US illicit drug use rose by 7.8 million people since 2021, per SAMHSA

Illicit drug use increased between 2021 and 2025, rising from 22.2% (62 million people) to 24% (69.8 million), according to Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2025 Companion Infographic Report.

The findings are based on the 2021-2025 National Surveys on Drug Use and Health, an annual survey of the U.S. noninstitutionalized population age 12 and older. SAMHSA evaluated whether measures showed statistically significant increases, decreases or no change between the 2021 baseline and 2025 using linear trend testing at the 0.05 significance level.

Here are nine things to know:

1. Marijuana use increased from 19% (53.2 million) to 21.2% (61.6 million), while adolescent marijuana use decreased from 10.9% to 8.7%.
   
2. Opioid misuse declined from 3.2% (9.1 million) in 2021 to 2.4% (7.1 million) in 2025. Illegally made fentanyl use showed no significant change since comparable data became available in 2022.
   
3. Substance use disorder decreased from 16.7% (46.8 million) to 15.3% (44.6 million). Alcohol use disorder and opioid use disorder also declined over the period.
   
4. Alcohol use fell from 47.4% to 44.4%, while binge drinking declined from 21.7% to 19.5% and heavy alcohol use decreased from 5.7% to 5%.
   
5. Adult cigarette smoking declined from 16% to 12.4%. Nicotine vaping estimates cannot be compared with 2021 because of methodological changes, but vaping increased between 2022 and 2025.
   
6. Serious mental illness decreased from 7.9% (20.1 million) to 6.9% (18.2 million), while the prevalence of any mental illness showed no significant change.
   
7. Major depressive episodes among adults decreased from 8.5% (21.6 million) to 7.4% (19.7 million). Co-occurring major depressive episodes and substance use disorder also declined.
   
8. Adult suicide plans and suicide attempts increased over the five-year period, while serious thoughts of suicide showed no significant change.
   
9. Among adolescents, suicidal thoughts, suicide plans and suicide attempts all declined between 2021 and 2025.

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