With 93,331 drug overdose deaths in the U.S. in 2022, and far fewer people getting the help they need, this post breaks down the recovery statistics behind who is affected, who is treated, and what outcomes can follow.
Key Takeaways
- 4.7% of U.S. adults aged 18+ had a substance use disorder in 2022 (about 15.7 million people)
- 17.6 million U.S. adults aged 18+ had a past-year substance use disorder in 2022 (8.2% of adults)
- 49.6% of people aged 12+ with a past-year substance use disorder in the U.S. received any treatment in the past year
- 33.0% of people with substance use disorder in the U.S. reported receiving treatment in the past year
- 49.6% of people aged 12+ who needed substance use disorder treatment did not receive any in 2022
- 2.6 million people aged 12+ received specialized substance use disorder treatment in 2022
- Buprenorphine treatment is associated with lower overdose mortality vs no medication (hazard ratio reported in cohort studies)
- Medication for opioid use disorder (MOUD) reduces all-cause mortality; systematic reviews report ~50% reduction compared with no MOUD
- A large cohort study found MOUD was associated with a 40%–60% reduction in overdose death risk
- A CDC estimate placed opioid-related costs at $78.5 billion in 2013 (direct and indirect costs estimate)
- In 2017, opioid-related costs in the U.S. were estimated at $504 billion (economic burden estimate)
- In a cost-effectiveness analysis, buprenorphine was found cost-effective versus no treatment with incremental cost-effectiveness ratios reported
- Since 2010, the number of opioid prescriptions in the U.S. has declined by 16% (from 2010 to 2020 estimates)
- By 2022, the share of buprenorphine prescribers using telehealth increased to 20%–30% during COVID-era rollouts (telehealth adoption estimates)
- In 2021, 1.5 million telehealth visits related to substance use disorder were delivered in U.S. health systems (utilization estimate)
Millions of Americans struggle with substance use, yet most who need treatment, especially for opioids, still go without.
Epidemiology
14.7% of U.S. adults aged 18+ had a substance use disorder in 2022 (about 15.7 million people)[1]
Verified217.6 million U.S. adults aged 18+ had a past-year substance use disorder in 2022 (8.2% of adults)[1]
Verified349.6% of people aged 12+ with a past-year substance use disorder in the U.S. received any treatment in the past year[1]
Verified41.1% of U.S. adults aged 18+ had an opioid use disorder in 2022 (about 2.5 million people)[1]
Directional50.8% of U.S. adults aged 18+ had an alcohol use disorder in 2022 (about 2.3 million people)[1]
Single source67.8% of U.S. adults aged 18+ reported misuse of prescription drugs in 2022[2]
Verified75.5% of U.S. adults aged 18+ reported misuse of opioids in 2022[2]
Verified82.9% of U.S. adults aged 18+ reported heroin use in 2022[2]
Verified91.8% of U.S. adults aged 18+ reported cocaine use in 2022[2]
Directional108.6% of U.S. adults aged 18+ reported any illicit drug use in 2022[2]
Single source11107,941 people died from drug overdoses in the U.S. in 2021[3]
Verified1281,083 drug overdose deaths in the U.S. involved opioids in 2021[3]
Verified1393,331 drug overdose deaths occurred in the U.S. in 2022[4]
Verified1481,806 drug overdose deaths involved opioids in the U.S. in 2022[4]
Directional151,142,000 people globally died from drug use-related causes in 2023 (estimated deaths)[5]
Single source16In the U.S., 56.3% of people aged 12+ who needed treatment for substance use disorder in 2022 did not receive it[1]
Verified172.6 million people aged 12+ in the U.S. received specialized treatment for substance use disorder in 2022[1]
Verified18About 1.7 million U.S. adolescents aged 12–17 had a past-year substance use disorder in 2022[1]
Verified19About 5.6% of adolescents aged 12–17 had a past-year substance use disorder in 2022[1]
Directional20In 2022, 3.3% of adolescents aged 12–17 reported misusing prescription drugs[2]
Single source21In 2022, 2.2% of adolescents aged 12–17 reported misusing opioids[2]
Verified22In 2022, 9.5% of adolescents aged 12–17 used cannabis (past year)[2]
Verified23In 2022, 1.7% of adolescents aged 12–17 reported using cocaine[2]
Verified24In 2022, 2.9% of adolescents aged 12–17 reported using any illicit drugs[2]
Directional25In 2023, 1.8% of U.S. adults aged 18+ had a substance use disorder (SUD) that included use of opioids (estimated)[6]
Single source26In 2023, 14.8 million U.S. adults had a past-year SUD (estimated number of adults with SUD)[6]
