Depression and stimulants
SAMHSA’s National Helpline | SAMHSA
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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.
SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders.
This service provides referrals to local treatment facilities, support groups, and community-based organizations.
Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.
The service is open 24/7, 365 days a year.
English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.
In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid.
If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.
No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.
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Suggested Resources
What Is Substance Abuse Treatment? A Booklet for Families
Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery.
Addresses concerns of children of parents with substance use/abuse problems.It's Not Your Fault (NACoA) (PDF | 12 KB)
Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.
For additional resources, please visit the SAMHSA Store.
Last Updated: 08/30/2022
Alcohol, Tobacco, and Other Drugs
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Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).
Alcohol
Data:
- Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers.
The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH) - Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
- In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
- Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
- The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31.
4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH) - Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
- Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily
Programs/Initiatives:
- STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
- Interagency Coordinating Committee on the Prevention of Underage Drinking
- Talk. They Hear You.
- Underage Drinking: Myths vs. Facts
- Talking with your College-Bound Young Adult About Alcohol
Relevant links:
- National Association of State Alcohol and Drug Abuse Directors
- Department of Transportation Office of Drug & Alcohol Policy & Compliance
- Alcohol Policy Information Systems Database (APIS)
- National Institute on Alcohol Abuse and Alcoholism
Tobacco
Data:
- In 2020, 20.
7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH) - Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
- Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
- The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes
Electronic cigarette (e-cigarette) use data:
- In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month.
The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people). - Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
- Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
- E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals
Resources:
- Tips for Teens: Tobacco
- Tips for Teens: E-cigarettes
- Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
- Synar Amendment Program
Links:
- Truth Initiative
- FDA Center for Tobacco Products
- CDC Office on Smoking and Health
- National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
- National Institute on Drug Abuse: E-Cigarettes
Opioids
Data:
- Among people aged 12 or older in 2021, 3.
3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH) - Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
- According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose
Resources:
- Medication-Assisted Treatment
- Opioid Overdose Prevention Toolkit
- TIP 63: Medications for Opioid Use Disorder
- Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
- Opioid Use Disorder and Pregnancy
- Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
- The Facts about Buprenorphine for Treatment of Opioid Addiction
- Pregnancy Planning for Women Being Treated for Opioid Use Disorder
- Tips for Teens: Opioids
- Rural Opioid Technical Assistance Grants
- Tribal Opioid Response Grants
- Provider’s Clinical Support System - Medication Assisted Treatment Grant Program
Links:
- National Institute on Drug Abuse: Opioids
- National Institute on Drug Abuse: Heroin
- HHS Prevent Opioid Abuse
- Community Anti-Drug Coalitions of America
- Addiction Technology Transfer Center (ATTC) Network
- Prevention Technology Transfer Center (PTTC) Network
Marijuana
Data:
- In 2021, marijuana was the most commonly used illicit drug, with 18.
7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people). - The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
- Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
- Marijuana can have significant health effects on youth and pregnant women.
Resources:
- Know the Risks of Marijuana
- Marijuana and Pregnancy
- Tips for Teens: Marijuana
Relevant links:
- National Institute on Drug Abuse: Marijuana
- Addiction Technology Transfer Centers on Marijuana
- CDC Marijuana and Public Health
Emerging Trends in Substance Misuse:
- Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year.
Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia. - Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
- Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors.
It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.
Resources:
- Tips for Teens: Methamphetamine
- Tips for Teens: Cocaine
- National Institute on Drug Abuse
More SAMHSA publications on substance use prevention and treatment.
Last Updated: 01/05/2023
Deep medial bundle stimulation helps with resistant depression
German scientists have published the results of a year-long study of invasive brain stimulation for the treatment of resistant depression. As reported in an article published in the journal Neuropsychopharmacology , symptoms improved in all 16 study participants, and half achieved remission.
Clinical depression is most often curable: to combat it, doctors prescribe antidepressants and also prescribe psychotherapy.
