Substance Use Disorder Demographics

Addiction is a chronic, yet treatable medical condition that impacts individuals from all walks of life, regardless of their gender, age, race, socioeconomic status, or occupation.

While addiction can happen to anyone, the article will discuss the unique ways substance use disorders affect people across a variety of demographic groups.

Addiction Statistics for Different Demographics

By taking a closer look at how addiction affects various demographic groups, it is possible to discover patterns of substance use that teach us more about the disease of addiction and overall health of our nation.

Some subsets of the American population are disproportionally affected by substance abuse, and access to addiction treatment does unfortunately differ, often by race and gender.¹

Statistics from the 2020 National Survey of Drug Use and Health, a nationwide report that tracks substance misuse and treatment across many demographic groups in America, help provide a current picture of addiction in the United States:

• In 2020, more than 40 million Americans aged 12 or older suffered from a substance use disorder, up from 20 million Americans in 2018.^2,3
• Among people with a substance use disorder in 2020, 6.5 million people had both an illicit drug use disorder and an alcohol use disorder.²
• Substance use disorders in 2020 were highest among young adults aged 18 to 25 (8.2 million people).²

Addiction Among Women

The 2020 National Survey on Drug Use and Health found that:⁴

• More than 41 million adult women in the United States suffered from a mental disorder and/or substance use disorder.
• 4 in 9 (7.4 million) women with a substance use disorder struggled with illicit drugs.
• 7 in 10 (12.2 million) women with a substance use disorder struggled with alcohol use.
• 1 in 7 (2.5 million) women with a substance use disorder struggled with both alcohol and illicit drugs.
• More than 16% of women between the ages of 18 and 25 had an alcohol use disorder in the past year.
• Over 5 million women misused opioids and over 1.5 million women had an opioid use disorder.
• The most commonly used illicit drug among pregnant women aged 15 to 44 was marijuana.

Learn more about addiction among women.

Addiction Among Men

Research on substance use among men has found that:

• Men are more likely to use all types of illicit drugs than women.⁵
• Men show consistently higher rates of alcohol-related hospitalizations and deaths.⁵
• Illicit drug use is more likely to result in an overdose death for men than for women.⁵
• Almost 25% of adult American men report binge drinking about 5 times per month.⁶
• Men are nearly 2 times more likely than women to binge drink alcohol.⁶
• Men are more likely than women to use alcohol before committing suicide.⁶

Although men have higher rates of drug and alcohol use than women across the board, women are just as likely as men to develop a substance use disorder.⁵

Addiction Among Adolescents and Young Adults

The following shows a glimpse of how addiction affects adolescents and young adults in the United States:²

• 6.3% of adolescents (aged 12 to 17) had a substance use disorder in 2020.
• 24.4% of young adults (aged 18 to 25) had a substance use disorder.
• Around 1 in 5 adolescents (4.5 million) perceived that the COVID-19 pandemic negatively affected their mental health “quite a bit or a lot.”
• 3.9 million young adults and 1.3 million adolescents reported using vaping devices within the past month of taking the survey.
• Approximately 90% of people tried cigarettes for the first time by the age of 25.
• Young adults were more likely to have an illicit drug use disorder than adolescents.

Addiction Among the LGBTQ+ Community

Millions of people in the LGBTQ+ community struggle with mental illness and substance use disorders. The LGBTQ+ community includes both sexual orientation (i.e. lesbian, gay, bisexual) and gender identity (i.e. transgender).⁷

Among adults who identify as lesbian, gay, or bisexual (LGB), data from the 2020 National Survey on Drug Use and Health shows that:⁸

• 10.3 million people (61.6% of the community) had a substance use disorder or mental illness in the past year.
• 3 out of 5 adults with a substance use disorder struggled with illicit drugs.
• 2 out of 3 adults with a substance use disorder struggled with alcohol use.
• 1 in 4 adults with a substance use disorder struggled with both alcohol and illicit drugs.
• 3.5 million adults aged 18+ had an alcohol use disorder in the past year.
• 6.6 million people had a marijuana use disorder in the past year.
• 2.2 million people had a psychotherapeutic drug use disorder in the past year and 1.8 million people had a hallucinogen use disorder in the past year.

