The State of Addiction: 2025

Substance addiction remains a major public health issue in the U.S., spanning alcohol, drug, and nicotine dependence. Below, we present the latest (2023–2025) facts, organized by substance type, with concise, sourced points from credible organizations like the CDC, NIH, and SAMHSA. The statistics highlight prevalence, health impacts, and key demographic trends, with numbered entries and full citations for clarity.

Statistics on Alcohol Addiction in the United States

Prevalence and Patterns of Alcohol Use
  1. An estimated 28.9 million Americans age 12 or older (10.2% of this population) had an alcohol use disorder (AUD) in the past year, according to 2023 NSDUH data. This indicates that roughly 1 in 10 people in the U.S. struggles with alcohol addiction.
  2. About 757,000 adolescents ages 12–17 (2.9% of youths) had AUD in 2023. 
  3. Alcohol use is widespread, with approximately 134.7 million Americans (47.5% of those age 12+) reporting drinking alcohol in the past month as of 2023. In other words, nearly half of the U.S. population are current drinkers, which underlines the need for awareness of healthy vs. harmful drinking patterns.
  4. 2.4% of all diagnoses at Haven Detox facilities in 2025 were for Severe Alcohol Use Disorder — reinforcing alcohol’s leading role in addiction treatment caseload (source: Haven Detox internal data).
  5. Heavy episodic drinking is also very common. About 61.4 million people (21.7% of Americans age 12+) engaged in binge drinking in the past month (defined as 5+ drinks for men or 4+ for women on one occasion).
Alcohol-Related Deaths and Health Risks
  1. Excessive alcohol use kills over 178,000 Americans each year (average for 2020–2021).

  2. Alcohol is one of the leading preventable causes of death in the U.S., second only to tobacco and unhealthy diet/inactivity.

  3. A recent analysis found that 1 in 8 deaths among Americans aged 20–64 was attributable to excessive drinking (based on 2015–2019 data).

  4. Among those 20–49 years old, alcohol’s impact was even higher – about 1 in 5 deaths.

  5. Deaths involving alcohol jumped from 78,927 in 2019 to 99,017 in 2020 – a 25.5% increase in one year.

  6. They rose again to 108,791 deaths in 2021, another 9.9% increase.

  7. There was a slight dip to ~105,000 in 2022, but the 2020–2021 increases represent a concerning trend, possibly reflecting heightened stress, isolation, and reduced access to treatment during the pandemic.

  8. 51,191 directly alcohol-induced deaths were recorded in 2022 (excluding accidents and homicides). These include deaths from conditions like alcohol poisoning, alcoholic liver disease, and alcohol-related organ damage.

  9. In particular, 30,910 deaths in 2022 were due to alcoholic liver disease (scarring and failure of the liver from chronic drinking).

  10. Alcohol is a major driver of liver illness. In 2023, 44.5% of all liver disease deaths (43,004 of 96,610 total) in the U.S. involved alcohol.

  11. Similarly, about half of all cirrhosis (chronic liver scarring) deaths were alcohol-related.

  12. Alcoholic liver disease has become a leading cause of liver transplants in the U.S., reflecting the severe damage chronic drinking can inflict.

Alcohol and Public Safety Issues
  1. Drunk driving remains a deadly consequence of alcohol addiction. In 2022, alcohol-impaired driving was responsible for 13,524 deaths on U.S. roads, accounting for 32% (nearly one-third) of all traffic fatalities that year.

  2. This was the highest number of alcohol-related traffic deaths since 2008, indicating that impaired driving is a persistent public safety problem.

  3. Alcohol misuse is often implicated in suicide as well. An estimated 21.0% of people who die by suicide have a blood alcohol level ≥0.10% (well above the legal limit) at the time of death.

  4. Additionally, alcohol use disorder is the second most common mental health condition among those who die by suicide – it’s involved in roughly 1 in 4 suicide deaths.

Youth and Gender Trends in Alcohol Use
  1. Despite legal drinking age being 21, many teenagers consume alcohol. In 2023, about 1.8 million youth ages 12–17 (6.9%) were current drinkers, and 1.0 million (3.9%) of youths binge drank in the past month.
  2. Historically, men have higher alcohol consumption, but young women are closing the gap. Among young adults (18–25), females now have a slightly higher binge drinking rate than males (31.6% vs 29.9%, as of 2021–2023).
Treatment and Economic Impact of Alcohol Addiction
  1. The vast majority of people with alcohol addiction do not get treatment. In 2023, only 7.9% of people with a past-year alcohol use disorder received any alcohol treatment.

