National Survey on Drug Use and Health: 2021 State-Specific Tables of Model-Based Estimates (Totals and Percentages), SAMHSA, CBHSQ

221027

UNITED STATES

Table 1A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the United States; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	39,995	1,844	8,472	29,680	38,152
Marijuana Use in the Past Year	52,454	2,724	11,833	37,897	49,730
Marijuana Use in the Past Month	36,363	1,499	8,073	26,791	34,864
Perceptions of Great Risk from Smoking Marijuana Once a Month	60,438	6,051	3,876	50,511	54,387
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	3,275	949	1,483	843	2,326
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	9,030	476	1,361	7,193	8,554
Cocaine Use in the Past Year	4,765	40	1,173	3,551	4,725
Perceptions of Great Risk from Using Cocaine Once a Month	185,264	13,199	19,676	152,389	172,065
Heroin Use in the Past Year⁵	--	--	66	1,033	1,099
Perceptions of Great Risk from Trying Heroin Once or Twice	229,686	15,279	26,188	188,219	214,407
Methamphetamine Use in the Past Year	2,549	37	166	2,346	2,512
Prescription Pain Reliever Misuse in the Past Year²	8,711	497	1,018	7,195	8,213
Opioid Misuse in the Past Year^2,6	9,236	497	1,035	7,703	8,738
ALCOHOL
Alcohol Use in the Past Month	133,057	1,820	16,774	114,464	131,238
Binge Alcohol Use in the Past Month⁷	60,039	995	9,754	49,290	59,045
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	123,452	11,229	12,935	99,288	112,224
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	5,916	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	3,242	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	54,696	683	5,614	48,399	54,013
Cigarette Use in the Past Month	43,614	392	3,839	39,383	43,222
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	193,687	16,863	21,634	155,190	176,824
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	11,265	46,539	57,804
Serious Mental Illness^4,10	--	--	3,822	10,264	14,086
Received Mental Health Services¹¹	--	--	6,436	36,344	42,780
Major Depressive Episode^4,12	--	5,229	6,226	14,813	21,039
Had Serious Thoughts of Suicide	--	--	4,356	7,947	12,303
Made Any Suicide Plans	--	--	1,641	1,884	3,525
Attempted Suicide	--	--	902	846	1,748
-- = not available. NOTE: Estimates in this table are aggregates of estimated numbers across all states. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

UNITED STATES

Table 1B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the United States; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	24,021	1,763	5,467	16,791	22,258
Pain Reliever Use Disorder^1,3	5,008	259	414	4,335	4,749
Opioid Use Disorder^1,3,4	5,559	259	438	4,862	5,300
Alcohol Use Disorder¹	29,543	894	5,012	23,637	28,649
Substance Use Disorder^1,2	46,251	2,224	8,550	35,476	44,027
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	18,963	1,442	5,029	12,492	17,521
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	28,595	872	4,936	22,788	27,724
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	40,748	1,915	8,078	30,755	38,833
NOTE: Estimates in this table are aggregates of estimated numbers across all states. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

UNITED STATES

Table 2A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the United States; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	14.29	7.09	25.32	13.47	15.03
Marijuana Use in the Past Year	18.74	10.47	35.37	17.20	19.59
Marijuana Use in the Past Month	12.99	5.76	24.13	12.16	13.74
Perceptions of Great Risk from Smoking Marijuana Once a Month	21.59	23.26	11.58	22.92	21.42
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.11	4.03	8.12	0.74	1.77
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.23	1.83	4.07	3.26	3.37
Cocaine Use in the Past Year	1.70	0.15	3.51	1.61	1.86
Perceptions of Great Risk from Using Cocaine Once a Month	66.20	50.73	58.81	69.15	67.78
Heroin Use in the Past Year⁵	--	--	0.20	0.47	0.43
Perceptions of Great Risk from Trying Heroin Once or Twice	82.10	58.72	78.27	85.41	84.47
Methamphetamine Use in the Past Year	0.91	0.14	0.50	1.06	0.99
Prescription Pain Reliever Misuse in the Past Year²	3.11	1.91	3.04	3.27	3.24
Opioid Misuse in the Past Year^2,6	3.30	1.91	3.09	3.50	3.44
ALCOHOL
Alcohol Use in the Past Month	47.55	6.99	50.13	51.94	51.70
Binge Alcohol Use in the Past Month⁷	21.45	3.82	29.15	22.37	23.26
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.11	43.15	38.66	45.06	44.21
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.14	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.29	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	19.55	2.63	16.78	21.96	21.28
Cigarette Use in the Past Month	15.59	1.51	11.47	17.87	17.03
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	69.21	64.81	64.66	70.42	69.66
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.67	21.12	22.77
Serious Mental Illness^4,10	--	--	11.42	4.66	5.55
Received Mental Health Services¹¹	--	--	19.23	16.49	16.85
Major Depressive Episode^4,12	--	20.10	18.61	6.72	8.29
Had Serious Thoughts of Suicide	--	--	13.02	3.61	4.85
Made Any Suicide Plans	--	--	4.90	0.86	1.39
Attempted Suicide	--	--	2.70	0.38	0.69
-- = not available. NOTE: Design-based estimates are given in this table. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

UNITED STATES

Table 2B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the United States; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.58	6.78	16.34	7.62	8.77
Pain Reliever Use Disorder^1,3	1.79	1.00	1.24	1.97	1.87
Opioid Use Disorder^1,3,4	1.99	1.00	1.31	2.21	2.09
Alcohol Use Disorder¹	10.56	3.44	14.98	10.73	11.29
Substance Use Disorder^1,2	16.53	8.55	25.55	16.10	17.35
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.78	5.54	15.03	5.67	6.90
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.22	3.35	14.75	10.34	10.92
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.56	7.36	24.14	13.96	15.30
NOTE: Design-based estimates are given in this table. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

NORTHEAST REGION

Table 3A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the Northeast Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	7,810	329	1,508	5,973	7,481
Marijuana Use in the Past Year	9,895	443	2,012	7,439	9,451
Marijuana Use in the Past Month	7,041	253	1,391	5,397	6,788
Perceptions of Great Risk from Smoking Marijuana Once a Month	9,815	936	612	8,266	8,879
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	602	158	273	172	445
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	1,800	72	272	1,456	1,728
Cocaine Use in the Past Year	995	2	232	761	993
Perceptions of Great Risk from Using Cocaine Once a Month	31,222	2,027	3,211	25,984	29,195
Heroin Use in the Past Year⁵	--	--	12	241	253
Perceptions of Great Risk from Trying Heroin Once or Twice	40,170	2,433	4,497	33,240	37,737
Methamphetamine Use in the Past Year	312	4	30	278	308
Prescription Pain Reliever Misuse in the Past Year²	1,577	88	165	1,324	1,490
Opioid Misuse in the Past Year^2,6	1,646	88	169	1,389	1,558
ALCOHOL
Alcohol Use in the Past Month	24,683	303	3,150	21,230	24,380
Binge Alcohol Use in the Past Month⁷	10,712	169	1,767	8,776	10,542
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	20,454	1,722	2,105	16,627	18,732
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	1,136	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	614	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	8,315	124	864	7,327	8,191
Cigarette Use in the Past Month	7,148	59	611	6,478	7,089
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	35,405	2,759	3,859	28,787	32,646
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	1,902	7,534	9,436
Serious Mental Illness^4,10	--	--	590	1,480	2,070
Received Mental Health Services¹¹	--	--	1,193	6,356	7,549
Major Depressive Episode^4,12	--	826	989	2,372	3,361
Had Serious Thoughts of Suicide	--	--	685	1,158	1,843
Made Any Suicide Plans	--	--	278	270	548
Attempted Suicide	--	--	129	92	221
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The Northeast region includes the following states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

NORTHEAST REGION

Table 3B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the Northeast Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	3,937	294	935	2,708	3,643
Pain Reliever Use Disorder^1,3	816	37	68	710	779
Opioid Use Disorder^1,3,4	870	37	71	763	833
Alcohol Use Disorder¹	5,288	138	856	4,294	5,150
Substance Use Disorder^1,2	8,090	386	1,439	6,264	7,703
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	3,130	248	858	2,024	2,882
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	5,131	141	849	4,142	4,990
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	7,486	313	1,397	5,776	7,173
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The Northeast region includes the following states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

NORTHEAST REGION

Table 4A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the Northeast Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	15.96	7.94	26.34	15.29	16.70
Marijuana Use in the Past Year	20.22	10.70	35.15	19.05	21.11
Marijuana Use in the Past Month	14.39	6.11	24.30	13.82	15.16
Perceptions of Great Risk from Smoking Marijuana Once a Month	20.05	22.58	10.70	21.16	19.82
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.18	4.02	8.57	0.84	1.88
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.68	1.74	4.75	3.73	3.86
Cocaine Use in the Past Year	2.03	0.04	4.05	1.95	2.22
Perceptions of Great Risk from Using Cocaine Once a Month	63.81	48.91	56.09	66.52	65.18
Heroin Use in the Past Year⁵	--	--	0.22	0.62	0.57
Perceptions of Great Risk from Trying Heroin Once or Twice	82.12	58.71	78.56	85.10	84.26
Methamphetamine Use in the Past Year	0.64	0.10	0.52	0.71	0.69
Prescription Pain Reliever Misuse in the Past Year²	3.22	2.12	2.89	3.39	3.33
Opioid Misuse in the Past Year^2,6	3.36	2.12	2.95	3.56	3.48
ALCOHOL
Alcohol Use in the Past Month	50.45	7.31	55.02	54.35	54.44
Binge Alcohol Use in the Past Month⁷	21.89	4.09	30.86	22.47	23.54
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	41.80	41.55	36.78	42.57	41.82
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	17.56	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	9.49	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	16.99	2.99	15.09	18.76	18.29
Cigarette Use in the Past Month	14.61	1.42	10.68	16.58	15.83
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	72.36	66.56	67.41	73.70	72.89
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.23	19.29	21.07
Serious Mental Illness^4,10	--	--	10.31	3.79	4.62
Received Mental Health Services¹¹	--	--	20.84	16.27	16.86
Major Depressive Episode^4,12	--	19.92	17.28	6.07	7.51
Had Serious Thoughts of Suicide	--	--	11.96	2.96	4.12
Made Any Suicide Plans	--	--	4.85	0.69	1.22
Attempted Suicide	--	--	2.26	0.23	0.49
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The Northeast region includes the following states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

NORTHEAST REGION

Table 4B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the Northeast Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.05	7.08	16.34	6.93	8.13
Pain Reliever Use Disorder^1,3	1.67	0.90	1.19	1.82	1.74
Opioid Use Disorder^1,3,4	1.78	0.90	1.24	1.95	1.86
Alcohol Use Disorder¹	10.81	3.34	14.96	10.99	11.50
Substance Use Disorder^1,2	16.53	9.32	25.14	16.04	17.20
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.40	5.97	14.99	5.18	6.44
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.49	3.39	14.82	10.60	11.14
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.30	7.55	24.41	14.79	16.02
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The Northeast region includes the following states: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MIDWEST REGION

Table 5A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the Midwest Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	8,662	420	1,852	6,390	8,242
Marijuana Use in the Past Year	11,481	614	2,627	8,239	10,866
Marijuana Use in the Past Month	8,003	379	1,831	5,793	7,624
Perceptions of Great Risk from Smoking Marijuana Once a Month	10,759	1,118	707	8,934	9,641
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	720	219	334	167	501
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	1,718	104	299	1,315	1,614
Cocaine Use in the Past Year	1,005	6	233	766	999
Perceptions of Great Risk from Using Cocaine Once a Month	38,015	2,700	4,116	31,199	35,316
Heroin Use in the Past Year⁵	--	--	14	188	202
Perceptions of Great Risk from Trying Heroin Once or Twice	47,254	3,178	5,494	38,582	44,076
Methamphetamine Use in the Past Year	502	11	33	458	492
Prescription Pain Reliever Misuse in the Past Year²	1,762	102	192	1,468	1,660
Opioid Misuse in the Past Year^2,6	1,833	103	207	1,523	1,730
ALCOHOL
Alcohol Use in the Past Month	29,303	441	3,875	24,987	28,861
Binge Alcohol Use in the Past Month⁷	13,487	232	2,328	10,926	13,255
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	23,491	2,198	2,424	18,870	21,293
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	1,356	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	726	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	13,127	177	1,362	11,588	12,950
Cigarette Use in the Past Month	10,329	98	955	9,275	10,230
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	38,036	3,435	4,476	30,124	34,601
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	2,489	9,792	12,281
Serious Mental Illness^4,10	--	--	822	2,145	2,967
Received Mental Health Services¹¹	--	--	1,549	8,218	9,767
Major Depressive Episode^4,12	--	1,165	1,314	3,170	4,484
Had Serious Thoughts of Suicide	--	--	958	1,756	2,714
Made Any Suicide Plans	--	--	359	353	712
Attempted Suicide	--	--	170	144	314
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The Midwest region includes the following states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MIDWEST REGION

Table 5B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the Midwest Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	5,284	414	1,209	3,661	4,870
Pain Reliever Use Disorder^1,3	1,037	54	77	906	983
Opioid Use Disorder^1,3,4	1,176	54	78	1,045	1,123
Alcohol Use Disorder¹	6,082	194	1,083	4,805	5,888
Substance Use Disorder^1,2	10,013	513	1,904	7,596	9,499
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	4,164	341	1,108	2,715	3,823
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	5,847	196	1,053	4,598	5,651
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	8,767	428	1,779	6,560	8,339
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The Midwest region includes the following states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MIDWEST REGION

Table 6A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the Midwest Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	14.93	7.66	26.07	14.06	15.69
Marijuana Use in the Past Year	19.78	11.20	36.99	18.13	20.68
Marijuana Use in the Past Month	13.79	6.90	25.78	12.75	14.51
Perceptions of Great Risk from Smoking Marijuana Once a Month	18.54	20.39	9.96	19.66	18.35
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.34	4.43	9.03	0.75	1.94
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.96	1.89	4.21	2.89	3.07
Cocaine Use in the Past Year	1.73	0.11	3.28	1.69	1.90
Perceptions of Great Risk from Using Cocaine Once a Month	65.52	49.24	57.95	68.66	67.21
Heroin Use in the Past Year⁵	--	--	0.19	0.41	0.38
Perceptions of Great Risk from Trying Heroin Once or Twice	81.47	57.97	77.35	84.91	83.89
Methamphetamine Use in the Past Year	0.87	0.19	0.47	1.01	0.94
Prescription Pain Reliever Misuse in the Past Year²	3.04	1.86	2.70	3.23	3.16
Opioid Misuse in the Past Year^2,6	3.16	1.87	2.91	3.35	3.29
ALCOHOL
Alcohol Use in the Past Month	50.50	8.05	54.55	54.99	54.93
Binge Alcohol Use in the Past Month⁷	23.24	4.24	32.78	24.05	25.23
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	40.48	40.09	34.12	41.53	40.52
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	16.65	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.92	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	22.63	3.22	19.18	25.50	24.65
Cigarette Use in the Past Month	17.80	1.79	13.45	20.41	19.47
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	65.55	62.65	63.02	66.30	65.86
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	35.04	21.55	23.37
Serious Mental Illness^4,10	--	--	11.57	4.72	5.65
Received Mental Health Services¹¹	--	--	21.80	18.09	18.59
Major Depressive Episode^4,12	--	21.25	18.51	6.98	8.53
Had Serious Thoughts of Suicide	--	--	13.48	3.87	5.16
Made Any Suicide Plans	--	--	5.05	0.78	1.35
Attempted Suicide	--	--	2.40	0.32	0.60
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The Midwest region includes the following states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MIDWEST REGION

Table 6B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the Midwest Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.11	7.55	17.02	8.06	9.27
Pain Reliever Use Disorder^1,3	1.79	0.99	1.09	1.99	1.87
Opioid Use Disorder^1,3,4	2.03	0.98	1.09	2.30	2.14
Alcohol Use Disorder¹	10.48	3.54	15.25	10.58	11.21
Substance Use Disorder^1,2	17.26	9.36	26.80	16.72	18.08
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.18	6.22	15.60	5.98	7.28
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.08	3.58	14.82	10.12	10.75
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.11	7.81	25.04	14.44	15.87
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The Midwest region includes the following states: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

