The Substance Abuse and Mental Health Services Administration (SAMHSA) released the 2025 National Survey on Drug Use and Health, which is a great look at how Americans are struggling with addiction and mental health issues, as well as how they are fighting help.
Buried in the tables and percentages is a powerful number: 22.3 million adults in this country now consider themselves in recovery from a substance use problem. I want every family who’s currently begging a son, a daughter, a spouse, or a parent to get help to sit with that for a moment.
Twenty-two million people who once met the same criteria your loved one meets right now got to the other side of it. Recovery isn’t a rumor. It isn’t a rare exception. It’s a documented, measurable, growing population of people who used to be exactly where your family is today.
I’ve been in that population myself since the mid-1980s, and I’ve spent the decades since building Confidential Recovery here in San Diego specifically for the families who don’t yet believe that 22.3 million figure applies to them.
So let me walk through what this year’s numbers actually mean, because the headline is only half the story.
Those Who “Need Help” Are Not “Getting Help” Nearly as Often as They Should
The same survey found that 44.6 million Americans age 12 and older met the clinical criteria for a substance use disorder. But, only about 16 percent received any treatment in the past year. That means roughly 85 percent of the people who could benefit from treatment did not get it. For opioid use disorder specifically, only about 15.7 percent received medication-based treatment, one of the most effective tools we have. For alcohol use disorder, the number receiving medication was barely above 2.5 percent.
People are Choosing Not to Seek Treatment
When SAMHSA asked people who didn’t get treatment why, the top answer, at nearly 83 percent, was some version of “I should be able to handle this on my own.” Another two-thirds said they weren’t ready to stop. Over half cited a lack of time. More than 4 in 10 pointed to stigma. Those aren’t statistics about willpower. They’re statistics about isolation, shame, and a system that still makes it too hard to ask.
That’s the family I hear from every week. Not one that doesn’t care. One that’s stuck between a loved one who insists they’ve got it under control and a treatment options that feel like they are built for family with a lot more time, money, and patience than they have. Despair not because there are well-worn paths to getting help for your loved one with an addiction, the best place to start is with a trained professional – like a drug & alcohol counselor or an interventionist.
The Mental Health Numbers Tell a Parallel Story
Beyond substance use, the survey found that 44.1 million adults consider themselves in recovery from a mental health issue, and 20.6 percent of adults, about 54.6 million people, experienced some form of mental illness in the past year.
Among adults 18 and older, 5.3 percent reported serious thoughts of suicide. Among kids 12 to 17, 15.1 percent experienced a major depressive episode. These numbers move together because addiction and mental health always have.
There’s Real Movement in the Right Direction
I don’t want to bury the good news under the hard news, because families need both. Tobacco and alcohol use declined across age groups. Binge drinking dropped. Marijuana initiation among teenagers fell by roughly 300,000 compared with recent years.
SAMHSA estimates alcohol use disorder declined by about 4 million people and substance use disorder overall declined by 2.2 million people since 2021. Something is working. Prevention is working. Treatment, when people get it, is working. That 22.3 million figure didn’t happen by accident.
To the Family Reading This Today
If you’re the parent lying awake calculating how much longer you can watch this, or the spouse who has said “get help” so many times the words don’t land anymore, here’s what I want you to take from this report. The 85 percent who don’t get treatment aren’t a life sentence. They’re a snapshot of a system that makes the first step harder than it should be, taken by people who, like I once did, believe they can outrun a problem that’s already caught them. Every one of the 22.3 million people now in recovery was in that 85 percent at some point. Something, or someone, helped them cross over.
You don’t have to solve the whole national treatment gap. You just have to help one person take the next step. That’s what interventions and counselors like myself do, and it’s what I’ve built my life’s work around since I got my own second chance nearly forty years ago. The numbers say recovery is real and it’s happening for millions of people. Your job, and mine, is making sure it happens for the one person you love most.
About the Author
Scott H. Silverman is a best-selling author, and his new book, ‘You’re Not God, That Job is Taken’ is an Amazon Bestseller.
Scott is also a family crisis coach, an interventionist, and speaks frequently about addiction and recovery on television and at public appearances. Scott empowers individuals and families to move forward past the crisis and onto the road of recovery. Confidential Recovery, the San Diego outpatient drug rehab program for professionals that Scott founded in 2014.
