Index Manuals Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health
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Key Substance Use and Mental Health Indicators in the United States:
Results from the 2020 National Survey on Drug Use and Health
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23. Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G.,
National Institute on Alcohol Abuse and Alcoholism. (2019). Drinking
Schulenberg, J. E., & Patrick, M. E. (2020). Monitoring the Future
national survey results on drug use 1975-2019: 2019 overview, key findings
overview-alcohol-consumption/moderate-binge-drinking
on adolescent drug use. Ann Arbor, MI: University of Michigan, Institute
33. Tese estimates were calculated from special analyses but are not
for Social Research. Retrieved from http://www.monitoringthefuture.
included in the appendix tables or in the 2020 detailed tables.
org/pubs/monographs/mtf-overview2019.pdf
34. Alcohol Policy Information System, National Institute on Alcohol Abuse
24. U.S. Food and Drug Administration. (2020). 2019 National Youth
and Alcoholism. (n.d.). Highlight on underage drinking. Retrieved from
Tobacco Survey shows youth e-cigarette use at alarming levels. Retrieved
from https://www.fda.gov
35. Te 2020 NSDUH questionnaire included separate sections for
25. Wang, T. W., Gentzke, A. S., Creamer, M. R., Cullen, K. A., Holder-
tranquilizer misuse and sedative misuse. Data from these sections
Hayes, E., Sawdey, M. D., Anic, G. M., Portnoy, D. B., Hu, S., Homa,
were combined to produce aggregate estimates for the misuse of any
D. M., Jamal, A., & Neff, L. J. (2019). Tobacco product use and
tranquilizer or sedative.
associated factors among middle and high school students — United
States, 2019. Morbidity and Mortality Weekly Report Surveillance
36. Te estimated numbers of current users of different illicit drugs are not
mutually exclusive because people could have used more than one type
ss6812a1
of illicit drug in the past month.
26. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G.,
37. LSD = lysergic acid diethylamide; PCP = phencyclidine; MDMA =
Schulenberg, J. E., & Patrick, M. E. (2021). Monitoring the Future
methylenedioxy-methamphetamine; DMT = dimethyltryptamine;
national survey results on drug use, 1975-2020: Volume I, Secondary school
AMT = alpha-methyltryptamine; Foxy = N, N-diisopropyl-5-
students. Ann Arbor, MI: University of Michigan, Institute for Social
methoxytryptamine (5-MeO-DIPT). Definitions for these hallucinogens
Research. Retrieved from http://www.monitoringthefuture.org/pubs/
also are included in Appendix A of the following reference: Center
monographs/mtf-vol1_2020.pdf
for Behavioral Health Statistics and Quality. (2021). 2020 National
Survey on Drug Use and Health: Methodological summary and definitions.
27. Gentzke, A. S., Wang, T. W., Jamal, A., Park-Lee, E., Ren, C., Cullen,
Retrieved from https://www.samhsa.gov/data/
K. A., & Neff, L. (2020). Tobacco product use among middle and high
school students — United States, 2020. Morbidity and Mortality Weekly
38. Desoxyn® was not mentioned in 2020 as some other stimulant and
has been mentioned only rarely in some years since 2015. Because
Desoxyn® is chemically similar to other prescription amphetamines (e.g.,
28. See the following reference: Center for Behavioral Health Statistics and
Adderall®), it was grouped with the other amphetamines.
Quality. (2014). Results from the 2013 National Survey on Drug Use and
Health: Summary of national findings (HHS Publication No. SMA 14-4863,
39. For example, the product label for Xanax®, which is prescribed as
NSDUH Series H-48). Retrieved from https://www.samhsa.gov/data/
a tranquilizer, indicates the drug has an average half-life of 11.2
hours (i.e., the length of time for half of the dosage of the drug to be
29. U.S. Food and Drug Administration. (2021). Tobacco 21. Retrieved
metabolized), with a range of 6.3 to 26.9 hours in healthy adults. In
comparison, the product label for Halcion®, a benzodiazepine prescribed
products/tobacco-21
as a sedative, has a short half-life in the range of 1.5 to 5.5 hours.
30. In the 2020 NSDUH, a “drink” was defined as a can or bottle of beer,
Product label information for these drugs is available on the U.S. Food
a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with
and Drug Administration’s Center for Drug Evaluation and Research
liquor in it. Times when respondents had only a sip or two from a drink
website at https://www.fda.gov/drugs/.
were not considered to be alcohol consumption.
40. Examples of forms of fentanyl presented to NSDUH respondents are
31. Te threshold for determining binge alcohol use for females was lowered
available by prescription. NSDUH respondents were not asked about
from five or more drinks on an occasion for the 2014 and earlier
the use of fentanyl illicitly manufactured in clandestine laboratories.
NSDUHs to four or more drinks on an occasion for the 2015 NSDUH
41. National Institute on Drug Abuse. (2021, April). DrugFacts: Cocaine.
to ensure consistency with federal definitions and other federal data
Retrieved from https://www.drugabuse.gov/publications/finder/t/160/
collection programs. Te threshold for males in 2015 remained at five or
drugfacts
more drinks on an occasion. New baselines began in 2015 for estimates
of binge and heavy alcohol use for females and for binge and heavy
42. National Institute on Drug Abuse. (2019, May). DrugFacts:
alcohol use for the overall population (both genders). Estimates from
2002 to 2020 for binge and heavy alcohol use among males are available
publications/finder/t/160/drugfacts
in the 2020 NSDUH detailed tables at https://www.samhsa.gov/data/.
43. National Institute on Drug Abuse. (2018, June). DrugFacts: Prescription
32. Te National Institute on Alcohol Abuse and Alcoholism (NIAAA)
defines binge drinking as a pattern of drinking that brings blood alcohol
finder/t/160/drugfacts
concentration (BAC) levels to 0.08 grams per deciliter (g/dL). Tis
44. Drug Enforcement Administration. (2020). Drugs of abuse, a DEA
typically occurs after four drinks for women and five drinks for men in
about 2 hours. See the following two references:
National Institute on Alcohol Abuse and Alcoholism. (2004, Winter).
NIAAA council approves definition of binge drinking. NIAAA
Newsletter/winter2004/Newsletter_Number3.pdf
Key Substance Use and Mental Health Indicators in the United States:
58 | October 2021
Results from the 2020 National Survey on Drug Use and Health
45. Schedule I controlled substances have no currently accepted medical use
55. Assessing whether respondents in the 2020 NSDUH had initiated
and have a high potential for abuse. See the following reference: Drug
misuse of a prescription psychotherapeutic drug in the past 12 months
Enforcement Administration. (2020). Drugs of abuse, a DEA resource
differed from assessing whether respondents had initiated the use of
other substances in that period because the psychotherapeutic drug
categories (e.g., prescription pain relievers) include many different types
46. U.S. National Library of Medicine. (2021). Diphenhydramine. Retrieved
of prescription drugs in a given category (e.g., pain relievers containing
hydrocodone, such as Vicodin®, Lortab®, Norco®, Zohydro® ER, or
47. U.S. National Library of Medicine. (2021). Phenylephrine. Retrieved
generic hydrocodone). Respondents in 2020 were asked questions about
initiation of misuse only for the specific prescription drugs they misused
in the past 12 months, including their age when they first misused a
48. National Institute on Drug Abuse. (2019, April). DrugFacts: Kratom.
drug and (if the first misuse occurred within a year of the current age)
Retrieved from https://www.drugabuse.gov/publications/finder/t/160/
the year and month of first misuse for that drug. Respondents who
drugfacts
reported they initiated misuse in the past 12 months for all of the
49. Although kratom is not scheduled nationally as a controlled substance,
specific prescription drugs in a given category they misused in that
the Drug Enforcement Administration includes kratom as a drug of
period were asked a follow-up question to establish whether they had
concern because it poses risks to people who use it. However, some
ever misused prescription drugs in that category more than 12 months
states may prohibit the possession and use of kratom. See the following
before being interviewed. Respondents who answered this follow-up
reference: Drug Enforcement Administration. (2020). Drugs of abuse, a
question as “no” were classified as being past year initiates of the misuse
of any prescription drug in the overall category. Tis answer meant
respondents had never misused any prescription drug in that category
50. National Institute on Drug Abuse. (2020, June). DrugFacts: Synthetic
more than 12 months prior to the interview date.
publications/finder/t/160/drugfacts
56. Section 3.4.2 in the following reference discusses the potential since
2015 for NSDUH respondents to underreport lifetime (but not past
51. National Institute on Drug Abuse. (2020, July). DrugFacts: Synthetic
year) misuse of prescription psychotherapeutic drugs: Center for
Behavioral Health Statistics and Quality. (2021). 2020 National Survey
publications/finder/t/160/drugfacts
on Drug Use and Health: Methodological summary and definitions.
