In the United States, estimates of the prevalence of substance use disorders are derived from nationwide surveys of the population. Participants may also underreport their own substance use in these surveys, and important populations like the homeless and the hospitalized are not included. To make an educated guess as to the rate of substance abuse in the United States, data from the Transformed Medicaid Statistical Information System (the benchmark) and the National Survey on Drug Use and Health (the multiplier) were used to estimate the prevalence of alcohol, cannabis, opioid, and stimulant use disorders in the United States in 2018 and 2019. For those 12 and up receiving full or comprehensive Medicaid benefits, T-MSIS gathers administrative information. Every year, the National Survey on Drug Use and Health (NSDUH) is a representative, cross-sectional survey of American adults. Researchers looked at information collected between February and June of 2022. The benchmark multiplier technique was applied to data from the T-MSIS and the NSDUH to estimate the prevalence of substance use disorders. Monte Carlo simulations were used to calculate confidence ranges for the multiplier method estimations. The sensitivity of prevalence estimates to different multiplier values was analyzed. Alcohol (1,017,308), cannabis (643,737), opioid (1,406,455), and stimulant (657,305) use disorders, as well as NSDUH participants with 12-month DSM-IV alcohol (n=3,390 in 2018; n=3,363 in 2019) and cannabis (n=1,426; n=1,604), opioid (n=448; n=369), and stimulant (n=610,862) diagnoses were included in this study. For both years and the combined 2018-2019 sample, the benchmark multiplier prevalence estimates were higher than NSDUH estimates for all substance use disorders. Alcohol use disorders had a 95% CI of 20.27–24.71 versus cannabis use disorders with a 95% CI of 1.68–1.79; cannabis use disorders with a 95% CI of 2.97–4.12 versus opioid use disorders with a 95% CI of 0.60–0.78; and stimulant use disorders with a 95% CI of 1.91–2.30 versus 0.85–0.96. Over a large range of hypothetical multipliers, the discrepancies between the benchmark multiplier method and NSDUH figures persisted in a sensitivity analysis. This study’s results show that the prevalence of substance use disorders is higher than estimated by the National Survey on Drug Use and Health (NSDUH) estimated, which may indicate that this issue is more prevalent than previously thought in the United States.

Source: jamanetwork.com/journals/jamapsychiatry/article-abstract/2796749