  2. In raw numbers, that means 2.3 million out of ~29 million people with AUD got help, while over 26 million did not.

  3. Excessive drinking also carries a heavy financial cost. The most recent comprehensive analysis (2010) estimated that alcohol misuse cost the United States $249 billion in a year, largely from lost workplace productivity, healthcare expenses, and criminal justice costs.

Statistics on Drug Addiction in the United States

Prevalence and Patterns of Drug Use
  1. Drug addiction (encompassing illicit drugs and prescription drug misuse) is widespread. In 2023, 17.1% of the U.S. population age 12 or older – approximately 48.5 million people – met the criteria for a substance use disorder (SUD).

  2. In an earlier estimate for 2021, about 20.0 million Americans had an illicit drug use disorder in the past year, which rises to 24.0 million when including prescription drug misuse.

  3. Drug use in general is very common. In 2023, 70.5 million people (24.9% of those age 12+) used some illicit drug in the past year. That means roughly 1 in 4 Americans annually engages in use of illicit or misused drugs — whether marijuana, cocaine, opioids, etc.

  4. Marijuana (cannabis) is by far the most widely used illicit substance. In 2023, about 61.8 million Americans (21.8% of people age 12+) used marijuana in the past year.

  5. Use of hallucinogenic drugs has grown in recent years. In 2023, an estimated 8.8 million people used hallucinogens (LSD, psilocybin, MDMA, etc.) in the past year. This is a notable increase; for comparison, only around 1.6 million people used hallucinogens monthly in 2015.

Opioid Addiction and the Overdose Crisis
  1. The misuse of prescription painkillers (opioid medications) remains a significant contributor to drug addiction. In 2023, about 8.6 million people misused prescription opioid pain relievers in the past year.

  2. Opioid addiction continues to be a national crisis. In 2023, an estimated 5.7 million Americans (approximately 2.0% of the population) had an opioid use disorder.

  3. In terms of broader opioid misuse (not just diagnosed disorder), about 8.9 million people (3.1% of Americans) reported misusing opioids in 2023. This rate has remained roughly steady in recent years (3.2% in 2022).

  4. In Haven Detox’s internal admissions data, Opioid Use Disorder, Severe accounted for 0.9% of all diagnoses, while Severe Cannabis Use Disorder represented about 1.0%, and Severe Cocaine Use Disorder accounted for ~0.7%.

The Rise of Stimulant and Cocaine Overdoses
  1. Stimulant addictions (to drugs like methamphetamine and cocaine) are also a concern. In 2023, NSDUH data showed 2.6 million people used methamphetamine in the past year and 5.0 million used cocaine in the past year.
  2. The United States is in the midst of an overdose epidemic. Provisional CDC data show that 107,543 drug overdose deaths occurred in 2023, a slight decrease of 3% from the 111,029 deaths in 2022. This marked the first annual decline in overdose deaths since 2018, offering a glimmer of progress.
  3. However, the toll remains staggeringly high – for context, overdose deaths were around 70,000 in 2017, meaning the annual number is still 50% higher than just five years ago.
  4. The majority of overdose deaths are caused by opioids, particularly illicit fentanyl. In 2023, opioid-related overdose deaths were about 81,000, down slightly from ~84,000 in 2022.
  5. By 2022, synthetic opioids were implicated in 73,838 deaths, which is over two-thirds of all overdose deaths. Fentanyl is often mixed into other drugs, leading to unsuspecting users overdosing.
  6. Deaths from psychostimulants (primarily methamphetamine) have surged in parallel with the opioid crisis. In 2022, approximately 34,022 people died from overdoses involving psychostimulants. This number has risen steadily each year since 2014, largely due to the increased availability of cheap methamphetamine, often laced with fentanyl.
  7. Cocaine-involved overdose deaths have also climbed sharply. In 2022, there were 27,569 overdose deaths involving cocaine, a 73.5% increase since 2019.
  8. A striking aspect of the crisis is how fentanyl has permeated multiple drug supply chains. Nearly 70% of stimulant (meth/cocaine) overdose deaths in 2022 involved fentanyl as well.
Demographic and Mental Health Overlaps
  1. Certain communities bear a disproportionate burden of substance use and addiction. For example, American Indian or Alaska Native and multiracial people have significantly higher rates of substance use and SUDs than other racial/ethnic groups. These disparities, noted in the 2023 NSDUH, point to underlying factors like socioeconomic inequalities, intergenerational trauma, and access to care.
  2. Drug use (and related disorders) is most common in the 18–25 age group. In 2023, 39.0% of young adults ages 18–25 had used illicit drugs in the past year – by far the highest rate of any age group.
  3. By comparison, 14.7% of adolescents ages 12–17 used an illicit drug in the past year, and 23.9% of adults aged 26 or older did so in 2023. Teen drug use is substantially lower than young adults’, partly due to prevention efforts and parental oversight, though 14.7% still indicates millions of teens using (primarily marijuana).
  4. There is a strong overlap between substance addiction and mental health disorders. In 2023, 17.1% of people age 12+ had a substance use disorder, and 22.8% had any mental illness – with many experiencing both.
  5. Among all diagnosed cases at Haven Detox facilities, Generalized Anxiety Disorder (3.2%) and Alcohol Use Disorder, Severe (2.4%) were the two most common diagnoses (source: Haven Detox internal data).
  6. Among admitted Haven Detox patients in 2025, 11.7% were homeless and 21.4% reported living in non-drug-free environments prior to treatment (source: Haven Detox internal data).
  7. Notably, 856,000 adolescents were reported to have had both a major depressive episode and a SUD in the past year.
Treatment Gaps and Recovery Trends
  1. As with alcohol, most people addicted to drugs are not getting treatment. Among the 48.5 million Americans with any SUD in 2023, 85.4% (about 41.1 million people) received no substance use treatment in the past year.

