Drug, substance abuse and addiction statistics 2024

Key points

• 25% of Americans (70 million people) admitted they use illicit drugs, according to the most recent National Survey on Drug Use.
• 48.7 million people nationwide struggle with substance abuse according to the same survey.
• Alcohol is the most commonly used drug, followed by tobacco and marijuana.
• Health insurance policies sold on the Affordable Care Act (ACA) Marketplace or provided by Medicaid are required to cover substance abuse.

Drug and substance abuse continues to be a major problem across the United States, with 1 in 4 Americans over the age of 12 admitting that they used illicit drugs in 2022.¹ While alcohol, tobacco and marijuana represent the most popular drugs among Americans, many struggle with more illicit drugs, including cocaine, methamphetamines and heroin, according to the most recent Substance Abuse and Mental Health Services Administration (SAMHSA) survey.³

Below, we’ve compiled comprehensive drug, substance abuse and addiction statistics that demonstrate the pervasiveness of the issue — and the importance of quality, affordable health insurance that offers substance abuse treatment.

How many people use drugs in the U.S.?

Nearly 25% of Americans ages 12 or older say they used illegal drugs in 2022. That’s 70.3 million people nationwide.¹ Approximately 50% of Americans 12 or older admit they used illegal drugs in their lifetime.² 

The breadth of the problem is detailed in the most recent SAMHSA survey, which asked participants about their drug use habits. The survey included questions about current use (defined as using a substance within the month prior to taking the survey) as well as lifetime use. 

Current use³

Based on survey results and the definition of current use:

• 16.5% of those who used illicit drugs in the survey year used marijuana, making it the most common illicit drug among those surveyed. 
• 3.4% of respondents admit to using marijuana and other illicit drugs within a month of taking the survey.
• Central nervous system stimulants and prescription psychotherapeutics (misuse) were the second most common illicit drugs, each representing just under 2% of reported use. 
• LSD, PCP, ecstasy and sedatives account for the lowest percentage of use, each representing 0.1% or less of illicit drugs used.

Lifetime use³

• 47% admitted to using marijuana at some time in their life, making it the most common illicit drug among lifetime use statistics.
• Hallucinogens were the second most widely used illicit drug, with 17% admitting they used them during their lifetime. 
• Cocaine was the third most commonly used illicit drug, with 15% of participants admitting to using it over their lifetime.

What is the most popular drug in the U.S.?

Alcohol is the most popular drug in the U.S., with nearly half of Americans ages 12 and older saying they used it in the last statistically available month, based on the SAMHSA survey. Nearly 22% admitted they engaged in binge drinking in the past month at the time of the survey.³

Tobacco use is also prevalent in the United States, with more than 1 in 5 Americans consuming tobacco in some form in the last statistically available month — and nearly 17% specifically smoking cigarettes.

While harder drug use is still a problem, less than 2% of Americans ages 12 and older reported having used cocaine in the past year. It’s even lower for methamphetamines (1%) and heroin (0.3%).

Note: These are self-reported usage statistics. It is possible some Americans may not accurately report drug use.

How many people die from drugs?

The U.S. has experienced a rising number of drug-related deaths for more than a decade, according to the latest National Safety Council Data. There were 108,490 drug-related deaths in 2022, according to preliminary data. That’s slightly lower than those reported in 2021 (106,699 deaths) but a 141% increase over the last decade and a 494% increase since 1999, the first year for which NSC data is available.⁴ 

This data includes drug-related deaths by suicide, homicide and undetermined intents. Of those 108,490 deaths, 92% (100,105) were categorized as preventable drug overdoses.

Opioid overdoses are the most common cause of drug-related deaths, but even cannabis (marijuana) has resulted in preventable deaths.

Here’s how those drug-related deaths break down according to NSC’s preliminary 2022 data:

^{Source: Preliminary 2022 data from the National Safety Council as of March 21, 2024}

How many people struggle with substance abuse?

Nationwide, 38,679,000 American adults reported having a substance abuse disorder in the last statistically available year.⁵ 

Montana has the highest self-reported rate (19.2% of adults) of substance abuse. Oregon, Washington, South Dakota and Kansas round out the top five.

Georgia is the state with the lowest rate of self-reported substance abuse (11.31% of adults).

^{Source: 2023 State of Mental Health in America Report}

What percentage of Americans abuse alcohol?

Alcohol abuse can be defined in two ways: binge drinking and alcohol use disorder (AUD).

