Substance Use Addiction Statistics

U.S. prevalence, age patterns, and the treatment gap. Reviewed by Dr. Meenu Vaid, MD.

How many people have a substance use disorder?

According to SAMHSA’s 2024 National Survey on Drug Use and Health, 48.4 million people aged 12 or older (16.8%) had a substance use disorder in the past year. That total includes:

• 27.9 million people with an alcohol use disorder
• 28.2 million people with a drug use disorder

Those two groups overlap, because a person can have both, which is why the components sum to more than the total. NIAAA reports the same 2024 figure for alcohol use disorder: 27.9 million people aged 12 and older, or 9.7% of that age group.

How does this differ by age?

Alcohol use disorder prevalence by age group, from the same national survey data:

Source: NIAAA, Alcohol Use Disorder in the United States (2024 NSDUH data). By sex: 16.7 million males and 11.2 million females aged 12 and older.

The pattern matters clinically. Rates climb sharply from adolescence into young adulthood, which is precisely the window when the brain is still developing and when early intervention changes long-term trajectories most.

The treatment gap

52.6 million people aged 12 or older (18.2%) needed substance use treatment in 2024. Most did not receive it.

The reasons are well documented and mostly practical rather than mysterious: cost and insurance barriers, not knowing where to go, long waits, fear of judgment from employers or family, and the belief (often reinforced by how addiction is portrayed) that treatment is only for people at the very bottom. Very few people wake up ready to describe themselves as an addict, and treatment systems that require that framing lose people before they start.

Overdose deaths, and a real decline

Drug overdose deaths in the United States peaked at 109,413 in 2022. They have fallen substantially since: 106,881 in 2023, 80,860 in 2024, and 69,939 in the twelve months ending December 2025, roughly a 36% drop from the peak.

Source: CDC National Center for Health Statistics, VSRR Provisional Drug Overdose Death Counts. Recent months are provisional and subject to revision.

This is the most encouraging trend in addiction medicine in a decade, and it is worth stating plainly: what changed was not willpower. Wider naloxone distribution, expanded access to medication for opioid use disorder, and fentanyl test strips are the interventions credited with bending this curve.

Two practical implications still follow. First, the illicit supply remains contaminated, because fentanyl turns up in counterfeit pills and in drugs sold as something else entirely. Second, naloxone works, is available without a prescription in California, and belongs in the same category as a smoke detector: something you hope never to need.

What these numbers mean if you are worried about yourself

Prevalence data will not tell you whether you have a problem. These questions are more useful than any statistic:

• Are you using more, or for longer, than you intended?
• Have you tried to cut down and found you could not?
• Is use continuing despite clear costs to health, work, or relationships?
• Do you need more than you used to for the same effect?
• Do you feel unwell, physically or emotionally, when you stop?

Answering yes to some of these does not make you an addict, and it does not commit you to anything. It means a conversation with a clinician would be worth having. Our addiction self-assessment tool is a private place to start.

Related statistics

Sources

• SAMHSA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health (Annual National Report).
• NIAAA. Alcohol Use Disorder (AUD) in the United States: Age Groups and Demographic Characteristics (2024 NSDUH data).
• CDC, National Center for Health Statistics. VSRR Provisional Drug Overdose Death Counts.