In the United States, roughly 48.4 million people aged 12 or older had a substance use disorder in 2024, according to the national household survey conducted by SAMHSA. That’s about 16.8% of the population in that age group, or nearly 1 in 6 Americans. Globally, the numbers are far larger, with hundreds of millions affected by drug and alcohol use disorders combined.
U.S. Drug Addiction by the Numbers
The most comprehensive picture of addiction in the United States comes from the National Survey on Drug Use and Health, which interviews tens of thousands of households each year. The 2024 survey found 48.4 million people met the criteria for a substance use disorder in the past year. This figure includes both drug and alcohol use disorders, since many people struggle with more than one substance at a time.
To put that in perspective, more Americans have a substance use disorder than the entire population of California. The 16.8% prevalence rate means that in a room of six adults, statistically one of them is dealing with addiction right now or was within the past year.
Which Drugs Affect the Most People
Not all substances carry equal weight in the addiction numbers. Opioids, stimulants, and alcohol each account for distinct portions of the total.
- Opioids: An estimated 2.5 million adults had opioid use disorder in 2021. This includes both prescription painkillers and illicit opioids like heroin and fentanyl. Opioids drive a disproportionate share of overdose deaths relative to their user base.
- Stimulants: About 4.3 million people had a stimulant use disorder in 2023. Within that group, 1.8 million were specifically addicted to methamphetamine and 1.3 million to cocaine.
- Alcohol: Globally, an estimated 400 million people live with alcohol use disorder, making it by far the most common addiction worldwide. In the U.S., alcohol use disorder accounts for a large share of the 48.4 million total.
These categories overlap. Someone addicted to both opioids and methamphetamine, for example, would appear in multiple counts but is one person in the 48.4 million total.
The Global Picture
Worldwide, over 3 million people die each year from alcohol and drug use combined. In 2019, approximately 600,000 deaths were directly attributable to drug use alone. Opioids account for close to 80% of those deaths, with about 125,000 people dying from opioid overdose specifically. The majority of drug-related deaths globally occur among men.
These figures almost certainly undercount the true toll. Many countries lack robust tracking systems, and drug-related deaths are frequently misclassified on death certificates or go unreported entirely.
How Many People Die From Overdoses in the U.S.
Drug overdose deaths in the United States have been declining from their peak but remain historically high. Provisional data through late 2025 shows roughly 68,000 to 70,000 overdose deaths in the most recent 12-month period. That’s a notable drop from the peak of over 110,000 annual deaths recorded in recent years, largely driven by changes in the fentanyl supply and expanded access to the overdose-reversal medication naloxone.
Even at this lower number, overdoses kill more Americans each year than car accidents. The economic toll is staggering as well. The opioid epidemic alone cost an estimated $1 trillion in 2017, factoring in healthcare spending, lost productivity, criminal justice costs, and the economic value of lives lost.
Most People With Addiction Don’t Get Treatment
Perhaps the most striking number in the data is the treatment gap. In 2024, only about 1 in 5 people who needed substance use treatment actually received it. That means 80% of people with a substance use disorder went without care in the past year.
The gap is especially stark for opioid addiction, where effective medications exist that cut the risk of overdose death roughly in half. Yet only 22% of adults with opioid use disorder received these medications in 2021. Barriers include cost, stigma, shortage of prescribing providers in rural areas, and insurance limitations that restrict how long someone can stay on treatment.
The treatment gap isn’t simply a matter of people choosing not to seek help. Long wait lists, lack of nearby facilities, inability to take time off work, and fear of legal consequences all keep people from accessing care they would otherwise want. For many, the path to treatment begins only after a crisis, such as an overdose or arrest, rather than through routine healthcare.
Who Is Most Affected
Addiction does not distribute evenly across the population. Young adults between 18 and 25 consistently show the highest rates of substance use disorders. Men are more likely than women to develop addiction and far more likely to die from overdose. Rural communities face higher overdose death rates partly because of limited access to treatment providers.
Among adolescents aged 12 to 17, substance use disorders are less common than in adults but still significant. The 2024 survey included this age group in its 48.4 million total, reflecting that addiction can take hold early, particularly with nicotine, cannabis, and misuse of prescription medications. Fentanyl-laced counterfeit pills have introduced a newer and more lethal risk for teens who experiment with what they believe are pharmaceutical drugs.
Race and socioeconomic status also shape who is affected and how. American Indian and Alaska Native communities have the highest per capita overdose death rates. Black Americans have seen the fastest-rising overdose rates in recent years, driven largely by fentanyl entering stimulant supply chains. Poverty, housing instability, and lack of health insurance all increase vulnerability to both developing and dying from addiction.