Polysubstance use (using more than one substance at the same time) is common among the LGB community. Polysubstance use involving opioids (i.e., heroin or prescription painkillers combined with alcohol or cocaine) may significantly increase a person’s risk of fatal overdose, compared to those who only use one substance.⁸

The survey also found that LGB adults aged 18+ who misused opioids in 2020 were more likely to use cocaine and methamphetamine in the past year than those who did not misuse opioids.⁸

Addiction Among Black Americans

The following provides more information about addiction among Black Americans in 2020:⁹

• 8.1 million African American adults aged 18 or older had a substance use disorder and/or mental illness.
• Nearly 3 out of 4 African Americans with a substance use disorder struggled with alcohol use.
• 2.9 million Black Americans had an alcohol use disorder in the past year.
• Opioid use disorders were most common among African Americans aged 26+.
• Marijuana was the most commonly used illicit drug, followed by psychotherapeutic drugs.

Similar to many other subsets of the population in the United States, Black Americans are seeing a significant increase in marijuana use, particularly among the 26 and older crowd. Even though there’s a noticeable increase in use, there hasn’t been a similar rise in marijuana use disorders.⁹

Black Americans are seeing a disturbing trend in mental illness, including an increase in mental health disorders, depressive episodes, suicidal thoughts, and co-occurring disorders (or when someone suffers from a mental health disorder and addiction at the same time).⁹

Perhaps the most alarming trend among African Americans is the lack of treatment for substance use disorders: 94.8% of those diagnosed with a SUD did not seek out or receive addiction treatment.⁹

Discrimination and social pressures may play a role in substance misuse within the Black community. A study on drug use among Black Americans found a stronger association between racial discrimination and frequent illicit drug use, compared to those in a higher socioeconomic position (SEP).¹⁰

Addiction Among Asian Americans/Native Hawaiians and Other Pacific Islanders

According to the 2020 National Survey on Drug Use and Health:¹¹

• 7% of Native Hawaiians and Other Pacific Islanders (1.5 million) aged 12 and older had a substance use disorder in the past year.
• 2% of this group had both a substance use disorder and a mental illness in the past year.
• American/NHOPI young adults aged 26 or older had the highest number of people with alcohol use disorders.
• The most common illicit drug used among Asian Americans/NHOPI aged 12+ was marijuana.
• 7% of this group had a pain reliever use disorder and 0.1% of the population had a heroin use disorder.

Most people in this group who misused opioids were misusing prescription pain relievers.¹¹

NHOPIs tend to misuse substances at much higher rates than the national average and other minority groups. This may be due to the fact that many live on islands with limited available care and a lack of economic opportunity.¹²

In addition, easy and regular access to drugs and alcohol at a young age may be common, and NHOPIs may be less likely to seek healthcare than other population groups.¹²

Addiction Among Native Americans

The 2020 National Survey on Drug Use and Health gathered following data on addiction among American Indians and Alaskan Natives (AI/ANs):¹³

• Marijuana was the most common illicit drug used among AI/AN people aged 12 or older, followed by psychotherapeutic drugs and hallucinogens.
• 7% of adults aged 26+ used marijuana daily or almost daily in 2020.
• 401,000 AI/ANs with a substance use disorder sought treatment.
• More than half of those who sought treatment received outpatient services.

Much of the data for AI/ANs from the 2020 survey—especially compared to the other demographic groups—was unavailable due to low precision.

