Section 9 PE - Results from the 2025 National Survey on Drug Use and Health: Detailed Tables, SAMHSA, CBHSQ

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Table 9.1A – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	235,799	238,006	242,804	240,934
Illicit Drugs or Nicotine Products^1,2	‑‑	193,531	195,171	199,643	195,383
Illicit Drugs or Alcohol^1,2	226,306	227,710	230,916	236,039	233,523
Nicotine Products or Alcohol	‑‑	232,461	234,635	238,414	238,141
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	200,284	200,711	203,572	198,982
Illicit Drugs or Nicotine Products^1,3,4	‑‑	109,387	110,455	112,278	110,640
Illicit Drugs or Alcohol¹	184,403	188,483	188,929	191,873	186,798
Nicotine Products or Alcohol^3,4	‑‑	194,805	194,779	197,123	192,692
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	168,668	167,179	167,994	162,797
Illicit Drugs or Nicotine Products^1,4	‑‑	85,966	87,709	86,973	87,078
Illicit Drugs or Alcohol¹	144,572	151,343^a	149,194	149,803	144,657
Nicotine Products or Alcohol⁴	‑‑	162,316	160,093	160,789	155,643
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.1B – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	83.6	84.0^a	84.2^b	82.9
Illicit Drugs or Nicotine Products^1,2	‑‑	68.6^a	68.9^b	69.3^b	67.3
Illicit Drugs or Alcohol^1,2	80.9	80.7	81.5^a	81.9^b	80.4
Nicotine Products or Alcohol	‑‑	82.4	82.8	82.7	82.0
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	71.0^b	70.8^b	70.6^b	68.5
Illicit Drugs or Nicotine Products^1,3,4	‑‑	38.8	39.0	39.0	38.1
Illicit Drugs or Alcohol¹	65.9^b	66.8^b	66.7^b	66.6^b	64.3
Nicotine Products or Alcohol^3,4	‑‑	69.1^b	68.7^b	68.4^b	66.3
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	59.8^b	59.0^b	58.3^b	56.0
Illicit Drugs or Nicotine Products^1,4	‑‑	30.5	30.9	30.2	30.0
Illicit Drugs or Alcohol¹	51.7^b	53.7^b	52.6^b	52.0^b	49.8
Nicotine Products or Alcohol⁴	‑‑	57.6^b	56.5^b	55.8^b	53.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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Table 9.2A – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	‑‑	‑‑	‑‑	8,018
Illicit Drugs or Nicotine Products^1,2	‑‑	‑‑	‑‑	‑‑	6,319
Illicit Drugs or Alcohol^1,2	‑‑	‑‑	‑‑	‑‑	6,707
Nicotine Products or Alcohol	‑‑	7,669	7,593	7,308	7,117
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	‑‑	‑‑	‑‑	5,718
Illicit Drugs or Nicotine Products^1,3,4	‑‑	‑‑	‑‑	‑‑	4,111
Illicit Drugs or Alcohol¹	‑‑	‑‑	‑‑	‑‑	4,964
Nicotine Products or Alcohol^3,4	‑‑	5,883^b	5,918^b	5,543	5,084
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	3,520^a	3,611^b	3,464^a	3,032
Illicit Drugs or Nicotine Products^1,4	‑‑	2,753^b	2,827^b	2,660^a	2,320
Illicit Drugs or Alcohol¹	3,065^b	2,881^b	2,914^b	2,949^b	2,427
Nicotine Products or Alcohol⁴	‑‑	2,852	2,933	2,751	2,582
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.2B – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	‑‑	‑‑	‑‑	31.5
Illicit Drugs or Nicotine Products^1,2	‑‑	‑‑	‑‑	‑‑	24.8
Illicit Drugs or Alcohol^1,2	‑‑	‑‑	‑‑	‑‑	26.3
Nicotine Products or Alcohol	‑‑	29.8^a	29.3	28.2	28.0
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	‑‑	‑‑	‑‑	22.5
Illicit Drugs or Nicotine Products^1,3,4	‑‑	‑‑	‑‑	‑‑	16.2
Illicit Drugs or Alcohol¹	‑‑	‑‑	‑‑	‑‑	19.5
Nicotine Products or Alcohol^3,4	‑‑	22.9^b	22.8^b	21.4	20.0
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	13.7^b	13.9^b	13.3^a	11.9
Illicit Drugs or Nicotine Products^1,4	‑‑	10.7^b	10.9^b	10.3^a	9.1
Illicit Drugs or Alcohol¹	11.8^b	11.2^b	11.2^b	11.4^b	9.5
Nicotine Products or Alcohol⁴	‑‑	11.1	11.3	10.6	10.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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Table 9.3A – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	226,618	228,964	233,239	232,916
Illicit Drugs or Nicotine Products^1,2	‑‑	186,109	187,827	191,593	189,064
Illicit Drugs or Alcohol^1,2	217,909	219,744	223,038	227,458	226,816
Nicotine Products or Alcohol	‑‑	224,792	227,043	231,105	231,024
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	193,385	193,764	196,784	193,263
Illicit Drugs or Nicotine Products^1,3,4	‑‑	104,187	105,209	107,023	106,529
Illicit Drugs or Alcohol¹	178,121	182,600	182,861	185,815	181,834
Nicotine Products or Alcohol^3,4	‑‑	188,922	188,861	191,580	187,608
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	165,148	163,568	164,530	159,765
Illicit Drugs or Nicotine Products^1,4	‑‑	83,213	84,882	84,312	84,759
Illicit Drugs or Alcohol¹	141,507	148,462	146,279	146,854	142,230
Nicotine Products or Alcohol⁴	‑‑	159,464	157,160	158,038	153,061
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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Table 9.3B – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	88.4	88.9^a	88.9^a	87.9
Illicit Drugs or Nicotine Products^1,2	‑‑	72.6^a	72.9^b	73.0^b	71.3
Illicit Drugs or Alcohol^1,2	85.9	85.7	86.6^a	86.7^a	85.6
Nicotine Products or Alcohol	‑‑	87.7	88.2^a	88.1^a	87.2
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	75.5^b	75.2^b	75.0^b	72.9
Illicit Drugs or Nicotine Products^1,3,4	‑‑	40.7	40.9	40.8	40.2
Illicit Drugs or Alcohol¹	70.2^a	71.2^b	71.0^b	70.8^b	68.6
Nicotine Products or Alcohol^3,4	‑‑	73.7^b	73.3^b	73.0^b	70.8
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	64.4^b	63.5^b	62.7^b	60.3
Illicit Drugs or Nicotine Products^1,4	‑‑	32.5	33.0	32.1	32.0
Illicit Drugs or Alcohol¹	55.7^b	57.9^b	56.8^b	56.0^b	53.7
Nicotine Products or Alcohol⁴	‑‑	62.2^b	61.0^b	60.3^b	57.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.4A – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	28,008	27,606	28,199	28,114
Illicit Drugs or Nicotine Products^1,2	‑‑	23,205	22,636	23,276	22,430
Illicit Drugs or Alcohol^1,2	26,201	27,062	26,666	27,246	27,120
Nicotine Products or Alcohol	‑‑	27,362	26,951	27,390	27,554
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	25,993	25,592	25,738	25,564
Illicit Drugs or Nicotine Products^1,3,4	‑‑	18,555	18,083	18,201	17,841
Illicit Drugs or Alcohol¹	24,186	25,028	24,504	24,738	24,526
Nicotine Products or Alcohol^3,4	‑‑	25,323	24,931	25,025	24,801
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	21,075	20,877	20,593	20,646
Illicit Drugs or Nicotine Products^1,4	‑‑	13,909	13,754	13,666	13,507
Illicit Drugs or Alcohol¹	19,184	19,682	19,189	18,896	19,066
Nicotine Products or Alcohol⁴	‑‑	20,096	19,802	19,480	19,484
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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Table 9.4B – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	80.5^b	81.1^b	80.7^b	77.9
Illicit Drugs or Nicotine Products^1,2	‑‑	66.7^b	66.5^b	66.6^b	62.1
Illicit Drugs or Alcohol^1,2	78.3^b	77.8^b	78.4^b	78.0^b	75.1
Nicotine Products or Alcohol	‑‑	78.7^b	79.2^b	78.4^a	76.3
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	74.7^b	75.2^b	73.7^b	70.8
Illicit Drugs or Nicotine Products^1,3,4	‑‑	53.3^b	53.1^b	52.1^a	49.4
Illicit Drugs or Alcohol¹	72.3^b	71.9^b	72.0^b	70.8^b	68.0
Nicotine Products or Alcohol^3,4	‑‑	72.8^b	73.3^b	71.6^b	68.7
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	60.6^b	61.3^b	58.9	57.2
Illicit Drugs or Nicotine Products^1,4	‑‑	40.0^a	40.4^b	39.1	37.4
Illicit Drugs or Alcohol¹	57.3^b	56.6^b	56.4^b	54.1	52.8
Nicotine Products or Alcohol⁴	‑‑	57.8^b	58.2^b	55.7	54.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.5A – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	198,611	201,357	205,040	204,802
Illicit Drugs or Nicotine Products^1,2	‑‑	162,904	165,191	168,317	166,634
Illicit Drugs or Alcohol^1,2	191,707	192,681	196,372	200,213	199,696
Nicotine Products or Alcohol	‑‑	197,430	200,092	203,715	203,471
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	167,391	168,172	171,046	167,700
Illicit Drugs or Nicotine Products^1,3,4	‑‑	85,632	87,126	88,822	88,688
Illicit Drugs or Alcohol¹	153,935	157,572	158,357	161,077	157,308
Nicotine Products or Alcohol^3,4	‑‑	163,599	163,930	166,555	162,808
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	144,073	142,692	143,937	139,119
Illicit Drugs or Nicotine Products^1,4	‑‑	69,304	71,128	70,646	71,252
Illicit Drugs or Alcohol¹	122,324	128,780	127,090	127,958	123,164
Nicotine Products or Alcohol⁴	‑‑	139,368	137,358	138,558	133,576
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.5B – General Substance Use in Lifetime, Past Year, and Past Month: Among People Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Illicit Drugs, Nicotine Products, or Alcohol^1,2	‑‑	89.7	90.1	90.2	89.4
Illicit Drugs or Nicotine Products^1,2	‑‑	73.5	73.9	74.0^a	72.8
Illicit Drugs or Alcohol^1,2	87.0	87.0	87.9	88.1	87.2
Nicotine Products or Alcohol	‑‑	89.1	89.5	89.6	88.9
PAST YEAR
Illicit Drugs, Nicotine Products, or Alcohol^1,3,4	‑‑	75.6^b	75.2^b	75.2^b	73.2
Illicit Drugs or Nicotine Products^1,3,4	‑‑	38.7	39.0	39.1	38.7
Illicit Drugs or Alcohol¹	69.9	71.1^b	70.9^b	70.9^b	68.7
Nicotine Products or Alcohol^3,4	‑‑	73.9^b	73.3^b	73.3^b	71.1
PAST MONTH
Illicit Drugs, Nicotine Products, or Alcohol^1,4	‑‑	65.0^b	63.8^b	63.3^b	60.8
Illicit Drugs or Nicotine Products^1,4	‑‑	31.3	31.8	31.1	31.1
Illicit Drugs or Alcohol¹	55.5^a	58.1^b	56.9^b	56.3^b	53.8
Nicotine Products or Alcohol⁴	‑‑	62.9^b	61.5^b	60.9^b	58.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ³ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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Table 9.6A – Illicit Drug Use in Lifetime: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	139,677	143,116	145,076	149,927	145,476
Marijuana	128,961^a	132,296	133,529	137,055	136,335
Cocaine	41,371	42,231	42,280	42,408	40,833
Crack	10,625	10,167	9,871	10,634	10,086
Heroin	6,684	6,558	6,210	6,515	6,436
Hallucinogens	46,474^a	48,850	48,438	51,559	50,765
LSD	30,114	31,074	30,247	30,935	29,162
Psilocybin	‑‑	‑‑	‑‑	35,347	34,154
Ecstasy	21,436	22,103	22,276	22,060	22,359
Inhalants³	‑‑	‑‑	‑‑	‑‑	21,884
Methamphetamine	17,461^a	16,588	16,130	15,294	15,279
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	1,607	1,432	1,911	1,615
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.6B – Illicit Drug Use in Lifetime: Among People Aged 12 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	49.9	50.7	51.2	52.0^b	50.1
Marijuana	46.1	46.9	47.1	47.5	46.9
Cocaine	14.8	15.0^a	14.9^a	14.7	14.1
Crack	3.8	3.6	3.5	3.7	3.5
Heroin	2.4	2.3	2.2	2.3	2.2
Hallucinogens	16.6	17.3	17.1	17.9	17.5
LSD	10.8	11.0^b	10.7	10.7	10.0
Psilocybin	‑‑	‑‑	‑‑	12.3	11.8
Ecstasy	7.7	7.8	7.9	7.7	7.7
Inhalants³	‑‑	‑‑	‑‑	‑‑	7.5
Methamphetamine	6.2^b	5.9^a	5.7	5.3	5.3
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	0.6	0.5	0.7	0.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.7A – Illicit Drug Use in Lifetime: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	‑‑	‑‑	‑‑	‑‑	4,149
Marijuana	3,555^b	3,466^b	3,462^b	3,363^a	2,915
Cocaine	103	65	84	109	106
Crack	18	4	9	25	17
Heroin	7	10	18	22	6
Hallucinogens	626	533	518	591	570
LSD	451^b	283^a	250	222	188
Psilocybin	‑‑	‑‑	‑‑	458	428
Ecstasy	155	124	131	127	148
Inhalants³	‑‑	‑‑	‑‑	‑‑	1,008
Methamphetamine	52	37	84	87	53
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	33	43	56	41
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.7B – Illicit Drug Use in Lifetime: Among People Aged 12 to 17; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	‑‑	‑‑	‑‑	‑‑	16.3
Marijuana	13.7^b	13.5^b	13.4^b	13.0^a	11.5
Cocaine	0.4	0.3	0.3	0.4	0.4
Crack	0.1	<0.1	<0.1	0.1	0.1
Heroin	<0.1	<0.1	0.1	0.1	<0.1
Hallucinogens	2.4	2.1	2.0	2.3	2.2
LSD	1.7^b	1.1	1.0	0.9	0.7
Psilocybin	‑‑	‑‑	‑‑	1.8	1.7
Ecstasy	0.6	0.5	0.5	0.5	0.6
Inhalants³	‑‑	‑‑	‑‑	‑‑	4.0
Methamphetamine	0.2	0.1	0.3	0.3	0.2
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	0.1	0.2	0.2	0.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.8A – Illicit Drug Use in Lifetime: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	133,939^a	137,739	139,745	143,653	141,327
Marijuana	125,406^a	128,829	130,067	133,692	133,420
Cocaine	41,268	42,165	42,196	42,299	40,727
Crack	10,606	10,163	9,862	10,609	10,070
Heroin	6,677	6,549	6,191	6,493	6,430
Hallucinogens	45,848^b	48,316	47,920	50,968	50,194
LSD	29,663	30,791	29,997	30,713	28,974
Psilocybin	‑‑	‑‑	‑‑	34,889	33,725
Ecstasy	21,281	21,979	22,145	21,933	22,211
Inhalants³	‑‑	‑‑	‑‑	‑‑	20,876
Methamphetamine	17,409^a	16,551	16,046	15,206	15,226
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	1,575	1,389	1,855	1,574
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.8B – Illicit Drug Use in Lifetime: Among People Aged 18 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	52.8	53.7	54.3	54.8^a	53.3
Marijuana	49.4	50.3	50.5	51.0	50.3
Cocaine	16.3	16.5^a	16.4^a	16.1	15.4
Crack	4.2	4.0	3.8	4.0	3.8
Heroin	2.6	2.6	2.4	2.5	2.4
Hallucinogens	18.1	18.9	18.6	19.4	18.9
LSD	11.7	12.0^b	11.6	11.7	10.9
Psilocybin	‑‑	‑‑	‑‑	13.3	12.7
Ecstasy	8.4	8.6	8.6	8.4	8.4
Inhalants³	‑‑	‑‑	‑‑	‑‑	7.9
Methamphetamine	6.9^b	6.5^a	6.2	5.8	5.7
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	0.6	0.5	0.7	0.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.9A – Illicit Drug Use in Lifetime: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	18,275	19,121	18,285	18,697	18,125
Marijuana	17,030	18,053	17,033	17,068	17,221
Cocaine	2,924^b	3,127^b	2,698^b	2,226	2,179
Crack	315^a	215	246	153	182
Heroin	349^a	218	224	180	179
Hallucinogens	5,349	5,889^a	5,259	5,661	5,245
LSD	3,317^b	3,583^b	3,000^a	2,817	2,591
Psilocybin	‑‑	‑‑	‑‑	4,468	4,378
Ecstasy	2,756^b	2,628^b	2,151^a	1,920	1,828
Inhalants³	‑‑	‑‑	‑‑	‑‑	2,243
Methamphetamine	606	682^a	569	464	468
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	135	181	176	138
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.9B – Illicit Drug Use in Lifetime: Among People Aged 18 to 25; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	54.6^b	55.0^b	53.7^b	53.5^b	50.2
Marijuana	50.9^b	51.9^b	50.0^a	48.8	47.7
Cocaine	8.7^b	9.0^b	7.9^b	6.4	6.0
Crack	0.9^a	0.6	0.7	0.4	0.5
Heroin	1.0^b	0.6	0.7	0.5	0.5
Hallucinogens	16.0	16.9^b	15.5	16.2^a	14.5
LSD	9.9^b	10.3^b	8.8^b	8.1	7.2
Psilocybin	‑‑	‑‑	‑‑	12.8	12.1
Ecstasy	8.2^b	7.6^b	6.3^b	5.5	5.1
Inhalants³	‑‑	‑‑	‑‑	‑‑	6.2
Methamphetamine	1.8^a	2.0^b	1.7	1.3	1.3
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	0.4	0.5	0.5	0.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.10A – Illicit Drug Use in Lifetime: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	115,664^a	118,618	121,460	124,955	123,202
Marijuana	108,376^b	110,776	113,034	116,624	116,199
Cocaine	38,344	39,038	39,498	40,074	38,548
Crack	10,292	9,948	9,616	10,455	9,888
Heroin	6,328	6,331	5,967	6,313	6,251
Hallucinogens	40,499^b	42,427	42,661	45,307	44,949
LSD	26,346	27,207	26,997	27,896	26,383
Psilocybin	‑‑	‑‑	‑‑	30,421	29,348
Ecstasy	18,524^a	19,351	19,995	20,013	20,383
Inhalants³	‑‑	‑‑	‑‑	‑‑	18,634
Methamphetamine	16,803^a	15,869	15,478	14,742	14,758
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	1,440	1,208	1,680	1,436
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.10B – Illicit Drug Use in Lifetime: Among People Aged 26 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS^1,2	52.5	53.6	54.3	55.0	53.8
Marijuana	49.2^a	50.0	50.6	51.3	50.7
Cocaine	17.4	17.6	17.7	17.6	16.8
Crack	4.7	4.5	4.3	4.6	4.3
Heroin	2.9	2.9	2.7	2.8	2.7
Hallucinogens	18.4^a	19.2	19.1	19.9	19.6
LSD	12.0	12.3	12.1	12.3	11.5
Psilocybin	‑‑	‑‑	‑‑	13.4	12.8
Ecstasy	8.4	8.7	8.9	8.8	8.9
Inhalants³	‑‑	‑‑	‑‑	‑‑	8.1
Methamphetamine	7.6^b	7.2^a	6.9	6.5	6.4
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	nr	nr	nr	nr	nr
Prescription Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Stimulants	nr	nr	nr	nr	nr
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	nr	nr	nr	nr	nr
Sedatives	nr	nr	nr	nr	nr
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids²	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Central Nervous System Stimulants	nr	nr	nr	nr	nr
Illicit Drugs Other Than Marijuana^2,4	nr	nr	nr	nr	nr
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL	‑‑	‑‑	‑‑	‑‑	‑‑
Illegally Made Fentanyl	‑‑	0.7	0.5	0.7	0.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Illicit drug use in lifetime includes the misuse of prescription psychotherapeutics, even though the lifetime misuse of prescription psychotherapeutics estimates are not reported due to potential underreporting in lifetime prescription psychotherapeutics estimates. ² Does not include illegally made fentanyl (IMF). ³ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.11A – Illicit Drug Use in Past Year: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	61,995^b	70,338	70,537	73,637^a	69,791
Marijuana	53,181^b	61,901	61,816	64,194	61,590
Cocaine	4,760	5,274	5,012	4,257	4,937
Crack	1,003	918	997	749	986
Heroin	1,089^b	1,049^b	660	556	581
Hallucinogens	7,572^b	8,509	8,795	10,423^a	9,139
LSD	2,579^b	2,322^b	1,698	1,619	1,400
Psilocybin	‑‑	‑‑	‑‑	7,890^b	6,518
Ecstasy	2,228	2,109	2,153	2,013	1,957
Inhalants²	‑‑	‑‑	‑‑	‑‑	2,385
Methamphetamine	2,640	2,705	2,621	2,384	2,653
Misuse of Prescription Psychotherapeutics	14,529^a	14,204^a	14,435^a	13,797	12,804
Pain Relievers	8,885^b	8,457^b	8,578^b	8,000	7,178
Prescription Opioids	8,534^b	7,948^a	8,196^b	7,570	6,881
Stimulants	3,910	4,298	3,922	3,899	3,940
Tranquilizers or Sedatives	4,813	4,848	4,722	4,575	4,237
Tranquilizers	4,284	4,153	3,993	3,829	3,665
Sedatives	878	959	1,063	920	977
Benzodiazepines	3,931	3,681	3,696	3,360	3,293
Misuse of Opioids^1,3	9,069^b	8,409^b	8,520^b	7,795	7,080
Misuse of Central Nervous System Stimulants	9,379	10,188	9,659	9,031	9,486
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	23,691
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	8,552^a	8,689^b	8,011	7,311
Illegally Made Fentanyl	‑‑	686	627	668	768
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.11B – Illicit Drug Use in Past Year: Among People Aged 12 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	22.2^b	24.9	24.9	25.5^b	24.0
Marijuana	19.0^b	22.0	21.8	22.3^a	21.2
Cocaine	1.7	1.9	1.8	1.5	1.7
Crack	0.4	0.3	0.4	0.3	0.3
Heroin	0.4^b	0.4^b	0.2	0.2	0.2
Hallucinogens	2.7^a	3.0	3.1	3.6^a	3.1
LSD	0.9^b	0.8^b	0.6	0.6	0.5
Psilocybin	‑‑	‑‑	‑‑	2.7^b	2.2
Ecstasy	0.8	0.7	0.8	0.7	0.7
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.8
Methamphetamine	0.9	1.0	0.9	0.8	0.9
Misuse of Prescription Psychotherapeutics	5.2^b	5.0^b	5.1^b	4.8	4.4
Pain Relievers	3.2^b	3.0^b	3.0^b	2.8	2.5
Prescription Opioids	3.0^b	2.8^b	2.9^b	2.6	2.4
Stimulants	1.4	1.5	1.4	1.4	1.4
Tranquilizers or Sedatives	1.7	1.7^a	1.7	1.6	1.5
Tranquilizers	1.5^a	1.5	1.4	1.3	1.3
Sedatives	0.3	0.3	0.4	0.3	0.3
Benzodiazepines	1.4^a	1.3	1.3	1.2	1.1
Misuse of Opioids^1,3	3.2^b	3.0^b	3.0^b	2.7	2.4
Misuse of Central Nervous System Stimulants	3.4	3.6	3.4	3.1	3.3
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	8.2
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	3.0^b	3.1^b	2.8	2.5
Illegally Made Fentanyl	‑‑	0.2	0.2	0.2	0.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.12A – Illicit Drug Use in Past Year: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	‑‑	‑‑	‑‑	‑‑	2,851
Marijuana	2,845^b	2,947^b	2,894^b	2,694^b	2,223
Cocaine	35	40	63	72	57
Crack	3	1	4	8	9
Heroin	1	3	4	10	<1
Hallucinogens	377	358	387	405	360
LSD	272^b	169^a	144	112	96
Psilocybin	‑‑	‑‑	‑‑	311	265
Ecstasy	96	63	75	57	70
Inhalants²	‑‑	‑‑	‑‑	‑‑	360
Methamphetamine	35	18	40	57	32
Misuse of Prescription Psychotherapeutics	908^b	640	785^a	647	598
Pain Relievers	550	406	570^a	425	420
Prescription Opioids	525	378	511	395	402
Stimulants	302	226	230	203	216
Tranquilizers or Sedatives	248	137	173	172	141
Tranquilizers	220	115	119	126	119
Sedatives	43	27	68	64	31
Benzodiazepines	203	113	111	107	122
Misuse of Opioids^1,3	525	378	515	400	403
Misuse of Central Nervous System Stimulants	338	272	285	293	241
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	1,131
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	392	525	432	431
Illegally Made Fentanyl	‑‑	20	36	38	34
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.12B – Illicit Drug Use in Past Year: Among People Aged 12 to 17; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	‑‑	‑‑	‑‑	‑‑	11.2
Marijuana	10.9^b	11.5^b	11.2^b	10.4^b	8.7
Cocaine	0.1	0.2	0.2	0.3	0.2
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	<0.1	<0.1	<0.1	<0.1	<0.1
Hallucinogens	1.4	1.4	1.5	1.6	1.4
LSD	1.0^b	0.7^a	0.6	0.4	0.4
Psilocybin	‑‑	‑‑	‑‑	1.2	1.0
Ecstasy	0.4	0.2	0.3	0.2	0.3
Inhalants²	‑‑	‑‑	‑‑	‑‑	1.4
Methamphetamine	0.1	0.1	0.2	0.2	0.1
Misuse of Prescription Psychotherapeutics	3.5^b	2.5	3.0^a	2.5	2.4
Pain Relievers	2.1	1.6	2.2	1.6	1.7
Prescription Opioids	2.0	1.5	2.0	1.5	1.6
Stimulants	1.2	0.9	0.9	0.8	0.8
Tranquilizers or Sedatives	1.0	0.5	0.7	0.7	0.6
Tranquilizers	0.8	0.4	0.5	0.5	0.5
Sedatives	0.2	0.1	0.3	0.2	0.1
Benzodiazepines	0.8	0.4	0.4	0.4	0.5
Misuse of Opioids^1,3	2.0	1.5	2.0	1.5	1.6
Misuse of Central Nervous System Stimulants	1.3	1.1	1.1	1.1	0.9
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	4.4
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	1.5	2.0	1.7	1.7
Illegally Made Fentanyl	‑‑	0.1	0.1	0.1	0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.13A – Illicit Drug Use in Past Year: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	58,192^b	66,650	66,721	69,720	66,940
Marijuana	50,337^b	58,955	58,922	61,500	59,367
Cocaine	4,725	5,235	4,949	4,185	4,881
Crack	1,000	917	993	741	977
Heroin	1,088^b	1,046^b	656	546	580
Hallucinogens	7,195^b	8,151	8,408	10,018^a	8,779
LSD	2,307^b	2,154^b	1,554	1,507	1,304
Psilocybin	‑‑	‑‑	‑‑	7,579^b	6,253
Ecstasy	2,132	2,046	2,078	1,956	1,887
Inhalants²	‑‑	‑‑	‑‑	‑‑	2,026
Methamphetamine	2,605	2,687	2,582	2,327	2,621
Misuse of Prescription Psychotherapeutics	13,621^a	13,564^a	13,651^a	13,150	12,206
Pain Relievers	8,335^b	8,051^b	8,008^a	7,575	6,758
Prescription Opioids	8,010^b	7,570^a	7,685^a	7,176	6,479
Stimulants	3,608	4,072	3,692	3,696	3,724
Tranquilizers or Sedatives	4,565	4,711	4,549	4,403	4,095
Tranquilizers	4,063	4,038	3,874	3,703	3,546
Sedatives	834	931	995	857	946
Benzodiazepines	3,729	3,569	3,585	3,253	3,172
Misuse of Opioids^1,3	8,545^b	8,031^b	8,005^b	7,396	6,678
Misuse of Central Nervous System Stimulants	9,042	9,916	9,374	8,738	9,245
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	22,559
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	8,160^b	8,164^b	7,580	6,880
Illegally Made Fentanyl	‑‑	666	591	630	734
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.13B – Illicit Drug Use in Past Year: Among People Aged 18 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	22.9^b	26.0	25.9	26.6^a	25.3
Marijuana	19.8^b	23.0	22.9	23.4^a	22.4
Cocaine	1.9	2.0	1.9	1.6	1.8
Crack	0.4	0.4	0.4	0.3	0.4
Heroin	0.4^b	0.4^b	0.3	0.2	0.2
Hallucinogens	2.8^a	3.2	3.3	3.8^a	3.3
LSD	0.9^b	0.8^b	0.6	0.6	0.5
Psilocybin	‑‑	‑‑	‑‑	2.9^b	2.4
Ecstasy	0.8	0.8	0.8	0.7	0.7
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.8
Methamphetamine	1.0	1.0	1.0	0.9	1.0
Misuse of Prescription Psychotherapeutics	5.4^b	5.3^b	5.3^b	5.0	4.6
Pain Relievers	3.3^b	3.1^b	3.1^b	2.9	2.5
Prescription Opioids	3.2^b	3.0^b	3.0^b	2.7	2.4
Stimulants	1.4	1.6	1.4	1.4	1.4
Tranquilizers or Sedatives	1.8	1.8^a	1.8	1.7	1.5
Tranquilizers	1.6^a	1.6	1.5	1.4	1.3
Sedatives	0.3	0.4	0.4	0.3	0.4
Benzodiazepines	1.5^a	1.4	1.4	1.2	1.2
Misuse of Opioids^1,3	3.4^b	3.1^b	3.1^b	2.8	2.5
Misuse of Central Nervous System Stimulants	3.6	3.9	3.6	3.3	3.5
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	8.5
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	3.2^b	3.2^b	2.9	2.6
Illegally Made Fentanyl	‑‑	0.3	0.2	0.2	0.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.14A – Illicit Drug Use in Past Year: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	13,036	14,221	13,256	13,299	13,094
Marijuana	12,133	13,299^a	12,435	12,226	12,167
Cocaine	1,225	1,295^b	1,043	811	950
Crack	75	39	67	46	23
Heroin	71^b	55^b	27^a	51^b	6
Hallucinogens	2,462	2,676^a	2,276	2,364	2,165
LSD	1,077^b	894^b	501	369	413
Psilocybin	‑‑	‑‑	‑‑	1,898	1,621
Ecstasy	709^a	639	521	405	505
Inhalants²	‑‑	‑‑	‑‑	‑‑	636
Methamphetamine	183	161	108	161	145
Misuse of Prescription Psychotherapeutics	2,638^b	2,542^b	2,025	2,019	1,909
Pain Relievers	1,050^a	1,099^b	841	955	775
Prescription Opioids	989^a	1,035^b	801	897	733
Stimulants	1,359^b	1,278^a	1,066	973	978
Tranquilizers or Sedatives	916^b	842^b	576	571	582
Tranquilizers	855^b	779^b	522	522	515
Sedatives	144	93	90	76	118
Benzodiazepines	825^b	747^b	480	488	470
Misuse of Opioids^1,3	1,009^a	1,056^b	806	925	736
Misuse of Central Nervous System Stimulants	2,230^b	2,272^b	1,895	1,646	1,681
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	4,015
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	1,081^b	828	976^a	750
Illegally Made Fentanyl	‑‑	48	78	99	57
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.14B – Illicit Drug Use in Past Year: Among People Aged 18 to 25; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	39.0^a	40.9^b	39.0^b	38.1	36.3
Marijuana	36.3^a	38.2^b	36.5^b	35.0	33.7
Cocaine	3.7^a	3.7^b	3.1	2.3	2.6
Crack	0.2	0.1	0.2^a	0.1	0.1
Heroin	0.2^b	0.2^b	0.1^a	0.1^b	<0.1
Hallucinogens	7.4^a	7.7^b	6.7	6.8	6.0
LSD	3.2^b	2.6^b	1.5	1.1	1.1
Psilocybin	‑‑	‑‑	‑‑	5.4^a	4.5
Ecstasy	2.1^b	1.8	1.5	1.2	1.4
Inhalants²	‑‑	‑‑	‑‑	‑‑	1.8
Methamphetamine	0.5	0.5	0.3	0.5	0.4
Misuse of Prescription Psychotherapeutics	7.9^b	7.3^b	6.0	5.8	5.3
Pain Relievers	3.1^b	3.2^b	2.5	2.7	2.1
Prescription Opioids	3.0^b	3.0^b	2.4	2.6	2.0
Stimulants	4.1^b	3.7^b	3.1	2.8	2.7
Tranquilizers or Sedatives	2.7^b	2.4^b	1.7	1.6	1.6
Tranquilizers	2.6^b	2.2^b	1.5	1.5	1.4
Sedatives	0.4	0.3	0.3	0.2	0.3
Benzodiazepines	2.5^b	2.1^b	1.4	1.4	1.3
Misuse of Opioids^1,3	3.0^b	3.0^b	2.4	2.6^a	2.0
Misuse of Central Nervous System Stimulants	6.7^b	6.5^b	5.6^a	4.7	4.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	11.1
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	3.1^b	2.4	2.8^a	2.1
Illegally Made Fentanyl	‑‑	0.1	0.2	0.3	0.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.15A – Illicit Drug Use in Past Year: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	45,156^b	52,429	53,465	56,421	53,846
Marijuana	38,204^b	45,656	46,487	49,274	47,199
Cocaine	3,500	3,939	3,907	3,374	3,930
Crack	925	877	926	695	954
Heroin	1,018^a	991^b	629	495	574
Hallucinogens	4,733^b	5,475^a	6,132	7,653^a	6,614
LSD	1,230^a	1,259^a	1,053	1,137	891
Psilocybin	‑‑	‑‑	‑‑	5,681^a	4,632
Ecstasy	1,423	1,407	1,557	1,551	1,382
Inhalants²	‑‑	‑‑	‑‑	‑‑	1,390
Methamphetamine	2,422	2,526	2,473	2,166	2,475
Misuse of Prescription Psychotherapeutics	10,983	11,022	11,625^a	11,131	10,297
Pain Relievers	7,286^a	6,953^a	7,167^a	6,620	5,983
Prescription Opioids	7,020^a	6,535	6,884^a	6,279	5,746
Stimulants	2,249	2,794	2,626	2,723	2,746
Tranquilizers or Sedatives	3,649	3,869	3,973	3,832	3,513
Tranquilizers	3,209	3,259	3,351	3,181	3,031
Sedatives	690	839	905	781	828
Benzodiazepines	2,904	2,822	3,105	2,766	2,702
Misuse of Opioids^1,3	7,536^b	6,975^a	7,199^b	6,471	5,941
Misuse of Central Nervous System Stimulants	6,812	7,644	7,479	7,092	7,564
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	18,544
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	7,079^a	7,336^a	6,604	6,130
Illegally Made Fentanyl	‑‑	617	513	531	676
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.15B – Illicit Drug Use in Past Year: Among People Aged 26 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	20.5^b	23.7	23.9	24.8^a	23.5
Marijuana	17.3^b	20.6	20.8	21.7	20.6
Cocaine	1.6	1.8	1.7	1.5	1.7
Crack	0.4	0.4	0.4	0.3	0.4
Heroin	0.5^b	0.4^b	0.3	0.2	0.3
Hallucinogens	2.1^b	2.5^a	2.7	3.4^a	2.9
LSD	0.6^a	0.6^a	0.5	0.5	0.4
Psilocybin	‑‑	‑‑	‑‑	2.5^a	2.0
Ecstasy	0.6	0.6	0.7	0.7	0.6
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.6
Methamphetamine	1.1	1.1	1.1	1.0	1.1
Misuse of Prescription Psychotherapeutics	5.0	5.0	5.2^b	4.9	4.5
Pain Relievers	3.3^b	3.1^b	3.2^b	2.9	2.6
Prescription Opioids	3.2^b	3.0^a	3.1^b	2.8	2.5
Stimulants	1.0	1.3	1.2	1.2	1.2
Tranquilizers or Sedatives	1.7	1.7	1.8	1.7	1.5
Tranquilizers	1.5	1.5	1.5	1.4	1.3
