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Statistics show that 22.5 million Americans aged 12 and over were classified with substance dependence or abuse in 2004.1 Additionally, 17 million people under the age of 18 live in a household where a parent or other adult is a binge or heavy drinker, and more than 9 million live with a parent or other adult who uses illicit drugs.2

Yet, there is hope. Like other chronic diseases, substance use disorders are medical conditions that can be treated effectively.3 People in recovery can spread a positive message to others, telling people what to expect from treatment and demonstrating that treatment is effective and recovery is possible. People in recovery can and do rejoin their families, their jobs, and their lives and communities.

Still, substance abuse disorders continue to be a major public health problem in the US. In 2004:

Among youths ages 12 to 17, an estimated 8.8% (2.2 million) were classified with substance dependence or abuse 4
An estimated 7.9% of Americans age 12 or older (19.1 million) were current users of illicit drugs, meaning they had used an illicit drug during the previous month
About 22.8% of Americans aged 12 and over (55 million) said they had participated in binge drinking (5 or more drinks on the same occasion) at least once in the past 30 days. A “drink” is defined as a 12 oz. can or bottle of beer, a 6 oz glass of wine, a wine cooler, a 1.5 oz shot of liquor, or a mixed drink with liquor in it.

1. Overview of Findings from the National Survey on Drug Use and Health, DHHS Publication No. (SMA) 05-4061, Rockville, MD, US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September, 2005, p. 7.

2. Grant, BF, “Estimates of US children exposed to alcohol abuse and dependence in the family”, American Journal of Public Health, 90(1), 2000, 112-115.

3. CASA Analysis of the National Survey on Drug Use and Health, New York, The National Center on Addiction and Substance Abuse at Columbia University, 2005.

4. Results from the 2004 National Survey on Drug Use and Health, DHHS Publication No. (SMA) 05-4062, Rockville, MD.

Much has been written about substance abuse, dependence, and addiction, and many studies have used different terminologies to explain their findings. To foster greater understanding and avoid perpetuating the stigma associated with these conditions, the phrase “substance use disorders” is used as an umbrella term to encompass all of these concepts.

People with substance use disorders often also have co-occurring disorders at the same time. This can include having serious psychological distress (SPD) while also suffering from a substance use disorder. Meeting the criteria for SPD indicates that a person exhibits high levels of distress due to any type of mental problem, which may include general symptoms related to phobias, anxiety of depression. For more information on these criteria, consult the 2004 National Survey on Drug Use and Health, which is available on the Web at

Adults with SPD are more likely to have substance use disorders than those who do not have SPD. In some cases, substance use disorders precede the development of mental health problems. For instance, anxiety and depression may be brought on as a response to stressors from broken relationships, lost jobs, and other situations. For more information about mental illness and health, you can visit the National Mental Health Association on the Web at

Overcoming substance use disorders is possible and there are many ways to accomplish this. People directly affected by substance use disorders need to learn about common misconceptions surrounding them. The general public also needs to be educated about stigma and discrimination in relation to substance use disorders and recovery. Stigma and discrimination can be tackled by public education about treatment effectiveness and stories about sustained recovery. Special training on strategies for reducing stigma and discrimination can also be helpful.

Being aware of how we talk about substance use disorders and the people who have them can also help. Stigmatizing words can discourage, isolate, shame, and embarrass those needing help.

When people with substance use disorders enter treatment, the healing can be significant. One year after treatment, people report a significant reduction in their alcohol and drug use, increase employment and income, improvements in mental and physical health, decreases in homelessness, and decreases in risky sexual behaviors.

Helping people with substance use disorders get into treatment and confronting the stigma and discrimination against those who suffer from these disorders are the first steps toward building a stronger, healthier community.

For additional information, please visit the Substance Abuse and Mental Health Services Administration website at