve Tension 10.8 (0.80)
Help with Sleep 3.3 (0.41)
Help with Feelings or Emotion 3.9 (0.46)
Experiment or See What It's Like 3.0 (0.35)
Feel Good or Get High 12.9 (0.74)
Increase or Decrease Effect of Other Drug 0.9 (0.19)
Because I Am Hooked or Have to Have It 2.1 (0.35)
Some Other Reason 0.9 (0.17)
Table A.14B – Source Where Pain Relievers Were Obtained for Most Recent Misuse among Individuals Aged 12 or Older Who Misused Pain Relievers in the Past Year
Source for Most Recent Misuse Past Year Misusers of Pain Relievers
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents were asked to choose one of eight sources as their best answer. Respondents with unknown data on Source for Most Recent Misuse and respondents with unknown or invalid responses to the corresponding other-specify questions were excluded from the analysis.
1 Some Other Way includes write-in responses not already listed in this table or responses with insufficient information that could allow them to be placed in another category.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
GOT THROUGH PRESCRIPTION(S) OR STOLE FROM A HEALTH CARE PROVIDER 37.5 (1.35)
Prescription from One Doctor 35.4 (1.34)
Prescriptions from More Than One Doctor 1.4 (0.27)
Stole from Doctor's Office, Clinic, Hospital, or Pharmacy 0.7 (0.20)
GIVEN BY, BOUGHT FROM, OR TOOK FROM A FRIEND OR RELATIVE 53.0 (1.31)
From Friend or Relative for Free 40.4 (1.28)
Bought from Friend or Relative 8.9 (0.70)
Took from Friend or Relative without Asking 3.7 (0.43)
BOUGHT FROM DRUG DEALER OR OTHER STRANGER 6.0 (0.54)
SOME OTHER WAY1 3.4 (0.43)
Table A.15B – 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 2016
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 2.9 (0.08) 2.7 (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) 1.5 (0.06)
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) 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) 0.2 (0.02)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.01) 0.1 (0.02)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0 (0.01) 0.0 (0.01)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.3 (0.03) 0.3 (0.02)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0 (0.05) 0.9 (0.05)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.8 (0.04) 0.7 (0.04)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3 (0.02) 0.2 (0.02)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.02) 0.2 (0.02)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.01) 0.1 (0.02)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9 (0.05) 0.8 (0.05)
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) 5.6 (0.13)
BOTH ILLICIT DRUGS AND ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0 (0.05) 0.9 (0.04)
ILLICIT DRUGS OR ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 7.8 (0.15) 7.5 (0.15)
Table A.16B – 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 2016
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 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, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 3.4 (0.17) 3.2 (0.18)
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) 2.3 (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) 0.1 (0.03)
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) 0.0 (0.00)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3 (0.06) 0.3 (0.05)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.04) 0.2 (0.04)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.1 (0.03) 0.0 (0.02)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9 (0.09) 0.9 (0.10)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.07) 0.6 (0.08)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3 (0.06) 0.3 (0.06)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.04) 0.2 (0.04)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.03) 0.1 (0.04)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.07) 0.6 (0.08)
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) 2.0 (0.13)
BOTH ILLICIT DRUGS AND ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 1.0 (0.10) 0.9 (0.09)
ILLICIT DRUGS OR ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 5.0* (0.20) 4.3 (0.20)
Table A.17B – 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 2016
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 7.2 (0.26) 7.0 (0.27)
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) 5.0 (0.24)
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) 0.6 (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) 0.4 (0.06)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.3 (0.05) 0.5 (0.07)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0 (0.02) 0.0 (0.01)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.4 (0.07) 0.4 (0.06)
Misuse of
   Psychotherapeutics
nc nc nc nc nc nc nc nc nc nc nc nc nc 2.0* (0.14) 1.6 (0.12)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 1.2* (0.11) 0.8 (0.09)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.08) 0.5 (0.07)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.5 (0.06) 0.5 (0.07)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.02) 0.1 (0.03)
Opioids (Heroin Use or
   Pain Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 1.5* (0.12) 1.1 (0.10)
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) 10.7 (0.32)
BOTH ILLICIT DRUGS
AND ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 2.9 (0.16) 2.5 (0.16)
ILLICIT DRUGS OR
ALCOHOL
nc nc nc nc nc nc nc nc nc nc nc nc nc 15.3 (0.37) 15.1 (0.37)
Table A.18B – 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 2016
nc = not comparable due to methodological changes.
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2016.
ILLICIT DRUGS nc nc nc nc nc nc nc nc nc nc nc nc nc 2.1 (0.09) 2.0 (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) 0.8 (0.06)
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) 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) 0.2 (0.03)
Hallucinogens nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0 (0.01) 0.1 (0.01)
Inhalants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.0 (0.01) 0.0 (0.01)
Methamphetamine -- -- -- -- -- -- -- -- -- -- -- -- -- 0.3 (0.04) 0.3 (0.03)
Misuse of Psychotherapeutics nc nc nc nc nc nc nc nc nc nc nc nc nc 0.9 (0.06) 0.8 (0.06)
Pain Relievers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.05) 0.6 (0.05)
Tranquilizers nc nc nc nc nc nc nc nc nc nc nc nc nc 0.2 (0.03) 0.2 (0.02)
Stimulants nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.02) 0.1 (0.02)
Sedatives nc nc nc nc nc nc nc nc nc nc nc nc nc 0.1 (0.01) 0.1 (0.02)
Opioids (Heroin Use or Pain
   Reliever Misuse)
nc nc nc nc nc nc nc nc nc nc nc nc nc 0.8 (0.06) 0.8 (0.06)
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) 5.2 (0.15)
BOTH ILLICIT DRUGS AND ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 0.7 (0.05) 0.6 (0.05)
ILLICIT DRUGS OR ALCOHOL nc nc nc nc nc nc nc nc nc nc nc nc nc 6.9 (0.17) 6.6 (0.17)
Table A.19B – Need for and Receipt of Treatment at a Specialty Facility for a Substance Use Problem in the Past Year among Individuals Aged 12 or Older, by Age Group
Needed/Received Substance Use Treatment 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 a substance use problem if they met the criteria for a substance 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, 2016.
Needed Treatment for a Substance Use Problem3 20,959 (407) 7.8 (0.15) 1,085 (50) 4.4 (0.20) 5,343 (130) 15.5 (0.37) 14,531 (377) 6.9 (0.18)
Received Treatment for a Substance Use Problem at a Specialty
   Facility among Individuals Who Needed Substance Use
   Treatment
2,229 (123) 10.6 (0.59) 89 (13) 8.2 (1.18) 383 (33) 7.2 (0.62) 1,756 (118) 12.1 (0.81)
Table A.20B – Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17
MDE 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
* The difference between this estimate and the 2016 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, 2004-2016.
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) 12.8 (0.32)
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) 9.0 (0.27)
Table A.21B – 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 2016
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
* The difference between this estimate and the 2016 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, 2005-2016.
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) 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) 10.9 (0.31)
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) 7.4 (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) 4.8 (0.25)
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) 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) 7.0 (0.27)
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) 4.7 (0.16)
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) 3.0 (0.22)
Table A.22B – 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 2016
AMI = any mental illness; SMI = serious mental illness.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2016.
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) 18.3 (0.24)
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) 22.1 (0.43)
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) 21.1 (0.33)
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) 14.5 (0.40)
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) 4.2 (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) 5.9 (0.24)
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) 5.3 (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) 2.7 (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) 14.0 (0.21)
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) 16.2 (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) 15.8 (0.29)
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) 11.8 (0.37)
Table A.23B – 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 2016
-- = not available.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year depression treatment data, unknown past year MDE data, and/or past year MDE with impairment data were excluded.
* The difference between this estimate and the 2016 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, 2004-2016.
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) 40.9 (1.30)
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) 46.7 (1.58)
Table A.24B – 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/Age Group 2009 2010 2011 2012 2013 2014 2015 2016
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year depression treatment data, unknown past year MDE data, and/or past year MDE with impairment data were excluded.
* The difference between this estimate and the 2016 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, 2009-2016.
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) 65.3 (1.09)
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) 44.1 (1.45)
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) 67.4 (1.35)
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) 77.3 (2.23)
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) 72.2 (1.23)
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) 51.3 (1.75)
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) 74.3 (1.52)
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) 84.1 (2.57)
Table A.25B – 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 2016
-- = not available; nc = not comparable due to methodological changes.
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.
* The difference between this estimate and the 2016 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 services 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, 2002-2016.
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) 14.7 (0.33)
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) 13.2 (0.32)
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) 3.0 (0.16)
NONSPECIALTY SERVICE nc nc nc nc nc nc nc 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) 15.4 (0.35)
Education1 nc nc nc nc nc nc nc 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) 13.1 (0.33)
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) 2.9 (0.15)
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) 0.2 (0.05)
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) 0.4 (0.07)
SPECIALTY MENTAL
HEALTH SERVICES AND
EDUCATION, GENERAL
MEDICINE, OR CHILD
WELFARE SERVICES1
nc nc nc nc nc nc nc 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) 6.2 (0.23)
Table A.26B – Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older, by Age Group
Mental Health Services1/
Age Group
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* The difference between this estimate and the 2016 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, 2002-2016.
ANY MENTAL HEALTH
SERVICE
13.0* (0.27) 13.2* (0.26) 12.8* (0.26) 13.0* (0.26) 12.9* (0.26) 13.3* (0.27) 13.5* (0.29) 13.4* (0.27) 13.8 (0.27) 13.6* (0.26) 14.5 (0.28) 14.6 (0.28) 14.8 (0.23) 14.2 (0.23) 14.4 (0.23)
18-25 10.5* (0.25) 11.1* (0.28) 10.8* (0.26) 11.2* (0.27) 10.8* (0.28) 10.4* (0.28) 11.0* (0.28) 11.2* (0.27) 11.0* (0.27) 11.4* (0.30) 12.0* (0.29) 12.2 (0.32) 11.9* (0.34) 11.7* (0.31) 12.9 (0.34)
26-49 14.5 (0.36) 14.5 (0.35) 14.4* (0.34) 13.9* (0.34) 14.0* (0.37) 14.3* (0.35) 14.1* (0.34) 14.6 (0.36) 14.9 (0.37) 14.9 (0.36) 15.2 (0.38) 15.5 (0.40) 15.3 (0.28) 15.3 (0.29) 15.4 (0.29)
