NSDUH 2020 released, new numbers reflected in new methodology

Abstract

There were almost 40 million people with substance use disorder in the United States in 2020, according to the most recent National Survey on Drug Use and Health (NSDUH), released by the Substance Abuse and Mental Health Services Administration (SAMHSA) Oct. 26. At first blush, this might seem like a huge increase from the previous NSDUH, but in fact, the methodology changed. The previous surveys may have undercounted people with the condition by far. In addition, COVID‐19 undoubtedly played a role in increased reliance on alcohol and other substances as people tried to cope with the pandemic. Nobody should be surprised by the change in methodology, but memories can be short. As announced two years ago (see “SAMHSA plans changes to NSDUH: DSM‐5 updates,” ADAW, Aug. 19, 2019; https://onlinelibrary.wiley.com/doi/10.1002/adaw.32461), SAMHSA updated the methodology to transfer from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria and added questions about craving. These changes were more sensitive to substance use disorders and do not mean that incidence of the problem “doubled” from 20 to 40 million or anything remotely like that. In fact, SAMHSA specifically states that the 2020 NSDUH should not be compared to previous years. Next week: full coverage of the survey. For the full report, go to https://www.samhsa.gov/data/data‐we‐collect/nsduh‐national‐survey‐drug‐use‐and‐health.