Characteristics of Adults Aged ≥18 Years Evaluated for Substance Use and Treatment Planning — United States, 2019

Abstract

In 2019, 65.8 million U.S. adults reported past-month binge drinking and 35.8 million reported illicit drug use or prescription pain reliever misuse during the past month; 20.4 million met diagnostic criteria for a substance use disorder during the past year (1). Approximately 81,000 persons died of a drug overdose* during May 2019-May 2020; excessive alcohol use contributes to an estimated 95,000 deaths per year (2). Persons with a substance use disorder are at elevated risk for overdose and associated harms (3). To examine the prevalence of past 30-day substance use patterns and the severity of problems experienced across seven biopsychosocial domains (alcohol, drug, employment, family, legal, medical, and psychiatric), CDC used 2019 data from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO) Addiction Severity Index-Multimedia Version (ASI-MV) tool (4); these data are collected from adults aged 18 years who seek substance use treatment in the United States. Alcohol was the most commonly reported substance used during the past 30 days (35.8%), followed by cannabis (24.9%), prescription opioids (misuse) (18.5%), illicit stimulants (14.0%), heroin (10.2%), prescription sedatives or tranquilizers (misuse) (8.5%), cocaine (7.4%), illicit fentanyl (4.9%), and prescription stimulants (misuse) (1.8%). Polysubstance use (use of two or more substances) during the past 30 days was reported by 32.6% of respondents. Among the biopsychosocial domains measured, 45.4% of assessments reported more severe problems with drugs; others reported psychiatric (35.2%), legal (28.8%), medical (27.4%), employment (25.0%), alcohol (24.2%), and family problems (22.8%). These findings highlight the complex nature of substance use in the United States, the interplay between substance use and mental illness, and the * https://emergency.cdc.gov/han/2020/han00438.asp Substances assessed in the ASI-MV tool include tobacco, alcohol, cannabis, cocaine, illicit stimulants (i.e., illegal amphetamines including crank, ice, or methamphetamines; this group does not include cocaine), heroin, illicit fentanyl, prescription opioids (misuse), prescription stimulants (misuse), prescription sedatives or tranquilizers, barbiturates, hallucinogens, inhalants, ecstasy, gamma hydroxybutyrate, ketamine, synthetic cannabinoids (e.g., K2), bath salts, rohypnol, over-the-counter medications, and other (unspecified) drugs. Prescription opioid misuse is any use that is not considered "use as prescribed," which requires 1) having a current pain problem and taking a prescribed opioid medication for pain during the past 30 days; 2) obtaining the medication only from one's own prescription; and 3) no use of the medication via an alternate route of administration. Prescription stimulant misuse is any use that is not considered "use as prescribed," which requires obtaining the stimulant medication only from one's own prescription and no use of the medication via an alternate route of administration. Misuse is also assigned if a respondent indicates having used the medication during the past 30 days "not in a way prescribed by your doctor to treat a diagnosed attention deficit or hyperactivity disorder." For prescription sedatives and tranquilizers, investigators were unable to determine whether these products, which might or might not be obtained by a prescription but are available in the market with a prescription, were misused specifically.

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