50 or Older 12.0* (0.54) 12.3* (0.53) 11.7* (0.51) 12.5* (0.53) 12.4* (0.48) 13.2 (0.53) 13.7 (0.57) 12.9 (0.52) 13.6 (0.52) 13.2 (0.47) 14.8 (0.51) 14.6 (0.52) 15.4* (0.42) 13.9 (0.40) 14.0 (0.42)
INPATIENT 0.7* (0.06) 0.8 (0.07) 0.9 (0.07) 1.0 (0.08) 0.7* (0.06) 1.0 (0.08) 0.9 (0.10) 0.8 (0.07) 0.8 (0.07) 0.8 (0.06) 0.8 (0.06) 0.9 (0.07) 1.0 (0.06) 0.9 (0.06) 0.9 (0.06)
18-25 0.9* (0.08) 1.0* (0.09) 1.2 (0.10) 1.1* (0.09) 1.1* (0.08) 1.1* (0.09) 1.1* (0.10) 1.1* (0.10) 1.0* (0.09) 1.1* (0.09) 1.1* (0.10) 1.3 (0.11) 1.2* (0.11) 1.4 (0.12) 1.5 (0.11)
26-49 0.8 (0.09) 0.9 (0.10) 0.8 (0.09) 0.9 (0.10) 0.8 (0.09) 1.1 (0.11) 0.8 (0.09) 1.0 (0.11) 0.8 (0.09) 0.8 (0.09) 0.7* (0.08) 1.0 (0.10) 1.0 (0.08) 0.9 (0.07) 1.0 (0.08)
50 or Older 0.5 (0.10) 0.7 (0.14) 0.9 (0.14) 1.0 (0.17) 0.5 (0.10) 0.7 (0.15) 0.9 (0.22) 0.6 (0.11) 0.7 (0.13) 0.7 (0.11) 0.8 (0.12) 0.7 (0.11) 1.0 (0.12) 0.8 (0.11) 0.7 (0.10)
OUTPATIENT 7.4 (0.21) 7.1 (0.19) 7.1 (0.19) 6.8 (0.20) 6.7 (0.20) 7.0 (0.19) 6.8 (0.20) 6.4* (0.19) 6.6 (0.20) 6.7 (0.19) 6.6 (0.19) 6.6 (0.21) 6.7 (0.16) 7.1 (0.17) 6.9 (0.16)
18-25 6.7 (0.21) 6.6* (0.21) 6.2* (0.21) 6.4* (0.22) 5.9* (0.23) 5.6* (0.21) 5.9* (0.21) 6.1* (0.20) 5.7* (0.21) 6.2* (0.22) 6.5* (0.22) 6.3* (0.22) 6.4* (0.25) 6.6* (0.24) 7.3 (0.26)
26-49 8.9* (0.29) 8.7 (0.28) 8.6 (0.27) 7.8 (0.27) 7.6 (0.27) 8.0 (0.28) 7.9 (0.26) 7.5 (0.27) 7.8 (0.28) 7.8 (0.28) 7.6 (0.26) 7.4 (0.29) 7.5 (0.20) 7.9 (0.22) 8.1 (0.22)
50 or Older 5.7 (0.39) 5.3 (0.35) 5.6 (0.36) 5.9 (0.39) 6.0 (0.37) 6.3 (0.37) 6.0 (0.39) 5.3 (0.34) 5.7 (0.35) 5.7 (0.34) 5.7 (0.33) 6.0 (0.37) 6.1 (0.29) 6.4 (0.29) 5.8 (0.27)
PRESCRIPTION
MEDICATION
10.5* (0.25) 10.9* (0.25) 10.5* (0.23) 10.7* (0.24) 10.9* (0.24) 11.2* (0.25) 11.4 (0.27) 11.3* (0.25) 11.7 (0.24) 11.5 (0.25) 12.4 (0.26) 12.5 (0.27) 12.6 (0.21) 11.8 (0.21) 12.0 (0.21)
18-25 7.5* (0.22) 8.3* (0.25) 8.1* (0.23) 8.3* (0.23) 8.0* (0.24) 8.0* (0.24) 8.1* (0.24) 8.5* (0.23) 8.4* (0.24) 8.8* (0.25) 9.0 (0.25) 9.4 (0.27) 8.8* (0.30) 8.6* (0.27) 9.7 (0.30)
26-49 11.4* (0.32) 11.9 (0.32) 11.7* (0.31) 11.4* (0.31) 11.7* (0.34) 11.8* (0.32) 11.7* (0.32) 12.3 (0.33) 12.5 (0.33) 12.3 (0.33) 13.0 (0.36) 13.1 (0.37) 12.8 (0.26) 12.6 (0.26) 12.6 (0.26)
50 or Older 10.5* (0.51) 10.9* (0.51) 10.1* (0.48) 10.8* (0.49) 11.0* (0.45) 11.7 (0.50) 12.2 (0.53) 11.3 (0.49) 12.0 (0.49) 11.8 (0.45) 12.9 (0.49) 12.9 (0.49) 13.5* (0.39) 12.0 (0.38) 12.3 (0.39)
Table A.27B – Type of Mental Health Services 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 Services1/Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
AMI = any mental illness; SMI = serious mental illness.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health service information were excluded.
* The difference between this estimate and the 2016 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, 2008-2016.
AMI                  
Mental Health Services 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) 43.1 (0.75)
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) 35.1 (0.94)
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) 43.1 (0.87)
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) 46.8 (1.57)
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) 3.3 (0.24)
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) 4.6 (0.41)
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) 3.4 (0.32)
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) 2.7 (0.48)
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) 24.5 (0.61)
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) 22.8 (0.84)
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) 26.0 (0.74)
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) 23.4 (1.28)
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) 37.1 (0.72)
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) 27.2 (0.87)
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) 36.7 (0.83)
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) 42.2 (1.54)
SMI                  
Mental Health Services 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) 64.8 (1.34)
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) 51.5 (2.05)
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) 66.1 (1.57)
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) 71.5 (3.16)
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) 7.6 (0.73)
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) 8.8 (1.06)
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) 8.1 (0.93)
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) 6.0 (1.67)
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) 42.6 (1.40)
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) 36.8 (1.88)
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) 44.8 (1.70)
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) 42.6 (3.56)
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) 58.0 (1.42)
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) 41.1 (2.00)
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) 59.1 (1.68)
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) 67.4 (3.29)
Table A.28B – Co-Occurring Substance Use Disorder (SUD) and Major Depressive Episode (MDE) and Co-Occurring SUD and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17
SUD and MDE 12 to 17
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown past year MDE data were excluded.
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, 2016.
MDE and SUD 1.4 (0.11)
MDE with Severe Impairment1 and SUD 1.1 (0.10)
Table A.29B – 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, 2016.
SUD 100.0 (0.00) da 10.8 (0.83) 3.2 (0.19)
MDE 33.0 (2.12) 11.9 (0.32) 100.0 (0.00) da
Table A.30B – 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
LSD = lysergic acid diethylamide; PCP = phencyclidine.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
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, 2016.
PAST YEAR USE      
Illicit Drugs 15.8 (0.35) 31.7 (1.25) 13.4 (0.36)
Marijuana 12.0 (0.31) 24.3 (1.14) 10.1 (0.31)
Cocaine 0.5 (0.07) 1.1 (0.27) 0.4 (0.07)
Crack 0.0 (0.02) 0.1 (0.09) 0.0 (0.01)
Heroin 0.1 (0.02) 0.1 (0.05) 0.0 (0.02)
Hallucinogens 1.8 (0.13) 4.1 (0.52) 1.5 (0.13)
LSD 0.8 (0.08) 1.3 (0.30) 0.7 (0.08)
PCP 0.1 (0.02) 0.2 (0.08) 0.1 (0.02)
Ecstasy 0.7 (0.08) 1.9 (0.37) 0.5 (0.08)
Inhalants 2.2 (0.14) 5.1 (0.59) 1.8 (0.13)
Methamphetamine 0.1 (0.03) 0.2 (0.08) 0.1 (0.03)
Misuse of Psychotherapeutics 5.3 (0.21) 13.3 (0.91) 4.0 (0.21)
Pain Relievers 3.5 (0.17) 9.2 (0.80) 2.6 (0.17)
Tranquilizers 1.7 (0.13) 4.8 (0.59) 1.2 (0.11)
Stimulants 1.7 (0.14) 4.6 (0.59) 1.3 (0.12)
Sedatives 0.4 (0.06) 1.4 (0.27) 0.2 (0.05)
Opioids (Heroin Use or Pain Reliever Misuse) 3.6 (0.17) 9.2 (0.80) 2.7 (0.17)
PAST MONTH USE      
Daily Cigarette Use 0.5 (0.06) 0.9 (0.20) 0.4 (0.07)
Heavy Alcohol Use 0.8 (0.09) 1.7 (0.35) 0.6 (0.08)
Table A.31B – Received Substance Use Treatment at a Specialty Facility and/or Mental Health Services in Past Year among Youths Aged 12 to 17, by Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) Status
Past Year SUD Status/MDE Status Received Substance Use Treatment
at a Specialty Facility OR Mental
Health Services
Received Substance Use Treatment
at a Specialty Facility but Not Mental
Health Services
Received Mental Health Services
but Not Substance Use Treatment at
a Specialty Facility
Received Substance Use Treatment
at a Specialty Facility AND Mental
Health Services
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
NOTE: Respondents with unknown information on mental health service were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
SUD and MDE 71.9 (3.83) 1.5 (0.99) 65.8 (4.00) 4.6 (1.52)
SUD and No MDE 37.1 (2.68) 3.5 (1.19) 30.5 (2.66) 3.1 (0.84)
MDE and No SUD 52.6 (1.35) 0.0 (0.01) 52.6 (1.35) 0.0 (0.02)
No SUD and No MDE 18.8 (0.40) 0.0 (0.01) 18.7 (0.39) 0.0 (0.02)
Table A.32B – Co-Occurring Past Year Substance Use Disorder and Level of Mental Illness Status in the Past Year among Adults Aged 18 or Older, by Age Group
SUD Status and Level of Mental Illness 18 or Older 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, 2016.
SUD and AMI 3.4 (0.10) 6.1 (0.24) 4.5 (0.18) 1.5 (0.14)
SUD and SMI 1.1 (0.06) 2.1 (0.14) 1.4 (0.10) 0.4 (0.07)
SUD and AMI Excluding SMI 2.3 (0.08) 4.1 (0.20) 3.1 (0.14) 1.1 (0.12)
Table A.33B – 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 18 or Older 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, 2016.
AMI        
SUD 43.3 (1.03) 40.6 (1.27) 47.9 (1.41) 37.0 (2.80)
No SUD 16.1 (0.24) 18.8 (0.44) 18.3 (0.32) 13.6 (0.40)
SMI        
SUD 13.8 (0.69) 13.6 (0.87) 15.3 (0.95) 11.0 (1.77)
No SUD 3.4 (0.12) 4.5 (0.22) 4.3 (0.17) 2.4 (0.19)
AMI EXCLUDING SMI        
SUD 29.5 (0.91) 27.0 (1.14) 32.7 (1.24) 26.0 (2.52)
No SUD 12.7 (0.22) 14.3 (0.38) 14.0 (0.29) 11.2 (0.37)
Table A.34B – 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 18 or Older 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, 2016.
AMI 18.5 (0.53) 27.8 (0.94) 21.3 (0.77) 10.3 (0.92)
SMI 25.4 (1.21) 34.9 (1.89) 26.9 (1.58) 16.3 (2.48)
AMI Excluding SMI 16.4 (0.58) 25.2 (1.08) 19.5 (0.82) 8.9 (0.99)
No Mental Illness 5.4 (0.15) 11.6 (0.38) 6.2 (0.22) 3.0 (0.21)
Table A.35B – Received Substance Use Treatment at a Specialty Facility and/or Any Mental Health Services in 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 Received Substance Use Treatment
at a Specialty Facility or Mental
Health Services
Received Substance Use Treatment
at a Specialty Facility but Not Mental
Health Services
Received Mental Health Services
but Not Substance Use Treatment at
a Specialty Facility
Received Substance Use Treatment
at a Specialty Facility and Mental
Health Services
** Low precision; no estimate reported.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown mental health services information were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
ANY MENTAL ILLNESS 48.1 (1.48) 2.9 (0.45) 38.2 (1.41) 6.9 (0.75)
18-25 42.0 (2.05) 3.1 (0.61) 35.1 (2.04) 3.8 (0.68)
26-49 47.9 (1.75) 2.8 (0.54) 37.0 (1.64) 8.0 (0.99)
50 or Older 56.3 (4.87) 3.0 (1.58) 45.1 (4.73) 8.1 (2.53)
SERIOUS MENTAL ILLNESS 65.6 (2.27) 2.3 (0.66) 51.2 (2.51) 12.0 (1.77)
18-25 55.7 (3.54) 2.3 (1.05) 49.6 (3.74) 3.8 (1.05)
26-49 69.0 (2.85) 2.2 (0.75) 54.1 (2.99) 12.7 (1.97)
50 or Older ** (**) ** (**) ** (**) ** (**)
Table A.36B – Had Serious Thoughts of Suicide in the Past Year among Adults Aged 18 or Older, by Age Group
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown suicide information were excluded.
* Difference between estimate and 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2016.
18 or Older 3.7 (0.13) 3.7 (0.13) 3.8 (0.14) 3.7* (0.13) 3.9 (0.13) 3.9 (0.14) 3.9 (0.12) 4.0 (0.12) 4.0 (0.11)
18-25 6.8* (0.23) 6.1* (0.20) 6.7* (0.22) 6.8* (0.25) 7.2* (0.23) 7.4* (0.24) 7.5* (0.25) 8.3 (0.26) 8.8 (0.28)
26-49 4.0 (0.19) 4.3 (0.20) 4.1 (0.20) 3.7* (0.17) 4.2 (0.21) 4.0 (0.21) 4.0 (0.17) 4.1 (0.17) 4.2 (0.16)
50 or Older 2.3 (0.23) 2.3 (0.23) 2.6 (0.22) 2.6 (0.23) 2.4 (0.21) 2.7 (0.26) 2.7 (0.18) 2.6 (0.19) 2.4 (0.17)
Table A.37B – Made Any Suicide Plans in the Past Year among Adults Aged 18 or Older, by Age Group
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown suicide information were excluded.
* Difference between estimate and 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2016.
18 or Older 1.0 (0.07) 1.0 (0.07) 1.1 (0.07) 1.0 (0.07) 1.1 (0.07) 1.1 (0.07) 1.1 (0.06) 1.1 (0.06) 1.1 (0.05)
18-25 2.0* (0.12) 2.0* (0.12) 1.9* (0.12) 1.9* (0.13) 2.4* (0.14) 2.5 (0.14) 2.3* (0.14) 2.7 (0.16) 2.9 (0.16)
26-49 1.1 (0.10) 1.0* (0.10) 1.0* (0.09) 1.1 (0.10) 1.3 (0.12) 1.3 (0.12) 1.1 (0.09) 1.1* (0.08) 1.3 (0.09)
50 or Older 0.7 (0.12) 0.6 (0.12) 0.9* (0.14) 0.7 (0.11) 0.6 (0.10) 0.6 (0.09) 0.7* (0.09) 0.7 (0.09) 0.5 (0.07)
Table A.38B – Attempted Suicide in the Past Year among Adults Aged 18 or Older, by Age Group
Age Group 2008 2009 2010 2011 2012 2013 2014 2015 2016
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Respondents with unknown suicide information were excluded.
* The difference between this estimate and the 2016 estimate is statistically significant at the .05 level.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2008-2016.
18 or Older 0.5 (0.05) 0.5 (0.04) 0.5 (0.05) 0.5 (0.05) 0.6 (0.04) 0.6 (0.05) 0.5 (0.03) 0.6 (0.04) 0.5 (0.04)
18-25 1.2* (0.10) 1.1* (0.09) 1.2* (0.09) 1.2* (0.10) 1.5 (0.12) 1.3* (0.10) 1.2* (0.10) 1.6 (0.13) 1.8 (0.13)
26-49 0.4 (0.07) 0.5 (0.06) 0.4 (0.06) 0.5 (0.07) 0.5 (0.08) 0.6 (0.09) 0.5 (0.06) 0.5 (0.06) 0.5 (0.05)
50 or Older 0.3 (0.08) 0.2 (0.06) 0.3 (0.08) 0.3 (0.08) 0.3 (0.06) 0.3 (0.07) 0.2 (0.04) 0.3 (0.07) 0.2 (0.06)
Table A.39B – Suicidal Thoughts, Plans, and Attempts in the Past Year among Adults Aged 18 or Older
Suicide Behavior Aged 18 or Older,
Numbers1
Percentage among Adults
Aged 18 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.
NOTE: Respondents with unknown suicide information were excluded.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2016.
Had Serious Thoughts of Suicide 9,829 (267) 4.0 (0.11)
Made Suicide Plans 2,756 (127) 1.1 (0.05)
Attempted Suicide 1,319 (96) 0.5 (0.04)
Made Suicide Plans 1,046 (82) 0.4 (0.03)
Did Not Make Suicide Plans 273 (51) 0.1 (0.02)