The treatment process can be long (for example, the first effect of drugs usually appears only a few weeks later) and difficult, but very effective: the symptoms in most cases can be stopped. nine0005
At the same time, depression can also be resistant: doctors make such a conclusion if the disease has not succumbed to two courses of treatment in a row. In this case, changing the course of treatment to another drug or another method of psychotherapy may not work, which is why scientists are developing new methods of treatment. For example, psilocybin (the active ingredient in hallucinogenic mushrooms) has been given Breakthrough Therapy status in the United States for treatment-resistant depression. In a new study, scientists led by Volker Coenen at the University of Freiburg set out to test how deep brain stimulation can help treat resistant depression. nine0005
Their study involved 16 people with resistant depression: the disease was observed in the participants for a period of 8 to 22 years, each of them received an average of 18 courses of medications, 20 courses of electroconvulsive therapy and about 70 hours of psychotherapy in the course of dealing with the disorder .
Electrodes were implanted into the participants' brains to stimulate the upper lateral portion of the medial forebrain bundle, which connects the midbrain to the forebrain and is considered one of the key parts of the brain's reward system. nine0005
Participants received continuous medial bundle stimulation for a year and their mental status was assessed weekly using standardized tests. Each participant received either active stimulation or "blank" stimulation to compare the experimental and control conditions, with active stimulation at one time or another received by each participant.
The researchers found that over the course of a year, depressive symptoms decreased in all participants, with the majority (10 people) already within the first week after the start of stimulation. The depression of eight people (exactly half of the participants) went into remission by the end of the annual stimulation. At the same time, the authors clarify that both active and “empty” stimulation had a positive effect on the participants, but an additional antidepressant effect was observed at the beginning of active stimulation.
The main side effect of this method of therapy was temporary strabismus. nine0005
Thus, a pilot study of the effectiveness of medial bundle stimulation led scientists to conclude that this method of therapy can be effective in the treatment of resistant depression.
Non-invasive stimulation can also help with depression: Last week, scientists found that electrical stimulation with alternating current can relieve symptoms of depression.
Elizaveta Ivtushok
Found a typo? Select the fragment and press Ctrl+Enter. nine0005
Treatment of severe depression: a study on the effectiveness of deep brain stimulation
Researchers who have followed people with deep brain stimulation implants for 8 years suggest that this 900 severe depression.
Regulators in the US have already approved deep brain stimulation for the treatment of Parkinson's disease, epilepsy, essential tremor and obsessive-compulsive disorder.
Treatment involves implanting wires in the brain and a stimulator in the chest or abdomen. The stimulator sends small electrical impulses to the brain. nine0005
Surgeons implant wires in areas of the brain that are responsible for the development of symptoms characteristic of certain conditions. For example, in the case of Parkinson's disease, wires are implanted in the area of the brain that controls movement.
A new study from the American Journal of Psychiatry examines the effectiveness of placing implants in the subcallosal cingulate gyrus.
Senior study author Dr. Helen S. Mayberg, Professor of Neurology, Neurosurgery and Psychiatry at the School of Medicine at Mount Sinai in New York, USA. Professor H.S. Maiberg and her team have been studying the subcallosal cingulate gyrus as a potential treatment target for severe depression for more than 10 years. nine0005
In a 2005 study, they showed how deep subcallosal cingulate stimulation can help people with severe depression who are not responding to other available treatments.
However, in a similar randomized clinical trial that was conducted at several medical centers, scientists stopped the study at an early stage. This decision was made due to the fact that after 6 months of the study, there was no statistically significant improvement in the symptoms of severe depression. nine0005
In this study, scientists compared the effect of real and sham implant stimulation. Neither the participants nor the treatment providers knew who was in which group.
Meanwhile Professor H.S. Mayberg and her team followed the 28 participants in the 2005 study over 8 years to see how much progress they had made over a longer period of time.
« Yes, larger studies were stopped early. However, the effect that the participants in our study achieved not only persists over time, but also improves ,” H.S. Mayberg.
The results of their analysis showed that for 8 years, the response to treatment remained at the level of 50% or more among the study participants.
