Substance Abuse & Addiction Statistics 2025: Overdose Trends & Mental Health
Substance Abuse & Addiction — Quick Reference Stats and Sources (2025)
| Key Statistic (U.S.) | Source |
|---|---|
| National totals & overdose context | |
| 105,007 drug overdose deaths in 2023. | NIDA (CDC) |
| Opioids involved in about 76% of overdose deaths in 2023 (79,358 of 105,007). | CDC |
| Provisional trend: ~87,000 deaths (Oct ’23–Sept ’24) — still high, below the 2022 peak. | CDC VSRR |
| Alcohol — use, disorder & mortality | |
| 9.7% (about 27.9M) had an Alcohol Use Disorder in 2024. | NSDUH 2024 |
| Underage (12–20) past-month alcohol use: 13.3% (~5.1M); binge drinking: 7.6%; heavy use: 1.5% (2024). | NSDUH 2024 |
| Alcohol-induced mortality rate fell ~7% from 2022→2023 (13.5 → 12.6 per 100k). | TFAH 2025 |
| Cannabis — use patterns | |
| Underage (12–20) past-month marijuana use: 10.5% (~4.0M) in 2024. | NSDUH 2024 |
| Among current marijuana users (12+), 38.0% vaped marijuana in the past month (2024). | NSDUH 2024 |
| Among adolescents who used marijuana in the past month, 71.1% vaped it (2024). | NSDUH 2024 |
| Opioids — use, disorder & overdose | |
| 1.7% (~4.8M) had an Opioid Use Disorder in 2024; 2.7% (~7.8M) misused opioids. | NSDUH 2024 |
| 72,776 deaths involved synthetic opioids (fentanyl) in 2023; 13,026 involved prescription opioids; 3,984 involved heroin. | NIDA (CDC) |
| 2.2M people received medication for opioid use disorder (MOUD) in 2024. | NSDUH 2024 |
| Stimulants — meth & prescription stimulants | |
| People with a CNS stimulant use disorder (e.g., meth/amphetamine): ~1.5% (~4.3M) in 2024. | NSDUH 2024 |
| 34,855 overdose deaths involved psychostimulants (mostly meth) in 2023; many events also involved fentanyl. | CDC MMWR 2025 |
| Cocaine — use & overdose | |
| 29,449 overdose deaths involved cocaine in 2023, often due to fentanyl contamination. | NIDA (CDC) |
| In 2023, an estimated ~70% of stimulant-involved deaths co-involved illicit fentanyl. | NIDA (CDC) |
| Sedatives / Benzodiazepines | |
| 10,870 overdose deaths involved benzodiazepines in 2023 (usually combined with opioids or alcohol). | NIDA (CDC) |
| Nicotine / Tobacco | |
| 22.1% (~63.7M) used a nicotine product in the past month (2024). | NSDUH 2024 |
| 27.7M people vaped nicotine in the past month (2024). | NSDUH 2024 |
| Youth & young adults | |
| Underage marijuana past-month: 10.5% (2024); see alcohol metrics above. | NSDUH 2024 |
| Young adults 18–25 with either mental illness or SUD: 45.8% (~16.0M) in 2024. | NSDUH 2024 |
| Treatment gap & co-occurring conditions | |
| 16.8% (about 48.4M) had a past-year SUD in 2024; 18.2% (~52.6M) needed SUD treatment. | NSDUH 2024 |
| Only 19.3% of those needing SUD treatment received it; among people with SUD, 12.3% (5.9M) got care (2024). | NSDUH 2024 |
| 1.3M received medication for alcohol use disorder (2024). | NSDUH 2024 |
Key takeaways
The U.S. recorded 105,000+ overdose deaths in 2023; fentanyl drove the crisis with ~72,800 deaths.
SUD affects ~1 in 6 Americans (17.1%). The treatment gap is massive—about 85% don’t receive specialty care.
Cocaine deaths (29,449) and stimulant overdoses are rising, often due to fentanyl contamination.
Mental health and addiction are intertwined. 48.5M adults had a mental illness in 2023, and co-occurrence is common—especially for teens (e.g., 856k with both MDE and SUD).
Provisional data suggest a decline to ~87k deaths (Oct ’23–Sept ’24), but fentanyl remains the dominant risk.
Help works. Medication-assisted treatment, counseling, and harm-reduction strategies (naloxone, never-use-alone, test strips where legal) save lives.
Substance use in 2025 shows marijuana and alcohol leading U.S. usage patterns, with lower but concerning levels of prescription drug misuse, opioids, cocaine, and methamphetamine. Data reflects 2024–2025 national surveys.
What counts as a substance use disorder (SUD)?
SUD is a medical condition marked by impaired control, cravings, continued use despite harm, and functional impact (school, work, health, or relationships). It includes alcohol use disorder (AUD) and drug use disorders (opioids, stimulants, cannabis, sedatives, etc.).
Signs to watch: escalating tolerance, withdrawal, secrecy, using more/longer than planned, giving up activities, and continued use despite consequences.
In 2023, 85% of people with a Substance Use Disorder—around 41 million Americans—went without treatment, highlighting the massive treatment gap in addiction care.
The latest numbers: what’s changed and what hasn’t
Overdoses remain historically high. 105k+ deaths in 2023.
Illicit fentanyl (often unknown to the user) is the primary driver with ~72.8k deaths.
Cocaine deaths reached 29,449; many involved fentanyl mixing.
Prescription opioid deaths fell to 13,026 as the epidemic shifted to illicit markets.
Benzodiazepines appear in 10,800+ deaths—usually combined with opioids, which suppress breathing.