HHS Publication No. SMA 17-5044
2017
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


Long Descriptions – Figures

Long description, Figure 1. Figure 1 is titled "Numbers of Past Month Tobacco Users among People Aged 12 or Older: 2016." 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. 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 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 2016 were 206.0 million people and 76.5 percent, respectively. The number and percentage of people with past month tobacco use were 63.4 million people and 23.5 percent, respectively.

For the bar graph in descending order, of the 63.4 million people aged 12 or older with past month tobacco use in 2016:

The number of people who had used cigarettes in the past month was 51.3 million (with a 95 percent confidence interval of 50.0 to 52.7 million).

The number of people who had used cigars in the past month was 12.3 million (with a 95 percent confidence interval of 11.7 to 12.9 million).

The number of people who had used smokeless tobacco in the past month was 8.8 million (with a 95 percent confidence interval of 8.3 to 9.3 million).

The number of people who had used pipe tobacco in the past month was 2.3 million (with a 95 percent confidence interval of 2.0 to 2.5 million).

Long description end. Return to Figure 1.

Long description, Figure 2. Figure 2 is titled "Type of Past Month Tobacco Use among Current Tobacco Users Aged 12 or Older: Percentages, 2016." 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. The following label is written below the chart: "63.4 Million Past Month Tobacco Users Aged 12 or Older."

Of the people who used tobacco products in the past month in 2016, 66.8 percent used only cigarettes, 14.1 percent used cigarettes and some other type of tobacco product, and 19.1 percent used non-cigarette tobacco products.

Long description end. Return to Figure 2.

Long description, Figure 3. Figure 3 is titled "Past Month Cigarette Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 "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: 2016." 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 per 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 2016, 21.6 million people and 42.1 percent of past month smokers were less than daily smokers, and 29.7 million people and 57.9 percent of past month smokers were daily smokers.

The smaller pie chart shows the following: Of the daily smokers in 2016, 17.5 million people and 58.9 percent smoked less than a pack per day, and 12.2 million people and 41.1 percent smoked one or more packs per day.

Long description end. Return to Figure 4.

Long description, Figure 5. Figure 5 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, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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. A note below the figure's table of estimates indicates that an asterisk is used when no estimate is reported because of low precision.

Long description end. Return to Figure 5.

Long description, Figure 6. Figure 6 is titled "Past Month Cigar Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 6.

Long description, Figure 7. Figure 7 is titled "Past Month Pipe Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 Smokeless Tobacco Use among People Aged 12 or Older, by Age Group: Percentages, 2016." 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 3.3 percent (with a 95 percent confidence interval of 3.1 to 3.5 percent).

The percentage of youths aged 12 to 17 who were past month smokeless tobacco users was 1.4 percent (with a 95 percent confidence interval of 1.2 to 1.6 percent).

The percentage of young adults aged 18 to 25 who were past month smokeless tobacco users was 5.2 percent (with a 95 percent confidence interval of 4.8 to 5.7 percent).

The percentage of adults aged 26 or older who were past month smokeless tobacco users was 3.1 percent (with a 95 percent confidence interval of 2.9 to 3.4 percent).

Long description end. Return to Figure 8.

Long description, Figure 9. Figure 9 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 or Older: 2016." 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, "Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion."

Of the 136.7 million people aged 12 or older in 2016 who were current alcohol users, 65.3 million were binge alcohol users, who made up 47.8 percent of all current alcohol users. There were 16.3 million people aged 12 or older who were heavy alcohol users, who made up 24.9 percent of all binge alcohol users and 11.9 percent of all current alcohol users.

Long description end. Return to Figure 9.

Long description, Figure 10. Figure 10 is titled "Past Month Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 10.

Long description, Figure 11. Figure 11 is titled "Past Month Binge and Heavy Alcohol Use among People Aged 12 or Older, by Age Group: Percentages, 2016." 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, "Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion."

Among people aged 12 or older in 2016, 24.2 percent were binge alcohol users (with a 95 percent confidence interval of 23.7 to 24.8 percent), and 6.0 percent were heavy alcohol users (with a 95 percent confidence interval of 5.8 to 6.3 percent).

Among youths aged 12 to 17 in 2016, 4.9 percent were binge alcohol users (with a 95 percent confidence interval of 4.5 to 5.3 percent), and 0.8 percent were heavy alcohol users (with a 95 percent confidence interval of 0.6 to 1.0 percent).

Among young adults aged 18 to 25 in 2016, 38.4 percent were binge alcohol users (with a 95 percent confidence interval of 37.3 to 39.4 percent), and 10.1 percent were heavy alcohol users (with a 95 percent confidence interval of 9.5 to 10.8 percent).

