One in three U.S. adults with co-occurring mental illness and substance use disorder does not receive treatment. Over 80,000 opioid overdose deaths occurred recently, highlighting a persistent crisis. This article presents the latest statistics on prevalence, treatment access, and mortality.
Key Takeaways
- In 2021, 1 in 4 U.S. adults with mental illness did not receive needed treatment; co-occurring SUD increases this unmet need to 1 in 3 (unmet need rates reported in SAMHSA analysis).
- Significantly more people received MOUD when offered immediately after overdose: 45% initiated buprenorphine/naloxone within 30 days vs 5% with delayed or no offer in an RCT (initiation within 30 days).
- MAT retention was higher with monthly extended-release buprenorphine vs daily sublingual: 48% vs 26% stayed in treatment at 12 weeks in a randomized trial (retention at 12 weeks).
- 30.4% of adults in the United States reported binge drinking at least once in 2020 (percentage reporting binge drinking in the past month).
- 15.5% of U.S. adults reported using illicit drugs in the past month in 2019 (percentage of adults reporting past-month illicit drug use).
- 1.6 million U.S. adults had opioid use disorder in 2019 (estimated number of adults with opioid use disorder).
- 80,411 opioid-involved overdose deaths occurred in the United States in 2020 (number of opioid-involved overdose deaths).
- 12.5% of U.S. adults aged 18–25 had SUD in 2022 (percentage by age group).
- 2.6x higher risk of all-cause mortality for patients with opioid use disorder vs. controls (hazard ratio reported in a large cohort study).
- Over 2,000,000 people received treatment with medications for opioid use disorder (MOUD) through substance use treatment programs in the U.S. in 2021 (number receiving MOUD in specialty facilities).
- $0.9 billion (2019) was spent by Medicare on substance use disorder treatment in the United States (Medicare payer expenditures).
- Only 15% of people with opioid use disorder worldwide received opioid agonist therapy in 2021 (treatment coverage percentage).
- $14.4 billion in state Medicaid expenditures were associated with substance use disorder services in 2018 (Medicaid spending on SUD).
- The National Institutes of Health funded $1.8 billion in awards related to substance use disorder research in FY2023 (NIH grant totals for substance use disorder research areas, NIH RePORTER).
- $5.0 billion was allocated to the State Targeted Response (STR) for opioid use disorder between 2017 and 2018 (grant allocation amount).
Half of adults need substance use treatment yet many lack access, even as overdose deaths and medication gaps persist.
Related reading
01 · Category
Treatment Access6 stats
01
In 2021, 1 in 4 U.S. adults with mental illness did not receive needed treatment; co-occurring SUD increases this unmet need to 1 in 3 (unmet need rates reported in SAMHSA analysis).
02
Significantly more people received MOUD when offered immediately after overdose: 45% initiated buprenorphine/naloxone within 30 days vs 5% with delayed or no offer in an RCT (initiation within 30 days).
03
MAT retention was higher with monthly extended-release buprenorphine vs daily sublingual: 48% vs 26% stayed in treatment at 12 weeks in a randomized trial (retention at 12 weeks).
04
Opioid use disorder: 43% reduction in mortality with methadone treatment vs no methadone (relative risk reduction reported in a systematic review).
05
80% of U.S. people with opioid use disorder can access naloxone within 1 mile in major metropolitan areas in 2022 (share of people with nearby access, modeled).
06
In the United States, 71.5% of county residents live within a 2-hour drive of an opioid treatment program (access modeled by SAMHSA program directory analysis).
Interpretation
Treatment Access Interpretation
Treatment Access gaps remain large in the United States, where unmet need rises from 1 in 4 adults with mental illness to 1 in 3 when substance use disorder is co-occurring, even though access improves for opioids in specific ways such as 71.5% of county residents living within a 2-hour drive of an opioid treatment program.
02 · Category
Epidemiology4 stats
01
30.4% of adults in the United States reported binge drinking at least once in 2020 (percentage reporting binge drinking in the past month).
02
15.5% of U.S. adults reported using illicit drugs in the past month in 2019 (percentage of adults reporting past-month illicit drug use).
03
1.6 million U.S. adults had opioid use disorder in 2019 (estimated number of adults with opioid use disorder).