• The Centers for Disease Control and Prevention defines binge drinking as five drinks on one occasion for men and four drinks on one occasion for women.⁶
• The National Institute on Alcohol Abuse and Alcoholism defines AUD as a medical condition wherein someone cannot stop or control their alcohol intake, no matter the consequences.⁷

Nationwide, an average of 21.7% of people reported having engaged in binge drinking in the past statistically available month, and 10.8% said they had dealt with alcohol use disorder in the last statistically available year.³

States with the highest alcohol abuse

North Dakota and Wisconsin are the two states with the highest rate of binge drinking, with 25.99% of people ages 12 and older reporting binge drinking in the past month.³ Nebraska, Vermont and Iowa also have high rates of binge drinking.

North Dakota also leads the country in alcohol use disorder, with more than 15% of individuals 12 and up reporting struggling with AUD in the past year. Montana, New Mexico, Oregon and Alaska round out the top five states with the highest rate of reported alcohol use disorder.

^{Source: SAMHSA National Survey on Drug Use and Health}

How many people die from alcohol each year?

In the United States, 178,000 people died from alcohol in the last statistically available year (2021). That’s 488 deaths every day from alcohol.⁸

Of those 178,000 deaths:

• 117,000 deaths are attributed to chronic conditions related to long-term alcohol use.
• 61,000 deaths are attributed to alcohol-related car crashes, alcohol poisoning or suicide. 

What percentage of Americans use tobacco?

Across the U.S., an average of 21.2% of people ages 12 and older reported tobacco use in the last statistically available month. More specifically, 16.82% reported smoking cigarettes.³

States with the most smokers

Kentucky is the state with the most tobacco users; more than one-third of Kentuckians ages 12 and older report using tobacco of some kind in the past month. Kentucky also leads the country in cigarette users, with 1 in 4 people self-reporting smoking cigarettes.³

More than 1 in 5 people smoke cigarettes in West Virginia, Missouri, Wyoming, Louisiana and Arkansas. West Virginia, Missouri and Louisiana are also close behind Kentucky for overall tobacco use as well.

Only 13.01% of Californians reported having used tobacco in the last statistically available month. Cigarette usage is even lower in Utah, where just over 10% of the state’s population reported cigarette usage.

^{Source: SAMHSA National Survey on Drug Use and Health}

How many people use marijuana?

On average, more than 13% of Americans ages 12 and older reported using cannabis, also known as marijuana, in the previous month.³

However, the most recent statistically significant data comes from 2021 to 2022. It’s important to note that since then, several additional states have legalized marijuana both medicinally and recreationally, which may lead to an increase in usage.

States with the highest rate of marijuana use

Vermont leads the nation with the highest rate of marijuana use; just over 22% of people 12 and up reported using marijuana in the last month. Recreational marijuana has been legal in Vermont since 2020.³

Alaska, Colorado, Oregon and Maine round out the top five states for marijuana usage. Recreational marijuana has been legal in Alaska and Oregon since 2014, Colorado since 2012 and Maine since 2016.

Oklahoma is the state with the highest rate of marijuana usage (16.61%) where recreational use is currently not legal.

^{Source: SAMHSA National Survey on Drug Use and Health}

How many people die from marijuana usage?

Preliminary data for 2022 indicates that there were 1,183 linked to marijuana and its derivatives, in the U.S., which marks an increase over the years prior.⁴ The National Safety Council specifies that marijuana derivatives can include THC, CBD or their synthetic derivatives.

^{Source: National Safety Council data}

The National Safety Council has data dating back to 1999 when there were only 36 cannabis-related deaths.

What percentage of people have used cocaine?

Nationwide, an average of 1.7% of people ages 12 and older reported having used cocaine in 2022, the last statistically available year.³

States with the highest rate of cocaine use

Vermont is the state with the highest rate of self-reported cocaine use, with 3.2% of people 12 and up saying they used the drug in the year prior. New York, Maryland, Massachusetts and Rhode Island make up the remaining top five states.³

The state with the lowest cocaine use is Texas, with just 1 in 100 Texans self-reporting cocaine use.

^{Source: SAMHSA National Survey on Drug Use and Health}

What percentage of people have used methamphetamines?

Nationwide, an average of 1% of people 12 and older reported having used methamphetamines in the last statistically available year.³

States with the highest rate of methamphetamine use

Nevada tops the list of states with the highest rate of methamphetamine usage. More than 1 in 50 people ages 12 and up reported using this drug in the last statistically available year. Self-reported meth use is also high in Tennessee, Iowa, Mississippi and Alabama.³

Connecticut and Florida have the lowest rate of methamphetamine use; just 0.52% of residents self-reported usage in the last statistically available year.

