SAMHSA Releases Annual National Survey on Drug Use and Health

Encouraging Trends Among Adolescents and Young Adults

Today, the Substance Abuse and Mental Health Services Administration (SAMHSA) released the results of the 2025 National Survey on Drug Use and Health (NSDUH), the nation’s primary source of data on how people living in the United States report their experience with mental health conditions, substance use and addiction, pursuit of treatment and recovery status. This year’s survey provides five years of data to examine trends among key substance use and mental health outcomes.

“Today’s release represents the earliest release of NSDUH to the public in the survey’s history, reflecting SAMHSA’s commitment to advancing gold-standard science and data-driven policy, program, and practice innovation,” said SAMHSA Principal Deputy Assistant Secretary Christopher D. Carroll. “Building on encouraging trends first reported in the 2024 NSDUH, in 2025, adolescents aged 12 to 17 and young adults aged 18 to 25 continued to show downward or stable trends in most behavioral health indicators over the past five years.”

The 2025 NSDUH provides a national snapshot of behavioral health in the United States based on self-reported responses from more than 60,000 people. A key focus of the annual report released today is examining trends in substance use and mental health among the U.S. population from 2021 to 2025.

Among 12- to 17-year-olds, declines in prevalence were seen for:

  • Past month tobacco, alcohol, binge drinking, and marijuana use;
  • Past year use of illicit drugs and marijuana use;
  • Past year initiation of alcohol use, nicotine vaping, and marijuana use;
  • Past year substance use disorder, alcohol use disorder, and drug use disorder;
  • Past year major depressive episode, major depressive episode with severe impairment, co-occurring major depressive episode and substance use disorder, co-occurring major depressive episode with severe impairment and substance use disorder; and
  • Past year serious thoughts of suicide, making a suicide plan, and attempting suicide.

Among 18- to 25-year-olds, declines in prevalence were seen for:

  • Past month nicotine products, tobacco, cigarette, vaping, alcohol, binge drinking, and marijuana use;
  • Past year use of illicit drugs, use of marijuana, cocaine, hallucinogens, and misuse of prescription stimulants, prescription tranquilizers or sedatives, and prescription opioids;
  • Past year initiation of nicotine vaping;
  • Past year substance use disorder and alcohol use disorder;
  • Past year major depressive episode, major depressive episode with severe impairment, co-occurring major depressive episode and substance use disorder, co-occurring major depressive episode with severe impairment and co-occurring substance use disorder, any mental illness, serious mental illness, co-occurring any mental illness and substance use disorder, and co-occurring serious mental illness and substance use disorder; and
  • Past year serious thoughts of suicide, making a suicide plan, and attempting suicide.

Additional Findings from the 2025 NSDUH include:

Mental Health

  • Among adolescents aged 12 to 17 in 2025, about 1 in 5 (18.0% or 4.6 million) had moderate or severe anxiety symptoms in the past 2 weeks and 15.1% (or 3.7 million) had past year major depressive episode.
  • Among adults aged 18 or older in 2025, 6.6% (or 17.5 million) had moderate or severe symptoms of anxiety in the past 2 weeks.
  • Among adults aged 18 or older in 2025, 20.6% (or 54.6 million) had any mental illness in the past year, and 6.9% (or 18.2 million) had a serious mental illness.

Substance Use

  • Among people aged 12 or older in 2025, 56.0% (or 162.8 million people) used tobacco, vaped nicotine, used alcohol, or used an illicit drug in the past month, including 44.4% (or 129.1 million people) who drank alcohol, 16.2% (or 46.9 million people) who used a tobacco product, 10.1% (or 29.3 million people) who vaped nicotine, and 16.4% (or 47.5 million people) who used an illicit drug.
  • In 2025, marijuana was the most commonly used illicit drug, with 21.2% of people aged 12 or older (or 61.6 million people) having used it in the past year.
  • Among people aged 12 or older, the percentage who used marijuana in the past year increased from 19.0% (or 53.2 million people) in 2021 to 21.2% (or 61.6 million people) in 2025. The percentage also increased from 2021 to 2025 among adults aged 26 or older.
  • In 2025, 3.1% of people aged 12 or older (or 9.1 million people) used hallucinogens in the past year. The percentage who used hallucinogens in the past year increased from 2.7% (or 7.6 million people) in 2021 to 3.1% (or 9.1 million people) in 2025. The percentage also increased among adults aged 26 or older.
  • In 2025, 2.4% of people aged 12 or older (or 6.9 million people) misused prescription opioids in the past year. The percentage who misused prescription opioids in the past year decreased from 3.0% (or 8.5 million people) in 2021 to 2.4% (or 6.9 million people) in 2025.
  • In 2025, 0.3% of people aged 12 or older (or 768,000 people) used illicitly made fentanyl in the past year. The percentage who used illicitly made fentanyl in the past year showed no change from 2021 to 2025.
  • In 2025, 44.6 million people aged 12 or older (or 15.3%) had a substance use disorder (SUD) in the past year, including 25.7 million people who had an alcohol use disorder (AUD), 26.0 million people who had a drug use disorder (DUD), and 7.1 million people who had both an AUD and a DUD.
  • Among people aged 12 or older, the percentage who had a past year SUD decreased from 16.7% (or 46.8 million people) in 2021 to 15.3% (or 44.6 million people) in 2025.
  • The percentage who had a past year AUD decreased from 10.6% (or 29.7 million people) in 2021 to 8.9% (or 25.7 million people) in 2025.
  • The percentage showed no change from 2021 to 2025 for DUD.

