Results from the 2024 National Survey on Drug Use and Health: Detailed Tables

Introduction

The Results from the 2024 National Survey on Drug Use and Health: Detailed Tables is a collection of tables presenting national estimates from the National Survey on Drug Use and Health (NSDUH). These tables present combined information for youths aged 12 to 17 and adults aged 18 or older on drug, alcohol, and tobacco use (including nicotine vaping), as well as substance use disorder (SUD), risk and availability of substance use, and treatment topics. Specific to youths, these tables present separate information on youth experiences, mental health treatment, suicidality, major depressive episode (MDE), co-occurrence of MDE with substance use or with SUDs, and severity of symptoms of generalized anxiety disorder (GAD). Specific to adults, these tables present separate information on any mental illness (AMI), serious mental illness (SMI), mental health treatment, suicidality, MDE, GAD, serious psychological distress (SPD), and co-occurrence of mental disorders with substance use or with SUDs. Estimates are presented by a variety of demographic, geographic, and other variables. The tables include prevalence rates of the behaviors, numbers of people engaging in these behaviors, and other statistics.

The reference tools section summarizes the tools provided to help navigate the detailed tables and to define the topics presented within them. These tools include the Table of Contents; glossary; List of Tables, including titles, numbers, and types; and a search feature. A glossary of topics and terms used in these detailed tables can be found in Appendix A. Where relevant, the glossary provides cross-references to refer data users to the correct entry in the glossary or to aid data users in understanding the meaning of the current definition. In addition to these tools, several NSDUH reports include more details on the topics presented in the detailed tables. The 2024 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions report provides further analytic details on the survey topics, design, and methodology.¹ The Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health report focuses on presenting data among people aged 12 or older.² The 2024 Companion Infographic Report: Results from the 2021 to 2024 National Surveys on Drug Use and Health shows comparisons of selected estimates from 2021 to 2024 among people aged 12 or older.³ Additional 2024 national reports and products can be found on the NSDUH Data Collection web page.

Survey Background

NSDUH is an annual multimode survey sponsored by the Substance Abuse and Mental Health Services Administration within the U.S. Department of Health and Human Services. The target population for NSDUH is the civilian, noninstitutionalized population aged 12 years or older residing within the United States. The survey covers residents of households (e.g., individuals living in houses or townhouses, apartments, and condominiums; civilians living in housing on military bases) and individuals in noninstitutional group quarters (e.g., shelters, rooming or boarding houses, college dormitories, migratory workers’ camps, halfway houses). The survey does not cover individuals without a fixed household address (e.g., homeless and/or transient people not in shelters), active-duty military personnel, and residents of institutional group quarters, such as jails or hospitals. Those who are unable to take the survey in either English or Spanish are part of the eligible population but are unable to complete it. For more information, see the 2024 Methodological Summary and Definitions report.

Analysis Weights

NSDUH person-level weights are calibrated to population estimates for the state and demographic domains provided by the U.S. Census Bureau. Starting with the 2021 NSDUH, population estimates based on the 2020 decennial census were used in developing the person-level analysis weights.

The use of multimode data collection starting in 2021 increased nonresponse rates due to web respondents discontinuing the survey prior to completion (i.e., breaking off). To reduce the potential bias that would arise from handling missing data due to break-offs the same way that other missing data (i.e., responses of “don’t know” or “refused”) were handled in analyses (i.e., excluding missing data or zero-fill method), break-off analysis weights were created. These break-off analysis weights were used for a subset of unimputed measures that were derived from questions asked later in the survey.

Relatively few youths aged 12 to 17 broke off the interview after the youth experiences section. Therefore, a break-off adjustment was not performed for youths aged 12 to 17. Nevertheless, a break-off weight was created for youths for use in analyses for people aged 12 or older that required the break-off analysis weight. For these analyses, the break-off weight that was created for youths was the same as the main weight. For more information on the analysis weights, see the 2024 Methodological Summary and Definitions report.

Analyses conducted for the 2021 NSDUH indicated that key substance use and mental health estimates differed between data collection modes (i.e., web or in person); these differences are known as “mode effects.” Specifically, web respondents tended to be less likely than in-person respondents to report most substance use or mental health issues. Weighting reduced the mode effects somewhat but not enough to eliminate statistically significant differences.

