SAMHSA Survey Shows Co-Occurring Disorders Declined Since 2021

Rates of co-occurring disorders have declined. SAMHSA released the results of its 2025 National Survey on Drug Use and Health on July 27, and the data show drops in the combination of mental illness and substance use disorder across both youth and adult populations. This shift matters for anyone searching for dual diagnosis treatment.

The survey draws on self-reported responses from more than 60,000 people and comprises the federal government’s primary data on mental health conditions, substance use, treatment and recovery. The 2025 release marks the fifth consecutive year of comparable data, allowing for an unbroken trend analysis. 

Declining Co-Occurring Conditions

Among adolescents aged 12 to 17, SAMHSA reported declines in past-year major depressive episode, major depressive episode with severe impairment, co-occurring major depressive episode and substance use disorder and co-occurring major depressive episode with severe impairment and substance use disorder.

Among adults 18 and older, declines appeared in major depressive episodes and serious mental illnesses with and without severe impairment, including substance use disorders.

SAMHSA described the youth findings as especially notable. They stated that for people aged 12 to 17 and 18 to 25, all key indicators in the annual report declined.

Suicide indicators moved in the same direction. In 2025, 2.6 million teens had serious thoughts of suicide. An estimated 1.3 million, or 5.1%, made a plan, and 738,000, or 2.9%, made an attempt.

Treatment Engagement and Recovery Numbers

A co-occurring disorder, also called dual diagnosis, means a person has both a mental health condition and a substance use disorder at the same time. The two interact. Untreated depression or anxiety raises the risk of substance use, and substance use worsens psychiatric symptoms and trauma. That’s why treating one and ignoring the other tends to produce poor results.

Integrated treatment addresses both conditions in the same plan with the same clinical team, rather than sequencing them. That structural difference separates a dual diagnosis program from a general addiction program that happens to have a therapist on staff.

The survey also measured the demographics receiving care. In 2025, 27% of adolescents received mental health treatment, as did 22% of adults.

The recovery figures are larger than many readers expect. More than 22 million Americans reported being in recovery from addiction, and more than 44 million reported being in recovery from mental illness.

Some Numbers Moved the Wrong Way

The report isn’t uniformly positive, and SAMHSA relayed that directly. Alongside the declines, the agency identified increases in past-month nicotine vaping and past-month marijuana use.

Substance use overall remains widespread. More than half of people aged 12 and older used nicotine, alcohol or an illicit drug in the past month, with alcohol accounting for most of that. Among current drinkers, 44% took part in binge drinking in 2025. Past-month binge drinking stood at 19.5%, down from nearly 22% in 2021.

Broader substance use indicators mostly held steady or improved between 2021 and 2025, including significant declines in past-month tobacco, cigarette, and alcohol use, past-year misuse of prescription opioids and tranquilizers, and past-year initiation of nicotine vaping and marijuana use and other substances.

Declining prevalence doesn’t mean declining need. Roughly 20% of adults still received mental health treatment in the past year, and co-occurring conditions remain common enough that integrated capacity matters at every level of care. 

For families comparing options, the practical question is whether a facility can treat both conditions concurrently rather than referring one out.

Comprehensive Treatment in Every Neighborhood

When comparing dual diagnosis programs, ask whether psychiatric and addiction care are delivered by one integrated team, any group therapies offered, whether medication management is available on site, and how the program handles Medicaid and private insurance.

Our online directory lists mental health and behavioral treatment centers by location, including programs that treat co-occurring disorders.

You can also dial 800-908-4823 (Sponsored) to speak with an expert for local resources and treatment options.

Author

Quentin Blount

Content Manager

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Quentin brings nearly a decade of experience as a writer, editor, and digital publisher to his role as Content Manager for Rehab.com. He aims to help people better understand their treatment options by creating engaging and informative content that is user-friendly, factually accurate, and optimized for search engine visibility. In his free time, Quentin enjoys the company of his friends, family, and his dog, Coop.

Editor

Peter Lee, PhD

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Peter W.Y. Lee is a writer and historian of American history during the Cold War. His primary focus is the relationship between youth and popular culture and its impact on U.S. society during the twentieth century. He has published widely on how the public has used popular culture as a mechanism to address political and social shifts throughout time