Retrieved from https://www.samhsa.gov/data/
52. To measure initiation for most substances, NSDUH respondents who
reported they ever used a particular substance were asked to report
57. More information about the methods for measuring and estimating the
their age when they first used it. To measure initiation of prescription
initiation of substance use and prescription drug misuse in NSDUH
drug misuse (i.e., misuse of pain relievers, tranquilizers, stimulants, and
can be found in Section 3.4.2 of the following reference: Center for
sedatives), NSDUH respondents who reported they misused a particular
Behavioral Health Statistics and Quality. (2021). 2020 National Survey
prescription drug in the past 12 months were asked to report their
on Drug Use and Health: Methodological summary and definitions.
age when they first misused it. Respondents who reported first use (or
Retrieved from https://www.samhsa.gov/data/
misuse in the case of prescription drugs) of a substance within a year
of their current age also were asked to report the year and month when
58. Numbers in Figure 21 refer to people who used a specific substance for
they first used (or misused) it.
the first time in the past year, regardless of whether the initiation of use
of other substances occurred prior to the past year.
53. Estimates relating to the periods prior to the 12-month reference
period have not been considered here because of concerns about their
59. Past year initiates of crack cocaine use are counted as past year initiates
validity resulting from recall bias. See the following reference: Gfroerer,
of cocaine use only if they initiated any use of cocaine in the past year.
J., Hughes, A., Chromy, J., Heller, D., & Packer, L. (2004, July).
Likewise, past year initiates of LSD, PCP, or Ecstasy use are counted as
Estimating trends in substance use based on reports of prior use in a
past year initiates of hallucinogen use only if respondents had previously
cross-sectional survey. In S. B. Cohen & J. M. Lepkowski (Eds.), Eighth
not used other hallucinogens.
Conference on Health Survey Research Methods: Conference proceedings
60. Survey questions for the perceived risk from using different substances
[Peachtree City, GA] (HHS Publication No. PHS 04-1013, pp. 29-34).
vary in terms of the frequency (e.g., use once or twice a week, use
Hyattsville, MD: U.S. Department of Health and Human Services,
nearly every day or daily) and quantity of use (e.g., having five or more
Public Health Service, Centers for Disease Control and Prevention,
drinks of alcohol, any use of marijuana, cocaine, or heroin), making
National Center for Health Statistics.
comparisons difficult for perceptions of risk from using different
54. For substances other than prescription psychotherapeutic drugs,
substances.
respondents who had ever used the substance (e.g., marijuana) were
61. Compton, W. M., Han, B., Jones, C. M., Blanco, C., & Hughes, A.
asked to report when they first used the substance, and respondents who
(2016). Marijuana use and use disorders in adults in the USA, 2002-14:
reported first use within a year of their current age were asked to report
Analysis of annual cross-sectional surveys. Lancet Psychiatry, 3, 954-964.
the year and month when they first used it. Tus, past year initiates of
the use of substances other than prescription psychotherapeutic drugs
reported their first use within 12 months of the interview date.
Key Substance Use and Mental Health Indicators in the United States:
Results from the 2020 National Survey on Drug Use and Health
October 2021
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59
62. Because of the cross-sectional nature of NSDUH data (i.e., reports of
72. Adolescents were first asked whether they ever had a period in their
perceived risk and substance use made at a single point in time instead
lifetime lasting several days or longer when any of the following was true
of from the same individuals over multiple points in time), causal
for most of the day: (a) feeling sad, empty, or depressed; (b) feeling very
connections cannot be made between perceptions of risk and substance
discouraged or hopeless about how things were going in their lives; or
use.
(c) losing interest and becoming bored with most things they usually
enjoy. Adolescents who reported any of these problems were asked
63. Volkow, N. D., Baler, R. D., Compton, W. M., & Weiss, S. R. B. (2014).
further questions about their experience with the nine symptoms of
Adverse health effects of marijuana use. New England Journal of Medicine,
MDE in their lifetime. Adolescents were classified as having an MDE
in their lifetime if they experienced at least five of the nine symptoms in
64. National Academies of Sciences, Engineering, and Medicine. (2017).
the same 2-week period in their lifetime; at least one of the symptoms
Te health effects of cannabis and cannabinoids: Te current state of
needed to be having a depressed mood or loss of interest or pleasure in
evidence and recommendations for research. Washington, DC: Te
activities that had been enjoyable. Adolescents who reported gaining
National Academies Press. https://doi.org/10.17226/24625
weight without trying were asked if their weight gain occurred because
they were growing; this question was not asked of adult respondents.
65. For more information about the DSM-5 criteria for SUDs, see Section
Adolescent respondents who had a lifetime MDE were asked if they
3.4.3 and the definitions for abuse and dependence in Appendix A
had a period of 2 weeks or longer in the past 12 months when they felt
of the following reference: Center for Behavioral Health Statistics
depressed or lost interest or pleasure in previously enjoyable activities,
and Quality. (2021). 2020 National Survey on Drug Use and Health:
and they reported having some of their other MDE symptoms. Tese
adolescents were classified as having a past year MDE.
samhsa.gov/data/
73. Adults were first asked whether they ever had a period in their lifetime
66. Te DSM-IV criteria for SUDs include separate criteria for dependence
lasting several days or longer when any of the following was true
or abuse. People who met the criteria for abuse for a given substance
for most of the day: (a) feeling sad, empty, or depressed; (b) feeling
(e.g., alcohol) did not meet the criteria for dependence for that
discouraged about how things were going in their lives; or (c) losing
substance. For more information, see Section 3.4.3 and the definitions
interest in most things they usually enjoy. Adults who reported any of
for abuse and dependence in Appendix A of the following reference:
these problems were asked further questions about their experience with
Center for Behavioral Health Statistics and Quality. (2020). 2019
the nine symptoms of MDE in their lifetime. Adults were classified
National Survey on Drug Use and Health: Methodological summary and
as having an MDE in their lifetime if they experienced at least five
of the nine symptoms in the same 2-week period in their lifetime; at
67. A Clinical Validation Study (CVS) was conducted in early 2020 to assess
least one of the symptoms needed to be having a depressed mood or
NSDUH SUD questions that were revised to be consistent with the
loss of interest or pleasure in activities that had been enjoyable. Adult
DSM-5 criteria. For more information on the CVS, see Section 3.4.3.4
respondents who had a lifetime MDE were asked if they had a period of
in the following reference: Center for Behavioral Health Statistics
2 weeks or longer in the past 12 months when they felt depressed or lost
and Quality. (2021). 2020 National Survey on Drug Use and Health:
interest or pleasure in previously enjoyable activities, and they reported
having some of their other MDE symptoms. Tese adults were classified
samhsa.gov/data/
as having a past year MDE. Data on MDE in the past year for adults
have been available in NSDUH since 2005.
68. For alcohol, for example, withdrawal symptoms include (but are not
limited to) trouble sleeping, hands trembling, hallucinations (seeing,
74. Questions measuring adolescents’ impairment in carrying out life
feeling, or hearing things that were not really there), or feeling anxious.
activities because of MDE were added to the survey in 2006.
69. Goldstein, R. B., Chou, S. P., Smith, S. M., Jung, J., Zhang, H., Saha,
75. Data on MDE with severe impairment for adults have been available
T. D., Pickering, R. P., Ruan, W. J., Huang, B., & Grant, B. F. (2015).
since 2009.
Nosologic comparisons of DSM-IV and DSM-5 alcohol and drug use
76. Details about the criteria for defining a NSDUH interview as usable
disorders: Results from the National Epidemiologic Survey on Alcohol
are provided in Section 2.3.1 of CBHSQ (2021). See the following
and Related Conditions-III. Journal of Studies on Alcohol and Drugs,
reference: Center for Behavioral Health Statistics and Quality. (2021).
2020 National Survey on Drug Use and Health: Methodological summary
70. Center for Behavioral Health Statistics and Quality. (2021). 2020
National Survey on Drug Use and Health: Detailed tables. Retrieved from
77. Bias refers to error in estimates that does not occur at random.
78. Details about the break-off analysis weights are provided in Sections
71. Respondents who reported any use of prescription drugs in a given
2.3.4, 3.4.7, and 6.2.2 of CBHSQ (2021). See the following reference:
prescription psychotherapeutic category in the past 12 months (e.g.,
Center for Behavioral Health Statistics and Quality. (2021). 2020
prescription pain relievers) but did not report misuse of any drugs in
National Survey on Drug Use and Health: Methodological summary and
that category in the past 12 months were not asked the SUD questions
for that category.
Key Substance Use and Mental Health Indicators in the United States:
60 | October 2021
Results from the 2020 National Survey on Drug Use and Health
79. Follow-up clinical interviews for classifying whether adults had a
90. Wang, J., Sumner, S. A., Simon, T. R., Crosby, A. E., Annor, F.
mental, behavioral, or emotional disorder in the past year used the
B., Gaylor, E., Xu, L., & Holland, K. M. (2020). Trends in the
Structured Clinical Interview for the DSM-IV-TR Axis I Disorders,
incidence and lethality of suicidal acts in the United States, 2006
Research Version, Non-patient Edition (SCID-I/NP). See the following
reference: First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W.
jamapsychiatry.2020.0596
(2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders,
91. Miron, O., Yu, K.-H., Wilf-Miron, R., & Kohane, I. S. (2019).
Research Version, Non-patient Edition (SCID-I/NP). New York, NY: New
Suicide rates among adolescents and young adults in the United
York State Psychiatric Institute, Biometrics Research.
