Dual diagnosis is the term addiction and mental health experts reserve for the identification of overlapping cases of mental illness and substance use disorder (substance abuse/substance addiction). People affected by such overlapping problems typically encounter much greater difficulties during treatment and recovery than people who only have a non-substance-related mental illness or who only have a diagnosable problem with drugs and/or alcohol.
In a report published in September 2014, researchers from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) estimated the number of people in the U.S. who meet the criteria for dual diagnosis.
Substance Use Disorder Statistics
The figures reported by the Substance Abuse and Mental Health Services Administration come from an annual SAMHSA-sponsored undertaking called the National Survey on Drug Use and Health (NSDUH). This survey uses data gathered from tens of thousands of nationally representative Americans to project larger, countrywide trends in issues related to substance abuse/addiction and mental health. The latest completed version of the NSDUH covers the year 2013.
In that year, a total of 21.6 million preteens, teenagers and adults had symptoms that would qualify them for a substance use disorder diagnosis; this number equals 8.2 percent of the total U.S. population over the age of 11. The vast majority of affected individuals (20.3 million) were adults at least 18 years old. Just 1.3 million 12- to 17-year-olds met the criteria for substance use disorder.
Altogether, roughly 8.5 percent of all Americans over the age of 17 had diagnosable cases of substance abuse and/or substance addiction. About 5.2 percent of all 12- to 17-year-olds were affected by substance abuse/addiction.
Mental Illness Statistics
The NSDUH tracks all forms of mental illness among American adults age 18 or older on a year-to-year basis. The survey also tracks the number of 12- to 17-year-olds who experience at least one episode of major depression in any given year.
The NSDUH figures indicate that a total of 43.8 million adults had some form of mental illness in 2013. This number equaled 18.5 percent of the entire adult population. Ten million affected American adults had a serious or severe mental illness (e.g., major depression, panic disorder, schizophrenia or bipolar disorder). This number equaled 4.2 percent of the adult population.
Roughly 2.6 million Americans between the ages of 12 and 17 experienced at least one episode of major depression in 2013. This translated into 10.7 percent of the total preteen and teen population.
Among the affected individuals, 1.9 million Americans between the ages of 12 and 17 experienced a debilitating episode of major depression. This translated into 7.7 percent of the preteen and teen population.
How Many People Have Dual Diagnosis?
The NSDUH doesn’t use the term “dual diagnosis” on its questionnaires or in its reported findings. However, the survey does identify people who meet the criteria for dual diagnosis as a result of having overlapping symptoms of diagnosable substance use disorder and a separately diagnosable, non-substance-related mental illness.
In 2013, 7.7 million American adults had a case of dual diagnosis involving substance use disorder and any form of additional mental illness; this number equaled 3.2 percent of the total U.S. adult population. Among the affected individuals, 2.3 million had a case of dual diagnosis involving substance use disorder and a severe mental illness. This number equaled 1 percent of the adult population.
Three hundred fifty-nine thousand U.S. preteens and teenagers had a case of dual diagnosis involving some form of substance use disorder and at least one episode of major depression. This number equaled 1.4 percent of the total population in the 12-to-17 age range.
It’s worth noting that the NSDUH doesn’t track Americans currently incarcerated in a jail or prison. In addition, the survey doesn’t track Americans who don’t have a fixed address. This means that the incarcerated population and the homeless population — two of the demographic groups most severely affected by substance problems and mental illness — aren’t included in the NSDUH figures.
In turn, the exclusion of these groups likely leads to a significant undercounting of the number of Americans affected by dual diagnosis. The exclusion of preteens and teens affected by mental illnesses other than major depression also likely contributes to the undercounting of affected individuals.
By: Gideon Hoyle