Sedatives	0.3	0.4	0.4	0.3	0.4
Benzodiazepines	1.3	1.3	1.4	1.2	1.2
Misuse of Opioids^1,3	3.4^b	3.1^b	3.2^b	2.8	2.6
Misuse of Central Nervous System Stimulants	3.1	3.5	3.3	3.1	3.3
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	8.1
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	3.2^a	3.3^b	2.9	2.7
Illegally Made Fentanyl	‑‑	0.3	0.2	0.2	0.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.16A – Illicit Drug Use in Past Month: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	40,564^b	46,603	47,657	48,224	47,546
Marijuana	36,950^b	42,317	43,647	44,266	43,776
Cocaine	1,846	2,015	1,814	1,671	1,993
Crack	519	573	507	392	457
Heroin	590	709^a	376	259	412
Hallucinogens	2,301	2,289	2,638	2,783	2,722
LSD	569^b	423	315	259	289
Psilocybin	‑‑	‑‑	‑‑	1,749	1,617
Ecstasy	603	389	471	532	480
Inhalants²	‑‑	‑‑	‑‑	‑‑	992
Methamphetamine	1,630	1,685	1,596	1,418	1,753
Misuse of Prescription Psychotherapeutics	4,288	4,612^a	4,089	4,279	3,781
Pain Relievers	2,427	2,439	2,173	2,113	1,953
Prescription Opioids	2,327	2,257	2,029	1,951	1,816
Stimulants	1,124	1,348	1,163	1,239	1,262
Tranquilizers or Sedatives	1,341	1,529	1,236	1,480	1,187
Tranquilizers	1,145	1,304	1,053	1,259	974
Sedatives	225	278	284	254	306
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	2,718^a	2,762^b	2,298	2,117	2,051
Misuse of Central Nervous System Stimulants	4,173	4,469	4,175	3,934	4,465
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	9,104
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	2,870^b	2,411	2,291	2,132
Illegally Made Fentanyl	‑‑	330	311	418	403
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.16B – Illicit Drug Use in Past Month: Among People Aged 12 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	14.5^b	16.5	16.8	16.7	16.4
Marijuana	13.2^b	15.0	15.4	15.4	15.1
Cocaine	0.7	0.7	0.6	0.6	0.7
Crack	0.2	0.2	0.2	0.1	0.2
Heroin	0.2	0.3^a	0.1	0.1	0.1
Hallucinogens	0.8	0.8	0.9	1.0	0.9
LSD	0.2^b	0.1	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	0.6	0.6
Ecstasy	0.2	0.1	0.2	0.2	0.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.3
Methamphetamine	0.6	0.6	0.6	0.5	0.6
Misuse of Prescription Psychotherapeutics	1.5	1.6^b	1.4	1.5	1.3
Pain Relievers	0.9^a	0.9^a	0.8	0.7	0.7
Prescription Opioids	0.8^a	0.8^a	0.7	0.7	0.6
Stimulants	0.4	0.5	0.4	0.4	0.4
Tranquilizers or Sedatives	0.5	0.5	0.4	0.5	0.4
Tranquilizers	0.4	0.5	0.4	0.4	0.3
Sedatives	0.1	0.1	0.1	0.1	0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	1.0^b	1.0^b	0.8	0.7	0.7
Misuse of Central Nervous System Stimulants	1.5	1.6	1.5	1.4	1.5
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	3.1
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	1.0^b	0.9	0.8	0.7
Illegally Made Fentanyl	‑‑	0.1	0.1	0.1	0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.17A – Illicit Drug Use in Past Month: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	1,964^b	1,884^b	1,864^b	1,950^b	1,482
Marijuana	1,586^a	1,647^b	1,563^a	1,554^a	1,279
Cocaine	5	5	22	13	7
Crack	1	<1	4	<1	*
Heroin	<1	<1	4	1	<1
Hallucinogens	91	99	110	123	101
LSD	53	39	33	15	17
Psilocybin	‑‑	‑‑	‑‑	63	73
Ecstasy	9	10	18	8	16
Inhalants²	‑‑	‑‑	‑‑	‑‑	113
Methamphetamine	16	3	29	35	16
Misuse of Prescription Psychotherapeutics	226	157	206	176	152
Pain Relievers	133	116	143	113	112
Prescription Opioids	131	102	128	106	105
Stimulants	80	33	32	33	50
Tranquilizers or Sedatives	52	37	44	38	29
Tranquilizers	36	34	38	28	24
Sedatives	20	7	14	11	8
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	131	102	132	107	105
Misuse of Central Nervous System Stimulants	100	40	72	80	54
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	329
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	113	140	129	117
Illegally Made Fentanyl	‑‑	11	9	23	17
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.17B – Illicit Drug Use in Past Month: Among People Aged 12 to 17; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	7.5^b	7.3^b	7.2^b	7.5^b	5.8
Marijuana	6.1^a	6.4^b	6.0^a	6.0^a	5.0
Cocaine	<0.1	<0.1	0.1	<0.1	<0.1
Crack	<0.1	<0.1	<0.1	<0.1	*
Heroin	<0.1	<0.1	<0.1	<0.1	<0.1
Hallucinogens	0.3	0.4	0.4	0.5	0.4
LSD	0.2	0.1	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	0.2	0.3
Ecstasy	<0.1	<0.1	0.1	<0.1	0.1
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.4
Methamphetamine	0.1	<0.1	0.1	0.1	0.1
Misuse of Prescription Psychotherapeutics	0.9	0.6	0.8	0.7	0.6
Pain Relievers	0.5	0.5	0.6	0.4	0.4
Prescription Opioids	0.5	0.4	0.5	0.4	0.4
Stimulants	0.3	0.1	0.1	0.1	0.2
Tranquilizers or Sedatives	0.2	0.1	0.2	0.1	0.1
Tranquilizers	0.1	0.1	0.1	0.1	0.1
Sedatives	0.1	<0.1	0.1	<0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	0.5	0.4	0.5	0.4	0.4
Misuse of Central Nervous System Stimulants	0.4	0.2	0.3	0.3	0.2
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	1.3
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	0.4	0.5	0.5	0.5
Illegally Made Fentanyl	‑‑	<0.1	<0.1	0.1	0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.18A – Illicit Drug Use in Past Month: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	38,600^b	44,719	45,794	46,273	46,064
Marijuana	35,364^b	40,670	42,083	42,712	42,497
Cocaine	1,841	2,010	1,792	1,658	1,985
Crack	519	572	503	392	457
Heroin	590	708^a	372	258	412
Hallucinogens	2,210	2,190	2,528	2,660	2,621
LSD	516^a	384	282	244	271
Psilocybin	‑‑	‑‑	‑‑	1,686	1,544
Ecstasy	593	379	453	524	464
Inhalants²	‑‑	‑‑	‑‑	‑‑	879
Methamphetamine	1,614	1,682	1,566	1,383	1,737
Misuse of Prescription Psychotherapeutics	4,062	4,456^a	3,884	4,103	3,629
Pain Relievers	2,294	2,323	2,030	2,000	1,841
Prescription Opioids	2,196	2,155	1,901	1,845	1,711
Stimulants	1,044	1,315	1,131	1,206	1,212
Tranquilizers or Sedatives	1,289	1,492	1,192	1,442	1,158
Tranquilizers	1,109	1,270	1,015	1,231	950
Sedatives	205	271	271	243	298
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	2,587^a	2,659^b	2,166	2,010	1,946
Misuse of Central Nervous System Stimulants	4,073	4,429	4,103	3,854	4,411
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	8,775
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	2,758^b	2,271	2,163	2,015
Illegally Made Fentanyl	‑‑	319	302	395	385
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.18B – Illicit Drug Use in Past Month: Among People Aged 18 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	15.2^b	17.4	17.8	17.6	17.4
Marijuana	13.9^b	15.9	16.3	16.3	16.0
Cocaine	0.7	0.8	0.7	0.6	0.7
Crack	0.2	0.2	0.2	0.1	0.2
Heroin	0.2	0.3^a	0.1	0.1	0.2
Hallucinogens	0.9	0.9	1.0	1.0	1.0
LSD	0.2^a	0.1	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	0.6	0.6
Ecstasy	0.2	0.1	0.2	0.2	0.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.3
Methamphetamine	0.6	0.7	0.6	0.5	0.7
Misuse of Prescription Psychotherapeutics	1.6	1.7^b	1.5	1.6	1.4
Pain Relievers	0.9^a	0.9^a	0.8	0.8	0.7
Prescription Opioids	0.9^a	0.8^a	0.7	0.7	0.6
Stimulants	0.4	0.5	0.4	0.5	0.5
Tranquilizers or Sedatives	0.5	0.6	0.5	0.5	0.4
Tranquilizers	0.4	0.5	0.4	0.5	0.4
Sedatives	0.1	0.1	0.1	0.1	0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	1.0^b	1.0^b	0.8	0.8	0.7
Misuse of Central Nervous System Stimulants	1.6	1.7	1.6	1.5	1.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	3.3
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	1.1^b	0.9	0.8	0.8
Illegally Made Fentanyl	‑‑	0.1	0.1	0.2	0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.19A – Illicit Drug Use in Past Month: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	8,648	9,478	8,901	8,884	8,808
Marijuana	8,236	9,013	8,562	8,439	8,405
Cocaine	363	403	219^a	221^a	353
Crack	31	13	5	13	8
Heroin	26	11	12	14	3
Hallucinogens	553	554	599	489	634
LSD	184^b	125	69	60	70
Psilocybin	‑‑	‑‑	‑‑	307	401
Ecstasy	178^a	99	94	94	76
Inhalants²	‑‑	‑‑	‑‑	‑‑	179
Methamphetamine	103	54	49	77	82
Misuse of Prescription Psychotherapeutics	608	654	558	512	507
Pain Relievers	232	214	170	242	199
Prescription Opioids	215	207	169	214	176
Stimulants	307	376	308	210	260
Tranquilizers or Sedatives	156	181	159	160	150
Tranquilizers	134	158	138	131	140
Sedatives	32	32	23	35	13
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	222	214	173	221	179
Misuse of Central Nervous System Stimulants	675	767	546	466	623
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	1,373
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	236	189	265	185
Illegally Made Fentanyl	‑‑	28	24^a	63^a	7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.19B – Illicit Drug Use in Past Month: Among People Aged 18 to 25; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	25.8	27.2^b	26.2^a	25.4	24.4
Marijuana	24.6	25.9^b	25.2^a	24.1	23.3
Cocaine	1.1	1.2	0.6	0.6	1.0
Crack	0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	<0.1	<0.1	<0.1	<0.1
Hallucinogens	1.7	1.6	1.8	1.4	1.8
LSD	0.6^b	0.4	0.2	0.2	0.2
Psilocybin	‑‑	‑‑	‑‑	0.9	1.1
Ecstasy	0.5^b	0.3	0.3	0.3	0.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.5
Methamphetamine	0.3	0.2	0.1	0.2	0.2
Misuse of Prescription Psychotherapeutics	1.8	1.9^a	1.6	1.5	1.4
Pain Relievers	0.7	0.6	0.5	0.7	0.6
Prescription Opioids	0.6	0.6	0.5	0.6	0.5
Stimulants	0.9	1.1	0.9	0.6	0.7
Tranquilizers or Sedatives	0.5	0.5	0.5	0.5	0.4
Tranquilizers	0.4	0.5	0.4	0.4	0.4
Sedatives	0.1	0.1	0.1	0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	0.7	0.6	0.5	0.6	0.5
Misuse of Central Nervous System Stimulants	2.0	2.2	1.6	1.3	1.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	3.8
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	0.7	0.6	0.8	0.5
Illegally Made Fentanyl	‑‑	0.1	0.1^a	0.2^a	<0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.20A – Illicit Drug Use in Past Month: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	29,952^b	35,241	36,892	37,390	37,257
Marijuana	27,128^b	31,657^a	33,521	34,273	34,092
Cocaine	1,478	1,607	1,572	1,437	1,633
Crack	488	559	498	378	449
Heroin	564	697^a	360	244	409
Hallucinogens	1,657	1,636	1,929	2,171	1,987
LSD	332	259	213	184	202
Psilocybin	‑‑	‑‑	‑‑	1,379	1,143
Ecstasy	415	281	359	429	388
Inhalants²	‑‑	‑‑	‑‑	‑‑	700
Methamphetamine	1,511	1,628	1,517	1,306	1,655
Misuse of Prescription Psychotherapeutics	3,454	3,802	3,326	3,591	3,122
Pain Relievers	2,061	2,109	1,860	1,758	1,642
Prescription Opioids	1,981	1,948	1,732	1,631	1,535
Stimulants	737	939	823	995	953
Tranquilizers or Sedatives	1,133	1,312	1,033	1,282	1,008
Tranquilizers	975	1,112	877	1,099	810
Sedatives	173	239	248	208	285
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	2,365^a	2,445^a	1,993	1,788	1,767
Misuse of Central Nervous System Stimulants	3,398	3,662	3,557	3,388	3,789
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	7,402
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	2,522^a	2,082	1,898	1,830
Illegally Made Fentanyl	‑‑	291	278	332	379
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.20B – Illicit Drug Use in Past Month: Among People Aged 26 or Older; Percentages, 2021‑2025
Drug	2021	2022	2023	2024	2025
ILLICIT DRUGS¹	13.6^b	15.9	16.5	16.4	16.3
Marijuana	12.3^b	14.3	15.0	15.1	14.9
Cocaine	0.7	0.7	0.7	0.6	0.7
Crack	0.2	0.3	0.2	0.2	0.2
Heroin	0.3	0.3^a	0.2	0.1	0.2
Hallucinogens	0.8	0.7	0.9	1.0	0.9
LSD	0.2	0.1	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	0.6	0.5
Ecstasy	0.2	0.1	0.2	0.2	0.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.3
Methamphetamine	0.7	0.7	0.7	0.6	0.7
Misuse of Prescription Psychotherapeutics	1.6	1.7^a	1.5	1.6	1.4
Pain Relievers	0.9	1.0^a	0.8	0.8	0.7
Prescription Opioids	0.9^a	0.9^a	0.8	0.7	0.7
Stimulants	0.3	0.4	0.4	0.4	0.4
Tranquilizers or Sedatives	0.5	0.6	0.5	0.6	0.4
Tranquilizers	0.4	0.5	0.4	0.5	0.4
Sedatives	0.1	0.1	0.1	0.1	0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids^1,3	1.1^a	1.1^b	0.9	0.8	0.8
Misuse of Central Nervous System Stimulants	1.5	1.7	1.6	1.5	1.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	3.2
MISUSE OF OPIOIDS INCLUDING ILLEGALLY MADE FENTANYL³	‑‑	1.1^b	0.9	0.8	0.8
Illegally Made Fentanyl	‑‑	0.1	0.1	0.1	0.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.21A – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	171,265	173,419	175,628	173,770
Tobacco Products	160,536	161,196	163,207	163,970	161,701
Cigarettes	144,864	146,135	147,213	147,571	144,921
Daily Cigarettes	82,667	81,708	81,469	80,874	79,492
Smokeless Tobacco	39,664	38,828	37,928	37,799	37,393
Cigars	79,527^a	84,474	85,827	84,273	84,041
Pipe Tobacco	29,015^b	27,278^b	27,494^b	25,725	24,162
Nicotine Vaping	‑‑	67,445^b	70,190^b	73,901	75,114
Alcohol	220,002	221,306	224,265	228,371	226,957
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	77,953	78,885	78,041	79,084
Tobacco Products¹	68,388^b	63,536	63,490	61,078	61,119
Cigarettes	53,684^b	50,139^a	48,536	47,125	46,373
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	10,224	8,290^b	9,451	9,261	10,000
Cigars	18,976	19,173	19,897	18,342	18,641
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	34,716^b	37,528^a	39,121	40,471
Alcohol	174,266	176,975	177,278	178,687	173,710
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	63,885	64,369	63,677	64,245
Tobacco Products	56,186^b	50,948^a	49,888	48,028	46,921
Cigarettes	44,763^b	41,062^b	38,692	37,780	36,107
Daily Cigarettes	27,509^b	24,103^b	22,774^b	22,273^a	19,909
Smokeless Tobacco	7,634	6,084^a	7,003	6,671	7,276
Cigars	10,429	10,392	10,721	9,447	9,833
Pipe Tobacco	1,887	1,799	2,000	1,804	1,883
Nicotine Vaping²	‑‑	23,497^b	26,594^b	27,680	29,274
Alcohol	132,512	137,446^b	134,729	134,330	129,088
Binge Alcohol Use	60,621^a	61,157^a	61,428^b	57,863	56,756
Heavy Alcohol Use³	16,069	16,089^a	16,412^b	14,541	14,534
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.21B – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	60.7	61.2^a	60.9^a	59.8
Tobacco Products	57.4^b	57.2^b	57.6^b	56.9^a	55.7
Cigarettes	51.8^b	51.8^b	51.9^b	51.2^a	49.9
Daily Cigarettes	29.5^b	29.0^b	28.7^b	28.1	27.4
Smokeless Tobacco	14.2^b	13.8^a	13.4	13.1	12.9
Cigars	28.4	30.0	30.3^a	29.2	28.9
Pipe Tobacco	10.4^b	9.7^b	9.7^b	8.9^a	8.3
Nicotine Vaping	‑‑	23.9^b	24.8^a	25.6	25.9
Alcohol	78.6	78.5	79.1^a	79.2^a	78.1
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	27.6	27.8	27.1	27.2
Tobacco Products¹	24.4^b	22.5^b	22.4^b	21.2	21.0
Cigarettes	19.2^b	17.8^b	17.1^b	16.3	16.0
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	3.7	2.9^b	3.3	3.2	3.4
Cigars	6.8	6.8	7.0^a	6.4	6.4
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	12.3^b	13.2	13.6	13.9
Alcohol	62.3^b	62.8^b	62.5^b	62.0^b	59.8
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	22.7	22.7	22.1	22.1
Tobacco Products	20.1^b	18.1^b	17.6^b	16.7	16.2
Cigarettes	16.0^b	14.6^b	13.7^b	13.1	12.4
Daily Cigarettes	9.8^b	8.5^b	8.0^b	7.7^b	6.9
Smokeless Tobacco	2.7	2.2^a	2.5	2.3	2.5
Cigars	3.7	3.7	3.8^a	3.3	3.4
Pipe Tobacco	0.7	0.6	0.7	0.6	0.6
Nicotine Vaping²	‑‑	8.3^b	9.4^a	9.6	10.1
Alcohol	47.4^b	48.7^b	47.5^b	46.6^b	44.4
Binge Alcohol Use	21.7^b	21.7^b	21.7^b	20.1	19.5
Heavy Alcohol Use³	5.7^b	5.7^b	5.8^b	5.0	5.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.22A – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	5,288	5,291	5,023	5,022
Tobacco Products	2,603^a	2,227	2,144	2,077	2,138
Cigarettes	1,929	1,710	1,738	1,612	1,720
Daily Cigarettes	185	157	149	208	129
Smokeless Tobacco	653^b	397	366	422	436
Cigars	950^a	721	649	639	689
Pipe Tobacco	247	204	170	209	212
Nicotine Vaping	‑‑	4,872	4,847	4,711	4,644
Alcohol	6,187^b	5,745^a	5,593	5,532	5,149
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	3,685^b	3,586^a	3,352	3,137
Tobacco Products¹	1,521^a	1,224	1,242	1,236	1,192
Cigarettes	1,018	886	895	802	877
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	364	188	205	282	253
Cigars	595^b	411	401	464	376
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	3,406^b	3,309^a	3,107	2,846
Alcohol	4,779^b	4,301^a	4,388^b	4,244^a	3,762
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	1,874	1,909	1,719	1,753
Tobacco Products	750^a	506	482	488	513
Cigarettes	432	319	344	320	340
Daily Cigarettes	70	10	20	12	6
Smokeless Tobacco	157	59	72	117	97
Cigars	197	170	112	135	135
Pipe Tobacco	73	58	45	32	44
Nicotine Vaping²	‑‑	1,758	1,751	1,567	1,610
Alcohol	1,886^a	1,753	1,800^a	1,725	1,514
Binge Alcohol Use	1,043^b	834	1,016^b	900	753
Heavy Alcohol Use³	104	63	141	98	81
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.22B – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	20.6	20.4	19.4	19.7
Tobacco Products	10.0^a	8.7	8.3	8.0	8.4
Cigarettes	7.4	6.6	6.7	6.2	6.8
Daily Cigarettes	0.7	0.6	0.6	0.8	0.5
Smokeless Tobacco	2.5^b	1.5	1.4	1.6	1.7
Cigars	3.7^a	2.8	2.5	2.5	2.7
Pipe Tobacco	1.0	0.8	0.7	0.8	0.8
Nicotine Vaping	‑‑	18.9	18.7	18.2	18.2
Alcohol	23.8^b	22.3^a	21.6	21.3	20.2
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	14.3^b	13.8^a	12.9	12.3
Tobacco Products¹	5.8^a	4.8	4.8	4.8	4.7
Cigarettes	3.9	3.4	3.5	3.1	3.4
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	1.4	0.7	0.8	1.1	1.0
Cigars	2.3^b	1.6	1.5	1.8	1.5
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	13.2^b	12.8^a	12.0	11.2
Alcohol	18.4^b	16.7^b	16.9^b	16.4^a	14.8
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	7.3	7.4	6.6	6.9
Tobacco Products	2.9^a	2.0	1.9	1.9	2.0
Cigarettes	1.7	1.2	1.3	1.2	1.3
Daily Cigarettes	0.3	<0.1	0.1	<0.1	<0.1
Smokeless Tobacco	0.6	0.2	0.3	0.5	0.4
Cigars	0.8	0.7	0.4	0.5	0.5
Pipe Tobacco	0.3	0.2	0.2	0.1	0.2
Nicotine Vaping²	‑‑	6.8	6.8	6.0	6.3
Alcohol	7.2^a	6.8	6.9^a	6.6	5.9
Binge Alcohol Use	4.0^b	3.2	3.9^b	3.5	3.0
Heavy Alcohol Use³	0.4	0.2	0.5	0.4	0.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.23A – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	165,978	168,128	170,605	168,748
Tobacco Products	157,933	158,968	161,062	161,892	159,563
Cigarettes	142,935	144,425	145,475	145,958	143,201
Daily Cigarettes	82,482	81,551	81,320	80,666	79,363
Smokeless Tobacco	39,011	38,431	37,562	37,378	36,957
Cigars	78,576^a	83,753	85,178	83,634	83,352
Pipe Tobacco	28,767^b	27,074^b	27,324^b	25,517	23,950
Nicotine Vaping	‑‑	62,574^b	65,342^b	69,191	70,470
Alcohol	213,815	215,561	218,672	222,839	221,808
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	74,268	75,299	74,688	75,947
Tobacco Products¹	66,867^b	62,311	62,248	59,842	59,928
Cigarettes	52,666^b	49,253^a	47,642	46,323	45,496
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	9,860	8,102^b	9,246	8,980	9,747
Cigars	18,381	18,762	19,496	17,878	18,265
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	31,309^b	34,219^b	36,014	37,625
Alcohol	169,487	172,675	172,890	174,444	169,948
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	62,012	62,459	61,958	62,491
Tobacco Products	55,436^b	50,443^a	49,406	47,540	46,408
Cigarettes	44,331^b	40,743^b	38,348	37,460	35,766
Daily Cigarettes	27,439^b	24,093^b	22,754^b	22,261^a	19,903
Smokeless Tobacco	7,478	6,026^a	6,931	6,554	7,180
Cigars	10,232	10,223	10,610	9,312	9,698
Pipe Tobacco	1,814	1,741	1,955	1,773	1,839
Nicotine Vaping²	‑‑	21,739^b	24,843^b	26,113	27,664
Alcohol	130,627	135,694^b	132,929	132,605	127,574
Binge Alcohol Use	59,578^a	60,323^a	60,412^b	56,963	56,003
Heavy Alcohol Use³	15,965	16,025^a	16,271^a	14,443	14,453
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.23B – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	64.8	65.3^b	65.0^a	63.7
Tobacco Products	62.2^b	62.0^b	62.5^b	61.7^a	60.2
Cigarettes	56.3^b	56.4^b	56.5^b	55.6^b	54.0
Daily Cigarettes	32.5^b	31.8^b	31.6^b	30.8	29.9
Smokeless Tobacco	15.4^b	15.0^a	14.6	14.3	13.9
Cigars	31.0	32.7^a	33.1^b	31.9	31.4
Pipe Tobacco	11.3^b	10.6^b	10.6^b	9.7^a	9.0
Nicotine Vaping	‑‑	24.4^b	25.4^a	26.4	26.6
Alcohol	84.2	84.1	84.9^a	85.0^b	83.7
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	29.0	29.2	28.5	28.7
Tobacco Products¹	26.3^b	24.3^b	24.2^b	22.8	22.6
Cigarettes	20.7^b	19.2^b	18.5^b	17.7	17.2
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	3.9	3.2^b	3.6	3.4	3.7
Cigars	7.2	7.3	7.6^a	6.8	6.9
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	12.2^b	13.3^a	13.7	14.2
Alcohol	66.8^b	67.4^b	67.1^b	66.5^b	64.1
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	24.2	24.3	23.6	23.6
Tobacco Products	21.8^b	19.7^b	19.2^b	18.1	17.5
Cigarettes	17.5^b	15.9^b	14.9^b	14.3	13.5
Daily Cigarettes	10.8^b	9.4^b	8.8^b	8.5^b	7.5
Smokeless Tobacco	2.9	2.4^a	2.7	2.5	2.7
Cigars	4.0	4.0	4.1^a	3.6	3.7
Pipe Tobacco	0.7	0.7	0.8	0.7	0.7
Nicotine Vaping²	‑‑	8.5^b	9.6^a	10.0	10.4
Alcohol	51.5^b	52.9^b	51.6^b	50.6^b	48.1
Binge Alcohol Use	23.5^b	23.5^b	23.5^b	21.7	21.1
Heavy Alcohol Use³	6.3^b	6.3^b	6.3^b	5.5	5.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.24A – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	19,498	19,156	19,464	19,178
Tobacco Products	14,994^a	14,469	14,229	13,849	13,668
Cigarettes	12,209	12,190	11,790	11,780	11,493
Daily Cigarettes	3,706^b	3,677^b	3,278^b	2,969^b	2,466
Smokeless Tobacco	4,356^b	3,693	3,545	3,701	3,604
Cigars	8,193^b	7,995^b	7,850^b	7,302	6,742
Pipe Tobacco	1,966^b	1,992^b	1,675	1,472	1,447
Nicotine Vaping	‑‑	17,268	17,062	17,458	17,195
Alcohol	25,058	25,747	25,439	25,805	25,830
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	13,919	13,859	13,625	13,576
Tobacco Products¹	8,980	8,610	8,794	8,363	8,555
Cigarettes	6,407	6,341	6,329	6,201	6,461
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	1,639^a	1,475^b	1,575^b	1,949	2,028
Cigars	3,981^b	3,929^b	3,949^b	3,784^a	3,252
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	11,483	11,480	11,262	11,006
Alcohol	22,790	23,608	23,179	23,361	23,077
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	10,435	10,216	10,100	10,059
Tobacco Products	5,863^a	5,354	5,356	5,021	5,094
Cigarettes	3,959	3,729	3,616	3,353	3,522
Daily Cigarettes	1,069^b	996^b	920^b	655^b	436
Smokeless Tobacco	1,003	818^b	949^a	1,170	1,235
Cigars	1,872^b	1,839^b	1,807^b	1,697^a	1,361
Pipe Tobacco	366	376^a	377^a	312	240
Nicotine Vaping²	‑‑	8,355	8,212	8,296	8,036
Alcohol	17,047	17,467	16,878	16,589	16,691
Binge Alcohol Use	10,025	10,261	9,764	9,329	9,644
Heavy Alcohol Use³	2,379	2,633	2,356	2,098	2,270
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.24B – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	56.0^b	56.3^b	55.7^a	53.1
Tobacco Products	44.8^b	41.6^b	41.8^b	39.6	37.9
Cigarettes	36.5^b	35.0^b	34.6^b	33.7	31.8
Daily Cigarettes	11.1^b	10.6^b	9.6^b	8.5^b	6.8
Smokeless Tobacco	13.0^b	10.6	10.4	10.6	10.0
Cigars	24.5^b	23.0^b	23.1^b	20.9^b	18.7
Pipe Tobacco	5.9^b	5.7^b	4.9^a	4.2	4.0
Nicotine Vaping	‑‑	49.6^a	50.1^a	50.0^a	47.6
Alcohol	74.9^b	74.0^a	74.7^b	73.8^a	71.6
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	40.0^a	40.7^b	39.0	37.6
Tobacco Products¹	26.8^b	24.8	25.8^a	23.9	23.7
Cigarettes	19.1	18.2	18.6	17.7	17.9
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	4.9	4.2^b	4.6^a	5.6	5.6
Cigars	11.9^b	11.3^b	11.6^b	10.8^b	9.0
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	33.0^b	33.7^b	32.2	30.5
Alcohol	68.1^b	67.9^b	68.1^b	66.8^b	63.9
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	30.0^a	30.0^a	28.9	27.9
Tobacco Products	17.5^b	15.4	15.7^a	14.4	14.1
Cigarettes	11.8^b	10.7	10.6	9.6	9.8
Daily Cigarettes	3.2^b	2.9^b	2.7^b	1.9^b	1.2
Smokeless Tobacco	3.0	2.4^b	2.8	3.3	3.4
Cigars	5.6^b	5.3^b	5.3^b	4.9^b	3.8
Pipe Tobacco	1.1^a	1.1^a	1.1^a	0.9	0.7
Nicotine Vaping²	‑‑	24.0^a	24.1^a	23.7	22.3
Alcohol	50.9^b	50.2^b	49.6^b	47.5	46.2
Binge Alcohol Use	30.0^b	29.5^b	28.7	26.7	26.7
Heavy Alcohol Use³	7.1	7.6^a	6.9	6.0	6.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.25A – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	146,480	148,973	151,142	149,570
Tobacco Products	142,939	144,499	146,834	148,043	145,896
Cigarettes	130,726	132,235	133,685	134,178	131,708
Daily Cigarettes	78,776	77,874	78,042	77,697	76,897
Smokeless Tobacco	34,655	34,737	34,017	33,676	33,353
Cigars	70,384^b	75,758	77,328	76,332	76,610
Pipe Tobacco	26,801^b	25,082^a	25,650^b	24,045	22,504
Nicotine Vaping	‑‑	45,306^b	48,280^b	51,732	53,274
Alcohol	188,757	189,814	193,233	197,034	195,978
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	60,349	61,441	61,064	62,371
Tobacco Products¹	57,887^b	53,701	53,454	51,479	51,373
Cigarettes	46,259^b	42,912^a	41,313	40,122	39,034
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	8,221	6,627^a	7,671	7,031	7,719
Cigars	14,399	14,833	15,547	14,094	15,013
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	19,827^b	22,739^b	24,753	26,619
Alcohol	146,696	149,067	149,711	151,083	146,871
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	51,577	52,243	51,858	52,432
Tobacco Products	49,573^b	45,089^a	44,050	42,519	41,314
Cigarettes	40,372^b	37,014^b	34,732	34,107	32,245
Daily Cigarettes	26,370^b	23,097^b	21,834^a	21,606^a	19,467
Smokeless Tobacco	6,474	5,207	5,981	5,384	5,945
Cigars	8,360	8,384	8,803	7,615	8,337
Pipe Tobacco	1,448	1,366	1,578	1,461	1,599
Nicotine Vaping²	‑‑	13,384^b	16,631^b	17,818^a	19,627
Alcohol	113,580	118,227^a	116,051	116,016	110,883
Binge Alcohol Use	49,553^a	50,062^a	50,649^b	47,634	46,358
Heavy Alcohol Use³	13,586	13,393	13,914^a	12,344	12,183
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.25B – Nicotine Product and Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
LIFETIME
Nicotine Products	‑‑	66.1	66.7^a	66.5	65.3
Tobacco Products	64.9	65.2^a	65.7^b	65.1^a	63.7
Cigarettes	59.3^b	59.7^b	59.8^b	59.0^a	57.5
Daily Cigarettes	35.7^b	35.2^a	34.9^a	34.2	33.6
Smokeless Tobacco	15.7^a	15.7^a	15.2	14.8	14.6
Cigars	31.9^a	34.2	34.6	33.6	33.5
Pipe Tobacco	12.2^b	11.3^b	11.5^b	10.6	9.8
Nicotine Vaping	‑‑	20.5^b	21.6^b	22.8	23.3
Alcohol	85.7	85.7	86.5	86.7^a	85.6
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST YEAR
Nicotine Products^1,2	‑‑	27.2	27.5	26.9	27.2
Tobacco Products¹	26.3^b	24.2^b	23.9^b	22.6	22.4
Cigarettes	21.0^b	19.4^b	18.5^b	17.6	17.0
Daily Cigarettes	‑‑	‑‑	‑‑	‑‑	‑‑
Smokeless Tobacco	3.7	3.0	3.4	3.1	3.4
Cigars	6.5	6.7	7.0	6.2	6.6
Pipe Tobacco¹	‑‑	‑‑	‑‑	‑‑	‑‑
Nicotine Vaping²	‑‑	9.0^b	10.2^b	10.9	11.6
Alcohol	66.6^b	67.3^b	67.0^b	66.5^b	64.1
Binge Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
Heavy Alcohol Use	‑‑	‑‑	‑‑	‑‑	‑‑
PAST MONTH
Nicotine Products²	‑‑	23.3	23.4	22.8	22.9
Tobacco Products	22.5^b	20.4^b	19.7^b	18.7	18.0
Cigarettes	18.3^b	16.7^b	15.5^b	15.0	14.1
Daily Cigarettes	12.0^b	10.4^b	9.8^b	9.5^a	8.5
Smokeless Tobacco	2.9	2.4	2.7	2.4	2.6
Cigars	3.8	3.8	3.9	3.3	3.6
Pipe Tobacco	0.7	0.6	0.7	0.6	0.7
Nicotine Vaping²	‑‑	6.0^b	7.4^b	7.8^a	8.6
Alcohol	51.5^b	53.4^b	51.9^b	51.0^b	48.4
Binge Alcohol Use	22.5^b	22.6^b	22.7^b	21.0	20.2
Heavy Alcohol Use³	6.2^b	6.0^a	6.2^b	5.4	5.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Information about past year use of pipe tobacco was not collected. Nicotine product use (including tobacco product use) in the past year excludes past year pipe tobacco use but includes past month pipe tobacco use. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.26A – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; by Sex, Numbers in Thousands, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	220,002	221,306	224,265	228,371	226,957
Past Year	174,266	176,975	177,278	178,687	173,710
Past Month	132,512	137,446^b	134,729	134,330	129,088
Binge Alcohol Use	60,621^a	61,157^a	61,428^b	57,863	56,756
Heavy Alcohol Use¹	16,069	16,089^a	16,412^b	14,541	14,534
MALE
Lifetime	109,690	110,160	111,096	113,708	111,833
Past Year	87,108	88,983	88,581	88,339	87,115
Past Month	68,444	71,048^a	69,489	69,160	66,730
Binge Alcohol Use	32,583	33,625^a	33,641^a	32,179	31,197
Heavy Alcohol Use¹	9,763	10,199^a	9,848	9,045	8,816
FEMALE
Lifetime	110,312	111,146	113,169	114,663	115,124
Past Year	87,157	87,992	88,697	90,348	86,594
Past Month	64,069	66,398^a	65,240	65,170	62,358
Binge Alcohol Use	28,038^a	27,532^a	27,787^a	25,684	25,559
Heavy Alcohol Use¹	6,306	5,889	6,564^a	5,496	5,718
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.26B – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 or Older; by Sex, Percentages, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	78.6	78.5	79.1^a	79.2^a	78.1
Past Year	62.3^b	62.8^b	62.5^b	62.0^b	59.8
Past Month	47.4^b	48.7^b	47.5^b	46.6^b	44.4
