Youth Mental Health, Drug Use Show Encouraging Trends

A new federal survey from the Substance Abuse and Mental Health Services Administration (SAMHSA) has revealed encouraging downward trends in youth substance use and improvements in several mental health indicators, signaling that years of prevention efforts and expanded access to mental health resources may be yielding results.

The 2025 National Survey on Drug Use and Health (NSDUH) — the primary federal source for data on substance use and mental health among Americans aged 12 and older — tracked trends from 2021 to 2025. Released on July 27, the report comes amid lingering questions about the survey’s future after the Trump administration laid off the entire 17-member NSDUH team in 2025.

Key Findings on Substance Use

Among adolescents aged 12 to 17, the survey found declines in past-month use of tobacco, alcohol, marijuana, and binge drinking. Past-year illicit drug use, marijuana use, and initiation of alcohol, vaping, or marijuana also decreased. Fewer adolescents reported substance use disorders related to alcohol, drugs, or both.

Young adults aged 18 to 25 similarly showed favorable declines across these substance use measures, according to data from the American Hospital Association’s analysis.

Mental Health Improvements

The survey also recorded declining trends in major depressive episodes among adolescents, along with fewer reports of serious thoughts of suicide, making a suicide plan, and suicide attempts. These findings mark a potential reversal of the widely publicized increases in youth mental health struggles observed in prior years.

Persistent Anxiety Concerns

Despite the positive trends, significant challenges remain. Nearly 20% of adolescents reported experiencing moderate or severe anxiety symptoms in the two weeks before the survey, compared with approximately 7% of adults aged 18 and older. This disparity underscores the ongoing mental health burden carried by young people even as other indicators improve.

Overall, more than half of people aged 12 and older used an illicit drug, drank alcohol, used tobacco, or vaped nicotine in the past month — including 44% who drank alcohol, 16% who used a tobacco product, 10% who vaped nicotine, and 16% who used an illicit drug.

Treatment Gap Remains a Critical Issue

An estimated 45 million Americans still have a substance use disorder, yet over 80% of those who needed treatment did not receive it in the past year. The survey found that 27.6% of adolescents received mental health treatment in the past year, while 21.6% of adults received treatment — figures that underscore a persistent and troubling gap between need and access to care.

“The trends among young people are promising, but there’s still a lot of work to be done,” said Robyn Oster, policy director for the Partnership to End Addiction, in AP News reporting. “Nearly 45 million people still have substance use disorder and still not nearly enough people are getting treatment. It’s still well over 80% of people who needed it did not get substance use treatment in the past year, let alone quality treatment.”

A Survey of Uncertain Future

The NSDUH’s survival was thrown into doubt after the Trump administration dismissed the survey’s entire 17-member team in 2025 as part of broader federal workforce reductions. The fact that SAMHSA was able to compile and release the 2021–2025 data demonstrates resilience in the nation’s behavioral health surveillance infrastructure, though experts have questioned whether the layoffs may have affected data collection or analysis integrity.

Implications and Outlook

The findings provide a cautiously optimistic baseline for policymakers considering federal funding for mental health and substance use programs. The simultaneous decline in youth substance use and improvement in key mental health metrics suggests that investments in school-based prevention programs, mental health awareness campaigns, and expanded treatment access may be having a measurable effect.

However, the persistently high rates of adolescent anxiety and the vast treatment gap for substance use disorders indicate that targeted investments remain urgently needed. As the data spanning 2021 to 2025 shows, progress is possible but far from complete. The coming years will reveal whether these positive trends can be sustained and deepened, particularly as questions about the NSDUH’s long-term stability remain unresolved.