Substance Use Workgroup

Objective Status

  • 3 Target met or exceeded
  • 1 Improving
  • 9 Little or no detectable change
  • 7 Getting worse
  • 0 Baseline only
  • 4 Developmental
  • 1 Research

Learn more about objective types

Substance Use Workgroup Objectives (25)

About the Workgroup

Approach and Rationale

In 2018, 20.3 million people age 12 years and older had a substance use disorder.1 And most people (94.9 percent) who needed substance use treatment but didn’t receive specialty treatment didn’t think they needed treatment in the past 12 months for their substance use.1 In addition, many people don’t recognize the risks associated with substance use disorders. Substance use has a major impact on individuals, families, and communities. The effects of substance use are cumulative, significantly contributing to costly social, physical, mental, and public health problems. Of particular concern in the last decade has been high rates of opioid addiction and a corresponding increase in opioid overdoses and opioid-related deaths. Healthy People 2030 has added several objectives, including developmental objectives, designed to monitor trends in opioid use, overdose deaths, and opioid use disorder treatment. 

Core objectives selected by the SU Workgroup aim to improve public understanding of the risks of substance use, improve access to treatment for substance use disorders, and expand the use of evidence-based practices for the prevention and treatment of substance use disorders. Wherever possible, objectives track disparities among racial/ethnic groups.

Understanding Substance Use

Though substance use and substance use disorder impact all racial/ethnic groups and socioeconomic brackets, some populations are disproportionately affected. For example, rates of substance use disorder are higher in men than women,2 and substance use disorder and overdose disproportionately affect American Indian/Alaskan Natives.3,4 The public health burden of substance use has been rising in both rural and urban areas, and geographic distance and lack of evidence-based care can inhibit treatment. The stigma surrounding substance use disorders also has an enormous impact across the continuum of care.

Emerging issues in Substance Use

Addiction has long been a public health challenge in America, and drug overdose deaths have been increasing exponentially since at least 1980. Tobacco is now responsible for nearly 500,000 deaths each year,5 and alcohol causes nearly 90,000 deaths.6 Average life expectancy in the United States, which had been increasing steadily since at least the mid-20th century, began declining in 2014 driven by deaths from drugs, alcohol, and suicide. As of 2020, emerging substance use trends include high overdose rates from synthetic opioids, increased overdose deaths involving stimulants, and unprecedented increases in adolescent substance exposure in the form of vaping. Due to the enormous impact of substance use and associated disease and death, unprecedented investments have been made in treatment infrastructure and innovative addiction research. This sets up the potential for meaningful progress in combating this public health challenge.



Substance Abuse and Mental Health Services Administration. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration.


Substance Abuse and Mental Health Services Administration. (2019). 2018 National Survey on Drug Use and Health: Detailed Tables. Retrieved from


Venner, K.L., et al. (2018). Future Directions for Medication Assisted Treatment for Opioid Use Disorder with American Indian/Alaska Natives. Addictive Behaviors, 86, 111117. DOI: 10.1016/j.addbeh.2018.05.017


Whitesell, N.R., Beals, J., Crow, C.B., Mitchell, C.M., & Novins, D.K. (2012). Epidemiology and Etiology of Substance Use Among American Indians and Alaska Natives: Risk, Protection, and Implications for Prevention. American Journal of Drug and Alcohol Abuse38(5), 376–382. DOI: 10.3109/00952990.2012.694527


U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services.


Centers for Disease Control and Prevention. (2013). Average for United States 2006-2010: Alcohol-Attributable Deaths Due to Excessive Alcohol Use. Retrieved from