SOUTH REGION

Table 7A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the South Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	12,320	585	2,712	9,022	11,734
Marijuana Use in the Past Year	16,596	916	4,025	11,656	15,681
Marijuana Use in the Past Month	11,077	476	2,615	7,986	10,601
Perceptions of Great Risk from Smoking Marijuana Once a Month	25,478	2,700	1,538	21,241	22,778
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1,121	339	534	247	781
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3,058	193	426	2,439	2,865
Cocaine Use in the Past Year	1,564	16	366	1,183	1,549
Perceptions of Great Risk from Using Cocaine Once a Month	74,260	5,299	7,872	61,089	68,961
Heroin Use in the Past Year⁵	--	--	29	416	445
Perceptions of Great Risk from Trying Heroin Once or Twice	88,998	6,051	10,038	72,909	82,947
Methamphetamine Use in the Past Year	992	14	51	927	978
Prescription Pain Reliever Misuse in the Past Year²	3,331	192	396	2,744	3,139
Opioid Misuse in the Past Year^2,6	3,614	191	393	3,030	3,423
ALCOHOL
Alcohol Use in the Past Month	48,361	654	5,976	41,732	47,708
Binge Alcohol Use in the Past Month⁷	22,029	343	3,387	18,300	21,686
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	48,570	4,563	5,111	38,897	44,008
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	2,029	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	1,099	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	22,724	246	2,166	20,312	22,478
Cigarette Use in the Past Month	17,498	123	1,413	15,962	17,375
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	72,881	6,561	8,100	58,220	66,320
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	4,131	17,570	21,700
Serious Mental Illness^4,10	--	--	1,454	3,922	5,376
Received Mental Health Services¹¹	--	--	2,289	13,228	15,517
Major Depressive Episode^4,12	--	1,923	2,294	5,595	7,889
Had Serious Thoughts of Suicide	--	--	1,626	2,942	4,568
Made Any Suicide Plans	--	--	620	769	1,389
Attempted Suicide	--	--	371	414	784
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The South region includes the following states: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

SOUTH REGION

Table 7B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the South Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8,746	584	1,876	6,286	8,162
Pain Reliever Use Disorder^1,3	2,071	99	159	1,813	1,972
Opioid Use Disorder^1,3,4	2,361	99	177	2,084	2,262
Alcohol Use Disorder¹	10,806	329	1,845	8,632	10,477
Substance Use Disorder^1,2	16,814	761	3,144	12,908	16,053
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6,589	489	1,708	4,392	6,100
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10,702	322	1,810	8,570	10,380
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14,374	679	2,932	10,762	13,694
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The South region includes the following states: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

SOUTH REGION

Table 8A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the South Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11.56	5.77	21.36	10.77	12.17
Marijuana Use in the Past Year	15.57	9.02	31.70	13.92	16.26
Marijuana Use in the Past Month	10.39	4.69	20.60	9.54	10.99
Perceptions of Great Risk from Smoking Marijuana Once a Month	23.90	26.60	12.11	25.37	23.61
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.75	3.57	7.18	0.53	1.43
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.87	1.90	3.36	2.91	2.97
Cocaine Use in the Past Year	1.47	0.15	2.88	1.41	1.61
Perceptions of Great Risk from Using Cocaine Once a Month	69.67	52.20	62.00	72.95	71.50
Heroin Use in the Past Year⁵	--	--	0.23	0.50	0.46
Perceptions of Great Risk from Trying Heroin Once or Twice	83.53	59.61	79.06	87.07	86.01
Methamphetamine Use in the Past Year	0.93	0.14	0.40	1.11	1.01
Prescription Pain Reliever Misuse in the Past Year²	3.13	1.89	3.12	3.28	3.26
Opioid Misuse in the Past Year^2,6	3.39	1.88	3.09	3.62	3.55
ALCOHOL
Alcohol Use in the Past Month	45.37	6.44	47.07	49.84	49.47
Binge Alcohol Use in the Past Month⁷	20.67	3.38	26.67	21.85	22.49
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	45.57	44.94	40.25	46.45	45.63
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.44	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	7.28	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	21.32	2.42	17.06	24.26	23.31
Cigarette Use in the Past Month	16.42	1.21	11.13	19.06	18.02
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	68.38	64.63	63.80	69.53	68.77
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	32.54	20.98	22.50
Serious Mental Illness^4,10	--	--	11.45	4.68	5.57
Received Mental Health Services¹¹	--	--	18.03	15.80	16.09
Major Depressive Episode^4,12	--	18.94	18.07	6.68	8.18
Had Serious Thoughts of Suicide	--	--	12.80	3.51	4.74
Made Any Suicide Plans	--	--	4.88	0.92	1.44
Attempted Suicide	--	--	2.92	0.49	0.81
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The South region includes the following states: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

SOUTH REGION

Table 8B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the South Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.21	5.75	14.78	7.51	8.46
Pain Reliever Use Disorder^1,3	1.94	0.98	1.25	2.16	2.04
Opioid Use Disorder^1,3,4	2.22	0.98	1.40	2.49	2.35
Alcohol Use Disorder¹	10.14	3.24	14.53	10.31	10.86
Substance Use Disorder^1,2	15.77	7.50	24.77	15.41	16.65
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.18	4.82	13.45	5.25	6.33
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.04	3.17	14.26	10.23	10.76
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	13.49	6.69	23.10	12.85	14.20
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The South region includes the following states: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

WEST REGION

Table 9A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the West Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11,204	509	2,400	8,295	10,695
Marijuana Use in the Past Year	14,483	751	3,169	10,563	13,732
Marijuana Use in the Past Month	10,242	391	2,236	7,615	9,851
Perceptions of Great Risk from Smoking Marijuana Once a Month	14,385	1,297	1,018	12,070	13,088
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	832	234	343	256	599
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2,455	107	364	1,983	2,347
Cocaine Use in the Past Year	1,200	16	342	842	1,184
Perceptions of Great Risk from Using Cocaine Once a Month	41,767	3,173	4,478	34,116	38,594
Heroin Use in the Past Year⁵	--	--	11	188	199
Perceptions of Great Risk from Trying Heroin Once or Twice	53,263	3,616	6,159	43,488	49,647
Methamphetamine Use in the Past Year	742	8	52	683	734
Prescription Pain Reliever Misuse in the Past Year²	2,040	116	265	1,659	1,924
Opioid Misuse in the Past Year^2,6	2,143	116	267	1,761	2,027
ALCOHOL
Alcohol Use in the Past Month	30,710	422	3,774	26,515	30,288
Binge Alcohol Use in the Past Month⁷	13,811	250	2,273	11,289	13,561
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	30,936	2,746	3,296	24,895	28,191
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	1,395	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	802	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	10,531	137	1,221	9,173	10,395
Cigarette Use in the Past Month	8,641	112	860	7,668	8,528
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	47,365	4,108	5,199	38,058	43,257
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	2,744	11,643	14,387
Serious Mental Illness^4,10	--	--	957	2,717	3,674
Received Mental Health Services¹¹	--	--	1,405	8,543	9,947
Major Depressive Episode^4,12	--	1,316	1,628	3,677	5,305
Had Serious Thoughts of Suicide	--	--	1,088	2,091	3,178
Made Any Suicide Plans	--	--	385	492	877
Attempted Suicide	--	--	232	196	428
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The West region includes the following states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

WEST REGION

Table 9B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the West Region; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	6,054	472	1,447	4,136	5,583
Pain Reliever Use Disorder^1,3	1,084	68	109	906	1,016
Opioid Use Disorder^1,3,4	1,151	69	112	970	1,083
Alcohol Use Disorder¹	7,367	233	1,228	5,906	7,134
Substance Use Disorder^1,2	11,335	564	2,063	8,708	10,771
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	5,081	364	1,356	3,361	4,716
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	6,916	213	1,224	5,478	6,703
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	10,122	495	1,970	7,657	9,627
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. NOTE: The West region includes the following states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

WEST REGION

Table 10A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the West Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	16.90	8.16	30.25	15.91	17.81
Marijuana Use in the Past Year	21.84	12.03	39.93	20.26	22.86
Marijuana Use in the Past Month	15.45	6.27	28.18	14.61	16.40
Perceptions of Great Risk from Smoking Marijuana Once a Month	21.69	20.79	12.83	23.15	21.78
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.51	4.45	8.61	1.06	2.15
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.70	1.72	4.59	3.80	3.91
Cocaine Use in the Past Year	1.81	0.26	4.31	1.62	1.97
Perceptions of Great Risk from Using Cocaine Once a Month	63.00	50.84	56.43	65.45	64.25
Heroin Use in the Past Year⁵	--	--	0.14	0.36	0.33
Perceptions of Great Risk from Trying Heroin Once or Twice	80.36	57.95	77.61	83.43	82.65
Methamphetamine Use in the Past Year	1.12	0.13	0.65	1.31	1.22
Prescription Pain Reliever Misuse in the Past Year²	3.08	1.86	3.34	3.18	3.20
Opioid Misuse in the Past Year^2,6	3.23	1.86	3.36	3.38	3.38
ALCOHOL
Alcohol Use in the Past Month	46.32	6.76	47.56	50.86	50.43
Binge Alcohol Use in the Past Month⁷	20.83	4.01	28.64	21.66	22.58
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	46.65	44.00	41.53	47.76	46.93
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	14.88	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.55	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	15.88	2.19	15.39	17.60	17.31
Cigarette Use in the Past Month	13.03	1.80	10.84	14.71	14.20
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	71.43	65.82	65.52	73.01	72.02
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	34.58	22.34	23.95
Serious Mental Illness^4,10	--	--	12.06	5.21	6.12
Received Mental Health Services¹¹	--	--	17.70	16.39	16.56
Major Depressive Episode^4,12	--	21.09	20.51	7.05	8.83
Had Serious Thoughts of Suicide	--	--	13.71	4.01	5.29
Made Any Suicide Plans	--	--	4.85	0.94	1.46
Attempted Suicide	--	--	2.92	0.38	0.71
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The West region includes the following states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

WEST REGION

Table 10B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the West Region; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.13	7.56	18.23	7.93	9.30
Pain Reliever Use Disorder^1,3	1.63	1.09	1.38	1.74	1.69
Opioid Use Disorder^1,3,4	1.74	1.10	1.42	1.86	1.80
Alcohol Use Disorder¹	11.11	3.73	15.47	11.33	11.88
Substance Use Disorder^1,2	17.10	9.04	26.00	16.70	17.93
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.66	5.84	17.08	6.45	7.85
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.43	3.41	15.43	10.51	11.16
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.27	7.93	24.83	14.69	16.03
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. NOTE: The West region includes the following states: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALABAMA

Table 11A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Alabama; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	403	17	98	288	386
Marijuana Use in the Past Year	537	30	152	355	507
Marijuana Use in the Past Month	315	16	90	209	299
Perceptions of Great Risk from Smoking Marijuana Once a Month	1,128	105	83	940	1,023
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	40	15	20	6	25
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	132	7	20	105	125
Cocaine Use in the Past Year	67	1	14	52	66
Perceptions of Great Risk from Using Cocaine Once a Month	3,066	210	334	2,522	2,856
Heroin Use in the Past Year⁵	--	--	2	12	14
Perceptions of Great Risk from Trying Heroin Once or Twice	3,567	236	402	2,929	3,331
Methamphetamine Use in the Past Year	65	1	2	62	64
Prescription Pain Reliever Misuse in the Past Year²	159	7	16	135	151
Opioid Misuse in the Past Year^2,6	175	7	17	150	167
ALCOHOL
Alcohol Use in the Past Month	1,636	24	202	1,411	1,613
Binge Alcohol Use in the Past Month⁷	798	14	119	666	785
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	1,862	170	208	1,484	1,692
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	71	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	39	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,062	11	96	955	1,051
Cigarette Use in the Past Month	698	5	58	635	693
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	2,769	253	316	2,200	2,516
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	150	717	867
Serious Mental Illness^4,10	--	--	61	182	243
Received Mental Health Services¹¹	--	--	96	549	645
Major Depressive Episode^4,12	--	75	81	253	334
Had Serious Thoughts of Suicide	--	--	71	123	194
Made Any Suicide Plans	--	--	22	21	43
Attempted Suicide	--	--	16	18	33
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALABAMA

Table 11B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Alabama; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	367	22	72	273	345
Pain Reliever Use Disorder^1,3	109	4	7	97	104
Opioid Use Disorder^1,3,4	136	5	9	122	131
Alcohol Use Disorder¹	390	11	69	309	379
Substance Use Disorder^1,2	660	30	128	502	629
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	269	18	62	188	250
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	407	14	66	328	394
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	517	25	113	379	492
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALABAMA

Table 12A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Alabama; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	9.51	4.38	19.26	8.63	10.04
Marijuana Use in the Past Year	12.66	7.57	29.85	10.64	13.18
Marijuana Use in the Past Month	7.42	3.96	17.66	6.27	7.77
Perceptions of Great Risk from Smoking Marijuana Once a Month	26.59	26.54	16.43	28.15	26.59
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.47	4.00	5.95	0.28	1.06
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.12	1.84	3.90	3.15	3.25
Cocaine Use in the Past Year	1.57	0.13	2.83	1.55	1.72
Perceptions of Great Risk from Using Cocaine Once a Month	72.28	53.23	65.68	75.53	74.22
Heroin Use in the Past Year⁵	--	--	0.30	0.37	0.36
Perceptions of Great Risk from Trying Heroin Once or Twice	84.09	59.59	79.21	87.70	86.57
Methamphetamine Use in the Past Year	1.53	0.13	0.46	1.86	1.67
Prescription Pain Reliever Misuse in the Past Year²	3.74	1.87	3.15	4.05	3.93
Opioid Misuse in the Past Year^2,6	4.12	1.83	3.35	4.51	4.35
ALCOHOL
Alcohol Use in the Past Month	38.57	5.96	39.69	42.26	41.92
Binge Alcohol Use in the Past Month⁷	18.82	3.44	23.37	19.95	20.40
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	43.89	42.98	41.00	44.44	43.99
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	11.98	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6.62	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	25.04	2.82	18.96	28.59	27.32
Cigarette Use in the Past Month	16.44	1.14	11.46	19.01	18.01
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	65.25	63.97	62.22	65.87	65.39
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	29.55	21.46	22.53
Serious Mental Illness^4,10	--	--	12.09	5.44	6.32
Received Mental Health Services¹¹	--	--	18.82	16.44	16.76
Major Depressive Episode^4,12	--	18.86	15.91	7.57	8.67
Had Serious Thoughts of Suicide	--	--	13.91	3.69	5.04
Made Any Suicide Plans	--	--	4.25	0.63	1.11
Attempted Suicide	--	--	3.06	0.53	0.87
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALABAMA

Table 12B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Alabama; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.65	5.55	14.25	8.17	8.97
Pain Reliever Use Disorder^1,3	2.56	1.11	1.44	2.90	2.71
Opioid Use Disorder^1,3,4	3.20	1.14	1.87	3.65	3.42
Alcohol Use Disorder¹	9.18	2.80	13.67	9.26	9.84
Substance Use Disorder^1,2	15.55	7.68	25.12	15.03	16.36
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.33	4.63	12.30	5.63	6.51
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.60	3.44	13.03	9.81	10.24
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	12.19	6.40	22.23	11.35	12.79
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALASKA

Table 13A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Alaska; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	127	6	22	99	121
Marijuana Use in the Past Year	158	11	28	119	147
Marijuana Use in the Past Month	122	4	23	96	119
Perceptions of Great Risk from Smoking Marijuana Once a Month	102	9	7	86	93
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	9	3	3	3	6
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	18	1	3	15	17
Cocaine Use in the Past Year	12	1	2	9	11
Perceptions of Great Risk from Using Cocaine Once a Month	360	29	37	294	331
Heroin Use in the Past Year⁵	--	--	*	3	3
Perceptions of Great Risk from Trying Heroin Once or Twice	469	34	50	385	434
Methamphetamine Use in the Past Year	5	0	1	4	5
Prescription Pain Reliever Misuse in the Past Year²	19	1	2	15	17
Opioid Misuse in the Past Year^2,6	20	1	2	16	19
ALCOHOL
Alcohol Use in the Past Month	293	4	33	256	289
Binge Alcohol Use in the Past Month⁷	125	2	17	105	123
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	259	24	26	209	236
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	12	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	139	2	12	126	138
Cigarette Use in the Past Month	114	1	9	104	113
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	391	39	40	312	352
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	26	112	138
Serious Mental Illness^4,10	--	--	10	24	34
Received Mental Health Services¹¹	--	--	16	84	100
Major Depressive Episode^4,12	--	14	16	42	58
Had Serious Thoughts of Suicide	--	--	10	22	32
Made Any Suicide Plans	--	--	3	4	7
Attempted Suicide	--	--	2	2	4
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALASKA

Table 13B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Alaska; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	76	6	15	55	70
Pain Reliever Use Disorder^1,3	11	1	1	10	11
Opioid Use Disorder^1,3,4	12	1	1	11	12
Alcohol Use Disorder¹	73	3	10	59	69
Substance Use Disorder^1,2	122	6	20	97	116
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	58	5	15	38	53
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	71	3	10	58	68
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	108	6	17	85	102
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALASKA

Table 14A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Alaska; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	21.61	9.99	32.84	21.49	22.91
Marijuana Use in the Past Year	27.01	18.29	43.10	25.81	27.98
Marijuana Use in the Past Month	20.91	6.47	34.58	20.80	22.52
Perceptions of Great Risk from Smoking Marijuana Once a Month	17.35	14.96	9.98	18.72	17.62
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	3.97	7.25	12.28	1.64	3.22
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.12	1.69	3.88	3.19	3.28
Cocaine Use in the Past Year	1.99	0.99	2.93	1.99	2.11
Perceptions of Great Risk from Using Cocaine Once a Month	61.36	48.41	55.51	63.85	62.80
Heroin Use in the Past Year⁵	--	--	*	0.55	0.50
Perceptions of Great Risk from Trying Heroin Once or Twice	79.99	58.23	75.17	83.44	82.40
Methamphetamine Use in the Past Year	0.89	0.13	0.97	0.97	0.97
Prescription Pain Reliever Misuse in the Past Year²	3.16	2.20	3.35	3.25	3.27
Opioid Misuse in the Past Year^2,6	3.39	2.24	3.59	3.51	3.52
ALCOHOL
Alcohol Use in the Past Month	49.95	6.65	49.71	55.53	54.81
Binge Alcohol Use in the Past Month⁷	21.32	3.63	26.29	22.87	23.30
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.29	40.17	40.03	45.43	44.75
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.86	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.62	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	23.78	2.69	18.39	27.25	26.14
Cigarette Use in the Past Month	19.51	1.72	14.05	22.56	21.50
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	66.76	66.00	60.94	67.70	66.85
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	39.23	24.32	26.19
Serious Mental Illness^4,10	--	--	14.56	5.21	6.38
Received Mental Health Services¹¹	--	--	24.53	18.16	18.96
Major Depressive Episode^4,12	--	23.69	25.01	9.01	11.02
Had Serious Thoughts of Suicide	--	--	14.59	4.86	6.08
Made Any Suicide Plans	--	--	4.80	0.92	1.41
Attempted Suicide	--	--	2.98	0.47	0.79
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ALASKA

Table 14B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Alaska; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	12.96	10.45	22.62	11.90	13.25
Pain Reliever Use Disorder^1,3	1.89	0.92	1.24	2.10	1.99
Opioid Use Disorder^1,3,4	2.10	0.93	0.94	2.42	2.23
Alcohol Use Disorder¹	12.41	5.76	15.50	12.81	13.15
Substance Use Disorder^1,2	20.86	10.43	29.66	20.94	22.03
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	9.96	9.08	22.34	8.29	10.05
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	12.07	4.60	14.76	12.63	12.90
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	18.40	10.46	25.07	18.46	19.29
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARIZONA

Table 15A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Arizona; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	1,133	63	306	764	1,070
Marijuana Use in the Past Year	1,348	71	374	904	1,278
Marijuana Use in the Past Month	1,108	44	304	761	1,064
Perceptions of Great Risk from Smoking Marijuana Once a Month	1,247	121	71	1,055	1,126
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	77	22	34	21	55
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	181	11	38	132	170
Cocaine Use in the Past Year	83	1	27	55	82
Perceptions of Great Risk from Using Cocaine Once a Month	4,112	282	457	3,374	3,830
Heroin Use in the Past Year⁵	--	--	1	11	12
Perceptions of Great Risk from Trying Heroin Once or Twice	5,055	335	587	4,133	4,720
Methamphetamine Use in the Past Year	55	1	6	48	54
Prescription Pain Reliever Misuse in the Past Year²	176	13	27	136	163
Opioid Misuse in the Past Year^2,6	189	13	27	148	176
ALCOHOL
Alcohol Use in the Past Month	2,797	41	398	2,357	2,756
Binge Alcohol Use in the Past Month⁷	1,265	19	230	1,016	1,246
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	2,958	246	327	2,385	2,712
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	141	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	70	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,230	11	138	1,081	1,219
Cigarette Use in the Past Month	930	9	92	830	921
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	4,429	386	472	3,572	4,044
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	244	970	1,214
Serious Mental Illness^4,10	--	--	85	229	314
Received Mental Health Services¹¹	--	--	130	710	840
Major Depressive Episode^4,12	--	127	143	315	458
Had Serious Thoughts of Suicide	--	--	88	163	251
Made Any Suicide Plans	--	--	40	49	88
Attempted Suicide	--	--	27	19	46
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARIZONA

Table 15B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Arizona; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	564	59	158	346	504
Pain Reliever Use Disorder^1,3	110	8	10	92	102
Opioid Use Disorder^1,3,4	123	8	11	103	115
Alcohol Use Disorder¹	646	21	106	519	625
Substance Use Disorder^1,2	1,032	62	208	761	969
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	479	44	151	284	435
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	626	19	106	501	607
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	926	63	195	668	863
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARIZONA

Table 16A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Arizona; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	18.40	10.76	40.28	15.87	19.20
Marijuana Use in the Past Year	21.91	12.21	49.20	18.77	22.92
Marijuana Use in the Past Month	18.00	7.49	39.98	15.80	19.09
Perceptions of Great Risk from Smoking Marijuana Once a Month	20.25	20.83	9.34	21.91	20.19
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.88	5.08	11.58	1.04	2.43
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.94	1.84	5.02	2.74	3.05
Cocaine Use in the Past Year	1.35	0.25	3.54	1.14	1.47
Perceptions of Great Risk from Using Cocaine Once a Month	66.81	48.49	60.11	70.08	68.71
Heroin Use in the Past Year⁵	--	--	0.13	0.24	0.22
Perceptions of Great Risk from Trying Heroin Once or Twice	82.15	57.56	77.28	85.85	84.68
Methamphetamine Use in the Past Year	0.89	0.13	0.74	1.00	0.97
Prescription Pain Reliever Misuse in the Past Year²	2.87	2.24	3.59	2.83	2.93
Opioid Misuse in the Past Year^2,6	3.06	2.24	3.59	3.08	3.15
ALCOHOL
Alcohol Use in the Past Month	45.43	7.04	52.43	48.97	49.44
Binge Alcohol Use in the Past Month⁷	20.56	3.30	30.33	21.10	22.36
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	48.05	42.40	42.99	49.54	48.64
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.89	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	7.90	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	19.98	1.91	18.18	22.45	21.87
Cigarette Use in the Past Month	15.11	1.47	12.05	17.24	16.53
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	71.96	66.37	62.06	74.20	72.54
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	32.14	20.15	21.78
Serious Mental Illness^4,10	--	--	11.17	4.75	5.63
Received Mental Health Services¹¹	--	--	17.17	14.74	15.07
Major Depressive Episode^4,12	--	21.86	18.80	6.54	8.21
Had Serious Thoughts of Suicide	--	--	11.56	3.40	4.51
Made Any Suicide Plans	--	--	5.25	1.01	1.59
Attempted Suicide	--	--	3.59	0.39	0.83
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARIZONA

Table 16B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Arizona; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.16	10.18	20.82	7.19	9.05
Pain Reliever Use Disorder^1,3	1.79	1.42	1.36	1.91	1.83
Opioid Use Disorder^1,3,4	2.00	1.43	1.48	2.15	2.06
Alcohol Use Disorder¹	10.49	3.56	13.97	10.79	11.22
Substance Use Disorder^1,2	16.76	10.74	27.38	15.81	17.39
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.79	7.61	19.90	5.90	7.81
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.17	3.26	13.94	10.41	10.89
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.04	10.76	25.68	13.88	15.48
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARKANSAS

Table 17A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Arkansas; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	281	13	62	206	268
Marijuana Use in the Past Year	393	23	97	274	370
Marijuana Use in the Past Month	233	12	60	162	221
Perceptions of Great Risk from Smoking Marijuana Once a Month	649	69	34	547	581
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	24	8	12	4	17
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	80	5	12	63	75
Cocaine Use in the Past Year	34	1	8	25	33
Perceptions of Great Risk from Using Cocaine Once a Month	1,816	130	192	1,494	1,686
Heroin Use in the Past Year⁵	--	--	1	10	10
Perceptions of Great Risk from Trying Heroin Once or Twice	2,112	147	239	1,727	1,966
Methamphetamine Use in the Past Year	35	0	1	33	35
Prescription Pain Reliever Misuse in the Past Year²	99	4	12	83	95
Opioid Misuse in the Past Year^2,6	109	4	11	93	105
ALCOHOL
Alcohol Use in the Past Month	982	16	141	825	966
Binge Alcohol Use in the Past Month⁷	515	8	87	421	507
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	1,114	105	116	893	1,009
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	46	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	27	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	654	8	65	582	647
Cigarette Use in the Past Month	509	4	37	467	505
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	1,591	160	188	1,243	1,431
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	100	424	524
Serious Mental Illness^4,10	--	--	39	110	148
Received Mental Health Services¹¹	--	--	57	335	392
Major Depressive Episode^4,12	--	45	53	141	194
Had Serious Thoughts of Suicide	--	--	45	69	113
Made Any Suicide Plans	--	--	17	17	34
Attempted Suicide	--	--	9	12	21
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARKANSAS

Table 17B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Arkansas; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	219	14	43	162	205
Pain Reliever Use Disorder^1,3	52	3	3	47	50
Opioid Use Disorder^1,3,4	61	3	4	54	59
Alcohol Use Disorder¹	238	8	43	187	230
Substance Use Disorder^1,2	385	17	78	290	368
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	169	14	39	116	155
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	236	9	42	185	228
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	307	16	69	222	291
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARKANSAS

Table 18A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Arkansas; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11.14	5.27	20.08	10.47	11.78
Marijuana Use in the Past Year	15.56	9.15	31.24	13.90	16.26
Marijuana Use in the Past Month	9.23	4.68	19.30	8.21	9.72
Perceptions of Great Risk from Smoking Marijuana Once a Month	25.71	27.62	10.97	27.79	25.50
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.47	3.05	6.54	0.37	1.20
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.17	1.96	3.95	3.20	3.30
Cocaine Use in the Past Year	1.36	0.38	2.57	1.29	1.46
Perceptions of Great Risk from Using Cocaine Once a Month	71.91	52.27	62.09	75.92	74.04
Heroin Use in the Past Year⁵	--	--	0.19	0.50	0.46
Perceptions of Great Risk from Trying Heroin Once or Twice	83.66	59.07	77.17	87.74	86.30
Methamphetamine Use in the Past Year	1.39	0.17	0.47	1.69	1.53
Prescription Pain Reliever Misuse in the Past Year²	3.92	1.63	3.77	4.23	4.17
Opioid Misuse in the Past Year^2,6	4.30	1.58	3.70	4.74	4.60
ALCOHOL
Alcohol Use in the Past Month	38.88	6.48	45.45	41.94	42.42
Binge Alcohol Use in the Past Month⁷	20.40	3.27	27.97	21.37	22.27
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.11	42.41	37.60	45.36	44.30
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	12.32	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	7.22	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	25.91	3.05	21.00	29.56	28.40
Cigarette Use in the Past Month	20.15	1.72	12.03	23.75	22.16
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	62.98	64.54	60.61	63.16	62.82
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	32.29	21.56	23.02
Serious Mental Illness^4,10	--	--	12.44	5.57	6.50
Received Mental Health Services¹¹	--	--	18.27	17.04	17.21
Major Depressive Episode^4,12	--	17.94	17.21	7.17	8.53
Had Serious Thoughts of Suicide	--	--	14.40	3.50	4.98
Made Any Suicide Plans	--	--	5.64	0.87	1.51
Attempted Suicide	--	--	2.96	0.61	0.93
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ARKANSAS

Table 18B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Arkansas; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.68	5.69	13.83	8.24	9.00
Pain Reliever Use Disorder^1,3	2.08	1.02	1.10	2.37	2.19
Opioid Use Disorder^1,3,4	2.42	1.01	1.38	2.77	2.58
Alcohol Use Disorder¹	9.43	3.25	13.93	9.50	10.10
Substance Use Disorder^1,2	15.23	6.88	25.15	14.73	16.14
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.68	5.55	12.63	5.89	6.80
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.36	3.52	13.67	9.42	10.00
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	12.15	6.39	22.41	11.27	12.78
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CALIFORNIA

Table 19A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in California; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	5,207	215	1,123	3,869	4,993
Marijuana Use in the Past Year	6,886	316	1,541	5,028	6,569
Marijuana Use in the Past Month	4,704	161	1,030	3,513	4,543
Perceptions of Great Risk from Smoking Marijuana Once a Month	7,974	699	588	6,687	7,275
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	401	102	167	132	299
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	1,363	49	169	1,145	1,314
Cocaine Use in the Past Year	662	3	180	480	659
Perceptions of Great Risk from Using Cocaine Once a Month	20,806	1,635	2,266	16,905	19,170
Heroin Use in the Past Year⁵	--	--	5	99	103
Perceptions of Great Risk from Trying Heroin Once or Twice	26,701	1,843	3,128	21,729	24,858
Methamphetamine Use in the Past Year	421	3	23	394	418
Prescription Pain Reliever Misuse in the Past Year²	1,054	54	135	865	1,000
Opioid Misuse in the Past Year^2,6	1,116	54	129	933	1,062
ALCOHOL
Alcohol Use in the Past Month	15,040	196	1,769	13,075	14,844
Binge Alcohol Use in the Past Month⁷	6,804	126	1,107	5,570	6,677
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	15,851	1,471	1,768	12,611	14,380
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	652	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	386	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	4,306	58	460	3,788	4,247
Cigarette Use in the Past Month	3,671	46	364	3,261	3,625
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	24,007	2,102	2,716	19,188	21,905
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	1,330	5,516	6,846
Serious Mental Illness^4,10	--	--	479	1,351	1,830
Received Mental Health Services¹¹	--	--	570	3,776	4,346
Major Depressive Episode^4,12	--	613	816	1,685	2,501
Had Serious Thoughts of Suicide	--	--	558	977	1,535
Made Any Suicide Plans	--	--	206	233	439
Attempted Suicide	--	--	120	91	212
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CALIFORNIA

Table 19B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in California; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	2,729	194	666	1,868	2,535
Pain Reliever Use Disorder^1,3	504	36	59	410	469
Opioid Use Disorder^1,3,4	521	36	60	426	485
Alcohol Use Disorder¹	3,650	103	608	2,940	3,547
Substance Use Disorder^1,2	5,362	235	954	4,172	5,127
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	2,327	144	616	1,567	2,183
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	3,371	94	609	2,669	3,277
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	4,817	200	942	3,675	4,617
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CALIFORNIA

Table 20A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in California; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	15.73	6.90	28.24	14.87	16.65
Marijuana Use in the Past Year	20.80	10.16	38.76	19.33	21.90
Marijuana Use in the Past Month	14.21	5.18	25.91	13.50	15.15
Perceptions of Great Risk from Smoking Marijuana Once a Month	24.08	22.47	14.77	25.71	24.25
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.27	3.65	7.99	1.02	2.02
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	4.12	1.58	4.25	4.40	4.38
Cocaine Use in the Past Year	2.00	0.09	4.52	1.84	2.20
Perceptions of Great Risk from Using Cocaine Once a Month	62.86	52.58	56.98	64.98	63.91
Heroin Use in the Past Year⁵	--	--	0.12	0.38	0.34
Perceptions of Great Risk from Trying Heroin Once or Twice	80.69	59.25	78.66	83.53	82.88
Methamphetamine Use in the Past Year	1.27	0.11	0.58	1.52	1.39
Prescription Pain Reliever Misuse in the Past Year²	3.18	1.73	3.40	3.32	3.33
Opioid Misuse in the Past Year^2,6	3.37	1.72	3.25	3.59	3.54
ALCOHOL
Alcohol Use in the Past Month	45.44	6.32	44.48	50.26	49.50
Binge Alcohol Use in the Past Month⁷	20.55	4.06	27.84	21.41	22.26
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	47.88	47.30	44.46	48.48	47.94
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.82	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.18	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	13.01	1.87	11.56	14.56	14.16
Cigarette Use in the Past Month	11.09	1.47	9.15	12.54	12.09
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	72.53	67.59	68.31	73.76	73.04
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.44	21.21	22.83
Serious Mental Illness^4,10	--	--	12.05	5.19	6.10
Received Mental Health Services¹¹	--	--	14.33	14.52	14.49
Major Depressive Episode^4,12	--	19.72	20.52	6.48	8.34
Had Serious Thoughts of Suicide	--	--	14.04	3.76	5.12
Made Any Suicide Plans	--	--	5.18	0.89	1.46
Attempted Suicide	--	--	3.03	0.35	0.71
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CALIFORNIA

