Key Substance Use and Mental Health Indicators in the United States:
Results from the 2016 National Survey on Drug Use and Health
This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) under Contract No. HHSS283201300001C with SAMHSA, U.S. Department of Health and Human Services (HHS).
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Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 15-E09D, Rockville, MD 20857.
Table of Contents
Illicit Drug Use in the Past Month
Any Illicit Drug Use
Misuse of Psychotherapeutic Drugs
Pain Reliever Misuse
Opioid Misuse in the Past Year
Past Year Opioid Misuse
Past Year Heroin Use
Past Year Pain Reliever Misuse
Misuse of Subtypes of Pain Relievers
Main Reasons for the Last Misuse of Pain Relievers
Source of the Last Pain Reliever That Was Misused
Substance Use Disorders in the Past Year
Alcohol Use Disorder
Illicit Drug Use Disorder
Marijuana Use Disorder
Cocaine Use Disorder
Heroin Use Disorder
Methamphetamine Use Disorder
Pain Reliever Use Disorder
Tranquilizer Use Disorder
Stimulant Use Disorder
Opioid Use Disorder
Substance Use Disorder (Alcohol or Illicit Drugs)
Mental Health Service Use in the Past Year
Treatment for Depression among Adolescents
Treatment for Depression among Adults
Any Mental Health Service Use among All Adolescents
Any Mental Health Service Use among All Adults
Any Mental Health Service Use among Adults with Mental Illness
Co-Occurring MDE and Substance Use among Adolescents
MDE among Adolescents with a Substance Use Disorder
Substance Use and Substance Use Disorders among Adolescents with MDE
Receipt of Services among Adolescents with Co-Occurring MDE and a Substance Use Disorder
Co-Occurring Mental Health Issues and Substance Use Disorders among Adults
Co-Occurring Mental Health Issues and Substance Use Disorders among All Adults
Mental Illness among Adults with a Substance Use Disorder
Substance Use Disorders among Adults with Mental Illness
Receipt of Services among Adults with Co-Occurring Mental Illness and a Substance Use Disorder
This national report summarizes key findings from the 2016 National Survey on Drug Use and Health (NSDUH) for indicators of substance use and mental health among people aged 12 years old or older in the civilian, noninstitutionalized population of the United States. Results are provided for the overall category of individuals aged 12 or older as well as by age subgroups. The NSDUH questionnaire underwent a partial redesign in 2015 to improve the quality of the NSDUH data and to address the changing needs of policymakers and researchers. For measures that started a new baseline in 2015, estimates are discussed only for 2016.
In 2016, an estimated 51.3 million people aged 12 or older were current cigarette smokers, including 29.7 million who were daily cigarette smokers and 12.2 million who smoked approximately a pack or more of cigarettes per day. Although about 1 in 5 people aged 12 or older were current cigarette smokers, cigarette use generally declined between 2002 and 2016 across all age groups.
NSDUH collects information on past month alcohol use, binge alcohol use, and heavy alcohol use. For men, binge alcohol use is defined in NSDUH as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days. For women, binge drinking is defined as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. Heavy alcohol use is defined as binge drinking on 5 or more days in the past 30 days. In 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, including 65.3 million who reported binge alcohol use in the past month and 16.3 million who reported heavy alcohol use in the past month.
In 2016, about 1 in 5 underage individuals aged 12 to 20 were current alcohol users. About 7.3 million people aged 12 to 20 reported drinking alcohol in the past month, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use. The percentage of underage drinkers in 2016 was lower than the percentages in 2002 through 2014 but was similar to the percentage in 2015. About 2 out of 5 young adults aged 18 to 25 in 2016 were binge alcohol users, and about 1 in 10 were heavy alcohol users.
Illicit Drug Use
In 2016, 28.6 million people aged 12 or older used an illicit drug in the past 30 days, which corresponds to about 1 in 10 Americans overall (10.6 percent) but ranges as high as 1 in 4 for young adults aged 18 to 25. Regardless of age, the illicit drug use estimate for 2016 continues to be driven primarily by marijuana use and the misuse of prescription pain relievers. Among people aged 12 or older, 24.0 million were current marijuana users and 3.3 million were current misusers of prescription pain relievers. Smaller numbers of people were current users of cocaine, hallucinogens, methamphetamine, inhalants, or heroin or were current misusers of prescription tranquilizers, stimulants, or sedatives.
The percentage of people aged 12 or older who were current marijuana users in 2016 was higher than the percentages from 2002 to 2015. In contrast, the percentages among people aged 12 or older have shown little change since 2007 for current use of cocaine, since 2008 for current use of crack cocaine, and since 2014 for current use of heroin. The increase in marijuana use reflects increases in marijuana use among adults aged 26 or older and, to a lesser extent, among young adults aged 18 to 25. Marijuana use among adolescents aged 12 to 17 was lower in 2016 than in most years from 2009 to 2014.
NSDUH also allows for analysis of opioid misuse, which is the use of heroin or the misuse of prescription opioid pain relievers. In 2016, an estimated 11.8 million people misused opioids in the past year, including 11.5 million pain reliever misusers and 948,000 heroin users. Additional information is gathered in NSDUH for the misuse of pain relievers in the past year. Among people aged 12 or older who misused pain relievers in the past year, about 6 out of 10 people indicated that the main reason they misused pain relievers the last time was to relieve physical pain (62.3 percent), and about half (53.0 percent) indicated that they obtained the last pain relievers they misused from a friend or relative.
Substance Use Disorders
In 2016, approximately 20.1 million people aged 12 or older had a substance use disorder (SUD) related to their use of alcohol or illicit drugs in the past year,1 including 15.1 million people who had an alcohol use disorder and 7.4 million people who had an illicit drug use disorder. Among those who had an illicit drug use disorder, the most common disorder was for marijuana (4.0 million people). An estimated 2.1 million people had an opioid use disorder, which includes 1.8 million people with a prescription pain reliever use disorder and 0.6 million people with a heroin use disorder.
Substance Use Treatment
In 2016, an estimated 21.0 million people aged 12 or older needed substance use treatment. This translates to about 1 in 13 people needing treatment. Among young adults aged 18 to 25, however, about 1 in 7 people needed treatment. For NSDUH, people are defined as needing substance use treatment if they had an SUD in the past year or if they received substance use treatment at a specialty facility in the past year.2
In 2016, 1.4 percent of people aged 12 or older (3.8 million people) received any substance use treatment in the past year, and 0.8 percent (2.2 million) received substance use treatment at a specialty facility. Only about 1 in 10 people aged 12 or older who needed substance use treatment received treatment at a specialty facility in the past year (10.6 percent).
Major Depressive Episode
In 2016, 12.8 percent of adolescents aged 12 to 17 (3.1 million adolescents) and 10.9 percent of young adults aged 18 to 25 (3.7 million) had a major depressive episode (MDE) during the past year. The percentages of adolescents and young adults in 2016 who had a past year MDE were higher than the corresponding percentages prior to 2015. Percentages of adolescents and young adults with a past year MDE have subsequently shown less change. In contrast, the percentages of adults aged 26 to 49 and those aged 50 or older with a past year MDE have remained stable.
Among the 3.1 million adolescents and 3.7 million young adults in 2016 who had a past year MDE, 1.2 million adolescents (40.9 percent) and 1.6 million young adults (44.1 percent) received treatment for depression. The percentage of adolescents in 2016 with an MDE who received treatment for their depression was similar to the percentages in most prior years. Among young adults, the percentage with an MDE who received treatment for depression was similar to or lower than the percentages in prior years.
Mental Illness among Adults
In 2016, an estimated 44.7 million adults aged 18 or older (18.3 percent) had any mental illness (AMI) in the past year. An estimated 10.4 million adults in the nation had a serious mental illness (SMI) in the past year, representing 4.2 percent of all U.S. adults.3 Although the 2016 percentages of adults with AMI or SMI among adults aged 18 or older were similar to the percentages since 2010, a higher percentage of young adults was experiencing AMI and SMI. The 2016 percentage of young adults with SMI was higher than the percentages in each year since 2008, and the 2016 percentage of young adults with AMI was higher than the percentages in 2008 to 2014.
Mental Health Service Use among Adults
In 2016, an estimated 35.0 million adults aged 18 or older (14.4 percent of adults) received mental health care during the past 12 months. Among the 44.7 million adults with AMI, 19.2 million (43.1 percent) received mental health services in the past year. About 6.7 million of the 10.4 million adults with past year SMI (64.8 percent) received mental health services in the past year. The percentages of adults with AMI or SMI who received mental health care in 2016 were similar to the corresponding percentages in most years from 2008 to 2015.
Co-Occurring MDE and Substance Use among Adolescents
In 2016, the percentage of adolescents aged 12 to 17 who used illicit drugs in the past year was higher among those with a past year MDE than it was among those without a past year MDE (31.7 vs. 13.4 percent). An estimated 333,000 adolescents (1.4 percent of all adolescents) had an SUD and an MDE in the past year. Among adolescents who had a co-occurring MDE and an SUD in the past year, 71.9 percent received either substance use treatment at a specialty facility or mental health services in the past year.
Co-Occurring Mental Illness and Substance Use Disorders among Adults
An estimated 8.2 million adults aged 18 or older (3.4 percent of all adults) had both AMI and SUDs in the past year, and 2.6 million adults (1.1 percent of all adults) had co-occurring SMI and SUDs in the past year. About half of the adults with co-occurring AMI and an SUD in the past year did not receive either mental health care or specialty substance use treatment, and about 1 in 3 adults with co-occurring SMI and an SUD did not receive either type of care.
Suicidal Thoughts and Behavior among Adults
In 2016, an estimated 9.8 million adults aged 18 or older reported they had thought seriously about trying to kill themselves, 2.8 million reported that they had made suicide plans, and 1.3 million made a nonfatal suicide attempt. The percentage of young adults aged 18 to 25 with serious thoughts of suicide was higher in 2016 than in 2008 to 2014. In contrast, similar percentages of adults aged 18 or older, those aged 26 to 49, and those aged 50 or older had serious thoughts of suicide in most years between 2008 and 2016.
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