Provisional 12-month deaths (Oct ’23–Sept ’24) ~87k, a step down from the 2022 peak. Progress is fragile.
Nearly 1 in 10 U.S. adults struggled with Alcohol Use Disorder in 2024 — about 27.9 million people.
Who is affected?
SUD prevalence: 17.1% of Americans had a past-year SUD in 2023.
Opioid misuse: 8.9M people (~3.2%).
Teens: overall use is lower than adults, but co-occurring depression and SUD hit ~856k adolescents.
High-risk groups: ages 18–25, people with family history, trauma, untreated mental health conditions, unstable housing, and high-stress occupations.
Opioids were involved in 76% of all overdose deaths in 2023—a stark reminder of the ongoing fentanyl-driven crisis in the U.S.
Mental health & addiction: the two-way street
Substances may be used to self-medicate anxiety, insomnia, or depression, but this worsens symptoms and disrupts sleep, mood, and focus. Conversely, depression, trauma, or ADHD can intensify cravings and complicate recovery.
Best outcomes come from integrated care: therapy (CBT, MI, family work), medications (e.g., buprenorphine, methadone, naltrexone for OUD), and support for sleep, nutrition, movement, and community.
n 2023, benzodiazepines were linked to over 10,800 overdose deaths, most often in dangerous combination with opioids that depress breathing.
Overdose trends & why fentanyl changed the risk
Potency & contamination: Fentanyl is 50x stronger than heroin (tiny amounts are lethal). It’s frequently found in counterfeit pills, cocaine, and meth.
Polysubstance risk: Opioids + benzos/alcohol greatly increase overdose risk.
Harm-reduction that saves lives:
Carry naloxone (Narcan). Teach family and friends.
Never use alone; if you do, use a virtual spotting service or call someone.
Test strips (where legal) for fentanyl/xylazine.
Start with a smaller amount if tolerance may have changed (after detox, jail, or illness).
Call 911—many states have Good Samaritan protections.
In 2024, about 22.1% of Americans (63.7 million people) reported using a nicotine product in the past month.
Getting help: what actually works
Evidence-based care improves survival and recovery:
Medication-assisted treatment (MAT) for opioid use disorder: buprenorphine, methadone, or naltrexone.
Therapies: CBT, Motivational Interviewing, Contingency Management, trauma-informed care, family therapy.
Wraparound supports: peer recovery, mutual-help groups, case management, housing, employment, and medical care.
For teens: family-based models (e.g., MDFT/CRAFT principles), school coordination, and skills-focused therapy.
Cocaine-related overdose deaths surged to 29,449 in 2023, with many linked to fentanyl contamination.
How families can support someone they love
Lead with curiosity, not confrontation.
Pick calm windows to talk; agree on one next step.
Discuss safety first (naloxone, no using alone, no mixing).
Offer practical help (rides to care, child care, help with calls or forms).
Celebrate micro-progress: fewer use days, more meals, one appointment kept.
Seek your own support—boundaries are easier with backup.
Getting help is possible — from calling 988 or talking with a therapist, to joining support groups, using medication-assisted treatment, or reaching out to friends, family, or your doctor. Recovery starts with connection and support.
Frequently Asked Questions About Substance Abuse & Addiction
1) How many people in the U.S. have a substance use disorder right now?
About 17.1% of Americans—roughly 1 in 6—had a past-year SUD in 2023. Many never receive specialty care, even when they want help.
2) Are overdose deaths going up or down?
The peak was 2022. 2023 stayed very high (105k+ deaths). Provisional data suggest a decline to ~87k deaths in the 12 months ending Sept 2024, but fentanyl continues to drive risk.
3) What drugs are most involved in fatal overdoses?
Illicit fentanyl leads by a wide margin. Cocaine deaths are rising (often fentanyl-related). Benzodiazepines and alcohol increase risk when combined with opioids.
4) Why is fentanyl so dangerous?
It’s extremely potent, and users may not know it’s present in counterfeit pills or mixed into cocaine or meth. Very small errors in dose can stop breathing.
5) How do mental health issues connect to addiction?
They co-occur frequently. Anxiety, depression, PTSD, or ADHD can increase use; use can worsen mood and sleep. Integrated treatment yields better outcomes than treating each problem in isolation.
6) What’s the biggest overdose risk factor I can control today?
Avoid mixing depressants (opioids + benzos/alcohol). Carry naloxone, avoid using alone, and consider test strips where legal.
7) What treatments actually work?
For opioid use disorder, buprenorphine or methadone reduce cravings and overdose risk. Therapy (CBT/MI), Contingency Management for stimulants, and trauma-informed care help across substances.
8) My teen is struggling—what should I do first?
Start with non-judgmental listening and a medical/therapy evaluation. Coordinate with school. For safety, secure medications/alcohol at home and discuss never using alone and calling 911.
9) How can families set boundaries without pushing someone away?
Name what you can do (rides, appointments, meals) and what you can’t (money for substances). Keep the tone caring + clear; revisit often as things change.
10) What if my loved one doesn’t want treatment yet?
Focus on harm reduction and relationship. Offer small yeses (a medical check, naloxone, one counseling session). Motivation often grows after people feel safer and supported.
11) How do I know if a program is reputable?
Look for licensed clinicians, evidence-based therapies, and medication options for OUD. Ask how they coordinate mental health and aftercare.
12) What’s the first step with South Denver Therapy?
A 15-minute consult to discuss goals, concerns, and fit. If higher-level care or MAT is needed, we’ll help coordinate referrals while providing therapy and family support.
