Substance use disorder (SUD) is a pervasive problem all across the United States. The issue affects many communities, and most people are likely to either know someone with SUD and/or experience SUD themselves. In this way, substance use truly is an epidemic.
However, the situation doesn’t impact everyone equally. Every community and demographic has unique risk factors and odds of being impacted by substance use. Understanding the statistics on drug abuse in 2023 is important to be able to understand the actions needed to stop the substance use epidemic in the United States. These efforts can help ensure everyone has access to the help they need to live their best and healthiest lives.
General Drug Abuse Statistics
There’s no shortage of statistics surrounding substance use disorder. Many of these figures generally apply to the United States, painting a broad picture of the substance use disorder epidemic. More specifically, they provide a data-based view of the problem SUD truly is before we get into the specifics regarding risk factors for certain communities and demographics.
Statistics from 2017-2020
The substance use epidemic has been going on for years, and the most complete data currently available was gathered between 2017 and 2020 and reported between 2018 and 2023. In 2017, it was found that 19.7 million adults in the United States were battling a substance use disorder. Of those 19.7 million people, 8.5 million were dealing with a comorbid mental health disorder, while 1 in 8 people were using both drugs and alcohol at the same time.1
In the years since, the numbers have only increased. According to the National Institute on Drug Abuse, 20.4 million people in the United States were diagnosed with a substance use disorder in the year 2019. Of these 20.4 million people, only 10.3% received treatment. 2020 was no better, as about 92,000 people died of a substance overdose that year.2
Projected Drug Abuse Statistics in 2023
It’s likely that these numbers are only going to increase in 2023 and beyond. This follows the current trend, as the numbers continue to climb each year.
If we want to reverse this trend, it is crucial for resource providers, loved ones, community organizations, and individuals to work together to ensure treatment and alternative coping methods are more widely available. With proper measures in place, the United States Office of Drug Control Strategy is aiming to reduce these numbers by 13% for the year 2025, so there’s still hope that the statistics won’t continue to climb.3
Statistics on Specific Substances
Not all substances have an equal impact on communities and populations. Different substances pose different risks depending on personal, social, economic, and cultural factors, but the impact only grows when these substances are used in combination. Understanding substance-specific statistics can help us outline exactly how each substance impacts a community and what can be done to combat it.
Alcohol Statistics
Alcohol is a legal substance that is heavily normalized in American culture. However, alcohol use disorder is one of the most prevalent SUDs and must be taken seriously. Of the 19.7 million adults who struggled with a substance use disorder in 2017, 74% of those disorders involved the use of alcohol. Millions of new consumers are introduced to alcohol each year and experience the regular use of alcohol on both special and everyday occasions. These numbers will only continue to climb if the situation is left unchecked.
The problem is magnified when alcohol is mixed with other substances. In 2017, 1 in 8 adults struggled with using both alcohol and another substance at the same time. This is very dangerous, especially if the alcohol is being used alongside a substance as dangerous and common as fentanyl or cocaine.1
Opioid Statistics
The most publicized substance use epidemic is the “opioid epidemic,” and for good reason. Opioids were overprescribed for pain relief at multiple points within the last few decades, and as more and more people became addicted to their pain medications, many turned to cheaper street versions to attain the same sensations. This illicit market has led to a boom in opioid overdoses, as more and more powerful versions of drugs like fentanyl are cut with other drugs and sold to unsuspecting people, who aren’t aware that they’re getting more than what they expected.
From 1999 to 2020, opioids consistently topped the list of drugs resulting in fatal overdoses. Fentanyl caused more than 60,000 overdoses in 2020 alone. Meanwhile, other prescription opioids and street opioids like heroin remain dangerous as well, causing thousands of overdose-related deaths each year. When combined, over 2 million people are introduced to some form of opioid each year, with the most frequent primary exposure being a valid prescription painkiller.2
Of course, although alcohol and opioids are the most prevalent, there are many other substances in circulation to teenagers and adults all over the United States. The most common addictive substances include cocaine, LSD, tobacco, and ecstasy. Marijuana, which can cause problems if not used responsibly, is especially common among adults in various communities. Overall, over 5 million people are introduced to one or more of these substances a year, a figure higher than the number of people introduced to opioids and alcohol together.4
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Substances do not target all communities equally. Not only are certain population areas more heavily impacted by substance use, but specific groups have unique risk factors. Understanding these numbers is necessary to be able to offer the correct help where it’s needed and to who needs it the most. The communities and groups that are most heavily affected are the ones who currently do not have reliable access to healthcare services, who have more substances circulating around their neighborhoods, and who have a wide variety of risk factors that make substance usage more likely.