AI/AN adults age 26 and up have seen significant increases in methamphetamine use, as well as increases in major depressive episodes in 18- to 25-year-olds, specifically among women. Alternatively, there has been a significant decline in cocaine use in young AI/AN adults.³

Substance misuse in minority populations may be considered the result of acculturation, or assimilation into a new culture. Native American elders, for example, believe troubles with addiction can occur when individuals lose connection to their culture and heritage. Evidence suggests that individuals who are closely connected to both sets of cultural values have fewer difficulties with alcohol or drug concerns.¹⁴

Additionally, a general mistrust of outside healthcare providers and cultural differences may prevent American Indians and Alaskan Natives from seeking mental health and/or substance abuse treatment. This group tends to be less likely to enter into treatment programs and may instead focus on traditional healing methods.³

Addiction Among Hispanic/Latino Americans

Hispanics and Latino Americans are the second-largest and fastest-growing race demographic in the country.¹⁵

The following statistics report addiction rates among Hispanic/Latino Americans in 2020:¹⁶

• 5.7 million people aged 18 or older had a substance use disorder.
• 7.7 million people aged 18+ had a mental illness.
• 2.4 million people aged 18 or older had both a substance use disorder and a mental illness.
• Among Hispanics with a substance use disorder, 3 in 4 struggled with alcohol use and 4 in 9 struggled with illicit drugs.
• Past-year alcohol use disorders were highest among Hispanic young adults aged 18 to 25.
• Marijuana was the most commonly used illicit drug among Hispanics in 2020.

Substance abuse occurs more frequently among Latino Americans who also have a co-occurring mental health disorder, no matter their age. It’s also common for someone from this population group who abuses one substance to abuse multiple substances, as well as have a mental health disorder. Co-occurring substance use and mental health disorders among Latino Americans is associated with increased suicidal thoughts, plans, and attempts.³

Hispanics have a strong sense of family that often differs from the white American nuclear family. Hispanic culture places women in a special place as the matriarchs of the family unit and has strict sanctions against women drinking.¹⁷

Those born within the U.S. or who immigrated at a young age may have higher rates of substance misuse than those born abroad or immigrating later in life, as the stress of acculturation and attempts to conform to a new society may increase drug and alcohol usage.¹⁷

In general, Latino Americans have worse outcomes in addiction treatment programs, though little is known as to why, largely because the issue hasn’t been studied well.¹⁸

Addiction Among White Americans

White Americans are the largest racial and ethnic group in the U.S.¹⁵ According to the 2020 National Survey on Drug Use and Health:¹⁹

• Nearly a quarter of white Americans aged 12 and older reported binge drinking in the past month.
• More than half of white Americans aged 12 and older have engaged in illicit drug use in their lifetime, while 22.5% engaged in illicit drug use in the past year.
• Over 19% of white Americans aged 12 and up used marijuana in the past year.

Among this demographic group, young adults aged 18–25 had the highest rates of addiction, including:

• 17% who met the criteria for an illicit drug use disorder in the past year.
• Nearly 19% who met the criteria an alcohol use disorder.
• 9% who met the criteria for any substance use disorder.

White Americans, and specifically white men, experience the highest rates of opioid misuse and deaths from opioid overdose. An estimated 47,304 white Americans died from an opioid overdose in 2020.²⁰ This may be due in part to the lack of effective addiction treatment in rural areas—92% of addiction treatment facilities are in urban locations.^21,22

In general, white Americans have fewer barriers to treatment than other races in the U.S. However, Americans of any race in rural areas, those living in poverty, and those without health insurance may have a difficult time accessing addiction treatment.^22,23

Finding Customized Addiction Care

Minority groups or people of color may suffer from substance abuse or mental health disorders at high rates due to difficulties accessing care, as well as other environmental, social, and financial concerns.

It is important not to generalize and assume that all people of specific races need the same thing. Each person is an individual.²⁴

While certain considerations for particular cultures or ethnicities may be made, each person will respond to treatment differently and has unique needs for care and recovery. A person’s culture, spiritual and religious beliefs, and primary language are all factors to be considered and accommodated during treatment. Social stigmas may need to be carefully dispelled and cultural sensitivity is vital.²⁴

American Addiction Centers’ facilities like AdCare understand the need for personalized, individualized treatment plans. Some locations even offer translators if necessary.

To learn more about the programs at our inpatient rehab in Rhode Island, ways to pay for rehab, or using insurance to pay for rehab, contact us at . Our admissions navigators are available around the clock to answer any questions and help start the admissions process.

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