Binge Alcohol Use	21.7^b	21.7^b	21.7^b	20.1	19.5
Heavy Alcohol Use¹	5.7^b	5.7^b	5.8^b	5.0	5.0
MALE
Lifetime	80.2	79.7	80.1	80.6	79.5
Past Year	63.7^a	64.4^b	63.9^a	62.7	61.9
Past Month	50.0^b	51.4^b	50.1^b	49.0^a	47.4
Binge Alcohol Use	23.8^a	24.3^b	24.3^b	22.8	22.2
Heavy Alcohol Use¹	7.1^a	7.4^b	7.1^a	6.4	6.3
FEMALE
Lifetime	77.1	77.3	78.1^a	77.9	76.8
Past Year	60.9^b	61.2^b	61.2^b	61.4^b	57.8
Past Month	44.8^b	46.2^b	45.0^b	44.3^b	41.6
Binge Alcohol Use	19.6^b	19.2^b	19.2^b	17.4	17.1
Heavy Alcohol Use¹	4.4	4.1	4.5^b	3.7	3.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.27A – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 20; by Sex, Numbers in Thousands, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	13,869^a	13,224	12,615	12,659	12,540
Past Year	11,476^b	10,934	10,604	10,413	10,036
Past Month	6,109^a	5,843	5,575	5,139	5,392
Binge Alcohol Use	3,379	3,154	3,283	2,946	3,110
Heavy Alcohol Use¹	616	646	663	576	701
MALE
Lifetime	6,578	6,468	6,100	6,199	6,214
Past Year	5,441	5,358	5,096	5,081	5,016
Past Month	2,919	2,763	2,691	2,448	2,777
Binge Alcohol Use	1,536	1,503	1,584	1,393	1,655
Heavy Alcohol Use¹	338	377	321	320	343
FEMALE
Lifetime	7,291^b	6,755	6,516	6,460	6,326
Past Year	6,035^b	5,575^a	5,509	5,332	5,020
Past Month	3,190^b	3,080^a	2,884	2,691	2,616
Binge Alcohol Use	1,843^a	1,650	1,699	1,552	1,455
Heavy Alcohol Use¹	278	269	342	256	357
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.27B – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 12 to 20; by Sex, Percentages, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	35.5^b	34.2^a	33.1	32.9	32.0
Past Year	29.4^b	28.3^b	27.9^a	27.0	25.6
Past Month	15.6^b	15.1^a	14.6	13.3	13.7
Binge Alcohol Use	8.6	8.2	8.6	7.6	7.9
Heavy Alcohol Use¹	1.6	1.7	1.7	1.5	1.8
MALE
Lifetime	32.8	32.3	31.1	31.4	30.7
Past Year	27.1	26.8	26.0	25.7	24.8
Past Month	14.6	13.8	13.7	12.4	13.7
Binge Alcohol Use	7.7	7.5	8.1	7.1	8.2
Heavy Alcohol Use¹	1.7	1.9	1.6	1.6	1.7
FEMALE
Lifetime	38.3^b	36.3^a	35.3	34.4	33.3
Past Year	31.7^b	29.9^b	29.8^b	28.4	26.4
Past Month	16.7^b	16.5^b	15.6^a	14.3	13.8
Binge Alcohol Use	9.7^b	8.9	9.2^a	8.3	7.7
Heavy Alcohol Use¹	1.5	1.4	1.9	1.4	1.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.28A – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 21 or Older; by Sex, Numbers in Thousands, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	206,133	208,082	211,649	215,712	214,416
Past Year	162,790	166,041	166,673	168,275	163,673
Past Month	126,403	131,603^a	129,154	129,191	123,696
Binge Alcohol Use	57,241^a	58,003^b	58,144^b	54,918	53,646
Heavy Alcohol Use¹	15,453^a	15,443^a	15,749^b	13,965	13,833
MALE
Lifetime	103,112	103,692	104,996	107,509	105,619
Past Year	81,667	83,624	83,485	83,258	82,099
Past Month	65,525	68,285^a	66,798	66,712	63,954
Binge Alcohol Use	31,047	32,122^a	32,056^a	30,786	29,542
Heavy Alcohol Use¹	9,425	9,823^a	9,527	8,724	8,473
FEMALE
Lifetime	103,021^a	104,390	106,653	108,203	108,797
Past Year	81,123	82,417	83,188	85,016	81,574
Past Month	60,878	63,318^a	62,356	62,479	59,742
Binge Alcohol Use	26,194^a	25,882	26,088^a	24,132	24,104
Heavy Alcohol Use¹	6,027	5,620	6,222^a	5,241	5,360
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.28B – Alcohol Use in Lifetime, Past Year, and Past Month: Among People Aged 21 or Older; by Sex, Percentages, 2021‑2025
Sex/Alcohol Use	2021	2022	2023	2024	2025
TOTAL
Lifetime	85.6	85.5	86.2	86.4^a	85.3
Past Year	67.6^b	68.2^b	67.9^b	67.4^b	65.1
Past Month	52.5^b	54.1^b	52.6^b	51.7^b	49.2
Binge Alcohol Use	23.8^b	23.8^b	23.7^b	22.0	21.3
Heavy Alcohol Use¹	6.4^b	6.3^b	6.4^b	5.6	5.5
MALE
Lifetime	88.3	87.7	88.2	88.7	87.7
Past Year	70.0	70.7^b	70.1^a	68.7	68.2
Past Month	56.1^b	57.8^b	56.1^b	55.0^a	53.1
Binge Alcohol Use	26.6^a	27.2^b	26.9^b	25.4	24.5
Heavy Alcohol Use¹	8.1^a	8.3^b	8.0^a	7.2	7.0
FEMALE
Lifetime	83.1	83.4	84.4	84.2	83.2
Past Year	65.4^b	65.9^b	65.8^b	66.2^b	62.4
Past Month	49.1^b	50.6^b	49.3^b	48.6^b	45.7
Binge Alcohol Use	21.1^b	20.7^b	20.6^b	18.8	18.4
Heavy Alcohol Use¹	4.9^a	4.5	4.9^b	4.1	4.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Heavy alcohol users are a subset of binge alcohol users. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.29B – Average Number of Days Used Specific Substances in Past Year: Among Past Year Users of Specific Substances Aged 12 or Older; Averages, 2021‑2025
Substance	2021	2022	2023	2024	2025
Marijuana	144.8^b	142.1^b	144.9^b	148.1	154.2
Cocaine	50.3	41.5^a	46.1	42.8^a	58.0
Crack	105.3	98.8	87.9	88.2	95.4
Heroin	157.9^a	173.8	123.1^b	172.4	219.4
Hallucinogens	15.7	15.3	16.2	14.6^a	18.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	35.8
Methamphetamine	157.9	153.0^a	163.5	168.0	190.3
Alcohol	90.0^b	89.1^b	86.0^b	83.4^a	79.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.30B – Average Number of Days Used Specific Substances in Past Month: Among Past Month Users of Specific Substances Aged 12 or Older; Averages, 2021‑2025
Substance	2021	2022	2023	2024	2025
Marijuana	16.1	16.2	16.2	16.5	16.5
Cocaine	7.4	6.4	6.8	7.3	8.0
Crack	12.9	11.4	11.5	12.5	12.5
Heroin	17.2^b	20.3^a	16.8^b	22.8	24.1
Hallucinogens	2.9	2.8	3.0	3.0	3.4
Inhalants¹	‑‑	‑‑	‑‑	‑‑	4.6
Methamphetamine	18.0	18.6	20.3	19.4	20.4
Misuse of Prescription Pain Relievers	7.0	7.1	8.7	8.1	8.0
Misuse of Prescription Stimulants	5.3	5.7	4.7	5.5	6.1
Misuse of Prescription Tranquilizers	6.4	5.5	6.1	7.2	7.9
Misuse of Prescription Sedatives	8.6	9.1	5.9	6.3	8.0
Cigarettes	22.7^b	21.6^b	21.7^b	21.7^b	20.7
Smokeless Tobacco	19.3	19.1	19.7	18.9	19.5
Cigars	9.0	8.8	10.4	9.1	9.2
Nicotine Vaping²	‑‑	18.2^b	18.7^b	19.5	19.8
Alcohol	8.5^b	8.1^b	8.3^b	7.9	7.7
Binge Alcohol Use	4.6	4.3	4.5	4.5	4.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.31A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 or Older and among Past Year Users of Specific Substances Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	13,302^b	15,073^a	15,740	16,930	16,892
Cocaine	244	116	117	91	223
Crack	137	61	52	59	96
Heroin	239	272	156	168	262
Hallucinogens	44	37	48	50	78
Inhalants¹	‑‑	‑‑	‑‑	‑‑	28
Methamphetamine	613	604^a	665	639	960
Alcohol	12,098^b	11,747^b	11,475^b	11,236^a	9,691
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	13,302^b	15,073^a	15,740	16,930	16,892
Cocaine	244	116	117	91	223
Crack	*	61	52	59	96
Heroin	239	272	156	168	*
Hallucinogens	44	37	48	50	78
Inhalants¹	‑‑	‑‑	‑‑	‑‑	28
Methamphetamine	613	604^a	665	639	960
Alcohol	12,098^b	11,747^b	11,475^b	11,236^a	9,691
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.31B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 or Older and among Past Year Users of Specific Substances Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	4.8^b	5.3	5.6	5.9	5.8
Cocaine	0.1	<0.1	<0.1	<0.1	0.1
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	0.1	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.2	0.2	0.2	0.2	0.3
Alcohol	4.3^b	4.2^b	4.0^b	3.9^a	3.3
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	25.0^a	24.4^b	25.5^a	26.4	27.4
Cocaine	5.1	2.2	2.3	2.1	4.5
Crack	*	6.6	5.2	7.8	9.8
Heroin	22.0	26.0	23.6	30.2	*
Hallucinogens	0.6	0.4	0.5	0.5	0.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1.2
Methamphetamine	23.2^a	22.3^b	25.4	26.8	36.2
Alcohol	6.9^b	6.6^b	6.5^a	6.3	5.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.32A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 to 17 and among Past Year Users of Specific Substances Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	278	285	275	325	327
Cocaine	4	1	7	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	8	6	3	2	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	4
Methamphetamine	2	2	*	<1	3
Alcohol	14	14	12	6	12
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	278	285	275	325	327
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	3	2	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	4
Methamphetamine	*	*	*	*	*
Alcohol	14	14	12	6	12
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.32B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 to 17 and among Past Year Users of Specific Substances Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	1.1	1.1	1.1	1.3	1.3
Cocaine	<0.1	<0.1	<0.1	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	<0.1	<0.1	<0.1	<0.1	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	<0.1	<0.1	*	<0.1	<0.1
Alcohol	0.1	0.1	<0.1	<0.1	<0.1
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	9.8^a	9.7^a	9.5^a	12.1	14.7
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	0.8	0.4	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1.2
Methamphetamine	*	*	*	*	*
Alcohol	0.3	0.3	0.3	0.1	0.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.33A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 18 or Older and among Past Year Users of Specific Substances Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	13,025^b	14,789^a	15,465	16,605	16,565
Cocaine	240	115	110	91	223
Crack	137	61	52	59	96
Heroin	239	272	156	168	262
Hallucinogens	36	31	45	48	78
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	610	603^a	665	639	957
Alcohol	12,084^b	11,733^b	11,463^b	11,231^a	9,678
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	13,025^b	14,789^a	15,465	16,605	16,565
Cocaine	240	115	110	91	223
Crack	*	61	52	59	96
Heroin	239	272	156	*	*
Hallucinogens	36	31	45	48	78
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	610	603^a	665	639	957
Alcohol	12,084^b	11,733^b	11,463^b	11,231^a	9,678
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.33B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 18 or Older and among Past Year Users of Specific Substances Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	5.1^b	5.8	6.0	6.3	6.2
Cocaine	0.1	<0.1	<0.1	<0.1	0.1
Crack	0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	0.1	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.2	0.2	0.3	0.2	0.4
Alcohol	4.8^b	4.6^b	4.5^b	4.3^a	3.7
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	25.9	25.1^b	26.2	27.0	27.9
Cocaine	5.1	2.2	2.2	2.2	4.6
Crack	*	6.6	5.2	7.9	9.9
Heroin	22.0	26.0	23.7	*	*
Hallucinogens	0.5	0.4	0.5	0.5	0.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1.1
Methamphetamine	23.4^a	22.4^b	25.8	27.5	36.5
Alcohol	7.1^b	6.8^b	6.6^b	6.4	5.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.34A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 18 to 25 and among Past Year Users of Specific Substances Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	2,824	3,402^a	3,132	3,069	2,964
Cocaine	24	7	2	6	4
Crack	10	<1	2	4	*
Heroin	14	4	6	7^a	<1
Hallucinogens	9	8	6	7	7
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	24	16	17	18	44
Alcohol	604^b	533^a	406	363	361
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	2,824	3,402^a	3,132	3,069	2,964
Cocaine	24	7	2	6	4
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	9	8	6	7	7
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Alcohol	604^b	533^a	406	363	361
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.34B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 18 to 25 and among Past Year Users of Specific Substances Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	8.4	9.8^b	9.2	8.8	8.2
Cocaine	0.1	<0.1	<0.1	<0.1	<0.1
Crack	<0.1	<0.1	<0.1	<0.1	*
Heroin	<0.1	<0.1	<0.1	<0.1^a	<0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	0.1	<0.1	0.1	0.1	0.1
Alcohol	1.8^b	1.5^a	1.2	1.0	1.0
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	23.3	25.6	25.2	25.1	24.4
Cocaine	2.0	0.5	0.2	0.8	0.4
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	0.4	0.3	0.3	0.3	0.3
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Alcohol	2.6^b	2.3^a	1.8	1.6	1.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.35A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 26 or Older and among Past Year Users of Specific Substances Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	10,200^b	11,387^b	12,333	13,536	13,600
Cocaine	216	108	107	84	219
Crack	127	61	50	55	96
Heroin	225	269	149	161	262
Hallucinogens	27	23	39	41	71
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	586	586	648	621	913
Alcohol	11,481^b	11,200^b	11,056^b	10,868^a	9,318
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	10,200^b	11,387^b	12,333	13,536	13,600
Cocaine	216	108	107	84	219
Crack	*	61	50	55	*
Heroin	225	269	149	*	*
Hallucinogens	27	23	39	41	71
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	586	586	648	621	913
Alcohol	11,481^b	11,200^b	11,056^b	10,868^a	9,318
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.35B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 26 or Older and among Past Year Users of Specific Substances Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	4.6^b	5.1^b	5.5	6.0	5.9
Cocaine	0.1	<0.1	<0.1	<0.1	0.1
Crack	0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	0.1	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.3	0.3	0.3	0.3	0.4
Alcohol	5.2^b	5.1^b	4.9^b	4.8^a	4.1
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	26.7	24.9^b	26.5	27.5	28.8
Cocaine	6.2	2.7	2.7	2.5	5.6
Crack	*	6.9	5.4	7.9	*
Heroin	22.1	27.1	23.8	*	*
Hallucinogens	0.6	0.4	0.6	0.5	1.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1.7
Methamphetamine	24.2^a	23.2^a	26.2	28.7	36.9
Alcohol	7.8^b	7.5^b	7.4^a	7.2	6.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.36A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 to 20 and among Past Year Users of Specific Substances Aged 12 to 20; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	1,087	1,251	1,257	1,124	1,118
Cocaine	15	1	7	3	<1
Crack	<1	<1	*	3	*
Heroin	13	*	*	*	*
Hallucinogens	11	6	3	2	7
Inhalants¹	‑‑	‑‑	‑‑	‑‑	4
Methamphetamine	4	2	4	2	9
Alcohol	91	127	68	48	96
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	1,087	1,251	1,257	1,124	1,118
Cocaine	*	1	*	*	<1
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	11	6	3	2	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	4
Methamphetamine	*	*	*	*	*
Alcohol	91	127	68	48	96
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.36B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 12 to 20 and among Past Year Users of Specific Substances Aged 12 to 20; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	2.8	3.2	3.3	2.9	2.9
Cocaine	<0.1	<0.1	<0.1	<0.1	<0.1
Crack	<0.1	<0.1	*	<0.1	*
Heroin	<0.1	*	*	*	*
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	<0.1	<0.1	<0.1	<0.1	<0.1
Alcohol	0.2	0.3	0.2	0.1	0.2
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	15.5	16.9	18.0	17.5	17.8
Cocaine	*	0.5	*	*	0.1
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	0.9	0.5	0.3	0.1	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.7
Methamphetamine	*	*	*	*	*
Alcohol	0.8	1.2	0.6	0.5	1.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.37A – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 21 or Older and among Past Year Users of Specific Substances Aged 21 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	12,215^b	13,822^b	14,484	15,806	15,773
Cocaine	229	114	110	88	222
Crack	137	61	52	56	96
Heroin	226	272	156	168	262
Hallucinogens	34	31	45	48	71
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	609	602^a	661	638	951
Alcohol	12,007^b	11,619^b	11,407^b	11,189^a	9,594
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	12,215^b	13,822^b	14,484	15,806	15,773
Cocaine	229	114	110	88	222
Crack	*	61	52	56	*
Heroin	226	272	156	*	*
Hallucinogens	34	31	45	48	71
Inhalants¹	‑‑	‑‑	‑‑	‑‑	23
Methamphetamine	609	602^a	661	638	951
Alcohol	12,007^b	11,619^b	11,407^b	11,189^a	9,594
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past year users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.37B – Daily or Almost Daily Use of Specific Substances in Past Year: Among People Aged 21 or Older and among Past Year Users of Specific Substances Aged 21 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG TOTAL POPULATION
Marijuana	5.1^b	5.7^a	5.9	6.3	6.3
Cocaine	0.1	<0.1	<0.1	<0.1	0.1
Crack	0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	0.1	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.3	0.2	0.3	0.3	0.4
Alcohol	5.0^b	4.8^b	4.6^b	4.5^a	3.8
DAILY/ALMOST DAILY USE IN PAST YEAR AMONG PAST YEAR USERS
Marijuana	26.4	25.4^b	26.4^a	27.4	28.5
Cocaine	5.1	2.3	2.3	2.2	4.7
Crack	*	6.6	5.3	7.7	*
Heroin	21.2	26.5	24.2	*	*
Hallucinogens	0.5	0.4	0.6	0.5	0.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1.3
Methamphetamine	23.9^a	22.7^b	26.0	27.8	36.7
Alcohol	7.4^b	7.0^b	6.8^b	6.6^a	5.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.38A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 or Older and among Past Month Users of Specific Substances Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	17,657^b	20,487	20,972	21,634	21,377
Cocaine	348	197	275	273	408
Crack	166	161	165	176	139
Heroin	343	436	181	190	333
Hallucinogens	52	54^a	80	90	133
Inhalants¹	‑‑	‑‑	‑‑	‑‑	61
Methamphetamine	860	977	1,036	827	1,188
Misuse of Prescription Pain Relievers	293	308	380	399	273
Misuse of Prescription Stimulants	62	101	50^a	109	125
Misuse of Prescription Tranquilizers	73	127	90	180	128
Misuse of Prescription Sedatives	60	54	29	16	34
Daily Cigarette Use²	27,509^b	24,103^b	22,774^b	22,273^a	19,909
Smokeless Tobacco	4,506	3,538^a	4,279	3,763	4,291
Cigars	2,218	2,183	2,788^b	1,999	2,022
Nicotine Vaping³	‑‑	12,754^b	14,724^b	16,446	17,501
Alcohol	22,455^b	20,732^b	20,954^b	19,054^a	17,174
Binge Alcohol Use	3,683	2,829	3,258	3,139	3,122
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	17,657^b	20,487	20,972	21,634	21,377
Cocaine	348	197	275	273	408
Crack	*	*	*	*	*
Heroin	*	*	*	190	*
Hallucinogens	52	54^a	80	90	133
Inhalants¹	‑‑	‑‑	‑‑	‑‑	61
Methamphetamine	860	977	1,036	827	1,188
Misuse of Prescription Pain Relievers	293	308	380	399	273
Misuse of Prescription Stimulants	62	101	50^a	109	125
Misuse of Prescription Tranquilizers	*	127	90	180	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	27,509^b	24,103^b	22,774^b	22,273^a	19,909
Smokeless Tobacco	4,506	3,538^a	4,279	3,763	4,291
Cigars	2,218	2,183	2,788^b	1,999	2,022
Nicotine Vaping³	‑‑	12,754^b	14,724^b	16,446	17,501
Alcohol	22,455^b	20,732^b	20,954^b	19,054^a	17,174
Binge Alcohol Use	3,683	2,829	3,258	3,139	3,122
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	11,649^b	9,580^b	9,000^b	8,377^a	7,116
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.38B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 or Older and among Past Month Users of Specific Substances Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	6.3^b	7.3	7.4	7.5	7.4
Cocaine	0.1	0.1	0.1	0.1	0.1
Crack	0.1	0.1	0.1	0.1	<0.1
Heroin	0.1	0.2	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.3	0.3	0.4	0.3	0.4
Misuse of Prescription Pain Relievers	0.1	0.1	0.1	0.1	0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Tranquilizers	<0.1	<0.1	<0.1	0.1	<0.1
Misuse of Prescription Sedatives	<0.1	<0.1	<0.1	<0.1	<0.1
Daily Cigarette Use²	9.8^b	8.5^b	8.0^b	7.7^b	6.9
Smokeless Tobacco	1.6	1.3	1.5	1.3	1.5
Cigars	0.8	0.8	1.0^b	0.7	0.7
Nicotine Vaping³	‑‑	4.5^b	5.2^b	5.7	6.0
Alcohol	8.0^b	7.4^b	7.4^b	6.6^a	5.9
Binge Alcohol Use	1.3	1.0	1.1	1.1	1.1
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	47.8	48.4	48.0	48.9	48.8
Cocaine	18.8	9.8^a	15.2	16.4	20.5
Crack	*	*	*	*	*
Heroin	*	*	*	73.3	*
Hallucinogens	2.2	2.4	3.0	3.2	4.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	6.1
Methamphetamine	52.8^a	58.0	64.9	58.3	67.8
Misuse of Prescription Pain Relievers	12.1	12.6	17.5	18.9	14.0
Misuse of Prescription Stimulants	5.5	7.5	4.3	8.8	9.9
Misuse of Prescription Tranquilizers	*	9.8	8.6	14.3	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	61.5^b	58.7^a	58.9^a	59.0^a	55.1
Smokeless Tobacco	59.0	58.2	61.1	56.4	59.0
Cigars	21.3	21.0	26.0^a	21.2	20.6
Nicotine Vaping³	‑‑	54.3^b	55.4^b	59.4	59.8
Alcohol	16.9^b	15.1^b	15.6^b	14.2	13.3
Binge Alcohol Use	6.1	4.6	5.3	5.4	5.5
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	42.4^b	39.8^a	39.6	37.7	35.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.39A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 to 17 and among Past Month Users of Specific Substances Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	458	488	400	471	471
Cocaine	4	*	1	1	*
Crack	*	*	*	*	*
Heroin	*	*	*	1	*
Hallucinogens	8	2	<1	11	12
Inhalants¹	‑‑	‑‑	‑‑	‑‑	14
Methamphetamine	8	1	19	5	15
Misuse of Prescription Pain Relievers	1	3	13	7	4
Misuse of Prescription Stimulants	9	<1	1	1	15
Misuse of Prescription Tranquilizers	*	<1	3	*	*
Misuse of Prescription Sedatives	1	*	3	2	*
Daily Cigarette Use²	70	10	20	12	6
Smokeless Tobacco	24	12	8	15	17
Cigars	20	30	15	22	14
Nicotine Vaping³	‑‑	596	614	656	656
Alcohol	41	23	15	27	30
Binge Alcohol Use	35	3	4	6	14
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	458	488	400	471	471
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	<1	*	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	1	3	*	*	*
Misuse of Prescription Stimulants	*	*	*	*	*
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	*	10	*	12	6
Smokeless Tobacco	*	*	*	*	*
Cigars	20	30	*	*	*
Nicotine Vaping³	‑‑	596	614	656	656
Alcohol	41	23	15	27	30
Binge Alcohol Use	*	3	4	6	14
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	*	*	*	*	*
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.39B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 to 17 and among Past Month Users of Specific Substances Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	1.8	1.9	1.5	1.8	1.8
Cocaine	<0.1	*	<0.1	<0.1	*
Crack	*	*	*	*	*
Heroin	*	*	*	<0.1	*
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.1
Methamphetamine	<0.1	<0.1	0.1	<0.1	0.1
Misuse of Prescription Pain Relievers	<0.1	<0.1	0.1	<0.1	<0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1	<0.1	0.1
Misuse of Prescription Tranquilizers	*	<0.1	<0.1	*	*
Misuse of Prescription Sedatives	<0.1	*	<0.1	<0.1	*
Daily Cigarette Use²	0.3	<0.1	0.1	<0.1	<0.1
Smokeless Tobacco	0.1	<0.1	<0.1	0.1	0.1
Cigars	0.1	0.1	0.1	0.1	0.1
Nicotine Vaping³	‑‑	2.3	2.4	2.5	2.6
Alcohol	0.2	0.1	0.1	0.1	0.1
Binge Alcohol Use	0.1	<0.1	<0.1	<0.1	0.1
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	28.8	29.6	25.6^b	30.3	36.8
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	0.4	*	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	0.6	2.6	*	*	*
Misuse of Prescription Stimulants	*	*	*	*	*
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	*	3.1	*	3.8	1.9
Smokeless Tobacco	*	*	*	*	*
Cigars	10.1	17.8	*	*	*
Nicotine Vaping³	‑‑	33.9	35.1	41.9	40.7
Alcohol	2.2	1.3	0.8	1.5	2.0
Binge Alcohol Use	*	0.4	0.4	0.7	1.8
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	*	*	*	*	*
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.40A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 18 or Older and among Past Month Users of Specific Substances Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	17,199^b	19,999	20,572	21,162	20,906
Cocaine	344	197	274	273	408
Crack	166	161	165	176	139
Heroin	343	436	181	189	333
Hallucinogens	44	52	79	79	121
Inhalants¹	‑‑	‑‑	‑‑	‑‑	47
Methamphetamine	852	975	1,016	821	1,173
Misuse of Prescription Pain Relievers	292	305	367	392	269
Misuse of Prescription Stimulants	53	101	49	107	110
Misuse of Prescription Tranquilizers	73	127	87	180	128
Misuse of Prescription Sedatives	60	54	25	14	34
Daily Cigarette Use²	27,439^b	24,093^b	22,754^b	22,261^a	19,903
Smokeless Tobacco	4,482	3,527^a	4,270	3,748	4,274
Cigars	2,199	2,153	2,773^b	1,976	2,008
Nicotine Vaping³	‑‑	12,158^b	14,111^b	15,790	16,845
Alcohol	22,415^b	20,709^b	20,939^b	19,028^a	17,144
Binge Alcohol Use	3,648	2,825	3,254	3,133	3,108
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	17,199^b	19,999	20,572	21,162	20,906
Cocaine	344	197	274	273	408
Crack	*	*	*	*	*
Heroin	*	*	*	189	*
Hallucinogens	44	52	79	79	121
Inhalants¹	‑‑	‑‑	‑‑	‑‑	47
Methamphetamine	852	975	1,016	821	1,173
Misuse of Prescription Pain Relievers	292	305	367	392	269
Misuse of Prescription Stimulants	53	101	49	107	110
Misuse of Prescription Tranquilizers	*	127	87	180	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	27,439^b	24,093^b	22,754^b	22,261^a	19,903
Smokeless Tobacco	4,482	3,527^a	4,270	3,748	4,274
Cigars	2,199	2,153	2,773^b	1,976	2,008
Nicotine Vaping³	‑‑	12,158^b	14,111^b	15,790	16,845
Alcohol	22,415^b	20,709^b	20,939^b	19,028^a	17,144
Binge Alcohol Use	3,648	2,825	3,254	3,133	3,108
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	11,643^b	9,580^b	9,000^b	8,377^a	7,116
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.40B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 18 or Older and among Past Month Users of Specific Substances Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	6.8^b	7.8	8.0	8.1	7.9
Cocaine	0.1	0.1	0.1	0.1	0.2
Crack	0.1	0.1	0.1	0.1	0.1
Heroin	0.1	0.2	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.3	0.4	0.4	0.3	0.4
Misuse of Prescription Pain Relievers	0.1	0.1	0.1	0.1	0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Tranquilizers	<0.1	<0.1	<0.1	0.1	<0.1
Misuse of Prescription Sedatives	<0.1	<0.1	<0.1	<0.1	<0.1
Daily Cigarette Use²	10.8^b	9.4^b	8.8^b	8.5^b	7.5
Smokeless Tobacco	1.8	1.4	1.7	1.4	1.6
Cigars	0.9	0.8	1.1^b	0.8	0.8
Nicotine Vaping³	‑‑	4.7^b	5.5^b	6.0	6.4
Alcohol	8.8^b	8.1^b	8.1^b	7.3^a	6.5
Binge Alcohol Use	1.4	1.1	1.3	1.2	1.2
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	48.6	49.2	48.9	49.5	49.2
Cocaine	18.7	9.8^a	15.3	16.4	20.6
Crack	*	*	*	*	*
Heroin	*	*	*	73.4	*
Hallucinogens	2.0	2.4	3.1	3.0	4.6
Inhalants¹	‑‑	‑‑	‑‑	‑‑	5.4
Methamphetamine	52.8	58.0	64.9	59.4	67.5
Misuse of Prescription Pain Relievers	12.7	13.1	18.1	19.6	14.6
Misuse of Prescription Stimulants	5.1	7.7	4.3	8.9	9.0
Misuse of Prescription Tranquilizers	*	10.0	8.6	14.6	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	61.9^b	59.1^a	59.3^a	59.4^a	55.6
Smokeless Tobacco	59.9	58.5	61.6	57.2	59.5
Cigars	21.5	21.1	26.1^a	21.2	20.7
Nicotine Vaping³	‑‑	55.9^b	56.8^b	60.5	60.9
Alcohol	17.2^b	15.3^b	15.8^b	14.3	13.4
Binge Alcohol Use	6.1	4.7	5.4	5.5	5.5
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	42.5^b	39.8^a	39.6	37.8	35.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.41A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 18 to 25 and among Past Month Users of Specific Substances Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	3,726	4,497^a	4,231	4,063	3,841
Cocaine	28	5	2	6	12
Crack	<1	4	1	2	1
Heroin	17	4	6	8^a	<1
Hallucinogens	9	*	6	17	18
Inhalants¹	‑‑	‑‑	‑‑	‑‑	1
Methamphetamine	30	29	23	31	40
Misuse of Prescription Pain Relievers	24	13	33	45	8
Misuse of Prescription Stimulants	8	24	16	21	4
Misuse of Prescription Tranquilizers	8	14	1	28	<1
Misuse of Prescription Sedatives	<1	<1	<1	1	*
Daily Cigarette Use²	1,069^b	996^b	920^b	655^b	436
Smokeless Tobacco	461	277^b	377^a	463	597
Cigars	304	411^b	378^b	347^b	206
Nicotine Vaping³	‑‑	4,749	4,615	4,944	4,783
Alcohol	1,200^b	1,098^b	1,106^b	889	717
Binge Alcohol Use	232	216	249	187	160
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	3,726	4,497^a	4,231	4,063	3,841
Cocaine	*	5	2	6	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	*	17	18
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	*	13	*	*	*
Misuse of Prescription Stimulants	8	24	*	*	4
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	1,069^b	996^b	920^b	655^b	436
Smokeless Tobacco	461	277^b	377^a	463	597
Cigars	304	411^b	378^b	347^b	206
Nicotine Vaping³	‑‑	4,749	4,615	4,944	4,783
Alcohol	1,200^b	1,098^b	1,106^b	889	717
Binge Alcohol Use	232	216	249	187	160
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	249^b	174^b	214^b	110	74
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.41B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 18 to 25 and among Past Month Users of Specific Substances Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	11.1	12.9^b	12.4^b	11.6	10.6
Cocaine	0.1	<0.1	<0.1	<0.1	<0.1
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	0.1	<0.1	<0.1	<0.1^a	<0.1
Hallucinogens	<0.1	*	<0.1	<0.1	0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.1	0.1	0.1	0.1	0.1
