Well-Being Mental Health

New CDC data detail overlap of substance misuse, psychiatric disorders

The data illustrate both geographic and gender differences in rates of illegal substances used.
Man looks at alcohol in store
The Associated Press/ Martin Meissner

Story at a glance


  • The fallout of the COVID-19 pandemic has taken a toll on Americans’ mental health.

  • Data from 2019 show that even before the pandemic, one third of individuals assessed at substance use treatment centers reported severe psychiatric conditions.

  • Researchers are calling for enhancement of substance use programs to better meet patient needs. 

Reports of increased substance use and rising rates of mental health disorders throughout the past few years are nothing new, especially as Americans struggled with the economic and humanistic toll of the COVID-19 pandemic. But data released today by the CDC document to what extent these two conditions overlap. 

According to the center’s latest Morbidity and Mortality Weekly Report, in 2019 at least one third of adults assessed for substance use at treatment centers reported severe psychiatric problems. Although the current data were collected prior to the COVID-19 pandemic, authors noted future research will focus on the crisis’ impact on trends.

In 2019, more than 65 million adults self-reported binge drinking while more than 35 million reported using illicit drugs during the past month, authors explained, noting individuals with substance use disorders are at an increased risk for overdose and other poor health outcomes. 

A total of 49,138 individuals were assessed at 339 treatment centers across 37 states. All individuals were at least 18 years of age and the most commonly reported substances used in the past month were alcohol, followed by cannabis, misuse of prescription opioids, and illicit stimulants, among others. 

One third of respondents also reported polysubstance use, defined as use of two or more substances, while 35.2 percent reported psychiatric problems. A quarter of patients reported having employment issues and 22.8 percent said they had family problems. 


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Of those included in the study, the majority were non-Hispanic white men who had a high school education or less. However, women reported higher use of all substances assessed apart from alcohol and 32.6 percent reported recent polysubstance use. 

Most patients were also assessed in metropolitan areas and in the southern portion of the United States. 

Younger adults between the ages 25 and 34 were more likely to report severe problems with drugs whereas those between the ages 55 and 64 reported more severe alcohol problems. 

In addition, the majority of unemployed adults listed more severe drug problems and retired or disabled adults experienced more severe psychiatric and medical problems, at 53.3 percent and 59.6 percent, respectively. 

“These findings highlight the complex nature of substance use in the United States, the interplay between substance use and mental illness, and the complex challenges that persons with substance use disorder face when seeking treatment,” authors wrote. 

Based on the findings, researchers called for more enhanced comprehensive substance use programs that include expanded linkage to services. 

“Continued surveillance of the illicit drug supply and substance use patterns to guide the tailored development of prevention, treatment, and harm reduction interventions will be important when devising public health strategies in U.S. communities,” they said.


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