80. Information on the definitions and estimation methods for the mental
jama.2019.5054
illness estimates is provided in Section 3.4.7 and Appendix A of
92. Mojtabai, R., & Olfson, M. (2020). National trends in mental health
CBHSQ (2021). See the following reference: Center for Behavioral
Health Statistics and Quality. (2021). 2020 National Survey on Drug
org/10.1001/jamapsychiatry.2020.0279
Use and Health: Methodological summary and definitions. Retrieved from
93. Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the
prevalence and treatment of depression in adolescents and young adults.
81. Hedegaard, H., Curtin, S. C., & Warner, M. (2021, February). Suicide
mortality in the United States, 1999-2019 (NCHS Data Brief No. 398).
1878
Retrieved from https://www.cdc.gov/nchs/products/databriefs.htm
94. Examples of ACEs include abuse, neglect, and negative family
82. Ahmad, F. B., & Anderson, R. N. (2021). Te leading causes of death
interactions. ACEs can occur anytime from birth to age 17.
jama.2021.5469
95. Tompson, M. P., Kingree, J. B., & Lamis, D. (2019). Associations
of adverse childhood experiences and suicidal behaviors in adulthood
83. Stone, D. M., Simon, T. R., Fowler, K. A., Kegler, S. R., Yuan, K.,
in a US nationally representative sample. Child: Care, Health and
Holland, K. M., Ivey-Stephenson, A. Z., & Crosby, A. E. (2018, June
8). Vital Signs: Trends in state suicide rates — United States, 1999-
2016 and circumstances contributing to suicide — 27 states, 2015.
96. Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D.
F., & Giles, W. H. (2001). Childhood abuse, household dysfunction,
org/10.15585/mmwr.mm6722a1
and the risk of attempted suicide throughout the life span: Findings
from the Adverse Childhood Experiences Study. JAMA, 286(24), 3089-
84. Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018, November).
Mortality in the United States, 2017 (NCHS Data Brief No. 328).
Retrieved from https://www.cdc.gov/nchs/products/databriefs.htm
97. Yard, E., Radhakrishnan, L., Ballesteros, M. F., Sheppard, M., Gates,
A., Stein, Z., Hartnett, K., Kite-Powell, A., Rodgers, L., Adjemian,
85. Xu, J., Murphy, S. L., Kochanek, K. D., & Arias, E. (2020, January).
J., Ehlman, D. C., Holland, K., Idaikkadar, N., Ivey-Stephenson, A.,
Mortality in the United States, 2018 (NCHS Data Brief No. 355).
Martinez, P., Law, R., & Stone, D. M. (2021). Emergency department
Retrieved from https://www.cdc.gov/nchs/products/databriefs.htm
visits for suspected suicide attempts among persons aged 12-25 years
86. Data are from the Centers for Disease Control and Prevention
before and during the COVID-19 pandemic — United States, January
WONDER (Wide-ranging ONline Data for Epidemiologic Research)
2019-May 2021. Morbidity and Mortality Weekly Report, 70(24), 888-
Multiple Cause of Death database, 2018-2019, as compiled from
data provided by the 57 vital statistics jurisdictions through the Vital
98. Respondents were eligible to be asked the substance use treatment
Statistics Cooperative Program. See the following reference: Centers for
questions if they reported lifetime use of alcohol, marijuana,
Disease Control and Prevention, National Center for Health Statistics.
cocaine (including crack), heroin, hallucinogens, inhalants,
or methamphetamine, or the lifetime misuse of prescription
wonder.cdc.gov/ucd-icd10-expanded.html
psychotherapeutic drugs (i.e., pain relievers, tranquilizers, stimulants, or
87. Crosby, A. E., Han, B., Ortega, L. A. G., Parks, S. E., & Gfroerer, J.
sedatives). Respondents who were lifetime users of tobacco products or
(2011, October 21). Suicidal thoughts and behaviors among adults aged
other substances (e.g., kratom) but who did not report lifetime use or
≥18 years—United States, 2008-2009. Morbidity and Mortality Weekly
misuse of the substances mentioned in the previous sentence were not
asked the substance use treatment questions.
99. Substance Abuse and Mental Health Services Administration. (2020).
88. Han, B., Kott, P. S., Hughes, A., McKeon, R., Blanco, C., & Compton,
W. M. (2016). Estimating the rates of deaths by suicide among adults
samhsa.gov/sites/default/files/otp-guidance-20200316.pdf
who attempt suicide in the United States. Journal of Psychiatric Research,
100. Drug Enforcement Administration. (2020). Use of telephone evaluations
to initiate buprenorphine prescribing. Retrieved on June 8, 2021, from
89. Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur,
N., Khan, M., O’Connor, R. C., Pirkis, J., & COVID-19 Suicide
101. U.S. Department of Health and Human Services. (2021). Best practice
Prevention Research Collaboration. (2020). Suicide risk and prevention
guide: Telehealth for behavioral health care: Billing for telebehavioral
doi.org/10.1016/S2215-0366(20)30171-1
providers/telehealth-for-behavioral-health/billing-for-telebehavioral-
health/
Key Substance Use and Mental Health Indicators in the United States:
Results from the 2020 National Survey on Drug Use and Health
October 2021
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61
102. Lin, L., Casteel, D., Shigekawa, E., Weyrich, M. S., Roby, D. H.,
111. Reported estimates in this section may differ slightly from corresponding
& McMenamin, S. B. (2019). Telemedicine-delivered treatment
estimates in the 2020 detailed tables because the estimates in this section
interventions for substance use disorders: A systematic review. Journal
used a special break-off analysis weight for adult respondents who did
not complete the interview. For more information about this break-off
jsat.2019.03.007
analysis weight, see Section 2.3.4 in the following reference: Center
for Behavioral Health Statistics and Quality. (2021). 2020 National
103. Fiacco, L., Pearson, B. L., & Jordan, R. (2021). Telemedicine works
Survey on Drug Use and Health: Methodological summary and definitions.
for treating substance use disorder: Te STAR clinic experience during
Retrieved from https://www.samhsa.gov/data/
org/10.1016/j.jsat.2021.108312
112. Waugh, M., Voyles, D., & Tomas, M. R. (2015). Telepsychiatry:
Benefits and costs in a changing health-care environment. International
104. Benavides-Vaello, S., Strode, A., & Sheeran, B. C. (2013). Using
technology in the delivery of mental health and substance abuse
15.1091291
treatment in rural communities: A review. Journal of Behavioral Health
113. Reay, R. E., Looi, J. C. L., & Keightley, P. (2020). Telehealth mental
9299-6
health services during COVID-19: Summary of evidence and
105. Substance use treatment at a specialty facility refers to substance
org/10.1177/1039856220943032
use treatment at a hospital (only as an inpatient), a drug or alcohol
rehabilitation facility (as an inpatient or outpatient), or a mental
114. Health professionals include general practitioners or family doctors;
health center. Tis NSDUH definition historically has not considered
other medical doctors (e.g., cardiologist, gynecologist, urologist);
emergency rooms, private doctors’ offices, prisons or jails, and self-
psychologists; psychiatrists or psychotherapists; social workers;
help groups to be specialty facilities for the receipt of substance use
counselors; other mental health professionals (e.g., mental health nurse
treatment.
or other therapist where type is not specified); and nurses, occupational
therapists, or other health professionals.
106. Te NSDUH definition of the need for treatment does not explicitly
indicate the need for treatment at a specialty facility. People with an
115. Te specialty mental health setting includes services in outpatient or
SUD in the past year can be considered to need some form of assistance
inpatient settings. Outpatient services include those from (a) a private
for their problems with substance use. For more information about
therapist, psychologist, psychiatrist, social worker, or counselor; (b) a
the DSM-5 criteria for having an SUD, see Section 3.4.3 and the
mental health clinic or center; (c) a partial day hospital or day treatment
definition for SUD in Appendix A of CBHSQ (2021). See the following
program; or (d) an in-home therapist, counselor, or family preservation
references:
worker. Inpatient or residential specialty mental health services in which
adolescents stayed overnight or longer include services in a hospital or a
American Psychiatric Association. (2013). Diagnostic and statistical
residential treatment center.
manual of mental disorders (DSM-5) (5th ed.). Arlington, VA: Author.