Misuse of Prescription Pain Relievers	0.1	<0.1	0.1	0.1	<0.1
Misuse of Prescription Stimulants	<0.1	0.1	<0.1	0.1	<0.1
Misuse of Prescription Tranquilizers	<0.1	<0.1	<0.1	0.1	<0.1
Misuse of Prescription Sedatives	<0.1	<0.1	<0.1	<0.1	*
Daily Cigarette Use²	3.2^b	2.9^b	2.7^b	1.9^b	1.2
Smokeless Tobacco	1.4	0.8^b	1.1^a	1.3	1.7
Cigars	0.9	1.2^b	1.1^b	1.0^b	0.6
Nicotine Vaping³	‑‑	13.7	13.6	14.1	13.3
Alcohol	3.6^b	3.2^b	3.2^b	2.5^a	2.0
Binge Alcohol Use	0.7	0.6	0.7^a	0.5	0.4
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	45.2	49.9^a	49.4	48.2	45.7
Cocaine	*	1.3	1.0	2.7	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	*	3.4	2.9
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	*	6.0	*	*	*
Misuse of Prescription Stimulants	2.7	6.3	*	*	1.5
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	27.0^b	26.7^b	25.4^b	19.5^b	12.4
Smokeless Tobacco	45.9	33.9^b	39.7	39.6	48.3
Cigars	16.3	22.3^a	20.9	20.4	15.1
Nicotine Vaping³	‑‑	56.8	56.2	59.6	59.5
Alcohol	7.0^b	6.3^b	6.6^b	5.4	4.3
Binge Alcohol Use	2.3	2.1	2.5	2.0	1.7
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	23.3	17.5	23.3	16.8	17.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.42A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 26 or Older and among Past Month Users of Specific Substances Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	13,473^b	15,503	16,341	17,099	17,065
Cocaine	315	191	272	267	396
Crack	165	157	163	173	138
Heroin	326	432	175	181	333
Hallucinogens	35	52	73	63	103
Inhalants¹	‑‑	‑‑	‑‑	‑‑	46
Methamphetamine	822	946	993	791	1,133
Misuse of Prescription Pain Relievers	267	292	333	348	261
Misuse of Prescription Stimulants	44	77	33^a	87	106
Misuse of Prescription Tranquilizers	65	112	85	152	127
Misuse of Prescription Sedatives	60	53	25	13	34
Daily Cigarette Use²	26,370^b	23,097^b	21,834^a	21,606^a	19,467
Smokeless Tobacco	4,021	3,250	3,893	3,285	3,677
Cigars	1,894	1,742	2,394^a	1,629	1,802
Nicotine Vaping³	‑‑	7,410^b	9,496^b	10,846^a	12,063
Alcohol	21,215^b	19,611^b	19,833^b	18,139	16,427
Binge Alcohol Use	3,416	2,609	3,005	2,946	2,948
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	13,473^b	15,503	16,341	17,099	17,065
Cocaine	315	191	272	267	396
Crack	*	*	*	*	*
Heroin	*	*	*	181	*
Hallucinogens	35	52	73	63	103
Inhalants¹	‑‑	‑‑	‑‑	‑‑	46
Methamphetamine	*	946	993	791	1,133
Misuse of Prescription Pain Relievers	267	292	333	348	261
Misuse of Prescription Stimulants	44	77	33^a	87	106
Misuse of Prescription Tranquilizers	*	112	85	152	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	26,370^b	23,097^b	21,834^a	21,606^a	19,467
Smokeless Tobacco	4,021	3,250	3,893	3,285	3,677
Cigars	1,894	1,742	2,394^a	1,629	1,802
Nicotine Vaping³	‑‑	7,410^b	9,496^b	10,846^a	12,063
Alcohol	21,215^b	19,611^b	19,833^b	18,139	16,427
Binge Alcohol Use	3,416	2,609	3,005	2,946	2,948
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	11,394^b	9,406^b	8,785^b	8,267^a	7,042
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.42B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 26 or Older and among Past Month Users of Specific Substances Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	6.1^b	7.0	7.3	7.5	7.5
Cocaine	0.1	0.1	0.1	0.1	0.2
Crack	0.1	0.1	0.1	0.1	0.1
Heroin	0.1	0.2	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.4	0.4	0.4	0.3	0.5
Misuse of Prescription Pain Relievers	0.1	0.1	0.1	0.2	0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1^a	<0.1	<0.1
Misuse of Prescription Tranquilizers	<0.1	0.1	<0.1	0.1	0.1
Misuse of Prescription Sedatives	<0.1	<0.1	<0.1	<0.1	<0.1
Daily Cigarette Use²	12.0^b	10.4^b	9.8^b	9.5^a	8.5
Smokeless Tobacco	1.8	1.5	1.7	1.4	1.6
Cigars	0.9	0.8	1.1^a	0.7	0.8
Nicotine Vaping³	‑‑	3.3^b	4.2^b	4.8^a	5.3
Alcohol	9.6^b	8.9^b	8.9^b	8.0^a	7.2
Binge Alcohol Use	1.6	1.2	1.3	1.3	1.3
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	49.7	49.0	48.7	49.9	50.1
Cocaine	21.3	11.9^a	17.3	18.6	24.3
Crack	*	*	*	*	*
Heroin	*	*	*	74.1	*
Hallucinogens	2.1	3.2	3.8	2.9	5.2
Inhalants¹	‑‑	‑‑	‑‑	‑‑	6.6
Methamphetamine	*	58.1	65.5	60.5	68.5
Misuse of Prescription Pain Relievers	13.0	13.9	17.9	19.8	15.9
Misuse of Prescription Stimulants	6.0	8.2	4.0^a	8.7	11.1
Misuse of Prescription Tranquilizers	*	10.1	9.7	13.9	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	65.3^b	62.4	62.9	63.3	60.4
Smokeless Tobacco	62.1	62.4	65.1	61.0	61.9
Cigars	22.7	20.8	27.2^a	21.4	21.6
Nicotine Vaping³	‑‑	55.4^b	57.1^a	60.9	61.5
Alcohol	18.7^b	16.6^b	17.1^b	15.6	14.8
Binge Alcohol Use	6.9	5.2	5.9	6.2	6.4
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	43.3^b	40.8^a	40.3	38.4	36.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.43A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 to 20 and among Past Month Users of Specific Substances Aged 12 to 20; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	1,556	1,862	1,745	1,605	1,625
Cocaine	19	<1	1	1	1
Crack	*	<1	*	*	1
Heroin	14	<1	*	1	*
Hallucinogens	11	2	1	19	23
Inhalants¹	‑‑	‑‑	‑‑	‑‑	14
Methamphetamine	10	5	21	8	24
Misuse of Prescription Pain Relievers	14	6	19	7	4
Misuse of Prescription Stimulants	9	<1	8	4	17
Misuse of Prescription Tranquilizers	*	2	3	*	*
Misuse of Prescription Sedatives	1	*	3	2	*
Daily Cigarette Use²	272^b	200^b	177^b	130	79
Smokeless Tobacco	98	63	63	102	105
Cigars	80	155^b	111	92	54
Nicotine Vaping³	‑‑	2,269	2,089	2,185	2,167
Alcohol	194	161	130	168	156
Binge Alcohol Use	93	62	51	44	55
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	1,556	1,862	1,745	1,605	1,625
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	1	*	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	*	6	*	*	*
Misuse of Prescription Stimulants	*	<1	*	*	*
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	272^b	200^b	177^b	130	79
Smokeless Tobacco	98	63	63	102	105
Cigars	80	155^b	111	92	54
Nicotine Vaping³	‑‑	2,269	2,089	2,185	2,167
Alcohol	194	161	130	168	156
Binge Alcohol Use	93	62	51	44	55
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	30	*	25	*	*
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.43B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 12 to 20 and among Past Month Users of Specific Substances Aged 12 to 20; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	4.0	4.8	4.6	4.2	4.1
Cocaine	<0.1	<0.1	<0.1	<0.1	<0.1
Crack	*	<0.1	*	*	<0.1
Heroin	<0.1	<0.1	*	<0.1	*
Hallucinogens	<0.1	<0.1	<0.1	<0.1	0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	<0.1	<0.1	0.1	<0.1	0.1
Misuse of Prescription Pain Relievers	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Tranquilizers	*	<0.1	<0.1	*	*
Misuse of Prescription Sedatives	<0.1	*	<0.1	<0.1	*
Daily Cigarette Use²	0.7^b	0.5^b	0.5^b	0.3	0.2
Smokeless Tobacco	0.2	0.2	0.2	0.3	0.3
Cigars	0.2	0.4^b	0.3	0.2	0.1
Nicotine Vaping³	‑‑	5.9	5.5	5.7	5.5
Alcohol	0.5	0.4	0.3	0.4	0.4
Binge Alcohol Use	0.2	0.2	0.1	0.1	0.1
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	36.9	40.9	40.5	39.7	40.9
Cocaine	*	*	*	*	*
Crack	*	*	*	*	*
Heroin	*	*	*	*	*
Hallucinogens	*	*	0.3	*	*
Inhalants¹	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	*	*	*	*	*
Misuse of Prescription Pain Relievers	*	2.8	*	*	*
Misuse of Prescription Stimulants	*	0.3	*	*	*
Misuse of Prescription Tranquilizers	*	*	*	*	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	19.4^b	16.5^b	14.2^b	11.1^a	5.8
Smokeless Tobacco	26.1	20.6	20.6	28.6	25.6
Cigars	10.9	21.2^a	19.2	17.9	11.0
Nicotine Vaping³	‑‑	48.2	46.9	54.2	51.9
Alcohol	3.2	2.8	2.3	3.3	2.9
Binge Alcohol Use	2.8	2.0	1.6	1.5	1.8
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	11.0	*	14.2	*	*
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260604

Table 9.44A – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 21 or Older and among Past Month Users of Specific Substances Aged 21 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	16,101^b	18,625	19,227	20,029	19,752
Cocaine	329	197	274	273	407
Crack	166	160	165	176	139
Heroin	329	436	181	189	333
Hallucinogens	41	52	79	71	110
Inhalants¹	‑‑	‑‑	‑‑	‑‑	47
Methamphetamine	851	971	1,015	818	1,164
Misuse of Prescription Pain Relievers	279	303	361	392	269
Misuse of Prescription Stimulants	52	101	41	104	108
Misuse of Prescription Tranquilizers	73	125	87	180	128
Misuse of Prescription Sedatives	60	54	25	14	34
Daily Cigarette Use²	27,238^b	23,903^b	22,597^b	22,143^a	19,831
Smokeless Tobacco	4,408	3,476	4,216	3,661	4,186
Cigars	2,138	2,028	2,677^a	1,907	1,968
Nicotine Vaping³	‑‑	10,485^b	12,636^b	14,261	15,334
Alcohol	22,262^b	20,571^b	20,825^b	18,886^a	17,018
Binge Alcohol Use	3,590	2,766	3,207	3,095	3,067
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	16,101^b	18,625	19,227	20,029	19,752
Cocaine	329	197	274	273	407
Crack	*	*	*	*	*
Heroin	*	*	*	189	*
Hallucinogens	41	52	79	71	110
Inhalants¹	‑‑	‑‑	‑‑	‑‑	47
Methamphetamine	851	971	1,015	818	1,164
Misuse of Prescription Pain Relievers	279	303	361	392	269
Misuse of Prescription Stimulants	52	101	41	104	108
Misuse of Prescription Tranquilizers	*	125	87	180	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	27,238^b	23,903^b	22,597^b	22,143^a	19,831
Smokeless Tobacco	4,408	3,476	4,216	3,661	4,186
Cigars	2,138	2,028	2,677^a	1,907	1,968
Nicotine Vaping³	‑‑	10,485^b	12,636^b	14,261	15,334
Alcohol	22,262^b	20,571^b	20,825^b	18,886^a	17,018
Binge Alcohol Use	3,590	2,766	3,207	3,095	3,067
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	11,619^b	9,556^b	8,975^b	8,366^a	7,112
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: This table presents estimates for multiple population domains, including the total population and past month users of a specific substance. Estimates reported as numbers (in thousands) may be repeated across domains because the numerator is the same. Percentages shown in the corresponding B table differ because they are calculated using different denominators. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.44B – Daily or Almost Daily Use of Specific Substances in Past Month: Among People Aged 21 or Older and among Past Month Users of Specific Substances Aged 21 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG TOTAL POPULATION
Marijuana	6.7^b	7.7	7.8	8.0	7.9
Cocaine	0.1	0.1	0.1	0.1	0.2
Crack	0.1	0.1	0.1	0.1	0.1
Heroin	0.1	0.2	0.1	0.1	0.1
Hallucinogens	<0.1	<0.1	<0.1	<0.1	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	0.4	0.4	0.4	0.3	0.5
Misuse of Prescription Pain Relievers	0.1	0.1	0.1	0.2	0.1
Misuse of Prescription Stimulants	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Tranquilizers	<0.1	0.1	<0.1	0.1	0.1
Misuse of Prescription Sedatives	<0.1	<0.1	<0.1	<0.1	<0.1
Daily Cigarette Use²	11.3^b	9.8^b	9.2^b	8.9^b	7.9
Smokeless Tobacco	1.8	1.4	1.7	1.5	1.7
Cigars	0.9	0.8	1.1^b	0.8	0.8
Nicotine Vaping³	‑‑	4.3^b	5.1^b	5.7	6.1
Alcohol	9.2^b	8.5^b	8.5^b	7.6^a	6.8
Binge Alcohol Use	1.5	1.1	1.3	1.2	1.2
DAILY/ALMOST DAILY USE IN PAST MONTH AMONG PAST MONTH USERS
Marijuana	49.2	49.3	48.9	49.8	49.6
Cocaine	18.5	10.1^a	15.8	16.9	21.2
Crack	*	*	*	*	*
Heroin	*	*	*	73.8	*
Hallucinogens	2.0	2.6	3.4	2.8	4.7
Inhalants¹	‑‑	‑‑	‑‑	‑‑	5.7
Methamphetamine	52.9	58.2	65.3	59.7	67.7
Misuse of Prescription Pain Relievers	12.6	13.5	18.3	20.3	15.5
Misuse of Prescription Stimulants	5.4	8.3	3.9	9.2	9.5
Misuse of Prescription Tranquilizers	*	10.0	8.9	15.0	*
Misuse of Prescription Sedatives	*	*	*	*	*
Daily Cigarette Use²	62.8^b	60.0	60.3^a	60.5^a	57.1
Smokeless Tobacco	60.7	60.1	62.9	58.0	61.0
Cigars	22.1	21.0	26.4^a	21.3	21.1
Nicotine Vaping³	‑‑	55.8^b	57.1^a	60.3	61.1
Alcohol	17.6^b	15.6^b	16.1^b	14.6	13.8
Binge Alcohol Use	6.3	4.8	5.5	5.6	5.7
SMOKED 1+ PACKS OF CIGARETTES PER DAY AMONG DAILY CIGARETTE USERS⁴	42.7^b	40.1^a	39.8	37.9	35.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Includes only respondents who smoked cigarettes on each of the past 30 days. ³ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Respondents with unknown data for the number of cigarettes smoked per day were excluded from the analysis. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.45A – Past Year Initiation of Substance Use: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	2,692	3,730^b	3,456^b	2,939^b	2,352
Cocaine	474	509	470	426	479
Crack	51	28	79	63	62
Heroin	24^a	73^b	28^a	30^a	5
Hallucinogens	1,337	1,411	1,510	1,632^a	1,216
LSD	731^b	509^a	364	293	317
Psilocybin	‑‑	‑‑	‑‑	‑‑	1,285
Ecstasy	547^b	380	507^a	377	298
Inhalants¹	‑‑	‑‑	‑‑	‑‑	542
Methamphetamine	98	176	78	104	114
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	1,809^a	1,322	1,380	1,522	1,280
Stimulants	802	800	712	619	691
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	898^a	747	530	704	573
Sedatives	176	144	252	205	132
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	1,234^b	1,350^a	1,499	1,481	1,661
Daily Cigarettes	319	274	322	237	233
Smokeless Tobacco	512^b	498^b	860	1,059	1,097
Cigars	1,413^a	1,564	1,984	1,560	1,837
Nicotine Vaping⁴	‑‑	5,876^b	5,723^b	5,123^b	4,249
ALCOHOL	4,174	4,221	4,214	4,218	4,258
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.45B – Past Year Initiation of Substance Use: Among People Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	1.0^a	1.3^b	1.2^b	1.0^b	0.8
Cocaine	0.2	0.2	0.2	0.1	0.2
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	<0.1^a	<0.1^b	<0.1^a	<0.1^a	<0.1
Hallucinogens	0.5	0.5	0.5^a	0.6^a	0.4
LSD	0.3^b	0.2^a	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	‑‑	0.4
Ecstasy	0.2^b	0.1	0.2^a	0.1	0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.2
Methamphetamine	<0.1	0.1	<0.1	<0.1	<0.1
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	0.6^a	0.5	0.5	0.5	0.4
Stimulants	0.3	0.3	0.3	0.2	0.2
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	0.3^a	0.3	0.2	0.2	0.2
Sedatives	0.1	0.1	0.1	0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	0.4^a	0.5	0.5	0.5	0.6
Daily Cigarettes	0.1	0.1	0.1	0.1	0.1
Smokeless Tobacco	0.2^b	0.2^b	0.3	0.4	0.4
Cigars	0.5^a	0.6	0.7	0.5	0.6
Nicotine Vaping⁴	‑‑	2.1^b	2.0^b	1.8^b	1.5
ALCOHOL	1.5	1.5	1.5	1.5	1.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.46A – Past Year Initiation of Substance Use: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	913^b	1,224^b	1,169^b	912^b	615
Cocaine	15	29	23	33	41
Crack	3	<1	4	6	9
Heroin	1	*	4	10	<1
Hallucinogens	202	220	248	238	204
LSD	153^a	127^a	101	88	62
Psilocybin	‑‑	‑‑	‑‑	‑‑	180
Ecstasy	56	40	61	26	51
Inhalants¹	‑‑	‑‑	‑‑	‑‑	194
Methamphetamine	26	9	15	14	16
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	148	191	210	153	164
Stimulants	157	108	91	61	95
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	73	51	42	56	36
Sedatives	16	16	41	14	11
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	393	437	452	342	363
Daily Cigarettes	34	27	22	35	37
Smokeless Tobacco	126	101	109	171	116
Cigars	294	237	245	224	185
Nicotine Vaping⁴	‑‑	1,403^b	1,406^b	1,100	968
ALCOHOL	1,841	1,798	1,821	1,651	1,590
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.46B – Past Year Initiation of Substance Use: Among People Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	3.5^b	4.8^b	4.5^b	3.5^b	2.4
Cocaine	0.1	0.1	0.1	0.1	0.2
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	<0.1	*	<0.1	<0.1	<0.1
Hallucinogens	0.8	0.9	1.0	0.9	0.8
LSD	0.6^a	0.5^a	0.4	0.3	0.2
Psilocybin	‑‑	‑‑	‑‑	‑‑	0.7
Ecstasy	0.2	0.2	0.2	0.1	0.2
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.8
Methamphetamine	0.1	<0.1	0.1	0.1	0.1
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	0.6	0.7	0.8	0.6	0.6
Stimulants	0.6	0.4	0.4	0.2	0.4
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	0.3	0.2	0.2	0.2	0.1
Sedatives	0.1	0.1	0.2	0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	1.5	1.7	1.7	1.3	1.4
Daily Cigarettes	0.1	0.1	0.1	0.1	0.1
Smokeless Tobacco	0.5	0.4	0.4	0.7	0.5
Cigars	1.1	0.9	0.9	0.9	0.7
Nicotine Vaping⁴	‑‑	5.5^b	5.4^b	4.2	3.8
ALCOHOL	7.1	7.0	7.0	6.4	6.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.47A – Past Year Initiation of Substance Use: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	1,779	2,506^b	2,287^b	2,027	1,736
Cocaine	459	479	447	393	437
Crack	48	27	75	57	53
Heroin	24^a	73^b	24	20	4
Hallucinogens	1,135	1,191	1,262	1,394^a	1,011
LSD	578^b	383	263	205	255
Psilocybin	‑‑	‑‑	‑‑	‑‑	1,105
Ecstasy	491^b	340	446^a	351	247
Inhalants¹	‑‑	‑‑	‑‑	‑‑	347
Methamphetamine	72	166	64	89	98
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	1,661^a	1,131	1,170	1,368	1,116
Stimulants	645	692	621	558	596
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	825	695	488	648	536
Sedatives	160	128	211	192	121
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	841^b	913^b	1,047	1,139	1,298
Daily Cigarettes	285	247	301	202	197
Smokeless Tobacco	387^b	396^b	751	888	981
Cigars	1,119^b	1,327	1,739	1,336	1,652
Nicotine Vaping⁴	‑‑	4,474^b	4,317^b	4,023^a	3,281
ALCOHOL	2,334	2,422	2,393	2,567	2,668
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.47B – Past Year Initiation of Substance Use: Among People Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	0.7	1.0^b	0.9^b	0.8	0.7
Cocaine	0.2	0.2	0.2	0.1	0.2
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	<0.1^a	<0.1^b	<0.1	<0.1	<0.1
Hallucinogens	0.4	0.5	0.5	0.5^a	0.4
LSD	0.2^b	0.1	0.1	0.1	0.1
Psilocybin	‑‑	‑‑	‑‑	‑‑	0.4
Ecstasy	0.2^b	0.1	0.2^a	0.1	0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.1
Methamphetamine	<0.1	0.1	<0.1	<0.1	<0.1
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	0.7^a	0.4	0.5	0.5	0.4
Stimulants	0.3	0.3	0.2	0.2	0.2
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	0.3^a	0.3	0.2	0.2	0.2
Sedatives	0.1	<0.1	0.1	0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	0.3^b	0.4^a	0.4	0.4	0.5
Daily Cigarettes	0.1	0.1	0.1	0.1	0.1
Smokeless Tobacco	0.2^b	0.2^b	0.3	0.3	0.4
Cigars	0.4^b	0.5	0.7	0.5	0.6
Nicotine Vaping⁴	‑‑	1.7^b	1.7^b	1.5^b	1.2
ALCOHOL	0.9	0.9	0.9	1.0	1.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.48A – Past Year Initiation of Substance Use: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	1,170	1,195	1,195	1,023	1,143
Cocaine	280	369^a	260	273	234
Crack	18	11	32	8	6
Heroin	11	28^a	7	20^a	1
Hallucinogens	739^a	703^a	635	582	520
LSD	390^b	219	143	116	171
Psilocybin	‑‑	‑‑	‑‑	‑‑	500
Ecstasy	289^a	175	233	146	151
Inhalants¹	‑‑	‑‑	‑‑	‑‑	306
Methamphetamine	24	57	13	23	11
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	259	262	191	241	190
Stimulants	325	294	277	244	272
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	220^b	174	123	110	98
Sedatives	47	38	23	14	47
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	736^b	791^b	945	1,002	1,146
Daily Cigarettes	141	171	198^a	161	107
Smokeless Tobacco	204^b	247^b	473	502	591
Cigars	804	824	1,065^a	867	823
Nicotine Vaping⁴	‑‑	1,410^b	1,315^b	1,123	982
ALCOHOL	2,088^a	2,247	2,284	2,356	2,551
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.48B – Past Year Initiation of Substance Use: Among People Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	3.5	3.4	3.5	2.9	3.2
Cocaine	0.8	1.1^a	0.8	0.8	0.6
Crack	0.1	<0.1	0.1	<0.1	<0.1
Heroin	<0.1	0.1^a	<0.1	0.1^a	<0.1
Hallucinogens	2.2^b	2.0^a	1.9	1.7	1.4
LSD	1.2^b	0.6	0.4	0.3	0.5
Psilocybin	‑‑	‑‑	‑‑	‑‑	1.4
Ecstasy	0.9^b	0.5	0.7	0.4	0.4
Inhalants¹	‑‑	‑‑	‑‑	‑‑	0.8
Methamphetamine	0.1	0.2^a	<0.1	0.1	<0.1
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	0.8	0.8	0.6	0.7	0.5
Stimulants	1.0	0.8	0.8	0.7	0.8
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	0.7^b	0.5^a	0.4	0.3	0.3
Sedatives	0.1	0.1	0.1	<0.1	0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	2.2^b	2.3^b	2.8	2.9	3.2
Daily Cigarettes	0.4	0.5	0.6^b	0.5	0.3
Smokeless Tobacco	0.6^b	0.7^b	1.4	1.4	1.6
Cigars	2.4	2.4	3.1^b	2.5	2.3
Nicotine Vaping⁴	‑‑	4.1^b	3.9^b	3.2	2.7
ALCOHOL	6.2	6.5	6.7	6.7	7.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.49A – Past Year Initiation of Substance Use: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	609	1,311^b	1,092^b	1,004^b	593
Cocaine	179	110	187	120	203
Crack	29	16	42	49	46
Heroin	13	45	17	*	3
Hallucinogens	395	487	627	812^a	491
LSD	188	164	120	88	84
Psilocybin	‑‑	‑‑	‑‑	‑‑	605
Ecstasy	203	165	213^a	205^a	96
Inhalants¹	‑‑	‑‑	‑‑	‑‑	42
Methamphetamine	48	109	50	66	87
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	1,402^a	869	979	1,127	926
Stimulants	320	397	344	313	324
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	605	522	366	538	439
Sedatives	113	89	188	178	74
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	105	122	103	138	152
Daily Cigarettes	144	76	102	41	90
Smokeless Tobacco	183^b	149^b	278	386	390
Cigars	315^b	503	674	469^a	829
Nicotine Vaping⁴	‑‑	3,063^a	3,002^a	2,900^a	2,299
ALCOHOL	246	175	109	210	117
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.49B – Past Year Initiation of Substance Use: Among People Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	0.3	0.6^b	0.5^b	0.4^b	0.3
Cocaine	0.1	<0.1	0.1	0.1	0.1
Crack	<0.1	<0.1	<0.1	<0.1	<0.1
Heroin	<0.1	<0.1	<0.1	*	<0.1
Hallucinogens	0.2	0.2	0.3	0.4^a	0.2
LSD	0.1	0.1	0.1	<0.1	<0.1
Psilocybin	‑‑	‑‑	‑‑	‑‑	0.3
Ecstasy	0.1	0.1	0.1^a	0.1^a	<0.1
Inhalants¹	‑‑	‑‑	‑‑	‑‑	<0.1
Methamphetamine	<0.1	<0.1	<0.1	<0.1	<0.1
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	0.6^a	0.4	0.4	0.5	0.4
Stimulants	0.1	0.2	0.2	0.1	0.1
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	0.3	0.2	0.2	0.2	0.2
Sedatives	0.1	<0.1	0.1	0.1	<0.1
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	<0.1	0.1	<0.1	0.1	0.1
Daily Cigarettes	0.1	<0.1	<0.1	<0.1	<0.1
Smokeless Tobacco	0.1^b	0.1^b	0.1	0.2	0.2
Cigars	0.1^b	0.2	0.3	0.2^a	0.4
Nicotine Vaping⁴	‑‑	1.4^b	1.3^b	1.3^a	1.0
ALCOHOL	0.1	0.1	<0.1	0.1	0.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.50B – Mean Age at First Substance Use: Among Past Year Initiates Aged 12 to 49; Averages, 2021‑2025
Substance	2021	2022	2023	2024	2025
ILLICIT DRUGS	nr	nr	nr	nr	nr
Marijuana	20.3	21.6	21.0	21.7	21.1
Cocaine	25.2	22.6^a	24.8	22.6^a	25.0
Crack	25.5	29.2	27.2	30.6	28.5
Heroin	26.3	27.9	29.1	18.3	*
Hallucinogens	22.8	23.7	25.1	26.0^a	23.4
LSD	21.6	22.5	22.8	23.0	21.1
Psilocybin	‑‑	‑‑	‑‑	‑‑	24.7
Ecstasy	24.8	25.4	24.8	27.2^a	23.3
Inhalants¹	‑‑	‑‑	‑‑	‑‑	19.2
Methamphetamine	24.3	26.9	25.4	31.5	28.3
Misuse of Prescription Psychotherapeutics	nr	nr	nr	nr	nr
Pain Relievers	29.6	26.5	27.8	29.2	27.2
Stimulants	25.3	25.8	25.1	27.3	25.4
Tranquilizers or Sedatives	nr	nr	nr	nr	nr
Tranquilizers	28.0	28.1	30.1	29.9	31.3
Sedatives	25.4	26.8	27.4	33.3^b	24.6
Benzodiazepines	‑‑	‑‑	‑‑	‑‑	‑‑
Misuse of Opioids	‑‑	‑‑	‑‑	‑‑	‑‑
Illicit Drugs Other Than Marijuana²	nr	nr	nr	nr	nr
NICOTINE PRODUCTS³	nr	nr	nr	nr	nr
Cigarettes	19.3	19.4	19.5	19.9	19.8
Daily Cigarettes	23.7	22.0	22.3	22.1	24.9
Smokeless Tobacco	23.0	23.3	23.6	24.2	24.3
Cigars	21.6^b	23.4	22.6	23.2	24.1
Nicotine Vaping⁴	‑‑	25.2	25.4	25.9	26.3
ALCOHOL	18.3	18.0	18.0	18.6	18.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Methodological limitations preclude the estimation of past year initiates for aggregate substance use categories having at least one prescription psychotherapeutic, including categories for overall illicit drugs, misuse of prescription psychotherapeutics, tranquilizers or sedatives, and illicit drugs other than marijuana. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ² Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ³ Because respondents were not asked initiation questions for pipe tobacco, initiation of the nicotine product use measure cannot be determined. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.51A – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 12 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	46,787	48,722^b	48,464^b	48,351^b	44,576
DRUGS	24,467	27,230	27,153	28,184^a	25,969
Marijuana	16,661^b	18,976	19,164	20,585	19,338
Cocaine	1,439	1,435	1,256	1,211	1,408
Heroin	990^b	900^b	587	496	477
Hallucinogens	506	592	428	433	495
Inhalants	354	332	304	352	257
Methamphetamine	1,628	1,826	1,784	1,571	1,807
Prescription Psychotherapeutics	7,445^a	8,227^b	7,889^b	7,628^a	6,428
Pain Relievers	5,020^b	5,577^b	5,344^b	4,952^a	3,945
Prescription Opioids	4,648^a	5,201^b	4,708^b	4,596^a	3,709
Stimulants	1,538	1,828	1,718	1,846	1,722
Tranquilizers or Sedatives	2,248^a	2,355^b	2,256^a	2,096	1,679
Tranquilizers	1,710	1,807	1,747	1,497	1,368
Sedatives	935^b	833^b	869^b	812^a	482
Opioids¹	5,211^b	5,741^b	5,043^b	4,822^a	3,972
Central Nervous System Stimulants	4,214	4,515	4,322	4,266	4,493
ALCOHOL	29,734^b	29,542^b	28,859^b	27,913^a	25,746
BOTH DRUGS AND ALCOHOL	7,414	8,049^a	7,549	7,746	7,139
DRUGS ONLY (NO ALCOHOL USE DISORDER)	17,053^a	19,180	19,604	20,438	18,830
ALCOHOL ONLY (NO DRUG USE DISORDER)	22,320^b	21,492^b	21,311^b	20,167	18,607
NO SUBSTANCE USE DISORDER	233,057^a	233,285^a	234,994^a	239,891	245,942
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.51B – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 12 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	16.7^b	17.3^b	17.1^b	16.8^b	15.3
DRUGS	8.7	9.7^a	9.6^a	9.8^b	8.9
Marijuana	6.0^b	6.7	6.8	7.1	6.7
Cocaine	0.5	0.5	0.4	0.4	0.5
Heroin	0.4^b	0.3^b	0.2	0.2	0.2
Hallucinogens	0.2	0.2	0.2	0.2	0.2
Inhalants	0.1	0.1	0.1	0.1	0.1
Methamphetamine	0.6	0.6	0.6	0.5	0.6
Prescription Psychotherapeutics	2.7^b	2.9^b	2.8^b	2.6^b	2.2
Pain Relievers	1.8^b	2.0^b	1.9^b	1.7^b	1.4
Prescription Opioids	1.7^b	1.8^b	1.7^b	1.6^a	1.3
Stimulants	0.5	0.6	0.6	0.6	0.6
Tranquilizers or Sedatives	0.8^a	0.8^b	0.8^a	0.7	0.6
Tranquilizers	0.6	0.6^a	0.6	0.5	0.5
Sedatives	0.3^b	0.3^b	0.3^b	0.3^a	0.2
Opioids¹	1.9^b	2.0^b	1.8^b	1.7^a	1.4
Central Nervous System Stimulants	1.5	1.6	1.5	1.5	1.5
ALCOHOL	10.6^b	10.5^b	10.2^b	9.7^b	8.9
BOTH DRUGS AND ALCOHOL	2.6	2.9^a	2.7	2.7	2.5
DRUGS ONLY (NO ALCOHOL USE DISORDER)	6.1	6.8	6.9	7.1^a	6.5
ALCOHOL ONLY (NO DRUG USE DISORDER)	8.0^b	7.6^b	7.5^b	7.0^a	6.4
NO SUBSTANCE USE DISORDER	83.3^b	82.7^b	82.9^b	83.2^b	84.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.52A – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 12 to 17; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	2,404^b	2,228^a	2,192^a	2,024	1,877
DRUGS	1,896^a	1,813^a	1,780^a	1,705	1,511
Marijuana	1,348	1,308	1,223	1,219	1,118
Cocaine	7	6	45	14	12
Heroin	2	2	*	9	<1
Hallucinogens	50	78	59	83	66
Inhalants	95	70	78	84	90
Methamphetamine	23	8	23	9	3
Prescription Psychotherapeutics	586^a	541	598^b	524	426
Pain Relievers	275	265	316	286	227
Prescription Opioids	239	222	230	262	207
Stimulants	272	259	244	191	208
Tranquilizers or Sedatives	138^b	135^a	140^b	119^a	62
Tranquilizers	103^b	77^b	89^b	84^b	25
Sedatives	56	64	72	44	44
Opioids¹	239	222	230	267	207
Central Nervous System Stimulants	283	267	268	210	213
ALCOHOL	965^a	753	757	775	710
BOTH DRUGS AND ALCOHOL	458	338	345	456	344
DRUGS ONLY (NO ALCOHOL USE DISORDER)	1,439^a	1,475^a	1,435^a	1,249	1,167
ALCOHOL ONLY (NO DRUG USE DISORDER)	508	415	412	319	366
NO SUBSTANCE USE DISORDER	23,615	23,498	23,723	23,928	23,578
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.52B – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 12 to 17; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	9.2^b	8.7^a	8.5^a	7.8	7.4
DRUGS	7.3^a	7.0^a	6.9	6.6	5.9
Marijuana	5.2	5.1	4.7	4.7	4.4
Cocaine	<0.1	<0.1	0.2	0.1	<0.1
Heroin	<0.1	<0.1	*	<0.1	<0.1
Hallucinogens	0.2	0.3	0.2	0.3	0.3
Inhalants	0.4	0.3	0.3	0.3	0.4
Methamphetamine	0.1	<0.1	0.1	<0.1	<0.1
Prescription Psychotherapeutics	2.3^a	2.1	2.3^a	2.0	1.7
Pain Relievers	1.1	1.0	1.2	1.1	0.9
Prescription Opioids	0.9	0.9	0.9	1.0	0.8
Stimulants	1.0	1.0	0.9	0.7	0.8
Tranquilizers or Sedatives	0.5^a	0.5^a	0.5^b	0.5^a	0.2
Tranquilizers	0.4^b	0.3^b	0.3^b	0.3^b	0.1
Sedatives	0.2	0.2	0.3	0.2	0.2
Opioids¹	0.9	0.9	0.9	1.0	0.8
Central Nervous System Stimulants	1.1	1.0	1.0	0.8	0.8
ALCOHOL	3.7^a	2.9	2.9	3.0	2.8
BOTH DRUGS AND ALCOHOL	1.8	1.3	1.3	1.8	1.4
DRUGS ONLY (NO ALCOHOL USE DISORDER)	5.5	5.7^a	5.5^a	4.8	4.6
ALCOHOL ONLY (NO DRUG USE DISORDER)	2.0	1.6	1.6	1.2	1.4
NO SUBSTANCE USE DISORDER	90.8^b	91.3^a	91.5^a	92.2	92.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.53A – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 18 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	44,383	46,494^b	46,272^b	46,327^b	42,699
DRUGS	22,571	25,417	25,373	26,480^a	24,458
Marijuana	15,313^b	17,669	17,941	19,366	18,220
Cocaine	1,431	1,429	1,212	1,197	1,396
Heroin	989^b	898^b	587	486	477
Hallucinogens	456	514	369	350	430
Inhalants	259	262	226	269	167
Methamphetamine	1,604	1,818	1,761	1,562	1,804
Prescription Psychotherapeutics	6,860	7,687^b	7,292^b	7,104^a	6,003
Pain Relievers	4,745^b	5,312^b	5,027^b	4,666^a	3,718
Prescription Opioids	4,409^a	4,979^b	4,478^b	4,334^a	3,502
Stimulants	1,266	1,569	1,474	1,655	1,514
Tranquilizers or Sedatives	2,110	2,221^a	2,116^a	1,976	1,617
Tranquilizers	1,607	1,730	1,659	1,413	1,343
Sedatives	879^b	769^b	797^b	767^a	438
Opioids¹	4,972^b	5,518^b	4,813^b	4,555^a	3,764
Central Nervous System Stimulants	3,932	4,247	4,053	4,056	4,280
ALCOHOL	28,769^b	28,788^b	28,103^b	27,138^a	25,036
BOTH DRUGS AND ALCOHOL	6,956	7,712^a	7,204	7,290	6,795
DRUGS ONLY (NO ALCOHOL USE DISORDER)	15,615^a	17,706	18,169	19,190	17,663
ALCOHOL ONLY (NO DRUG USE DISORDER)	21,812^b	21,077^b	20,899^b	19,848^a	18,241
NO SUBSTANCE USE DISORDER	209,442^b	209,788^b	211,270^a	215,964	222,364
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.53B – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 18 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	17.5^b	18.1^b	18.0^b	17.7^b	16.1
DRUGS	8.9	9.9^a	9.9	10.1^a	9.2
Marijuana	6.0^b	6.9	7.0	7.4	6.9
Cocaine	0.6	0.6	0.5	0.5	0.5
Heroin	0.4^b	0.4^b	0.2	0.2	0.2
Hallucinogens	0.2	0.2	0.1	0.1	0.2
Inhalants	0.1	0.1	0.1	0.1	0.1
Methamphetamine	0.6	0.7	0.7	0.6	0.7
Prescription Psychotherapeutics	2.7^a	3.0^b	2.8^b	2.7^a	2.3
Pain Relievers	1.9^b	2.1^b	2.0^b	1.8^b	1.4
Prescription Opioids	1.7^b	1.9^b	1.7^b	1.7^a	1.3
Stimulants	0.5	0.6	0.6	0.6	0.6
Tranquilizers or Sedatives	0.8^a	0.9^b	0.8^a	0.8	0.6
Tranquilizers	0.6	0.7	0.6	0.5	0.5
Sedatives	0.3^b	0.3^b	0.3^b	0.3^b	0.2
Opioids¹	2.0^b	2.2^b	1.9^b	1.7^a	1.4
Central Nervous System Stimulants	1.5	1.7	1.6	1.5	1.6
ALCOHOL	11.3^b	11.2^b	10.9^b	10.3^b	9.4
BOTH DRUGS AND ALCOHOL	2.7	3.0^b	2.8	2.8	2.6
DRUGS ONLY (NO ALCOHOL USE DISORDER)	6.2	6.9	7.1	7.3^a	6.7
ALCOHOL ONLY (NO DRUG USE DISORDER)	8.6^b	8.2^b	8.1^b	7.6^a	6.9
NO SUBSTANCE USE DISORDER	82.5^b	81.9^b	82.0^b	82.3^b	83.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.54A – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 18 to 25; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	8,764	9,669^a	9,228	9,056	8,577
DRUGS	5,569	6,482^a	6,113	6,210	5,723
Marijuana	4,918	5,740^a	5,634	5,536	5,089
Cocaine	267	268	189	280	224
Heroin	67^b	35^b	17	33^b	4
Hallucinogens	202	228^a	132	102	129
Inhalants	90	91^a	39	82^a	28
Methamphetamine	121	84	71	96	85
Prescription Psychotherapeutics	910	945	769	805	775
Pain Relievers	417	410	392	341	351
Prescription Opioids	381	365	343	314	335
Stimulants	390	476	315	411	352
Tranquilizers or Sedatives	307	290	222	239	235
Tranquilizers	251	236	162	194	176
Sedatives	108	81	77	90	74
Opioids¹	408	379	347	335	337
Central Nervous System Stimulants	647	755	525	722	591
ALCOHOL	5,181	5,689^b	5,123	5,029	4,731
BOTH DRUGS AND ALCOHOL	1,986	2,502^b	2,008	2,183	1,877
DRUGS ONLY (NO ALCOHOL USE DISORDER)	3,583	3,980	4,105	4,027	3,846
ALCOHOL ONLY (NO DRUG USE DISORDER)	3,195	3,186	3,115	2,846	2,854
NO SUBSTANCE USE DISORDER	24,694^b	25,118^b	24,805^b	25,890	27,516
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.54B – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 18 to 25; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	26.2^b	27.8^b	27.1^b	25.9^a	23.8
DRUGS	16.6	18.6^b	18.0^b	17.8^b	15.9
Marijuana	14.7	16.5^b	16.6^b	15.8^a	14.1
Cocaine	0.8	0.8	0.6	0.8	0.6
Heroin	0.2^b	0.1^b	<0.1	0.1^b	<0.1
Hallucinogens	0.6	0.7^a	0.4	0.3	0.4
Inhalants	0.3	0.3^a	0.1	0.2^a	0.1
Methamphetamine	0.4	0.2	0.2	0.3	0.2
Prescription Psychotherapeutics	2.7	2.7^a	2.3	2.3	2.1
Pain Relievers	1.2	1.2	1.2	1.0	1.0
Prescription Opioids	1.1	1.1	1.0	0.9	0.9
Stimulants	1.2	1.4	0.9	1.2	1.0
Tranquilizers or Sedatives	0.9	0.8	0.7	0.7	0.7
Tranquilizers	0.7	0.7	0.5	0.6	0.5
Sedatives	0.3	0.2	0.2	0.3	0.2
Opioids¹	1.2	1.1	1.0	1.0	0.9
Central Nervous System Stimulants	1.9	2.2^a	1.5	2.1	1.6
ALCOHOL	15.5^b	16.4^b	15.1^b	14.4^a	13.1
BOTH DRUGS AND ALCOHOL	5.9	7.2^b	5.9	6.2^a	5.2
DRUGS ONLY (NO ALCOHOL USE DISORDER)	10.7	11.4	12.1^a	11.5	10.7
ALCOHOL ONLY (NO DRUG USE DISORDER)	9.6^b	9.2^a	9.2^a	8.1	7.9
NO SUBSTANCE USE DISORDER	73.8^b	72.2^b	72.9^b	74.1^a	76.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.55A – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 26 or Older; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	35,619	36,825^a	37,044^a	37,271^a	34,121
DRUGS	17,002	18,935	19,260	20,269	18,735
Marijuana	10,395^b	11,928	12,308	13,830	13,132
Cocaine	1,164	1,161	1,023	917	1,171
Heroin	921^b	864^b	570	453	473
Hallucinogens	255	286	237	248	300
Inhalants	168	171	187	187	139
Methamphetamine	1,483	1,734	1,690	1,465	1,719
Prescription Psychotherapeutics	5,950	6,742^b	6,523^b	6,300^a	5,228
Pain Relievers	4,328^b	4,902^b	4,636^b	4,325^a	3,367
Prescription Opioids	4,028^a	4,613^b	4,135^b	4,020^a	3,167
Stimulants	876	1,093	1,158	1,243	1,162
Tranquilizers or Sedatives	1,803	1,931^a	1,894^a	1,737	1,382
Tranquilizers	1,356	1,495	1,497	1,219	1,167
Sedatives	771^b	688^b	720^b	677^a	364
Opioids¹	4,564^b	5,139^b	4,466^b	4,220^a	3,427
Central Nervous System Stimulants	3,285	3,492	3,529	3,334	3,689
ALCOHOL	23,587^b	23,099^b	22,980^b	22,108^a	20,304
BOTH DRUGS AND ALCOHOL	4,970	5,209	5,197	5,106	4,918
DRUGS ONLY (NO ALCOHOL USE DISORDER)	12,032^a	13,726	14,064	15,163	13,817
ALCOHOL ONLY (NO DRUG USE DISORDER)	18,617^b	17,890^b	17,784^b	17,002^a	15,387
NO SUBSTANCE USE DISORDER	184,747^a	184,670^a	186,465^a	190,074	194,848
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.55B – Substance Use Disorder for Specific Substances in Past Year: Among People Aged 26 or Older; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	16.2^b	16.6^b	16.6^b	16.4^b	14.9
DRUGS	7.7	8.5	8.6	8.9^a	8.2
Marijuana	4.7^b	5.4	5.5	6.1	5.7
Cocaine	0.5	0.5	0.5	0.4	0.5
Heroin	0.4^b	0.4^b	0.3	0.2	0.2
Hallucinogens	0.1	0.1	0.1	0.1	0.1
Inhalants	0.1	0.1	0.1	0.1	0.1
Methamphetamine	0.7	0.8	0.8	0.6	0.8
Prescription Psychotherapeutics	2.7^a	3.0^b	2.9^b	2.8^a	2.3
Pain Relievers	2.0^b	2.2^b	2.1^b	1.9^b	1.5
Prescription Opioids	1.8^b	2.1^b	1.9^b	1.8^a	1.4
Stimulants	0.4	0.5	0.5	0.5	0.5
Tranquilizers or Sedatives	0.8	0.9^a	0.8^a	0.8	0.6
Tranquilizers	0.6	0.7	0.7	0.5	0.5
Sedatives	0.3^b	0.3^b	0.3^b	0.3^a	0.2
Opioids¹	2.1^b	2.3^b	2.0^b	1.9^a	1.5
Central Nervous System Stimulants	1.5	1.6	1.6	1.5	1.6
ALCOHOL	10.7^b	10.4^b	10.3^b	9.7^a	8.9
BOTH DRUGS AND ALCOHOL	2.3	2.4	2.3	2.2	2.1
DRUGS ONLY (NO ALCOHOL USE DISORDER)	5.5	6.2	6.3	6.7^a	6.0
ALCOHOL ONLY (NO DRUG USE DISORDER)	8.4^b	8.1^b	8.0^b	7.5^a	6.7
NO SUBSTANCE USE DISORDER	83.8^b	83.4^b	83.4^b	83.6^b	85.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.56A – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	53,420	54,707	53,829	56,437	54,631
18‑25	11,101	12,236^b	11,144	11,149	10,331
18‑20	4,296^a	4,413^b	3,629	3,740	3,687
21‑25	6,804	7,824^b	7,515^a	7,409^a	6,644
26 or Older	42,319	42,471	42,685	45,288	44,301
26‑49	26,818	27,802	27,955	29,255	28,492
26‑29	5,676	5,920	5,943	5,863	5,480
30‑34	6,859	7,282	7,359	7,452	7,275
35‑39	5,765	5,752	6,072	6,264	5,803
40‑44	4,481^b	4,796^b	4,726^b	5,234	5,722
45‑49	4,036	4,052	3,856	4,442	4,212
50 or Older	15,501	14,669	14,730	16,033	15,809
50‑54	3,917	3,462	3,268	3,853	3,212
55‑59	2,973	2,957	2,799	3,539	2,898
60‑64	3,093	3,202	3,097	2,975	3,195
65 or Older	5,518	5,049^a	5,567	5,666	6,504
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.56B – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	21.0	21.3	20.9	21.5^a	20.6
18‑25	33.2^b	35.2^b	32.7^b	31.9^b	28.6
18‑20	32.9^b	34.1^b	29.9^a	29.8^a	26.7
21‑25	33.4^b	35.8^b	34.3^b	33.1^b	29.8
26 or Older	19.2	19.2	19.1	19.9	19.3
26‑49	26.2	27.1	27.0	27.7	27.1
26‑29	32.5	34.8	33.8	33.6	31.8
30‑34	30.2	31.4	32.5	31.7	31.0
35‑39	25.9	26.1	26.2	27.0	25.8
40‑44	22.0^b	23.1^a	22.3^b	23.4	26.1
45‑49	20.7	20.8	20.5	23.1	20.8
50 or Older	13.1	12.3	12.3	13.2	12.8
50‑54	20.0	17.5	17.5	19.6	17.8
55‑59	13.9	14.8	13.6	18.2	14.8
60‑64	13.9	14.1	13.5	13.2	14.1
65 or Older	10.1	8.9	9.6	9.5	10.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.57A – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	20,062^a	21,552^b	20,335^b	20,380^b	18,201
18‑25	5,619^b	6,108^b	5,194^b	4,925^a	4,369
18‑20	2,138^b	2,157^b	1,703	1,657	1,528
21‑25	3,481^b	3,951^b	3,490^b	3,268^a	2,841
26 or Older	14,443	15,444^a	15,142	15,455^a	13,832
26‑49	10,261	10,601	10,997	10,891	10,111
26‑29	2,403	2,318	2,628	2,483	2,235
30‑34	2,587	3,024	2,966	2,960	2,650
35‑39	2,233	2,191	2,204	2,049	2,079
40‑44	1,536	1,647	1,769	1,842	1,847
45‑49	1,502	1,421	1,429	1,558	1,300
50 or Older	4,183	4,843^a	4,145	4,564	3,721
50‑54	1,257	1,288	1,121	1,575	1,110
55‑59	939	1,259	884	1,146	845
60‑64	917	1,172^a	949	731	682
65 or Older	1,071	1,124	1,190	1,112	1,083
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.57B – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	7.9^b	8.4^b	7.9^b	7.8^b	6.9
18‑25	16.8^b	17.6^b	15.3^b	14.1^b	12.1
18‑20	16.4^b	16.7^b	14.0^b	13.2^a	11.1
21‑25	17.1^b	18.1^b	15.9^b	14.6^a	12.7
26 or Older	6.6	7.0^b	6.8^a	6.8^b	6.0
26‑49	10.0	10.3	10.6^a	10.3	9.6
26‑29	13.8	13.6	14.9	14.2	13.0
30‑34	11.4	13.0	13.1	12.6	11.3
35‑39	10.0	9.9	9.5	8.8	9.2
40‑44	7.5	7.9	8.3	8.2	8.4
45‑49	7.7	7.3	7.6	8.1	6.4
50 or Older	3.5	4.1^b	3.5	3.8^a	3.0
50‑54	6.4	6.5	6.0	8.0	6.1
55‑59	4.4	6.3	4.3	5.9	4.3
60‑64	4.1	5.2^a	4.2	3.2	3.0
65 or Older	2.0	2.0	2.1	1.9	1.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.58A – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	53,420	54,707	53,829	56,437	54,631
SEX
Male	20,159^a	22,611	21,615	23,434	22,298
Female	33,261	32,096	32,214	33,003	32,333
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	45,174	45,775	44,919	47,014	44,694
AIAN	377	233	249	284	360
Asian	2,292	2,411	2,623	2,610	2,821
Black or African American	6,023	5,623	5,609	5,956	5,349
NHPI	156	*	*	140	151
White	34,773	35,551	34,302	36,204^a	33,448
Two or More Races	1,554^b	1,685^b	1,793^b	1,821^b	2,565
Hispanic or Latino	8,246^b	8,932	8,909	9,423	9,938
EDUCATION LEVEL
< High School	5,107	4,939	4,717	4,473	4,746
High School Graduate	13,042	13,324	13,618	13,752	14,139
Some College/Associate’s Degree	19,416	19,258	18,716	19,729	18,195
College Graduate	15,855^a	17,187	16,778	18,483	17,552
EMPLOYMENT STATUS
Full‑Time	22,605	24,855	24,760	25,660^a	23,427
Part‑Time	8,505	8,610	7,700^a	8,486	8,611
Unemployed	4,136	3,574^b	3,482^b	4,174	4,547
Other¹	18,175	17,668	17,888	18,118	18,047
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.58B – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	21.0	21.3	20.9	21.5^a	20.6
SEX
Male	16.3	18.1	17.2	18.3	17.5
Female	25.5^b	24.5	24.4	24.5	23.5
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	21.4	21.6	21.2	21.9^a	20.8
AIAN	23.0	18.7	22.5	24.6	22.8
Asian	15.4	15.6	16.4	15.2	16.0
Black or African American	19.7	18.2	18.0	18.8	17.2
NHPI	15.4	*	*	12.1	15.2
White	22.0	22.5	21.8	22.9^a	21.5
Two or More Races	34.0	33.4	34.0	33.4	31.6
Hispanic or Latino	19.1	20.2	19.6	19.7	20.0
EDUCATION LEVEL
< High School	18.1	20.3	19.3	18.6	19.4
High School Graduate	18.8	19.3	19.6	19.6	19.9
Some College/Associate’s Degree	25.2	24.8	24.3	25.3^a	23.5
College Graduate	20.1	20.2	19.4	20.5^a	19.0
EMPLOYMENT STATUS
Full‑Time	19.8	21.0	20.5	21.2^a	19.9
Part‑Time	28.0^a	26.2	24.4	26.2	24.7
Unemployed	31.6	32.4	30.4	32.4	33.2
Other¹	18.9	18.8	19.1	18.9	18.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.59A – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	20,062^a	21,552^b	20,335^b	20,380^b	18,201
SEX
Male	7,297	8,834^b	7,763	8,295^a	7,182
Female	12,765^b	12,718^b	12,572^b	12,085^a	11,019
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	16,846^a	18,018^b	16,837^b	17,284^b	15,055
AIAN	217^a	114	47	69	88
Asian	685	839	751	811	803
Black or African American	1,969	2,203^b	2,004^a	1,991^a	1,529
NHPI	78	*	*	*	*
White	13,286^b	14,021^b	13,046^a	13,459^b	11,631
Two or More Races	611^a	753	927	901	964
Hispanic or Latino	3,216	3,534	3,498	3,096	3,146
EDUCATION LEVEL
< High School	1,667^a	1,759^a	1,722^a	1,372	1,230
High School Graduate	4,845	5,716^a	5,287	4,900	4,832
Some College/Associate’s Degree	8,274^b	8,182^b	7,619^a	7,885^b	6,598
College Graduate	5,276	5,895	5,707	6,223	5,542
EMPLOYMENT STATUS
Full‑Time	8,252	9,173^b	9,339^b	8,900^b	7,592
Part‑Time	3,373	3,658	3,332	3,326	3,479
Unemployed	1,755	1,719	1,549	1,704	1,708
Other¹	6,681^b	7,002^b	6,115	6,451^a	5,422
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.59B – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	7.9^b	8.4^b	7.9^b	7.8^b	6.9
SEX
Male	5.9	7.1^b	6.2	6.5^a	5.6
Female	9.8^b	9.7^b	9.5^b	9.0^b	8.0
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	8.0^b	8.5^b	7.9^b	8.1^b	7.0
AIAN	13.2^a	9.2	4.3	6.0	5.6
Asian	4.6	5.4	4.7	4.7	4.5
Black or African American	6.4^a	7.1^b	6.4^a	6.3^a	4.9
NHPI	7.8	*	*	*	*
White	8.4^a	8.9^b	8.3^a	8.5^b	7.5
Two or More Races	13.4	14.9	17.6^a	16.5^a	11.9
Hispanic or Latino	7.5	8.0^b	7.7^a	6.5	6.3
EDUCATION LEVEL
< High School	5.9	7.2^b	7.0^a	5.7	5.0
High School Graduate	7.0	8.3^b	7.6	7.0	6.8
Some College/Associate’s Degree	10.7^b	10.5^b	9.9^b	10.1^b	8.5
College Graduate	6.7	6.9^a	6.6	6.9^a	6.0
EMPLOYMENT STATUS
Full‑Time	7.2^a	7.7^b	7.7^b	7.3^b	6.4
Part‑Time	11.1	11.1	10.6	10.3	10.0
Unemployed	13.4	15.6^a	13.5	13.2	12.5
Other¹	7.0^b	7.4^b	6.5^a	6.7^b	5.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.60A – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	53,420	54,707	53,829	56,437	54,631
GEOGRAPHIC DIVISION
Northeast	8,687	8,993	9,375	9,269	9,274
New England	2,514	2,566	2,939	2,917	2,623
Middle Atlantic	6,174	6,428	6,437	6,352	6,651
Midwest	11,356	11,841	11,049	12,080	11,559
East North Central	7,614	7,988	7,539	8,175	7,808
West North Central	3,742	3,853	3,510	3,905	3,751
South	20,254	19,820	20,077	20,922	19,906
South Atlantic	10,603	10,149	10,706	10,825	10,745
East South Central	3,390	3,410	3,271	3,451	3,168
West South Central	6,262	6,262	6,100	6,646	5,993
West	13,123	14,053	13,328	14,166	13,892
Mountain	4,253	4,949	4,747	4,635	4,776
Pacific	8,869	9,104	8,581	9,531	9,117
COUNTY TYPE¹
Large Metro	28,404	29,547	29,322	31,825	30,433
Small Metro	16,764	17,762	17,319	18,137	17,602
Nonmetro	8,252^b	7,399	7,188	6,475	6,597
Urbanized	3,269	2,935	2,955	2,674	2,697
Less Urbanized	3,011	2,791	2,607	2,361	2,569
Completely Rural	1,972^a	1,673	1,625	1,440	1,331
POVERTY LEVEL²
Less Than 100%	10,240	9,995^a	10,734	11,293	11,316
100‑199%	12,758	11,977	11,539	12,303	12,692
200% or More	30,380	32,734^a	31,544	32,797^a	30,527
HEALTH INSURANCE³
Private	28,897	30,982	30,056	31,778^a	29,712
Medicaid/CHIP	13,894	14,514	15,424	14,703	14,693
Other⁴	12,430	11,064^a	11,728	12,127	12,626
No Coverage	5,683	5,469	4,731^a	5,711	5,627
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.60B – Any Mental Illness in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	21.0	21.3	20.9	21.5^a	20.6
GEOGRAPHIC DIVISION
Northeast	19.4	20.0	20.9	20.3	20.1
New England	20.9	21.2	24.2	23.6	21.1
Middle Atlantic	18.8	19.6	19.6	19.1	19.7
Midwest	21.6	22.4	20.9	22.6	21.4
East North Central	21.0	22.0	20.7	22.2	21.0
West North Central	22.9	23.5	21.3	23.4	22.3
South	21.0^a	20.2	20.3	20.7	19.4
South Atlantic	20.6	19.4	20.3	20.0	19.6
East South Central	22.9	22.8	21.8	22.7	20.6
West South Central	20.7	20.3	19.5	20.8^a	18.4
West	21.8	23.2	21.9	22.9	22.3
Mountain	22.2	25.4	24.1	23.0	23.5
Pacific	21.7	22.1	20.9	22.8	21.7
COUNTY TYPE¹
Large Metro	20.3	20.4	20.0	21.1	20.1
Small Metro	22.4	22.9^a	22.5	22.5	21.2
Nonmetro	21.0	21.8	21.1	21.1	21.4
Urbanized	23.0	21.6	22.4	21.7	24.1
Less Urbanized	20.4	22.5	21.0	21.7	20.5
Completely Rural	19.0	20.9	19.2	19.2	18.5
POVERTY LEVEL²
Less Than 100%	27.0	27.6	27.2	27.6	26.2
100‑199%	25.1	24.0	23.6	24.4	23.0
200% or More	18.4	19.2	18.7	19.2	18.3
HEALTH INSURANCE³
Private	18.7	19.9	19.1	19.7	18.9
Medicaid/CHIP	29.3	30.2	31.0	30.3	29.0
Other⁴	16.5	14.4	15.2	15.6	15.4
No Coverage	22.9	23.5	21.0	23.8	23.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.61A – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	20,062^a	21,552^b	20,335^b	20,380^b	18,201
GEOGRAPHIC DIVISION
Northeast	3,159	3,227	3,539^b	3,352^a	2,731
New England	987	904	1,104	1,124	841
Middle Atlantic	2,172	2,322	2,435	2,228	1,890
Midwest	4,392	4,593	4,016	4,774	4,247
East North Central	2,834	3,001	2,699	3,265	2,808
West North Central	1,558	1,592	1,317	1,509	1,439
South	7,357^a	8,075^b	7,607^b	7,209^a	6,160
South Atlantic	3,685	4,189^b	3,955^a	3,608	3,148
East South Central	1,220	1,442^a	1,351^a	1,227	1,031
West South Central	2,452	2,444	2,301	2,373	1,981
West	5,154	5,658	5,174	5,044	5,063
Mountain	1,562	2,182	1,909	1,734	1,742
Pacific	3,592	3,476	3,265	3,310	3,322
COUNTY TYPE¹
Large Metro	10,431	11,227^b	10,473	11,045^b	9,502
Small Metro	6,499	7,043	7,110^a	6,888	6,252
Nonmetro	3,132^a	3,281^a	2,753	2,447	2,446
Urbanized	1,295	1,256	1,156	1,010	1,134
Less Urbanized	1,173	1,254	1,061	881	870
Completely Rural	664	771	536	556	442
POVERTY LEVEL²
Less Than 100%	4,307	4,244	4,406	4,516	4,302
100‑199%	4,713	5,353	4,597	4,524	4,548
200% or More	11,036^b	11,954^b	11,328^b	11,323^b	9,308
HEALTH INSURANCE³
Private	10,364	11,482^b	10,667^a	10,899^b	9,460
Medicaid/CHIP	5,619	6,573^a	6,296	6,045	5,636
Other⁴	4,149	3,865	3,869	3,931	3,421
No Coverage	2,246	2,371	2,034	2,248	2,101
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.61B – Serious Mental Illness in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	7.9^b	8.4^b	7.9^b	7.8^b	6.9
GEOGRAPHIC DIVISION
Northeast	7.1	7.2^a	7.9^b	7.3^a	5.9
New England	8.2	7.5	9.1^a	9.1	6.8
Middle Atlantic	6.6	7.1	7.4^a	6.7	5.6
Midwest	8.4	8.7	7.6	8.9	7.9
East North Central	7.8	8.3	7.4	8.9	7.6
West North Central	9.5	9.7	8.0	9.1	8.6
South	7.6^b	8.2^b	7.7^b	7.1^b	6.0
South Atlantic	7.2^a	8.0^b	7.5^b	6.7	5.8
East South Central	8.2	9.7^a	9.0^a	8.1	6.7
West South Central	8.1^a	7.9^a	7.4	7.4	6.1
West	8.6	9.3	8.5	8.1	8.1
Mountain	8.2	11.2^a	9.7	8.6	8.6
Pacific	8.8	8.5	7.9	7.9	7.9
COUNTY TYPE¹
Large Metro	7.5^b	7.8^b	7.2^a	7.3^b	6.3
Small Metro	8.7^a	9.1^b	9.2^b	8.5^a	7.5
Nonmetro	8.0	9.7^a	8.1	8.0	7.9
Urbanized	9.1	9.2	8.7	8.2	10.2
Less Urbanized	7.9	10.1^a	8.6	8.1	6.9
Completely Rural	6.4	9.6	6.3	7.4	6.2
POVERTY LEVEL²
Less Than 100%	11.4	11.7^a	11.2	11.0	10.0
100‑199%	9.3	10.7^b	9.4	9.0	8.2
200% or More	6.7^b	7.0^b	6.7^b	6.6^b	5.6
HEALTH INSURANCE³
Private	6.7^a	7.4^b	6.8^b	6.8^a	6.0
Medicaid/CHIP	11.8	13.7^b	12.6^a	12.5	11.1
Other⁴	5.5^b	5.0	5.0	5.1^a	4.2
No Coverage	9.1	10.2	9.0	9.4	8.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.62A – Co‑Occurring Substance Use Disorder and Level of Mental Illness in Past Year: Among People Aged 18 or Older; by Age Group, Numbers in Thousands, 2021‑2025
Co‑Occurring Substance Use Disorder and Level of Mental Illness/Age Group	2021	2022	2023	2024	2025
Substance Use Disorder and Any Mental Illness	18,807	20,467^a	19,457	20,128^a	18,452
18‑25	4,443	5,113^b	4,662^a	4,545^a	4,022
26 or Older	14,364	15,354	14,794	15,583	14,431
26‑49	10,220	11,104	10,753	11,518	10,505
50 or Older	4,144	4,250	4,042	4,065	3,926
Substance Use Disorder and Serious Mental Illness	8,773	9,829^b	9,155^b	9,278^b	7,804
18‑25	2,539^b	2,940^b	2,571^b	2,407^b	1,950
26 or Older	6,234	6,889^a	6,584	6,871^a	5,854
26‑49	4,719	4,900	5,170	5,282	4,613
50 or Older	1,515	1,989^b	1,414	1,589	1,241
Substance Use Disorder and Any Mental Illness Excluding Serious Mental Illness	10,034	10,638	10,302	10,849	10,649
18‑25	1,904	2,173	2,091	2,138	2,072
26 or Older	8,130	8,465	8,210	8,712	8,577
26‑49	5,501	6,204	5,583	6,235	5,891
50 or Older	2,628	2,261	2,628	2,476	2,685
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. NOTE: Mental illness aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Serious mental illness (SMI) is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.62B – Co‑Occurring Substance Use Disorder and Level of Mental Illness in Past Year: Among People Aged 18 or Older; by Age Group, Percentages, 2021‑2025
Co‑Occurring Substance Use Disorder and Level of Mental Illness/Age Group	2021	2022	2023	2024	2025
Substance Use Disorder and Any Mental Illness	7.4	8.0^b	7.6^a	7.7^a	7.0
18‑25	13.3^b	14.7^b	13.7^b	13.0^b	11.1
26 or Older	6.5	6.9^a	6.6	6.9	6.3
26‑49	10.0	10.8	10.4	10.9^a	10.0
50 or Older	3.5	3.6	3.4	3.3	3.2
Substance Use Disorder and Serious Mental Illness	3.5^b	3.8^b	3.6^b	3.5^b	2.9
18‑25	7.6^b	8.5^b	7.6^b	6.9^b	5.4
26 or Older	2.8	3.1^b	2.9^a	3.0^a	2.6
26‑49	4.6	4.8	5.0^a	5.0	4.4
50 or Older	1.3	1.7^b	1.2	1.3	1.0
Substance Use Disorder and Any Mental Illness Excluding Serious Mental Illness	4.0	4.2	4.0	4.1	4.0
18‑25	5.7	6.2	6.1	6.1	5.7
26 or Older	3.7	3.8	3.7	3.8	3.7
26‑49	5.4	6.0	5.4	5.9	5.6
50 or Older	2.2	1.9	2.2	2.0	2.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. NOTE: Mental illness aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. Serious mental illness (SMI) is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.63A – Substance Use in Past Year and Past Month: Among People Aged 18 or Older with Any Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	22,139	24,602	23,348	25,333	23,675
Marijuana	18,798^b	21,846	20,734	22,213	21,152
Cocaine	2,481	2,538	2,264	2,181	2,262
Crack	595	568	420	447	586
Heroin	811^b	678^b	304	373	341
Hallucinogens	3,615	3,924	3,943	5,005^a	4,177
LSD	1,253^b	1,103^a	820	808	746
Psilocybin	‑‑	‑‑	‑‑	3,621^a	2,910
Ecstasy	1,121	965	1,044	945	874
Inhalants²	‑‑	‑‑	‑‑	‑‑	1,095
Methamphetamine	1,378	1,534	1,441	1,332	1,385
Misuse of Prescription Psychotherapeutics	6,906^b	6,363^a	5,943	5,958	5,341
Pain Relievers	4,089^b	3,677^b	3,205	3,273	2,857
Prescription Opioids	3,971^b	3,574^b	3,088	3,114	2,760
Stimulants	1,868	2,202	1,985	1,943	1,896
Tranquilizers or Sedatives	2,731^a	2,609	2,453	2,371	2,162
Tranquilizers	2,520^b	2,160	2,224	2,109	1,831
Sedatives	472	639	464	398	561
Benzodiazepines	2,294^b	1,957	2,000	1,823	1,614
Misuse of Opioids^1,3	4,319^b	3,839^b	3,219	3,227	2,864
Misuse of Central Nervous System Stimulants	4,559	4,971^a	4,581	4,488	4,266
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	9,600
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	3,927^b	3,335	3,342	2,961
Illegally Made Fentanyl	‑‑	448	403	509	393
PAST MONTH USE
Alcohol	28,682	31,026^b	28,808	29,592	27,814
Binge Alcohol Use	15,201	16,310^b	14,554	14,694	13,822
Heavy Alcohol Use⁵	4,648	5,072^a	4,582	4,268	4,120
Cigarettes	13,213^b	12,416^b	11,383	11,673	10,718
Daily Cigarettes	8,081^b	7,273^b	6,574^a	6,676^a	5,523
Nicotine Vaping⁶	‑‑	8,711^b	9,669	10,718	10,198
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.63B – Substance Use in Past Year and Past Month: Among People Aged 18 or Older with Any Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	41.4	45.0	43.4	44.9	43.3
Marijuana	35.2^b	39.9	38.5	39.4	38.7
Cocaine	4.6	4.6	4.2	3.9	4.1
Crack	1.1	1.0	0.8	0.8	1.1
Heroin	1.5^b	1.2^b	0.6	0.7	0.6
Hallucinogens	6.8	7.2	7.3	8.9^a	7.6
LSD	2.3^b	2.0^a	1.5	1.4	1.4
Psilocybin	‑‑	‑‑	‑‑	6.4^a	5.3
Ecstasy	2.1	1.8	1.9	1.7	1.6
Inhalants²	‑‑	‑‑	‑‑	‑‑	2.0
Methamphetamine	2.6	2.8	2.7	2.4	2.5
Misuse of Prescription Psychotherapeutics	12.9^b	11.6^b	11.0	10.6	9.8
Pain Relievers	7.7^b	6.7^b	6.0	5.8	5.2
Prescription Opioids	7.4^b	6.5^b	5.7	5.5	5.1
Stimulants	3.5	4.0	3.7	3.4	3.5
Tranquilizers or Sedatives	5.1^a	4.8	4.6	4.2	4.0
Tranquilizers	4.7^b	3.9	4.1^a	3.7	3.4
Sedatives	0.9	1.2	0.9	0.7	1.0
Benzodiazepines	4.3^b	3.6	3.7^a	3.2	3.0
Misuse of Opioids^1,3	8.1^b	7.0^b	6.0	5.7	5.2
Misuse of Central Nervous System Stimulants	8.5	9.1^a	8.5	8.0	7.8
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	17.6
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	7.2^b	6.2	5.9	5.4
Illegally Made Fentanyl	‑‑	0.8	0.7	0.9	0.7
PAST MONTH USE
Alcohol	53.7^a	56.7^b	53.5^a	52.4	50.9
Binge Alcohol Use	28.5^b	29.8^b	27.0	26.0	25.3
Heavy Alcohol Use⁵	8.7	9.3^b	8.5	7.6	7.5
Cigarettes	24.7^b	22.7^b	21.1	20.7	19.6
Daily Cigarettes	15.1^b	13.3^b	12.2^b	11.8^a	10.1
Nicotine Vaping⁶	‑‑	15.9^b	18.0	19.0	18.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.64A – Substance Use in Past Year and Past Month: Among People Aged 18 to 25 with Any Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	5,808	6,788^b	5,763	5,910^a	5,236
Marijuana	5,346	6,337^b	5,455^a	5,402	4,872
Cocaine	563	683^a	562	455	493
Crack	27	30	30	36	16
Heroin	58^b	37^b	12	40^b	4
Hallucinogens	1,365	1,495^a	1,181	1,299	1,140
LSD	611^b	542^b	282	217	233
Psilocybin	‑‑	‑‑	‑‑	1,038	865
Ecstasy	363	304	286	215	246
Inhalants²	‑‑	‑‑	‑‑	‑‑	346
Methamphetamine	110	91	68	112	86
Misuse of Prescription Psychotherapeutics	1,499^b	1,446^b	1,088	1,130	963
Pain Relievers	602^b	661^b	453	487	369
Prescription Opioids	581^b	620^b	434	470	362
Stimulants	703	722^a	559	589	507
Tranquilizers or Sedatives	640^b	543^a	378	371	394
Tranquilizers	595^b	498	348	326	365
Sedatives	124^a	74	66	67	63
Benzodiazepines	568^b	474^a	335	298	330
Misuse of Opioids^1,3	597^b	630^b	436	492	365
Misuse of Central Nervous System Stimulants	1,091^a	1,231^b	970	939	852
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	1,996
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	650^b	457	534^a	374
Illegally Made Fentanyl	‑‑	37	57	83	47
PAST MONTH USE
Alcohol	6,344^a	7,169^b	6,155	6,133	5,593
Binge Alcohol Use	3,673^a	4,259^b	3,602	3,489	3,172
Heavy Alcohol Use⁵	984	1,215^b	1,045^a	863	823
Cigarettes	1,824	1,777	1,582	1,640	1,535
Daily Cigarettes	441^b	459^b	409^b	344^b	184
Nicotine Vaping⁶	‑‑	3,799^b	3,486^a	3,492^a	3,048
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.64B – Substance Use in Past Year and Past Month: Among People Aged 18 to 25 with Any Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	52.3	55.5^b	51.7	53.0	50.7
Marijuana	48.2	51.8^b	48.9	48.4	47.2
Cocaine	5.1	5.6	5.0	4.1	4.8
Crack	0.2	0.2	0.3	0.3	0.2
Heroin	0.5^b	0.3^b	0.1	0.4^b	<0.1
Hallucinogens	12.3	12.2	10.6	11.6	11.0
LSD	5.5^b	4.4^b	2.5	1.9	2.3
Psilocybin	‑‑	‑‑	‑‑	9.3	8.4
Ecstasy	3.3	2.5	2.6	1.9	2.4
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.3
Methamphetamine	1.0	0.7	0.6	1.0	0.8
Misuse of Prescription Psychotherapeutics	13.5^b	11.8^a	9.8	10.1	9.3
Pain Relievers	5.4^b	5.4^b	4.1	4.4	3.6
Prescription Opioids	5.2^a	5.1^a	3.9	4.2	3.5
Stimulants	6.3	5.9	5.0	5.3	4.9
Tranquilizers or Sedatives	5.8^a	4.4	3.4	3.3	3.8
Tranquilizers	5.4^a	4.1	3.1	2.9	3.5
Sedatives	1.1	0.6	0.6	0.6	0.6
Benzodiazepines	5.1^b	3.9	3.0	2.7	3.2
Misuse of Opioids^1,3	5.4^b	5.2^a	3.9	4.4	3.5
Misuse of Central Nervous System Stimulants	9.8	10.1	8.7	8.4	8.2
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	19.3
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	5.3^b	4.1	4.8	3.6
Illegally Made Fentanyl	‑‑	0.3	0.5	0.7	0.5
PAST MONTH USE
Alcohol	57.1	58.6^a	55.2	55.0	54.1
Binge Alcohol Use	33.1	34.8^a	32.3	31.3	30.7
Heavy Alcohol Use⁵	8.9	9.9^a	9.4	7.7	8.0
Cigarettes	16.4	14.5	14.2	14.7	14.9
Daily Cigarettes	4.0^b	3.7^b	3.7^b	3.1^b	1.8
Nicotine Vaping⁶	‑‑	31.0	31.3	31.3	29.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.65A – Substance Use in Past Year and Past Month: Among People Aged 26 or Older with Any Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	16,331^a	17,814	17,585	19,423	18,439
Marijuana	13,452^b	15,509	15,279	16,811	16,280
Cocaine	1,918	1,855	1,701	1,725	1,769
Crack	567	539	389	411	571
Heroin	754^b	641^b	293	333	337
Hallucinogens	2,250^b	2,430^a	2,762	3,706^a	3,037
LSD	642	561	538	592	514
Psilocybin	‑‑	‑‑	‑‑	2,583^a	2,045
Ecstasy	758	661	758	730	628
Inhalants²	‑‑	‑‑	‑‑	‑‑	749
Methamphetamine	1,268	1,443	1,374	1,220	1,299
Misuse of Prescription Psychotherapeutics	5,406^a	4,917	4,855	4,828	4,378
Pain Relievers	3,486^b	3,016	2,752	2,785	2,488
Prescription Opioids	3,391^b	2,953^a	2,654	2,644	2,399
Stimulants	1,165	1,480	1,426	1,354	1,389
