Analysis of U.S. Substance Use and Mental Health in Relation to Sustainable Development Goals

A 2024 report from the Substance Abuse and Mental Health Services Administration (SAMHSA), based on the National Survey on Drug Use and Health (NSDUH), provides key data points for evaluating progress toward United Nations Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. The findings highlight challenges and opportunities related to specific targets, including Target 3.5 (strengthen the prevention and treatment of substance abuse) and Target 3.4 (promote mental health and well-being).

Substance Use Trends and SDG Target 3.5

The survey indicates mixed results concerning the prevention and treatment of substance abuse, a core component of SDG Target 3.5. While alcohol consumption has seen a slight decline, nicotine vaping has increased, and illicit drug use remains a significant public health issue.

• Nicotine Vaping: The percentage of individuals aged 12 and older who vaped nicotine in the past month increased from 8.3% in 2022 to 9.6% in 2024.
• Alcohol Use: A modest improvement was observed, with past-month binge drinking rates dropping from 21.7% in 2021 to 20.1% in 2024. Heavy alcohol use also declined from 5.7% to 5.0% in the same period.
• Illicit Drug Use: In 2024, 16.7% of the population aged 12 or older reported using an illicit drug in the past month. Over the past year, 25.5% used an illicit drug, with 2.7% misusing opioids.

Mental Health and Well-being: Progress Toward SDG Target 3.4

Data on mental health reveals a stable but concerning situation, indicating that significant efforts are still required to achieve the promotion of mental health and well-being as outlined in SDG Target 3.4.

1. Prevalence of Mental Illness: In the past year, 23.4% of adults (61.5 million people) experienced any mental illness, and 5.6% (14.6 million) had a serious mental illness. These figures have remained largely unchanged since 2021.
2. Major Depressive Episodes: The rate of adults experiencing a major depressive episode in the past year was 8.2%, a slight decrease from 8.5% in 2021.
3. Adolescent Mental Health: A critical concern is that 10.1% of adolescents (ages 12-17) reported having serious thoughts of suicide. While a slight improvement from 2021, this highlights an urgent need for targeted interventions to protect the well-being of young people.

Challenges in Achieving Universal Health Coverage (SDG 3.8) and Reducing Inequalities (SDG 10)

Expert analysis of the NSDUH data underscores a profound treatment gap, which directly impedes progress on SDG Target 3.8 (achieve universal health coverage, including access to quality essential health-care services) and exacerbates issues related to SDG 10 (Reduced Inequalities).

Key Barriers and Concerns

• Substance Use Disorder (SUD) Treatment Gap: An alarming 90% of individuals aged 12 or older with a past-year SUD received no treatment. This staggering gap illustrates a systemic failure to provide accessible, evidence-based care and support, undermining national health and well-being.
• Mental Healthcare Accessibility: Despite a slight increase in treatment rates for mental illness (from 47.2% in 2021 to 52.1% in 2024), nearly half of all individuals with a mental health condition still do not receive care. This disparity represents a significant barrier to achieving health equity.
• Data Gaps and Health Equity: The 2024 report’s lack of racial or ethnic data breakdowns makes it difficult to assess progress in addressing health disparities among the most underserved communities, a key objective of SDG 10.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to health and well-being, with a secondary focus on inequality. The following SDGs are relevant:

• SDG 3: Good Health and Well-being: This is the central theme of the article. It extensively discusses substance use (nicotine, alcohol, illicit drugs), mental health conditions (any mental illness, severe mental illness, major depressive episodes), and access to treatment for these issues. The entire report from the Substance Abuse and Mental Health Services Administration (SAMHSA) is dedicated to topics covered under this goal.
• SDG 10: Reduced Inequalities: The article touches upon this goal by highlighting concerns for specific population groups and the lack of disaggregated data. It mentions that “If they’re from a minority population, they’re even more anxious” and criticizes the report because it “does not highlight race or ethnic breakdowns for any of the data, so it is hard to know if we are making progress among communities who are most underserved.” This points directly to the need to ensure well-being and access to services for all, leaving no one behind.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion of substance abuse, mental health, and access to care, the following specific targets can be identified:

1. Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Explanation: The article’s focus on mental health statistics, such as the prevalence of “any mental illness” (23.4% of adults), “severe mental illness” (5.6%), and “major depressive episode” (8.2%), directly relates to the promotion of mental health and well-being. The mention that “10.1% of adolescents (12-17) had serious thoughts of suicide” also underscores the urgency of this target.
2. Target 3.5: Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol.
   • Explanation: This target is explicitly addressed. The article provides detailed statistics on nicotine vaping, binge drinking, heavy alcohol use, and illicit drug use, including opioids. It further emphasizes the need to strengthen treatment by stating that “nearly 90% of people aged 12 or older with an SUD in the past year received no treatment for it.”
3. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
   • Explanation: The article highlights significant gaps in health service access. The fact that “nearly half of people with a mental health condition aren’t getting treatment” and the “staggering treatment gap” for substance use disorders are direct evidence of a lack of universal access to essential health services. The concern that “Millions are at risk of losing their insurance” also relates to this target.
4. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
   • Explanation: This target is relevant due to the article’s critique of the data’s limitations. The statement that the report “does not highlight race or ethnic breakdowns for any of the data” shows a failure to monitor the well-being and inclusion of different ethnic groups, making it “hard to know if we are making progress among communities who are most underserved.”

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article is rich with statistics that serve as direct or proxy indicators for measuring progress.

• For Target 3.4 (Mental Health):
  • Prevalence of mental illness: The data points that “23.4% of adults 18 and older (61.5 million) had any mental illness” and “5.6% (14.6 million) had a severe mental illness” are direct indicators of the state of mental health in the population.
  • Prevalence of suicidal ideation: The statistic that “10.1% of adolescents (12-17) had serious thoughts of suicide” is a critical indicator for mental well-being and suicide prevention efforts.
• For Target 3.5 (Substance Abuse):
  • Prevalence of substance use: The article provides several indicators, including the percentage of people who vaped nicotine (9.6%), participated in binge drinking (20.1%), were “heavy” alcohol users (5.0%), and used an illicit drug (16.7%).
  • Coverage of treatment for substance use disorders: The finding that “nearly 90% of people aged 12 or older with an SUD in the past year received no treatment for it” is a direct indicator of the treatment gap.
• For Target 3.8 (Universal Health Coverage):
  • Coverage of essential health services: The treatment rates for mental illness (“52.1% for any mental illness in 2024”) and the corresponding gap (“nearly half of people with a mental health condition aren’t getting treatment”) serve as indicators for access to mental healthcare services.
• For Target 10.2 (Reduced Inequalities):
  • Lack of disaggregated data: The article’s key point that the report “does not highlight race or ethnic breakdowns for any of the data” is itself an indicator. It indicates a gap in the ability to monitor and ensure equal outcomes for all population groups, particularly for “communities who are most underserved.”

4. Summary Table of SDGs, Targets, and Indicators

Source: medpagetoday.com