Table 20B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in California; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.24	6.25	16.75	7.18	8.45
Pain Reliever Use Disorder^1,3	1.52	1.15	1.48	1.58	1.56
Opioid Use Disorder^1,3,4	1.58	1.17	1.50	1.64	1.62
Alcohol Use Disorder¹	11.03	3.31	15.28	11.30	11.83
Substance Use Disorder^1,2	16.20	7.56	24.00	16.04	17.09
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.03	4.61	15.49	6.03	7.28
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.18	3.01	15.31	10.26	10.93
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.55	6.45	23.69	14.13	15.39
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

COLORADO

Table 21A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Colorado; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	995	48	191	756	948
Marijuana Use in the Past Year	1,217	78	243	895	1,138
Marijuana Use in the Past Month	916	31	179	706	885
Perceptions of Great Risk from Smoking Marijuana Once a Month	894	72	68	754	822
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	62	21	25	16	41
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	191	10	34	148	182
Cocaine Use in the Past Year	89	2	29	59	87
Perceptions of Great Risk from Using Cocaine Once a Month	2,954	209	293	2,451	2,744
Heroin Use in the Past Year⁵	--	--	1	11	12
Perceptions of Great Risk from Trying Heroin Once or Twice	3,999	252	451	3,296	3,747
Methamphetamine Use in the Past Year	43	1	4	38	42
Prescription Pain Reliever Misuse in the Past Year²	144	10	16	117	134
Opioid Misuse in the Past Year^2,6	143	10	18	115	133
ALCOHOL
Alcohol Use in the Past Month	2,704	34	332	2,338	2,670
Binge Alcohol Use in the Past Month⁷	1,163	20	196	947	1,143
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	2,233	175	218	1,840	2,058
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	127	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	76	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	901	11	106	784	890
Cigarette Use in the Past Month	691	8	70	612	683
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	3,557	289	372	2,896	3,268
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	196	923	1,119
Serious Mental Illness^4,10	--	--	64	205	269
Received Mental Health Services¹¹	--	--	132	787	919
Major Depressive Episode^4,12	--	104	121	317	438
Had Serious Thoughts of Suicide	--	--	78	179	257
Made Any Suicide Plans	--	--	23	46	69
Attempted Suicide	--	--	15	17	32
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

COLORADO

Table 21B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Colorado; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	514	41	112	362	474
Pain Reliever Use Disorder^1,3	73	4	7	62	69
Opioid Use Disorder^1,3,4	75	4	6	65	71
Alcohol Use Disorder¹	602	27	93	483	575
Substance Use Disorder^1,2	944	49	159	736	895
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	432	34	110	288	399
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	584	21	93	469	562
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	872	46	155	671	826
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

COLORADO

Table 22A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Colorado; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	20.20	10.68	32.57	19.43	21.15
Marijuana Use in the Past Year	24.70	17.52	41.47	22.99	25.41
Marijuana Use in the Past Month	18.60	6.84	30.56	18.14	19.77
Perceptions of Great Risk from Smoking Marijuana Once a Month	18.15	16.20	11.63	19.36	18.34
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	3.14	6.66	10.36	1.12	2.46
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.89	2.20	5.77	3.79	4.05
Cocaine Use in the Past Year	1.81	0.36	4.91	1.50	1.95
Perceptions of Great Risk from Using Cocaine Once a Month	59.96	46.93	49.90	62.97	61.25
Heroin Use in the Past Year⁵	--	--	0.17	0.29	0.27
Perceptions of Great Risk from Trying Heroin Once or Twice	81.21	56.48	76.77	84.68	83.64
Methamphetamine Use in the Past Year	0.87	0.17	0.65	0.98	0.94
Prescription Pain Reliever Misuse in the Past Year²	2.92	2.24	2.76	3.02	2.98
Opioid Misuse in the Past Year^2,6	2.91	2.24	3.06	2.97	2.98
ALCOHOL
Alcohol Use in the Past Month	54.89	7.61	56.62	60.05	59.60
Binge Alcohol Use in the Past Month⁷	23.61	4.48	33.43	24.32	25.51
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	45.34	39.28	37.09	47.28	45.94
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	18.43	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	11.11	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	18.29	2.41	18.05	20.14	19.87
Cigarette Use in the Past Month	14.03	1.89	11.97	15.73	15.24
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	72.21	64.71	63.38	74.40	72.95
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.35	23.71	24.97
Serious Mental Illness^4,10	--	--	10.87	5.27	6.01
Received Mental Health Services¹¹	--	--	22.48	20.22	20.52
Major Depressive Episode^4,12	--	23.40	20.60	8.15	9.78
Had Serious Thoughts of Suicide	--	--	13.32	4.59	5.74
Made Any Suicide Plans	--	--	3.91	1.19	1.55
Attempted Suicide	--	--	2.52	0.45	0.72
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

COLORADO

Table 22B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Colorado; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	10.44	9.09	19.11	9.29	10.58
Pain Reliever Use Disorder^1,3	1.48	0.96	1.14	1.59	1.53
Opioid Use Disorder^1,3,4	1.53	0.95	1.10	1.66	1.59
Alcohol Use Disorder¹	12.22	5.95	15.76	12.40	12.84
Substance Use Disorder^1,2	19.17	10.97	27.10	18.91	19.99
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	8.77	7.53	18.82	7.40	8.90
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	11.85	4.81	15.88	12.05	12.55
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	17.71	10.39	26.37	17.24	18.44
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CONNECTICUT

Table 23A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Connecticut; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	482	24	98	360	458
Marijuana Use in the Past Year	619	27	136	455	591
Marijuana Use in the Past Month	418	13	87	318	405
Perceptions of Great Risk from Smoking Marijuana Once a Month	552	60	46	446	492
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	39	11	18	10	28
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	100	4	17	79	96
Cocaine Use in the Past Year	52	*	13	40	52
Perceptions of Great Risk from Using Cocaine Once a Month	2,143	126	227	1,790	2,017
Heroin Use in the Past Year⁵	--	--	1	8	9
Perceptions of Great Risk from Trying Heroin Once or Twice	2,569	147	302	2,120	2,422
Methamphetamine Use in the Past Year	16	0	2	14	16
Prescription Pain Reliever Misuse in the Past Year²	85	5	10	70	80
Opioid Misuse in the Past Year^2,6	89	5	10	74	83
ALCOHOL
Alcohol Use in the Past Month	1,748	19	221	1,508	1,729
Binge Alcohol Use in the Past Month⁷	619	10	111	499	610
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	1,395	103	150	1,143	1,293
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	57	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	31	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	510	7	55	447	503
Cigarette Use in the Past Month	429	2	41	386	427
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	2,286	186	254	1,846	2,100
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	123	450	573
Serious Mental Illness^4,10	--	--	38	84	122
Received Mental Health Services¹¹	--	--	91	492	583
Major Depressive Episode^4,12	--	56	72	146	218
Had Serious Thoughts of Suicide	--	--	44	70	113
Made Any Suicide Plans	--	--	22	17	39
Attempted Suicide	--	--	9	3	12
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CONNECTICUT

Table 23B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Connecticut; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	231	19	64	147	211
Pain Reliever Use Disorder^1,3	42	3	4	35	40
Opioid Use Disorder^1,3,4	50	2	4	43	47
Alcohol Use Disorder¹	320	8	63	250	312
Substance Use Disorder^1,2	489	24	97	368	465
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	194	16	61	118	178
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	324	7	62	256	317
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	460	18	92	350	442
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CONNECTICUT

Table 24A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Connecticut; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	15.52	8.89	25.82	14.67	16.16
Marijuana Use in the Past Year	19.92	10.08	35.96	18.54	20.87
Marijuana Use in the Past Month	13.45	4.74	22.90	12.96	14.28
Perceptions of Great Risk from Smoking Marijuana Once a Month	17.76	21.85	12.17	18.17	17.36
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.38	4.55	9.08	0.83	1.99
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.22	1.55	4.48	3.22	3.38
Cocaine Use in the Past Year	1.69	*	3.34	1.62	1.85
Perceptions of Great Risk from Using Cocaine Once a Month	68.98	46.29	59.97	72.89	71.16
Heroin Use in the Past Year⁵	--	--	0.17	0.34	0.32
Perceptions of Great Risk from Trying Heroin Once or Twice	82.72	54.01	79.79	86.33	85.45
Methamphetamine Use in the Past Year	0.52	0.06	0.52	0.57	0.56
Prescription Pain Reliever Misuse in the Past Year²	2.74	2.00	2.63	2.84	2.81
Opioid Misuse in the Past Year^2,6	2.86	2.01	2.62	3.00	2.94
ALCOHOL
Alcohol Use in the Past Month	56.27	7.00	58.47	61.41	61.01
Binge Alcohol Use in the Past Month⁷	19.94	3.58	29.27	20.32	21.51
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.91	37.62	39.54	46.56	45.62
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.15	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.10	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	16.42	2.68	14.65	18.22	17.74
Cigarette Use in the Past Month	13.82	0.84	10.74	15.74	15.07
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	73.59	68.30	67.19	75.17	74.10
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	32.38	18.33	20.21
Serious Mental Illness^4,10	--	--	9.97	3.43	4.31
Received Mental Health Services¹¹	--	--	24.03	20.04	20.57
Major Depressive Episode^4,12	--	20.42	18.93	5.95	7.69
Had Serious Thoughts of Suicide	--	--	11.49	2.83	3.99
Made Any Suicide Plans	--	--	5.86	0.69	1.38
Attempted Suicide	--	--	2.26	0.12	0.41
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

CONNECTICUT

Table 24B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Connecticut; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	7.42	7.10	16.93	5.99	7.46
Pain Reliever Use Disorder^1,3	1.36	0.92	1.18	1.44	1.41
Opioid Use Disorder^1,3,4	1.60	0.90	1.10	1.75	1.67
Alcohol Use Disorder¹	10.30	2.82	16.52	10.17	11.02
Substance Use Disorder^1,2	15.73	8.70	25.61	14.99	16.41
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.25	5.85	16.01	4.79	6.29
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.44	2.58	16.31	10.41	11.20
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.80	6.45	24.35	14.26	15.60
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DELAWARE

Table 25A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Delaware; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	144	7	28	109	137
Marijuana Use in the Past Year	164	9	37	119	155
Marijuana Use in the Past Month	128	4	26	98	124
Perceptions of Great Risk from Smoking Marijuana Once a Month	166	16	9	141	150
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	11	4	4	2	7
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	30	1	6	23	29
Cocaine Use in the Past Year	18	0	4	14	18
Perceptions of Great Risk from Using Cocaine Once a Month	588	36	56	496	551
Heroin Use in the Past Year⁵	--	--	*	7	9
Perceptions of Great Risk from Trying Heroin Once or Twice	728	42	75	611	686
Methamphetamine Use in the Past Year	9	0	1	8	9
Prescription Pain Reliever Misuse in the Past Year²	27	2	4	21	26
Opioid Misuse in the Past Year^2,6	28	2	4	22	26
ALCOHOL
Alcohol Use in the Past Month	433	5	52	376	428
Binge Alcohol Use in the Past Month⁷	191	2	36	153	189
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	382	32	35	315	350
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	17	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	12	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	168	2	15	151	166
Cigarette Use in the Past Month	147	1	12	134	146
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	612	45	64	502	566
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	31	125	156
Serious Mental Illness^4,10	--	--	12	22	34
Received Mental Health Services¹¹	--	--	20	122	143
Major Depressive Episode^4,12	--	15	20	42	62
Had Serious Thoughts of Suicide	--	--	13	17	31
Made Any Suicide Plans	--	--	7	4	12
Attempted Suicide	--	--	2	2	5
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DELAWARE

Table 25B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Delaware; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	75	6	19	50	69
Pain Reliever Use Disorder^1,3	14	1	1	12	13
Opioid Use Disorder^1,3,4	17	1	2	14	16
Alcohol Use Disorder¹	96	2	17	77	94
Substance Use Disorder^1,2	147	7	29	111	140
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	58	5	18	35	53
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	94	2	16	76	92
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	134	6	26	102	128
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DELAWARE

Table 26A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Delaware; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	16.81	9.73	30.14	15.79	17.48
Marijuana Use in the Past Year	19.16	11.69	39.65	17.22	19.87
Marijuana Use in the Past Month	14.98	5.64	27.69	14.28	15.86
Perceptions of Great Risk from Smoking Marijuana Once a Month	19.35	21.26	9.96	20.42	19.17
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.48	6.01	10.18	0.71	1.83
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.54	2.00	6.45	3.31	3.68
Cocaine Use in the Past Year	2.13	0.07	4.65	2.01	2.32
Perceptions of Great Risk from Using Cocaine Once a Month	68.73	49.22	60.31	71.94	70.56
Heroin Use in the Past Year⁵	--	--	*	1.06	1.13
Perceptions of Great Risk from Trying Heroin Once or Twice	85.19	57.34	81.00	88.70	87.79
Methamphetamine Use in the Past Year	1.02	0.08	1.13	1.11	1.11
Prescription Pain Reliever Misuse in the Past Year²	3.21	2.53	4.63	3.09	3.27
Opioid Misuse in the Past Year^2,6	3.22	2.48	4.13	3.17	3.29
ALCOHOL
Alcohol Use in the Past Month	50.70	6.54	56.77	54.59	54.86
Binge Alcohol Use in the Past Month⁷	22.35	3.25	38.74	22.20	24.15
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.66	43.66	37.87	45.67	44.75
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.59	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	10.64	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	19.63	2.87	16.42	21.86	21.21
Cigarette Use in the Past Month	17.14	0.74	13.14	19.42	18.68
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	71.55	61.62	69.82	72.84	72.48
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.85	18.10	19.96
Serious Mental Illness^4,10	--	--	12.69	3.17	4.30
Received Mental Health Services¹¹	--	--	21.87	17.76	18.24
Major Depressive Episode^4,12	--	20.46	21.78	6.08	7.93
Had Serious Thoughts of Suicide	--	--	14.23	2.53	3.91
Made Any Suicide Plans	--	--	8.12	0.64	1.52
Attempted Suicide	--	--	2.58	0.31	0.58
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DELAWARE

Table 26B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Delaware; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.77	8.73	20.46	7.21	8.77
Pain Reliever Use Disorder^1,3	1.65	1.19	1.42	1.73	1.69
Opioid Use Disorder^1,3,4	1.96	1.20	1.92	2.05	2.03
Alcohol Use Disorder¹	11.27	2.60	18.87	11.17	12.09
Substance Use Disorder^1,2	17.20	9.70	31.18	16.14	17.91
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.74	6.73	19.06	5.10	6.75
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.99	2.51	17.59	11.00	11.78
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.69	8.22	28.59	14.75	16.39
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DISTRICT OF COLUMBIA

Table 27A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the District of Columbia; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	133	3	26	103	130
Marijuana Use in the Past Year	182	4	33	145	178
Marijuana Use in the Past Month	125	4	21	100	121
Perceptions of Great Risk from Smoking Marijuana Once a Month	79	8	8	63	71
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	5	1	3	1	4
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	26	1	4	21	26
Cocaine Use in the Past Year	21	0	3	18	21
Perceptions of Great Risk from Using Cocaine Once a Month	316	18	39	260	298
Heroin Use in the Past Year⁵	--	--	0	3	3
Perceptions of Great Risk from Trying Heroin Once or Twice	452	21	59	372	431
Methamphetamine Use in the Past Year	4	0	0	3	3
Prescription Pain Reliever Misuse in the Past Year²	18	0	2	16	18
Opioid Misuse in the Past Year^2,6	17	0	2	15	17
ALCOHOL
Alcohol Use in the Past Month	347	2	53	292	344
Binge Alcohol Use in the Past Month⁷	175	2	30	143	173
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	249	16	28	206	233
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	87	1	13	72	86
Cigarette Use in the Past Month	68	0	9	59	68
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	428	23	56	349	405
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	26	127	153
Serious Mental Illness^4,10	--	--	8	18	26
Received Mental Health Services¹¹	--	--	16	98	113
Major Depressive Episode^4,12	--	6	12	40	52
Had Serious Thoughts of Suicide	--	--	9	17	26
Made Any Suicide Plans	--	--	3	4	7
Attempted Suicide	--	--	2	4	6
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DISTRICT OF COLUMBIA

