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Drug Use, Abuse and Dependence (Addiction) In America

Substance Use Disorder (SUD) is a psychiatric term listed under addictive disorders. It is commonly called "addiction." These data were collected under DSM-IV. During 2013, per APA (DSM 5), the definition was tweaked and dropped the terms "abuse" or "dependence." They were replaced by the concept of a single fluid spectrum of harmful use which can range from mild to moderate to severe. The most severe cases are rare but highly publicized. New research has showed that over 70 percent of SUD ended in recovery with no treatment and without relapse.

Alcohol Use Disorders (AUD) are the most common type of SUD.Tobacco is treated separately and is not included in the SUD statistics.

SUD is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM 5) from the American Psychiatric Association.


1. SUD is not the normal result of the use of any drug.

2. Substance use disorder (SUD) or "addiction" is dominated by alcohol use disorder (AUD). About 68 percent of current cases are alcohol alone and 12 percent are AUD comorbid (simultaneous) with other drugs. Another 13 percent have a previous history of comorbid AUD. Alcohol is a major factor in about 95 percent of all cases of SUD. The drug effects of alcohol are the worst of any drug in terms of many important effects on others, including the victims of alcohol induced violent behavior, damage to the fetus and the loss of mental and physical control that contributes to so many rapes, assaults and accidents.

3. Age is a critical factor in SUD. SUD peaks about age 22 at over three times the normal rate. After age 22 recovery outpaces rapidly declining new cases of SUD. No policy can produce any significant increase in adult SUD when natural recovery comes with maturity.Policy must focus on the young.

4. Recovery from SUD is normal. There are dramatic increases in SUD from ages 18 to 22 and dramatic rates of recovery from 22 to 25. Despite over 7 million new drug users each year, the number of SUD cases has been stable at about 22 million for the ten years from 2002 through 2011.

5. Illegal [prohibited] drugs have been readily available to any teen who wanted them for over 30 years. Except for marijuana, almost all refuse to use them. It is the best measure of the total failure of prohibitions.

6. Among teens who do choose to use prohibited drugs, nearly all use is experimental and quickly stops. Prohibition dramatically increases the risks.

7. Whether a drug is legal or illegal appears to have little impact on its use.

8. Marijuana has an especially vital and unique place in discussions of drug policy.

9. Comparisons of other drugs with alcohol provide a vital missing dimension in discussions of drug policy.

10. Charts and tables

11. Sources


13. National Survey on Drug Use and Health Archive


To weigh the costs and benefits of our drug policy, we must clearly understand the size and nature of SUD. We emphasize that SUD defines harmful use. There is no scientific justification for treating most drug use as a criminal offense, Current laws for alcohol and tobacco provide a good general outline.

Reactions to drugs vary widely among individuals. Those individual reactions also vary widely based on dosage - the amount used and the time within which it is used. Political rhetoric and media reports emphasize the most sensational and unusual cases.
The numbers have been quite consistent for each of the 10 years from 2002 - 2011 even though there were over 40 million new users of alcohol and 25 million new users of illicit drugs during that time. It is the most accurate picture we have ever had.
National Survey on Drug Use and Health was redesigned in 2002. It was called the National Household Survey on Drug Abuse prior to 2002) and has been a project of the Substance Abuse and Mental Health Services Administration (SAMHSA) since 1971. It is the primary source of information on the use of illicit drugs, alcohol, and tobacco by the civilian, noninstitutionalized population in the United States.

Monitoring The Future (MTF) is an ongoing study of the behaviors, attitudes, and values of students and young adults begun in 1975. Funded by the National Institute on Drug Abuse (NIDA), MTF annually surveys eighth, tenth, and twelfth graders in public and private schools in the coterminous United States and a subsample of college students and adults from previous graduating classes who participated in the survey as seniors.

Please see our GLOSSARY for more information.

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