Among adults aged 26 or older in 2016, 24.2 percent were binge alcohol users (with a 95 percent confidence interval of 23.6 to 24.9 percent), and 6.0 percent were heavy alcohol users (with a 95 percent confidence interval of 5.7 to 6.3 percent).

Long description end. Return to Figure 11.

Long description, Figure 12. Figure 12 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: 2016." 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, "Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion."

Of the 7.3 million people aged 12 to 20 in 2016 who were current alcohol users, 4.5 million were binge alcohol users, who made up 62.5 percent of all current alcohol users. There were 1.1 million people aged 12 to 20 who were heavy alcohol users, who made up 23.5 percent of all binge alcohol users and 14.7 percent of all current alcohol users.

Long description end. Return to Figure 12.

Long description, Figure 13. Figure 13 is titled "Current, Binge, and Heavy Alcohol Use among People Aged 12 to 20: Percentages, 2016." 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, "Since 2015, the threshold for determining binge alcohol use for males is consuming five or more drinks on an occasion and for females is consuming four or more drinks on an occasion."

The percentage of people aged 12 to 20 who were current (i.e., past month) alcohol users was 19.3 percent (with a 95 percent confidence interval of 18.5 to 20.2 percent).

The percentage of people aged 12 to 20 who were binge alcohol users in the past month was 12.1 percent (with a 95 percent confidence interval of 11.4 to 12.8 percent).

The percentage of people aged 12 to 20 who were heavy alcohol users in the past month was 2.8 percent (with a 95 percent confidence interval of 2.5 to 3.2 percent).

Long description end. Return to Figure 13.

Long description, Figure 14. Figure 14 is titled "Current Alcohol Use among People Aged 12 to 20: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 14.

Long description, Figure 15. Figure 15 is titled "Numbers of Past Month Illicit Drug Users among People Aged 12 or Older: 2016." 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 2016 were 240.9 million people and 89.4 percent, respectively. The number and percentage of people with past month illicit drug use were 28.6 million people and 10.6 percent, respectively.

For the bar graph in descending order, of the 28.6 million people aged 12 or older with past month illicit drug use in 2016:

The number of people who had used marijuana in the past month was 24.0 million (with a 95 percent confidence interval of 23.1 to 24.9 million).

The number of people who had misused prescription pain relievers in the past month was 3.3 million (with a 95 percent confidence interval of 3.1 to 3.7 million).

The number of people who had misused prescription tranquilizers in the past month was 2.0 million (with a 95 percent confidence interval of 1.7 to 2.2 million).

The number of people who had used cocaine in the past month was 1.9 million (with a 95 percent confidence interval of 1.7 to 2.1 million).

The number of people who had misused prescription stimulants in the past month was 1.7 million (with a 95 percent confidence interval of 1.5 to 2.0 million).

The number of people who had used hallucinogens in the past month was 1.4 million (with a 95 percent confidence interval of 1.2 to 1.6 million).

The number of people who had used methamphetamine in the past month was 0.7 million (with a 95 percent confidence interval of 0.5 to 0.8 million).

The number of people who had used inhalants in the past month was 0.6 million (with a 95 percent confidence interval of 0.5 to 0.7 million).

The number of people who had misused prescription sedatives in the past month was 0.5 million (with a 95 percent confidence interval of 0.4 to 0.7 million).

The number of people who had used heroin in the past month was 0.5 million (with a 95 percent confidence interval of 0.4 to 0.6 million).

Long description end. Return to Figure 15.

Long description, Figure 16. Figure 16 is titled "Past Month Illicit Drug Use among People Aged 12 or Older, by Age Group: 2016." 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 millions, the horizontal axis on the right shows the percentages that correspond to the number of people in each age group, 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 28.6 million people aged 12 or older in 2016 who were past month illicit drug users (with a 95 percent confidence interval of 27.6 to 29.5 million), or 10.6 percent of people aged 12 or older (with a 95 percent confidence interval of 10.3 to 11.0 percent).

There were 2.0 million youths aged 12 to 17 who were past month illicit drug users (with a 95 percent confidence interval of 1.8 to 2.1 million), or 7.9 percent of youths (with a 95 percent confidence interval of 7.4 to 8.4 percent).

There were 8.0 million young adults aged 18 to 25 who were past month illicit drug users (with a 95 percent confidence interval of 7.7 to 8.3 million), or 23.2 percent of young adults (with a 95 percent confidence interval of 22.3 to 24.0 percent).

There were 18.6 million adults aged 26 or older who were past month illicit drug users (with a 95 percent confidence interval of 17.8 to 19.5 million), or 8.9 percent of adults aged 26 or older (with a 95 percent confidence interval of 8.5 to 9.3 percent).

Long description end. Return to Figure 16.

Long description, Figure 17. Figure 17 is titled "Past Month Marijuana Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 "Numbers of Past Month Prescription Psychotherapeutic Misusers among People Aged 12 or Older: 2016." 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 psychotherapeutic misuse and the percentage and number of people with past month psychotherapeutic misuse. The bar graph breaks down the people with past month psychotherapeutic misuse by showing the number of people in millions on the horizontal axis and four types of prescription psychotherapeutics 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 misusers of different psychotherapeutics are not mutually exclusive because people could have used more than one type of psychotherapeutic in the past month."

For the pie chart, the number and percentage of people aged 12 or older with no past month psychotherapeutic misuse in 2016 were 263.2 million people and 97.7 percent, respectively. The number and percentage of people with past month psychotherapeutic misuse were 6.2 million people and 2.3 percent, respectively.

For the bar graph in descending order, of the 6.2 million people aged 12 or older with past month prescription psychotherapeutic misuse in 2016:

The number of people who had misused prescription pain relievers in the past month was 3.3 million (with a 95 percent confidence interval of 3.1 to 3.7 million).

The number of people who had misused prescription tranquilizers in the past month was 2.0 million (with a 95 percent confidence interval of 1.7 to 2.2 million).

The number of people who had misused prescription stimulants in the past month was 1.7 million (with a 95 percent confidence interval of 1.5 to 2.0 million).

The number of people who had misused prescription sedatives in the past month was 0.5 million (with a 95 percent confidence interval of 0.4 to 0.7 million).

Long description end. Return to Figure 18.

Long description, Figure 19. Figure 19 is titled "Past Month Prescription Psychotherapeutic Misuse among People Aged 12 or Older, by Age Group: 2016." 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 millions, the horizontal axis on the right shows the percentages that correspond to the number of people in each age group, 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 6.2 million people aged 12 or older in 2016 who were past month prescription psychotherapeutic misusers (with a 95 percent confidence interval of 5.8 to 6.6 million), or 2.3 percent of people aged 12 or older (with a 95 percent confidence interval of 2.2 to 2.5 percent).

There were 0.4 million youths aged 12 to 17 who were past month prescription psychotherapeutic misusers (with a 95 percent confidence interval of 0.3 to 0.5 million), or 1.6 percent of youths (with a 95 percent confidence interval of 1.4 to 1.8 percent).

There were 1.6 million young adults aged 18 to 25 who were past month prescription psychotherapeutic misusers (with a 95 percent confidence interval of 1.5 to 1.8 million), or 4.6 percent of young adults (with a 95 percent confidence interval of 4.2 to 5.1 percent).

There were 4.2 million adults aged 26 or older who were past month prescription psychotherapeutic misusers (with a 95 percent confidence interval of 3.9 to 4.6 million), or 2.0 percent of adults aged 26 or older (with a 95 percent confidence interval of 1.8 to 2.2 percent).

Long description end. Return to Figure 19.

Long description, Figure 20. Figure 20 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, 2016." It is a pie chart that shows the number in millions and the percentage of people who were current misusers of prescription pain relievers, as well as the number in millions and the percentage of people who were current misusers of prescription psychotherapeutics excluding prescription pain relievers. The following label is written below the chart: "6.2 Million Current Misusers of Prescription Psychotherapeutics."

Of the 6.2 million current misusers of psychotherapeutic drugs in 2016, 3.3 million people were current misusers of prescription pain relievers, or 54.0 percent, and 2.9 million people were current misusers of prescription psychotherapeutics excluding prescription pain relievers, or 46.0 percent.

Long description end. Return to Figure 20.

Long description, Figure 21. Figure 21 is titled "Past Month Prescription Psychotherapeutic Misuse among People Aged 12 or Older, by Age Group: Percentages, 2016." It is a bar graph, where the four types of prescription psychotherapeutics are shown on the horizontal axis and the percentage for past month misuse of prescription psychotherapeutic drugs is shown on the vertical axis. For each psychotherapeutic drug, the figure shows a bar representing each of the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older).

Among people aged 12 or older, 1.2 percent misused prescription pain relievers (with a 95 percent confidence interval of 1.1 to 1.4 percent), 0.7 percent misused prescription tranquilizers (with a 95 percent confidence interval of 0.6 to 0.8 percent), 0.6 percent misused prescription stimulants (with a 95 percent confidence interval of 0.6 to 0.7 percent), and 0.2 percent misused prescription sedatives (with a 95 percent confidence interval of 0.1 to 0.2 percent).

Among youths aged 12 to 17, 1.0 percent misused prescription pain relievers (with a 95 percent confidence interval of 0.8 to 1.2 percent), 0.5 percent misused prescription tranquilizers (with a 95 percent confidence interval of 0.4 to 0.6 percent), 0.4 percent misused prescription stimulants (with a 95 percent confidence interval of 0.3 to 0.5 percent), and 0.1 percent misused prescription sedatives (with a 95 percent confidence interval of 0.1 to 0.2 percent).

Among young adults aged 18 to 25, 1.8 percent misused prescription pain relievers (with a 95 percent confidence interval of 1.6 to 2.1 percent), 1.5 percent misused prescription tranquilizers (with a 95 percent confidence interval of 1.3 to 1.8 percent), 2.2 percent misused prescription stimulants (with a 95 percent confidence interval of 1.9 to 2.6 percent), and 0.1 percent misused prescription sedatives (with a 95 percent confidence interval of 0.1 to 0.2 percent).

Among adults aged 26 or older, 1.2 percent misused prescription pain relievers (with a 95 percent confidence interval of 1.0 to 1.3 percent), 0.6 percent misused prescription tranquilizers (with a 95 percent confidence interval of 0.5 to 0.7 percent), 0.4 percent misused prescription stimulants (with a 95 percent confidence interval of 0.3 to 0.5 percent), and 0.2 percent misused prescription sedatives (with a 95 percent confidence interval of 0.1 to 0.3 percent).

Long description end. Return to Figure 21.

Long description, Figure 22. Figure 22 is titled "Past Month Cocaine Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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. A note below the figure's table of estimates indicates that an asterisk is used when no estimate is reported because of low precision. Another note below the figure's table of estimates states, "Estimates of less than 0.1 percent round to 0.0 percent when shown to the nearest tenth of a percent."

Long description end. Return to Figure 23.