116. Due to questionnaire changes in 2009, estimates for the receipt of youth
Center for Behavioral Health Statistics and Quality. (2021). 2020
mental health services in educational settings are not comparable with
National Survey on Drug Use and Health: Methodological summary and
estimates prior to 2009. Additionally, estimates for the receipt of youth
mental health services in juvenile justice settings were not available prior
107. Tere were 40.3 million people aged 12 or older in 2020 with an SUD
to 2009.
in the past year. Approximately 98 percent of the people in 2020 who
117. Compton, W. M., Tomas, Y. F., Stinson, F. S., & Grant, B. F.
needed treatment for a substance use problem were classified as such
(2007). Prevalence, correlates, disability, and comorbidity of DSM-
because they had an SUD in the past year, regardless of whether they
IV drug abuse and dependence in the United States: Results from the
received substance use treatment at a specialty facility.
National Epidemiologic Survey on Alcohol and Related Conditions.
108. As per the definition of the need for substance use treatment, people
with an SUD were classified as needing substance use treatment.
archpsyc.64.5.566
109. Due to rounding, estimated numbers and percentages of people in
118. Mojtabai, R., Chen, L.-Y., Kaufmann, C. N., & Crum, R. M. (2014).
Figure 45 who made an effort or did not make an effort to get substance
Comparing barriers to mental health treatment and substance use
use treatment do not sum to the total number of people who needed
disorder treatment among individuals with comorbid major depression
substance use treatment, did not receive specialty treatment in the
and substance use disorders. Journal of Substance Abuse Treatment, 46,
past year, and perceived a need for treatment.
110. Respondents in Quarter 4 of 2020 who did not report receiving
119. Hartz, S. M., Pato, C. N., Medeiros, H., Cavazos-Rehg, P.,
substance use treatment in the past year were not asked if they received
Sobell, J. L., Knowles, J. A., Bierut, L. J., & Pato, M. T. (2014).
telehealth services as substance use treatment. Terefore, reasons for not
Comorbidity of severe psychotic disorders with measures of substance
receiving treatment from Quarter 4 can include reasons for not receiving
telehealth services.
jamapsychiatry.2013.3726
120. Watkins, K. E., Hunter, S. B., Burnam, M. A., Pincus, H. A., &
Nicholson, G. (2005). Review of treatment recommendations for
persons with a co-occurring affective or anxiety and substance use
ps.56.8.913
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62 | October 2021
Results from the 2020 National Survey on Drug Use and Health
121. Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current
status of co-occurring mood and substance use disorders: A new
doi.org/10.1176/appi.ajp.2012.12010112
122. Han, B., Compton, W. M., Blanco, C., & Colpe, L. J. (2017).
Prevalence, treatment, and unmet treatment needs of US adults with
mental health and substance use disorders. Health Affairs (Millwood),
123. Centers for Disease Control and Prevention. (n.d.). COVID Data
Tracker: Trends in number of COVID-19 cases and deaths in the US
reported to CDC, by state/territory. Retrieved on June 18, 2021, from
124. National Institute on Alcohol Abuse and Alcoholism. (2021, June 15).
State alcohol-related laws during the COVID-19 emergency for on-premises
and off-premises establishments as of June 15, 2021. Alcohol Policy
Information System (APIS). Retrieved from https://alcoholpolicy.niaaa.
nih.gov/resource/covid-19/98
125. Barbosa, C., Cowell, A. J., & Dowd, W. N. (2020). Alcohol
consumption in response to the COVID-19 pandemic in the United
ADM.0000000000000767
126. Pollard, M. S., Tucker, J. S., & Green, Jr., H. D. (2020). Changes in
adult alcohol use and consequences during the COVID-19 pandemic
jamanetworkopen.2020.22942
127. European Monitoring Centre for Drugs and Drug Addiction. (2021).
European Drug Report 2021: Trends and developments. Luxembourg:
Publications Office of the European Union.
128. Use of drugs other than alcohol included the use of marijuana,
cocaine (including crack), heroin, hallucinogens, inhalants, or
methamphetamine in the past year or any use (i.e., not necessarily
misuse) of prescription pain relievers, tranquilizers, stimulants, or
sedatives in the past year. Drugs other than alcohol did not include
tobacco products or nicotine vaping.
129. U.S. Department of Health and Human Services. (2021, May). What is
patients/understanding-telehealth/
Key Substance Use and Mental Health Indicators in the United States:
Results from the 2020 National Survey on Drug Use and Health
October 2021
| A-1
Appendix A: Special Tables of Estimates for Substance Use and Mental Health Indicators
in the United States
Table A.1B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among People Aged 12 or Older; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
61.0
(0.40)
60.1
(0.38)
59.6
(0.40)
61.1
(0.39)
60.7
(0.39)
60.5
(0.37)
60.6
(0.38)
60.6
(0.36)
60.9
(0.39)
60.3
(0.38)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products
30.4
(0.35)
29.8
(0.34)
29.2
(0.33)
29.4
(0.35)
29.6
(0.35)
28.7
(0.34)
28.4
(0.35)
27.7
(0.33)
27.5
(0.34)
26.5
(0.33)
Cigarettes
26.0
(0.34)
25.4
(0.33)
24.9
(0.32)
24.9
(0.32)
25.0
(0.33)
24.3
(0.33)
24.0
(0.32)
23.3
(0.32)
23.0
(0.31)
22.1
(0.32)
Daily Cigarette Smoking1
63.4
(0.66)
62.9
(0.67)
62.3
(0.63)
63.0
(0.62)
62.3
(0.59)
61.3
(0.65)
61.5
(0.70)
61.0
(0.68)
59.5
(0.71)
60.7
(0.71)
Smoked 1+ Packs of
Cigarettes per Day2
53.1
(0.91)
53.5
(0.82)
54.0
(0.87)
51.4
(0.86)
50.6
(0.85)
50.9
(0.88)
49.2
(0.94)
45.9
(0.98)
45.1
(0.94)
43.8
(0.90)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
5.4
(0.15)
5.4
(0.14)
5.7
(0.13)
5.6
(0.15)
5.6
(0.14)
5.4
(0.14)
5.3
(0.15)
5.3
(0.14)
5.2
(0.14)
5.0
(0.14)
Pipe Tobacco
0.8
(0.07)
0.7
(0.06)
0.8
(0.06)
0.9
(0.06)
0.9
(0.07)
0.8
(0.07)
0.8
(0.06)
0.8
(0.06)
0.8
(0.06)
0.8
(0.06)
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
51.0
(0.42)
50.1
(0.39)
50.3
(0.40)
51.8
(0.40)
51.0
(0.39)
51.2
(0.41)
51.6
(0.39)
51.9
(0.38)
51.8
(0.39)
51.8
(0.39)
Binge Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Heavy Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.0
(0.01)
0.0
(0.00)
0.0
(0.01)
0.0
(0.00)
0.0
(0.01)
0.0
(0.01)
Nonprescription Cough or Cold Medicine
--
--
--
--
0.2
(0.02)
0.2
(0.02)
0.2
(0.02)
0.2
(0.02)
0.2
(0.03)
0.2
(0.02)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.1B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among People Aged 12 or Older; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
