Alarming Trends in Substance Use-Related Health Outcomes. What Can Primary Care Physicians Do?


Key trends are emerging from the latest surveillance data on substance use outcomes in the United States, including data from the Substance Abuse and Mental Health Services Administration (SAMHSA)’s Drug Abuse Warning Network (DAWN) and the Centers for Disease Control and Prevention (CDC)’s National Vital Statistics System.

  1. Alcohol is leading all drug-related emergency department (ED) visits.
    There were an estimated 7.7 million drug-related ED visits in the United States in 2022, a rate of 2,153 per 100,000 people. Alcohol was the most frequently (45%) reported substance in these ED visits and opioids and cannabis followed closely at 12.7% and 11.9%, respectively. (See the DAWN 2022 Findings Report.)
  2. Alcohol is leading all polysubstance use-related ED visits.
    Over 21% of the 7.7 million drug-related ED visits involved polysubstance use (more than one substance). Alcohol was also the most commonly reported substance in polysubstance-related ED visits, and was often combined with cannabis, cocaine, and methamphetamine. (See the DAWN 2022 Findings Report.)
  3. Opioid use and polysubstance use (specifically opioid and benzodiazepine co-use) are driving non-fatal overdoses.
    From 2021-2022, an estimated 599,075 of drug-related ED visits involved a non-fatal overdose. Almost half (48.1%) of those visits involved an opioid, and almost 40% involved polysubstance use. (See the DAWN 2022 Non-Fatal Overdoses Short Report.) 
  4. Opioid use, stimulant use, and polysubstance use (specifically opioid and stimulant co-use) are driving fatal overdoses.
    The predicted number of fatal overdoses (drug overdose deaths) in 2022 was 109,680. About 75% (82,998) of those drug overdose deaths were predicted to involve opioids, which is also an increase from the previous year. The predicted number of drug overdose deaths involving fentanyl and methamphetamine also increased compared to those from the previous year. (See the CDC 2022 Provisional Drug Overdose Data.)

Primary care physicians are in an optimal position to help reduce these negative health outcomes. The majority of patients with substance use disorders do not seek or do not have access to specialty substance use treatment, yet they are overrepresented in primary care. The Academy for Integrating Behavioral Health and Primary Care has several resources that can help primary care physicians identify and manage substance use in their practices.
●    This frequently asked questions guide provides an overview of the medications used to treat alcohol use disorder and answers common questions from primary care physicians.
●    This playbook provides practical, evidence-based guidance for implementing medication assisted treatment for opioid use disorders in primary care settings.
●    This stimulant use disorders topic brief offers practical, evidence-based guidance and resources for providing patient-centered integrated behavioral health care for stimulant use in primary care settings.
●    This polysubstance use topic brief provides practical, evidence-based guidance for addressing polysubstance use in a primary care setting, with a focus on leveraging an integrated behavioral health team.

By managing substance use in primary care, primary care physicians can help decrease drug-related morbidity and mortality.

To review additional research and data on these topics, see:

For recovery support, please visit: