National report shows less underage drinking and smoking, but overall substance use and mental illness levels remain constant

A new report provides special focus on the misuse of prescription pain relievers
Thursday, September 8, 2016

Some forms of substance use, such as adolescent (aged 12 to 17) underage drinking and alcohol use among young adults (aged 18 to 25), continued to drop according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) latest (2015) National Survey on Drug Use and Health (NSDUH) report. Other substance use levels among youth and young adults, including marijuana and heroin use, remained relatively stable over the past few years. The report also finds that mental illness levels among adults aged 26 and older generally remain steady, but there is a slight rise in the levels of major depressive episodes among adolescents and young adults.

“These findings offer hope that marijuana and heroin use may be slowing down,” said SAMHSA Principal Deputy Administrator Kana Enomoto. “And more American youth are rejecting alcohol and tobacco. This is great progress. But our nation still faces a public health crisis of untreated mental and substance use disorders. In 2015, one out of five adults in America met criteria for a mental illness or substance use disorder and only 39 percent of them received services. These are potentially life-threatening, disabling conditions. Our country must redouble its efforts to provide evidence-based prevention and treatment services in every community to ensure all Americans get the help and hope they need to lead healthy and productive lives.”

“We know that evidence-based prevention efforts are the most effective way to reduce drug use and to support the roughly 90 percent of American youth who do not use illicit drugs,” said Michael Botticelli, Director of National Drug Control Policy. “However the data also show that too many people don’t get the treatment they need for their substance use disorders. That is why the President has repeatedly called for $1.1 billion in new funding for States to expand access to treatment. Every day that passes without Congressional action to provide these additional resources is a missed opportunity to save lives.”

SAMHSA issued its 2015 NSDUH report on key substance use and mental health indicators as part of the 27th annual observance of National Recovery Month. Recovery Month expands public awareness that behavioral health is essential to health, prevention works, treatment for substance use and mental disorders is effective, and people can and do recover from these disorders. In addition, SAMHSA released a second 2015 NSDUH report which unveils for the first time detailed information on both the use and misuse of prescription drugs.

The report shows that there continues to be a significant treatment gap for mental and substance use disorders. For example in 2015, an estimated 21.7 million people aged 12 or older needed substance use treatment, but only 2.3 million received treatment at a specialty facility. The President’s Budget called for $1.1 billion in new funding to expand access to treatment to address the prescription opioid and heroin epidemic ( At this time, Congress has not provided this funding.

The main NSDUH report found some areas of lower substance use particularly regarding tobacco and alcohol. For example, the rate of current (past month) cigarette smoking dropped from 26 percent for all people aged 12 and older in 2002 to 19.4 percent in 2015. The drop is particularly significant among young adults – down from 40.8 percent in 2002 to 26.7 percent in 2015. The level of adolescents and young adults smoking cigarettes daily also decreased substantially during this period – from 31.8 percent of adolescent smokers in 2002 to 20 percent in 2015, and from 51.8 percent of young adult smokers in 2002 to 42 percent in 2015. Some of this decline may reflect the use of electronic vaporizing devices for delivering nicotine, such as e-cigarettes; however, NSDUH does not currently ask direct questions about e-cigarette use.

Similarly, alcohol use among adolescents continues to decline. The level of current alcohol use by adolescents dropped from 17.6 percent in 2002 to 9.6 percent in 2015. Alcohol use disorder rates also dropped among adolescents from 5.9 percent in 2002 to 2.5 percent in 2015. Rates of alcohol use and alcohol use disorder also dropped among young adults, from 60.5 percent in 2002 to 58.3 percent in 2015 for alcohol use and from 17.7 percent in 2002 to 10.9 percent in 2015 for alcohol use disorder.

Marijuana is still the most commonly used illicit drug. In 2015, 8.3 percent of people aged 12 were current marijuana users -- comparable to the previous year, yet higher than the level in 2002 (6.2 percent). The percentage of adolescents who were current marijuana users remained steady over the past year -- 7 percent in 2015 versus 7.4 percent in 2014 -- and is similar to recent years.

Heroin use levels remain about the same as last year. Cocaine use levels are similar to most previous years, although slightly higher than in 2014. However, there is an increase in past month cocaine use for young adults to 1.7 percent in 2015 compared to 1.1 percent in 2012 and 2013.

The new second NSDUH report released today features more comprehensive information on prescription psychotherapeutic medications including tranquilizers, stimulants, sedatives and pain relievers (including those containing opioids). This report contains information on the total number of people using these medications based on questions on any use and misuse. It also provides insight into several important issues such as why people misuse these medications and how misuse may be associated with other forms of substance use and/or mental issues

This report shows that among people aged 12 and older 6.4 million people currently (in the past month) misuse psychotherapeutic medications. About three-fifths (59.3 percent) of this current misuse consists of the 3.8 million people currently misusing prescription pain relievers. The report also shows that most people who used prescription drugs in the past year did not misuse them. In fact, 84.1 percent of them did not misuse prescription drugs even once in the past year.

NOTE: As explained in the NSDUH report, changes in survey methodology for seven of the 10 illicit drug categories—hallucinogens, inhalants, methamphetamine, and the misuse of prescription pain relievers, tranquilizers, stimulants, and sedatives—prevent direct comparisons of measurements involving those illicit drugs between 2015 and prior years.

In terms of the mental health findings, the NSDUH report shows that in 2015, 43.4 million adults aged 18 or older (17.9 percent) experienced some form of mental illness in the past year – virtually the same level as in 2014 (18.1 percent). However, a slight uptick continues among young adults (aged 18 to 25), with any mental illness rising from 18.0 percent in 2009 to 21.7 percent in 2015. In 2015, 9.8 million adults (4.0 percent) had a serious mental illness, including 1.8 million young adults. Levels of major depressive episodes also increased slightly among young adults in recent years from 8.7 percent in 2013 to 10.3 percent in 2015.

An estimated 34.2 million adults aged 18 or older received mental health care during the past 12 months, including 6.4 million adults with past year serious mental illness. However, treatment for depression has remained stable over time.

NSDUH is a scientific annual survey of approximately 67,500 people throughout the country, aged 12 and older. NSDUH is a primary source of information on the scope and nature of many substance use and mental health issues affecting the nation.

The complete findings for both of the NSDUH reports issued today are available on the SAMHSA web site.

National Recovery Month held each September is a national observance to educate Americans that substance use treatment and mental health services can enable those with a mental and/or substance use disorder to live a healthy and rewarding life. For more information about Recovery Month visit

For more information, contact the SAMHSA Press Office at 240-276-2130.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (DHHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.

Last Updated: 09/08/2016