60.9
(0.30)
60.2
(0.30)
60.7
(0.32)
60.2
(0.35)
60.1
(0.32)
58.7
(0.51)
Illicit Drugs or Alcohol
nc
nc
nc
54.1
(0.31)
53.4
(0.32)
54.3
(0.33)
53.9
(0.36)
54.2
(0.34)
53.6
(0.52)
Tobacco Products or Alcohol
61.0
(0.37)
60.6
(0.39)
61.0
(0.31)
59.8
(0.30)
58.9
(0.30)
59.4
(0.32)
58.8
(0.35)
58.3
(0.33)
56.9
(0.51)
ILLICIT DRUGS
nc
nc
nc
10.1
(0.17)
10.6
(0.18)
11.2
(0.19)
11.7
(0.21)
13.0
(0.20)
13.5
(0.32)
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
20.7
(0.41)
Tobacco Products
26.7
(0.34)
25.5
(0.32)
25.2
(0.28)
23.9
(0.26)
23.5
(0.27)
22.4
(0.26)
21.5
(0.27)
21.1
(0.25)
18.7
(0.40)
Cigarettes
22.1
(0.32)
21.3
(0.30)
20.8
(0.26)
19.4
(0.25)
19.1
(0.25)
17.9
(0.25)
17.2
(0.25)
16.7
(0.23)
15.0
(0.38)
Daily Cigarette Smoking1
60.7
(0.71)
59.6
(0.73)
58.8
(0.59)
58.1
(0.64)
57.9
(0.66)
57.1
(0.69)
58.2
(0.71)
58.4
(0.71)
60.1
(1.25)
Smoked 1+ Packs of
Cigarettes per Day2
42.0
(0.94)
41.3
(1.00)
40.3
(0.83)
41.1
(0.87)
41.1
(0.89)
41.2
(0.92)
39.6
(0.94)
40.5
(0.95)
37.8
(1.78)
Smokeless Tobacco
nc
nc
nc
3.4
(0.11)
3.3
(0.10)
3.2
(0.09)
2.9
(0.09)
3.1
(0.10)
2.5
(0.14)
Cigars
5.2
(0.15)
4.7
(0.14)
4.5
(0.11)
4.7
(0.12)
4.6
(0.11)
4.6
(0.11)
4.5
(0.12)
4.3
(0.11)
3.8
(0.19)
Pipe Tobacco
1.0
(0.07)
0.9
(0.06)
0.8
(0.05)
0.8
(0.05)
0.8
(0.05)
0.9
(0.05)
0.8
(0.04)
0.7
(0.04)
0.7
(0.08)
Nicotine Vaping
--
--
--
--
--
--
--
--
3.8
(0.15)
ALCOHOL
52.1
(0.39)
52.2
(0.41)
52.7
(0.33)
51.7
(0.32)
50.7
(0.31)
51.7
(0.33)
51.1
(0.37)
50.8
(0.34)
50.0
(0.52)
Binge Alcohol Use
nc
nc
nc
24.9
(0.27)
24.2
(0.26)
24.5
(0.27)
24.5
(0.26)
23.9
(0.26)
22.2
(0.41)
Heavy Alcohol Use
nc
nc
nc
6.5
(0.14)
6.0
(0.14)
6.1
(0.13)
6.1
(0.14)
5.8
(0.14)
6.4
(0.23)
OTHER SUBSTANCE USE
GHB
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.0
(0.00)
(*)
0.0
(0.00)
0.0
(0.01)
0.0
(0.01)
Nonprescription Cough or Cold Medicine
0.2
(0.03)
0.2
(0.03)
0.1
(0.02)
0.2
(0.02)
0.2
(0.02)
0.2
(0.03)
0.2
(0.03)
0.3
(0.04)
0.3
(0.05)
Kratom
--
--
--
--
--
--
--
0.3
(0.03)
0.4
(0.06)
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
0.2
(0.03)
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
0.0
(0.01)
* = low precision; -- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance testing between 2020 and prior years was
not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for the number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.2B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Adolescents Aged 12 to 17; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
24.0
(0.38)
23.6
(0.38)
23.4
(0.35)
22.0
(0.37)
21.8
(0.37)
21.1
(0.38)
19.7
(0.35)
19.7
(0.36)
18.2
(0.36)
17.5
(0.36)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products
15.2
(0.33)
14.4
(0.32)
14.4
(0.32)
13.1
(0.31)
12.9
(0.29)
12.4
(0.30)
11.5
(0.28)
11.8
(0.29)
10.7
(0.28)
10.0
(0.27)
Cigarettes
13.0
(0.30)
12.2
(0.29)
11.9
(0.30)
10.8
(0.28)
10.4
(0.26)
9.9
(0.27)
9.2
(0.25)
9.0
(0.26)
8.4
(0.26)
7.8
(0.24)
Daily Cigarette Smoking1
31.8
(1.03)
29.7
(1.06)
27.6
(1.13)
25.8
(1.12)
26.5
(1.19)
26.4
(1.16)
22.3
(1.11)
23.0
(1.17)
22.5
(1.29)
22.7
(1.28)
Smoked 1+ Packs of
Cigarettes per Day2
21.8
(1.61)
22.0
(1.68)
19.4
(1.80)
20.1
(1.87)
17.9
(1.94)
18.7
(2.14)
18.4
(2.08)
17.9
(2.12)
16.7
(2.24)
14.8
(1.97)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
4.5
(0.19)
4.5
(0.17)
4.8
(0.18)
4.2
(0.18)
4.1
(0.16)
4.3
(0.18)
3.8
(0.16)
4.0
(0.16)
3.2
(0.15)
3.4
(0.16)
Pipe Tobacco
0.6
(0.06)
0.6
(0.07)
0.7
(0.08)
0.6
(0.07)
0.7
(0.07)
0.7
(0.08)
0.7
(0.07)
0.9
(0.09)
0.6
(0.07)
0.7
(0.07)
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
17.6
(0.32)
17.7
(0.33)
17.6
(0.32)
16.5
(0.32)
16.7
(0.32)
16.0
(0.34)
14.7
(0.32)
14.8
(0.32)
13.6
(0.33)
13.3
(0.31)
Binge Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Heavy Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.0
(0.01)
0.0
(0.01)
0.0
(0.00)
0.0
(0.01)
(*)
0.0
(0.00)
Nonprescription Cough or Cold Medicine
--
--
--
--
0.5
(0.05)
0.5
(0.06)
0.4
(0.05)
0.4
(0.05)
0.4
(0.05)
0.3
(0.05)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.2B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Adolescents Aged 12 to 17; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
15.6
(0.37)
14.7
(0.36)
15.1
(0.37)
14.2
(0.34)
15.0
(0.34)
12.2
(0.68)
Illicit Drugs or Alcohol
nc
nc
nc
14.2
(0.35)
13.2
(0.35)
13.8
(0.35)
13.2
(0.33)
14.1
(0.33)
11.5
(0.64)
Tobacco Products or Alcohol
16.5
(0.34)
15.1
(0.33)
14.6
(0.35)
12.4
(0.33)
11.8
(0.33)
12.0
(0.34)
11.0
(0.32)
11.2
(0.32)
9.4
(0.62)
ILLICIT DRUGS
nc
nc
nc
8.8
(0.27)
7.9
(0.26)
7.9
(0.26)
8.0
(0.27)
8.7
(0.28)
6.7
(0.45)
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
6.5
(0.49)
Tobacco Products
8.6
(0.25)
7.8
(0.24)
7.0
(0.25)
6.0
(0.23)
5.3
(0.21)
4.9
(0.21)
4.2
(0.19)
3.8
(0.19)
2.4
(0.29)
Cigarettes
6.6
(0.22)
5.6
(0.20)
4.9
(0.21)
4.2
(0.20)
3.4
(0.18)
3.2
(0.17)
2.7
(0.16)
2.3
(0.15)
1.4
(0.22)
Daily Cigarette Smoking1
22.0
(1.33)
19.4
(1.35)
24.1
(1.89)
20.0
(1.84)
15.0
(1.64)
12.2
(1.64)
14.7
(2.04)
13.2
(2.04)
(*)
Smoked 1+ Packs of
Cigarettes per Day2
10.8
(1.88)
11.9
(2.47)
11.9
(2.52)
7.8
(2.51)
(*)
(*)
(*)
(*)
(*)
Smokeless Tobacco
nc
nc
nc
1.5
(0.10)
1.4
(0.11)
1.3
(0.10)
1.1
(0.10)
1.0
(0.10)
0.6
(0.11)
Cigars
2.6
(0.13)
2.3
(0.13)
2.1
(0.13)
2.1
(0.14)
1.8
(0.12)
1.9
(0.13)
1.7
(0.13)
1.4
(0.12)
0.8
(0.15)
Pipe Tobacco
0.7
(0.07)
0.6
(0.07)
0.7
(0.08)
0.3
(0.06)
0.5
(0.06)
0.4
(0.07)
0.3
(0.06)
0.3
(0.06)
0.3
(0.12)
Nicotine Vaping
--
--
--
--
--
--
--
--
5.1
(0.43)
ALCOHOL
12.9
(0.31)
11.6
(0.29)
11.5
(0.33)
9.6
(0.29)
9.2
(0.30)
9.9
(0.30)
9.0
(0.29)
9.4
(0.30)
8.2
(0.57)
Binge Alcohol Use
nc
nc
nc
5.8
(0.23)
4.9
(0.22)
5.3
(0.22)
4.7
(0.22)
4.9
(0.22)
4.1
(0.42)
Heavy Alcohol Use
nc
nc
nc
0.9
(0.10)
0.8
(0.09)
0.7
(0.08)
0.5
(0.07)
0.8
(0.10)
0.6
(0.15)
OTHER SUBSTANCE USE
GHB
0.0
(0.02)
(*)
0.0
(0.01)
(*)
(*)
(*)
(*)
0.0
(0.02)
(*)
Nonprescription Cough or Cold Medicine
0.4
(0.06)
0.3
(0.05)
0.2
(0.04)
0.3
(0.06)
0.3
(0.06)
0.3
(0.05)
0.3
(0.05)
0.2
(0.04)
0.1
(0.04)
Kratom
--
--
--
--
--
--
--
0.1
(0.03)
0.1
(0.08)
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
0.5
(0.14)
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
0.0
(0.03)
* = low precision; -- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance testing between 2020 and prior years was
not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for the number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.3B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Young Adults Aged 18 to 25; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