As long as the proportion of interviews completed via these two different modes is stable across years, then mode effects would have little effect on differences in estimates over time. However, the proportions of interviews completed via the web or in person had not stabilized in 2021 and 2022. Specifically, more than half of interviews in 2021 (54.6 percent) were completed via the web, but less than half in 2022 (42.4 percent) were completed via the web. Moreover, less than 40 percent of interviews in Quarter 2 (April to June) and Quarter 4 (October to December) of 2022 were completed via the web. Consequently, mode effects could distort differences in estimates between 2021 and 2022, unless the analysis weights are adjusted to take these different mode proportions into account.

The analysis weights used for tables for the 2021 NSDUH included two-way interactions of quarter with other demographic characteristics in the adjustment models as a means of partially accounting for quarterly variations in interview mode proportions. However, including these interaction terms did not adjust the proportions of interviews that were completed via the web or in person to a set of fixed proportions. Without further adjustment to the weights, apparent increases in estimates between 2021 and 2022 could be due to a greater proportion of in-person interviews in 2022 rather than real changes in the population. Stated another way, apparent increases in estimates for 2022 could be partially due to the greater proportion of in-person respondents in 2022, and not just to true changes in prevalence in the population. Similarly, decreases in prevalence may be partially obscured by the changes in proportions.

For this reason, the 2024 Detailed Tables include revised estimates for 2021 that were created using the updated person-level weights. These updated weights for 2021 were adjusted so that 2021 and 2022 estimates were based on consistent annual mode proportions for comparison. Consequently, NSDUH estimates for 2021 that are presented in the 2024 Detailed Tables may differ from the previously published estimates in national reports and tables for the 2021 NSDUH. For more information on the creation of the revised weights, investigations to update the 2021 weights, and the effects of the recalibrated 2021 weights on the 2021 estimates, see the 2022 Methodological Summary and Definitions report.⁴

Changes and Impact

NSDUH has undergone changes over the years to improve the quality of its data and to address the changing needs of policymakers and researchers with regard to substance use and mental health issues. Information pertaining to some of the major changes for the 2024 NSDUH are summarized below. For more information on the revisions summarized below as well as other revisions to the survey including imputed measures, see the 2024 Methodological Summary and Definitions report.

Inhalant Use

Questions for inhalant use were revised for the 2024 NSDUH. The introductory language for the inhalants section was revised for brevity, and the individual inhalant question wording was revised from asking about use of inhalants “for kicks or to get high” to “for fun or to get high.” The wording update was intended to make the questions more relatable and understandable, especially for younger respondents. Review of the final data from all 12 months of 2024 indicated that this change in questionnaire wording affected the reporting of the use of inhalants, especially among adolescent respondents aged 12 to 17.

Consequently, 2024 estimates in the detailed tables based on questions from the inhalants section of the interview were considered not to be comparable with those from prior years for the following:

• lifetime, past year, and past month use of any inhalant;
• lifetime use of all specific inhalants (e.g., amyl nitrite, poppers, locker room odorizers, or Rush; correction fluid, degreaser, or cleaning fluid; gasoline or lighter fluid);
• past year initiation of inhalant use, including risk for initiation, age at first use, and the date of first use; and
• past year and past month frequency of use (i.e., number of days used).

The 2024 estimates in the detailed tables also were considered not to be comparable with those from prior years for the use of illicit drugs other than marijuana in the lifetime, past year, and past month because a relatively large proportion of people who used illicit drugs other than marijuana used inhalants.

The change in question wording for inhalants did not appear to affect the comparability of estimates between 2024 and prior years for the overall use of any illicit drug in the lifetime, past year, and past month and for inhalant use disorder in the past year. However, investigations into comparability were limited and may not cover other comparisons that data users want to make.

Youth Experiences

Starting with the 2024 NSDUH, response options were revised for questions corresponding to how respondents aged 12 to 17 think their parents would feel about them using substances. Response options also were revised for questions corresponding to how respondents would feel about their peers using substances. Two new response options were added for “strongly approve” and “somewhat approve.” The response option order was also reversed to begin with “strongly disapprove” as a first option and “strongly approve” as the last option. Prior to 2024, response options for these questions were limited to “neither approve nor disapprove,” “somewhat disapprove,” and “strongly disapprove.” The following behaviors were asked about in these questions:

• smoking cigarettes every day (revised from asking about smoking one or more packs of cigarettes per day),
• trying marijuana or any cannabis product,
• using marijuana or any cannabis product once a month or more, and
• having one or two alcoholic beverages nearly every day.

Also beginning in 2024, the question measuring screen time was revised to ask respondents aged 12 to 17 how often their parents limited the amount of time spent with television, tablets, smartphones, computer, or video games. Prior to 2024, respondents were asked specifically how often their parents limited the amount of time they watched television in the past 12 months.