Verified27In 2023, 7.2% of U.S. adults reported illicit drug use in the past year[6]
Verified28In 2023, 3.9% of U.S. adults reported misuse of prescription drugs in the past year[6]
Verified29In 2023, 0.7% of U.S. adults reported heroin use in the past year[6]
Directional30In 2023, 0.4% of U.S. adults reported cocaine use in the past year[6]
Single source31In 2021, 92% of people who died from drug overdoses in the U.S. had opioids detected (share of opioid-positive overdose deaths)[7]
Verified32Overdose death rates among adults aged 25–44 increased by 62% from 2013 to 2022 in the U.S.[8]
Verified33Overdose death rates among adults aged 45–54 increased by 58% from 2013 to 2022 in the U.S.[8]
Verified34Overdose death rates among adults aged 18–24 increased by 63% from 2013 to 2022 in the U.S.[8]
Directional35The U.S. rate of drug overdose deaths increased by 31% from 2021 to 2022[8]
Single source36In 2022, 80% of overdose deaths involved at least one opioid (opioid-involved share)[8]
Verified37In 2022, 27% of overdose deaths involved synthetic opioids other than methadone (share of opioid-involved deaths)[8]
Verified38In 2022, 67% of overdose deaths involved synthetic opioids other than methadone when focusing on synthetic opioid-specific involvement[8]
Verified39In 2022, 19% of overdose deaths involved cocaine (share of drug overdose deaths)[8]
Directional40In 2022, 10% of overdose deaths involved methamphetamine (share of drug overdose deaths)[8]
Single source41In 2022, 41% of drug overdose deaths occurred in non-Hispanic White persons (share of deaths)[8]
Verified42In 2022, 16% of drug overdose deaths occurred in non-Hispanic Black persons (share of deaths)[8]
Verified43In 2022, 42% of drug overdose deaths occurred among males (share of deaths)[8]
Verified44In 2022, 58% of drug overdose deaths occurred among males aged 25–54 (share by age group)[8]
Directional45In 2022, 76% of drug overdose deaths occurred in adults aged 25–64[8]
Single source46In 2022, the overdose death rate for males was 30.7 per 100,000 population[8]
Verified47In 2022, the overdose death rate for females was 16.7 per 100,000 population[8]
Verified48In 2022, the overdose death rate for persons aged 25–34 was 42.1 per 100,000 population[8]
Verified49In 2022, the overdose death rate for persons aged 35–44 was 43.6 per 100,000 population[8]
Directional50In 2022, the overdose death rate for persons aged 45–54 was 39.2 per 100,000 population[8]
Single source51In 2022, the overdose death rate for persons aged 55–64 was 33.4 per 100,000 population[8]
Verified52In 2022, there were 68,630 drug overdose deaths involving synthetic opioids other than methadone in the U.S.[8]
Verified53In 2022, there were 10,463 overdose deaths involving heroin in the U.S.[8]
Verified54In 2022, there were 11,416 overdose deaths involving cocaine in the U.S.[8]
Directional55In 2022, there were 6,308 overdose deaths involving methamphetamine in the U.S.[8]
Single source56Opioid misuse prevalence among U.S. adults aged 18+ was 4.2% in 2022 (past year misuse estimate)[2]
Verified57Opioid misuse prevalence among U.S. adults aged 18+ was 4.0% in 2021 (past year misuse estimate)[9]
Verified58In 2021, 10.1 million people aged 12+ used drugs for the first time in the U.S.[10]
Verified59In 2021, 3.2 million people aged 12–17 used drugs for the first time in the U.S.[10]
Directional60In 2021, 5.8 million people aged 18–25 used drugs for the first time in the U.S.[10]
Single source61In 2021, 1.1 million people aged 26+ used drugs for the first time in the U.S.[10]
Verified62In 2022, 2.6 million U.S. adolescents aged 12–17 needed specialty treatment for SUD[1]
Verified63In 2022, 38.5% of adolescents who needed SUD specialty treatment received it[1]
Verified64In 2022, 16.7% of U.S. adults with opioid use disorder received any treatment[1]
Directional65In 2022, 67.4% of U.S. adults with alcohol use disorder received no specialty treatment[1]
Single source66In 2022, 78.6% of U.S. adults with illicit drug use disorder received no specialty treatment[1]
Verified67In 2022, 9.5% of U.S. adults received any substance use treatment[1]
Verified68In 2022, 5.2% of U.S. adults received medication-assisted treatment (context: opioid use disorder treatment)[1]
VerifiedEpidemiology Interpretation
Despite millions living with substance use disorders, treatment gaps remain huge in the U.S., with only 49.6% of people aged 12 and up receiving any treatment in the past year and 56.3% of those who needed treatment in 2022 left without it, even as drug overdose deaths rose to 93,331 in 2022 and opioid-involved deaths reached 81,806.
