Every year, the Substance Abuse and Mental Health Services Administration (SAMHSA) administers a large national survey to track drug use trends in the U.S. The survey is called the National Survey on Drug Use and Health (or NSDUH), and is considered an official source of data about the use of drugs, alcohol, and tobacco.[1] This article will provide an overview of some of the main trends reflected in the 2024 NSDUH.
What is the NSDUH?
The NSDUH is the National Survey on Drug Use and Health, which is one of the largest and most official sources of data on drug and alcohol use in the U.S. Each year, the NSDUH conducts tens of thousands of interviews to identify drug, alcohol, and tobacco use in Americans ages 12 and up. The report is available to view for free online and details trends in substance use across different age groups. [1]
In addition to collecting data on substance use, the NSDUH also collects information about mental health conditions as well as the percentage of individuals receiving mental health or addiction treatment. The NSDUH is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), and provides most of the data cited by the NIH. [1][2]Â
Because it takes time to collect and analyze data, the most recent report details data from 2024 and compares it to data collected over the previous three years. The 2024 report compared substance use and mental health trends in 2024 to annual data collected since 2021. Along with data from another large national study called Monitoring the Future (tracking drug use in high school students), NSDUH is one of the primary sources of data on the national prevalence of drug and alcohol use in America. [1][2][3]
Substance use trends in the US in 2024
Overall, substance use trends in 2024 are stable from the data since 2021. In some categories, there are modest improvements, including data that suggests young adults are avoiding heavy and regular and binge drinking behaviors. Drinking is more common and problematic in adults and older adults, who are also more likely to experience health problems as a result of drinking. [2]Â
Overall, rates of prescription medication abuse are unchanged or decreased, with fewer reports of stimulant, opioid, and sedative abuse. In some categories, there were increases noted in drug, alcohol, and tobacco use over the past four years. For example, rates of marijuana and THC use have increased in adults, and more adults are struggling with cannabis use disorder as a result. [2]
Rates of nicotine vaping are also problematic, particularly among teens ages 12-17 and young adults ages 18-25. Data from the Monitoring the Future report from 2024 had similar findings, with teens and young adults reporting less drinking and prescription drug use, and more nicotine vaping, THC use, and a modest increase in experimentation with hallucinogens. [2]
Why substance use varies by age
Substance use trends have always varied by age groups, which is often related to different lifestyles and routines seen in individuals across the lifespan. Teens and young adults are often in experimentation phases with drugs and alcohol, and may be more likely to engage in recreational and social drug and alcohol use patterns. More serious drug and alcohol addictions are likely to present in adults, with alcohol use disorders being the most common. [2][3]
Substance use among adolescents (12-17 years old)
Overall, the number of teens who struggle with problem drug and alcohol abuse has decreased in the past few years, according to data from the 2024 NSDUH. Overall, rates of underage alcohol use and use of illicit or prescription drugs have remained unchanged or decreased slightly in teens. There are two areas in which teen substance use remains a significant and common problem - nicotine vaping and the use of cannabis and THC products.
The 2024 NSDUH estimates that 27 million Americans ages 12 and up have reported nicotine vaping in the past month. Approximately 6% of teens between the ages of 12 and 17 are regularly vaping nicotine products, which has become much more common than tobacco use in this age group.Â
The data also suggests that cannabis, marijuana, and THC products (i.e., vapes, edibles, concentrates, and analogs) have remained stable since 2021, but still represent the most commonly abused illicit substance besides alcohol. In 2024, an estimated 10% of teens were estimated to be using THC products. [2]Â
Substance abuse among young adults (18-25 years old)
Young adults between the ages of 18 and 25 years of age have always represented a particularly high-risk age group for drug and alcohol use. More than any other age group, this group is more likely to report high levels of initiation of nicotine, cannabis, alcohol, and hallucinogenic drugs. In 2024, 28.9% (or 10 million) young adults reported using nicotine (either vaping or tobacco products) in the past month.Â
Alcohol use has historically been highly problematic for young adults, and alcohol remains the most commonly abused substance across all age groups in the U.S. Fewer young adults are reporting the use of alcohol in the past month, dropping from 50% in 2021 to 47.5% in 2024. Also, rates of problem drinking and binge drinking have decreased in young adults in the past few years.Â
In 2024, an estimated 38% of young adults reported using illicit drugs in the past year, with marijuana being the most commonly abused drug. 35% of young adults reported using marijuana products, including THC edibles and vapes, in the past year. About 6% reported use of hallucinogenic drugs, which is still uncommon, but represents a rising trend among adults in the U.S. [2]
Substance abuse among adults (26 years old & up)
The 2024 NSDUH data suggest that alcohol use has remained largely unchanged for adults between the ages of 26 and 49 years old over the past few years. Some data suggest that there have been slight improvements in rates of alcohol abuse and binge drinking in the past year.Â
One area of increase is in the category of marijuana, cannabis, and products containing THC. In 2021, 17% of adults in this age group reported past-year use of these products. In 2024, this number rose to 21%. Overall, this age group was the only one to see a rise in overall illicit drug use in 2024.Â
In 2021, 20% of adults reported using illicit drugs in the past year, and this number rose to 24.8% in 2024. Increases were also noted in this age group for the use of hallucinogens, with 2% reporting past-year use in 2021 versus 3.5% in 2024. [2]
How patterns & substance use trends have changed
Overall, the landscape of drug, alcohol, and tobacco use continues to evolve. Nicotine vaping has become more common, particularly among teens and young adults, while rates of tobacco use have dropped in these age ranges. Older adults are more likely to use tobacco products, rather than vaping nicotine products.Â
Alcohol use and binge drinking have also decreased among young adults and adults, who seem to be turning towards THC edibles, vapes, and cannabis with more frequency. This has also resulted in an increase in cannabis dependency and cannabis use disorder. Still, alcohol remains the most commonly abused substance, and remains a considerable public health concern.
Prescription drug abuse has also decreased, with lower rates of prescription opioid, sedative, and stimulant abuse reported by people of all ages. The rising trends of psychedelic drug use (i.e., microdosing, psychedelic therapies, etc.) are also reflected in the data, which shows increased use in young adults and adults over the past few years.
The NSDUH estimated that in 2024, 18% of people ages 12 and over needed addiction treatment, but only 3.5% reported receiving it. With treatment, most people are able to overcome their addiction and dependence on drugs or alcohol and achieve lasting sobriety.[2]Â
