Substance use means using products like alcohol, tobacco, or drugs that are swallowed, smoked, injected, or inhaled. These substances can affect the body and mind and may lead to health problems or dependence. Substance use can involve legal products, such as alcohol and tobacco, as well as illegal drugs and inhalants.
A substance use disorder (SUD) is a long-term but treatable health condition. It happens when a person keeps using a substance even though it causes serious problems in their life, such as issues with health, work, or relationships. Doctors look at patterns of symptoms to diagnose SUD and connect people to treatment. SUDs can be mild or severe and affect people of all backgrounds. They can involve alcohol, tobacco, cannabis, opioids, stimulants, sedatives, hallucinogens, inhalants, or other substances.
In 2024, American Indian/Alaska Native (AI/AN) adults ages 21 and over were 3% more likely than all U.S. adults over 21 to have binged alcohol in the past month.
In 2024, AI/AN adults were 9% more likely than U.S. adults overall to have ever used an illicit drug.
In 2022, AI/AN people were twice as likely to die from a drug overdose and more than 5 times as likely to die of an alcohol-induced death than the U.S. population overall.
In 2024, AI/AN adults were more than 3 times as likely to receive substance use treatment in the past year as U.S. adults overall.
In 2024, AI/AN youth ages 12 to 17 were 19% more likely than people from that age group overall to have participated in an alcohol, tobacco, or drug prevention program outside of school in the past year.
In 2024, AI/AN adults were 37% more likely than U.S. adults overall to have substance use disorder together with mental illness.
Drug overdose deaths, age-adjusted rate per 100,000 population, 2022
AI/AN*
Total Population
Ratio (AI/AN* / Total)
Male
83.4
45.6
1.83
Female
47.1
19.4
2.43
Both
65.2
32.6
2.00
Source: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). Deaths: Final data for 2022 (National Vital Statistics Report, Vol. 74, No. 4, Table 11). U.S. Department of Health and Human Services.
Alcohol-induced deaths, age-adjusted rate per 100,000 population, 2022
AI/AN*
Total Population
Ratio (AI/AN* / Total)
Male
98.4
19.5
5.05
Female
59.4
7.8
7.62
Both
78.4
13.5
5.81
Source: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). Deaths: Final data for 2022 (National Vital Statistics Report, Vol. 74, No. 4, Table 11). U.S. Department of Health and Human Services.
Health Care Use
Adults
Adults ages 18 and over who received substance use treatment in past year, percentage, 2024
