Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health Acknowledgments This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), under Contract No. HHSS283201700002C with RTI International. Rachel N. Lipari and Eunice Park-Lee were the SAMHSA authors. Peter Tice served as the government project officer and as the contracting officer representative. Public Domain Notice All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. Electronic Access and Printed Copies This publication may be downloaded or ordered at https://store.samhsa.gov. Or call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). Recommended Citation Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ Originating Office Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 15-E09D, Rockville, MD 20857. For questions about this report, please e-mail [email protected]. Nondiscrimination Notice SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality Populations Survey Branch August 2019 Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health August 2019 | iii Table of Contents Summary ������������������������������������������������������������������������������������1 Perceived Risk from Substance Use among Adults Aged 26 or Older ............................................................................32 Introduction ��������������������������������������������������������������������������������5 Substance Use Disorders in the Past Year ��������������������������������32 Survey Background ��������������������������������������������������������������������5 Alcohol Use Disorder ...................................................................32 Data Presentation and Interpretation ������������������������������������������5 Illicit Drug Use Disorder................................................................33 Marijuana Use Disorder ................................................................35 Substance Use in the Past Month �����������������������������������������������6 Cocaine Use Disorder ..................................................................35 Tobacco Use in the Past Month ���������������������������������������������������7 Heroin Use Disorder .....................................................................36 Cigarette Use ................................................................................8 Methamphetamine Use Disorder ...................................................37 Daily Cigarette Use ........................................................................9 Stimulant Use Disorder ................................................................37 Tranquilizer Use Disorder or Sedative Use Disorder ........................38 Alcohol Use in the Past Month ��������������������������������������������������10 Pain Reliever Use Disorder ...........................................................38 Any Alcohol Use ..........................................................................10 Opioid Use Disorder .....................................................................39 Binge Alcohol Use ........................................................................11 Substance Use Disorder (Alcohol or Illicit Drugs) ............................39 Heavy Alcohol Use .......................................................................11 Major Depressive Episode in the Past Year �������������������������������41 Illicit Drug Use in the Past Year �������������������������������������������������12 MDE and MDE with Severe Impairment among Adolescents ...........41 Any Illicit Drug Use ......................................................................12 MDE and MDE with Severe Impairment among Adults ....................42 Marijuana Use .............................................................................13 Cocaine Use ................................................................................14 Any Mental Illness among Adults in the Past Year ��������������������43 Heroin Use ..................................................................................15 Serious Mental Illness among Adults in the Past Year ��������������43 Methamphetamine Use ................................................................15 Hallucinogen Use .........................................................................16 Co‑Occurring MDE and SUD among Adolescents ����������������������44 Inhalant Use ................................................................................17 Substance Use among Adolescents with MDE ��������������������������45 Misuse of Psychotherapeutic Drugs ..............................................17 Stimulant Misuse .........................................................................18 Co‑Occurring Mental Health Issues and SUD among Adults �����45 Tranquilizer or Sedative Misuse ....................................................18 Co-Occurring AMI and SUD ..........................................................45 Benzodiazepine Misuse ................................................................19 Co-Occurring SMI and SUD ..........................................................46 Pain Reliever Misuse ...................................................................20 Substance Use among Adults with Mental Health Issues ���������47 Opioid Misuse .............................................................................23 Suicidal Thoughts and Behavior among Adults �������������������������47 Initiation of Substance Use �������������������������������������������������������24 Serious Thoughts of Suicide .........................................................48 Initiation of Cigarette Use .............................................................24 Suicide Plans ..............................................................................48 Initiation of Alcohol Use ................................................................25 Suicide Attempts .........................................................................49 Initiation of Marijuana Use ............................................................25 Initiation of Cocaine Use ...............................................................26 Substance Use Treatment in the Past Year �������������������������������50 Initiation of Heroin Use .................................................................26 Need for Substance Use Treatment ...............................................50 Initiation of Methamphetamine Use ...............................................27 Receipt of Substance Use Treatment .............................................50 Initiation of Hallucinogen Use........................................................27 Perceived Need for Substance Use Treatment ................................53 Initiation of Inhalant Use ...............................................................28 Reasons for Not Receiving Specialty Substance Use Treatment .......54 Initiation of Stimulant Misuse........................................................28 Mental Health Service Use in the Past Year ������������������������������55 Initiation of Tranquilizer or Sedative Misuse ...................................28 Treatment for Depression among Adolescents ...............................55 Initiation of Pain Reliever Misuse ..................................................29 Treatment for Depression among Adults ........................................55 Perceived Risk from Substance Use �����������������������������������������30 Any Mental Health Service Use among All Adolescents ...................57 Perceived Risk from Substance Use among Adolescents ................30 Any Mental Health Service Use among All Adults ...........................58 Perceived Risk from Substance Use among Young Adults ...............31 Any Mental Health Service Use among Adults with AMI ..................59 Key Substance Use and Mental Health Indicators in the United States: iv | August 2019 Results from the 2018 National Survey on Drug Use and Health Any Mental Health Service Use among Adults with SMI