Visit for the latest Coronavirus Disease (COVID-19) updates.

You are here

Substance Abuse

Substance Abuse


Reduce substance abuse to protect the health, safety, and quality of life for all, especially children.


In 2005, an estimated 22 million Americans struggled with a drug or alcohol problem. Almost 95 percent of people with substance use problems are considered unaware of their problem.* Of those who recognize their problem, 273,000 have made an unsuccessful effort to obtain treatment. These estimates highlight the importance of increasing prevention efforts and improving access to treatment for substance abuse and co-occurring disorders.1

Why Is Substance Abuse Important?

Substance abuse has a major impact on individuals, families, and communities. The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental, and public health problems. These problems include:

  • Teenage pregnancy
  • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
  • Other sexually transmitted diseases (STDs)
  • Domestic violence
  • Child abuse
  • Motor vehicle crashes
  • Physical fights
  • Crime
  • Homicide
  • Suicide1

The field has made progress in addressing substance abuse, particularly among youth. According to data from the National Institute of Drug Abuse (NIDA) Monitoring the Future (MTF) survey, which is an ongoing study of the behaviors and values of America’s youth between 2004 and 2009:

A drop in past-year use of methamphetamine was reported for all grades, and lifetime use dropped significantly among 8th graders, from 2.3 to 1.6 percent.

Among 10th and 12th graders, 5-year declines were reported for past-year use of amphetamines and cocaine; among 12th graders, past-year use of cocaine decreased significantly, from 4.4 to 3.4 percent.

Decreases were observed in lifetime, past-year, past-month, and binge use of alcohol across the 3 grades surveyed.

In addition, in 2009:

  • Past-year use of hallucinogens and LSD fell significantly, from 5.9 to 4.7 percent, and from 2.7 to 1.9 percent, respectively.
  • Past-year use of hallucinogens other than LSD decreased from 5.0 to 4.2 percent among 12th graders.
  • Marijuana use across the 3 grades showed a consistent decline starting in the mid-1990s; however, the trend in marijuana use has stalled, with prevalence rates remaining steady over the past 5 years.

Back to Top

Understanding Substance Abuse

Substance abuse refers to a set of related conditions associated with the consumption of mind- and behavior-altering substances that have negative behavioral and health outcomes. Social attitudes and political and legal responses to the consumption of alcohol and illicit drugs make substance abuse one of the most complex public health issues. In addition to the considerable health implications, substance abuse has been a flash-point in the criminal justice system and a major focal point in discussions about social values: people argue over whether substance abuse is a disease with genetic and biological foundations or a matter of personal choice.

Advances in research have led to the development of evidence-based strategies to effectively address substance abuse.

Improvements in brain-imaging technologies and the development of medications that assist in treatment have gradually shifted the research community’s perspective on substance abuse. There is now a deeper understanding of substance abuse as a disorder that develops in adolescence and, for some individuals, will develop into a chronic illness that will require lifelong monitoring and care.

Improved evaluation of community-level prevention has enhanced researchers’ understanding of environmental and social factors that contribute to the initiation and abuse of alcohol and illicit drugs, leading to a more sophisticated understanding of how to implement evidence-based strategies in specific social and cultural settings.

A stronger emphasis on evaluation has expanded evidence-based practices for drug and alcohol treatment. Improvements have focused on the development of better clinical interventions through research and increasing the skills and qualifications of treatment providers.

Emerging Issues in Substance Abuse

In recent years, the impact of substance and alcohol abuse has been notable across several areas, including the following:

Adolescent abuse of prescription drugs has continued to rise over the past 5 years. The 2007 MTF survey found high rates of nonmedical use of the prescription pain relievers Vicodin and OxyContin. It is believed that 2 factors have led to the increase in abuse. First, the availability of prescription drugs is increasing from many sources, including the family medicine cabinet, the Internet, and doctors. Second, many adolescents believe that prescription drugs are safer to take than street drugs.2

Military operations in Iraq and Afghanistan have placed a great strain on military personnel and their families. This strain can lead to family disintegration, mental health disorders, and even suicide. Data from the Substance Abuse and Mental Health Services Administration (SAMSHA) National Survey on Drug Use and Health indicate that from 2004 to 2006, 7.1 percent of veterans (an estimated 1.8 million people) had a substance use disorder in the past year.3

In addition, as the Federal Government begins to implement health reform legislation, it will focus attention on providing services for individuals with mental illness and substance use disorders, including new opportunities for access to and coverage of treatment and prevention services.


1US Department of Health and Human Services (HHS), Office of Disease Prevention and Health Promotion. Healthy People 2010 midcourse review: Focus area 26, substance abuse [Internet]. Washington: HHS; 2006 [cited 2010 April 12]. Available from: [PDF - 1.36 MB]

2National Institutes of Health, National Institute on Drug Abuse (NIDA). Prescription Drug Abuse: A Research Update from the National Institute on Drug Abuse [Internet]. Bethesda, MD: NIDA; 2011 Dec [cited 2017 Aug 23].

3National Institutes of Health, National Institute on Drug Abuse (NIDA). NIDA topics in brief: Substance abuse among the military, veterans, and their families. Bethesda, MD: NIDA; 2009 Jul [cited 2010 Apr 22]. Available from:


*The term “problem” is defined as meeting the diagnostic criteria for treatment for the abuse of or dependence on alcohol and illicit drugs. This definition includes the nonmedical use of prescription drugs and also includes adolescents who meet the diagnostic criteria. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies.

Back to Top