04
3.6% of global deaths were attributable to substance use and illicit drug use in 2019 (fraction of total deaths).
Interpretation
Epidemiology Interpretation
From an epidemiology perspective, substance use remains highly prevalent with 30.4% of U.S. adults reporting binge drinking in 2020 and 15.5% reporting past-month illicit drug use in 2019, while opioid use disorder affected an estimated 1.6 million adults and substance use and illicit drug use accounted for 3.6% of global deaths in 2019.
03 · Category
Mortality & Morbidity4 stats
01
80,411 opioid-involved overdose deaths occurred in the United States in 2020 (number of opioid-involved overdose deaths).
02
12.5% of U.S. adults aged 18–25 had SUD in 2022 (percentage by age group).
03
2.6x higher risk of all-cause mortality for patients with opioid use disorder vs. controls (hazard ratio reported in a large cohort study).
04
2,465,503 overdose deaths prevented by naloxone distribution programs in the United States between 1996 and 2019 (estimated overdose reversals).
Interpretation
Mortality & Morbidity Interpretation
Mortality and morbidity data show that opioid-involved deaths remain extremely high with 80,411 deaths in 2020, even as naloxone distribution programs are estimated to have prevented 2,465,503 overdose deaths from 1996 to 2019.
More related reading
04 · Category
Market & Services4 stats
01
Over 2,000,000 people received treatment with medications for opioid use disorder (MOUD) through substance use treatment programs in the U.S. in 2021 (number receiving MOUD in specialty facilities).
02
$0.9 billion (2019) was spent by Medicare on substance use disorder treatment in the United States (Medicare payer expenditures).
03
Only 15% of people with opioid use disorder worldwide received opioid agonist therapy in 2021 (treatment coverage percentage).
04
In 2022, there were 15,000+ clinicians registered to prescribe buprenorphine in the U.S. (count of providers by registration program).
Interpretation
Market & Services Interpretation
In the U.S., the market for substance use treatment is expanding and supported by a growing service capacity, evidenced by over 2,000,000 people receiving MOUD in 2021 and more than 15,000 clinicians registered to prescribe buprenorphine in 2022, even as global treatment coverage remains low with only 15% of people with opioid use disorder receiving opioid agonist therapy in 2021.
05 · Category
Policy & Funding7 stats
01
$14.4 billion in state Medicaid expenditures were associated with substance use disorder services in 2018 (Medicaid spending on SUD).
02
The National Institutes of Health funded $1.8 billion in awards related to substance use disorder research in FY2023 (NIH grant totals for substance use disorder research areas, NIH RePORTER).
03
$5.0 billion was allocated to the State Targeted Response (STR) for opioid use disorder between 2017 and 2018 (grant allocation amount).
04
The SAMHSA “Behavioral Health Barometer” reported 4,000+ grants awarded for substance use prevention and treatment between 2020 and 2023 (grant count).
05
In FY2022, the Substance Abuse and Mental Health Services Administration (SAMHSA) budget included $6.9 billion for behavioral health programs (agency total).
06
The 2021–2022 HHS opioid response package included $3.6 billion for treatment, prevention, and recovery (HHS investment amount).
07
The 21st Century Cures Act included $1.5 billion for opioid and behavioral health programs over several years (law-related funding authorization).
Interpretation
Policy & Funding Interpretation
Across policy and funding, the scale of government support for substance use disorder is substantial and rising, with $14.4 billion in 2018 Medicaid spending on SUD alongside major federal investments like $3.6 billion in the 2021 to 2022 HHS opioid response and $1.5 billion authorized through the 21st Century Cures Act.
Reference
Cite This Report
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APA
James Okoro. (2026, February 13). Substance Use Disorder Statistics. Gitnux. https://gitnux.org/substance-use-disorder-statistics
MLA
James Okoro. "Substance Use Disorder Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/substance-use-disorder-statistics.
Chicago
James Okoro. 2026. "Substance Use Disorder Statistics." Gitnux. https://gitnux.org/substance-use-disorder-statistics.
Sources & references
25 datasets cited across this report · attribution is report-level
+14 additional datasets cited (not shown individually)