Long description, Figure 24. Figure 24 is titled "Past Month Hallucinogen Use among People Aged 12 or Older, by Age Group: Percentages, 2016." 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 (with a 95 percent confidence interval of 0.5 to 0.6 percent).

The percentage of youths aged 12 to 17 who were past month hallucinogen users was 0.5 percent (with a 95 percent confidence interval of 0.4 to 0.6 percent).

The percentage of young adults aged 18 to 25 who were past month hallucinogen users was 1.9 percent (with a 95 percent confidence interval of 1.7 to 2.2 percent).

The percentage of adults aged 26 or older who were past month hallucinogen users was 0.3 percent (with a 95 percent confidence interval of 0.2 to 0.4 percent).

Long description end. Return to Figure 24.

Long description, Figure 25. Figure 25 is titled "Past Month Inhalant Use among People Aged 12 or Older, by Age Group: Percentages, 2016." 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 (with a 95 percent confidence interval of 0.2 to 0.3 percent).

The percentage of youths aged 12 to 17 who were past month inhalant users was 0.6 percent (with a 95 percent confidence interval of 0.5 to 0.8 percent).

The percentage of young adults aged 18 to 25 who were past month inhalant users was 0.4 percent (with a 95 percent confidence interval of 0.2 to 0.5 percent).

The percentage of adults aged 26 or older who were past month inhalant users was 0.2 percent (with a 95 percent confidence interval of 0.1 to 0.2 percent).

Long description end. Return to Figure 25.

Long description, Figure 26. Figure 26 is titled "Past Month Methamphetamine Use among People Aged 12 or Older, by Age Group: Percentages, 2016." 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. A note below the figure states, "Estimates of less than 0.1 percent round to 0.0 percent when shown to the nearest tenth of a percent."

The percentage of people aged 12 or older who were past month methamphetamine users was 0.2 percent (with a 95 percent confidence interval of 0.2 to 0.3 percent).

The percentage of youths aged 12 to 17 who were past month methamphetamine users was 0.0 percent (with a 95 percent confidence interval of 0.0 to 0.1 percent).

The percentage of young adults aged 18 to 25 who were past month methamphetamine users was 0.2 percent (with a 95 percent confidence interval of 0.1 to 0.3 percent).

The percentage of adults aged 26 or older who were past month methamphetamine users was 0.3 percent (with a 95 percent confidence interval of 0.2 to 0.4 percent).

Long description end. Return to Figure 26.

Long description, Figure 27. Figure 27 is titled "Past Year Opioid Misuse among People Aged 12 or Older: 2016." It is a Venn diagram with a label and a note below the figure. The label says, "11.8 Million People Aged 12 or Older with Past Year Opioid Misuse." The note says, "Opioid misuse is defined as heroin use or prescription pain reliever misuse." The Venn diagram shows overlapping circles, with the circle on the right being much smaller than the circle on the left. The larger circle on the left represents people who were past year pain reliever misusers. The much smaller circle on the right represents people who were past year heroin users. The intersection of the two circles represents people who were past year pain reliever misusers and heroin users. In addition, the area of the larger circle that does not intersect with the smaller circle represents people who were past year pain reliever misusers but not heroin users. Also, the area of the smaller circle that does not intersect with the larger circle represents people who were past year heroin users but not pain reliever misusers.

The number of people aged 12 or older in 2016 who were past year pain reliever misusers was 11.5 million (or 97.4 percent of opioid misusers), including 10.9 million who were pain reliever misusers but not heroin users (or 92.0 percent of opioid misusers). The number of people who were past year heroin users was 948,000 (or 8.0 percent of opioid misusers), including 307,000 who were heroin users but not pain reliever misusers (or 2.6 percent of opioid misusers). There were 641,000 people who were past year pain reliever misusers and heroin users (or 5.4 percent of opioid misusers).

Long description end. Return to Figure 27.

Long description, Figure 28. Figure 28 is titled "Past Year Opioid Misuse among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, and the shared vertical axis shows the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older). A note below the figure states, "Opioid misuse is defined as heroin use or prescription pain reliever misuse."

There were 11,824,000 people aged 12 or older in 2016 who were past year opioid misusers (with a 95 percent confidence interval of 11,265,000 to 12,409,000), or 4.4 percent of people aged 12 or older (with a 95 percent confidence interval of 4.2 to 4.6 percent).

There were 891,000 youths aged 12 to 17 who were past year opioid misusers (with a 95 percent confidence interval of 811,000 to 979,000), or 3.6 percent of youths (with a 95 percent confidence interval of 3.3 to 3.9 percent).

There were 2,516,000 young adults aged 18 to 25 who were past year opioid misusers (with a 95 percent confidence interval of 2,338,000 to 2,707,000), or 7.3 percent of young adults (with a 95 percent confidence interval of 6.8 to 7.8 percent).

There were 8,417,000 adults aged 26 or older who were past year opioid misusers (with a 95 percent confidence interval of 7,905,000 to 8,961,000), or 4.0 percent of adults aged 26 or older (with a 95 percent confidence interval of 3.8 to 4.3 percent).

Long description end. Return to Figure 28.

Long description, Figure 29. Figure 29 is titled "Past Year Heroin Use among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 29.

Long description, Figure 30. Figure 30 is titled "Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 11,517,000 people aged 12 or older in 2016 who were past year prescription pain reliever misusers (with a 95 percent confidence interval of 10,969,000 to 12,091,000), or 4.3 percent of people aged 12 or older (with a 95 percent confidence interval of 4.1 to 4.5 percent).

There were 881,000 youths aged 12 to 17 who were past year prescription pain reliever misusers (with a 95 percent confidence interval of 802,000 to 969,000), or 3.5 percent of youths (with a 95 percent confidence interval of 3.2 to 3.9 percent).

There were 2,454,000 young adults aged 18 to 25 who were past year prescription pain reliever misusers (with a 95 percent confidence interval of 2,279,000 to 2,642,000), or 7.1 percent of young adults (with a 95 percent confidence interval of 6.6 to 7.6 percent).

There were 8,181,000 adults aged 26 or older who were past year prescription pain reliever misusers (with a 95 percent confidence interval of 7,679,000 to 8,716,000), or 3.9 percent of adults aged 26 or older (with a 95 percent confidence interval of 3.7 to 4.2 percent).

Long description end. Return to Figure 30.

Long description, Figure 31. Figure 31 is titled "Prescription Pain Reliever Subtypes in the 2016 NSDUH Questionnaire." It is an organization-type chart that outlines the specific prescription pain relievers asked about in the NSDUH questionnaire and categorizes them into 12 subtypes. A red box in the top left corner says, "Prescription Pain Relievers," and has a blue line coming straight down from the box. Each of the 12 subtypes, shown in blue boxes, branches off to the right of the blue line. When applicable, the blue subtype box has a brown box branching off to the right listing the specific individually named prescription pain relievers that are included in the subtypes.

Two notes are below the figure, the first of which says, "Prescription pain reliever categories shown in the red and blue boxes represent estimates for subtypes that are shown in Table A.12B in Appendix A." The second note says, "The following drugs in this figure are generic drugs: Hydrocodone, Oxycodone, Tramadol, Extended-Release Tramadol, Codeine Pills, Morphine, Extended-Release Morphine, Fentanyl, Buprenorphine, Buprenorphine Plus Naloxone, Oxymorphone, Extended-Release Oxymorphone, Hydromorphone, Extended-Release Hydromorphone, and Methadone."

The 12 subtypes include (1) Hydrocodone Products, (2) Oxycodone Products, (3) Tramadol Products, (4) Codeine Products, (5) Morphine Products, (6) Fentanyl Products, (7) Buprenorphine Products, (8) Oxymorphone Products, (9) Demerol®, (10) Hydromorphone Products, (11) Methadone, and (12) Other Prescription Pain Relievers. The subtype for Hydrocodone Products includes the prescription pain relievers Vicodin®, Lortab®, Norco®, Zohydro® ER, and Hydrocodone. The subtype for Oxycodone Products includes the prescription pain relievers OxyContin®, Percocet®, Percodan®, Roxicodone®, and Oxycodone. The subtype for Tramadol Products includes the prescription pain relievers Ultram®, Ultram® ER, Ultracet®, Tramadol, and Extended-Release Tramadol. The subtype for Codeine Products includes the prescription pain relievers Tylenol® with Codeine 3 or 4 and Codeine Pills. The subtype for Morphine Products includes the prescription pain relievers Avinza®, Kadian®, MS Contin®, Morphine, and Extended-Release Morphine. The subtype for Fentanyl Products includes the prescription pain relievers Duragesic®, Fentora®, and Fentanyl. The subtype for Buprenorphine Products includes the prescription pain relievers Suboxone®, Buprenorphine, and Buprenorphine Plus Naloxone. The subtype for Oxymorphone Products includes the prescription pain relievers Opana®, Opana® ER, Oxymorphone, and Extended-Release Oxymorphone. The subtype for Hydromorphone Products includes two sets of prescription pain relievers: (1) Dilaudid® or Hydromorphone and (2) Exalgo® or Extended-Release Hydromorphone. The blue subtype boxes for Demerol®, Methadone, and Other Prescription Pain Relievers do not have further categorizations.

Long description end. Return to Figure 31.

Long description, Figure 32. Figure 32 is titled "Past Year Prescription Pain Reliever Misuse among People Aged 12 or Older, by Selected Pain Reliever Subtype: 2016." 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 in each group. The shared vertical axis shows nine prescription pain reliever misuse subtypes: (1) Any Pain Reliever Misuse, (2) Hydrocodone, (3) Oxycodone, (4) Codeine, (5) Tramadol, (6) Buprenorphine, (7) Morphine, (8) Methadone, and (9) Fentanyl.

There were 11,517,000 people aged 12 or older in 2016 who were past year misusers of any pain reliever (with a 95 percent confidence interval of 10,969,000 to 12,091,000), or 4.3 percent of people aged 12 or older (with a 95 percent confidence interval of 4.1 to 4.5 percent).

There were 6,924,000 people aged 12 or older who were past year hydrocodone misusers (with a 95 percent confidence interval of 6,505,000 to 7,369,000), or 2.6 percent of people aged 12 or older (with a 95 percent confidence interval of 2.4 to 2.7 percent).

There were 3,905,000 people aged 12 or older who were past year oxycodone misusers (with a 95 percent confidence interval of 3,599,000 to 4,236,000), or 1.4 percent of people aged 12 or older (with a 95 percent confidence interval of 1.3 to 1.6 percent).

There were 2,767,000 people aged 12 or older who were past year codeine misusers (with a 95 percent confidence interval of 2,496,000 to 3,068,000), or 1.0 percent of people aged 12 or older (with a 95 percent confidence interval of 0.9 to 1.1 percent).