Tranquilizers or Sedatives	2,091	2,066	2,074	1,999	1,768
Tranquilizers	1,925^a	1,662	1,876	1,783	1,466
Sedatives	347	566	398	331	499
Benzodiazepines	1,726^a	1,483	1,666^a	1,526	1,284
Misuse of Opioids^1,3	3,722^b	3,209^a	2,783	2,735	2,499
Misuse of Central Nervous System Stimulants	3,468	3,740	3,611	3,549	3,414
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	7,605
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	3,277^a	2,879	2,808	2,587
Illegally Made Fentanyl	‑‑	411	345	426	346
PAST MONTH USE
Alcohol	22,338	23,857	22,652	23,459	22,221
Binge Alcohol Use	11,529	12,052^a	10,952	11,206	10,650
Heavy Alcohol Use⁵	3,664	3,857	3,537	3,405	3,297
Cigarettes	11,389^b	10,639^a	9,801	10,033	9,183
Daily Cigarettes	7,641^b	6,814^b	6,165	6,332^a	5,339
Nicotine Vaping⁶	‑‑	4,912^b	6,183^a	7,226	7,149
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.65B – Substance Use in Past Year and Past Month: Among People Aged 26 or Older with Any Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	38.6^a	41.9	41.2	42.9	41.6
Marijuana	31.8^b	36.5	35.8	37.1	36.7
Cocaine	4.5	4.4	4.0	3.8	4.0
Crack	1.3	1.3	0.9	0.9	1.3
Heroin	1.8^b	1.5^b	0.7	0.7	0.8
Hallucinogens	5.3^a	5.7	6.5	8.2	6.9
LSD	1.5	1.3	1.3	1.3	1.2
Psilocybin	‑‑	‑‑	‑‑	5.7	4.6
Ecstasy	1.8	1.6	1.8	1.6	1.4
Inhalants²	‑‑	‑‑	‑‑	‑‑	1.7
Methamphetamine	3.0	3.4	3.2	2.7	2.9
Misuse of Prescription Psychotherapeutics	12.8^b	11.6^a	11.4	10.7	9.9
Pain Relievers	8.2^b	7.1^a	6.4	6.1	5.6
Prescription Opioids	8.0^b	7.0^a	6.2	5.8	5.4
Stimulants	2.8	3.5	3.3	3.0	3.1
Tranquilizers or Sedatives	4.9	4.9	4.9	4.4	4.0
Tranquilizers	4.5^a	3.9	4.4^a	3.9	3.3
Sedatives	0.8	1.3	0.9	0.7	1.1
Benzodiazepines	4.1^a	3.5	3.9^a	3.4	2.9
Misuse of Opioids^1,3	8.8^b	7.6^b	6.5	6.0	5.6
Misuse of Central Nervous System Stimulants	8.2	8.8	8.5	7.8	7.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	17.2
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	7.7^b	6.7	6.2	5.8
Illegally Made Fentanyl	‑‑	1.0	0.8	0.9	0.8
PAST MONTH USE
Alcohol	52.8	56.2^b	53.1^a	51.8	50.2
Binge Alcohol Use	27.2^b	28.4^b	25.7	24.7	24.0
Heavy Alcohol Use⁵	8.7	9.1^a	8.3	7.5	7.4
Cigarettes	26.9^b	25.0^b	23.0	22.2	20.7
Daily Cigarettes	18.1^b	16.0^b	14.4^a	14.0^a	12.1
Nicotine Vaping⁶	‑‑	11.6^b	14.5	16.0	16.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.66A – Substance Use in Past Year and Past Month: Among People Aged 26 to 49 with Any Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	11,963^b	13,415	13,517	14,641	13,643
Marijuana	10,345^b	12,065	12,109	12,905	12,114
Cocaine	1,377	1,475	1,268	1,367	1,505
Crack	271	326	207^a	217^a	378
Heroin	469^a	520^b	266	243	267
Hallucinogens	2,079^a	2,153	2,410	3,171^a	2,588
LSD	602	504	442	534	451
Psilocybin	‑‑	‑‑	‑‑	2,290	1,824
Ecstasy	698	566	656	665	607
Inhalants²	‑‑	‑‑	‑‑	‑‑	676
Methamphetamine	956	1,003	1,061	906	910
Misuse of Prescription Psychotherapeutics	3,596	3,531	3,513	3,470	3,257
Pain Relievers	2,115	2,097	1,913	1,790	1,763
Prescription Opioids	2,054	2,056	1,866	1,701	1,727
Stimulants	1,070	1,272	1,213	1,237	1,282
Tranquilizers or Sedatives	1,501	1,401	1,480	1,477	1,329
Tranquilizers	1,433	1,219	1,343	1,329	1,185
Sedatives	241	258	247	252	276
Benzodiazepines	1,348	1,142	1,186	1,176	1,078
Misuse of Opioids^1,3	2,245	2,272^a	1,972	1,781	1,816
Misuse of Central Nervous System Stimulants	2,643	2,886	2,833	2,890	2,771
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	5,864
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	2,339	2,042	1,820	1,899
Illegally Made Fentanyl	‑‑	346	289	246	293
PAST MONTH USE
Alcohol	15,946	17,712^b	16,631	17,206^a	15,591
Binge Alcohol Use	8,498	9,566^b	8,454	8,434	8,048
Heavy Alcohol Use⁵	2,768	2,924	2,576	2,539	2,461
Cigarettes	7,131^b	7,234^b	6,242	6,250	5,926
Daily Cigarettes	4,577^b	4,302^b	3,814^a	3,404	3,134
Nicotine Vaping⁶	‑‑	4,149^b	5,223^a	6,189	6,055
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.66B – Substance Use in Past Year and Past Month: Among People Aged 26 to 49 with Any Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	44.6^a	48.3	48.4	50.0	47.9
Marijuana	38.6^b	43.4	43.3	44.1	42.5
Cocaine	5.1	5.3	4.5	4.7	5.3
Crack	1.0	1.2	0.7^a	0.7^a	1.3
Heroin	1.7^a	1.9^b	1.0	0.8	0.9
Hallucinogens	7.8	7.7	8.6	10.8^a	9.1
LSD	2.2	1.8	1.6	1.8	1.6
Psilocybin	‑‑	‑‑	‑‑	7.8	6.4
Ecstasy	2.6	2.0	2.3	2.3	2.1
Inhalants²	‑‑	‑‑	‑‑	‑‑	2.4
Methamphetamine	3.6	3.6	3.8	3.1	3.2
Misuse of Prescription Psychotherapeutics	13.4^a	12.7	12.6	11.9	11.4
Pain Relievers	7.9^a	7.5	6.8	6.1	6.2
Prescription Opioids	7.7^a	7.4	6.7	5.8	6.1
Stimulants	4.0	4.6	4.3	4.2	4.5
Tranquilizers or Sedatives	5.6	5.0	5.3	5.0	4.7
Tranquilizers	5.3	4.4	4.8	4.5	4.2
Sedatives	0.9	0.9	0.9	0.9	1.0
Benzodiazepines	5.0^a	4.1	4.2	4.0	3.8
Misuse of Opioids^1,3	8.4^b	8.2^a	7.1	6.1	6.4
Misuse of Central Nervous System Stimulants	9.9	10.4	10.1	9.9	9.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	20.6
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	8.4^a	7.3	6.2	6.7
Illegally Made Fentanyl	‑‑	1.2	1.0	0.8	1.0
PAST MONTH USE
Alcohol	59.5^b	63.7^b	59.5^b	58.8^b	54.7
Binge Alcohol Use	31.7^a	34.4^b	30.2	28.8	28.2
Heavy Alcohol Use⁵	10.3	10.5^a	9.2	8.7	8.6
Cigarettes	26.6^b	26.0^b	22.3	21.4	20.8
Daily Cigarettes	17.1^b	15.5^b	13.6^b	11.6	11.0
Nicotine Vaping⁶	‑‑	14.9^b	18.7^a	21.2	21.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.67A – Substance Use in Past Year and Past Month: Among People Aged 50 or Older with Any Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	4,368	4,398	4,068	4,782	4,796
Marijuana	3,107^a	3,444	3,170^a	3,906	4,167
Cocaine	541	380	433	358	265
Crack	296	213	183	194	193
Heroin	285	121	26	90	70
Hallucinogens	172^a	277	352	535	449
LSD	40	56	96	58	62
Psilocybin	‑‑	‑‑	‑‑	293	221
Ecstasy	60	95	102	65	21
Inhalants²	‑‑	‑‑	‑‑	‑‑	74
Methamphetamine	313	440	312	313	389
Misuse of Prescription Psychotherapeutics	1,810^a	1,385	1,342	1,358	1,121
Pain Relievers	1,371^a	919	839	995	724
Prescription Opioids	1,336^a	897	788	943	672
Stimulants	94	207	213	117	107
Tranquilizers or Sedatives	590	665	595	522	439
Tranquilizers	492	443	534	454	281
Sedatives	106	307	151	80	223
Benzodiazepines	378	341	480^a	350	206
Misuse of Opioids^1,3	1,477^b	937	810	955	682
Misuse of Central Nervous System Stimulants	825	855	778	659	643
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	1,741
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	937	837	988	689
Illegally Made Fentanyl	‑‑	65	56	180	54
PAST MONTH USE
Alcohol	6,392	6,146	6,021	6,253	6,630
Binge Alcohol Use	3,031	2,486	2,498	2,771	2,602
Heavy Alcohol Use⁵	895	934	962	866	836
Cigarettes	4,258^a	3,405	3,559	3,783	3,257
Daily Cigarettes	3,064^a	2,512	2,351	2,928	2,206
Nicotine Vaping⁶	‑‑	763	960	1,038	1,094
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.67B – Substance Use in Past Year and Past Month: Among People Aged 50 or Older with Any Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	28.2	30.0	27.6	29.8	30.3
Marijuana	20.0^a	23.5	21.5^a	24.4	26.4
Cocaine	3.5^a	2.6	2.9	2.2	1.7
Crack	1.9	1.5	1.2	1.2	1.2
Heroin	1.8	0.8	0.2	0.6	0.4
Hallucinogens	1.1^a	1.9	2.4	3.3	2.8
LSD	0.3	0.4	0.7	0.4	0.4
Psilocybin	‑‑	‑‑	‑‑	1.8	1.4
Ecstasy	0.4	0.6	0.7	0.4	0.1
Inhalants²	‑‑	‑‑	‑‑	‑‑	0.5
Methamphetamine	2.0	3.0	2.1	2.0	2.5
Misuse of Prescription Psychotherapeutics	11.7^a	9.4	9.1	8.5	7.1
Pain Relievers	8.8^b	6.3	5.7	6.2	4.6
Prescription Opioids	8.6^b	6.1	5.3	5.9	4.2
Stimulants	0.6	1.4	1.4	0.7	0.7
Tranquilizers or Sedatives	3.8	4.5	4.0	3.3	2.8
Tranquilizers	3.2	3.0	3.6^a	2.8	1.8
Sedatives	0.7	2.1	1.0	0.5	1.4
Benzodiazepines	2.4	2.3	3.3^a	2.2	1.3
Misuse of Opioids^1,3	9.5^b	6.4	5.5	6.0	4.3
Misuse of Central Nervous System Stimulants	5.3	5.8	5.3	4.1	4.1
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	11.0
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	6.4	5.7	6.2	4.4
Illegally Made Fentanyl	‑‑	0.4	0.4	1.1	0.3
PAST MONTH USE
Alcohol	41.2	41.9	40.9	39.0	41.9
Binge Alcohol Use	19.6	16.9	17.0	17.3	16.5
Heavy Alcohol Use⁵	5.8	6.4	6.5	5.4	5.3
Cigarettes	27.5^b	23.2	24.2	23.6	20.6
Daily Cigarettes	19.8^a	17.1	16.0	18.3	14.0
Nicotine Vaping⁶	‑‑	5.2	6.5	6.5	6.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Any mental illness (AMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.68A – Substance Use in Past Year and Past Month: Among People Aged 18 or Older with Serious Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	9,751	11,341^b	10,323	11,428^b	9,646
Marijuana	8,138	10,094^b	9,334	10,095^b	8,509
Cocaine	1,055	1,191	1,040	1,142	1,093
Crack	212	341	178	287	285
Heroin	415^b	319^b	109	197	128
Hallucinogens	1,905	1,992	2,009	2,618^a	2,087
LSD	637	554	461	431	432
Psilocybin	‑‑	‑‑	‑‑	1,796	1,458
Ecstasy	487	455	481	479	499
Inhalants²	‑‑	‑‑	‑‑	‑‑	616
Methamphetamine	674	834	730	786	717
Misuse of Prescription Psychotherapeutics	3,358^b	3,184^a	2,731	3,091	2,536
Pain Relievers	1,964^b	1,882^b	1,505	1,664	1,299
Prescription Opioids	1,895^b	1,831^b	1,464	1,635	1,275
Stimulants	982	1,043	965	1,120	986
Tranquilizers or Sedatives	1,390	1,408	1,186	1,255	1,119
Tranquilizers	1,281	1,140	1,115	1,164	997
Sedatives	290	393	156	165	291
Benzodiazepines	1,157	1,012	1,016	1,029	887
Misuse of Opioids^1,3	2,004^b	1,953^b	1,482	1,696	1,332
Misuse of Central Nervous System Stimulants	2,188	2,409	2,085	2,424	2,138
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	4,554
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	1,996^b	1,559	1,747	1,364
Illegally Made Fentanyl	‑‑	243	224	335	167
PAST MONTH USE
Alcohol	11,138^b	12,348^b	11,534^b	11,145^b	9,654
Binge Alcohol Use	6,120^b	6,468^b	6,020^b	5,609^a	4,847
Heavy Alcohol Use⁵	1,758	2,215^b	1,945	1,873	1,623
Cigarettes	5,217^b	5,336^b	4,809^a	5,008^b	4,061
Daily Cigarettes	3,179^b	3,125^b	2,745^a	2,779^a	2,076
Nicotine Vaping⁶	‑‑	4,350	4,538	4,874^a	4,107
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.68B – Substance Use in Past Year and Past Month: Among People Aged 18 or Older with Serious Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	48.6^a	52.6	50.8	56.1	53.0
Marijuana	40.6^b	46.8	45.9	49.5	46.8
Cocaine	5.3	5.5	5.1	5.6	6.0
Crack	1.1	1.6	0.9	1.4	1.6
Heroin	2.1^a	1.5^a	0.5	1.0	0.7
Hallucinogens	9.5	9.2^a	9.9	12.8	11.5
LSD	3.2	2.6	2.3	2.1	2.4
Psilocybin	‑‑	‑‑	‑‑	8.8	8.0
Ecstasy	2.4	2.1	2.4	2.3	2.7
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.4
Methamphetamine	3.4	3.9	3.6	3.9	3.9
Misuse of Prescription Psychotherapeutics	16.7^a	14.8	13.4	15.2	13.9
Pain Relievers	9.8^a	8.7	7.4	8.2	7.1
Prescription Opioids	9.4^a	8.5	7.2	8.0	7.0
Stimulants	4.9	4.8	4.7	5.5	5.4
Tranquilizers or Sedatives	6.9	6.5	5.8	6.2	6.1
Tranquilizers	6.4	5.3	5.5	5.7	5.5
Sedatives	1.4	1.8	0.8^a	0.8^a	1.6
Benzodiazepines	5.8	4.7	5.0	5.0	4.9
Misuse of Opioids^1,3	10.0^a	9.1	7.3	8.3	7.3
Misuse of Central Nervous System Stimulants	10.9	11.2	10.3	11.9	11.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	25.0
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	9.3	7.7	8.6	7.5
Illegally Made Fentanyl	‑‑	1.1	1.1	1.6	0.9
PAST MONTH USE
Alcohol	55.5	57.3^a	56.7^a	54.7	53.0
Binge Alcohol Use	30.5^a	30.0^a	29.6	27.5	26.6
Heavy Alcohol Use⁵	8.8	10.3	9.6	9.2	8.9
Cigarettes	26.0^a	24.8	23.6	24.6	22.3
Daily Cigarettes	15.8^b	14.5^a	13.5	13.6	11.4
Nicotine Vaping⁶	‑‑	20.2	22.3	23.9	22.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.69A – Substance Use in Past Year and Past Month: Among People Aged 18 to 25 with Serious Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	3,093^b	3,708^b	2,979^b	2,971^b	2,418
Marijuana	2,803^b	3,471^b	2,800^b	2,702^a	2,254
Cocaine	235	386^b	341	285	221
Crack	15	16	19	33	10
Heroin	45^a	21^a	5	33^a	3
Hallucinogens	755^a	865^b	660	752^a	545
LSD	323^b	299^b	172^a	121	93
Psilocybin	‑‑	‑‑	‑‑	573^a	386
Ecstasy	199	166	155	133	139
Inhalants²	‑‑	‑‑	‑‑	‑‑	154
Methamphetamine	64	57	33	78	50
Misuse of Prescription Psychotherapeutics	838^b	864^b	672^a	678^a	474
Pain Relievers	345^b	438^b	283^a	300^a	171
Prescription Opioids	332^b	401^b	264^a	298^a	166
Stimulants	348	425^b	329	354	237
Tranquilizers or Sedatives	415^b	329	233	251	231
Tranquilizers	374^a	312	212	231	210
Sedatives	113^b	26	44	39	35
Benzodiazepines	356^a	295	206	197	195
Misuse of Opioids^1,3	345^b	409^b	265^a	317^b	169
Misuse of Central Nervous System Stimulants	514	708^b	559^a	560^a	384
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	936
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	424^b	278^a	339^b	172
Illegally Made Fentanyl	‑‑	21	25	58^a	15
PAST MONTH USE
Alcohol	3,247^b	3,726^b	3,015^a	2,861	2,515
Binge Alcohol Use	1,837^b	2,181^b	1,851^b	1,656^a	1,321
Heavy Alcohol Use⁵	423	636^b	534^a	471	357
Cigarettes	963^a	1,018^a	817	906	743
Daily Cigarettes	263^b	318^b	182^a	188^a	102
Nicotine Vaping⁶	‑‑	2,103^b	1,780^b	1,703^a	1,383
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.69B – Substance Use in Past Year and Past Month: Among People Aged 18 to 25 with Serious Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	55.1	60.7^a	57.4	60.3	55.3
Marijuana	49.9	56.8^a	53.9	54.9	51.6
Cocaine	4.2	6.3	6.6	5.8	5.1
Crack	0.3	0.3	0.4	0.7	0.2
Heroin	0.8^a	0.3	0.1	0.7^a	0.1
Hallucinogens	13.4	14.2	12.7	15.3	12.5
LSD	5.7^b	4.9^b	3.3	2.5	2.1
Psilocybin	‑‑	‑‑	‑‑	11.6	8.8
Ecstasy	3.5	2.7	3.0	2.7	3.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.5
Methamphetamine	1.1	0.9	0.6	1.6	1.1
Misuse of Prescription Psychotherapeutics	14.9^a	14.1^a	12.9	13.8	10.8
Pain Relievers	6.1^a	7.2^b	5.5	6.1	3.9
Prescription Opioids	5.9	6.6^b	5.1	6.1	3.8
Stimulants	6.2	7.0	6.3	7.2	5.4
Tranquilizers or Sedatives	7.4	5.4	4.5	5.1	5.3
Tranquilizers	6.7	5.1	4.1	4.7	4.8
Sedatives	2.0^a	0.4	0.8	0.8	0.8
Benzodiazepines	6.3	4.8	4.0	4.0	4.5
Misuse of Opioids^1,3	6.1^a	6.7^b	5.1	6.4^a	3.9
Misuse of Central Nervous System Stimulants	9.1	11.6	10.8	11.4	8.8
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	21.4
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	6.9^b	5.3	6.9^a	3.9
Illegally Made Fentanyl	‑‑	0.3	0.5	1.2^a	0.3
PAST MONTH USE
Alcohol	57.8	61.0	58.0	58.1	57.6
Binge Alcohol Use	32.7	35.7^a	35.6^a	33.6	30.2
Heavy Alcohol Use⁵	7.5	10.4	10.3	9.6	8.2
Cigarettes	17.1	16.7	15.7	18.4	17.0
Daily Cigarettes	4.7^b	5.2^b	3.5	3.8	2.3
Nicotine Vaping⁶	‑‑	34.4	34.3	34.6	31.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.70A – Substance Use in Past Year and Past Month: Among People Aged 26 or Older with Serious Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	6,658	7,633	7,345	8,457^a	7,228
Marijuana	5,335^a	6,623	6,534	7,394^a	6,255
Cocaine	820	805	698	857	872
Crack	197	325	159	254	274
Heroin	371^a	298^a	104	163	125
Hallucinogens	1,150^a	1,127^a	1,349	1,866	1,542
LSD	315	255	289	310	339
Psilocybin	‑‑	‑‑	‑‑	1,223	1,073
Ecstasy	288	289	326	345	360
Inhalants²	‑‑	‑‑	‑‑	‑‑	462
Methamphetamine	610	777	696	708	667
Misuse of Prescription Psychotherapeutics	2,520	2,321	2,059	2,414	2,062
Pain Relievers	1,620^a	1,444	1,222	1,363	1,128
Prescription Opioids	1,563^a	1,430	1,200	1,337	1,109
Stimulants	634	618	636	767	749
Tranquilizers or Sedatives	975	1,079	953	1,003	887
Tranquilizers	907	828	903	933	787
Sedatives	177	367	112^a	126	256
Benzodiazepines	801	717	810	831	692
Misuse of Opioids^1,3	1,659^a	1,544	1,217	1,379	1,164
Misuse of Central Nervous System Stimulants	1,674	1,701	1,526	1,864	1,754
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	3,618
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	1,573	1,282	1,408	1,192
Illegally Made Fentanyl	‑‑	222	199	277	152
PAST MONTH USE
Alcohol	7,890	8,623^b	8,520^b	8,284^a	7,139
Binge Alcohol Use	4,283^a	4,287^a	4,169^a	3,953	3,526
Heavy Alcohol Use⁵	1,335	1,579	1,411	1,403	1,266
Cigarettes	4,253^b	4,318^b	3,991^a	4,102^a	3,318
Daily Cigarettes	2,916^b	2,807^b	2,562^a	2,590^a	1,973
Nicotine Vaping⁶	‑‑	2,247	2,758	3,171	2,724
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.70B – Substance Use in Past Year and Past Month: Among People Aged 26 or Older with Serious Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	46.1^a	49.4	48.5	54.7	52.3
Marijuana	36.9^b	42.9	43.2	47.8	45.2
Cocaine	5.7	5.2	4.6	5.5	6.3
Crack	1.4	2.1	1.0	1.6	2.0
Heroin	2.6^a	1.9^a	0.7	1.1	0.9
Hallucinogens	8.0^a	7.3^b	8.9	12.1	11.1
LSD	2.2	1.7	1.9	2.0	2.5
Psilocybin	‑‑	‑‑	‑‑	7.9	7.8
Ecstasy	2.0	1.9	2.2	2.2	2.6
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.3
Methamphetamine	4.2	5.0	4.6	4.6	4.8
Misuse of Prescription Psychotherapeutics	17.4	15.0	13.6	15.6	14.9
Pain Relievers	11.2^a	9.4	8.1	8.8	8.2
Prescription Opioids	10.8	9.3	7.9	8.7	8.0
Stimulants	4.4	4.0	4.2	5.0	5.4
Tranquilizers or Sedatives	6.8	7.0	6.3	6.5	6.4
Tranquilizers	6.3	5.4	6.0	6.0	5.7
Sedatives	1.2	2.4	0.7^a	0.8^a	1.9
Benzodiazepines	5.5	4.6	5.4	5.4	5.0
Misuse of Opioids^1,3	11.5^a	10.0	8.0	8.9	8.4
Misuse of Central Nervous System Stimulants	11.6	11.0	10.1	12.1	12.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	26.2
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	10.2	8.5	9.1	8.6
Illegally Made Fentanyl	‑‑	1.4	1.3	1.8	1.1
PAST MONTH USE
Alcohol	54.6	55.8	56.3^a	53.6	51.6
Binge Alcohol Use	29.7^a	27.8	27.5	25.6	25.5
Heavy Alcohol Use⁵	9.2	10.2	9.3	9.1	9.2
Cigarettes	29.4^b	28.0^a	26.4	26.5	24.0
Daily Cigarettes	20.2^b	18.2^a	16.9	16.8	14.3
Nicotine Vaping⁶	‑‑	14.6^b	18.2	20.5	19.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.71A – Substance Use in Past Year and Past Month: Among People Aged 26 to 49 with Serious Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	5,237	5,689	6,076	6,422	5,746
Marijuana	4,462	5,117	5,466	5,656	5,061
Cocaine	581	571	553	635	751
Crack	116	161	96	119	192
Heroin	213^a	221^a	104	99	89
Hallucinogens	1,102	1,018^a	1,230	1,527	1,397
LSD	314	255	242	291	313
Psilocybin	‑‑	‑‑	‑‑	1,075	975
Ecstasy	287	267	326	293	354
Inhalants²	‑‑	‑‑	‑‑	‑‑	408
Methamphetamine	481	507	585	516	452
Misuse of Prescription Psychotherapeutics	1,860	1,648	1,662	1,712	1,624
Pain Relievers	1,132	979	957	858	839
Prescription Opioids	1,087	971	935	832	831
Stimulants	610	538	596	684	685
Tranquilizers or Sedatives	744	699	751	744	694
Tranquilizers	723	575	702	713	609
Sedatives	125	171	112	75^a	184
Benzodiazepines	675	518	621	671	567
Misuse of Opioids^1,3	1,130	1,059	952	862	885
Misuse of Central Nervous System Stimulants	1,326	1,239	1,295	1,478	1,394
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	2,914
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	1,088	1,001	880	907
Illegally Made Fentanyl	‑‑	182	169	143	132
PAST MONTH USE
Alcohol	6,101	6,494^b	6,539^b	6,574^b	5,461
Binge Alcohol Use	3,445	3,436	3,325	3,077	3,047
Heavy Alcohol Use⁵	1,154	1,227	1,065	1,061	1,068
Cigarettes	2,928^a	2,953^a	2,792	2,783	2,411
Daily Cigarettes	1,934^b	1,749^b	1,806^b	1,544	1,262
Nicotine Vaping⁶	‑‑	1,886^a	2,418	2,733	2,333
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.71B – Substance Use in Past Year and Past Month: Among People Aged 26 to 49 with Serious Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	51.0^a	53.7	55.3	59.0	56.8
Marijuana	43.5^a	48.3	49.7	51.9	50.1
Cocaine	5.7	5.4	5.0^a	5.8	7.4
Crack	1.1	1.5	0.9	1.1	1.9
Heroin	2.1^a	2.1^a	0.9	0.9	0.9
Hallucinogens	10.7	9.6^a	11.2	14.0	13.8
LSD	3.1	2.4	2.2	2.7	3.1
Psilocybin	‑‑	‑‑	‑‑	9.9	9.6
Ecstasy	2.8	2.5	3.0	2.7	3.5
Inhalants²	‑‑	‑‑	‑‑	‑‑	4.0
Methamphetamine	4.7	4.8	5.3	4.7	4.5
Misuse of Prescription Psychotherapeutics	18.1	15.5	15.1	15.7	16.1
Pain Relievers	11.0	9.2	8.7	7.9	8.3
Prescription Opioids	10.6	9.2	8.5	7.6	8.2
Stimulants	5.9	5.1	5.4	6.3	6.8
Tranquilizers or Sedatives	7.3	6.6	6.8	6.8	6.9
Tranquilizers	7.0	5.4	6.4	6.5	6.0
Sedatives	1.2	1.6	1.0	0.7^a	1.8
Benzodiazepines	6.6	4.9	5.7	6.2	5.6
Misuse of Opioids^1,3	11.0	10.0	8.7	7.9	8.8
Misuse of Central Nervous System Stimulants	12.9	11.7	11.8	13.6	13.8
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	28.8
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	10.3	9.1	8.1	9.0
Illegally Made Fentanyl	‑‑	1.7	1.5	1.3	1.3
PAST MONTH USE
Alcohol	59.5^a	61.3^b	59.5^a	60.4^b	54.0
Binge Alcohol Use	33.6	32.4	30.2	28.2	30.1
Heavy Alcohol Use⁵	11.2	11.6	9.7	9.7	10.6
Cigarettes	28.5^a	27.9^a	25.4	25.6	23.8
Daily Cigarettes	18.8^b	16.5^b	16.4^b	14.2	12.5
Nicotine Vaping⁶	‑‑	17.8^b	22.0	25.1	23.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.72A – Substance Use in Past Year and Past Month: Among People Aged 50 or Older with Serious Mental Illness; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	1,421	1,944	1,269	2,034	1,482
Marijuana	873	1,507	1,068	1,738	1,194
Cocaine	238	234	145	222	121
Crack	81	164	63	135	82
Heroin	158	77	<1	64	*
Hallucinogens	*	108	119	339	145
LSD	1	*	47	19	26
Psilocybin	‑‑	‑‑	‑‑	148	98
Ecstasy	1	22	*	52	7
Inhalants²	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	130	269	112	192	215
Misuse of Prescription Psychotherapeutics	660	673	397	701	438
Pain Relievers	487	465	265	506	289
Prescription Opioids	476	459	265	505	279
Stimulants	24	80	40	*	64
Tranquilizers or Sedatives	231	380	202	259	193
Tranquilizers	184	253	201	220	178
Sedatives	51	196	<1^a	50	72
Benzodiazepines	126	199	189	160	125
Misuse of Opioids^1,3	529	485	265	516	279
Misuse of Central Nervous System Stimulants	348	462	231	386	360
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	704
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	485	281	528	285
Illegally Made Fentanyl	‑‑	40	30	134	20
PAST MONTH USE
Alcohol	1,790	2,128	1,980	1,709	1,678
Binge Alcohol Use	838	851^a	844^a	877^a	480
Heavy Alcohol Use⁵	181	352	346	341	198
Cigarettes	1,325	1,366	1,199	1,319	907
Daily Cigarettes	982	1,057	757	1,046	712
Nicotine Vaping⁶	‑‑	362	340	439	391
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.72B – Substance Use in Past Year and Past Month: Among People Aged 50 or Older with Serious Mental Illness; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	34.0	40.1	30.6	44.6	39.8
Marijuana	20.9^a	31.1	25.8	38.1	32.1
Cocaine	5.7	4.8	3.5	4.9	3.3
Crack	1.9	3.4	1.5	3.0	2.2
Heroin	3.8	1.6	<0.1	1.4	*
Hallucinogens	*	2.2	2.9	7.4	3.9
LSD	<0.1	*	1.1	0.4	0.7
Psilocybin	‑‑	‑‑	‑‑	3.2	2.6
Ecstasy	<0.1	0.5	*	1.1	0.2
Inhalants²	‑‑	‑‑	‑‑	‑‑	*
Methamphetamine	3.1	5.6	2.7	4.2	5.8
Misuse of Prescription Psychotherapeutics	15.8	13.9	9.6	15.4	11.8
Pain Relievers	11.7	9.6	6.4	11.1	7.8
Prescription Opioids	11.4	9.5	6.4	11.1	7.5
Stimulants	0.6	1.7	1.0	*	1.7
Tranquilizers or Sedatives	5.5	7.8	4.9	5.7	5.2
Tranquilizers	4.4	5.2	4.9	4.8	4.8
Sedatives	1.2	4.1	<0.1^a	1.1	1.9
Benzodiazepines	3.0	4.1	4.6	3.5	3.4
Misuse of Opioids^1,3	12.6	10.0	6.4	11.3	7.5
Misuse of Central Nervous System Stimulants	8.3	9.5	5.6	8.5	9.7
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	18.9
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	10.0	6.8	11.6	7.7
Illegally Made Fentanyl	‑‑	0.8	0.7	2.9	0.5
PAST MONTH USE
Alcohol	42.8	44.0	47.8	37.5	45.1
Binge Alcohol Use	20.0	17.6	20.4^a	19.2	12.9
Heavy Alcohol Use⁵	4.3	7.3	8.4	7.5	5.3
Cigarettes	31.7	28.2	28.9	28.9	24.4
Daily Cigarettes	23.5	21.8	18.3	22.9	19.1
Nicotine Vaping⁶	‑‑	7.5	8.2	9.6	10.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Serious mental illness (SMI) aligns with DSM‑5 criteria and is defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental or substance use disorder. SMI is a subset of any mental illness (AMI) because SMI is limited to people with AMI that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic criteria. NOTE: Some 2021‑2024 estimates may differ from previously published estimates due to updates that were made to the mental illness model beginning in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.73A – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	21,553^a	22,475^b	21,899^b	21,414^a	19,674
18‑25	6,442^b	6,990^b	5,953^b	5,541	5,116
18‑20	2,601^b	2,627^b	1,923	2,014	1,957
21‑25	3,842^b	4,363^b	4,030^b	3,528	3,159
26 or Older	15,111	15,485	15,946	15,873	14,557
26‑49	9,810	9,975	10,567	10,534	9,614
26‑29	2,306	2,170	2,587	2,391	2,179
30‑34	2,324	2,698	2,752	2,774	2,402
35‑39	2,012	1,961	2,124	1,954	1,825
40‑44	1,507	1,584	1,721	1,783	1,814
45‑49	1,660	1,562	1,383	1,631	1,395
50 or Older	5,301	5,510	5,379	5,339	4,943
50‑54	1,438	1,348	1,339	1,449	1,219
55‑59	1,120	1,427^a	934	988	966
60‑64	1,167	1,206	1,380	1,039	879
65 or Older	1,577	1,528	1,727	1,863	1,880
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.73B – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	8.5^b	8.8^b	8.5^b	8.2^b	7.4
18‑25	19.3^b	20.1^b	17.5^b	15.9^a	14.2
18‑20	19.9^b	20.3^b	15.8	16.0	14.2
21‑25	18.8^b	20.0^b	18.4^b	15.8	14.2
26 or Older	6.9	7.0^a	7.1^b	7.0^a	6.4
26‑49	9.6	9.7	10.2^a	10.0	9.1
26‑29	13.2	12.7	14.7	13.7	12.6
30‑34	10.2	11.6	12.1^a	11.8	10.2
35‑39	9.0	8.9	9.2	8.4	8.1
40‑44	7.4	7.6	8.1	8.0	8.3
45‑49	8.5	8.0	7.3	8.5	6.9
50 or Older	4.5	4.6	4.5	4.4	4.0
50‑54	7.3	6.8	7.2	7.4	6.7
55‑59	5.3	7.1^a	4.5	5.1	4.9
60‑64	5.2	5.3	6.0^a	4.6	3.9
65 or Older	2.9	2.7	3.0	3.1	3.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.74A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	14,889	15,873^b	15,294^a	14,656	13,788
18‑25	4,603^b	5,109^b	4,381^b	4,014	3,689
18‑20	1,864^b	1,934^b	1,437	1,434	1,338
21‑25	2,739	3,175^b	2,944^b	2,580	2,351
26 or Older	10,286	10,764	10,913	10,642	10,099
26‑49	6,792	7,068	7,649	7,448	7,027
26‑29	1,643	1,658	1,941	1,684	1,625
30‑34	1,624	1,864	1,986	2,002	1,699
35‑39	1,396	1,462	1,573^a	1,347	1,233
40‑44	1,034^a	1,062^a	1,241	1,248	1,419
45‑49	1,095	1,022	907	1,167	1,051
50 or Older	3,494	3,695	3,264	3,193	3,072
50‑54	1,065	894	922	1,079	782
55‑59	854	986^a	529	661	554
60‑64	818	838	936	567	636
65 or Older	757	977	877	887	1,099
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.74B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	5.9^b	6.2^b	5.9^b	5.6	5.2
18‑25	13.8^b	14.7^b	12.9^b	11.5^a	10.2
18‑20	14.3^b	15.0^b	11.8^a	11.4	9.7
21‑25	13.4^b	14.5^b	13.5^b	11.5	10.5
26 or Older	4.7	4.9	4.9	4.7	4.4
26‑49	6.6	6.9	7.4	7.0	6.7
26‑29	9.4	9.7	11.0	9.6	9.4
30‑34	7.2	8.0	8.8	8.5	7.2
35‑39	6.3	6.6	6.8^a	5.8	5.5
40‑44	5.1	5.1	5.9	5.6	6.5
45‑49	5.6	5.2	4.8	6.1	5.2
50 or Older	3.0	3.1	2.7	2.6	2.5
50‑54	5.4	4.5	4.9	5.5	4.3
55‑59	4.0	4.9^a	2.6	3.4	2.8
60‑64	3.7	3.7	4.1	2.5	2.8
65 or Older	1.4	1.7	1.5	1.5	1.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.75A – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	21,553^a	22,475^b	21,899^b	21,414^a	19,674
SEX
Male	7,844	8,780^b	7,956	8,203^a	7,230
Female	13,709	13,695^a	13,943^a	13,211	12,443
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	18,074^a	18,573^b	18,142^b	18,179^b	16,247
AIAN	177	94	46	97	106
Asian	746	963	777	962	808
Black or African American	2,121	2,038	2,021	1,927	1,641
NHPI	44	*	*	25	64
White	14,342^b	14,574^b	14,335^b	14,324^b	12,538
Two or More Races	644^b	825	892	845	1,091
Hispanic or Latino	3,479	3,902	3,757	3,235	3,426
EDUCATION LEVEL
< High School	1,715	1,742^a	1,597	1,259	1,306
High School Graduate	4,835	5,507	5,568	4,906	5,150
Some College/Associate’s Degree	8,848^b	8,666^b	8,188^a	8,210^a	7,084
College Graduate	6,155	6,560	6,546	7,038^a	6,134
EMPLOYMENT STATUS
Full‑Time	9,000	9,608^b	9,741^b	9,172^a	8,158
Part‑Time	3,739	3,967	3,764	3,711	3,730
Unemployed	1,687	1,574	1,541	1,590	1,716
Other¹	7,128^a	7,326^b	6,853	6,942	6,069
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.75B – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	8.5^b	8.8^b	8.5^b	8.2^b	7.4
SEX
Male	6.4	7.0^b	6.3	6.4^a	5.7
Female	10.5^b	10.4^b	10.5^b	9.8	9.1
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	8.6^b	8.8^b	8.6^b	8.5^b	7.5
AIAN	10.8	7.6	4.2	8.4	6.7
Asian	5.0	6.3	4.8	5.6	4.6
Black or African American	6.9^a	6.6	6.5	6.1	5.3
NHPI	4.3	*	*	2.1	6.4
White	9.1^b	9.2^b	9.1^b	9.1^b	8.0
Two or More Races	14.1	16.4	16.9	15.5	13.4
Hispanic or Latino	8.1	8.8^b	8.3^a	6.8	6.9
EDUCATION LEVEL
< High School	6.1	7.1^a	6.5	5.2	5.3
High School Graduate	7.0	8.0	8.0	7.0	7.3
Some College/Associate’s Degree	11.5^b	11.1^b	10.6^b	10.5^b	9.2
College Graduate	7.8^a	7.7^a	7.6^a	7.8^b	6.6
EMPLOYMENT STATUS
Full‑Time	7.9^a	8.1^b	8.1^b	7.6	6.9
Part‑Time	12.3	12.1	11.9	11.5	10.7
Unemployed	12.9	14.3	13.5	12.3	12.5