Suicidal Thoughts and Behaviors

  • In 2025, 13.9 million adults aged 18 or older (5.3%) had serious thoughts of suicide in the past year, 4.9 million (1.8%) made a suicide plan, and 2.3 million (0.9%) attempted suicide.
  • In 2025, 2.6 million adolescents aged 12 to 17 (10.3%) had serious thoughts of suicide in the past year, 1.3 million (5.1%) made a suicide plan, and 738,000 (2.9%) attempted suicide.

Non-suicidal Self Harm

  • Beginning in 2025, NSDUH began including questions to assess non-suicidal self-harm among adolescents aged 12 to 17.
  • In 2025, 11.2% of adolescents aged 12 to 17 (or 2.8 million people) engaged in non-suicidal self-harm in the past year. However, 2.9% of adolescents (or 735,000 people) were unsure or did not know whether they had intentionally harmed themselves without trying to kill themselves, and 5.6% (or 1.4 million people) did not want to report whether they had engaged in these behaviors.

Substance Use Treatment Services

  • Among people 12 or older in 2025, 2.6% (or 7.6 million people) received substance use treatment in the past year.
  • Among the estimated 47.2 million people aged 12 or older in 2025 who needed substance use treatment in the past year, 16.0% (or 7.6 million people) received substance use treatment in the past year; 84.0% (or 39.6 million people) did not receive treatment in the past year.
  • Among the 4.0 million people aged 12 or older with a past year opioid use disorder, 15.7% (or 623,000 people) received medications for opioid use disorder in the past year.
  • Among the 25.7 million people aged 12 or older with a past year alcohol use disorder, 2.6% (or 679,000 people) received medications for alcohol use disorder treatment in the past year.
  • Common reasons for not receiving treatment among those who perceived an unmet need for treatment included thinking they should have been able to handle their alcohol or drug use on their own (82.5%), not being ready to stop or cut back on using alcohol or drugs (68.4%), not being ready to start treatment (67.7%), not having enough time for treatment (54.3%), and being worried about what people would think or say if they got treatment (41.4%).

Mental Health Treatment Services

  • In 2025, 27.6% of adolescents aged 12 to 17 (or 7.0 million people) received mental health treatment in the past year.
  • Among the 3.7 million adolescents who had a past year major depressive episode, 57.7% (or 2.1 million people) received mental health treatment in the past year.
  • In 2025, 21.6% of adults aged 18 or older (or 57.3 million people) received mental health treatment in the past year.
  • Among the 54.6 million adults with any mental illness in the past year, 50.9% (or 27.8 million people) received mental health treatment in the past year.
  • Among the 18.2 million adults with serious mental illness in the past year, about two thirds (67.7% or 12.3 million people) received mental health treatment in the past year.
  • Common reasons for not receiving treatment among those who perceived an unmet need for treatment included thinking they should have been able to handle their mental health, emotions, or behavior on their own (72.9%), thinking treatment would cost too much (61.4%), not having enough time for treatment (48.3%), not being ready to start treatment (47.7%), and not knowing how or where to get treatment (44.9%).

Recovery

  • 30.6 million adults aged 18 or older (or 11.6%) perceived that they ever had a problem with their use of drugs or alcohol.
  • Among these adults, 73.0% (or 22.3 million people) considered themselves to be in recovery or to have recovered from their drug or alcohol use problem.
  • 63.8 million adults aged 18 or older (or 24.3%) perceived that they ever had a problem with their mental health.
  • Among these adults, 69.4% (or 44.1 million people) considered themselves to be in recovery or to have recovered from their mental health issue.

About the National Survey on Drug Use and Health

Conducted by the federal government since 1971, the NSDUH is the primary source of statistical information on self-reported substance use and mental health of the U.S. civilian, noninstitutionalized population aged 12 or older.

The NSDUH measures include:

  • Use of illegal drugs, prescription drugs, alcohol, and tobacco;
  • Substance use disorder and substance use treatment;
  • Major depressive episodes, anxiety, suicidal thoughts and behaviors, and other symptoms of mental illness, mental health care; and
  • Recovery from substance use and mental health disorders.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. To learn how to get support for mental health, drug or alcohol issues, visit FindSupport.gov. If you are ready to locate a treatment facility or provider, you can go directly to FindTreatment.gov or call 800-662-HELP (4357).

Credentialed media outlets may send their requests for comment.

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 access and better outcomes for all.

Last Updated: