THE 2025 National Survey on Drug Use and Health shows improving behavioral health trends among adolescents and young adults.
Based on self-reported responses from more than 60,000 people, the national survey examined substance use and mental health outcomes across the U.S. population between 2021 and 2025. Adolescents aged 12–17 years and young adults aged 18–25 years experienced declining or stable prevalence across most behavioral health indicators during this period.
National Survey on Drug Use Shows Youth Progress
Among adolescents, declines were reported in past-month tobacco, alcohol, binge drinking, and marijuana use. Past-year illicit drug use, substance use disorders, major depressive episodes, suicidal thoughts, suicide planning, and suicide attempts also decreased.
Young adults experienced declines in nicotine, tobacco, cigarette, vaping, alcohol, binge drinking, and marijuana use. Reduced prevalence was also observed for cocaine, hallucinogen, and prescription medication misuse, alongside decreases in substance use disorder, alcohol use disorder, mental illness, and suicidal behaviors.
Despite these trends, behavioral health conditions remained common. In 2025, 18.0% of adolescents had moderate or severe anxiety symptoms during the previous 2 weeks, while 15.1% experienced a major depressive episode during the past year. Among adults, 20.6% had any mental illness and 6.9% had serious mental illness.
Substance Use Patterns Remain Mixed
More than half of people aged 12 years or older reported using tobacco, vaping nicotine, drinking alcohol, or using an illicit drug during the past month. Marijuana remained the most commonly used illicit drug, with past-year use increasing from 19.0% in 2021 to 21.2% in 2025.
By contrast, prescription opioid misuse declined from 3.0% to 2.4%. Past-year substance use disorder also decreased from 16.7% to 15.3%, driven partly by a reduction in alcohol use disorder.
Treatment Gaps Persist Across Behavioral Health
Only 16.0% of the estimated 47.2 million people who needed substance use treatment received it. Among people with opioid use disorder, 15.7% received medication, while only 2.6% of those with alcohol use disorder received medication.
Mental health treatment reached 57.7% of adolescents with a major depressive episode and 50.9% of adults with any mental illness. Common barriers included cost, limited time, uncertainty about accessing care, stigma, and beliefs that individuals should manage their conditions independently.
These findings suggest that improving youth trends have not eliminated the substantial need for accessible substance use and mental health services.
Reference
Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA Releases Annual National Survey on Drug Use and Health. 27 July 2026. Available at: https://www.samhsa.gov/newsroom/press-announcements/20260727/samhsa-releases-annual-national-survey-on-drug-use-and-health. Last accessed: July 30, 2026.
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