70.3
(0.48)
70.7
(0.46)
70.2
(0.48)
70.1
(0.49)
71.0
(0.47)
69.9
(0.47)
69.7
(0.47)
70.4
(0.49)
70.2
(0.46)
69.6
(0.48)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products
45.3
(0.48)
44.8
(0.48)
44.6
(0.50)
44.3
(0.48)
44.0
(0.49)
41.9
(0.50)
41.4
(0.47)
41.6
(0.50)
40.9
(0.49)
39.5
(0.49)
Cigarettes
40.8
(0.48)
40.2
(0.47)
39.5
(0.49)
39.0
(0.47)
38.5
(0.48)
36.2
(0.49)
35.7
(0.45)
35.8
(0.48)
34.3
(0.47)
33.5
(0.47)
Daily Cigarette Smoking1
51.8
(0.72)
52.7
(0.69)
51.6
(0.72)
50.1
(0.73)
48.8
(0.77)
49.2
(0.76)
47.8
(0.81)
45.3
(0.80)
45.8
(0.80)
45.3
(0.86)
Smoked 1+ Packs of
Cigarettes per Day2
39.1
(0.93)
37.1
(0.88)
34.9
(0.86)
36.9
(0.93)
34.4
(0.93)
32.9
(0.92)
31.6
(0.91)
29.5
(0.92)
27.3
(0.94)
26.1
(0.97)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
11.0
(0.27)
11.4
(0.26)
12.7
(0.30)
12.0
(0.28)
12.1
(0.29)
11.9
(0.28)
11.4
(0.29)
11.5
(0.29)
11.3
(0.30)
10.9
(0.29)
Pipe Tobacco
1.1
(0.08)
0.9
(0.08)
1.2
(0.09)
1.5
(0.11)
1.3
(0.10)
1.2
(0.10)
1.4
(0.10)
1.8
(0.12)
1.8
(0.12)
1.9
(0.14)
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
60.5
(0.53)
61.4
(0.50)
60.5
(0.51)
60.9
(0.51)
62.0
(0.51)
61.3
(0.52)
61.1
(0.49)
61.8
(0.52)
61.4
(0.50)
60.7
(0.54)
Binge Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Heavy Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.0
(0.01)
0.1
(0.03)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
Nonprescription Cough or Cold Medicine
--
--
--
--
0.3
(0.05)
0.4
(0.06)
0.3
(0.05)
0.4
(0.05)
0.4
(0.06)
0.3
(0.04)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.3B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Young Adults Aged 18 to 25; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
67.9
(0.49)
66.8
(0.51)
65.8
(0.56)
64.4
(0.52)
64.0
(0.54)
59.7
(1.03)
Illicit Drugs or Alcohol
nc
nc
nc
61.9
(0.52)
61.5
(0.53)
60.9
(0.59)
59.9
(0.55)
59.8
(0.56)
56.9
(1.05)
Tobacco Products or Alcohol
69.0
(0.46)
67.9
(0.49)
67.6
(0.53)
66.3
(0.49)
64.6
(0.52)
63.7
(0.56)
61.8
(0.53)
60.8
(0.56)
56.6
(1.02)
ILLICIT DRUGS
nc
nc
nc
22.3
(0.42)
23.2
(0.43)
24.2
(0.47)
23.9
(0.48)
24.9
(0.45)
23.9
(0.84)
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
25.1
(0.83)
Tobacco Products
38.1
(0.47)
37.0
(0.49)
35.0
(0.54)
33.0
(0.48)
30.0
(0.48)
29.1
(0.48)
25.8
(0.43)
24.3
(0.45)
19.2
(0.74)
Cigarettes
31.8
(0.47)
30.6
(0.46)
28.4
(0.53)
26.7
(0.46)
23.5
(0.47)
22.3
(0.44)
19.1
(0.39)
17.5
(0.40)
13.9
(0.64)
Daily Cigarette Smoking1
45.1
(0.88)
43.1
(0.83)
43.0
(0.91)
42.0
(1.02)
39.9
(1.03)
38.4
(1.02)
37.4
(1.11)
35.4
(1.13)
33.1
(2.24)
Smoked 1+ Packs of
Cigarettes per Day2
25.1
(0.90)
22.3
(0.90)
22.5
(1.16)
22.5
(1.11)
26.2
(1.42)
25.0
(1.45)
23.4
(1.49)
25.0
(1.60)
20.8
(3.03)
Smokeless Tobacco
nc
nc
nc
5.4
(0.22)
5.2
(0.22)
4.8
(0.21)
4.4
(0.19)
4.9
(0.22)
3.9
(0.38)
Cigars
10.7
(0.27)
10.0
(0.29)
9.7
(0.30)
8.9
(0.27)
8.8
(0.27)
9.1
(0.29)
8.6
(0.27)
7.7
(0.26)
5.9
(0.46)
Pipe Tobacco
1.8
(0.11)
2.2
(0.14)
1.9
(0.13)
1.8
(0.13)
1.7
(0.12)
1.6
(0.14)
1.8
(0.14)
1.2
(0.11)
1.2
(0.18)
Nicotine Vaping
--
--
--
--
--
--
--
--
11.7
(0.57)
ALCOHOL
60.2
(0.49)
59.6
(0.53)
59.6
(0.56)
58.3
(0.53)
57.1
(0.55)
56.3
(0.60)
55.1
(0.57)
54.3
(0.58)
51.5
(1.04)
Binge Alcohol Use
nc
nc
nc
39.0
(0.51)
38.4
(0.54)
36.9
(0.57)
34.9
(0.51)
34.3
(0.54)
31.4
(0.95)
Heavy Alcohol Use
nc
nc
nc
10.9
(0.33)
10.1
(0.32)
9.6
(0.34)
9.0
(0.34)
8.4
(0.29)
8.6
(0.54)
OTHER SUBSTANCE USE
GHB
0.0
(0.02)
0.0
(0.01)
(*)
0.0
(0.01)
0.0
(0.02)
(*)
(*)
0.0
(0.02)
(*)
Nonprescription Cough or Cold Medicine
0.3
(0.07)
0.3
(0.05)
0.3
(0.06)
0.4
(0.06)
0.3
(0.06)
0.2
(0.04)
0.4
(0.07)
0.4
(0.07)
0.3
(0.10)
Kratom
--
--
--
--
--
--
--
0.5
(0.07)
0.2
(0.07)
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
0.5
(0.17)
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
0.0
(0.02)
* = low precision; -- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance testing between 2020 and prior years was
not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for the number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.4B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Adults Aged 26 or Older; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
64.5
(0.51)
63.2
(0.47)
62.7
(0.51)
64.9
(0.49)
64.2
(0.48)
64.1
(0.47)
64.3
(0.48)
64.1
(0.45)
64.6
(0.48)
64.1
(0.48)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products
29.9
(0.44)
29.3
(0.41)
28.5
(0.41)
29.0
(0.43)
29.4
(0.43)
28.6
(0.42)
28.4
(0.44)
27.3
(0.40)
27.2
(0.42)
26.3
(0.41)
Cigarettes
25.2
(0.42)
24.7
(0.41)
24.1
(0.39)
24.3
(0.39)
24.7
(0.40)
24.1
(0.40)
23.8
(0.41)
23.0
(0.39)
22.8
(0.38)
21.9
(0.39)
Daily Cigarette Smoking1
68.8
(0.87)
68.0
(0.86)
67.8
(0.80)
68.9
(0.79)
67.9
(0.74)
66.3
(0.83)
67.0
(0.86)
67.2
(0.84)
64.8
(0.86)
66.5
(0.88)
Smoked 1+ Packs of
Cigarettes per Day2
57.1
(1.12)
58.0
(0.99)
59.2
(1.05)
55.1
(1.02)
54.5
(1.00)
55.1
(1.06)
53.0
(1.10)
49.4
(1.16)
48.8
(1.09)
47.4
(1.05)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
4.6
(0.18)
4.5
(0.18)
4.6
(0.17)
4.7
(0.18)
4.6
(0.18)
4.4
(0.16)
4.4
(0.18)
4.4
(0.18)
4.4
(0.17)
4.2
(0.18)
Pipe Tobacco
0.8
(0.09)
0.6
(0.07)
0.7
(0.08)
0.8
(0.08)
0.9
(0.09)
0.8
(0.09)
0.6
(0.07)
0.7
(0.07)
0.7
(0.07)
0.7
(0.07)
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
53.9
(0.53)
52.5
(0.49)
53.0
(0.51)
55.1
(0.51)
53.7
(0.49)
54.1
(0.52)
54.7
(0.50)
54.9
(0.48)
54.9
(0.48)
55.1
(0.49)
Binge Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Heavy Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.0
(0.01)
(*)
0.0
(0.01)
(*)
0.0
(0.01)
0.0
(0.01)
Nonprescription Cough or Cold Medicine
--
--
--
--
0.1
(0.02)
0.1
(0.02)
0.1
(0.03)
0.1
(0.03)
0.1
(0.03)
0.1
(0.03)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.4B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Month: Among Adults Aged 26 or Older; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
65.2
(0.36)
64.5
(0.36)
65.3
(0.38)
64.9
(0.40)
64.6
(0.39)
63.8
(0.60)
Illicit Drugs or Alcohol
nc
nc
nc
57.6
(0.37)
56.8
(0.39)
58.0
(0.39)
57.6
(0.43)
57.9
(0.40)
57.9
(0.61)
Tobacco Products or Alcohol
65.1
(0.45)
65.0
(0.47)
65.5
(0.36)
64.4
(0.36)
63.5
(0.36)
64.3
(0.38)
63.9
(0.40)
63.3
(0.39)
62.4
(0.60)
ILLICIT DRUGS
nc
nc
nc
8.2
(0.19)
8.9
(0.21)
9.5
(0.22)
10.1
(0.24)
11.6
(0.23)
12.6
(0.37)
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
21.6
(0.50)
Tobacco Products
27.0
(0.42)
25.7
(0.40)
25.8
(0.33)
24.5
(0.32)
24.6
(0.33)
23.4
(0.31)
22.8
(0.33)
22.6
(0.30)
20.4
(0.50)
Cigarettes
22.4
(0.40)
21.6
(0.38)
21.5
(0.32)
20.0
(0.31)
20.2
(0.31)
18.9
(0.30)
18.5
(0.30)
18.2
(0.28)
16.7
(0.47)
