Alcohol and Substance Use Disorders (SUD)

Substance use disorders (SUD) affect millions of Americans and are a major contributor to preventable illness and death. According to the National Institute on Drug Abuse (NIDA), over 46 million people aged 12 or older met the criteria for at least one SUD in 2021, representing nearly 17% of the U.S. population in that age group⁶. In 2022 alone, over 109,000 drug overdose deaths occurred in the United States, with fentanyl and other synthetic opioids involved in nearly 70% of those fatalities⁴. In addition, alcohol-related deaths have more than doubled in the past two decades, with alcohol now contributing to more than 1 in 10 deaths among working-age adults⁵.

High-risk populations include adolescents, older adults, individuals with co-occurring mental health disorders, LGBTQ+ individuals, pregnant and postpartum people, and those with a history of trauma or chronic pain^2,3. Youth with untreated anxiety, depression, or ADHD are particularly vulnerable, as early substance use increases the risk of addiction later in life. Among older adults, even moderate alcohol or medication misuse can exacerbate chronic illnesses, increase fall risk, and interact with prescription drugs.

Primary care and behavioral health providers are well-positioned to identify early warning signs of SUD through regular screening, clinical observation, and open dialogue. Evidence-based treatment typically includes a multidisciplinary approach, combining behavioral therapies, family and community support, and medication management when indicated^2,3. Close follow-up and coordination of care, especially for patients with complex social or medical needs, are essential to improving outcomes.