Table 27B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the District of Columbia; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	62	2	16	44	60
Pain Reliever Use Disorder^1,3	12	0	1	11	12
Opioid Use Disorder^1,3,4	10	0	1	8	9
Alcohol Use Disorder¹	90	1	15	74	89
Substance Use Disorder^1,2	133	3	24	106	130
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	55	2	15	38	53
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	86	1	15	70	85
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	130	3	25	103	128
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DISTRICT OF COLUMBIA

Table 28A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in the District of Columbia; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	23.31	9.15	34.18	22.54	24.21
Marijuana Use in the Past Year	32.03	12.23	43.18	31.65	33.29
Marijuana Use in the Past Month	22.00	12.38	27.92	21.72	22.61
Perceptions of Great Risk from Smoking Marijuana Once a Month	13.87	24.25	10.73	13.65	13.23
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.63	3.21	10.35	0.85	2.55
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	4.63	2.14	5.69	4.63	4.78
Cocaine Use in the Past Year	3.66	0.19	3.55	3.93	3.87
Perceptions of Great Risk from Using Cocaine Once a Month	55.48	52.26	50.44	56.56	55.68
Heroin Use in the Past Year⁵	--	--	0.08	0.55	0.49
Perceptions of Great Risk from Trying Heroin Once or Twice	79.47	62.08	77.26	81.09	80.54
Methamphetamine Use in the Past Year	0.62	0.25	0.39	0.69	0.65
Prescription Pain Reliever Misuse in the Past Year²	3.22	1.36	2.08	3.55	3.34
Opioid Misuse in the Past Year^2,6	3.00	1.35	2.76	3.17	3.11
ALCOHOL
Alcohol Use in the Past Month	60.90	6.85	68.64	63.58	64.29
Binge Alcohol Use in the Past Month⁷	30.71	4.95	39.20	31.19	32.33
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	43.78	47.49	36.03	44.81	43.54
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	24.06	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	11.79	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	15.21	2.47	17.50	15.78	16.03
Cigarette Use in the Past Month	12.01	1.38	11.80	12.84	12.69
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	75.20	67.88	72.74	76.12	75.64
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	33.30	27.69	28.49
Serious Mental Illness^4,10	--	--	10.54	3.88	4.83
Received Mental Health Services¹¹	--	--	20.29	21.34	21.19
Major Depressive Episode^4,12	--	16.53	15.52	8.64	9.62
Had Serious Thoughts of Suicide	--	--	12.01	3.74	4.92
Made Any Suicide Plans	--	--	3.78	0.84	1.26
Attempted Suicide	--	--	2.69	0.79	1.07
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

DISTRICT OF COLUMBIA

Table 28B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in the District of Columbia; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	10.87	6.87	20.81	9.51	11.13
Pain Reliever Use Disorder^1,3	2.16	0.70	1.33	2.40	2.25
Opioid Use Disorder^1,3,4	1.68	0.70	1.28	1.82	1.75
Alcohol Use Disorder¹	15.80	2.47	19.97	16.09	16.64
Substance Use Disorder^1,2	23.40	9.77	31.91	22.99	24.26
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	9.64	6.25	19.86	8.20	9.86
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	15.13	3.31	20.15	15.16	15.87
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	22.91	7.78	33.08	22.33	23.87
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

FLORIDA

Table 29A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Florida; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	2,179	76	432	1,671	2,103
Marijuana Use in the Past Year	2,805	142	608	2,055	2,663
Marijuana Use in the Past Month	1,996	59	395	1,542	1,937
Perceptions of Great Risk from Smoking Marijuana Once a Month	5,065	412	264	4,390	4,653
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	192	59	80	53	134
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	468	27	63	379	441
Cocaine Use in the Past Year	246	2	54	190	244
Perceptions of Great Risk from Using Cocaine Once a Month	13,692	801	1,228	11,662	12,891
Heroin Use in the Past Year⁵	--	--	3	51	55
Perceptions of Great Risk from Trying Heroin Once or Twice	16,172	902	1,552	13,719	15,270
Methamphetamine Use in the Past Year	98	1	5	91	97
Prescription Pain Reliever Misuse in the Past Year²	471	34	59	378	437
Opioid Misuse in the Past Year^2,6	505	34	57	414	471
ALCOHOL
Alcohol Use in the Past Month	9,264	101	919	8,243	9,162
Binge Alcohol Use in the Past Month⁷	3,794	48	515	3,230	3,746
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	8,901	700	833	7,368	8,202
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	373	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	190	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	3,344	31	268	3,045	3,313
Cigarette Use in the Past Month	2,737	14	160	2,563	2,723
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	13,694	979	1,317	11,398	12,715
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	628	2,981	3,610
Serious Mental Illness^4,10	--	--	237	664	901
Received Mental Health Services¹¹	--	--	314	2,023	2,337
Major Depressive Episode^4,12	--	337	383	914	1,297
Had Serious Thoughts of Suicide	--	--	269	509	778
Made Any Suicide Plans	--	--	93	155	249
Attempted Suicide	--	--	71	79	150
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

FLORIDA

Table 29B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Florida; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	1,413	89	269	1,055	1,324
Pain Reliever Use Disorder^1,3	341	15	23	303	326
Opioid Use Disorder^1,3,4	357	15	26	315	342
Alcohol Use Disorder¹	1,838	51	250	1,537	1,788
Substance Use Disorder^1,2	2,753	111	445	2,197	2,642
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	1,011	76	264	671	935
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	1,833	47	248	1,538	1,787
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	2,348	101	419	1,827	2,247
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

FLORIDA

Table 30A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Florida; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11.63	5.02	22.43	10.93	12.21
Marijuana Use in the Past Year	14.98	9.38	31.54	13.45	15.48
Marijuana Use in the Past Month	10.66	3.90	20.52	10.09	11.26
Perceptions of Great Risk from Smoking Marijuana Once a Month	27.03	27.21	13.68	28.72	27.02
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.53	3.82	6.45	0.57	1.21
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.50	1.77	3.25	2.48	2.57
Cocaine Use in the Past Year	1.32	0.13	2.80	1.24	1.42
Perceptions of Great Risk from Using Cocaine Once a Month	73.11	52.89	63.77	76.30	74.88
Heroin Use in the Past Year⁵	--	--	0.17	0.34	0.32
Perceptions of Great Risk from Trying Heroin Once or Twice	86.39	59.55	80.56	89.76	88.72
Methamphetamine Use in the Past Year	0.52	0.10	0.28	0.60	0.56
Prescription Pain Reliever Misuse in the Past Year²	2.52	2.26	3.04	2.48	2.54
Opioid Misuse in the Past Year^2,6	2.70	2.26	2.98	2.71	2.74
ALCOHOL
Alcohol Use in the Past Month	49.49	6.69	47.71	53.93	53.26
Binge Alcohol Use in the Past Month⁷	20.26	3.16	26.76	21.14	21.77
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	47.54	46.18	43.27	48.21	47.66
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.41	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	7.83	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	17.85	2.04	13.91	19.92	19.24
Cigarette Use in the Past Month	14.61	0.92	8.31	16.77	15.82
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	73.13	64.60	68.38	74.57	73.88
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	32.63	19.51	20.98
Serious Mental Illness^4,10	--	--	12.31	4.34	5.24
Received Mental Health Services¹¹	--	--	16.33	13.24	13.58
Major Depressive Episode^4,12	--	22.22	19.88	5.98	7.54
Had Serious Thoughts of Suicide	--	--	13.95	3.33	4.52
Made Any Suicide Plans	--	--	4.85	1.01	1.44
Attempted Suicide	--	--	3.70	0.51	0.87
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

FLORIDA

Table 30B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Florida; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	7.55	5.89	13.97	6.90	7.69
Pain Reliever Use Disorder^1,3	1.82	1.01	1.18	1.99	1.89
Opioid Use Disorder^1,3,4	1.90	1.00	1.37	2.06	1.98
Alcohol Use Disorder¹	9.82	3.34	13.00	10.06	10.40
Substance Use Disorder^1,2	14.70	7.32	23.12	14.37	15.35
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	5.40	5.01	13.71	4.39	5.43
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.80	3.08	12.88	10.07	10.39
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	12.54	6.65	21.77	11.96	13.06
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

GEORGIA

Table 31A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Georgia; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	1,100	64	246	790	1,036
Marijuana Use in the Past Year	1,546	81	346	1,119	1,466
Marijuana Use in the Past Month	1,032	53	250	729	979
Perceptions of Great Risk from Smoking Marijuana Once a Month	2,027	251	147	1,629	1,776
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	91	25	45	21	66
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	287	23	38	227	265
Cocaine Use in the Past Year	145	2	31	112	143
Perceptions of Great Risk from Using Cocaine Once a Month	6,442	467	721	5,254	5,975
Heroin Use in the Past Year⁵	--	--	2	27	29
Perceptions of Great Risk from Trying Heroin Once or Twice	7,545	535	873	6,138	7,010
Methamphetamine Use in the Past Year	71	2	2	67	69
Prescription Pain Reliever Misuse in the Past Year²	290	15	31	244	275
Opioid Misuse in the Past Year^2,6	321	15	30	276	306
ALCOHOL
Alcohol Use in the Past Month	3,919	53	471	3,395	3,866
Binge Alcohol Use in the Past Month⁷	1,593	29	293	1,271	1,565
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	4,364	434	466	3,463	3,929
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	176	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	96	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,984	24	191	1,769	1,960
Cigarette Use in the Past Month	1,550	11	131	1,407	1,539
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	6,040	581	696	4,764	5,460
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	381	1,491	1,872
Serious Mental Illness^4,10	--	--	118	308	426
Received Mental Health Services¹¹	--	--	177	1,077	1,254
Major Depressive Episode^4,12	--	158	192	494	686
Had Serious Thoughts of Suicide	--	--	149	231	381
Made Any Suicide Plans	--	--	59	58	117
Attempted Suicide	--	--	38	33	70
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

GEORGIA

Table 31B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Georgia; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	768	58	168	542	710
Pain Reliever Use Disorder^1,3	145	10	14	121	135
Opioid Use Disorder^1,3,4	171	9	16	146	161
Alcohol Use Disorder¹	875	26	164	685	849
Substance Use Disorder^1,2	1,453	72	267	1,113	1,380
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	622	46	141	434	575
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	901	26	160	716	875
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	1,286	67	252	967	1,219
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

GEORGIA

Table 32A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Georgia; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	12.22	6.99	22.03	11.33	12.81
Marijuana Use in the Past Year	17.18	8.83	30.97	16.06	18.12
Marijuana Use in the Past Month	11.46	5.79	22.34	10.46	12.10
Perceptions of Great Risk from Smoking Marijuana Once a Month	22.51	27.44	13.12	23.37	21.95
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.75	3.00	7.17	0.56	1.51
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.19	2.47	3.40	3.26	3.27
Cocaine Use in the Past Year	1.61	0.18	2.79	1.61	1.77
Perceptions of Great Risk from Using Cocaine Once a Month	71.56	51.13	64.46	75.37	73.86
Heroin Use in the Past Year⁵	--	--	0.15	0.39	0.36
Perceptions of Great Risk from Trying Heroin Once or Twice	83.84	58.59	78.07	88.04	86.66
Methamphetamine Use in the Past Year	0.78	0.20	0.16	0.96	0.85
Prescription Pain Reliever Misuse in the Past Year²	3.22	1.62	2.77	3.50	3.40
Opioid Misuse in the Past Year^2,6	3.56	1.60	2.73	3.95	3.78
ALCOHOL
Alcohol Use in the Past Month	43.52	5.79	42.12	48.70	47.79
Binge Alcohol Use in the Past Month⁷	17.70	3.15	26.21	18.24	19.34
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	48.47	47.56	41.67	49.68	48.57
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	12.62	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6.89	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	22.04	2.63	17.12	25.37	24.23
Cigarette Use in the Past Month	17.22	1.22	11.74	20.19	19.02
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	67.09	63.59	62.22	68.34	67.49
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	34.10	21.39	23.14
Serious Mental Illness^4,10	--	--	10.58	4.42	5.27
Received Mental Health Services¹¹	--	--	15.80	15.45	15.50
Major Depressive Episode^4,12	--	17.33	17.17	7.08	8.47
Had Serious Thoughts of Suicide	--	--	13.35	3.32	4.70
Made Any Suicide Plans	--	--	5.30	0.84	1.45
Attempted Suicide	--	--	3.37	0.47	0.87
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

GEORGIA

Table 32B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Georgia; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.53	6.36	15.00	7.78	8.78
Pain Reliever Use Disorder^1,3	1.61	1.05	1.28	1.74	1.67
Opioid Use Disorder^1,3,4	1.90	1.04	1.39	2.09	2.00
Alcohol Use Disorder¹	9.72	2.87	14.63	9.83	10.49
Substance Use Disorder^1,2	16.14	7.93	23.88	15.97	17.06
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.90	5.04	12.65	6.23	7.11
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.01	2.82	14.27	10.27	10.82
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.28	7.32	22.55	13.87	15.07
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

HAWAII

Table 33A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Hawaii; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	126	6	34	87	120
Marijuana Use in the Past Year	175	9	44	123	166
Marijuana Use in the Past Month	111	5	28	78	106
Perceptions of Great Risk from Smoking Marijuana Once a Month	283	15	14	254	268
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	14	5	4	5	9
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	34	2	7	25	32
Cocaine Use in the Past Year	18	0	5	13	18
Perceptions of Great Risk from Using Cocaine Once a Month	772	47	64	660	725
Heroin Use in the Past Year⁵	--	--	*	4	4
Perceptions of Great Risk from Trying Heroin Once or Twice	916	53	86	777	863
Methamphetamine Use in the Past Year	9	0	1	8	8
Prescription Pain Reliever Misuse in the Past Year²	35	2	4	29	33
Opioid Misuse in the Past Year^2,6	35	2	4	29	33
ALCOHOL
Alcohol Use in the Past Month	508	6	63	439	502
Binge Alcohol Use in the Past Month⁷	253	3	31	219	250
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	558	41	44	472	517
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	22	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	11	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	161	2	19	139	158
Cigarette Use in the Past Month	160	2	15	143	159
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	851	62	77	712	789
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	41	186	227
Serious Mental Illness^4,10	--	--	12	43	55
Received Mental Health Services¹¹	--	--	19	106	125
Major Depressive Episode^4,12	--	19	19	55	74
Had Serious Thoughts of Suicide	--	--	13	33	46
Made Any Suicide Plans	--	--	3	7	10
Attempted Suicide	--	--	3	2	5
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

HAWAII

Table 33B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Hawaii; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	78	7	17	54	71
Pain Reliever Use Disorder^1,3	14	1	2	11	13
Opioid Use Disorder^1,3,4	13	1	2	10	12
Alcohol Use Disorder¹	107	3	15	89	104
Substance Use Disorder^1,2	163	9	26	128	154
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	66	6	17	43	60
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	112	4	15	93	108
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	153	9	25	120	144
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