Other¹	7.4^b	7.8^b	7.3^a	7.2^a	6.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.76A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	14,889	15,873^b	15,294^a	14,656	13,788
SEX
Male	5,170	6,246^a	5,564	5,686	5,285
Female	9,719^a	9,627^a	9,730^a	8,969	8,503
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	12,484	13,151^b	12,705^a	12,549	11,500
AIAN	126	65	28^a	60	87
Asian	515	781	603	683	629
Black or African American	1,439	1,507	1,371	1,377	1,207
NHPI	41	34	*	10	*
White	9,924^a	10,090^b	9,914^a	9,729^a	8,730
Two or More Races	440^b	674	734	691	795
Hispanic or Latino	2,404	2,722	2,589	2,107	2,288
EDUCATION LEVEL
< High School	1,186	1,217	1,123	888	980
High School Graduate	3,275	4,123	4,015	3,331	3,621
Some College/Associate’s Degree	6,572^b	6,347^b	5,752	5,813	5,188
College Graduate	3,856	4,186	4,403	4,623	3,998
EMPLOYMENT STATUS
Full‑Time	6,065	6,415^a	6,588^b	6,258^a	5,479
Part‑Time	2,474	2,772	2,572	2,528	2,691
Unemployed	1,194	1,147	1,162	1,159	1,218
Other¹	5,155	5,538^b	4,971	4,710	4,400
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.76B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	5.9^b	6.2^b	5.9^b	5.6	5.2
SEX
Male	4.2	5.0^b	4.4	4.5	4.1
Female	7.5^b	7.3^b	7.4^b	6.7	6.2
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	5.9^a	6.2^b	6.0^a	5.8^a	5.3
AIAN	7.7	5.2	2.5	5.2	5.5
Asian	3.5	5.1	3.8	4.0	3.6
Black or African American	4.7	4.9	4.4	4.3	3.9
NHPI	4.1	2.8	*	0.8	*
White	6.3^a	6.4^b	6.3^a	6.2	5.6
Two or More Races	9.6	13.4	13.9^a	12.7	9.8
Hispanic or Latino	5.6	6.2^b	5.7^a	4.4	4.6
EDUCATION LEVEL
< High School	4.2	5.0	4.6	3.7	4.0
High School Graduate	4.7	6.0	5.8	4.7	5.1
Some College/Associate’s Degree	8.5^b	8.2^b	7.5	7.5	6.7
College Graduate	4.9	4.9	5.1^a	5.1^a	4.3
EMPLOYMENT STATUS
Full‑Time	5.3	5.4^a	5.4^b	5.2	4.6
Part‑Time	8.1	8.4	8.2	7.8	7.7
Unemployed	9.1	10.4	10.2	9.0	8.9
Other¹	5.4^a	5.9^b	5.3^a	4.9	4.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.77A – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	21,553^a	22,475^b	21,899^b	21,414^a	19,674
GEOGRAPHIC DIVISION
Northeast	3,281	3,495	3,851	3,634	3,148
New England	1,020	957	1,232	1,165	929
Middle Atlantic	2,260	2,537	2,619	2,469	2,219
Midwest	4,579	4,879	4,249	4,759	4,644
East North Central	2,992	3,200	2,905	3,259	3,011
West North Central	1,587	1,679	1,344	1,501	1,633
South	7,991^a	8,393^b	8,191^b	7,590	6,792
South Atlantic	4,089	4,344	4,361^a	4,076	3,643
East South Central	1,339	1,415	1,419	1,299	1,073
West South Central	2,563	2,634^a	2,411	2,215	2,076
West	5,702	5,708	5,608	5,430	5,090
Mountain	1,843	2,126	2,151	1,729	1,766
Pacific	3,859	3,582	3,457	3,701	3,325
COUNTY TYPE¹
Large Metro	11,235	11,893^a	11,426	11,747^a	10,370
Small Metro	7,184	7,454	7,437	7,062	6,651
Nonmetro	3,133	3,128	3,036	2,605	2,653
Urbanized	1,306	1,275	1,273	1,179	1,200
Less Urbanized	1,226	1,205	1,061	876	884
Completely Rural	600	648	701	550	568
POVERTY LEVEL²
Less Than 100%	4,373	4,059	4,582	4,416	4,277
100‑199%	4,951	5,509^a	4,731	4,723	4,642
200% or More	12,215^a	12,906^b	12,580^b	12,249^b	10,692
HEALTH INSURANCE³
Private	11,750^a	12,551^b	11,825^a	11,813^a	10,547
Medicaid/CHIP	5,584	6,432^a	6,534^a	5,838	5,533
Other⁴	4,534	4,399	4,614	4,580	4,080
No Coverage	2,297	2,196	1,969	2,217	2,201
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.77B – Major Depressive Episode in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	8.5^b	8.8^b	8.5^b	8.2^b	7.4
GEOGRAPHIC DIVISION
Northeast	7.3	7.8	8.6^a	8.0	6.8
New England	8.5	7.9	10.2^a	9.5	7.5
Middle Atlantic	6.9	7.7	8.0	7.4	6.6
Midwest	8.7	9.2	8.0	8.9	8.6
East North Central	8.3	8.8	8.0	8.8	8.1
West North Central	9.7	10.2	8.2	9.0	9.7
South	8.3^b	8.6^b	8.3^b	7.5^a	6.6
South Atlantic	8.0^a	8.3^b	8.3^b	7.5	6.7
East South Central	9.0	9.5^a	9.5^a	8.6	7.0
West South Central	8.5^a	8.5^b	7.7	6.9	6.4
West	9.5^a	9.4^a	9.2	8.8	8.2
Mountain	9.6	10.9^a	10.9^a	8.6	8.7
Pacific	9.4	8.7	8.4	8.9	7.9
COUNTY TYPE¹
Large Metro	8.0^b	8.2^b	7.8^a	7.8^a	6.9
Small Metro	9.6^b	9.6^b	9.7^b	8.8	8.0
Nonmetro	8.0	9.2	8.9	8.5	8.6
Urbanized	9.2	9.4	9.6	9.6	10.7
Less Urbanized	8.3	9.7^a	8.6	8.1	7.1
Completely Rural	5.8	8.1	8.3	7.3	7.9
POVERTY LEVEL²
Less Than 100%	11.6	11.2	11.6^a	10.8	9.9
100‑199%	9.7^a	11.1^b	9.7	9.4	8.4
200% or More	7.4^b	7.6^b	7.4^b	7.2^a	6.4
HEALTH INSURANCE³
Private	7.6^a	8.0^b	7.5^a	7.3^a	6.7
Medicaid/CHIP	11.8	13.4^b	13.1^b	12.0	10.9
Other⁴	6.0^a	5.7	6.0^a	5.9	5.0
No Coverage	9.3	9.4	8.7	9.2	9.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.78A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	14,889	15,873^b	15,294^a	14,656	13,788
GEOGRAPHIC DIVISION
Northeast	2,268	2,465	2,618	2,460	2,272
New England	714	697	851	889	635
Middle Atlantic	1,554	1,768	1,767	1,571	1,637
Midwest	3,105	3,390	2,985	3,317	3,369
East North Central	1,960	2,225	2,035	2,235	2,178
West North Central	1,145	1,165	950	1,082	1,191
South	5,549^a	6,044^b	5,509^a	5,277	4,628
South Atlantic	2,760	3,287^a	2,821	2,862	2,491
East South Central	952	920	1,001^a	836	709
West South Central	1,837	1,837	1,687	1,578	1,428
West	3,966	3,974	4,182	3,602	3,519
Mountain	1,379	1,482	1,560	1,142	1,283
Pacific	2,587	2,492	2,622	2,460	2,236
COUNTY TYPE¹
Large Metro	7,759	8,523^b	7,884	7,863	7,203
Small Metro	4,912	5,143	5,471^a	4,912	4,677
Nonmetro	2,217	2,206	1,939	1,881	1,907
Urbanized	938	895	813	907	861
Less Urbanized	905	838	749	621	641
Completely Rural	374	474	378	353	406
POVERTY LEVEL²
Less Than 100%	3,281	2,984	3,393	3,247	3,209
100‑199%	3,502	4,067	3,452	3,364	3,413
200% or More	8,093^a	8,821^b	8,446^b	8,026^a	7,121
HEALTH INSURANCE³
Private	7,837	8,394^b	7,889^a	7,785	7,041
Medicaid/CHIP	4,164	4,973	4,838	4,393	4,247
Other⁴	3,166	3,185	3,020	2,883	2,778
No Coverage	1,413	1,563	1,505	1,527	1,555
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.78B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	5.9^b	6.2^b	5.9^b	5.6	5.2
GEOGRAPHIC DIVISION
Northeast	5.1	5.5	5.8	5.4	4.9
New England	5.9	5.8	7.0^a	7.2	5.1
Middle Atlantic	4.7	5.4	5.4	4.7	4.9
Midwest	5.9	6.4	5.7	6.2	6.2
East North Central	5.4	6.1	5.6	6.1	5.9
West North Central	7.0	7.1	5.8	6.5	7.1
South	5.8^b	6.2^b	5.6^b	5.2^a	4.5
South Atlantic	5.4	6.3^b	5.3	5.3	4.6
East South Central	6.4^a	6.2	6.7^a	5.5	4.6
West South Central	6.1^a	6.0^a	5.4	4.9	4.4
West	6.6	6.6	6.9^a	5.8	5.6
Mountain	7.2	7.6	7.9	5.7	6.3
Pacific	6.3	6.1	6.4	5.9	5.3
COUNTY TYPE¹
Large Metro	5.6^a	5.9^b	5.4^a	5.2	4.8
Small Metro	6.6^a	6.6^a	7.1^b	6.1	5.6
Nonmetro	5.6	6.5	5.7	6.1	6.2
Urbanized	6.6	6.6	6.2	7.4	7.7
Less Urbanized	6.1	6.8	6.0	5.7	5.1
Completely Rural	3.6	5.9	4.5	4.7	5.7
POVERTY LEVEL²
Less Than 100%	8.7	8.2	8.6	7.9	7.4
100‑199%	6.9	8.2^b	7.0	6.7	6.2
200% or More	4.9^a	5.2^b	5.0^b	4.7	4.3
HEALTH INSURANCE³
Private	5.1^a	5.4^b	5.0^a	4.8	4.5
Medicaid/CHIP	8.8	10.3^b	9.7^a	9.0	8.4
Other⁴	4.2	4.2	3.9	3.7	3.4
No Coverage	5.7	6.7	6.7	6.4	6.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.79A – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	12,521^a	13,200	12,821	14,339	13,946
18‑25	4,497^a	4,746^b	4,165	4,390^a	3,892
18‑20	1,863	1,958	1,591	1,711	1,664
21‑25	2,634^a	2,788^b	2,574	2,679^a	2,228
26 or Older	8,024^b	8,453^b	8,656^a	9,949	10,053
26‑49	5,629^a	5,629^a	6,077	6,442	6,517
26‑29	1,539	1,403	1,580	1,587	1,636
30‑34	1,415	1,502	1,747	1,696	1,541
35‑39	1,163	1,173	1,170	1,156	1,293
40‑44	807^b	933^a	788^b	1,180	1,305
45‑49	705	619	793	822	742
50 or Older	2,395^b	2,824	2,579^a	3,507	3,536
50‑54	746	687	558	804	636
55‑59	425	780	444	715	505
60‑64	464	703	578	768	768
65 or Older	761^b	654^b	999^a	1,221	1,627
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.79B – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	4.9	5.2	5.0	5.5	5.3
18‑25	13.4^b	13.6^b	12.2^a	12.6^b	10.8
18‑20	14.3^a	15.1^b	13.1	13.6	12.1
21‑25	12.9^b	12.8^b	11.8^a	12.0^b	10.0
26 or Older	3.6^b	3.8^a	3.9^a	4.4	4.4
26‑49	5.5	5.5	5.9	6.1	6.2
26‑29	8.8	8.2	9.0	9.1	9.5
30‑34	6.2	6.5	7.7	7.2	6.6
35‑39	5.2	5.3	5.0	5.0	5.7
40‑44	4.0^b	4.5^a	3.7^b	5.3	6.0
45‑49	3.6	3.2	4.2	4.3	3.7
50 or Older	2.0^a	2.4	2.1^a	2.9	2.9
50‑54	3.8	3.5	3.0	4.1	3.5
55‑59	2.0	3.9	2.2	3.7	2.6
60‑64	2.1	3.1	2.5	3.4	3.4
65 or Older	1.4^b	1.2^b	1.7	2.0	2.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.80A – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	3,624^b	3,753^b	3,704^b	4,639	4,855
18‑25	1,737	1,714^a	1,436	1,452	1,437
18‑20	846	788	604	565	635
21‑25	892	926	832	888	802
26 or Older	1,886^b	2,040^b	2,268^b	3,186	3,418
26‑49	1,482^b	1,372^b	1,657^a	1,903	2,073
26‑29	296^a	383	389	488	570
30‑34	305	416	554	500	451
35‑39	334	219^a	291	347	390
40‑44	307	228^a	222^a	342	435
45‑49	240	126	200	226	227
50 or Older	405^b	667^b	611^b	1,284	1,345
50‑54	77	111	257	316	175
55‑59	84	269	86	188	190
60‑64	146	141	134	294	314
65 or Older	98^b	146^b	135^b	486	666
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.80B – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	1.4^b	1.5^b	1.4^b	1.8	1.8
18‑25	5.2^b	4.9^a	4.2	4.2	4.0
18‑20	6.5^a	6.1^a	5.0	4.5	4.6
21‑25	4.4	4.2	3.8	4.0	3.6
26 or Older	0.9^b	0.9^b	1.0^b	1.4	1.5
26‑49	1.4^a	1.3^b	1.6	1.8	2.0
26‑29	1.7^a	2.2	2.2	2.8	3.3
30‑34	1.3	1.8	2.4	2.1	1.9
35‑39	1.5	1.0^a	1.3	1.5	1.7
40‑44	1.5	1.1^a	1.0^a	1.5	2.0
45‑49	1.2	0.6	1.1	1.2	1.1
50 or Older	0.3^b	0.6^b	0.5^b	1.1	1.1
50‑54	0.4	0.6	1.4	1.6	1.0
55‑59	0.4	1.3	0.4	1.0	1.0
60‑64	0.7	0.6	0.6	1.3	1.4
65 or Older	0.2^b	0.3^b	0.2^b	0.8	1.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.81A – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Numbers in Thousands, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	1,811	1,623^b	1,458^b	2,202	2,283
18‑25	947^a	728	675	682	672
18‑20	494^a	329	307	321	317
21‑25	453	399	368	361	355
26 or Older	864^b	895^b	783^b	1,520	1,612
26‑49	676	485^b	584^b	818	956
26‑29	177	178	149	216	274
30‑34	109	150	158	268	151
35‑39	121	50^a	119	143	154
40‑44	125	75^b	86^a	122	255
45‑49	144	32^a	72	69	122
50 or Older	188^b	410	199^b	703	656
50‑54	37	101	108	83	111
55‑59	10	92	29	153	76
60‑64	25	146	7	142	163
65 or Older	116	70	55^a	325	306
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.81B – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Detailed Age Category, Percentages, 2021‑2025
Age Category	2021	2022	2023	2024	2025
TOTAL	0.7	0.6^a	0.6^b	0.8	0.9
18‑25	2.8^b	2.1	2.0	2.0	1.9
18‑20	3.8^a	2.5	2.5	2.6	2.3
21‑25	2.2	1.8	1.7	1.6	1.6
26 or Older	0.4^b	0.4^b	0.4^b	0.7	0.7
26‑49	0.7	0.5^b	0.6^a	0.8	0.9
26‑29	1.0	1.0	0.8	1.2	1.6
30‑34	0.5	0.6	0.7	1.1	0.6
35‑39	0.5	0.2^a	0.5	0.6	0.7
40‑44	0.6	0.4^b	0.4^a	0.5	1.2
45‑49	0.7	0.2^a	0.4	0.4	0.6
50 or Older	0.2^b	0.3	0.2^b	0.6	0.5
50‑54	0.2	0.5	0.6	0.4	0.6
55‑59	<0.1	0.5	0.1	0.8	0.4
60‑64	0.1	0.6	<0.1	0.6	0.7
65 or Older	0.2	0.1	0.1^a	0.5	0.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.82A – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	12,521^a	13,200	12,821	14,339	13,946
SEX
Male	5,572^b	6,269	5,584^b	6,978	6,994
Female	6,949	6,930	7,236	7,362	6,952
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	10,408	11,151	10,567	11,740	11,036
AIAN	133	87	52	84	119
Asian	379	520	680	751	603
Black or African American	1,423	1,702	1,251	1,748	1,617
NHPI	69	*	27	31	31
White	8,015	8,290	7,925	8,541	8,142
Two or More Races	390	471	632	584	524
Hispanic or Latino	2,114^b	2,049^b	2,253^a	2,599	2,909
EDUCATION LEVEL
< High School	1,171	1,185	1,005	1,438	1,310
High School Graduate	3,208^a	3,931	3,587	3,945	3,952
Some College/Associate’s Degree	5,101	4,986	4,976	5,307	4,949
College Graduate	3,041^a	3,097^a	3,254	3,649	3,734
EMPLOYMENT STATUS
Full‑Time	5,079	5,506	5,588	6,069	5,466
Part‑Time	2,204	2,584	2,203	2,200	2,457
Unemployed	1,391	962^b	1,078^a	1,457	1,478
Other¹	3,846	4,148	3,952	4,613	4,544
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.82B – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	4.9	5.2	5.0	5.5	5.3
SEX
Male	4.5^b	5.0	4.5^b	5.5	5.5
Female	5.3	5.3	5.5	5.5	5.1
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	4.9	5.3	5.0	5.5	5.1
AIAN	8.1	7.0	4.7	7.3	7.6
Asian	2.5	3.4	4.2	4.4	3.4
Black or African American	4.6	5.5	4.0	5.5	5.2
NHPI	6.8	*	2.6	2.6	3.1
White	5.1	5.2	5.0	5.4	5.2
Two or More Races	8.5	9.3	12.0^b	10.7^b	6.4
Hispanic or Latino	4.9	4.6^a	5.0	5.4	5.9
EDUCATION LEVEL
< High School	4.1	4.9	4.1	6.0	5.4
High School Graduate	4.6^a	5.7	5.2	5.6	5.6
Some College/Associate’s Degree	6.6	6.4	6.5	6.8	6.4
College Graduate	3.9	3.6	3.8	4.1	4.0
EMPLOYMENT STATUS
Full‑Time	4.4	4.7	4.6	5.0	4.6
Part‑Time	7.3	7.9	7.0	6.8	7.0
Unemployed	10.6	8.7	9.4	11.3	10.8
Other¹	4.0	4.4	4.2	4.8	4.6
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.83A – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,624^b	3,753^b	3,704^b	4,639	4,855
SEX
Male	1,639^b	1,678^b	1,548^b	2,308	2,350
Female	1,985^a	2,075	2,156	2,330	2,505
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	2,881^b	3,126^a	3,101^a	3,846	3,714
AIAN	*	31	20	31	23
Asian	134	128	166	201	133
Black or African American	359^a	542	462	629	615
NHPI	6	2	14	10	5
White	2,236^a	2,276^a	2,295^a	2,781	2,797
Two or More Races	115	148	144	195	141
Hispanic or Latino	743^a	627^b	603^b	792^a	1,141
EDUCATION LEVEL
< High School	447	390	394	539	500
High School Graduate	1,192	1,267	1,217	1,519	1,427
Some College/Associate’s Degree	1,412	1,415	1,300^a	1,657	1,830
College Graduate	573^b	681^a	792	924	1,098
EMPLOYMENT STATUS
Full‑Time	1,233^a	1,385	1,385	1,777	1,704
Part‑Time	655	857	721	654	804
Unemployed	527	348^b	433	492	576
Other¹	1,209^a	1,163^a	1,164^a	1,716	1,771
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.83B – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	1.4^b	1.5^b	1.4^b	1.8	1.8
SEX
Male	1.3^a	1.3^a	1.2^b	1.8	1.8
Female	1.5	1.6	1.6	1.7	1.8
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	1.4^a	1.5	1.5	1.8	1.7
AIAN	*	2.5	1.8	2.7	1.5
Asian	0.9	0.8	1.0	1.2	0.8
Black or African American	1.2^a	1.8	1.5	2.0	2.0
NHPI	0.6	0.1	1.4	0.9	0.5
White	1.4^a	1.4^a	1.5^a	1.8	1.8
Two or More Races	2.5	2.9	2.7	3.6^b	1.7
Hispanic or Latino	1.7	1.4^a	1.3^b	1.7	2.3
EDUCATION LEVEL
< High School	1.6	1.6	1.6	2.2	2.0
High School Graduate	1.7	1.8	1.8	2.2	2.0
Some College/Associate’s Degree	1.8	1.8^a	1.7^a	2.1	2.4
College Graduate	0.7^a	0.8^a	0.9	1.0	1.2
EMPLOYMENT STATUS
Full‑Time	1.1^a	1.2	1.1	1.5	1.4
Part‑Time	2.2	2.6	2.3	2.0	2.3
Unemployed	4.0	3.2	3.8	3.8	4.2
Other¹	1.3^a	1.2^a	1.2^a	1.8	1.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.84A – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	1,811	1,623^b	1,458^b	2,202	2,283
SEX
Male	771	748	641^a	1,035	1,011
Female	1,040	875^a	818^a	1,167	1,273
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	1,306	1,377	1,184^a	1,746	1,620
AIAN	20	19	15	20	6
Asian	53	36	76	30	78
Black or African American	294	289	259	336	371
NHPI	8	1	10	7	*
White	887	956	756^a	1,252	1,086
Two or More Races	45	76	68	102	75
Hispanic or Latino	505	245^b	274^b	456	663
EDUCATION LEVEL
< High School	272	244	279	327	281
High School Graduate	620	654	574^a	810	835
Some College/Associate’s Degree	763	561	380^b	633	876
College Graduate	156	163	226	432	291
EMPLOYMENT STATUS
Full‑Time	603	468	531	710	661
Part‑Time	308	264	244	316	350
Unemployed	260	182	195	275	269
Other¹	639	709	488^b	901	1,002
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.84B – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	0.7	0.6^a	0.6^b	0.8	0.9
SEX
Male	0.6	0.6	0.5^a	0.8	0.8
Female	0.8	0.7^a	0.6^a	0.9	0.9
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	0.6	0.6	0.6^a	0.8	0.8
AIAN	1.2	1.5^a	1.3	1.7^a	0.4
Asian	0.4	0.2	0.5	0.2	0.4
Black or African American	1.0	0.9	0.8	1.1	1.2
NHPI	0.8	0.1	1.0	0.6	*
White	0.6	0.6	0.5^a	0.8	0.7
Two or More Races	1.0	1.5	1.3	1.9	0.9
Hispanic or Latino	1.2	0.6^b	0.6^a	1.0	1.3
EDUCATION LEVEL
< High School	1.0	1.0	1.1	1.4	1.1
High School Graduate	0.9	0.9	0.8^a	1.2	1.2
Some College/Associate’s Degree	1.0	0.7	0.5^b	0.8	1.1
College Graduate	0.2	0.2	0.3	0.5	0.3
EMPLOYMENT STATUS
Full‑Time	0.5	0.4	0.4	0.6	0.6
Part‑Time	1.0	0.8	0.8	1.0	1.0
Unemployed	2.0	1.7	1.7	2.1	2.0
Other¹	0.7	0.8	0.5^a	0.9	1.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Includes students, people keeping house or caring for children full time, retired or disabled people, or other people not in the labor force. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.85A – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	12,521^a	13,200	12,821	14,339	13,946
GEOGRAPHIC DIVISION
Northeast	1,703	2,087	2,344	2,392	2,223
New England	435	602	772^a	770	518
Middle Atlantic	1,268	1,485	1,571	1,621	1,705
Midwest	2,874	2,875	2,488^a	3,212	3,018
East North Central	2,008	1,971	1,610^a	2,228	2,096
West North Central	866	904	878	984	922
South	4,649	4,691	4,745	5,252	5,127
South Atlantic	2,318	2,519	2,637	2,515	2,554
East South Central	723	804	732	827	825
West South Central	1,607	1,368	1,376	1,911	1,749
West	3,296	3,546	3,244	3,483	3,576
Mountain	992^a	1,363	1,356	1,308	1,345
Pacific	2,304	2,183	1,887	2,175	2,232
COUNTY TYPE¹
Large Metro	6,405^b	6,777	6,614^a	7,844	7,800
Small Metro	4,019	4,436	4,555	4,793	4,534
Nonmetro	2,098^a	1,986	1,652	1,702	1,612
Urbanized	852	812	699	685	738
Less Urbanized	668	727	690	665	591
Completely Rural	578^a	447	263	352	283
POVERTY LEVEL²
Less Than 100%	2,782	2,786	2,506^a	3,350	3,090
100‑199%	2,881	3,309	3,131	3,069	3,253
200% or More	6,855	7,104	7,182	7,904	7,570
HEALTH INSURANCE³
Private	6,374^a	6,988	6,995	7,689	7,260
Medicaid/CHIP	3,166^a	4,009	3,847	3,812	3,820
Other⁴	2,512	2,108^b	2,192^a	2,823	2,990
No Coverage	1,803	1,521	1,372	1,843	1,700
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.85B – Had Serious Thoughts of Suicide in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	4.9	5.2	5.0	5.5	5.3
GEOGRAPHIC DIVISION
Northeast	3.8	4.6	5.2	5.2	4.8
New England	3.6	5.0	6.4^a	6.2^a	4.2
Middle Atlantic	3.9	4.5	4.8	4.9	5.1
Midwest	5.5	5.4	4.7^a	6.0	5.6
East North Central	5.5	5.4	4.4^a	6.1	5.6
West North Central	5.3	5.5	5.3	5.9	5.5
South	4.8	4.8	4.8	5.2	5.0
South Atlantic	4.5	4.8	5.0	4.7	4.7
East South Central	4.9	5.4	4.9	5.4	5.4
West South Central	5.3	4.4	4.4	6.0	5.4
West	5.5	5.9	5.3	5.6	5.7
Mountain	5.2	7.0	6.9	6.5	6.6
Pacific	5.6	5.3	4.6	5.2	5.3
COUNTY TYPE¹
Large Metro	4.6	4.7	4.5	5.2	5.2
Small Metro	5.4	5.7	5.9	5.9	5.5
Nonmetro	5.3	5.8	4.8	5.5	5.2
Urbanized	6.0	6.0	5.3	5.6	6.6
Less Urbanized	4.5	5.9	5.6	6.1	4.7
Completely Rural	5.6	5.6	3.1	4.7	3.9
POVERTY LEVEL²
Less Than 100%	7.3	7.7	6.4	8.2	7.2
100‑199%	5.7	6.6	6.4	6.1	5.9
200% or More	4.2	4.2	4.2	4.6	4.5
HEALTH INSURANCE³
Private	4.1	4.5	4.5	4.8	4.6
Medicaid/CHIP	6.7	8.3	7.7	7.9	7.5
Other⁴	3.3	2.7^a	2.8^a	3.6	3.7
No Coverage	7.3	6.5	6.1	7.7	7.1
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.86A – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,624^b	3,753^b	3,704^b	4,639	4,855
GEOGRAPHIC DIVISION
Northeast	434^a	434^a	620	592	704
New England	141	106^a	174	292	200
Middle Atlantic	293	328	447	300	504
Midwest	730^b	881	692^b	1,108	1,075
East North Central	521^a	632	521^a	749	755
West North Central	209^a	249	171^b	359	320
South	1,545	1,461	1,498	1,750	1,854
South Atlantic	774	795	813	869	1,046
East South Central	250	253	265	293	283
West South Central	521	413	420	588	524
West	914	978	893	1,189	1,222
Mountain	257^a	442	452	454	582
Pacific	657	536	441	735	640
COUNTY TYPE¹
Large Metro	1,827^b	1,826^b	1,856^b	2,469	2,938
Small Metro	1,248	1,378	1,318	1,579	1,489
Nonmetro	548	550	529	590	429
Urbanized	212	230	202	213	208
Less Urbanized	186	239	253^a	237	137
Completely Rural	149	81	75	140	83
POVERTY LEVEL²
Less Than 100%	989	977	954	1,151	1,109
100‑199%	966	931^a	942^a	999	1,303
200% or More	1,665^b	1,845^a	1,806^a	2,482	2,428
HEALTH INSURANCE³
Private	1,570^b	1,962	1,662^b	2,370	2,284
Medicaid/CHIP	1,221	1,283	1,366	1,368	1,478
Other⁴	627^b	521^b	612^b	1,115	1,148
No Coverage	629	407	478	583	574
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.86B – Made Any Suicide Plans in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	1.4^b	1.5^b	1.4^b	1.8	1.8
GEOGRAPHIC DIVISION
Northeast	1.0^a	1.0^a	1.4	1.3	1.5
New England	1.2	0.9^a	1.4	2.4	1.6
Middle Atlantic	0.9	1.0	1.4	0.9	1.5
Midwest	1.4^b	1.7	1.3^b	2.1	2.0
East North Central	1.4	1.7	1.4	2.0	2.0
West North Central	1.3	1.5	1.0^b	2.2	1.9
South	1.6	1.5	1.5	1.7	1.8
South Atlantic	1.5	1.5	1.5	1.6	1.9
East South Central	1.7	1.7	1.8	1.9	1.8
West South Central	1.7	1.3	1.3	1.8	1.6
West	1.5	1.6	1.5	1.9	2.0
Mountain	1.3^a	2.3	2.3	2.3	2.9
Pacific	1.6	1.3	1.1	1.8	1.5
COUNTY TYPE¹
Large Metro	1.3^b	1.3^b	1.3^b	1.6	1.9
Small Metro	1.7	1.8	1.7	2.0	1.8
Nonmetro	1.4	1.6	1.6	1.9	1.4
Urbanized	1.5	1.7	1.5	1.7	1.9
Less Urbanized	1.3	1.9	2.0^a	2.2^a	1.1
Completely Rural	1.4	1.0	0.9	1.9	1.2
POVERTY LEVEL²
Less Than 100%	2.6	2.7	2.4	2.8	2.6
100‑199%	1.9	1.9	1.9	2.0	2.4
200% or More	1.0^b	1.1^a	1.1^a	1.5	1.5
HEALTH INSURANCE³
Private	1.0^b	1.3	1.1^b	1.5	1.5
Medicaid/CHIP	2.6	2.7	2.7	2.8	2.9
Other⁴	0.8^a	0.7^b	0.8^b	1.4	1.4
No Coverage	2.5	1.7	2.1	2.4	2.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.87A – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	1,811	1,623^b	1,458^b	2,202	2,283
GEOGRAPHIC DIVISION
Northeast	161	248	212	379	279
New England	35	85	50	145^a	54
Middle Atlantic	126	163	162	233	225
Midwest	408	419	241^a	436	416
East North Central	314	224	201	296	297
West North Central	94	196	39^b	141	119
South	785	650^a	774	896	1,045
South Atlantic	350	329	402	372	583
East South Central	134	109	148	165	171
West South Central	301	211	223	359	291
West	457	306	232^a	491	544
Mountain	109	171	136	187	213
Pacific	348	135^a	96^a	305	331
COUNTY TYPE¹
Large Metro	973	757^b	666^b	1,274	1,267
Small Metro	572	568^a	570	602	819
Nonmetro	265	298	222	326	197
Urbanized	87	113	86	131	106
Less Urbanized	70	109	112	143	49
Completely Rural	108	76	25	51	42
POVERTY LEVEL²
Less Than 100%	426^a	503	489	574	652
100‑199%	508	472	409	577	640
200% or More	876	648	558^a	1,046	977
HEALTH INSURANCE³
Private	711	641	496^b	996	878
Medicaid/CHIP	644	732	589	789	757
Other⁴	379	338	245^a	614	566
No Coverage	251	192^a	254	275	340
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.87B – Attempted Suicide in Past Year: Among People Aged 18 or Older; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	0.7	0.6^a	0.6^b	0.8	0.9
GEOGRAPHIC DIVISION
Northeast	0.4	0.6	0.5	0.8	0.6
New England	0.3	0.7	0.4	1.2^a	0.4
Middle Atlantic	0.4	0.5	0.5	0.7	0.7
Midwest	0.8	0.8	0.5^a	0.8	0.8
East North Central	0.9	0.6	0.6	0.8	0.8
West North Central	0.6	1.2	0.2^b	0.8	0.7
South	0.8	0.7^a	0.8	0.9	1.0
South Atlantic	0.7	0.6	0.8	0.7	1.1
East South Central	0.9	0.7	1.0	1.1	1.1
West South Central	1.0	0.7	0.7	1.1	0.9
West	0.8	0.5	0.4^a	0.8	0.9
Mountain	0.6	0.9	0.7	0.9	1.0
Pacific	0.9	0.3^a	0.2^a	0.7	0.8
COUNTY TYPE¹
Large Metro	0.7	0.5^a	0.5^b	0.8	0.8
Small Metro	0.8	0.7	0.7	0.7	1.0
Nonmetro	0.7	0.9	0.7	1.1	0.6
Urbanized	0.6	0.8	0.6	1.1	1.0
Less Urbanized	0.5	0.9	0.9	1.3	0.4
Completely Rural	1.0	1.0	0.3	0.7	0.6
POVERTY LEVEL²
Less Than 100%	1.1	1.4	1.2	1.4	1.5
100‑199%	1.0	0.9	0.8	1.1	1.2
200% or More	0.5	0.4^a	0.3^a	0.6	0.6
HEALTH INSURANCE³
Private	0.5	0.4	0.3^b	0.6	0.6
Medicaid/CHIP	1.4	1.5	1.2	1.6	1.5
Other⁴	0.5	0.4	0.3^a	0.8	0.7
No Coverage	1.0	0.8^a	1.1	1.1	1.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents aged 18 to 22 who were living in a college dormitory were excluded. ³ Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ⁴ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.88A – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	5,186^b	4,823^b	4,517^b	3,840	3,706
AGE GROUP
12‑13	1,130^b	1,030^b	896	767	735
14‑15	1,754^b	1,881^b	1,682^a	1,366	1,393
16‑17	2,302^b	1,911^a	1,939^b	1,706	1,578
SEX
Male	1,545^b	1,452^b	1,207	1,082	1,092
Female	3,641^b	3,371^b	3,310^b	2,758	2,614
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	3,716^b	3,590^b	3,348^b	2,824	2,707
AIAN	*	29	41	17	26
Asian	204	230	193	172	143
Black or African American	479	566^b	458	364	377
NHPI	*	*	*	*	*
White	2,703^b	2,605^b	2,431^b	2,048	1,917
Two or More Races	241	153^a	217	222	234
Hispanic or Latino	1,470^b	1,233^a	1,169	1,016	999
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.88B – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	20.8^b	19.5^b	18.1^b	15.4	15.1
AGE GROUP
12‑13	13.5^b	13.0^b	11.9^a	10.1	9.8
14‑15	21.3^b	21.4^b	19.1^a	16.0	16.4
16‑17	27.5^b	23.8^b	22.7^b	19.3	18.3
SEX
Male	12.0^b	11.5^b	9.4	8.4	8.7
Female	30.1^b	28.0^b	27.3^b	22.6	21.7
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	20.0^b	19.5^b	18.2^b	15.4	15.0
AIAN	*	14.1	18.2	8.6	9.9
Asian	15.0	14.9	13.7	11.9	9.6
Black or African American	14.1	16.7^b	13.3	10.5	11.4
NHPI	*	*	*	*	*
White	21.4^b	21.0^b	19.6^b	16.8	16.4
Two or More Races	27.9^a	19.1	24.4	22.2	18.3
Hispanic or Latino	23.1^b	19.5^b	18.0	15.4	15.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.89A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,773^b	3,595^b	3,358^b	2,834	2,717
AGE GROUP
12‑13	788^b	718^b	618	567	503
14‑15	1,345^b	1,419^b	1,287^a	1,000	1,029
16‑17	1,639^b	1,458^a	1,453^a	1,267	1,186
SEX
Male	1,048^a	996^a	845	735	788
Female	2,725^b	2,599^b	2,513^b	2,099	1,929
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	2,740^b	2,669^b	2,491^b	2,055	2,032
AIAN	*	20	18	12	17
Asian	151	169^a	128	135	82
Black or African American	367	402^a	343	260	278
NHPI	*	*	*	*	*
White	1,977^b	1,970^b	1,823^a	1,483	1,476
Two or More Races	167	101^a	174	163	170
Hispanic or Latino	1,033^b	926^a	867	779	685
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.89B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	15.2^b	14.6^b	13.5^b	11.3	11.0
AGE GROUP
12‑13	9.5^b	9.1^b	8.2	7.4	6.7
14‑15	16.4^b	16.2^b	14.6^a	11.7	12.1
16‑17	19.6^b	18.2^b	17.0^a	14.3	13.8
SEX
Male	8.2^a	7.9^a	6.6	5.7	6.3
Female	22.6^b	21.7^b	20.8^b	17.2	16.0
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	14.8^b	14.5^b	13.5^b	11.2	11.3
AIAN	*	9.7	8.2	6.1	6.7
Asian	11.1^a	11.0^a	9.1	9.4	5.6
Black or African American	10.8	11.9^a	10.0	7.5	8.4
NHPI	*	*	*	*	*
White	15.7^b	15.9^b	14.7^a	12.2	12.7
Two or More Races	19.2	12.7	19.6^a	16.4	13.3
Hispanic or Latino	16.4^b	14.7^b	13.3^a	11.8	10.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.90A – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	5,186^b	4,823^b	4,517^b	3,840	3,706
GEOGRAPHIC DIVISION
Northeast	811	713	623	563	594
New England	175	188^a	170	136	110
Middle Atlantic	636	524	453	427	485
Midwest	1,214^b	954^a	1,063^b	818	760
East North Central	752^b	646	662	516	520
West North Central	462^b	309	401^b	303	240
South	1,791^a	1,888^b	1,769^a	1,482	1,463
South Atlantic	912^a	971^b	913^a	653	729
East South Central	280	312	256	274	268
West South Central	599	605	600	555	467
West	1,370^b	1,268^b	1,061	976	888
Mountain	510^b	489^b	435^a	350	317
Pacific	860^a	779	626	625	571
COUNTY TYPE¹
Large Metro	2,696^b	2,834^b	2,657^b	2,008	2,058
Small Metro	1,662^b	1,450	1,262	1,396	1,224
Nonmetro	829^b	539	598^a	436	424
Urbanized	387^b	250^a	220^a	153	140
Less Urbanized	263	170	234	142	180
Completely Rural	180	118	144	141	104
POVERTY LEVEL
Less Than 100%	963	833	813	765	815
100‑199%	1,168^b	1,149^b	958	768	800
200% or More	3,055^b	2,841^b	2,746^b	2,307	2,090
HEALTH INSURANCE²
Private	2,835^b	2,700^b	2,566^b	2,218	2,034
Medicaid/CHIP	2,053^b	1,989^b	1,784^a	1,581	1,524
Other³	287	295	310	163^b	286
No Coverage	301^b	153	169	149	143
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.90B – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	20.8^b	19.5^b	18.1^b	15.4	15.1
GEOGRAPHIC DIVISION
Northeast	20.7^a	18.3	15.9	14.4	15.2
New England	17.6	19.0^a	17.5^a	13.5	11.1
Middle Atlantic	21.8	18.0	15.4	14.7	16.6
Midwest	23.0^b	18.3^a	20.4^b	15.8	14.9
East North Central	21.0^b	18.4	18.8	14.8	15.2
West North Central	27.4^b	18.3	23.7^b	17.8	14.2
South	18.3^b	19.4^b	17.9^a	14.8	14.9
South Atlantic	18.9^a	20.1^b	18.5^a	13.2	15.0
East South Central	18.5	21.3	17.5	18.0	18.4
West South Central	17.3	17.7^a	17.3	15.7	13.4
West	23.0^b	21.6^b	17.9	16.6	15.3
Mountain	25.7^b	24.5^b	21.9^b	17.8	16.0
Pacific	21.7^b	20.1^a	15.9	16.0	15.0
COUNTY TYPE¹
Large Metro	19.7^b	19.5^b	18.9^b	13.9	14.7