There were 1,591,000 people aged 12 or older who were past year tramadol misusers (with a 95 percent confidence interval of 1,392,000 to 1,817,000), or 0.6 percent of people aged 12 or older (with a 95 percent confidence interval of 0.5 to 0.7 percent).

There were 712,000 people aged 12 or older who were past year buprenorphine misusers (with a 95 percent confidence interval of 594,000 to 852,000), or 0.3 percent of people aged 12 or older (with a 95 percent confidence interval of 0.2 to 0.3 percent).

There were 536,000 people aged 12 or older who were past year morphine misusers (with a 95 percent confidence interval of 434,000 to 662,000), or 0.2 percent of people aged 12 or older (with a 95 percent confidence interval of 0.2 to 0.2 percent when the lower and upper bound percentages for the confidence interval were rounded to the nearest tenth of a percent).

There were 346,000 people aged 12 or older who were past year methadone misusers (with a 95 percent confidence interval of 257,000 to 465,000), or 0.1 percent of people (with a 95 percent confidence interval of 0.1 to 0.2 percent).

There were 228,000 people aged 12 or older who were past year fentanyl misusers (with a 95 percent confidence interval of 169,000 to 308,000), or 0.1 percent of people aged 12 or older (with a 95 percent confidence interval of 0.1 to 0.1 percent when the lower and upper bound percentages for the confidence interval were rounded to the nearest tenth of a percent).

Long description end. Return to Figure 32.

Long description, Figure 33. Figure 33 is titled "Main Reason for the Most Recent Prescription Pain Reliever Misuse among People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year: Percentages, 2016." It is a pie chart with the following label written below the chart: "11.5 Million People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year." A note below the chart states, "The percentages do not add to 100 percent due to rounding."

The pie chart shows the reasons for the most recent prescription pain reliever misuse, which include (1) relieve physical pain; (2) relax or relieve tension; (3) help with sleep; (4) help with feelings or emotions; (5) experiment or see what it's like; (6) feel good or get high; (7) increase or decrease the effects of other drugs; (8) hooked or have to have the drug; and (9) some other reason.

For the pie chart, 62.3 percent of people aged 12 or older who misused prescription pain relievers in the past year reported their main reason for their most recent misuse was to relieve physical pain. Another 10.8 percent of past year misusers reported that their main reason was to relax or relieve tension; 3.3 percent of past year misusers reported that their main reason was to help with sleep; 3.9 percent of past year misusers reported that their main reason was to help with feelings or emotions; 3.0 percent of past year misusers reported that their main reason was to experiment or see what it's like; 12.9 percent of past year misusers reported that their main reason was to feel good or get high; 0.9 percent of past year misusers reported that their main reason was to increase or decrease the effects of other drugs; 2.1 percent of past year misusers reported that their main reason was that they were hooked or have to have the drug; and 0.9 percent of past year misusers reported that their main reason was some other reason.

Long description end. Return to Figure 33.

Long description, Figure 34. Figure 34 is titled "Source Where Pain Relievers Were Obtained for Most Recent Misuse among People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year: Percentages: 2016." It is a pie chart with the following label written below the chart: "11.5 Million People Aged 12 or Older Who Misused Prescription Pain Relievers in the Past Year." Also, two notes are below the figure, the first of which says, "Respondents with unknown data for Source for Most Recent Misuse or who reported Some Other Way but did not specify a valid way were excluded." The second note says, "The percentages do not add to 100 percent due to rounding."

The pie chart shows in bold type four sources for obtaining the last prescription pain relievers that were misused, which include (1) got through prescription(s) or stole from a health care provider; (2) given by, bought from, or took from a friend or relative; (3) bought from drug dealer or other stranger; and (4) some other way. The "Got through Prescriptions(s) or Stole from a Health Care Provider" group is broken out further to show the following three specific sources: (1) prescription from one doctor; (2) prescriptions from more than one doctor; and (3) stole from doctor's office, clinic, hospital, or pharmacy. The "Given by, Bought from, or Took from a Friend or Relative" group is broken out further to show the following three specific sources: (1) from friend or relative for free, (2) bought from friend or relative, and (3) took from a friend or relative without asking.

For the pie chart, 53.0 percent of people aged 12 or older who misused prescription pain relievers in the past year reported that they obtained pain relievers the last time from a friend or relative, including 40.4 percent who got them from a friend or relative for free, 8.9 percent who bought them from a friend or relative, and 3.7 percent who took them from a friend or relative without asking. Another 37.5 percent of past year misusers reported obtaining pain relievers the last time through prescriptions(s) or stealing them from a health care provider, including 35.4 percent who got them through a prescription from one doctor, 1.4 percent who got them through prescriptions from more than one doctor, and 0.7 percent who stole the pain relievers from a doctor's office, clinic, hospital, or pharmacy. In addition, 6.0 percent of past year misusers reported they bought the pain relievers that they last misused from a drug dealer or other stranger, and 3.4 percent reported that they got the pain relievers some other way.

Long description end. Return to Figure 34.

Long description, Figure 35. Figure 35 is titled "Alcohol Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 35.

Long description, Figure 36. Figure 36 is titled "Illicit Drug Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 7,381,000 people aged 12 or older in 2016 who had an illicit drug use disorder in the past year (with a 95 percent confidence interval of 6,949,000 to 7,839,000), or 2.7 percent of people aged 12 or older (with a 95 percent confidence interval of 2.6 to 2.9 percent).

There were 789,000 youths aged 12 to 17 who had an illicit drug use disorder in the past year (with a 95 percent confidence interval of 707,000 to 880,000), or 3.2 percent of youths (with a 95 percent confidence interval of 2.8 to 3.5 percent).

There were 2,428,000 young adults aged 18 to 25 who had an illicit drug use disorder in the past year (with a 95 percent confidence interval of 2,252,000 to 2,617,000), or 7.0 percent of young adults (with a 95 percent confidence interval of 6.5 to 7.6 percent).

There were 4,164,000 adults aged 26 or older who had an illicit drug use disorder in the past year (with a 95 percent confidence interval of 3,802,000 to 4,558,000), or 2.0 percent of adults aged 26 or older (with a 95 percent confidence interval of 1.8 to 2.2 percent).

Long description end. Return to Figure 36.

Long description, Figure 37. Figure 37 is titled "Marijuana Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 37.

Long description, Figure 38. Figure 38 is titled "Cocaine Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 38.

Long description, Figure 39. Figure 39 is titled "Heroin Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: Percentages, 2002-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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. A note below the figure's table of estimates states, "Estimates of less than 0.1 percent round to 0.0 percent when shown to the nearest tenth of a percent."

Long description end. Return to Figure 39.

Long description, Figure 40. Figure 40 is titled "Pain Reliever Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 1,753,000 people aged 12 or older in 2016 who had a pain reliever use disorder in the past year (with a 95 percent confidence interval of 1,541,000 to 1,993,000), or 0.7 percent of people aged 12 or older (with a 95 percent confidence interval of 0.6 to 0.7 percent).

There were 152,000 youths aged 12 to 17 who had a pain reliever use disorder in the past year (with a 95 percent confidence interval of 116,000 to 198,000), or 0.6 percent of youths (with a 95 percent confidence interval of 0.5 to 0.8 percent).

There were 291,000 young adults aged 18 to 25 who had a pain reliever use disorder in the past year (with a 95 percent confidence interval of 238,000 to 357,000), or 0.8 percent of young adults (with a 95 percent confidence interval of 0.7 to 1.0 percent).

There were 1,310,000 adults aged 26 or older who had a pain reliever use disorder in the past year (with a 95 percent confidence interval of 1,117,000 to 1,535,000), or 0.6 percent of adults aged 26 or older (with a 95 percent confidence interval of 0.5 to 0.7 percent).

Long description end. Return to Figure 40.

Long description, Figure 41. Figure 41 is titled "Opioid Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, and the shared vertical axis shows the four age groups (12 or older, 12 to 17, 18 to 25, and 26 or older). A note below the figure states, "Opioid use disorder is defined as meeting DSM-IV criteria for heroin use disorder or pain reliever use disorder in the past 12 months."

There were 2,144,000 people aged 12 or older in 2016 who had an opioid use disorder in the past year (with a 95 percent confidence interval of 1,909,000 to 2,407,000), or 0.8 percent of people aged 12 or older (with a 95 percent confidence interval of 0.7 to 0.9 percent).

There were 153,000 youths aged 12 to 17 who had an opioid use disorder in the past year (with a 95 percent confidence interval of 117,000 to 199,000), or 0.6 percent of youths (with a 95 percent confidence interval of 0.5 to 0.8 percent).

There were 392,000 young adults aged 18 to 25 who had an opioid use disorder in the past year (with a 95 percent confidence interval of 329,000 to 465,000), or 1.1 percent of young adults (with a 95 percent confidence interval of 1.0 to 1.3 percent).

There were 1,599,000 adults aged 26 or older who had an opioid use disorder in the past year (with a 95 percent confidence interval of 1,384,000 to 1,848,000), or 0.8 percent of adults aged 26 or older (with a 95 percent confidence interval of 0.7 to 0.9 percent).

Long description end. Return to Figure 41.

Long description, Figure 42. Figure 42 is titled "Numbers of People Aged 12 or Older with a Past Year Substance Use Disorder: 2016." 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 2016 were 249.3 million people and 92.5 percent, respectively. The number and percentage of people with a past year substance use disorder were 20.1 million people and 7.5 percent, respectively.

For the bar graph in descending order, of the 20.1 million people aged 12 or older with a past year substance use disorder in 2016:

The number of people who had an alcohol use disorder in the past year was 15.1 million (with a 95 percent confidence interval of 14.4 to 15.7 million).

The number of people who had an illicit drug use disorder in the past year was 7.4 million (with a 95 percent confidence interval of 6.9 to 7.8 million).

The number of people who had a marijuana use disorder in the past year was 4.0 million (with a 95 percent confidence interval of 3.7 to 4.3 million).

The number of people who had a pain reliever use disorder in the past year was 1.8 million (with a 95 percent confidence interval of 1.5 to 2.0 million).

The number of people who had a cocaine use disorder in the past year was 0.9 million (with a 95 percent confidence interval of 0.7 to 1.0 million).

The number of people who had a methamphetamine use disorder in the past year was 0.7 million (with a 95 percent confidence interval of 0.6 to 0.8 million).

The number of people who had a heroin use disorder in the past year was 0.6 million (with a 95 percent confidence interval of 0.5 to 0.8 million).

The number of people who had a stimulant use disorder in the past year was 0.5 million (with a 95 percent confidence interval of 0.4 to 0.7 million).

Long description end. Return to Figure 42.