HAWAII

Table 34A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Hawaii; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	10.72	6.36	28.55	8.96	11.11
Marijuana Use in the Past Year	14.86	9.14	37.15	12.68	15.38
Marijuana Use in the Past Month	9.42	4.87	24.03	8.07	9.83
Perceptions of Great Risk from Smoking Marijuana Once a Month	23.90	15.65	12.30	26.20	24.65
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.29	6.25	7.07	1.01	1.69
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.91	2.14	5.88	2.62	2.98
Cocaine Use in the Past Year	1.55	0.20	4.05	1.37	1.67
Perceptions of Great Risk from Using Cocaine Once a Month	65.22	48.47	54.74	68.23	66.73
Heroin Use in the Past Year⁵	--	--	*	0.40	0.39
Perceptions of Great Risk from Trying Heroin Once or Twice	77.40	53.79	73.30	80.28	79.51
Methamphetamine Use in the Past Year	0.75	0.49	0.71	0.78	0.77
Prescription Pain Reliever Misuse in the Past Year²	2.96	1.85	3.23	3.05	3.07
Opioid Misuse in the Past Year^2,6	2.94	1.87	3.70	2.96	3.04
ALCOHOL
Alcohol Use in the Past Month	42.97	5.70	53.75	45.40	46.34
Binge Alcohol Use in the Past Month⁷	21.37	3.18	26.52	22.58	23.02
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	47.12	41.57	37.87	48.82	47.62
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	15.25	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	7.30	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	13.57	2.43	16.50	14.35	14.58
Cigarette Use in the Past Month	13.55	1.85	13.00	14.82	14.62
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	71.92	63.72	65.34	73.57	72.66
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	34.72	19.26	20.97
Serious Mental Illness^4,10	--	--	10.35	4.43	5.08
Received Mental Health Services¹¹	--	--	16.22	10.95	11.53
Major Depressive Episode^4,12	--	19.15	15.87	5.72	6.84
Had Serious Thoughts of Suicide	--	--	11.46	3.41	4.30
Made Any Suicide Plans	--	--	2.97	0.70	0.95
Attempted Suicide	--	--	2.45	0.18	0.42
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

HAWAII

Table 34B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Hawaii; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	6.57	6.93	14.17	5.60	6.54
Pain Reliever Use Disorder^1,3	1.16	0.94	1.81	1.11	1.18
Opioid Use Disorder^1,3,4	1.12	0.91	1.60	1.08	1.14
Alcohol Use Disorder¹	9.09	3.43	13.19	9.15	9.60
Substance Use Disorder^1,2	13.80	9.45	22.23	13.19	14.19
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	5.56	5.64	14.10	4.49	5.55
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.49	4.10	13.13	9.58	9.98
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	12.96	8.81	21.20	12.35	13.34
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IDAHO

Table 35A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Idaho; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	184	11	47	126	173
Marijuana Use in the Past Year	242	15	68	159	227
Marijuana Use in the Past Month	161	8	48	105	152
Perceptions of Great Risk from Smoking Marijuana Once a Month	323	38	20	265	285
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	19	5	8	5	14
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	44	3	7	34	41
Cocaine Use in the Past Year	20	1	7	12	19
Perceptions of Great Risk from Using Cocaine Once a Month	1,012	85	110	818	928
Heroin Use in the Past Year⁵	--	--	0	4	4
Perceptions of Great Risk from Trying Heroin Once or Twice	1,262	95	151	1,016	1,167
Methamphetamine Use in the Past Year	15	0	1	13	14
Prescription Pain Reliever Misuse in the Past Year²	40	3	6	31	37
Opioid Misuse in the Past Year^2,6	42	3	7	33	40
ALCOHOL
Alcohol Use in the Past Month	658	10	102	546	648
Binge Alcohol Use in the Past Month⁷	306	6	60	241	301
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	659	69	63	527	590
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	29	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	16	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	314	5	43	266	309
Cigarette Use in the Past Month	232	4	29	199	228
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	1,040	104	120	816	936
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	73	304	377
Serious Mental Illness^4,10	--	--	26	71	97
Received Mental Health Services¹¹	--	--	44	235	279
Major Depressive Episode^4,12	--	35	44	104	148
Had Serious Thoughts of Suicide	--	--	29	62	91
Made Any Suicide Plans	--	--	8	12	20
Attempted Suicide	--	--	5	5	11
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IDAHO

Table 35B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Idaho; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	139	12	37	90	127
Pain Reliever Use Disorder^1,3	27	1	2	23	25
Opioid Use Disorder^1,3,4	29	1	2	26	28
Alcohol Use Disorder¹	183	8	35	141	175
Substance Use Disorder^1,2	270	15	56	200	256
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	110	8	36	66	102
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	170	7	35	129	163
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	229	13	50	166	216
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IDAHO

Table 36A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Idaho; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11.65	6.74	24.25	10.33	12.25
Marijuana Use in the Past Year	15.31	8.80	34.99	13.07	16.09
Marijuana Use in the Past Month	10.14	4.89	24.51	8.58	10.78
Perceptions of Great Risk from Smoking Marijuana Once a Month	20.40	22.55	10.31	21.71	20.14
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.15	3.26	8.19	0.87	1.91
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.78	1.96	3.68	2.75	2.88
Cocaine Use in the Past Year	1.26	0.64	3.69	0.96	1.33
Perceptions of Great Risk from Using Cocaine Once a Month	63.91	49.57	56.45	67.12	65.64
Heroin Use in the Past Year⁵	--	--	0.25	0.32	0.31
Perceptions of Great Risk from Trying Heroin Once or Twice	79.69	55.54	77.82	83.36	82.59
Methamphetamine Use in the Past Year	0.92	0.15	0.68	1.07	1.01
Prescription Pain Reliever Misuse in the Past Year²	2.53	1.58	3.02	2.58	2.64
Opioid Misuse in the Past Year^2,6	2.68	1.54	3.38	2.72	2.81
ALCOHOL
Alcohol Use in the Past Month	41.51	5.95	52.61	44.76	45.84
Binge Alcohol Use in the Past Month⁷	19.34	3.36	30.81	19.76	21.29
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	41.61	40.32	32.45	43.27	41.77
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	12.66	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6.82	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	19.83	2.94	22.20	21.82	21.88
Cigarette Use in the Past Month	14.67	2.42	15.03	16.33	16.15
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	65.66	60.81	62.00	66.94	66.26
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	37.51	24.94	26.67
Serious Mental Illness^4,10	--	--	13.49	5.82	6.88
Received Mental Health Services¹¹	--	--	22.83	19.24	19.74
Major Depressive Episode^4,12	--	20.72	22.71	8.54	10.50
Had Serious Thoughts of Suicide	--	--	14.72	5.11	6.44
Made Any Suicide Plans	--	--	4.06	1.02	1.44
Attempted Suicide	--	--	2.69	0.44	0.76
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IDAHO

Table 36B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Idaho; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.79	6.87	19.16	7.40	9.02
Pain Reliever Use Disorder^1,3	1.69	0.86	1.06	1.90	1.79
Opioid Use Disorder^1,3,4	1.86	0.86	1.15	2.12	1.98
Alcohol Use Disorder¹	11.56	4.55	17.96	11.53	12.41
Substance Use Disorder^1,2	17.08	8.52	29.05	16.37	18.12
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.93	4.69	18.32	5.42	7.20
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.73	4.05	17.80	10.55	11.55
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.46	7.40	25.73	13.66	15.32
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ILLINOIS

Table 37A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Illinois; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	1,726	80	353	1,293	1,646
Marijuana Use in the Past Year	2,247	121	477	1,649	2,126
Marijuana Use in the Past Month	1,597	89	350	1,158	1,508
Perceptions of Great Risk from Smoking Marijuana Once a Month	2,100	199	176	1,724	1,901
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	132	40	54	38	92
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	333	17	54	261	315
Cocaine Use in the Past Year	191	1	41	150	190
Perceptions of Great Risk from Using Cocaine Once a Month	6,992	497	771	5,725	6,496
Heroin Use in the Past Year⁵	--	--	2	58	61
Perceptions of Great Risk from Trying Heroin Once or Twice	8,707	583	999	7,124	8,123
Methamphetamine Use in the Past Year	65	4	5	56	61
Prescription Pain Reliever Misuse in the Past Year²	304	20	27	257	284
Opioid Misuse in the Past Year^2,6	324	20	35	268	304
ALCOHOL
Alcohol Use in the Past Month	5,300	96	679	4,525	5,204
Binge Alcohol Use in the Past Month⁷	2,376	55	407	1,914	2,321
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	4,491	419	488	3,584	4,073
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	262	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	135	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	2,110	32	181	1,896	2,078
Cigarette Use in the Past Month	1,691	29	130	1,532	1,663
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	7,411	653	884	5,875	6,759
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	408	1,687	2,095
Serious Mental Illness^4,10	--	--	119	296	415
Received Mental Health Services¹¹	--	--	233	1,195	1,428
Major Depressive Episode^4,12	--	234	181	510	692
Had Serious Thoughts of Suicide	--	--	156	304	460
Made Any Suicide Plans	--	--	54	79	133
Attempted Suicide	--	--	32	27	59
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ILLINOIS

Table 37B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Illinois; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	926	83	189	654	844
Pain Reliever Use Disorder^1,3	186	12	15	158	174
Opioid Use Disorder^1,3,4	221	12	15	195	210
Alcohol Use Disorder¹	1,052	35	179	838	1,017
Substance Use Disorder^1,2	1,762	107	301	1,355	1,656
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	761	67	167	527	694
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	968	41	177	750	927
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	1,629	87	299	1,243	1,542
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ILLINOIS

Table 38A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Illinois; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	16.11	7.95	27.67	15.34	16.96
Marijuana Use in the Past Year	20.98	11.96	37.39	19.58	21.92
Marijuana Use in the Past Month	14.91	8.78	27.42	13.75	15.54
Perceptions of Great Risk from Smoking Marijuana Once a Month	19.60	19.72	13.83	20.47	19.59
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.28	4.38	8.21	0.87	1.89
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.11	1.72	4.25	3.10	3.25
Cocaine Use in the Past Year	1.78	0.07	3.18	1.78	1.96
Perceptions of Great Risk from Using Cocaine Once a Month	65.28	49.16	60.45	67.94	66.95
Heroin Use in the Past Year⁵	--	--	0.19	0.69	0.63
Perceptions of Great Risk from Trying Heroin Once or Twice	81.31	57.74	78.32	84.56	83.73
Methamphetamine Use in the Past Year	0.60	0.42	0.39	0.66	0.62
Prescription Pain Reliever Misuse in the Past Year²	2.84	1.95	2.12	3.05	2.93
Opioid Misuse in the Past Year^2,6	3.03	2.00	2.78	3.19	3.13
ALCOHOL
Alcohol Use in the Past Month	49.48	9.49	53.24	53.70	53.64
Binge Alcohol Use in the Past Month⁷	22.18	5.47	31.91	22.71	23.92
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	41.93	41.44	38.28	42.54	41.98
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	17.23	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.87	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	19.70	3.21	14.21	22.51	21.42
Cigarette Use in the Past Month	15.79	2.86	10.21	18.19	17.14
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	69.19	64.62	69.29	69.73	69.67
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	31.98	20.03	21.60
Serious Mental Illness^4,10	--	--	9.34	3.51	4.27
Received Mental Health Services¹¹	--	--	18.28	14.18	14.72
Major Depressive Episode^4,12	--	23.14	14.21	6.06	7.13
Had Serious Thoughts of Suicide	--	--	12.26	3.61	4.75
Made Any Suicide Plans	--	--	4.23	0.94	1.37
Attempted Suicide	--	--	2.50	0.32	0.61
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

ILLINOIS

Table 38B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Illinois; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	8.65	8.20	14.85	7.76	8.70
Pain Reliever Use Disorder^1,3	1.73	1.16	1.21	1.88	1.79
Opioid Use Disorder^1,3,4	2.07	1.14	1.20	2.31	2.16
Alcohol Use Disorder¹	9.82	3.43	14.06	9.94	10.48
Substance Use Disorder^1,2	16.45	10.55	23.57	16.09	17.07
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.11	6.59	13.10	6.26	7.16
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.04	4.07	13.89	8.90	9.56
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.21	8.64	23.44	14.75	15.90
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

INDIANA

Table 39A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Indiana; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	740	37	179	525	703
Marijuana Use in the Past Year	1,062	53	282	727	1,008
Marijuana Use in the Past Month	668	28	188	452	640
Perceptions of Great Risk from Smoking Marijuana Once a Month	1,195	146	74	975	1,049
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	65	18	35	11	46
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	163	11	30	122	152
Cocaine Use in the Past Year	85	1	21	63	84
Perceptions of Great Risk from Using Cocaine Once a Month	3,861	280	441	3,140	3,581
Heroin Use in the Past Year⁵	--	--	1	14	15
Perceptions of Great Risk from Trying Heroin Once or Twice	4,673	321	585	3,766	4,352
Methamphetamine Use in the Past Year	59	0	3	56	59
Prescription Pain Reliever Misuse in the Past Year²	180	11	26	143	169
Opioid Misuse in the Past Year^2,6	189	11	25	153	178
ALCOHOL
Alcohol Use in the Past Month	2,513	34	379	2,101	2,480
Binge Alcohol Use in the Past Month⁷	1,199	18	239	942	1,181
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	2,335	244	246	1,845	2,091
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	103	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	55	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,353	15	146	1,192	1,338
Cigarette Use in the Past Month	1,077	6	107	965	1,072
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	3,609	348	450	2,811	3,261
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	272	945	1,217
Serious Mental Illness^4,10	--	--	101	208	309
Received Mental Health Services¹¹	--	--	167	766	933
Major Depressive Episode^4,12	--	123	156	323	480
Had Serious Thoughts of Suicide	--	--	113	180	293
Made Any Suicide Plans	--	--	46	36	82
Attempted Suicide	--	--	22	14	36
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

INDIANA

Table 39B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Indiana; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	586	40	146	400	546
Pain Reliever Use Disorder^1,3	85	6	8	71	79
Opioid Use Disorder^1,3,4	108	5	9	93	103
Alcohol Use Disorder¹	602	19	101	482	583
Substance Use Disorder^1,2	1,098	48	215	836	1,051
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	474	37	135	303	438
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	626	17	96	513	609
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	955	44	194	716	911
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

INDIANA

Table 40A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Indiana; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	13.00	6.55	24.28	11.93	13.70
Marijuana Use in the Past Year	18.65	9.54	38.28	16.53	19.64
Marijuana Use in the Past Month	11.74	5.07	25.52	10.28	12.46
Perceptions of Great Risk from Smoking Marijuana Once a Month	20.98	25.99	10.01	22.18	20.44
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.04	3.56	9.10	0.48	1.74
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.86	1.98	4.07	2.78	2.96
Cocaine Use in the Past Year	1.49	0.16	2.86	1.43	1.63
Perceptions of Great Risk from Using Cocaine Once a Month	67.83	50.03	59.97	71.41	69.77
Heroin Use in the Past Year⁵	--	--	0.18	0.32	0.30
Perceptions of Great Risk from Trying Heroin Once or Twice	82.11	57.32	79.56	85.66	84.78
Methamphetamine Use in the Past Year	1.04	0.08	0.43	1.27	1.15
Prescription Pain Reliever Misuse in the Past Year²	3.15	1.97	3.51	3.25	3.28
Opioid Misuse in the Past Year^2,6	3.33	1.96	3.41	3.49	3.48
ALCOHOL
Alcohol Use in the Past Month	44.14	6.00	51.46	47.79	48.30
Binge Alcohol Use in the Past Month⁷	21.05	3.16	32.53	21.42	23.01
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	41.00	43.47	33.44	41.96	40.73
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	12.58	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6.74	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	23.77	2.60	19.85	27.12	26.08
Cigarette Use in the Past Month	18.93	1.01	14.51	21.95	20.88
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	63.39	62.05	61.19	63.93	63.54
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	36.96	21.48	23.70
Serious Mental Illness^4,10	--	--	13.73	4.73	6.02
Received Mental Health Services¹¹	--	--	22.73	17.41	18.17
Major Depressive Episode^4,12	--	22.01	21.26	7.36	9.35
Had Serious Thoughts of Suicide	--	--	15.38	4.10	5.71
Made Any Suicide Plans	--	--	6.21	0.82	1.59
Attempted Suicide	--	--	3.01	0.32	0.71
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

INDIANA

Table 40B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Indiana; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	10.29	7.08	19.86	9.09	10.64
Pain Reliever Use Disorder^1,3	1.49	0.98	1.11	1.61	1.54
Opioid Use Disorder^1,3,4	1.90	0.95	1.26	2.13	2.00
Alcohol Use Disorder¹	10.57	3.45	13.72	10.95	11.34
Substance Use Disorder^1,2	19.29	8.49	29.16	19.02	20.47
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	8.33	6.52	18.29	6.90	8.53
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.99	3.06	13.02	11.67	11.86
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	16.77	7.91	26.40	16.29	17.74
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IOWA

