The 2024 National Survey on Drug Use and Health shows that key substance use and mental health outcome measures are improving, but experts say there is still significant work to do. Over the past four years, most key mental health and substance use outcome measures—such as suicide attempts among adolescents and past-month prescription opioid misuse–either improved or stayed the same, according to the 2024 National Survey on Drug Use and Health (NSDUH), which the Substance Abuse and Mental Health Services Administration (SAMHSA) released this week.
Improvements Among Mental Health Outcomes
Substance Use Findings
Between 2021 and 2024, some substance use measures improved. Past-year cocaine use dropped from 1.7% to 1.5%, while past-year prescription opioid misuse fell from 3% to 2.6%. Past-year methamphetamine use, past-year prescription stimulant misuse, and past-year opioid use disorder remained unchanged.
There were also areas where substance use trends worsened. Past-year hallucinogen use rose from 2.7% in 2021 to 3.6% in 2024, while past-year cannabis use rose from 19% to 22.3%. There was also a corresponding rise in cannabis use disorder, from 6% in 2021 to 7.1% in 2024.
“We’re making some progress, but the scale of this problem is vastly under-appreciated,” Busch said. When extrapolating NSDUH data to the national population, 48.4 million people ages 12 years and older had a past-year SUD (and that doesn’t include tobacco products).
“This should be an all-hands-on-deck, national initiative. Right now, we have nearly 50 million people with an SUD, yet we don’t really have any national plan on how we’re going to manage it,” said Gerald Busch, M.D., M.P.H., a member of APA’s Council on Addiction Psychiatry, assistant professor of psychiatry at the Uniform Services University of the Health Sciences, and faculty on the Child and Family Behavioral Health Services Unit at Tripler Army Medical Center.. “We don’t have an organized treatment infrastructure. Screening for substance use disorders in all clinics, dissemination of evidence-based psychosocial interventions, and standardized prevention efforts are in dire need. Paradoxically, we’re cutting back services.”