  2. Only 15.6% (7.1 million) received treatment for their addiction. Young adults (18–25) were the least likely to get help.

  3. On a hopeful note, many Americans have successfully overcome substance problems. A 2023 survey found that 30.5 million adults (12%) acknowledge having had a substance use problem in their lifetime, and 22.2 million of them (73%) consider themselves “in recovery”.

Statistics on Nicotine Addiction in the United States

Smoking Trends and Health Risks
  1. Cigarette smoking has declined to record lows. In 2022, only 11.6% of U.S. adults (28.8 million people) were current cigarette smokers.

  2. This is a dramatic drop from past decades – for instance, in 1965 about 42% of adults smoked, so rates have fallen by 73% over the long term. Nonetheless, over 28 million adults still smoke, which means nicotine addiction remains a significant issue.

  3. Many people use tobacco/nicotine in forms beyond just cigarettes. In 2022, 19.8% of adults (49.2 million people) were current users of any tobacco product (including cigarettes, cigars, e-cigarettes, smokeless tobacco, etc.). In other words, nearly 1 in 5 adults use nicotine in some form, highlighting that while cigarette smoking declined, other products (like e-cigarettes) have gained traction.

  4. Nicotine addiction from tobacco exacts a huge health toll. Cigarette smoking remains the #1 cause of preventable disease and death in the United States, responsible for more than 480,000 deaths each year. This means smoking kills roughly half a million Americans annually – more than the yearly deaths from alcohol, drug overdoses, homicide, and HIV combined.

  5. Men are more likely to smoke than women, and middle-aged adults smoke more than younger or older adults. In 2022, 13.1% of adult men smoked vs. 10.1% of adult women.

  6. By age group, the highest smoking rate was observed among those 45–64 years old (14.9%), while the lowest was among young adults 18–24 (only 5.3%).

Tobacco and Nicotine Use Among Youth
  1. Nicotine use among teenagers has been declining in recent years, especially for vaping. In 2023, 10.0% of U.S. middle and high school students (about 2.80 million youth) reported current use of any tobacco product.
  2. This was a notable improvement from 2022, when 11.3% of teens (3.08 million) used tobacco.
  3. E-cigarettes remain the most popular tobacco product among teens. In 2023, 7.7% of middle/high school students (2.13 million kids) used e-cigarettes.
  4. Among high schoolers alone, vaping fell from 14.1% in 2022 down to 10.0% in 2023, a substantial decline.
  5. While this downturn is encouraging, the fact that 1 in 10 high school students still vapes – and 25% of those vape users do so daily – shows that nicotine addiction is still affecting a significant minority of youth.
Vaping Trends in Adults
  1. In adults, vaping has been increasing as some smokers switch to e-cigarettes or new users pick up vaping. In 2023, 6.5% of U.S. adults reported using e-cigarettes, up from 4.5% in 2019. This upward trend means roughly 16 million adult vapers (since there are ~250 million adults in the U.S.).

  2. Notably, young adults (age 21–24) have the highest vaping rate at 15.5% in 2023, suggesting that many nicotine users of the younger generation prefer vaping over traditional smoking.

  3. Overall, when combining adults and youth, the number of people using electronic cigarettes is substantial. An estimated 26.6 million Americans vaped nicotine in the past month in 2023 (this includes all ages 12 and up)

Other Forms of Tobacco Use
  1. While cigarettes and e-cigarettes dominate, other tobacco products also contribute to nicotine addiction. In 2023, about 7.0 million people used smokeless tobacco (chewing tobacco, dip, snuff) in the past month.