Table 41A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Iowa; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	334	17	71	246	317
Marijuana Use in the Past Year	519	28	109	382	491
Marijuana Use in the Past Month	303	13	68	222	289
Perceptions of Great Risk from Smoking Marijuana Once a Month	463	53	34	376	410
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	38	14	18	7	24
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	79	7	13	60	72
Cocaine Use in the Past Year	41	0	11	29	41
Perceptions of Great Risk from Using Cocaine Once a Month	1,724	127	198	1,399	1,597
Heroin Use in the Past Year⁵	--	--	1	5	6
Perceptions of Great Risk from Trying Heroin Once or Twice	2,146	146	259	1,741	2,000
Methamphetamine Use in the Past Year	46	1	3	43	45
Prescription Pain Reliever Misuse in the Past Year²	76	4	9	62	71
Opioid Misuse in the Past Year^2,6	76	5	10	61	71
ALCOHOL
Alcohol Use in the Past Month	1,450	28	197	1,225	1,422
Binge Alcohol Use in the Past Month⁷	655	13	112	531	643
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	984	98	110	775	886
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	79	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	39	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	629	10	62	556	618
Cigarette Use in the Past Month	527	8	45	474	519
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	1,661	166	223	1,272	1,495
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	126	486	612
Serious Mental Illness^4,10	--	--	42	114	157
Received Mental Health Services¹¹	--	--	73	413	486
Major Depressive Episode^4,12	--	62	67	159	226
Had Serious Thoughts of Suicide	--	--	48	82	130
Made Any Suicide Plans	--	--	16	15	32
Attempted Suicide	--	--	6	6	12
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IOWA

Table 41B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Iowa; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	269	22	58	188	247
Pain Reliever Use Disorder^1,3	41	3	3	35	38
Opioid Use Disorder^1,3,4	51	2	3	45	48
Alcohol Use Disorder¹	309	12	60	237	297
Substance Use Disorder^1,2	504	29	101	374	475
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	193	17	54	122	176
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	285	13	58	214	272
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	417	24	93	301	393
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IOWA

Table 42A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Iowa; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	12.47	6.62	20.08	11.90	13.09
Marijuana Use in the Past Year	19.34	10.69	30.86	18.47	20.26
Marijuana Use in the Past Month	11.28	5.07	19.20	10.72	11.95
Perceptions of Great Risk from Smoking Marijuana Once a Month	17.25	20.39	9.68	18.15	16.92
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.56	5.24	8.39	0.71	2.01
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.93	2.51	3.55	2.88	2.98
Cocaine Use in the Past Year	1.52	0.08	3.16	1.42	1.67
Perceptions of Great Risk from Using Cocaine Once a Month	64.28	48.83	56.14	67.60	65.93
Heroin Use in the Past Year⁵	--	--	0.22	0.25	0.25
Perceptions of Great Risk from Trying Heroin Once or Twice	80.04	56.04	73.40	84.15	82.58
Methamphetamine Use in the Past Year	1.73	0.44	0.77	2.06	1.87
Prescription Pain Reliever Misuse in the Past Year²	2.82	1.71	2.49	3.02	2.94
Opioid Misuse in the Past Year^2,6	2.82	1.76	2.79	2.97	2.94
ALCOHOL
Alcohol Use in the Past Month	54.04	10.79	55.81	59.20	58.69
Binge Alcohol Use in the Past Month⁷	24.43	4.84	31.66	25.67	26.54
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	36.67	37.67	31.28	37.47	36.56
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	19.29	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	9.40	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	23.45	4.00	17.58	26.89	25.54
Cigarette Use in the Past Month	19.64	3.03	12.66	22.92	21.43
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	61.93	63.77	63.19	61.48	61.73
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	35.82	23.47	25.26
Serious Mental Illness^4,10	--	--	11.98	5.53	6.46
Received Mental Health Services¹¹	--	--	20.74	19.96	20.07
Major Depressive Episode^4,12	--	23.65	19.08	7.67	9.33
Had Serious Thoughts of Suicide	--	--	13.65	3.97	5.38
Made Any Suicide Plans	--	--	4.64	0.75	1.31
Attempted Suicide	--	--	1.78	0.28	0.50
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

IOWA

Table 42B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Iowa; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	10.02	8.57	16.58	9.09	10.18
Pain Reliever Use Disorder^1,3	1.53	0.97	0.97	1.69	1.59
Opioid Use Disorder^1,3,4	1.90	0.96	0.90	2.18	2.00
Alcohol Use Disorder¹	11.51	4.43	17.05	11.47	12.27
Substance Use Disorder^1,2	18.79	10.99	28.64	18.09	19.62
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	7.18	6.47	15.25	5.90	7.26
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.62	5.12	16.33	10.34	11.21
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.55	9.19	26.31	14.53	16.24
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KANSAS

Table 43A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Kansas; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	318	17	72	229	301
Marijuana Use in the Past Year	459	21	109	329	438
Marijuana Use in the Past Month	294	13	73	208	281
Perceptions of Great Risk from Smoking Marijuana Once a Month	465	49	35	381	415
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	29	7	14	9	22
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	65	5	14	46	60
Cocaine Use in the Past Year	32	0	10	22	32
Perceptions of Great Risk from Using Cocaine Once a Month	1,605	121	181	1,303	1,484
Heroin Use in the Past Year⁵	--	--	0	6	6
Perceptions of Great Risk from Trying Heroin Once or Twice	1,972	142	239	1,591	1,830
Methamphetamine Use in the Past Year	31	1	1	30	31
Prescription Pain Reliever Misuse in the Past Year²	79	5	11	63	75
Opioid Misuse in the Past Year^2,6	79	5	11	63	74
ALCOHOL
Alcohol Use in the Past Month	1,197	17	191	989	1,179
Binge Alcohol Use in the Past Month⁷	572	8	107	456	564
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	970	99	108	763	871
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	52	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	29	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	620	8	69	543	612
Cigarette Use in the Past Month	472	4	44	425	469
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	1,526	160	182	1,184	1,366
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	113	389	502
Serious Mental Illness^4,10	--	--	37	105	142
Received Mental Health Services¹¹	--	--	69	353	423
Major Depressive Episode^4,12	--	54	61	140	201
Had Serious Thoughts of Suicide	--	--	40	81	121
Made Any Suicide Plans	--	--	16	20	36
Attempted Suicide	--	--	6	8	14
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KANSAS

Table 43B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Kansas; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	224	16	48	159	207
Pain Reliever Use Disorder^1,3	48	3	4	42	45
Opioid Use Disorder^1,3,4	54	3	3	48	51
Alcohol Use Disorder¹	265	9	60	196	256
Substance Use Disorder^1,2	412	20	93	298	391
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	168	13	44	111	155
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	253	9	59	185	244
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	354	17	87	250	337
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KANSAS

Table 44A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Kansas; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	13.13	7.01	22.56	12.33	13.83
Marijuana Use in the Past Year	18.95	8.63	34.09	17.74	20.13
Marijuana Use in the Past Month	12.12	5.14	22.98	11.19	12.91
Perceptions of Great Risk from Smoking Marijuana Once a Month	19.18	19.79	10.87	20.52	19.11
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.20	3.16	8.11	0.85	2.00
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.66	1.91	4.29	2.49	2.75
Cocaine Use in the Past Year	1.33	0.13	3.21	1.17	1.47
Perceptions of Great Risk from Using Cocaine Once a Month	66.26	48.83	56.73	70.21	68.24
Heroin Use in the Past Year⁵	--	--	0.13	0.31	0.28
Perceptions of Great Risk from Trying Heroin Once or Twice	81.43	57.16	74.98	85.75	84.17
Methamphetamine Use in the Past Year	1.30	0.22	0.41	1.59	1.42
Prescription Pain Reliever Misuse in the Past Year²	3.27	1.87	3.48	3.42	3.43
Opioid Misuse in the Past Year^2,6	3.26	1.85	3.44	3.42	3.42
ALCOHOL
Alcohol Use in the Past Month	49.38	7.02	59.89	53.27	54.23
Binge Alcohol Use in the Past Month⁷	23.60	3.31	33.74	24.58	25.92
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	40.04	39.93	33.89	41.12	40.06
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	14.74	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.14	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	25.59	3.12	21.78	29.24	28.16
Cigarette Use in the Past Month	19.50	1.46	13.74	22.90	21.56
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	62.97	64.22	57.18	63.80	62.83
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	35.36	20.96	23.06
Serious Mental Illness^4,10	--	--	11.57	5.67	6.53
Received Mental Health Services¹¹	--	--	21.80	19.04	19.44
Major Depressive Episode^4,12	--	21.65	19.22	7.54	9.25
Had Serious Thoughts of Suicide	--	--	12.48	4.37	5.55
Made Any Suicide Plans	--	--	4.98	1.08	1.65
Attempted Suicide	--	--	1.86	0.43	0.64
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KANSAS

Table 44B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Kansas; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.23	6.63	15.06	8.58	9.53
Pain Reliever Use Disorder^1,3	1.98	1.04	1.11	2.25	2.09
Opioid Use Disorder^1,3,4	2.23	1.05	1.08	2.58	2.36
Alcohol Use Disorder¹	10.92	3.45	18.91	10.55	11.77
Substance Use Disorder^1,2	16.99	8.15	29.22	16.07	18.00
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.95	5.35	13.87	5.98	7.13
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.44	3.64	18.52	9.97	11.22
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.62	6.86	27.43	13.47	15.51
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KENTUCKY

Table 45A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Kentucky; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	434	25	93	316	409
Marijuana Use in the Past Year	573	33	156	384	540
Marijuana Use in the Past Month	375	20	92	263	355
Perceptions of Great Risk from Smoking Marijuana Once a Month	817	91	57	669	726
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	39	13	20	6	26
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	122	7	19	95	115
Cocaine Use in the Past Year	55	1	12	43	55
Perceptions of Great Risk from Using Cocaine Once a Month	2,612	184	286	2,142	2,428
Heroin Use in the Past Year⁵	--	--	2	28	30
Perceptions of Great Risk from Trying Heroin Once or Twice	3,160	206	366	2,588	2,954
Methamphetamine Use in the Past Year	50	0	3	47	49
Prescription Pain Reliever Misuse in the Past Year²	122	7	16	99	115
Opioid Misuse in the Past Year^2,6	146	7	15	124	139
ALCOHOL
Alcohol Use in the Past Month	1,472	23	210	1,239	1,449
Binge Alcohol Use in the Past Month⁷	718	11	131	576	707
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	1,498	138	137	1,224	1,361
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	74	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	36	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,251	13	118	1,120	1,238
Cigarette Use in the Past Month	938	7	81	850	931
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	2,269	220	256	1,792	2,049
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	156	632	788
Serious Mental Illness^4,10	--	--	56	175	231
Received Mental Health Services¹¹	--	--	102	581	683
Major Depressive Episode^4,12	--	68	97	211	308
Had Serious Thoughts of Suicide	--	--	60	118	178
Made Any Suicide Plans	--	--	22	23	45
Attempted Suicide	--	--	11	10	22
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KENTUCKY

Table 45B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Kentucky; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	372	25	82	265	348
Pain Reliever Use Disorder^1,3	122	3	5	113	119
Opioid Use Disorder^1,3,4	128	3	6	118	124
Alcohol Use Disorder¹	331	13	64	254	318
Substance Use Disorder^1,2	615	26	123	465	589
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	247	21	74	152	226
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	323	11	63	249	312
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	465	22	107	337	443
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KENTUCKY

Table 46A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Kentucky; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	11.49	6.90	20.34	10.68	11.97
Marijuana Use in the Past Year	15.19	9.35	34.00	12.99	15.80
Marijuana Use in the Past Month	9.93	5.52	19.99	8.90	10.39
Perceptions of Great Risk from Smoking Marijuana Once a Month	21.65	25.55	12.41	22.61	21.24
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	1.76	3.53	7.46	0.43	1.43
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.23	2.03	4.22	3.22	3.35
Cocaine Use in the Past Year	1.47	0.15	2.57	1.46	1.60
Perceptions of Great Risk from Using Cocaine Once a Month	69.24	51.78	62.48	72.39	71.05
Heroin Use in the Past Year⁵	--	--	0.49	0.95	0.88
Perceptions of Great Risk from Trying Heroin Once or Twice	83.80	57.94	79.92	87.47	86.46
Methamphetamine Use in the Past Year	1.32	0.05	0.57	1.58	1.45
Prescription Pain Reliever Misuse in the Past Year²	3.24	2.00	3.50	3.35	3.37
Opioid Misuse in the Past Year^2,6	3.87	2.02	3.25	4.19	4.06
ALCOHOL
Alcohol Use in the Past Month	39.01	6.42	45.93	41.87	42.41
Binge Alcohol Use in the Past Month⁷	19.04	3.06	28.70	19.47	20.70
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	39.71	38.70	29.94	41.35	39.82
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.87	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	6.81	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	33.16	3.69	25.68	37.85	36.22
Cigarette Use in the Past Month	24.86	1.87	17.71	28.73	27.25
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	60.14	61.95	56.00	60.57	59.95
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	34.02	21.35	23.05
Serious Mental Illness^4,10	--	--	12.19	5.92	6.76
Received Mental Health Services¹¹	--	--	22.20	19.63	19.98
Major Depressive Episode^4,12	--	19.19	21.25	7.12	9.01
Had Serious Thoughts of Suicide	--	--	13.03	3.99	5.20
Made Any Suicide Plans	--	--	4.86	0.76	1.31
Attempted Suicide	--	--	2.43	0.35	0.63
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

KENTUCKY

Table 46B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Kentucky; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.87	6.91	17.95	8.97	10.17
Pain Reliever Use Disorder^1,3	3.23	0.91	1.13	3.83	3.47
Opioid Use Disorder^1,3,4	3.38	0.94	1.33	4.00	3.64
Alcohol Use Disorder¹	8.78	3.76	13.98	8.57	9.30
Substance Use Disorder^1,2	16.30	7.43	26.93	15.72	17.23
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.54	5.84	16.12	5.15	6.62
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	8.57	3.21	13.77	8.41	9.13
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	12.33	6.15	23.29	11.38	12.97
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

LOUISIANA

Table 47A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Louisiana; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	550	28	137	385	522
Marijuana Use in the Past Year	727	46	189	492	681
Marijuana Use in the Past Month	497	28	133	336	469
Perceptions of Great Risk from Smoking Marijuana Once a Month	896	106	55	735	790
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	42	13	20	9	29
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	140	8	16	116	132
Cocaine Use in the Past Year	66	1	12	53	65
Perceptions of Great Risk from Using Cocaine Once a Month	2,707	209	295	2,203	2,498
Heroin Use in the Past Year⁵	--	--	1	20	22
Perceptions of Great Risk from Trying Heroin Once or Twice	3,237	236	358	2,643	3,001
Methamphetamine Use in the Past Year	49	0	1	48	49
Prescription Pain Reliever Misuse in the Past Year²	143	9	15	119	134
Opioid Misuse in the Past Year^2,6	156	9	15	133	147
ALCOHOL
Alcohol Use in the Past Month	1,681	26	215	1,440	1,655
Binge Alcohol Use in the Past Month⁷	900	15	129	756	885
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	1,791	170	189	1,432	1,621
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	76	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	45	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	1,044	11	85	947	1,033
Cigarette Use in the Past Month	771	5	51	716	767
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	2,509	233	303	1,973	2,276
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	139	673	812
Serious Mental Illness^4,10	--	--	46	156	202
Received Mental Health Services¹¹	--	--	87	488	575
Major Depressive Episode^4,12	--	65	67	212	280
Had Serious Thoughts of Suicide	--	--	50	113	164
Made Any Suicide Plans	--	--	29	25	53
Attempted Suicide	--	--	13	20	33
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

LOUISIANA

Table 47B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Louisiana; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	396	34	80	281	361
Pain Reliever Use Disorder^1,3	104	4	6	94	100
Opioid Use Disorder^1,3,4	114	4	7	104	110
Alcohol Use Disorder¹	399	10	61	328	389
Substance Use Disorder^1,2	698	40	120	537	657
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	316	27	71	218	289
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	398	10	60	327	387
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	607	34	112	461	573
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