Small Metro	22.1^b	19.8^b	16.5	17.8	15.5
Nonmetro	22.1^b	18.9	18.7	16.1	15.8
Urbanized	28.1^b	21.9^a	19.7	15.0	14.5
Less Urbanized	19.9	17.2	18.5	14.2	15.8
Completely Rural	17.0	16.4	17.5	20.2	18.0
POVERTY LEVEL
Less Than 100%	18.4	16.6	15.0	14.4	15.1
100‑199%	21.6^b	20.7^b	18.6^a	15.0	14.5
200% or More	21.4^b	20.1^b	19.1^b	15.8	15.3
HEALTH INSURANCE²
Private	21.3^b	19.8^b	18.9^b	15.7	15.1
Medicaid/CHIP	19.9^b	19.5^b	17.1	15.7	15.1
Other³	21.7	20.5	22.8	12.1^b	21.0
No Coverage	23.7^b	16.3	14.4	12.9	13.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.91A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,773^b	3,595^b	3,358^b	2,834	2,717
GEOGRAPHIC DIVISION
Northeast	537	510	482	449	458
New England	127	142	127	107	82
Middle Atlantic	410	368	355	343	377
Midwest	884^b	735^a	792^b	579	562
East North Central	547^a	500	484	365	384
West North Central	338^b	235	308^b	214	178
South	1,310^a	1,428^b	1,324^a	1,108	1,056
South Atlantic	652	724^b	675^a	493	504
East South Central	221	227	188	232	181
West South Central	438	476	461	383	371
West	1,041^b	923^b	760	698	641
Mountain	426^b	344^a	298	246	234
Pacific	614^a	579^a	461	453	407
COUNTY TYPE¹
Large Metro	1,977^b	2,140^b	1,983^b	1,513	1,499
Small Metro	1,204^a	1,067	908	1,022	908
Nonmetro	591^b	387	467^b	299	311
Urbanized	282^b	179	176^a	109	102
Less Urbanized	186	115	175	100	134
Completely Rural	124	94	116	89	75
POVERTY LEVEL
Less Than 100%	709	616	612	567	640
100‑199%	865^b	901^b	741^a	607	570
200% or More	2,198^b	2,079^b	2,006^b	1,660	1,507
HEALTH INSURANCE²
Private	2,065^b	1,955^b	1,895^b	1,633	1,446
Medicaid/CHIP	1,495^b	1,552^b	1,351	1,206	1,149
Other³	218	213	253	111^b	218
No Coverage	226^a	119	127	96	114
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.91B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	15.2^b	14.6^b	13.5^b	11.3	11.0
GEOGRAPHIC DIVISION
Northeast	13.7	13.1	12.3	11.5	11.7
New England	12.8	14.5^a	13.0	10.6	8.3
Middle Atlantic	14.1	12.7	12.1	11.8	12.9
Midwest	16.8^b	14.1^a	15.2^b	11.2	11.0
East North Central	15.3^a	14.2	13.7	10.4	11.2
West North Central	20.0^b	13.9	18.2^b	12.7	10.5
South	13.4^a	14.7^b	13.4^a	11.1	10.8
South Atlantic	13.5^a	15.0^b	13.7^a	9.9	10.4
East South Central	14.7	15.5	12.8	15.3	12.4
West South Central	12.6	13.9	13.3	10.8	10.7
West	17.7^b	15.7^b	12.8	11.9	11.1
Mountain	21.5^b	17.2^a	15.0	12.5	11.8
Pacific	15.7^b	15.0^a	11.7	11.5	10.7
COUNTY TYPE¹
Large Metro	14.5^b	14.7^b	14.1^b	10.5	10.7
Small Metro	16.1^b	14.6^b	11.9	13.0	11.5
Nonmetro	15.8^a	13.6	14.6	11.0	11.6
Urbanized	20.5^b	15.7	15.7	10.8	10.6
Less Urbanized	14.1	11.6	13.9	10.0	11.7
Completely Rural	11.8	13.0	14.1	12.8	13.0
POVERTY LEVEL
Less Than 100%	13.6	12.3	11.3	10.7	11.8
100‑199%	16.1^b	16.3^b	14.4^b	11.9	10.4
200% or More	15.4^b	14.7^b	14.0^b	11.4	11.0
HEALTH INSURANCE²
Private	15.5^b	14.4^b	14.0^b	11.6	10.7
Medicaid/CHIP	14.6^b	15.2^b	12.9	12.0	11.4
Other³	16.5	14.8	18.6	8.3^b	16.0
No Coverage	18.0^a	12.7	10.9	8.3	10.5
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.92A – Substance Use in Past Year and Past Month: Among People Aged 12 to 17 with Major Depressive Episode in Past Year; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	‑‑	‑‑	‑‑	‑‑	803
Marijuana	1,093^b	1,066^b	990^b	961^b	649
Cocaine	6^a	25	27	22	30
Crack	1	<1	*	6	<1
Heroin	*	*	*	4	*
Hallucinogens	147	142	151	155	127
LSD	108^a	84^a	67	54	36
Psilocybin	‑‑	‑‑	‑‑	120	88
Ecstasy	47	29	18	26	37
Inhalants²	‑‑	‑‑	‑‑	‑‑	122
Methamphetamine	14	9	17	7	11
Misuse of Prescription Psychotherapeutics	415^b	249	278^a	217	190
Pain Relievers	241^b	143	159	122	107
Prescription Opioids	238^b	132	138	102	101
Stimulants	145	97	123	67	89
Tranquilizers or Sedatives	134^a	72	89	93	59
Tranquilizers	116	57	66	68	52
Sedatives	31	21	29	31	11
Benzodiazepines	97	56	64	49	48
Misuse of Opioids^1,3	238^b	132	138	106	101
Misuse of Central Nervous System Stimulants	147	123	132	84	98
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	354
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	134	139	106	101
Illegally Made Fentanyl	‑‑	7	21	*	*
PAST MONTH USE
Alcohol	705^b	560^a	587^b	478	393
Binge Alcohol Use	351^b	263	322^b	239	179
Heavy Alcohol Use⁵	30	18	18	24	32
Cigarettes	179	130	112	116	100
Daily Cigarettes	5	3	<1	2	4
Nicotine Vaping⁶	‑‑	651^b	640^b	608^a	442
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.92B – Substance Use in Past Year and Past Month: Among People Aged 12 to 17 with Major Depressive Episode in Past Year; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	‑‑	‑‑	‑‑	‑‑	21.7
Marijuana	21.1	22.1^a	21.9^a	25.0^b	17.5
Cocaine	0.1^a	0.5	0.6	0.6	0.8
Crack	<0.1	<0.1	*	0.2	<0.1
Heroin	*	*	*	0.1	*
Hallucinogens	2.8	3.0	3.3	4.0	3.4
LSD	2.1	1.8	1.5	1.4	1.0
Psilocybin	‑‑	‑‑	‑‑	3.1	2.4
Ecstasy	0.9	0.6	0.4	0.7	1.0
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.3
Methamphetamine	0.3	0.2	0.4	0.2	0.3
Misuse of Prescription Psychotherapeutics	8.0^a	5.2	6.2	5.6	5.1
Pain Relievers	4.6	3.0	3.5	3.2	2.9
Prescription Opioids	4.6	2.7	3.1	2.7	2.7
Stimulants	2.8	2.0	2.7	1.7	2.4
Tranquilizers or Sedatives	2.6	1.5	2.0	2.4	1.6
Tranquilizers	2.2	1.2	1.5	1.8	1.4
Sedatives	0.6	0.4	0.6	0.8	0.3
Benzodiazepines	1.9	1.2	1.4	1.3	1.3
Misuse of Opioids^1,3	4.6	2.7	3.1	2.8	2.7
Misuse of Central Nervous System Stimulants	2.8	2.6	2.9	2.2	2.6
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	9.6
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	2.8	3.1	2.8	2.7
Illegally Made Fentanyl	‑‑	0.1	0.5	*	*
PAST MONTH USE
Alcohol	13.6	11.6	13.0	12.4	10.6
Binge Alcohol Use	6.8	5.5	7.1^a	6.2	4.8
Heavy Alcohol Use⁵	0.6	0.4	0.4	0.6	0.9
Cigarettes	3.4	2.7	2.5	3.0	2.7
Daily Cigarettes	0.1	0.1	<0.1	<0.1	0.1
Nicotine Vaping⁶	‑‑	13.5	14.2	15.8^a	11.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.93A – Substance Use in Past Year and Past Month: Among People Aged 12 to 17 with Major Depressive Episode with Severe Impairment in Past Year; Numbers in Thousands, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	‑‑	‑‑	‑‑	‑‑	624
Marijuana	859^b	895^b	791^b	767^b	496
Cocaine	6	13	26	21	22
Crack	1	<1	*	6	*
Heroin	*	*	*	4	*
Hallucinogens	121	122	143	115	102
LSD	86^b	71^a	62^a	41	23
Psilocybin	‑‑	‑‑	‑‑	100	67
Ecstasy	44	17	18	23	29
Inhalants²	‑‑	‑‑	‑‑	‑‑	91
Methamphetamine	14	7	17	6	11
Misuse of Prescription Psychotherapeutics	372^b	193	228	173	159
Pain Relievers	219^b	111	137	112	85
Prescription Opioids	216^b	102	119	92	79
Stimulants	124	75	107	49	68
Tranquilizers or Sedatives	131^a	67	70	65	58
Tranquilizers	113	51	53	48	52
Sedatives	31	21	23	22	11
Benzodiazepines	94	51	53	46	48
Misuse of Opioids^1,3	216^b	102	119	97	79
Misuse of Central Nervous System Stimulants	126	90	116	65	77
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	282
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	102	120	97	79
Illegally Made Fentanyl	‑‑	5	21	*	*
PAST MONTH USE
Alcohol	509^b	443^a	448^a	373	304
Binge Alcohol Use	270^b	209	253^b	180	137
Heavy Alcohol Use⁵	18	14	15	21	31
Cigarettes	141	110	90	81	95
Daily Cigarettes	5	2	<1	<1	4
Nicotine Vaping⁶	‑‑	529^b	549^b	452	347
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.93B – Substance Use in Past Year and Past Month: Among People Aged 12 to 17 with Major Depressive Episode with Severe Impairment in Past Year; Percentages, 2021‑2025
Substance	2021	2022	2023	2024	2025
PAST YEAR USE
Illicit Drugs¹	‑‑	‑‑	‑‑	‑‑	23.0
Marijuana	22.8	24.9^b	23.6^a	27.0^b	18.3
Cocaine	0.2^a	0.4	0.8	0.7	0.8
Crack	<0.1	<0.1	*	0.2	*
Heroin	*	*	*	0.2	*
Hallucinogens	3.2	3.4	4.3	4.1	3.8
LSD	2.3^a	2.0	1.8	1.4	0.9
Psilocybin	‑‑	‑‑	‑‑	3.5	2.5
Ecstasy	1.2	0.5	0.5	0.8	1.1
Inhalants²	‑‑	‑‑	‑‑	‑‑	3.3
Methamphetamine	0.4	0.2	0.5	0.2	0.4
Misuse of Prescription Psychotherapeutics	9.9^b	5.4	6.8	6.1	5.8
Pain Relievers	5.8^a	3.1	4.1	3.9	3.1
Prescription Opioids	5.7^a	2.8	3.5	3.3	2.9
Stimulants	3.3	2.1	3.2	1.7	2.5
Tranquilizers or Sedatives	3.5	1.9	2.1	2.3	2.2
Tranquilizers	3.0	1.4	1.6	1.7	1.9
Sedatives	0.8	0.6	0.7	0.8	0.4
Benzodiazepines	2.5	1.4	1.6	1.6	1.8
Misuse of Opioids^1,3	5.7^a	2.8	3.5	3.4	2.9
Misuse of Central Nervous System Stimulants	3.3	2.5	3.4	2.3	2.8
Illicit Drugs Other Than Marijuana^1,2,4	‑‑	‑‑	‑‑	‑‑	10.4
Misuse of Opioids Including Illegally Made Fentanyl³	‑‑	2.8	3.6	3.4	2.9
Illegally Made Fentanyl	‑‑	0.1	0.6	*	*
PAST MONTH USE
Alcohol	13.5	12.3	13.4	13.2	11.2
Binge Alcohol Use	7.2	5.8	7.5	6.3	5.0
Heavy Alcohol Use⁵	0.5	0.4	0.5	0.7	1.1
Cigarettes	3.7	3.1	2.7	2.9	3.5
Daily Cigarettes	0.1	0.1	<0.1	<0.1	0.2
Nicotine Vaping⁶	‑‑	14.7	16.3	16.0	12.8
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Does not include illegally made fentanyl (IMF). ² Changes were made to the inhalant questions in 2025. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ³ Some 2021‑2023 estimates may differ from previously published estimates due to updates in how opioids were defined beginning in 2024. See Chapter 4 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. ⁴ Illicit drugs other than marijuana excludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs. ⁵ Heavy alcohol users are a subset of binge alcohol users. ⁶ Some 2022‑2024 estimates may differ from previously published estimates due to updates. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.94A – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Past Year Substance Use Disorder and Sex, Numbers in Thousands, 2021‑2025
Substance Use Disorder/Sex	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	1,018^b	922^b	856^b	792^a	604
Male	310^a	285^a	178	247	188
Female	708^b	637^b	678^b	545^a	415
Drug Use Disorder	782^b	769^b	712^a	696^a	533
Male	261	241	154	217	162
Female	522^a	528^a	559^b	479	371
Alcohol Use Disorder	506^b	339^a	341^b	328^a	218
Male	*	96	63	76	49
Female	373^b	243	279^a	251	168
NO SUBSTANCE USE DISORDER	4,168^b	3,901^b	3,660^b	3,047	3,102
Male	1,235^b	1,167^a	1,029	834	904
Female	2,933^b	2,734^b	2,631^b	2,213	2,198
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.94B – Major Depressive Episode in Past Year: Among People Aged 12 to 17; by Past Year Substance Use Disorder and Sex, Percentages, 2021‑2025
Substance Use Disorder/Sex	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	44.5^b	43.1^b	41.1^a	41.0^a	33.9
Male	31.5	30.1	21.9	30.0	21.6
Female	54.2	53.3	53.2	49.2	45.7
Drug Use Disorder	43.5	44.2	42.2	42.8	37.1
Male	31.8	30.6	23.9	30.7	23.0
Female	53.2	55.6	53.5	52.3	50.5
Alcohol Use Disorder	54.3^b	46.1^a	47.1^b	44.3^a	32.5
Male	*	34.8^a	24.7	30.9^a	16.4
Female	60.6^a	52.9	59.2	51.0	45.6
NO SUBSTANCE USE DISORDER	18.4^b	17.3^b	16.0^b	13.2	13.6
Male	10.4^b	10.0^b	8.6	7.0	7.7
Female	27.2^b	25.2^b	24.3^b	20.0	19.7
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.95A – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Past Year Substance Use Disorder and Sex, Numbers in Thousands, 2021‑2025
Substance Use Disorder/Sex	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	781^b	750^b	717^b	632^a	467
Male	199	199	144	204	128
Female	582^b	551^b	573^b	428	339
Drug Use Disorder	617^b	639^b	602^b	557^a	411
Male	173	180^a	122	181	104
Female	443^a	460^b	480^b	376	307
Alcohol Use Disorder	387^b	279^b	287^b	265^a	168
Male	*	66	51	61	43
Female	292^b	213^a	236^b	204^a	125
NO SUBSTANCE USE DISORDER	2,991^b	2,845^b	2,641^a	2,202	2,250
Male	848^a	797	701	531	660
Female	2,143^b	2,048^b	1,940^a	1,671	1,590
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.95B – Major Depressive Episode with Severe Impairment in Past Year: Among People Aged 12 to 17; by Past Year Substance Use Disorder and Sex, Percentages, 2021‑2025
Substance Use Disorder/Sex	2021	2022	2023	2024	2025
SUBSTANCE USE DISORDER	34.3^a	35.2^b	34.5^a	32.8^a	26.3
Male	20.3	21.1	17.7	24.7^a	14.7
Female	44.8	46.6	45.2	38.9	37.3
Drug Use Disorder	34.3	37.0^a	35.8	34.4	28.6
Male	21.2	22.8	19.0	25.5^a	14.8
Female	45.2	49.0	46.1	41.4	41.9
Alcohol Use Disorder	41.9^b	38.0^b	39.8^b	35.9^a	25.1
Male	*	23.8	20.2	24.9	14.4
Female	47.9	46.5	50.4^a	41.4	33.8
NO SUBSTANCE USE DISORDER	13.2^b	12.6^b	11.6^b	9.6	9.9
Male	7.2^a	6.8	5.8	4.4	5.7
Female	19.9^b	18.9^b	17.9^b	15.1	14.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. NOTE: Respondents with unknown MDE data or unknown impairment data were excluded. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.96A – Co‑Occurring Substance Use Disorder and Major Depressive Episode (MDE) or MDE with Severe Impairment in Past Year: Among People Aged 12 to 17; by Sex, Numbers in Thousands, 2021‑2025
Co‑Occurring Substance Use Disorder and MDE/Sex	2021	2022	2023	2024	2025
Substance Use Disorder and MDE	1,018^b	922^b	856^b	792^a	604
Male	310^a	285^a	178	247	188
Female	708^b	637^b	678^b	545^a	415
Substance Use Disorder and MDE with Severe Impairment^1,2	781^b	750^b	717^b	632^a	467
Male	199	199	144	204	128
Female	582^b	551^b	573^b	428	339
Drug Use Disorder and MDE	782^b	769^b	712^a	696^a	533
Male	261	241	154	217	162
Female	522^a	528^a	559^b	479	371
Drug Use Disorder and MDE with Severe Impairment^1,2	617^b	639^b	602^b	557^a	411
Male	173	180^a	122	181	104
Female	443^a	460^b	480^b	376	307
Alcohol Use Disorder and MDE	506^b	339^a	341^b	328^a	218
Male	133^a	96	63	76	49
Female	373^b	243	279^a	251	168
Alcohol Use Disorder and MDE with Severe Impairment^1,2	387^b	279^b	287^b	265^a	168
Male	96	66	51	61	43
Female	292^b	213^a	236^b	204^a	125
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ² Respondents with unknown MDE data or unknown impairment data were excluded. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.96B – Co‑Occurring Substance Use Disorder and Major Depressive Episode (MDE) or MDE with Severe Impairment in Past Year: Among People Aged 12 to 17; by Sex, Percentages, 2021‑2025
Co‑Occurring Substance Use Disorder and MDE/Sex	2021	2022	2023	2024	2025
Substance Use Disorder and MDE	4.1^b	3.7^b	3.4^b	3.2^a	2.5
Male	2.4^a	2.2^a	1.4	1.9	1.5
Female	5.9^b	5.3^b	5.6^b	4.5^a	3.4
Substance Use Disorder and MDE with Severe Impairment^1,2	3.1^b	3.0^b	2.9^b	2.5^a	1.9
Male	1.6	1.6	1.1	1.6	1.0
Female	4.8^b	4.6^b	4.7^b	3.5	2.8
Drug Use Disorder and MDE	3.1^b	3.1^b	2.9^a	2.8^a	2.2
Male	2.0	1.9	1.2	1.7	1.3
Female	4.3^a	4.4^b	4.6^b	3.9	3.1
Drug Use Disorder and MDE with Severe Impairment^1,2	2.5^a	2.6^b	2.4^b	2.2^a	1.7
Male	1.4	1.4^a	1.0	1.4	0.8
Female	3.7^a	3.8^b	4.0^b	3.1	2.5
Alcohol Use Disorder and MDE	2.0^b	1.4^a	1.4^a	1.3^a	0.9
Male	1.0^a	0.8	0.5	0.6	0.4
Female	3.1^b	2.0	2.3^a	2.1	1.4
Alcohol Use Disorder and MDE with Severe Impairment^1,2	1.6^b	1.1^b	1.2^b	1.1^a	0.7
Male	0.7	0.5	0.4	0.5	0.3
Female	2.4^b	1.8^a	2.0^b	1.7^a	1.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: Substance use disorder is based on DSM‑5 criteria. See Chapter 3 of the 2025 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details on who was eligible to receive questions on substance use disorder. NOTE: Major depressive episode aligns with DSM‑5 criteria, which specifies a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had a majority of specified depression symptoms. NOTE: Respondents with unknown past year major depressive episode (MDE) data were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Major depressive episode (MDE) with severe impairment is a subset of MDE. Impairment is based on the Sheehan Disability Scale role domains, which measure the impact of a disorder on a person’s life. Ratings greater than or equal to 7 on a scale of 0 to 10 in any of the role domains indicate severe impairment. ² Respondents with unknown MDE data or unknown impairment data were excluded. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.97A – Had Serious Thoughts of Suicide in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,355^b	3,427^b	3,189^b	2,613	2,625
AGE GROUP
12‑13	894^a	790	641	661	668
14‑15	1,149	1,389^b	1,325^b	917	988
16‑17	1,312^b	1,248^a	1,223^a	1,035	969
SEX
Male	1,112^b	1,151^b	1,038^a	831	799
Female	2,244^b	2,277^b	2,151^a	1,782	1,827
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	2,512^b	2,596^b	2,377^a	1,972	1,993
AIAN	*	18	30	16	23
Asian	164	197	152	141	119
Black or African American	410	425	354	314	338
NHPI	*	*	*	*	*
White	1,702^b	1,820^b	1,675^b	1,347	1,324
Two or More Races	156	127	162	146	184
Hispanic or Latino	843^a	832^a	812	641	632
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.97B – Had Serious Thoughts of Suicide in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	12.9^b	13.4^b	12.3^b	10.1	10.4
AGE GROUP
12‑13	10.1	9.4	8.1	8.2	8.5
14‑15	13.5	15.4^b	14.5^b	10.4	11.4
16‑17	15.3^b	15.3^b	13.9^b	11.5	10.9
SEX
Male	8.4^b	8.8^b	7.9^a	6.3	6.2
Female	17.7^b	18.2^b	17.0^a	14.1	14.7
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	13.0^b	13.7^b	12.5^a	10.4	10.7
AIAN	*	8.2	12.8	7.6	8.6
Asian	11.4	12.3	10.5	9.3	7.8
Black or African American	11.7	12.2	9.9	8.8	10.0
NHPI	*	*	*	*	*
White	13.0^a	14.2^b	13.1^a	10.7	11.0
Two or More Races	17.5	15.2	17.5	14.0	13.8
Hispanic or Latino	12.7^a	12.6^a	12.0^a	9.3	9.3
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.98A – Made Any Suicide Plans in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	1,604^a	1,666^b	1,457	1,186	1,288
AGE GROUP
12‑13	472	436	265	327	353
14‑15	558	664^b	656^a	385	466
16‑17	575	567	536	474	469
SEX
Male	470	461	377	356	376
Female	1,134^a	1,206^b	1,080	830	912
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	1,119	1,291^b	1,046	923	1,003
AIAN	*	*	10	12	11
Asian	71	80	85	56	50
Black or African American	191	262^a	184	175	156
NHPI	*	*	*	<1	*
White	764	874^a	684	601	688
Two or More Races	39^b	57	77	78	97
Hispanic or Latino	486^b	375	411	264	286
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.98B – Made Any Suicide Plans in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	6.2^a	6.5^b	5.6	4.6	5.1
AGE GROUP
12‑13	5.3	5.2	3.3	4.0	4.5
14‑15	6.6	7.4^a	7.2^a	4.4	5.4
16‑17	6.7	6.9	6.1	5.3	5.3
SEX
Male	3.6	3.5	2.9	2.7	2.9
Female	8.9	9.6^b	8.6	6.6	7.4
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	5.8	6.8^a	5.5	4.9	5.4
AIAN	*	*	4.2	5.8	4.1
Asian	4.9	5.0	5.8	3.7	3.2
Black or African American	5.4	7.5^a	5.1	4.9	4.6
NHPI	*	*	*	<0.1	*
White	5.8	6.8	5.3	4.8	5.7
Two or More Races	4.4	6.8	8.3	7.5	7.3
Hispanic or Latino	7.3^b	5.7	6.1	3.8	4.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.99A – Attempted Suicide in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Numbers in Thousands, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	940^a	953^a	856	700	738
AGE GROUP
12‑13	315	256	185	210	225
14‑15	326	397	385	219	279
16‑17	299	300	286	271	233
SEX
Male	316^b	295^a	207	220	178
Female	623	658	649	480	560
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	646	703	631	529	591
AIAN	*	5	9	9	10
Asian	44	41	44	27	15
Black or African American	141	164^a	137	121	92
NHPI	*	*	*	*	*
White	403	437	395	333	428
Two or More Races	26	48	40	38	45
Hispanic or Latino	294^b	250^a	225	171	147
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.99B – Attempted Suicide in Past Year: Among People Aged 12 to 17; by Demographic Characteristics, Percentages, 2021‑2025
Demographic Characteristic	2021	2022	2023	2024	2025
TOTAL	3.6	3.7^a	3.3	2.7	2.9
AGE GROUP
12‑13	3.6	3.0	2.3	2.6	2.9
14‑15	3.8	4.4	4.2	2.5	3.2
16‑17	3.5	3.7	3.3	3.0	2.6
SEX
Male	2.4^a	2.3^a	1.6	1.7	1.4
Female	4.9	5.3	5.1	3.8	4.5
HISPANIC ORIGIN AND RACE
Not Hispanic or Latino	3.4	3.7	3.3	2.8	3.2
AIAN	*	2.3	3.8	4.4	3.6
Asian	3.0	2.6	3.0	1.8	1.0
Black or African American	4.0	4.7^a	3.8	3.4	2.7
NHPI	*	*	*	*	*
White	3.1	3.4	3.1	2.6	3.6
Two or More Races	2.9	5.8	4.3	3.7	3.4
Hispanic or Latino	4.4^b	3.8^a	3.3	2.5	2.2
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.100A – Had Serious Thoughts of Suicide in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	3,355^b	3,427^b	3,189^b	2,613	2,625
GEOGRAPHIC DIVISION
Northeast	456	459	436	430	407
New England	76	105	120	105	95
Middle Atlantic	381	355	316	324	312
Midwest	891^b	667	768^b	500	543
East North Central	552^b	444	514^a	298	361
West North Central	340^b	222	254	201	182
South	1,184	1,351^b	1,323^b	1,009	978
South Atlantic	550	712^b	613	488	503
East South Central	231	194	247	164	193
West South Central	403	445^a	463^a	357	282
West	824	950^a	663	675	696
Mountain	301	311	280	272	261
Pacific	523	639^a	383	403	436
COUNTY TYPE¹
Large Metro	1,710	2,006^b	1,808^a	1,411	1,438
Small Metro	1,046	1,091^a	936	889	881
Nonmetro	600^b	331	445^a	313	306
Urbanized	274^b	142	170	115	109
Less Urbanized	183	129	147	100	133
Completely Rural	142^a	60	127	98	65
POVERTY LEVEL
Less Than 100%	658	555	562	482	585
100‑199%	746	797^a	676	493	598
200% or More	1,952^b	2,076^b	1,952^b	1,638	1,442
HEALTH INSURANCE²
Private	1,765^b	1,979^b	1,853^b	1,527	1,396
Medicaid/CHIP	1,372^a	1,376^a	1,259	1,089	1,096
Other³	247	204	191	123^b	255
No Coverage	183^a	98	99	86	94
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.100B – Had Serious Thoughts of Suicide in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	12.9^b	13.4^b	12.3^b	10.1	10.4
GEOGRAPHIC DIVISION
Northeast	11.1	11.3	10.8	10.5	10.2
New England	7.1	10.0	11.6	10.1	9.4
Middle Atlantic	12.5	11.8	10.5	10.7	10.5
Midwest	16.3^b	12.4	14.2^b	9.2	10.3
East North Central	14.9^b	12.3	14.0^a	8.2	10.2
West North Central	19.3^b	12.8	14.5^a	11.4	10.6
South	11.7	13.4^b	12.9^b	9.8	9.7
South Atlantic	11.0	14.3^b	12.1	9.5	10.0
East South Central	15.0	12.7	16.0	10.7	12.8
West South Central	11.3	12.5^b	12.8^a	9.8	7.9
West	13.2	15.6^b	10.8	11.0	11.6
Mountain	14.5	15.1	13.6	13.2	12.7
Pacific	12.6	15.8^a	9.4	9.9	11.0
COUNTY TYPE¹
Large Metro	12.0^a	13.3^b	12.4^b	9.4	9.9
Small Metro	13.5^a	14.4^b	11.8	11.0	10.8
Nonmetro	15.2^a	11.2	13.4	11.3	11.2
Urbanized	18.5^a	11.9	14.6	11.1	11.1
Less Urbanized	13.5	12.6	11.4	9.8	11.5
Completely Rural	12.9	8.1	15.0	13.5	10.9
POVERTY LEVEL
Less Than 100%	12.0	10.6	9.9	8.8	10.4
100‑199%	13.3^a	13.9^a	12.7	9.3	10.5
200% or More	13.1^b	14.2^b	13.2^b	10.9	10.3
HEALTH INSURANCE²
Private	12.8^b	14.1^b	13.3^b	10.4	10.1
Medicaid/CHIP	12.7^a	13.0^a	11.6	10.5	10.5
Other³	17.8	13.6	13.7	8.9^b	17.6
No Coverage	13.8	9.7	8.0	7.2	8.4
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.101A – Made Any Suicide Plans in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	1,604^a	1,666^b	1,457	1,186	1,288
GEOGRAPHIC DIVISION
Northeast	212	203	206	165	210
New England	31	58	65	45	48
Middle Atlantic	181	145	142	119	162
Midwest	426^b	356^a	364^a	243	242
East North Central	255^b	231^a	243^a	146	144
West North Central	171	125	121	98	98
South	596	638	570	447	491
South Atlantic	241	345	242	230	250
East South Central	131	115	127	74	90
West South Central	225	178	202	142	150
West	370	469	316	331	345
Mountain	144	146	123	130	126
Pacific	226	323	193	201	220
COUNTY TYPE¹
Large Metro	729	954^b	808	597	682
Small Metro	581	519	441	425	423
Nonmetro	294^a	194	208	164	184
Urbanized	149^b	75	81	42	55
Less Urbanized	84	77	60	71	89
Completely Rural	61	41	67	52	39
POVERTY LEVEL
Less Than 100%	349	325	301	236	316
100‑199%	341	397	323	261	315
200% or More	914^b	943^b	833^a	689	657
HEALTH INSURANCE²
Private	858^a	895^b	849^a	665	642
Medicaid/CHIP	658	724	642	530	604
Other³	91	116	49^a	74	114
No Coverage	103	32	48	39	56
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.101B – Made Any Suicide Plans in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	6.2^a	6.5^b	5.6	4.6	5.1
GEOGRAPHIC DIVISION
Northeast	5.1	5.0	5.1	4.0	5.3
New England	2.9	5.5	6.2	4.4	4.8
Middle Atlantic	5.9	4.8	4.7	3.9	5.5
Midwest	7.8^b	6.6^a	6.7^a	4.5	4.6
East North Central	6.9^a	6.4^a	6.6^a	4.0	4.0
West North Central	9.7	7.2	6.9	5.6	5.7
South	5.9	6.3^a	5.6	4.3	4.9
South Atlantic	4.8	6.9^a	4.8	4.5	5.0
East South Central	8.5	7.5	8.2	4.8	6.0
West South Central	6.3	5.0	5.6	3.9	4.2
West	5.9	7.7	5.2	5.4	5.8
Mountain	6.9	7.1	5.9	6.3	6.1
Pacific	5.5	8.0	4.7	4.9	5.6
COUNTY TYPE¹
Large Metro	5.1	6.3^a	5.5	4.0	4.7
Small Metro	7.5^a	6.8^a	5.6	5.3	5.2
Nonmetro	7.5	6.6	6.3	5.9	6.8
Urbanized	10.1	6.3	7.0	4.0	5.6
Less Urbanized	6.2	7.5	4.6	6.9	7.7
Completely Rural	5.5	5.6	7.8	7.2	6.7
POVERTY LEVEL
Less Than 100%	6.4	6.2	5.3	4.3	5.6
100‑199%	6.1	6.9	6.1	4.9	5.5
200% or More	6.2^a	6.5^b	5.6	4.6	4.7
HEALTH INSURANCE²
Private	6.2^a	6.4^b	6.1^a	4.5	4.6
Medicaid/CHIP	6.1	6.8	5.9	5.1	5.8
Other³	6.6	7.7	3.5^a	5.3	7.9
No Coverage	7.8	3.2	3.8	3.3	5.0
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.102A – Attempted Suicide in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Numbers in Thousands, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	940^a	953^a	856	700	738
GEOGRAPHIC DIVISION
Northeast	111	114	132	100	137
New England	25	31	26	30	18
Middle Atlantic	86	83	106	70	118
Midwest	238	195	220	150	163
East North Central	157^a	127	144	86	91
West North Central	81	67	76	64	72
South	389	353	336	296	271
South Atlantic	179	182	161	157	157
East South Central	66	73	90^a	59	40
West South Central	144	98	85	80	74
West	201	292^a	168	154	168
Mountain	86	104	55	61	70
Pacific	115	188	113	93	97
COUNTY TYPE¹
Large Metro	445	521	435	340	381
Small Metro	310	321	298	255	247
Nonmetro	185	111	124	106	110
Urbanized	99^a	41	40	31	30
Less Urbanized	48	43	38	48	68
Completely Rural	38	27	46^a	27	12
POVERTY LEVEL
Less Than 100%	242	211	200	185	193
100‑199%	212	272	214	166	205
200% or More	486^a	470^a	441	350	340
HEALTH INSURANCE²
Private	482^a	388	450	343	332
Medicaid/CHIP	420	533	408	382	392
Other³	49	62	32	43	70
No Coverage	63	22	21	30	33
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

260506

Table 9.102B – Attempted Suicide in Past Year: Among People Aged 12 to 17; by Geographic and Socioeconomic Characteristics, Percentages, 2021‑2025
Geographic/Socioeconomic Characteristic	2021	2022	2023	2024	2025
TOTAL	3.6	3.7^a	3.3	2.7	2.9
GEOGRAPHIC DIVISION
Northeast	2.7	2.8	3.3	2.5	3.4
New England	2.3	3.0	2.5	2.9	1.8
Middle Atlantic	2.8	2.8	3.5	2.3	4.0
Midwest	4.4	3.6	4.1	2.8	3.1
East North Central	4.2	3.5	3.9	2.4	2.6
West North Central	4.6	3.9	4.3	3.6	4.1
South	3.9	3.5	3.3	2.9	2.7
South Atlantic	3.6	3.6	3.2	3.1	3.1
East South Central	4.3	4.8	5.8^a	3.8	2.7
West South Central	4.0	2.8	2.4	2.2	2.1
West	3.2	4.8^a	2.7	2.5	2.8
Mountain	4.1	5.1	2.7	3.0	3.4
Pacific	2.8	4.6	2.8	2.3	2.5
COUNTY TYPE¹
Large Metro	3.1	3.5	3.0	2.3	2.6
Small Metro	4.0	4.2	3.8	3.2	3.0
Nonmetro	4.7	3.7	3.7	3.8	4.0
Urbanized	6.7	3.4	3.4	3.0	3.0
Less Urbanized	3.5	4.2	2.9	4.7	5.9
Completely Rural	3.5	3.6	5.4	3.7	2.1
POVERTY LEVEL
Less Than 100%	4.4	4.0	3.5	3.4	3.4
100‑199%	3.8	4.7	4.0	3.1	3.6
200% or More	3.3	3.2	3.0	2.3	2.4
HEALTH INSURANCE²
Private	3.5^a	2.8	3.2	2.3	2.4
Medicaid/CHIP	3.9	5.0	3.7	3.7	3.8
Other³	3.5	4.2	2.3	3.1	4.9
No Coverage	4.8	2.2	1.7	2.5	2.9
* = low precision; ‑‑ = not available or not shown due to methodological or questionnaire changes; da = does not apply; nr = not reported due to measurement issues. NOTE: Estimates for 2021 may differ from previously published estimates because the 2021 analysis weights were updated to facilitate between‐year comparisons. See Chapter 2 of the 2022 National Survey on Drug Use and Health (NSDUH): Methodological Summary and Definitions for details. NOTE: For youth suicidality measures, responses of “Yes,” “No,” “Not Sure,” “Don’t Know,” “Don’t Want to Answer,” and “Refuse” are categorized as valid, known data. Respondents with unknown suicidality data for other categories were excluded. ^a,b The difference between this estimate and the 2025 estimate is statistically significant at the .05 level (a) or .01 level (b). Rounding may make the estimates appear identical. ¹ Because the 2023 Rural‐Urban Continuum Codes were used to create the county type variables, the 2021‑2024 estimates may differ from previously published estimates. ² Respondents could indicate multiple types of health insurance; thus, these response categories are not mutually exclusive. ³ Other health insurance is defined as having Medicare, military‐related health care, or any other type of health insurance. Definitions: Measures and terms are defined in Appendix A. Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2021‑2025.

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