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SAMHSA’s annual mental health, substance use data provide roadmap for future action

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Today the Substance Abuse and Mental Health Services Administration released the 2019 National Survey on Drug Use and Health (NSDUH). The annual survey is the nation’s primary resource for data on mental health and substance use among Americans.

As the NSDUH demonstrates, substance misuse and mental illness continue to be major problems for Americans. These issues demand continued attention and focus across all American communities. The data also reflect impressive progress on the nation’s opioid crisis.

  • Opioid use disorder decreased significantly from 2.1 million in 2018 to 1.6 million. Efforts to increase access to Medication-Assisted Treatment and psychosocial/community recovery supports have had a positive effect.
  • Pain reliever misuse decreased significantly from 2018 for those 12–17 years of age and continues trending downward for 18–25 year olds.
  • Heroin initiation decreased significantly with a 57 percent decline from 2018.

These data reflect that the Trump Administration’s commitment to addressing the opioid crisis through the advancement of evidence-based prevention, treatment and recovery strategies has worked. The unprecedented funding supported by the President has assisted communities across the nation.

Substance misuse and mental illness continue to affect the lives of millions of Americans. Data reveal that:

  • Past-month marijuana use and past-year daily or almost daily marijuana use significantly increased in adults aged 26+.
  • Past-year marijuana use disorder significantly increased in adolescents.
  • An upward trend in methamphetamine use and significant increase over 2016–17 in adults 26 and older.
  • Prescription stimulant misuse is trending downward in those 18–25 year olds.
  • Mental illness appears to be a great source of concern with serious mental illness significantly increasing in adults aged 18+, 18–25, and 26–49 between 2018 and 2019. Major depressive episode significantly increased in all age groups (except for those aged 50+) between 2018 and 2019.
  • Also troubling are the data on mental illness and America’s young people. Major depressive episodes with severe impairment significantly increased in adolescents and young adults between 2018 and 2019. Suicidal thoughts and behaviors significantly increased in young adults and adults aged 26–49 between 2009 and 2019.
  • Co-occurring substance use and mental disorders are common and the data tell us that one condition can impact greatly the effects of the other. Individuals with serious mental illness (SMI) or any mental illness are more likely to misuse substances; the reverse is also true with individuals misusing substances being more likely to experience mental health issues.
  • Polysubstance use occurs frequently and underscores the need for screening and addressing all substance issues that a person may have because treating one substance problem will not treat other co-occurring substance problems.

“This year’s National Survey on Drug Use and Health has some very encouraging news: The number of Americans with opioid use disorder dropped substantially, and fewer young adults are abusing heroin and other substances,” said Health and Human Services Secretary Alex Azar. “Increases in marijuana and methamphetamine use and in serious mental illness are very concerning, and we expect that these challenges will be exacerbated by this year’s pandemic. The Trump Administration has put more of a focus than any previous administration on connecting Americans with substance use disorders and serious mental illness to evidence-based treatment, grounded in the best science we have. The data are clear: We’re making progress, but we must redouble our efforts.”

“The NSDUH data provide a foundation that helps to focus resources to address the important areas of mental health and substance use issues in our nation,” said Dr. Elinore McCance-Katz, the Assistant Secretary for Mental Health and Substance Use. “I am especially pleased to see that our opioid abuse prevention efforts appear to be working, and we will continue to deliver those important messages.” SAMHSA has been working to expand access to treatment for serious mental illness and serious emotional disturbance.

SAMHSA has been focusing its efforts on the co-occurrence of mental and substance use disorders. Through efforts such as the Technology Transfer Centers – which span substance abuse prevention, addiction, and mental health – and the Clinical Support System for SMI, SAMHSA has mounted an extensive effort to ensure the training of professionals on co-occurring disorders. The agency will continue to provide needed training and technical assistance on these issues to America’s communities.

The NSDUH report is available at

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The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

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