94% of Patients with SUD Don’t Get Treatment, National Survey on Drug Use and Health Reveals

A staggering 94% of people 12 and older with a substance use disorder (SUD) didn’t receive treatment in 2021.

That’s according to a new federal survey that is shining a brighter light on Americans’ behavioral health needs. The survey – released Wednesday by Substance Abuse and Mental Health Services Administration (SAMHSA) – asked Americans about their substance use and mental health indicators.

Authors of the National Survey on Drug Use and Health (NSDUH) noted that results are not comparable with estimates from prior years.


“The annual NSDUH results help inform our efforts to expand access to treatment options and recovery supports across the nation,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon said in a statement. “Harnessing the power of data and evidence is critical to ensuring policies and programs have the greatest opportunity to achieve positive outcomes.”

The research found that, at the time of their response, over half the U.S. population used tobacco, alcohol or an illicit drug in the past month. Alcohol was the most popular substance used by people in the U.S. In fact, roughly 47.5% of the population used alcohol, 19% used a tobacco product and 14.3% used an illicit drug in the last month.

More than 46 million people met the DSM-5 criteria for having a SUD in 2021. This included 29.5 million who were classified as having alcohol use disorder. The highest rates of people with SUD was among individuals aged 18 to 25.


About 15.6% of individuals aged 12 and over needed SUD treatment, according to the report. Yet 96.8% of individuals with an illicit drug or alcohol use disorder that didn’t receive treatment at a speciality facility said they didn’t feel they needed treatment.

Illicit drugs continue to be an issue in the U.S.

About 61.2 million people aged 12 and older used an illicit drug in the past year, according to the survey. While marijuana was the most common, 9.2 million people also reported misusing opioids in the past year. That breaks down to about 8.7 million people who misused prescription pain relievers in the last year and 1.1 million who used heroin.

Mental health conditions were also prevalent in 2021, according to the research. A quarter of adults reported experiencing a mental illness in the last year. That number was even higher in young adults who experienced mental illness at a rate of 1 in 3. Researchers found that white and multiracial adults were the most likely to receive mental health services in the past year.

A number of young adults (13.5%) experienced both a SUD and any mental illness. Additionally, 46% of young adults had either a SUD or mental illness.

The bulk (72.2%) of adults who reported ever having a SUD considered themselves in recovery. Additionally two-thirds of adults who ever had a mental health condition reported being in recovery or recovering.

The federal government is actively investing in the SUD and mental health treatment. The recently passed omnibus funding bill put at least $10 billion into behavioral health efforts.

In 2021, White House announced $1.6 billion investment into community programs aimed at addressing the addiction and overdose crisis.

The federal government is also looking to make it easier for patients to get care. In December, HHS along with tSAMHSA released a proposed rule that would allow for take-home doses of methadone and would let authorized physicians treat patients with buprenorphine and methadone-assisted over telehealth.

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