Because of these changes for 2024, these measures are not considered comparable with those from prior years.

Substance Use Treatment

New follow-up questions were added to the 2024 NSDUH for respondents who reported that they received treatment in an inpatient or outpatient location but they did not report any substances for which they received treatment. These respondents were given a second opportunity to specify the substances for which they received inpatient or outpatient treatment or to enter “None” if they did not receive treatment.

Starting in June 2024, additional changes were included in the questionnaire to improve respondent understanding of whether they received treatment for their use of alcohol or drugs at specific inpatient or outpatient locations. The following changes were made:

• Introductory text for questions about inpatient and outpatient treatment was revised to mention “any of the locations below” for response choices for specific locations.
• For each inpatient and outpatient location that was presented to respondents, text was added to indicate that the treatment was “for alcohol or drug treatment.” For example, the response option for a mental health treatment center as an outpatient was revised to mention a mental health center as an outpatient “for alcohol or drug treatment.”
• In the grid format for respondents to report the locations where they received inpatient treatment, the heading “Stayed overnight or longer for alcohol or drug treatment in…” was replaced with “LOCATION.”
• In the grid format for respondents to report the locations where they received outpatient treatment, the heading “Received outpatient alcohol or drug treatment at…” was replaced with “LOCATION.”

Analysis of the data from June to December 2024 indicated that the changes implemented in June 2024 not only reduced the number of respondents who did not report the specific substances for which they received inpatient or outpatient treatment but also affected reporting of the receipt of treatment in inpatient and outpatient locations. As a consequence of these changes, substance use treatment estimates overall and for inpatient or outpatient locations from 2024 are not comparable with those from 2023.

Due to the changes for 2024 that were described previously, estimates from 2024 for the perceived unmet need for substance use treatment and reasons for not receiving treatment also are not considered comparable with corresponding estimates from prior years.

Mental Health Treatment

Starting in June 2024, changes were included in the questionnaire to improve respondent understanding of whether they received treatment for their mental health, emotions, or behavior at specific inpatient or outpatient locations. The following changes were made:

• Introductory text for questions about inpatient and outpatient treatment was revised to mention “any of the locations below” for response choices for specific locations.
• For each inpatient and outpatient location that was presented to respondents, text was added to indicate that the treatment was “for mental health, emotions, or behavior.” For example, the response option for receiving treatment at a general medical clinic or doctor’s office as an outpatient was revised to mention receiving treatment at a general medical clinic or doctor’s office as an outpatient “for mental health, emotions, or behavior.”
• In the grid format for respondents to report the locations where they received inpatient treatment, the heading “Stayed overnight or longer for treatment in…” was replaced with “LOCATION.”
• In the grid format for respondents to report the locations where they received outpatient treatment, the heading “Received outpatient treatment at…” was replaced with “LOCATION.”

Analysis of the data from June to December 2024 indicated that the changes to the mental health treatment questions in June 2024 affected estimates of the receipt of any mental health treatment, inpatient mental health treatment, and outpatient mental health treatment in the past year. As a consequence of these changes, mental health treatment estimates overall and for inpatient or outpatient locations from 2024 are not comparable with those from 2023.

Due to the changes for 2024 that were described previously, estimates from 2024 for the perceived unmet need for mental health treatment and reasons for not receiving treatment also are not considered comparable with corresponding estimates from prior years.

Opioid Use

Beginning with the 2024 NSDUH, opioids refer to heroin or prescription opioids. Measures were created for both any use of opioids and misuse of opioids that do not include the use of illegally made fentanyl (IMF). Measures of misuse of opioids that do include IMF are also available. See Chapter 4 in the 2024 Methodological Summary and Definitions report for additional details.

Because of the change in definition, 2021-2023 estimates in the 2024 Detailed Tables may differ from previously published estimates for the following measures:

• any use of opioids in past year,
• misuse of opioids in past year and past month,
• misuse of opioids including IMF in past year and past month, and
• opioid use disorder in past year.

Changes to Suppression

Beginning with SAMHSA publications that include 2024 NSDUH data, direct estimates from NSDUH are defined as unreliable based on the following:

• prevalence (for proportion estimates),
• relative standard error (RSE, defined as the SE divided by the estimate), and
• sample size.

The suppression criteria for the prevalence rates, were changed for data products using 2024 NSDUH data, primarily for greater simplicity. The new suppression criteria for 2024 were also applied to estimates from 2021 to 2023 presented in the 2024 Detailed Tables. Consequently, some estimates from 2021 to 2023 that were suppressed in prior years may be published in reports and tables for the 2024 NSDUH. For documentation of the suppression rules used in earlier reports and tables, see Chapter 3 in the 2023 Methodological Summary and Definitions.⁵

Table Presentation

The 2024 Detailed Tables present estimates from the 2021-2024 NSDUHs. The following sections provide information on how the tables are organized, the types and purpose of tables that are available, information about specific indicators used for the tables, information on missingness, information on the impact of rounding on estimates presented in the tables, and how totals are to be interpreted within the tables.

Table Numbering

The detailed tables are numbered using a three-part numbering scheme (e.g., 1.15A). The first part of the table number (1.15A) is the subject matter section to which a particular table belongs. The second part (1.15A) is the number of the table within a particular section. The third part (1.15A) is a table type indicator, an alphabetic letter appended to the table number. Each table number, as explained below, has multiple table types. Tables are numbered sequentially within each subject matter section. Identical tables across years may not be assigned the same table number each year.

The 10 subject matter sections and the number of tables per section in 2024 are as follows:

• Section 1: Illicit Drug Use/Misuse Tables - 1.1 to 1.134
• Section 2: Tobacco Product Use, Nicotine Vaping, and Alcohol Use Tables - 2.1 to 2.47
• Section 3: Risk and Protective Factor Tables - 3.1 to 3.15
• Section 4: Incidence Tables - 4.1 to 4.11
• Section 5: Substance Use Disorder and Treatment Tables - 5.1 to 5.36
• Section 6: Adult Mental Health Tables - 6.1 to 6.89
• Section 7: Youth Mental Health Tables - 7.1 to 7.42
• Section 8: Miscellaneous Tables - 8.1 to 8.39
• Section 9: Trend Tables - 9.1 to 9.83
• Section 10: Sample Size and Population Tables - 10.1 to 10.8

Table Types and Purpose

The table type indicators are primarily defined as follows:

Table Indicators

Each 2024 detailed table, including those for all of the above table types, contains the following definitional footnote, regardless of whether any or all of the indicators were used in the table:

* = low precision; -- = not available or not comparable due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues.

The “* = low precision” portion of the footnote indicates an estimate is being suppressed (i.e., not shown) due to low precision. For more information on how low precision is defined, see Section 3.2.2 of the 2024 Methodological Summary and Definitions report.

The “-- = not available or not comparable due to methodological or questionnaire changes” portion of the footnote indicates that for the given year, either the questions used to produce the estimates were not available or the measures exist for prior years but are no longer comparable with the current year estimate. For example, information about past year use of pipe tobacco is not collected. Thus, estimates for past year pipe tobacco use are shown with the “--” notation.

The “da = does not apply” portion of the footnote indicates that the question or estimate does not apply to a certain group. For example, in the incidence tables that show numbers in thousands and percentages in the same table, the p values for the numbers in thousands are replaced with “da” because the detailed tables show only p values of tests of differences of percentages.

The “nr = not reported due to measurement issues” portion of the footnote indicates that the estimate could be calculated based on available data but is not calculated due to potential measurement issues. For example, lifetime use of prescription pain relievers is shown as “nr” because the questionnaire was changed to focus on past year misuse of pain relievers rather than lifetime use of pain relievers, and there appears to be an underestimate of lifetime pain reliever use compared with prior years.

Rounding and Estimate Presentation

Definitions of Totals

Totals are defined in different ways within the detailed tables. Totals can refer to the estimated number of people with a specific characteristic, as shown in table type A and displayed in numbers of thousands. For example, in Table 2.1, the total estimated population of youths aged 12 to 17 who used cigarettes in the past year in 2024 was approximately 802,000 and was shown as 802 in table type A. Totals can also be presented in the table rows or columns, either as a total of a subgroup category or listed as the “Total Population.” If the estimate is a total of a subgroup category (e.g., total of sex), the estimate is the total number of both males and females combined. Instances where measures have missing data may cause the subcategories to not add up to a total and are noted in the tables. If the estimate is shown as the “Total Population” on the row, then that estimate is usually included as a reference. This total population estimate is normally the number being used in the denominator to allow users to easily see that estimate without having to switch tables. For example, in Table 6.17, the total population row for table type A shows the estimated number of people who fit the criteria in the columns, which are the column denominators (i.e., there was an estimated 61,506,000 adults with past year any mental illness for 2024), and this number is used as the denominator in all the 2024 substance use disorder severity estimates.