An estimated 48 million Americans have a substance use problem

RRates of mental illness and substance use remained largely stable in 2023, according to federal data, underscoring the severity of America’s long-running mental health crisis and the worst rates of illicit drug use in the world.

And while overall nicotine use also remained about the same, the way people consumed it changed slightly. Overall, slightly more Americans vaped nicotine, while slightly fewer smoked cigarettes.

The study, released Tuesday by the Substance Abuse and Mental Health Services Administration, is a reminder of the severity of the country’s ongoing substance use and mental health crises. And it also highlights that even for people seeking help for a substance use or mental health disorder, treatment is often unavailable.

“These data tell us that we have a lot of work to do across the spectrum of behavioral health,” said Miriam Delphin-Rittmon, director of SAMHSA. “It also tells us that we need to spread the message that treatment is available and recovery is possible.”

While the study found some minor changes in substance use trends, the study found that use of alcohol, opioids and stimulants such as cocaine or methamphetamine was largely stable in 2023.

Nearly half of respondents age 12 and older reported drinking alcohol in the past 30 days, and 5.7% reported heavy drinking. The binge drinking numbers were identical to those in 2022 and 2021: In the past 30 days, 21.7% of Americans had engaged in binge drinking – defined as five drinks per day for men and four drinks per day for women.

Rates for use of marijuana and other illegal drugs, including stimulants and opioids, were also about the same as the year before. Fentanyl abuse fell from 0.4% of the population to 0.3% – a small change that nevertheless amounts to about 160,000 fewer people abusing the powerful synthetic opioid.

A total of 17.1% of the population, or 48.5 million people, met criteria for a substance use disorder at some point in the past year. Yet fewer than 1 in 4 individuals needing addiction treatment received medical care related to their substance use.

One area of ​​slight change was nicotine: 9.4% of Americans over the age of 12 reported consuming nicotine via vaping last year, an increase of more than 1% from the year before. Similarly, 13.7% reported smoking cigarettes, a decrease of just under 1%.

What is striking, however, is that the trend among underage nicotine consumers – between the ages of 10 and 20 – was the opposite. While totals remained largely stable, teens made up a slightly higher share of cigarette smokers in 2023 compared to the year before, and a slightly smaller share of vapers.

Nearly a quarter of all Americans were estimated to have a mental illness at some point in 2023, and 5.7% of the population reported a serious mental illness that “substantially disrupted” their daily lives.

The mental health crisis among adolescents also remained severe. Nearly 1 in 3 Americans between the ages of 12 and 17 have received some form of mental health treatment in the past year, an increase of about half a million. But SAMHSA officials called the increase a positive development, arguing that it was mostly a reflection of increased treatment availability and reduced stigma, rather than an overall decline in teen mental health.

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