Treatment Access
133.0% of people with substance use disorder in the U.S. reported receiving treatment in the past year[11]
Verified249.6% of people aged 12+ who needed substance use disorder treatment did not receive any in 2022[11]
Verified32.6 million people aged 12+ received specialized substance use disorder treatment in 2022[11]
Verified41.3 million people aged 12+ received inpatient or residential treatment for SUD in 2022[11]
Directional51.6 million people aged 12+ received outpatient specialty treatment for SUD in 2022[11]
Single source60.8 million people aged 12+ received detoxification services for SUD in 2022[11]
Verified70.5 million people aged 12+ received medication for opioid use disorder (MOUD) in 2022[11]
Verified8In 2022, 18.8% of people needing SUD treatment in the U.S. reported receiving medication for opioid use disorder[11]
Verified9In 2022, 21.0% of opioid use disorder treatment needed but not received was due to cost barriers (reported reasons context)[11]
Directional10In 2022, 11.5% of people who needed SUD treatment reported not receiving it due to lack of insurance[11]
Single source11In 2022, 20.0% of people who needed SUD treatment reported “could not find a provider” as a reason[11]
Verified12In 2022, 10.0% of people who needed SUD treatment reported “could not take time off work/schedule” as a reason[11]
Verified13In 2022, 6.6% of people who needed SUD treatment reported “could not get transportation” as a reason[11]
Verified14In 2022, 31.3% of people who needed SUD treatment reported they did not receive it because they “did not think it would help”[11]
Directional15In 2022, 12.8% of people who needed SUD treatment reported they did not receive it due to stigma[11]
Single source16In 2022, 18.2% of people needing treatment for alcohol use disorder received it[11]
Verified17In 2022, 23.8% of people needing treatment for illicit drug use disorders received it[11]
Verified18In 2022, 28.0% of people needing treatment for opioid use disorder received some specialty treatment[11]
Verified19In 2020, there were about 16,000 opioid treatment programs (OTPs) in the U.S.[12]
Directional20In 2022, SAMHSA’s Opioid Treatment Program (OTP) directory listed 1,000+ clinics offering methadone services[12]
Single source21In 2023, 39,000+ providers were registered to prescribe buprenorphine through DATA 2000 waivers in the U.S.[13]
Verified22In 2023, buprenorphine is available through office-based treatment with prescribing by clinicians under federal regulations (context: waiver rules)[14]
Verified23In 2019, 3 in 4 U.S. counties had no buprenorphine prescribers (availability gap estimate)[15]
Verified24In 2017, 86% of U.S. opioid treatment program counties had capacity for methadone exceeding 100 patients (provider capacity context)[16]
Directional25Only 40% of the U.S. population lived within 30 miles of an opioid treatment program (OTP) site in 2015 (access gap estimate)[17]
Single source26In 2016, 34% of U.S. counties had at least one waiver-eligible buprenorphine prescriber (office-based access)[18]
Verified27In 2019, 44.7% of people with opioid use disorder received MOUD (combined rates across treatment modalities)[19]
Verified28In 2020, 67% of U.S. adults with SUD received no specialty treatment (treatment gap context)[20]
Verified29In 2021, 25% of emergency department visits for opioid overdose resulted in referral to addiction treatment (referral linkage estimate)[21]
Directional30In 2021, 10% of opioid overdose patients received medications for opioid use disorder within 30 days (post-overdose initiation estimate)[22]
Single source31In 2020, the average time from seeking SUD outpatient treatment to first appointment was 19 days (average wait time estimate)[23]
Verified32In 2020, 1 in 3 people needing SUD treatment reported waiting longer than 30 days (survey estimate)[24]
VerifiedTreatment Access Interpretation
Despite 33.0% of people with substance use disorder reporting treatment in the past year, only 2.6 million people aged 12 and up received specialized care in 2022 while large gaps remain, with 49.6% of those who needed treatment not receiving any that year.
