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Epidemiology of DSM-5 Drug Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III

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Grant, Bridget F., Saha, Tulshi D., Ruan, W. June, Goldstein, Risë B., Chou, S. Patricia, Jung, Jeesun, Zhang, Haitao, Smith, Sharon M. +3 more·2016·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2015.2132PMC PMC5062605
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Abstract

IMPORTANCE: Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source. OBJECTIVE: To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level. DESIGN, SETTING, AND PARTICIPANTS: In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015. MAIN OUTCOMES AND MEASURES: Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders. RESULTS: Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively. CONCLUSIONS AND RELEVANCE: DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.

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Crossref · 10.1001/jamapsychiatry.2015.2132

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  • Although SUDs remain more prevalent in men than in women, the gender gap has been narrowing, possibly in part due to changes in gender roles.

    “Although SUDs remain more prevalent in men than in women, the gender gap has been narrowing 150,328- 330 , possibly in part due to changes in gender roles 331 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [150]

    The Results section reports that drug use disorder rates were generally higher among men than women. Our copy does not establish that the gender gap has narrowed over time. The separate suggestion about changing gender roles is attached to citation 331, not this source. (LLM, conf=0.86)

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  • Although SUDs are generally associated with more severe consequences than substance misuse, substance misuse is much more prevalent.

    “Although SUDs are gen erally associated with more severe consequences than substance misuse, the latter is much more prevalent 148- 150 .”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [150]

    The Discussion (page unavailable) describes drug use disorder as a serious condition associated with comorbidity and disability, and the Results report its prevalence. The paper does not compare its consequences or prevalence with substance misuse, so it does not establish that misuse is much more prevalent. (LLM, conf=0.83)

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  1. [56]Johnson BA Addiction Medicine: Science and Practice New York, NY Springer 2011

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Authors
Grant, B. F., Saha, T. D., Ruan, W. J., Goldstein, R. B., Chou, S. P., Jung, J., Zhang, H., Smith, S. M., Pickering, R. P., Huang, B., & Hasin, D. S.
Affiliations
  • National Institutes of Health (US)
  • New York State Psychiatric Institute (US)
Corresponding author
Grant, Bridget F.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2016-01-01
Volume
73
Issue
1
Pages
39
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2015.2132
PMC
PMC5062605
OpenAlex
W2743294273
Cited by
877
References
56
Citations by year
2026: 59 · 2025: 69 · 2024: 74 · 2023: 68 · 2022: 82 · 2021: 115 · 2020: 110 · 2019: 104 · 2018: 94 · 2017: 73 · 2016: 29
FWCI
51.26
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute on Alcohol Abuse and Alcoholism (Z01AA000449)
  • National Institute on Drug Abuse (R01DA018652)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
drug use disorders, DSM-5, prevalence, sociodemographic correlates, psychiatric comorbidity, substance use disorders, major depressive disorder, bipolar disorder, post-traumatic stress disorder, antisocial personality disorder, borderline personality disorder, schizophrenia, disability, treatment, alcoholism, cannabis use disorder, opioid use disorder, cocaine dependence, stimulant use disorder, sedative use disorder
MeSH terms
Adolescent, Adult, Aged, Antisocial Personality Disorder, Bipolar Disorder, Borderline Personality Disorder, Marijuana Abuse, Major Depressive Disorder, Depressive Disorder, Major, Female, Heroin Dependence, Humans, Male, Middle Aged, Opioid-Related Disorders, Personality Disorders, Schizotypal Personality Disorder, Severity of Illness Index, Stress Disorders, Post-Traumatic, United States, Comorbidity, Prevalence, Dysthymic Disorder, Substance-Related Disorders, Amphetamine-Related Disorders, Cocaine-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders, Young Adult, Inhalant Abuse

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