Long description, Figure 43. Figure 43 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): 2016." It is a Venn diagram with a label below the figure that says, "20.1 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 people with a past year alcohol use disorder. The smaller circle on the right represents people with a past year illicit drug use disorder. The intersection of the two circles represents people who had past year alcohol and illicit drug use disorders. In addition, the area of the larger circle that does not intersect with the smaller circle represents people who had an alcohol use disorder but not an illicit drug use disorder. Also, the area of the smaller circle that does not intersect with the larger circle represents people who had an illicit drug use disorder but not an alcohol use disorder.

The number of people aged 12 or older in 2016 with a past year alcohol use disorder was 15.1 million (or 74.9 percent of people with an SUD), including 12.7 million who had an alcohol use disorder but not an illicit drug use disorder (or 63.3 percent of people with an SUD). The number of people with a past year illicit drug use disorder was 7.4 million (or 36.7 percent of people with an SUD), including 5.1 million who had an illicit drug use disorder but not an alcohol use disorder (or 25.1 percent of people with an SUD). There were 2.3 million people who had past year alcohol and illicit drug use disorders (or 11.6 percent of people with an SUD).

Long description end. Return to Figure 43.

Long description, Figure 44. Figure 44 is titled "Substance Use Disorder in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 20,112,000 people aged 12 or older in 2016 who had a substance use disorder in the past year (with a 95 percent confidence interval of 19,351,000 to 20,900,000), or 7.5 percent of people aged 12 or older (with a 95 percent confidence interval of 7.2 to 7.8 percent).

There were 1,064,000 youths aged 12 to 17 who had a substance use disorder in the past year (with a 95 percent confidence interval of 970,000 to 1,167,000), or 4.3 percent of youths (with a 95 percent confidence interval of 3.9 to 4.7 percent).

There were 5,236,000 young adults aged 18 to 25 who had a substance use disorder in the past year (with a 95 percent confidence interval of 4,987,000 to 5,495,000), or 15.1 percent of young adults (with a 95 percent confidence interval of 14.4 to 15.9 percent).

There were 13,812,000 adults aged 26 or older who had a substance use disorder in the past year (with a 95 percent confidence interval of 13,116,000 to 14,542,000), or 6.6 percent of adults aged 26 or older (with a 95 percent confidence interval of 6.2 to 6.9 percent).

Long description end. Return to Figure 44.

Long description, Figure 45. Figure 45 is titled "Need for Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 20,959,000 people aged 12 or older in 2016 who needed substance use treatment in the past year (with a 95 percent confidence interval of 20,173,000 to 21,772,000), or 7.8 percent of people aged 12 or older (with a 95 percent confidence interval of 7.5 to 8.1 percent).

There were 1,085,000 youths aged 12 to 17 who needed substance use treatment in the past year (with a 95 percent confidence interval of 990,000 to 1,188,000), or 4.4 percent of youths (with a 95 percent confidence interval of 4.0 to 4.8 percent).

There were 5,343,000 young adults aged 18 to 25 who needed substance use treatment in the past year (with a 95 percent confidence interval of 5,093,000 to 5,602,000), or 15.5 percent of young adults (with a 95 percent confidence interval of 14.7 to 16.2 percent).

There were 14,531,000 adults aged 26 or older who needed substance use treatment in the past year (with a 95 percent confidence interval of 13,809,000 to 15,289,000), or 6.9 percent of adults aged 26 or older (with a 95 percent confidence interval of 6.6 to 7.3 percent).

Long description end. Return to Figure 45.

Long description, Figure 46. Figure 46 is titled "Received Any Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 3,755,000 people aged 12 or older in 2016 who received substance use treatment in the past year (with a 95 percent confidence interval of 3,431,000 to 4,109,000), or 1.4 percent of people aged 12 or older (with a 95 percent confidence interval of 1.3 to 1.5 percent).

There were 180,000 youths aged 12 to 17 who received substance use treatment in the past year (with a 95 percent confidence interval of 147,000 to 221,000), or 0.7 percent of youths (with a 95 percent confidence interval of 0.6 to 0.9 percent).

There were 624,000 young adults aged 18 to 25 who received substance use treatment in the past year (with a 95 percent confidence interval of 543,000 to 717,000), or 1.8 percent of young adults (with a 95 percent confidence interval of 1.6 to 2.1 percent).

There were 2,950,000 adults aged 26 or older who received substance use treatment in the past year (with a 95 percent confidence interval of 2,646,000 to 3,289,000), or 1.4 percent of adults aged 26 or older (with a 95 percent confidence interval of 1.3 to 1.6 percent).

Long description end. Return to Figure 46.

Long description, Figure 47. Figure 47 is titled "Received Specialty Substance Use Treatment in the Past Year among People Aged 12 or Older, by Age Group: 2016." 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 in each age group, 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 2,229,000 people aged 12 or older in 2016 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 1,985,000 to 2,502,000), or 0.8 percent of people aged 12 or older (with a 95 percent confidence interval of 0.7 to 0.9 percent).

There were 89,000 youths aged 12 to 17 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 67,000 to 119,000), or 0.4 percent of youths (with a 95 percent confidence interval of 0.3 to 0.5 percent).

There were 383,000 young adults aged 18 to 25 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 322,000 to 456,000), or 1.1 percent of young adults (with a 95 percent confidence interval of 0.9 to 1.3 percent).

There were 1,756,000 adults aged 26 or older who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 1,524,000 to 2,024,000), or 0.8 percent of adults aged 26 or older (with a 95 percent confidence interval of 0.7 to 1.0 percent).

Long description end. Return to Figure 47.

Long description, Figure 48. Figure 48 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: 2016." 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 in each age group who needed substance use treatment, 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 2,229,000 people aged 12 or older in 2016 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 1,999,000 to 2,482,000), or 10.6 percent of people aged 12 or older who needed substance use treatment in the past year (with a 95 percent confidence interval of 9.5 to 11.8 percent).

There were 89,000 youths aged 12 to 17 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 67,000 to 118,000), or 8.2 percent of youths who needed substance use treatment in the past year (with a 95 percent confidence interval of 6.2 to 10.9 percent).

There were 383,000 young adults aged 18 to 25 who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 323,000 to 454,000), or 7.2 percent of young adults who needed substance use treatment in the past year (with a 95 percent confidence interval of 6.0 to 8.5 percent).

There were 1,756,000 adults aged 26 or older who received specialty substance use treatment in the past year (with a 95 percent confidence interval of 1,537,000 to 2,002,000), or 12.1 percent of adults aged 26 or older who needed substance use treatment in the past year (with a 95 percent confidence interval of 10.6 to 13.8 percent).

Long description end. Return to Figure 48.

Long description, Figure 49. Figure 49 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: 2016." It is a pie chart, with the following label written below the chart: "3.1 Million Youths with a Past Year MDE (12.8% of All Youths)." Two notes are below the chart, the first of which says, "Youth respondents with unknown past year MDE data or unknown impairment data were excluded." The second note says, "The percentages do not add to 100 percent due to rounding." 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 3.1 million youths with an MDE in the past year, 2.2 million youths had an MDE with severe impairment. This represents 9.0 percent of all youths and 70.5 percent of youths with an MDE. Also, 0.9 million youths had an MDE without severe impairment, which represents 3.7 percent of all youths and 29.4 percent of youths with an MDE.

Long description end. Return to Figure 49.

Long description, Figure 50. Figure 50 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Youths Aged 12 to 17: Percentages, 2004-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of youths with a major depressive episode 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 2016, and the other line shows the percentage with a major depressive episode with severe impairment over the years 2006 through 2016. Tests of statistical significance at the .05 level were performed between 2016 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 50.

Long description, Figure 51. Figure 51 is titled "Major Depressive Episode (MDE) and MDE with Severe Impairment in the Past Year among Adults Aged 18 or Older: 2016." It is a pie chart, with the following label written below the chart: "16.2 Million Adults with a Past Year MDE (6.7% of All Adults)." Two notes are below the chart, the first of which says, "Adult respondents with unknown past year MDE data or unknown impairment data were excluded." The second note says, "The percentages do not add to 100 percent due to rounding." 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 16.2 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 35.8 percent of adults with an MDE.

Long description end. Return to Figure 51.

Long description, Figure 52. Figure 52 is titled "Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2005-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 52.

Long description, Figure 53. Figure 53 is titled "Major Depressive Episode with Severe Impairment in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2009-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 "Any Mental Illness (AMI), Serious Mental Illness (SMI), and AMI Excluding SMI in the Past Year among Adults Aged 18 or Older: 2016." It is a pie chart, with the following label written below the chart: "44.7 Million Adults with AMI in the Past Year (18.3% 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 44.7 million adults in 2016 with AMI in the past year, 34.3 million adults had AMI excluding SMI. This represents 14.0 percent of all adults and 76.8 percent of adults with AMI. Also, 10.4 million adults had SMI, which represents 4.2 percent of all adults and 23.2 percent of adults with AMI.

Long description end. Return to Figure 54.

Long description, Figure 55. Figure 55 is titled "Any Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 "Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 56.

Long description, Figure 57. Figure 57 is titled "Any Mental Illness Excluding Serious Mental Illness in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 57.

Long description, Figure 58. Figure 58 is titled "Received Treatment in the Past Year for Depression among Youths Aged 12 to 17 with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2004-2016." 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 2016, 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 Adults Aged 18 or Older with a Past Year Major Depressive Episode (MDE) or MDE with Severe Impairment: Percentages, 2009-2016." 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 over the years 2009 through 2016, 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 2016. Tests of statistical significance at the .05 level were performed between 2016 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 "Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: 2016." 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. Two notes are below the figure, the first of which says "Mental health service for youths aged 12 to 17 is defined as having received treatment/counseling for emotional or behavioral problems not caused by substance use." The second note says, "Nonspecialty settings do not include youths who received mental health services in the past year from a juvenile justice setting."

There were 3,598,000 youths aged 12 to 17 in 2016 who received mental health services in a specialty mental health setting in the past year (with a 95 percent confidence interval of 3,442,000 to 3,760,000), or 14.7 percent of youths (with a 95 percent confidence interval of 14.1 to 15.4 percent).

There were 3,193,000 youths who received mental health services in an education setting in the past year (with a 95 percent confidence interval of 3,040,000 to 3,353,000), or 13.1 percent of youths (with a 95 percent confidence interval of 12.5 to 13.8 percent).

There were 708,000 youths who received mental health services in a general medical setting in the past year (with a 95 percent confidence interval of 637,000 to 786,000), or 2.9 percent of youths (with a 95 percent confidence interval of 2.6 to 3.2 percent).

There were 108,000 youths who received mental health services in a child welfare setting in the past year (with a 95 percent confidence interval of 80,000 to 146,000), or 0.4 percent of youths (with a 95 percent confidence interval of 0.3 to 0.6 percent).

There were 53,000 youths who received mental health services in a juvenile justice setting in the past year (with a 95 percent confidence interval of 35,000 to 81,000), or 0.2 percent of youths (with a 95 percent confidence interval of 0.1 to 0.3 percent).

