The Substance Abuse and Mental Health Services Administration (SAMSA) recently released their annual national report, based on data from the 2018 National Survey on Drug Use and Health (NSDUH). The NSDUH survey is a comprehensive household interview survey that collects data on substance use, substance use disorders, mental health, and treatment services for these disorders in the United States from January to December each year. It includes approximately 67,500 people annually in civilian populations, excluding active military, prison populations, homeless individuals not in shelters, and long-term hospital residents. With respect to the national opioid epidemic, an estimated 2.1 million Americans had opioid use disorder, however there were significant decreases in pain reliever misuse observed for all ages, and a downward trend in heroin use compared to 2016. Buprenorphine continues to have a high rate of misuse relative to other prescribed opioids. There was a significant increase in the use of marijuana reported for young adults, between the ages of 18-25, especially in young women. In 2018, a total of 43.5 million Americans used marijuana. Frequent marijuana use was associated with opioid misuse, heavy alcohol use, and depression in ages 12-25 years old. A significant decrease in substance use by pregnant women was reported, including significant decreases in daily or near daily marijuana use compared to 2016 by nearly 50%. There were 5.5 million users of cocaine in 2018, and 5.6 million users of hallucinogens. In 2018, a total of 1.9 million Americans used methamphetamines, 2.0 million used inhalants, and 808,000 reportedly used heroin.
Young adults had increasing rates of serious mental illness, major depression, and suicidality. Substance use and mental illnesses continue to be reported as co-occurring, however there are major gaps in treatment received by individual patients. In 2018, 57.8 million Americans had a mental illness, and out of those people, 11.4 million people had a serious mental illness. According to the survey, 19.3 million Americans over the age of 18 had a substance use disorder (SUD). Among those with a SUD, 74.5%, or 14.4 million struggled with alcohol use, 38.3% or 7.4 million struggled with illicit drug use, and 12.9% or 2.5 million struggled with both illicit drug use and alcohol use. Additionally, 9.2 million Americans over the age of 18 had both a SUD and a mental illness. Between 2015 and 2018, there was a decrease in alcohol use disorder (AUD) in both adolescents and young adults, but remained unchanged in ages 26 and older. SAMSA attributes this trend to their Center for Substance Prevention (CSAP) Drug Free Community (DFC) program that has reported a 27% reduction in alcohol use in middle-school and a 23% reduction in use by high school students. Significant increases in serious mental illness was reported in young adults (18-25 year-olds) and adults (26-49 year-olds), since 2016, and of those individuals, many did not get treatment. Of the 53.8% (1.4 million) young adults, 46.2% did not have treatment. Of the 63.5% (3.8 million) adults, 36.3% did not get treatment. There were significant increases in major depressive disorder (MDD), in ages 26-49 years old, relative to 2015. Significant increases in all aspects of suicidality (ideation, planning, attempting) since 2008 were observed in individuals age 18-25 years old. The results of this annual report highlight important areas where improvement in treatment and prevention need to be addressed.
Reference:
The National Survey on Drug Use and Health: 2018. Substance Abuse and Mental Health Administration. U.S. Department of Health and Human Services. Full Report
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