Population Statistics
Substances and substance use disorders are generally more common in urban communities than in rural ones, with more people in large urban areas having used substances than people outside of those areas. This may be a factor because, with more population density, substances can circulate more quickly.5 In addition, many urban communities are in some ways disadvantaged economically and socially, which can lead to a higher prevalence of specific risk factors. This is an issue known worldwide and is not any less serious in the United States, where the term urban poverty has been studied for decades.
When we look at individual states, the numbers line up. More populous states, such as California, Florida, Massachusetts, Michigan, and New York, see higher numbers of opioid usage, alcohol abuse (including underage drinking and driving while under the influence), 6789 and overdose-related deaths in general. Of course, the problem isn’t any less important in less populous areas; even Wyoming, which is the least populated state in America, sees thousands of deaths a year from substance use.
Economic Statistics
As mentioned, impoverished areas and communities are more likely to see substances circulate throughout. This is due to a complex mix of risk factors that are associated with lower economic status. Substance usage is more common among people who are trying to cope with an outside issue or mental health disorder, as substances can offer temporary relief from these negative situations.
These risk factors include stress, depression, anxiety, troubled home lives, struggles in school, trauma and post-traumatic stress disorder, and more. People in less wealthy communities are generally more likely to suffer from these issues, as there’s less access to help, and the environments themselves tend to be less stable, increasing the risk of negative and stressful life events. Millions of people struggling with a substance use disorder are thus also struggling with another comorbid mental health struggle, often because they’re unable to cope and don’t know how to get the help they need.
Another major factor is whether or not someone has ever committed a crime or gone to jail, as an estimated 65% of people in the American prison system are struggling with substance use disorders.10 Factors such as these can also play a more indirect role in why people turn to substances, as they can make it really difficult to find or hold down a job. In fact, unit increases in state unemployment correspond to an over 9% increase in opioid use disorder, with similar figures noted for other substances.11
Race, Age, and Gender Statistics
Who a person is, in terms of their race, ethnicity, age, gender, and more, is just as important as other socioeconomic factors when it comes to their risk of developing a substance use disorder. It can impact everything from the type of substances they may use to the when and how of their actual use.
When it comes to race, it appears that each group suffers to a different degree. Native Americans, including Native Alaskans, make up a combined total of about 12% of substance use dependence reported. Pacific Islanders are less likely to suffer a substance use disorder in comparison, with only about 4% of the total. Following Native Americans are Caucasians and African Americans, making up 7.7% and 6.8%, respectively, in the same year. Asian Americans are the least likely to suffer from a substance use disorder, acting as only 3.8% of the total.1
Gender-wise, men are more likely to use substances than women, with 9.4% compared to 5.2% in 2017. However, women are more likely to develop a dependency on prescription drugs, and they can be just as prone to dependencies in general when they do take substances. More overdose-related deaths happen to men, but the numbers for women are climbing each year.12
The LGBTQ+ community is at a higher risk as well. The rates of discrimination faced against people in the community lead to greater overall stress and, as a result, higher than average amounts of substance use. Alcohol, opioids, and methamphetamine are specific examples of substances that the LGBTQ+ community is more likely to struggle with.
Age is another interesting factor. Many studies consider “adults” to be anyone aged 12 or up, which means that many of the reported adult overdose-related deaths are happening to adolescents and teenagers. Among kids ages 12-17, over 2 million have reported using substances in 2020, with nearly 600,000 of these kids using a substance besides marijuana.
However, the substance most common for people in this age group is alcohol. Underage drinking causes thousands of deaths a year, and over 400,000 kids met the criteria to be diagnosed with an alcohol use disorder. 8 Adolescents are often even more susceptible to an SUD because they’re less experienced and more swayed by peer pressure; if their peers are using substances and appear to be having fun, they’re more likely to try an illicit substance as well and can easily underestimate their potency.
It’s not all doom and gloom; many people across the United States are on the path of recovery, and opportunities to get help are continuing to grow. In a recent year, over 4 million people received the treatment they needed, and with thousands of substance use treatment centers in the United States, this number can continue to grow. 1 We as a community need to work to remove the barriers that are preventing people from getting the help they need. This effort will give everyone a chance to recover regardless of who they are or where they come from.
Here at Alternative to Meds Center, our mission is to help improve upon the above statistics.
Our efforts to help people in Arizona recover from substance use disorders focus on the avoidance of adding harmful prescription medications in the process. An evidence-based, addiction treatment program can give each person the care they truly need to find recovery while considering the unique circumstances and risk factors that led to their substance use.
This content has been reviewed and approved by a licensed physician.
Dr. Samuel Lee
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.
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