There were 1,513,000 youths who received mental health services in both specialty and nonspecialty settings in the past year (with a 95 percent confidence interval of 1,407,000 to 1,626,000), or 6.2 percent of youths (with a 95 percent confidence interval of 5.8 to 6.7 percent).

Long description end. Return to Figure 60.

Long description, Figure 61. Figure 61 is titled "Sources of Mental Health Services in the Past Year among Youths Aged 12 to 17: Percentages, 2009-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of youths receiving mental health services from six sources in the past year is shown on the vertical axis. There is a line showing the percentage who received that source of mental health service over the years 2009 through 2016 for each of 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. Two notes are below the figure, the first of which says "Mental health service for youths aged 12 to 17 is defined as having received treatment/counseling for emotional or behavioral problems not caused by substance use." The second note says, "Nonspecialty settings do not include youths who received mental health services in the past year from a juvenile justice setting." Tests of statistical significance at the .05 level were performed between 2016 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 61.

Long description, Figure 62. Figure 62 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older: Percentages, 2002-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults 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 2016. A note below the figure says, "Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health." Tests of statistical significance at the .05 level were performed between 2016 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 62.

Long description, Figure 63. Figure 63 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Any Mental Illness in the Past Year: Percentages, 2008-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults with any mental illness 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 with any mental illness receiving mental health services over the years 2008 through 2016. A note below the figure says, "Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health." Tests of statistical significance at the .05 level were performed between 2016 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 63.

Long description, Figure 64. Figure 64 is titled "Type of Mental Health Services Received in the Past Year among Adults Aged 18 or Older with Serious Mental Illness in the Past Year: Percentages, 2008-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage of adults with serious mental illness 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 with serious mental illness receiving mental health services over the years 2008 through 2016. A note below the figure says, "Mental health service is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health." Tests of statistical significance at the .05 level were performed between 2016 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 64.

Long description, Figure 65. Figure 65 is titled "Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) Status among Youths Aged 12 to 17: Percentages, 2016." 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 4.3 percent (with a 95 percent confidence interval of 3.9 to 4.7 percent).

The percentage of youths aged 12 to 17 with an MDE in the past year was 12.8 percent (with a 95 percent confidence interval of 12.1 to 13.4 percent).

The percentage of youths aged 12 to 17 with an MDE with severe impairment in the past year was 9.0 percent (with a 95 percent confidence interval of 8.4 to 9.5 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 (with a 95 percent confidence interval of 1.2 to 1.6 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 1.1 percent (with a 95 percent confidence interval of 1.0 to 1.4 percent).

Long description end. Return to Figure 65.

Long description, Figure 66. Figure 66 is titled "Past Year Substance Use Disorder (SUD) and Major Depressive Episode (MDE) among Youths Aged 12 to 17: Numbers in Millions, 2016." 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 2016 with a past year SUD was 1.1 million, including 0.7 million who had an SUD and no MDE. The number of youths with a past year MDE was 3.1 million, including 2.8 million who had an MDE and no SUD. There were 0.3 million youths who had both an MDE and an SUD.

Long description end. Return to Figure 66.

Long description, Figure 67. Figure 67 is titled "Past Year Illicit Drug Use among Youths Aged 12 to 17, by Past Year Major Depressive Episode (MDE) Status: Percentages, 2016." 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) misuse of prescription psychotherapeutics, (4) inhalants, and (5) hallucinogens. For each type of illicit drug, the figure shows three bars. The first bar shows the percentage among all youths aged 12 to 17. The second bar shows the percentage among youths who had an MDE in the past year. The third bar shows the percentage among youths who did not have an MDE in the past year.

Among all youths aged 12 to 17 in 2016, 15.8 percent used illicit drugs in the past year (with a 95 percent confidence interval of 15.2 to 16.5 percent). Corresponding percentages for illicit drug use in the past year were 31.7 percent among youths who had a past year MDE (with a 95 percent confidence interval of 29.3 to 34.2 percent) and 13.4 percent among youths who did not have a past year MDE (with a 95 percent confidence interval of 12.7 to 14.1 percent).

Among all youths aged 12 to 17, 12.0 percent used marijuana in the past year (with a 95 percent confidence interval of 11.4 to 12.6 percent). Corresponding percentages for marijuana use in the past year were 24.3 percent among youths who had a past year MDE (with a 95 percent confidence interval of 22.2 to 26.6 percent) and 10.1 percent among youths who did not have a past year MDE (with a 95 percent confidence interval of 9.5 to 10.7 percent).

Among all youths aged 12 to 17, 5.3 percent reported misuse of psychotherapeutics in the past year (with a 95 percent confidence interval of 4.9 to 5.7 percent). Corresponding percentages for misuse of psychotherapeutics in the past year were 13.3 percent among youths who had a past year MDE (with a 95 percent confidence interval of 11.6 to 15.2 percent) and 4.0 percent among youths who did not have a past year MDE (with a 95 percent confidence interval of 3.6 to 4.5 percent).

Among all youths aged 12 to 17, 2.2 percent used inhalants in the past year (with a 95 percent confidence interval of 2.0 to 2.5 percent). Corresponding percentages for use of inhalants in the past year were 5.1 percent among youths who had a past year MDE (with a 95 percent confidence interval of 4.1 to 6.4 percent) and 1.8 percent among youths who did not have a past year MDE (with a 95 percent confidence interval of 1.5 to 2.1 percent).

Among all youths aged 12 to 17, 1.8 percent used hallucinogens in the past year (with a 95 percent confidence interval of 1.6 to 2.1 percent). Corresponding percentages for use of hallucinogens in the past year were 4.1 percent among youths who had a past year MDE (with a 95 percent confidence interval of 3.2 to 5.3 percent) and 1.5 percent among youths who did not have a past year MDE (with a 95 percent confidence interval of 1.2 to 1.7 percent).

Long description end. Return to Figure 67.

Long description, Figure 68. Figure 68 is titled "Past Year Substance Use Disorder (SUD) and Mental Illness among Adults Aged 18 or Older: Numbers in Millions, 2016." 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 2016 with a past year SUD was 19.0 million, including 10.8 million with an SUD but no mental illness. The number of adults who had mental illness was 44.7 million, including 36.4 million with a mental illness but no SUD. There were 8.2 million adults who had both an SUD and mental illness.

Long description end. Return to Figure 68.

Long description, Figure 69. Figure 69 is titled "Past Year Substance Use Disorder (SUD) and Serious Mental Illness (SMI) among Adults Aged 18 or Older: Numbers in Millions, 2016." 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 2016 with a past year SUD was 19.0 million, including 16.4 million who had an SUD but no SMI. The number of adults who had SMI was 10.4 million, including 7.7 million who had SMI but no SUD. There were 2.6 million adults who had both an SUD and SMI.

Long description end. Return to Figure 69.

Long description, Figure 70. Figure 70 is titled "Past Year Substance Use Disorder among Adults Aged 18 or Older with Any Mental Illness in the Past Year, by Age Group: 2016." 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 18.5 percent (with a 95 percent confidence interval of 17.5 to 19.5 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 27.8 percent (with a 95 percent confidence interval of 26.0 to 29.7 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 21.3 percent (with a 95 percent confidence interval of 19.9 to 22.9 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 10.3 percent (with a 95 percent confidence interval of 8.6 to 12.3 percent).

Long description end. Return to Figure 70.

Long description, Figure 71. Figure 71 is titled "Past Year Substance Use Disorder among Adults Aged 18 or Older with Serious Mental Illness in the Past Year, by Age Group: 2016." 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 25.4 percent (with a 95 percent confidence interval of 23.1 to 27.8 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 34.9 percent (with a 95 percent confidence interval of 31.3 to 38.7 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 26.9 percent (with a 95 percent confidence interval of 23.9 to 30.1 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 16.3 percent (with a 95 percent confidence interval of 12.0 to 21.8 percent).

Long description end. Return to Figure 71.

Long description, Figure 72. Figure 72 is titled "Receipt of Mental Health Services and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older with Past Year Mental Illness and Substance Use Disorders: Percentages, 2016." It is a pie chart, with the following label written below the chart: "8.2 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 service 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 service and specialty substance use treatment.

Of the 8.2 million adults with co-occurring mental illness and substance use disorders, 51.9 percent received no treatment, 38.2 percent received mental health services only, 2.9 percent received specialty substance use treatment only, and 6.9 percent received mental health services and specialty substance use treatment.

Long description end. Return to Figure 72.

Long description, Figure 73. Figure 73 is titled "Receipt of Mental Health Services and Specialty Substance Use Treatment in the Past Year among Adults Aged 18 or Older with Past Year Serious Mental Illness and Substance Use Disorders: Percentages, 2016." It is a pie chart, with the following label written below the chart: "2.6 Million Adults with Co-Occurring Serious Mental Illness and Substance Use Disorders." Also, two notes are below the figure, the first of which says, "Mental health service 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 service and specialty substance use treatment.

Of the 2.6 million adults with co-occurring serious mental illness and substance use disorders, 34.4 percent received no treatment, 51.2 percent received mental health services only, 2.3 percent received specialty substance use treatment only, and 12.0 percent received mental health services and specialty substance use treatment.

Long description end. Return to Figure 73.

Long description, Figure 74. Figure 74 is titled "Suicidal Thoughts, Plans, and Attempts in the Past Year among Adults Aged 18 or Older: Numbers in Millions, 2016." It is a Venn diagram, where the outer circle represents the number of adults in millions who had serious thoughts of committing suicide and the overlapping inner circles represent the numbers in millions in the following categories of suicidal thoughts and behavior: (1) made suicide plans, (2) attempted suicide, (3) made plans and attempted suicide, and (4) made no plans and attempted suicide.

Of the 9.8 million adults aged 18 or older in 2016 who had serious thoughts of committing suicide in the past year, 2.8 million made suicide plans, 1.3 million attempted suicide, 1.0 million made plans and attempted suicide, and 0.3 million made no plans and attempted suicide.

Long description end. Return to Figure 74.

Long description, Figure 75. Figure 75 is titled "Suicidal Thoughts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage with suicidal thoughts 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 suicidal thoughts over the years 2008 through 2016. Tests of statistical significance at the .05 level were performed between 2016 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 75.

Long description, Figure 76. Figure 76 is titled "Suicide Plans in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage who made suicide plans 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 who made suicide plans over the years 2008 through 2016. Tests of statistical significance at the .05 level were performed between 2016 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 76.

Long description, Figure 77. Figure 77 is titled "Suicide Attempts in the Past Year among Adults Aged 18 or Older, by Age Group: Percentages, 2008-2016." It is a line graph, where the survey years are shown on the horizontal axis and the percentage who made suicide attempts 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 who made suicide attempts over the years 2008 through 2016. Tests of statistical significance at the .05 level were performed between 2016 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 77.

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