Daily Cigarette Smoking1
66.0
(0.85)
64.9
(0.88)
63.3
(0.72)
62.7
(0.76)
62.2
(0.75)
61.5
(0.79)
62.3
(0.79)
62.5
(0.79)
64.1
(1.36)
Smoked 1+ Packs of
Cigarettes per Day2
45.2
(1.09)
44.7
(1.15)
43.3
(0.93)
44.1
(0.98)
43.1
(1.00)
43.2
(1.02)
41.4
(1.03)
42.0
(1.01)
38.9
(1.86)
Smokeless Tobacco
nc
nc
nc
3.2
(0.13)
3.1
(0.12)
3.1
(0.11)
2.9
(0.11)
3.1
(0.11)
2.5
(0.17)
Cigars
4.5
(0.19)
4.1
(0.17)
3.9
(0.12)
4.3
(0.14)
4.2
(0.13)
4.2
(0.13)
4.1
(0.14)
4.0
(0.14)
3.9
(0.23)
Pipe Tobacco
0.9
(0.09)
0.7
(0.07)
0.7
(0.06)
0.8
(0.06)
0.7
(0.06)
0.8
(0.06)
0.7
(0.05)
0.7
(0.05)
0.6
(0.09)
Nicotine Vaping
--
--
--
--
--
--
--
--
2.4
(0.15)
ALCOHOL
55.6
(0.48)
55.9
(0.50)
56.5
(0.39)
55.6
(0.38)
54.6
(0.38)
55.8
(0.40)
55.3
(0.43)
55.0
(0.41)
54.6
(0.62)
Binge Alcohol Use
nc
nc
nc
24.8
(0.32)
24.2
(0.32)
24.7
(0.32)
25.1
(0.31)
24.5
(0.31)
22.9
(0.49)
Heavy Alcohol Use
nc
nc
nc
6.4
(0.17)
6.0
(0.17)
6.2
(0.16)
6.2
(0.17)
6.0
(0.17)
6.7
(0.28)
OTHER SUBSTANCE USE
GHB
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
(*)
0.0
(0.00)
0.0
(0.01)
0.0
(0.01)
0.0
(0.02)
Nonprescription Cough or Cold Medicine
0.1
(0.03)
0.1
(0.04)
0.1
(0.02)
0.1
(0.02)
0.2
(0.03)
0.2
(0.04)
0.2
(0.03)
0.3
(0.04)
0.3
(0.06)
Kratom
--
--
--
--
--
--
--
0.3
(0.04)
0.4
(0.07)
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
0.1
(0.02)
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
0.0
(0.01)
* = low precision; -- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance testing between 2020 and prior years was
not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
1 Percentages for daily cigarette smoking are among past month cigarette smokers.
2 Percentages for smoking one or more packs of cigarettes per day are among daily cigarette smokers in the past month. Respondents with missing data for the number of cigarettes smoked per day were excluded from the analysis.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.5B Type of Nicotine Product Use: Among Past Month Nicotine Product Users Aged 12 or Older; by Age Group, 2020
Nicotine Product Use1
Total
12 to 17
18 to 25
26 or Older
Only Nicotine Vaping2
9.7
(0.47)
63.1
(3.54)
23.6
(1.42)
5.4
(0.46)
Nicotine Vaping and Tobacco Products2,3
8.5
(0.48)
15.7
(2.24)
22.9
(1.41)
5.7
(0.49)
Nicotine Vaping and Only Cigarettes2
4.7
(0.35)
7.7
(1.84)
10.6
(1.08)
3.5
(0.36)
Nicotine Vaping, Cigarettes, and Noncigarette Tobacco Products2,4
2.1
(0.25)
3.5
(0.95)
6.4
(0.83)
1.3
(0.27)
Nicotine Vaping and Only Noncigarette Tobacco Products2,4
1.7
(0.22)
4.4
(1.24)
5.9
(0.83)
0.9
(0.21)
Only Tobacco Products3
81.8
(0.70)
21.2
(2.95)
53.4
(1.72)
88.9
(0.67)
NOTE: Estimates shown are percentages with standard errors included in parentheses. Percentages for only nicotine vaping, nicotine vaping and tobacco products, and only tobacco products in an age group category
may not add to 100 percent due to rounding.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
1 Nicotine product use refers to the use of tobacco or nicotine vaping.
2 Nicotine vaping refers to the use of an e-cigarette or other vaping device to vape nicotine or tobacco.
3 Tobacco products include cigarettes, smokeless tobacco (such as snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. Use of any tobacco product does not include nicotine vaping because people could have
used a vaping device to vape nicotine-containing products other than tobacco.
4 Noncigarette tobacco products include smokeless tobacco (such as snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, Quarters 1 and 4, 2020.
Table A.6B Type of Tobacco Product Use: Among Past Month Tobacco Users Aged 12 or Older; by Age Group, 2020
Tobacco Product Use1
Total
12 to 17
18 to 25
26 or Older
Only Cigarettes
65.3
(1.10)
(*)
49.3
(2.03)
68.0
(1.24)
Cigarettes and Noncigarette Tobacco Products2
14.8
(0.81)
22.7
(4.94)
23.2
(1.68)
13.4
(0.90)
Only Noncigarette Tobacco Products2
19.9
(0.88)
(*)
27.6
(1.96)
18.5
(0.98)
* = low precision.
NOTE: Estimates shown are percentages with standard errors included in parentheses. Percentages in an age group category may not add to 100 percent due to rounding.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
1 Tobacco products include cigarettes, smokeless tobacco (such as snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco. Use of any tobacco product does not include nicotine vaping because people could have
used a vaping device to vape nicotine-containing products other than tobacco.
2 Noncigarette tobacco products include smokeless tobacco (such as snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, Quarters 1 and 4, 2020.
Table A.7B Nicotine Product1 and Alcohol Use in the Past Month: Among People Aged 12 to 20; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
TOBACCO PRODUCTS OR
NICOTINE VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products2
24.7
(0.35)
23.9
(0.36)
23.8
(0.36)
22.8
(0.34)
22.5
(0.35)
21.6
(0.34)
21.3
(0.32)
21.6
(0.36)
21.0
(0.35)
19.6
(0.35)
Cigarettes
21.6
(0.33)
20.8
(0.34)
20.3
(0.34)
19.2
(0.32)
18.9
(0.33)
17.7
(0.32)
17.6
(0.30)
17.6
(0.33)
16.9
(0.33)
16.1
(0.33)
Nicotine Vaping3
--
--
--
--
--
--
--
--
--
--
ALCOHOL
28.8
(0.39)
29.0
(0.41)
28.7
(0.39)
28.2
(0.41)
28.4
(0.42)
28.0
(0.46)
26.5
(0.40)
27.2
(0.43)
26.2
(0.41)
25.1
(0.47)
Binge Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Heavy Alcohol Use
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.7B Nicotine Product1 and Alcohol Use in the Past Month: Among People Aged 12 to 20; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
TOBACCO PRODUCTS OR
NICOTINE VAPING
--
--
--
--
--
--
--
--
11.8
(0.61)
Tobacco Products2
17.8
(0.35)
16.9
(0.33)
15.3
(0.34)
13.7
(0.33)
12.3
(0.31)
11.4
(0.30)
10.1
(0.27)
9.1
(0.27)
6.7
(0.47)
Cigarettes
14.1
(0.32)
13.0
(0.31)
11.5
(0.30)
10.2
(0.30)
8.6
(0.28)
8.0
(0.25)
6.8
(0.22)
6.0
(0.22)
4.1
(0.33)
Nicotine Vaping3
--
--
--
--
--
--
--
--
7.7
(0.46)
ALCOHOL
24.3
(0.48)
22.7
(0.40)
22.8
(0.46)
20.3
(0.42)
19.3
(0.45)
19.7
(0.47)
18.8
(0.42)
18.5
(0.45)
16.1
(0.72)
Binge Alcohol Use
nc
nc
nc
13.4
(0.36)
12.1
(0.35)
11.9
(0.37)
11.4
(0.33)
11.1
(0.36)
9.2
(0.59)
Heavy Alcohol Use
nc
nc
nc
3.3
(0.20)
2.8
(0.17)
2.5
(0.18)
2.3
(0.16)
2.2
(0.14)
1.8
(0.25)
-- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance
testing between 2020 and prior years was not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
1 Nicotine product use refers to the use of tobacco or nicotine vaping.
2 Tobacco products include cigarettes, smokeless tobacco (such as snuff, dip, chewing tobacco, or snus), cigars, or pipe tobacco.