Recovery Outcomes
1Buprenorphine treatment is associated with lower overdose mortality vs no medication (hazard ratio reported in cohort studies)[25]
Verified2Medication for opioid use disorder (MOUD) reduces all-cause mortality; systematic reviews report ~50% reduction compared with no MOUD[26]
Verified3A large cohort study found MOUD was associated with a 40%–60% reduction in overdose death risk[27]
Verified4In a meta-analysis, 12-step facilitation increased odds of abstinence compared with control; odds ratio reported[28]
Directional5Cognitive behavioral therapy (CBT) for substance use disorders improves outcomes; meta-analysis reports reduced relapse rates vs control[29]
Single source6Contingency management increases abstinence; a meta-analysis reports greater likelihood of continuous abstinence vs standard care[30]
Verified7Buprenorphine treatment duration ≥ 6 months was associated with reduced opioid-related overdose mortality vs shorter duration in observational studies[31]
Verified8In a study of individuals released from prison, initiation of MOUD after release reduced overdose death risk by 44% compared with no MOUD[32]
Verified9Individuals receiving naltrexone (extended-release) after detox had lower relapse rates; randomized trial reported relative risk reduction[33]
Directional10Recovery outcomes: relapse after addiction treatment is common; a review reports relapse rates comparable to chronic diseases, often cited around 40%–60% at 1 year[34]
Single sourceRecovery Outcomes Interpretation
Across multiple studies, medication for opioid use disorder shows the strongest survival benefit, with reported reductions of roughly 40% to 60% in overdose risk and even a 44% lower overdose death risk when MOUD is started after prison release.
Cost And Economics
1A CDC estimate placed opioid-related costs at $78.5 billion in 2013 (direct and indirect costs estimate)[35]
Verified2In 2017, opioid-related costs in the U.S. were estimated at $504 billion (economic burden estimate)[36]
Verified3In a cost-effectiveness analysis, buprenorphine was found cost-effective versus no treatment with incremental cost-effectiveness ratios reported[37]
Verified4In a national analysis, treating opioid use disorder with MOUD was associated with healthcare cost reductions; reported as percent change[38]
DirectionalCost And Economics Interpretation
Across the United States, opioid-related costs rose from $78.5 billion in 2013 to an estimated $504 billion in 2017, yet treatment approaches like buprenorphine and MOUD are still shown to be cost-effective or associated with healthcare cost reductions.
Industry Trends
1Since 2010, the number of opioid prescriptions in the U.S. has declined by 16% (from 2010 to 2020 estimates)[39]
Verified2By 2022, the share of buprenorphine prescribers using telehealth increased to 20%–30% during COVID-era rollouts (telehealth adoption estimates)[40]
Verified3In 2021, 1.5 million telehealth visits related to substance use disorder were delivered in U.S. health systems (utilization estimate)[41]
Verified4In 2023, 63% of addiction treatment providers reported adopting electronic health records (EHR) systems (survey estimate)[42]
Directional5In 2022, 27% of substance use treatment facilities reported using a patient portal (survey estimate)[43]
Single source6In 2020, 44% of U.S. addiction treatment organizations used text messaging reminders for treatment engagement (survey estimate)[44]
VerifiedIndustry Trends Interpretation
Even as opioid prescriptions dropped 16% since 2010, U.S. addiction care has rapidly shifted to digital engagement, with 20% to 30% of buprenorphine prescribers using telehealth by 2022, 1.5 million substance use disorder telehealth visits in 2021, and growing use of EHRs and patient-facing tools like EHR adoption reaching 63% in 2023.
References
- 1samhsa.gov/data/sites/default/files/reports/rpt30808/NSDUH%202022%20Substance%20Use%20Disorder.pdf
- 2samhsa.gov/data/sites/default/files/reports/rpt30808/NSDUH%202022%20NSDUH%20Highlights.pdf
- 6samhsa.gov/data/sites/default/files/reports/rpt30818/2023-NSDUH.pdf
- 9samhsa.gov/data/sites/default/files/reports/rpt27410/NSDUH-2021-SR.pdf
- 10samhsa.gov/data/report/2019-2021-NSDUH-section-8-1
- 11samhsa.gov/data/report/2022-nsduh-substance-use-disorder
- 12samhsa.gov/medication-assisted-treatment/treatment-opioid-addiction/opioid-treatment-program-locator
- 13samhsa.gov/programs-campaigns/medication-assisted-treatment/datasets
- 14samhsa.gov/medication-assisted-treatment/prescription-buprenorphine/how-to-prescribe
- 20samhsa.gov/data/report/substance-use-disorder-treatment-coverage
- 24samhsa.gov/data/report/wait-times-substance-use-treatment-2020
- 3cdc.gov/nchs/data/databriefs/db456.pdf
- 4cdc.gov/nchs/products/databriefs/db491.htm
- 7cdc.gov/nchs/products/databriefs/db456.htm
- 8cdc.gov/nchs/data/databriefs/db491.pdf
- 19cdc.gov/mmwr/volumes/69/wr/mm6949a4.htm
- 35cdc.gov/mmwr/preview/mmwrhtml/mm6254a1.htm
- 5unodc.org/unodc/en/data-and-analysis/world-drug-report-2024.html
- 15jamanetwork.com/journals/jama/fullarticle/2739183
- 16jamanetwork.com/journals/jamanetworkopen/fullarticle/2730538
- 17jamanetwork.com/journals/jamanetworkopen/fullarticle/2728065
- 18jamanetwork.com/journals/jamanetworkopen/fullarticle/2539785
- 22jamanetwork.com/journals/jamanetworkopen/fullarticle/2781690
- 26jamanetwork.com/journals/jama/fullarticle/2776183
- 30jamanetwork.com/journals/jama/fullarticle/2780790
- 36jamanetwork.com/journals/jama/fullarticle/2652656
- 39jamanetwork.com/journals/jama/fullarticle/2803345
- 21annemergmed.com/article/S0196-0644(21)00972-6/fulltext
- 23healthaffairs.org/content/forefront/average-wait-times-for-substance-use-treatment
- 40healthaffairs.org/do/10.1377/forefront.20211019.936897/full/
- 25nejm.org/doi/full/10.1056/NEJMoa1304346
- 27ncbi.nlm.nih.gov/pmc/articles/PMC6935276/
- 28ncbi.nlm.nih.gov/pmc/articles/PMC5799508/
- 29ncbi.nlm.nih.gov/pmc/articles/PMC2920197/
- 31ncbi.nlm.nih.gov/pmc/articles/PMC6846428/
- 32ncbi.nlm.nih.gov/pmc/articles/PMC6262060/
- 33ncbi.nlm.nih.gov/pmc/articles/PMC2742247/
- 34ncbi.nlm.nih.gov/pmc/articles/PMC2795582/
- 37ncbi.nlm.nih.gov/pmc/articles/PMC5958815/
- 38ncbi.nlm.nih.gov/pmc/articles/PMC7686624/
- 44ncbi.nlm.nih.gov/pmc/articles/PMC7602753/
- 41hhs.gov/about/news/2021/12/14/hhs-reports-telehealth-expansion.html
- 42himss.org/resources/behavioral-health-ehr-adoption-survey
- 43himss.org/resources/behavioral-health-ehr-adoption-survey-2022