  2. Additionally, 10.7 million smoked cigars and 2.0 million smoked pipe tobacco in the past month.

 
Secondhand Smoke, Advertising, and Policy Responses
  1. For every smoking-related death, many more live with illness. It’s estimated that over 16 million Americans are living with a disease caused by smoking (such as emphysema, heart disease, or cancer).
  2. Menthol cigarettes (a mint-flavored type) are used disproportionately by certain groups, contributing to addiction disparities. Around 37% of adult smokers smoke menthols, with rates highest among Black smokers (around 85% of Black smokers use menthol brands).
  3. The good news is that quitting smoking is also common. Over 60% of adults who ever smoked have quit – there are now more former smokers than current smokers in the U.S.
  4. Surveys indicate roughly 55% of smokers made a quit attempt in the past year, and many used nicotine replacement or other aids.
  5. Nicotine addiction doesn’t just harm the user – it endangers others through secondhand smoke. Each year, secondhand smoke exposure causes an estimated 41,000 deaths among non-smoking Americans, including from lung cancer and heart disease.
  6. In the U.S., cigarette and smokeless tobacco companies spend over $8 billion per year on advertising and promotions (nearly $1 million every hour) – often targeting price discounts that make tobacco more affordable.
  7. In response to the youth vaping epidemic, new regulations have been implemented. The FDA banned most flavored cartridge-based e-cigarettes in 2020 and has begun reviewing vape products for authorization.
  8. Many states have also raised the tobacco sales age to 21 (nationally enacted in 2019) and restricted retail sales of vaping products. Early data suggest these measures are helping – as seen by the decline in high school vaping from 2020 to 2023.

Conclusion

Substance addictions continue to take a major toll on Americans in 2023–2025, from rising alcohol-related deaths to a worsening opioid overdose crisis and persistent nicotine dependence. While cigarette smoking rates are at record lows, challenges like e-cigarette use and untreated addiction remain. Yet there is progress: over 22 million Americans now identify as in recovery. These trends highlight both the urgency of action and the impact of evidence-based policies, expanded treatment access, and prevention efforts in turning the tide on the U.S. addiction crisis.

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  2. Alcohol-Related Emergencies and Deaths in the United States | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  3. Deaths from Excessive Alcohol Use — United States, 2016–2021 | MMWR
  4. 1 in 5 deaths of US adults 20 to 49 is from excessive drinking | CNN
  5. Alcohol and the Human Body | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  6. Alcohol Use in the United States: Age Groups and Demographic Characteristics | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  7. National Survey Reveals Sex Shift in Alcohol Use | Conexiant
  8. Alcohol Treatment in the United States | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  9. FastStats – Alcohol Use (CDC)
  10. Economic Burden of Alcohol Misuse in the United States | National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  11. SAMHSA releases new data on rates of mental illness and substance use disorder in the U.S. | National Association of Counties
  12. 2021 National Survey on Drug Use and Health (NSDUH) Releases | CBHSQ Data
  13. Key Substance Use and Mental Health Indicators in the United States: Results from the 2023 National Survey on Drug Use and Health
  14. U.S. Overdose Deaths Decrease in 2023, First Time Since 2018 
  15. Drug Overdose Deaths: Facts and Figures | National Institute on Drug Abuse (NIDA)
  16. Burden of Cigarette Use in the U.S. | Data and Statistics | Campaign Resources | Tips From Former Smokers | CDC
  17. Tobacco Trends Brief: Overall Tobacco Trends Brief | American Lung Association
  18. Current Cigarette Smoking Among Adults in the United States | Smoking and Tobacco Use | CDC
  19. Tobacco Product Use Among U.S. Middle and High School Students — National Youth Tobacco Survey, 2023 | MMWR
  20. Electronic Cigarette Use Among Adults in the United States, 2019–2023 (CDC) 
  21. Tobacco Use – Healthy People 2030 | odphp.health.gov
  22. Quitting Tobacco: Facts and Stats | Truth Initiative
  23. Patterns of Smoking Cessation Among U.S. Adults, Young Adults, and Youth | NIH   
  24. Tobacco-Related Mortality | CDC 
  25. Burden of Cigarette Use in the U.S. | Data and Statistics | Campaign Resources | Tips From Former Smokers | CDC
  26. Impact of the FDA flavour enforcement policy on flavoured electronic cigarette use behaviour changes – PMC 
  27. Tobacco 21 | FDA 

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