LOUISIANA

Table 48A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Louisiana; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	14.39	7.48	30.32	12.85	15.14
Marijuana Use in the Past Year	19.03	12.24	41.71	16.44	19.76
Marijuana Use in the Past Month	13.00	7.54	29.32	11.22	13.60
Perceptions of Great Risk from Smoking Marijuana Once a Month	23.44	28.30	12.20	24.55	22.92
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.07	4.44	8.40	0.59	1.62
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.66	2.13	3.57	3.86	3.83
Cocaine Use in the Past Year	1.72	0.22	2.60	1.77	1.88
Perceptions of Great Risk from Using Cocaine Once a Month	70.82	55.72	65.11	73.57	72.45
Heroin Use in the Past Year⁵	--	--	0.33	0.68	0.63
Perceptions of Great Risk from Trying Heroin Once or Twice	84.72	62.90	79.02	88.28	87.06
Methamphetamine Use in the Past Year	1.29	0.12	0.27	1.59	1.41
Prescription Pain Reliever Misuse in the Past Year²	3.75	2.40	3.30	3.99	3.90
Opioid Misuse in the Past Year^2,6	4.08	2.37	3.22	4.43	4.27
ALCOHOL
Alcohol Use in the Past Month	43.99	6.94	47.48	48.10	48.02
Binge Alcohol Use in the Past Month⁷	23.54	4.00	28.39	25.25	25.67
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	46.86	45.43	41.79	47.82	47.02
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.59	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.15	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	27.31	2.96	18.86	31.64	29.96
Cigarette Use in the Past Month	20.18	1.21	11.18	23.92	22.24
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	65.65	62.27	66.92	65.88	66.01
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	30.59	22.48	23.54
Serious Mental Illness^4,10	--	--	10.14	5.20	5.85
Received Mental Health Services¹¹	--	--	19.19	16.31	16.69
Major Depressive Episode^4,12	--	17.40	14.86	7.09	8.11
Had Serious Thoughts of Suicide	--	--	11.08	3.79	4.75
Made Any Suicide Plans	--	--	6.30	0.82	1.54
Attempted Suicide	--	--	2.98	0.66	0.96
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

LOUISIANA

Table 48B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Louisiana; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	10.35	9.18	17.66	9.40	10.48
Pain Reliever Use Disorder^1,3	2.72	1.08	1.27	3.15	2.90
Opioid Use Disorder^1,3,4	2.99	1.10	1.44	3.46	3.20
Alcohol Use Disorder¹	10.45	2.72	13.48	10.96	11.29
Substance Use Disorder^1,2	18.26	10.77	26.48	17.95	19.07
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	8.27	7.31	15.56	7.28	8.37
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	10.40	2.80	13.22	10.93	11.23
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	15.89	9.12	24.73	15.39	16.62
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MAINE

Table 49A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Maine; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	241	8	37	195	232
Marijuana Use in the Past Year	298	11	51	236	287
Marijuana Use in the Past Month	222	8	36	179	214
Perceptions of Great Risk from Smoking Marijuana Once a Month	192	16	8	168	176
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	14	4	6	5	11
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	35	2	5	28	33
Cocaine Use in the Past Year	23	0	4	18	23
Perceptions of Great Risk from Using Cocaine Once a Month	759	48	64	648	711
Heroin Use in the Past Year⁵	--	--	*	6	7
Perceptions of Great Risk from Trying Heroin Once or Twice	988	54	93	841	934
Methamphetamine Use in the Past Year	10	0	1	9	10
Prescription Pain Reliever Misuse in the Past Year²	32	1	3	27	30
Opioid Misuse in the Past Year^2,6	38	1	3	33	36
ALCOHOL
Alcohol Use in the Past Month	590	7	70	512	583
Binge Alcohol Use in the Past Month⁷	212	3	37	172	209
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	452	36	35	382	416
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	25	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	11	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	253	3	28	222	250
Cigarette Use in the Past Month	226	2	17	207	224
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	783	60	79	644	723
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	43	215	258
Serious Mental Illness^4,10	--	--	14	44	59
Received Mental Health Services¹¹	--	--	34	214	248
Major Depressive Episode^4,12	--	19	24	73	97
Had Serious Thoughts of Suicide	--	--	17	31	47
Made Any Suicide Plans	--	--	5	5	9
Attempted Suicide	--	--	2	2	5
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MAINE

Table 49B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Maine; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	112	7	22	84	105
Pain Reliever Use Disorder^1,3	23	1	1	21	22
Opioid Use Disorder^1,3,4	25	1	1	23	24
Alcohol Use Disorder¹	124	3	17	104	121
Substance Use Disorder^1,2	200	8	32	160	192
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	78	6	20	52	72
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	118	3	17	98	115
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	169	7	28	134	162
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MAINE

Table 50A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Maine; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	20.04	9.11	30.94	19.73	20.95
Marijuana Use in the Past Year	24.83	11.71	42.24	23.93	25.94
Marijuana Use in the Past Month	18.54	8.58	29.41	18.13	19.37
Perceptions of Great Risk from Smoking Marijuana Once a Month	15.99	17.46	6.91	16.98	15.87
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.56	4.16	10.97	1.08	2.27
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	2.89	1.76	3.98	2.85	2.98
Cocaine Use in the Past Year	1.91	0.11	3.56	1.88	2.06
Perceptions of Great Risk from Using Cocaine Once a Month	63.26	51.80	52.46	65.68	64.21
Heroin Use in the Past Year⁵	--	--	*	0.58	0.62
Perceptions of Great Risk from Trying Heroin Once or Twice	82.38	58.62	77.08	85.23	84.34
Methamphetamine Use in the Past Year	0.84	0.03	0.84	0.91	0.91
Prescription Pain Reliever Misuse in the Past Year²	2.63	1.31	2.56	2.77	2.75
Opioid Misuse in the Past Year^2,6	3.13	1.36	2.56	3.37	3.28
ALCOHOL
Alcohol Use in the Past Month	49.17	7.70	58.12	51.93	52.63
Binge Alcohol Use in the Past Month⁷	17.71	3.52	30.80	17.43	18.89
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	37.68	38.49	28.62	38.71	37.61
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	18.43	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.06	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	21.06	3.32	22.88	22.52	22.55
Cigarette Use in the Past Month	18.81	1.96	14.10	20.98	20.23
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	65.25	64.55	65.09	65.33	65.30
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	35.41	21.78	23.28
Serious Mental Illness^4,10	--	--	11.89	4.50	5.31
Received Mental Health Services¹¹	--	--	28.35	21.69	22.42
Major Depressive Episode^4,12	--	20.13	20.16	7.38	8.78
Had Serious Thoughts of Suicide	--	--	13.75	3.13	4.29
Made Any Suicide Plans	--	--	4.00	0.46	0.84
Attempted Suicide	--	--	1.99	0.23	0.42
* = low precision; no estimate reported; -- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MAINE

Table 50B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Maine; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.35	7.41	18.00	8.47	9.51
Pain Reliever Use Disorder^1,3	1.91	0.71	0.90	2.15	2.02
Opioid Use Disorder^1,3,4	2.08	0.70	0.97	2.35	2.20
Alcohol Use Disorder¹	10.37	3.63	14.12	10.53	10.93
Substance Use Disorder^1,2	16.64	8.58	26.27	16.21	17.31
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	6.48	6.36	16.66	5.24	6.49
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	9.86	3.28	13.94	9.97	10.41
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	14.08	7.34	22.85	13.63	14.65
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MARYLAND

Table 51A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Maryland; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	768	34	166	569	735
Marijuana Use in the Past Year	988	50	230	708	938
Marijuana Use in the Past Month	724	24	162	538	700
Perceptions of Great Risk from Smoking Marijuana Once a Month	1,093	103	65	925	990
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	61	22	25	13	38
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	169	9	25	134	160
Cocaine Use in the Past Year	115	0	19	96	115
Perceptions of Great Risk from Using Cocaine Once a Month	3,338	233	335	2,771	3,105
Heroin Use in the Past Year⁵	--	--	2	43	45
Perceptions of Great Risk from Trying Heroin Once or Twice	4,230	281	456	3,493	3,949
Methamphetamine Use in the Past Year	28	1	1	26	27
Prescription Pain Reliever Misuse in the Past Year²	185	12	20	154	173
Opioid Misuse in the Past Year^2,6	188	12	18	158	177
ALCOHOL
Alcohol Use in the Past Month	2,599	25	289	2,285	2,574
Binge Alcohol Use in the Past Month⁷	1,158	14	184	960	1,144
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	2,307	212	224	1,870	2,095
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	92	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	58	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	846	11	87	748	836
Cigarette Use in the Past Month	701	3	70	628	698
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	3,801	298	395	3,108	3,503
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	203	886	1,089
Serious Mental Illness^4,10	--	--	68	139	207
Received Mental Health Services¹¹	--	--	131	738	870
Major Depressive Episode^4,12	--	93	118	254	372
Had Serious Thoughts of Suicide	--	--	79	118	197
Made Any Suicide Plans	--	--	34	22	56
Attempted Suicide	--	--	15	8	24
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation = X₁ ÷ 2, where X₁ is the number of marijuana initiates in the past 24 months. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MARYLAND

Table 51B – Substance Use Disorder and Treatment in the Past Year: Among People Aged 12 or Older in Maryland; by Age Group, Estimated Numbers (in Thousands), 2021
Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	480	30	123	326	449
Pain Reliever Use Disorder^1,3	88	6	8	74	82
Opioid Use Disorder^1,3,4	102	6	7	90	97
Alcohol Use Disorder¹	578	14	105	458	564
Substance Use Disorder^1,2	922	38	173	711	884
Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use^5,6,7	374	26	111	237	348
Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use⁵	550	12	104	435	538
Needing But Not Receiving Treatment at a Specialty Facility for Substance Use^5,6,7	783	33	170	579	750
NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-estimated-totals-state. NOTE: Estimated numbers appearing as 0 in this table mean that the estimate is greater than 0 but less than 500 because estimated numbers are shown in thousands. ¹ Substance Use Disorder (SUD) estimates are based on Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. SUD is defined as meeting the criteria for drug or alcohol use disorder. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows include prescription drug use disorder data from all past year users of prescription drugs. ² Drug use includes the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine in the past year or any use (i.e., not necessarily misuse) of prescription pain relievers, tranquilizers, stimulants, or sedatives in the past year. ³ Pain relievers are a type of prescription drug. ⁴ Opioid Use Disorder is defined as meeting the criteria for heroin or pain reliver use disorder. ⁵ Respondents were classified as needing substance use treatment if they met the DSM-5 criteria for an illicit drug or alcohol use disorder 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). Substance use treatment questions are asked of respondents who used alcohol or illicit drugs in their lifetime. Respondents who used prescription drugs but who did not misuse prescription drugs in their lifetime may not receive these questions. Needing But Not Receiving Substance Use Treatment refers to respondents who are classified as needing illicit drug or alcohol use treatment but who did not receive illicit drug or alcohol use treatment at a specialty facility. ⁶ Illicit drug or alcohol use disorder estimates are based on DSM-5 criteria. Beginning with the 2021 NSDUH, questions on prescription drug use disorder were asked of all past year users of prescription drugs, regardless of whether they misused prescription drugs. The estimates in these rows do not include prescription drug use disorder data from the past year users of prescription drugs who were not also misusers of prescription drugs. ⁷ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

221027

MARYLAND

Table 52A – Substance Use, Perceptions of Great Risk, and Mental Health Measures: Among People Aged 12 or Older in Maryland; by Age Group, Percentages, 2021
Measure	12+	12-17	18-25	26+	18+
ILLICIT DRUGS
Illicit Drug Use in the Past Month^1,2	14.81	7.10	28.30	13.79	15.60
Marijuana Use in the Past Year	19.05	10.41	39.22	17.18	19.93
Marijuana Use in the Past Month	13.97	5.04	27.69	13.04	14.87
Perceptions of Great Risk from Smoking Marijuana Once a Month	21.06	21.54	11.10	22.43	21.01
First Use of Marijuana in the Past Year among Those at Risk for Initiation of Marijuana Use^3,4	2.11	5.01	8.52	0.63	1.60
Illicit Drug Use Other Than Marijuana in the Past Month^1,2	3.25	1.85	4.34	3.26	3.39
Cocaine Use in the Past Year	2.22	0.03	3.27	2.32	2.44
Perceptions of Great Risk from Using Cocaine Once a Month	64.36	48.87	57.08	67.19	65.92
Heroin Use in the Past Year⁵	--	--	0.29	1.04	0.95
Perceptions of Great Risk from Trying Heroin Once or Twice	81.57	59.02	77.70	84.70	83.82
Methamphetamine Use in the Past Year	0.54	0.14	0.25	0.62	0.58
Prescription Pain Reliever Misuse in the Past Year²	3.57	2.44	3.36	3.73	3.68
Opioid Misuse in the Past Year^2,6	3.63	2.42	3.14	3.84	3.75
ALCOHOL
Alcohol Use in the Past Month	50.11	5.24	49.19	55.42	54.65
Binge Alcohol Use in the Past Month⁷	22.32	3.00	31.28	23.28	24.28
Perceptions of Great Risk from Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week	44.47	44.52	38.25	45.36	44.47
Alcohol Use in the Past Month⁸ (People Aged 12 to 20)	13.25	--	--	--	--
Binge Alcohol Use in the Past Month^7,8 (People Aged 12 to 20)	8.36	--	--	--	--
TOBACCO PRODUCTS
Tobacco Product Use in the Past Month⁹	16.31	2.23	14.86	18.15	17.74
Cigarette Use in the Past Month	13.51	0.55	11.99	15.23	14.82
Perceptions of Great Risk from Smoking One or More Packs of Cigarettes per Day	73.27	62.52	67.31	75.37	74.36
MENTAL HEALTH MEASURES IN THE PAST YEAR
Any Mental Illness^4,10	--	--	34.61	21.49	23.13
Serious Mental Illness^4,10	--	--	11.57	3.36	4.39
Received Mental Health Services¹¹	--	--	22.39	17.90	18.46
Major Depressive Episode^4,12	--	19.57	20.06	6.16	7.89
Had Serious Thoughts of Suicide	--	--	13.45	2.86	4.18
Made Any Suicide Plans	--	--	5.80	0.54	1.19
Attempted Suicide	--	--	2.60	0.20	0.50
-- = not available. NOTE: Estimates are based on a survey-weighted hierarchical Bayes small area estimation approach. For confidence intervals, see Tables 1 to 35 in 2021 National Survey on Drug Use and Health: Model-Based Prevalence Estimates (50 States and the District of Columbia) at https://www.samhsa.gov/data/report/2021-nsduh-state-prevalence-estimates. ¹ Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana (including vaping), cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drug Use Other Than Marijuana includes the misuse of prescription psychotherapeutics or the use of cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Illicit Drugs Other Than Marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ² Prescription pain relievers are a type of prescription psychotherapeutic. Misuse of prescription psychotherapeutics is 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; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. ³ First use of marijuana in the past year among those at risk for initiation (%) = 100 × {[X₁ ÷ (0.5 × X₁ + X₂)] ÷ 2}, where X₁ is the number of marijuana initiates in the past 24 months and X₂ is the number of individuals who never used marijuana (with the at-risk population defined as 0.5 × X₁ + X₂). Both of the computation components, X₁ and X₂, are based on a survey-weighted hierarchical Bayes small area estimation approach. The age group shown is based on a respondent’s age at the time of the interview, not his or her age at first use. ⁴ For details, see Section B of 2021 National Survey on Drug Use and Health: Guide to State Tables and Summary of Small Area Estimation Methodology at https://www.samhsa.gov/data/report/2021-nsduh-guide-state-tables-and-summary-sae-methodology. ⁵ Estimates for youths aged 12 to 17 are not available for past year heroin use because past year heroin use was extremely rare among youths aged 12 to 17 in the 2021 NSDUH. As a result, estimates for people aged 12 or older are also not produced. ⁶ Respondents were classified as misusing opioids in the past year if they reported using heroin or misusing prescription pain relievers in the past year. ⁷ Binge Alcohol Use is defined as drinking five or more drinks (for males) or four or more drinks (for females) on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. ⁸ Underage drinking is defined for individuals aged 12 to 20; therefore, the “12+” estimate reflects that age group and not individuals aged 12 or older. ⁹ Tobacco Products include cigarettes, smokeless tobacco (i.e., snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. ¹⁰ Mental Illness aligns with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Estimates of serious mental illness (SMI) are a subset of estimates of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These estimates are based on indicators of AMI and SMI rather than direct measures of diagnostic status. ¹¹ Mental Health Services for adults includes inpatient treatment/counseling; outpatient treatment/counseling; or use of prescription medication for problems with emotions, nerves, or mental health. ¹² Major depressive episode (MDE) is based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition, which specifies a period of at least 2 weeks when an individual experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. There are minor wording differences in the questions in the adult and adolescent MDE modules. Therefore, data from youths aged 12 to 17 were not combined with data from adults aged 18 or older to produce an estimate for those aged 12 or older. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021.

Measure	12+	12-17	18-25	26+	18+
SUBSTANCE USE DISORDER AND TREATMENT
Drug Use Disorder^1,2	9.24	6.36