3 Nicotine vaping refers to the use of an e-cigarette or other vaping device to vape nicotine or tobacco.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.8B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Year: Among People Aged 12 or Older; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
72.5
(0.36)
71.5
(0.36)
71.1
(0.36)
72.8
(0.35)
72.2
(0.35)
71.8
(0.34)
72.0
(0.37)
72.3
(0.34)
72.3
(0.36)
71.8
(0.35)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products1
36.0
(0.38)
35.1
(0.35)
34.5
(0.34)
34.9
(0.36)
35.0
(0.36)
34.3
(0.35)
33.8
(0.37)
33.2
(0.34)
32.9
(0.36)
31.8
(0.35)
Cigarettes
30.3
(0.36)
29.4
(0.34)
29.1
(0.33)
29.1
(0.34)
29.1
(0.34)
28.5
(0.34)
28.1
(0.34)
27.5
(0.33)
27.0
(0.33)
26.1
(0.33)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
11.0
(0.21)
10.7
(0.19)
10.8
(0.19)
11.1
(0.20)
10.9
(0.19)
10.8
(0.20)
10.5
(0.20)
10.6
(0.20)
10.3
(0.20)
9.7
(0.20)
Pipe Tobacco1
--
--
--
--
--
--
--
--
--
--
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
66.1
(0.39)
65.0
(0.37)
65.1
(0.37)
66.5
(0.38)
66.0
(0.37)
65.8
(0.39)
66.0
(0.38)
66.8
(0.36)
66.4
(0.38)
66.2
(0.38)
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.1
(0.01)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.1
(0.02)
0.0
(0.01)
Nonprescription Cough or Cold Medicine
--
--
--
--
0.6
(0.04)
0.5
(0.03)
0.6
(0.04)
0.6
(0.04)
0.7
(0.06)
0.6
(0.04)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
Table A.8B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Year: Among People Aged 12 or Older; 2002-2020 (continued)
Substance
2012
2013
2014
2015
2016
2017
2018
2019
2020
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
72.5
(0.28)
71.5
(0.29)
72.3
(0.31)
72.1
(0.31)
71.8
(0.30)
70.3
(0.50)
Illicit Drugs or Alcohol
nc
nc
nc
68.1
(0.29)
67.2
(0.31)
68.2
(0.33)
67.9
(0.34)
68.0
(0.32)
67.1
(0.51)
Tobacco Products or Alcohol
72.2
(0.34)
71.8
(0.36)
72.1
(0.30)
71.2
(0.28)
70.2
(0.29)
70.9
(0.31)
70.7
(0.31)
70.2
(0.30)
68.6
(0.51)
ILLICIT DRUGS
nc
nc
nc
17.8
(0.23)
18.0
(0.23)
19.0
(0.24)
19.4
(0.26)
20.8
(0.27)
21.4
(0.39)
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
25.6
(0.43)
Tobacco Products1
31.9
(0.36)
30.8
(0.33)
30.6
(0.29)
29.2
(0.28)
28.5
(0.28)
27.5
(0.28)
26.7
(0.29)
26.2
(0.26)
23.3
(0.43)
Cigarettes
26.1
(0.34)
25.3
(0.32)
24.8
(0.28)
23.1
(0.27)
22.7
(0.27)
21.5
(0.27)
21.0
(0.27)
20.2
(0.24)
18.4
(0.39)
Smokeless Tobacco
nc
nc
nc
4.7
(0.12)
4.4
(0.11)
4.3
(0.10)
4.0
(0.10)
4.2
(0.11)
3.3
(0.16)
Cigars
9.9
(0.20)
9.5
(0.19)
9.0
(0.15)
9.1
(0.16)
8.5
(0.14)
8.6
(0.15)
8.4
(0.16)
8.1
(0.15)
7.1
(0.23)
Pipe Tobacco1
--
--
--
--
--
--
--
--
--
Nicotine Vaping
--
--
--
--
--
--
--
--
6.5
(0.20)
ALCOHOL
66.7
(0.37)
66.3
(0.38)
66.6
(0.31)
65.7
(0.30)
64.8
(0.30)
65.7
(0.34)
65.5
(0.35)
65.1
(0.32)
64.2
(0.52)
OTHER SUBSTANCE USE
GHB
0.1
(0.02)
0.0
(0.01)
0.1
(0.01)
0.1
(0.02)
0.0
(0.01)
0.0
(0.01)
0.0
(0.01)
0.1
(0.01)
0.1
(0.02)
Nonprescription Cough or Cold Medicine
0.5
(0.04)
0.6
(0.05)
0.5
(0.03)
0.6
(0.04)
0.6
(0.04)
0.6
(0.05)
0.6
(0.05)
0.7
(0.05)
0.9
(0.09)
Kratom
--
--
--
--
--
--
--
0.7
(0.04)
0.8
(0.08)
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
0.4
(0.05)
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
0.0
(0.02)
-- = not available; nc = not comparable due to methodological changes.
NOTE: Estimates shown are percentages with standard errors included in parentheses.
NOTE: Estimates in the 2020 column are italicized to indicate caution should be used when comparing estimates between 2020 and prior years because of methodological changes for 2020. Due to these changes, significance testing between 2020 and prior years was
not performed. See the 2020 National Survey on Drug Use and Health: Methodological Summary and Definitions for details.
NOTE: Additional estimates may be found in the detailed tables for the 2020 NSDUH at https://www.samhsa.gov/data/. Measures and terms are defined in Appendix A of the 2020 detailed tables.
NOTE: Estimates of 0.0 percent round to less than 0.1 percent when shown to the nearest tenth of a percent.
1 Information about past year use of pipe tobacco was not collected. Tobacco product use in the past year excludes past year pipe tobacco use, but includes past month pipe tobacco use.
Source: SAMHSA, Center for Behavioral Health Statistics and Quality, National Survey on Drug Use and Health, 2002-2019 and Quarters 1 and 4, 2020.
Table A.9B Types of Illicit Drug, Tobacco Product, Alcohol, and Other Substance Use in the Past Year: Among Adolescents Aged 12 to 17; 2002-2020
Substance
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
GENERAL SUBSTANCE USE
Illicit Drugs, Tobacco Products, or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Illicit Drugs or Alcohol
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Tobacco Products or Alcohol
39.9
(0.45)
39.2
(0.44)
38.6
(0.42)
37.9
(0.44)
37.4
(0.43)
36.2
(0.45)
35.1
(0.41)
35.0
(0.44)
33.1
(0.44)
31.8
(0.44)
ILLICIT DRUGS
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
TOBACCO PRODUCTS OR NICOTINE
VAPING
--
--
--
--
--
--
--
--
--
--
Tobacco Products1
23.6
(0.37)
22.5
(0.37)
22.1
(0.38)
21.2
(0.39)
20.9
(0.36)
19.8
(0.38)
19.1
(0.34)
19.5
(0.38)
18.1
(0.37)
16.8
(0.34)
Cigarettes
20.3
(0.35)
19.0
(0.36)
18.4
(0.35)
17.3
(0.36)
17.0
(0.35)
15.7
(0.34)
15.1
(0.32)
15.1
(0.34)
14.2
(0.34)
13.2
(0.31)
Smokeless Tobacco
nc
nc
nc
nc
nc
nc
nc
nc
nc
nc
Cigars
10.1
(0.26)
10.0
(0.26)
10.2
(0.27)
9.8
(0.27)
9.4
(0.25)
9.4
(0.26)
8.5
(0.24)
9.0
(0.25)
7.7
(0.22)
7.8
(0.24)
Pipe Tobacco1
--
--
--
--
--
--
--
--
--
--
Nicotine Vaping
--
--
--
--
--
--
--
--
--
--
ALCOHOL
34.6
(0.42)
34.3
(0.42)
33.9
(0.41)
33.3
(0.41)
33.0
(0.42)
31.9
(0.42)
31.0
(0.41)
30.5
(0.42)
28.7
(0.43)
27.8
(0.43)
OTHER SUBSTANCE USE
GHB
--
--
--
--
0.1
(0.02)
0.0
(0.01)
0.0
(0.01)
0.1
(0.02)
0.0
(0.01)
0.0
(0.02)
Nonprescription Cough or Cold Medicine
--
--
--
--
1.9
(0.12)
1.7
(0.12)
1.6
(0.10)
1.5
(0.10)
1.5
(0.11)
1.3
(0.10)
Kratom
--
--
--
--
--
--
--
--
--
--
Synthetic Marijuana (Fake Weed, K2,
Spice)
--
--
--
--
--
--
--
--
--
--
Synthetic Stimulants (“Bath Salts,” Flakka)
--
--
--
--
--
--
--
--
--
--
NOTE: Footnotes and source information are shown at the end of the second half of this table.
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