^{Source: SAMHSA National Survey on Drug Use and Health}

What percentage of people abuse prescription pain pills?

Nationwide, an average of 3.12% of people 12 and older reported having abused prescription pain pills in the last statistically available year.³

States with the highest rate of prescription pain pill abuse

Tennessee leads the country in prescription pain pill misuse. More than 4% of the state’s population, ages 12 and older, reported having abused pain relievers in the year prior.³

Prescription pain pill abuse is also high in Arkansas, Nevada, Louisiana and Alabama.

Nebraska is the state with the lowest rate of self-reported pain pill abuse (2.39%).

^{Source: SAMHSA National Survey on Drug Use and Health}

What percentage of people have used heroin?

Nationwide, an average of 0.3% of people ages 12 and up reported having used heroin in the last statistically available year.³

States with the highest rate of heroin use

Heroin use is most common in the state of Delaware, where 0.6% (that’s more than 1 in every 200 residents) of people ages 12 and up reported having used heroin in the year prior. The only other states with a rate higher than 1 in 200 are Maine, Vermont and Alaska.³

Texas is the state with the lowest rate of self-reported heroin use: Only 0.15% of Texans 12 and up reported having used the drug in the most recent statistically available year.

^{Source: SAMHSA National Survey on Drug Use and Health}

What percentage of people have abused opioids?

Across the country, an average of 3.3% of Americans ages 12 and up reported having abused opioids in the year prior.³

States with the highest rate of opioid abuse

Tennessee has the highest rate of opioid abuse in the U.S. Nearly 4.7% of people in the state reported having engaged in opioid abuse in the last statistically available year. Arkansas, Alabama, Louisiana and Nevada round out the top five.³ 

Nebraska has the lowest rate of opioid abuse in the country, with only 2.4% saying they had abused opioids in the year prior.

^{Source: SAMHSA National Survey on Drug Use and Health}

States with the highest number of overdose deaths

West Virginia has the highest rate of overdose death in the U.S., with 84 overdose deaths for every 100,000 people. Nebraska and South Dakota has the lowest rate of overdose deaths, with 9 deaths for every 100,000 people.¹⁰

Overdose deaths are on the rise in West Virginia (up by 7.3%) but on the decline in South Dakota (down by 16.7%). Oregon has seen the biggest increase (41.5%) in overdose deaths over the last statistically available 12 months.

^{Source: SAMHSA National Survey on Drug Use and Health}

What drug causes the most overdose deaths?

Opioids are involved in more overdose deaths than any other drug. In 2022, there were 108,490 drug-related deaths — and just over 75% of them (82,234 deaths) involved an opioid.⁴

Fentanyl is by far the deadliest opioid. Of the 82,234 opioid-related deaths, 70,601 of them involved fentanyl.

^{Source: Preliminary 2022 data from the National Safety Council as of March 21, 2024}

Health insurance and substance abuse

Substance abuse disorders represent a dangerous health condition — one that deserves the proper care and treatment. Yet 93.5% of Americans with a self-reported substance abuse problem do not seek help.⁵

If you or someone you love is suffering from substance abuse, know that there are options available. Many health insurance plans include coverage for mental health and substance abuse. If you purchase health insurance from the ACA Marketplace, the insurer is required to cover substance abuse counseling and treatment.¹¹ Medicare will also pay for treatment of alcoholism and substance use disorders, though its coverage is not as extensive as it is for other services.

If you’re not sure if your current health plan covers mental health surveys or substance abuse counseling and treatment, contact your insurer to discuss your benefits. 

Looking for better health insurance that includes coverage for substance abuse disorders? Browse our roundup of the best health insurance companies to get started.

Worried about the cost? How to save money on health insurance

For free, confidential help with substance abuse, contact the SAMHSA's National Helpline at 1-800-662-HELP(4357). The service is available 24/7, 365 days a year to help individuals and families facing mental and/or substance use disorders find treatment referrals and information services.

Article sources

1. United States Department of Health and Human Services
2. National Center for Drug Abuse Statistics
3. Substance Abuse and Mental Health Services Administration - National Survey on Drug Use and Health
4. National Safety Council
5. State of Mental Health in America Report
6. Centers for Disease Control and Prevention - Binge Drinking
7. National Institute on Alcohol Abuse and Alcoholism
8. Centers for Disease Control and Prevention - Excessive Alcohol Deaths
9. National Institute on Drug Abuse - Drug Overdose Death Rates
10. Centers for Disease Control - Provisional Drug Overdose Death Counts
11. Substance Abuse and Affordable Care Act