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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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    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

What is psychological trauma?

Psychological trauma or psychotrauma is the harm from the impact of negative factors on the human psyche, which can contribute to the development of mental illness. Often, the presence of psychological trauma can cause a person to need treatment for post-traumatic stress disorder. Psychotrauma can be associated with physical trauma that threatens a person's life or violates a sense of security, which is accompanied by a strong emotional shock.

How does psychological trauma occur?

Psychotrauma always appears as a result of external influence, which carries with it some internal consequences. It can be associated with both a real threat to a person’s life, and with some unfavorable circumstances. In the first case, it can be a terrorist attack, bombing, or, for example, rape, which objectively have a destructive effect on a person's life and health and can lead to mental illness, such as PTSD. In the second case, any negative, uncomfortable, destructive, threatening event that a person perceives as traumatic can become a psychological trauma, but according to objective criteria, it is not. For example, such an event for a child may be a transfer to another school or a change of residence. Another example of such a trauma is when a child sees his father beating his mother. In this case, the child himself is not subject to physical violence, but he still experiences fear, and such events can form a psychological trauma for him.

Psychotrauma disrupts the normal organization of the psyche and can lead to the development of mental disorders.

Whether a person perceives a certain factor as traumatic depends on his individual characteristics, the significance of the event for the person, as well as the degree of his psychological security and resistance to life situations. The perception of a certain factor or event as trauma is based on fear and anxiety. It happens that psychotrauma develops under the influence of some general external factor that causes anxiety, for example, a difficult political situation in the country or poverty in the family. Against the background of such situations, a person may develop a sense of anxiety, which will eventually form in the form of psychological trauma. A similar feeling can also develop in a child who is left alone by his parents for a long time, even though they return each time.

See also

What is borderline personality disorder?

Psychological trauma can lead to psychosomatic illnesses, neuroses, as well as emotional reactions to events that bring the person back to the trauma. Also, psychotrauma can play a role in the development of psychosomatic diseases, such as angina pectoris, myocardial infarction, or peptic ulcer of the gastrointestinal tract. Sometimes psychological trauma has an impact on the brain, as a result of which people lose the ability to adapt to stress and develop increased anxiety. Psychotrauma disrupts the normal organization of the psyche and can lead to the development of mental disorders. At the borderline level, both temporary sensations of discomfort and stable conditions can appear that weaken the immune system, performance and adaptive thinking abilities.

How does psychological trauma lead to mental disorder?

It is important to note that trauma is a possible cause of the disorder, not the disease itself. There are traumatic events in everyone's life. Many parents in childhood were dropped due to an oversight, everyone was once frightened by the sound of a siren or a car horn, many had a kindergarten teacher or a teacher at school who cursed and screamed - we all went through some kind of traumatic events. However, not all of these traumatic events caused some kind of psychopathology. Why, despite the fact that the teacher yelled at everyone in the kindergarten group, this event became traumatic for only one child, and in the future contributed to the development of, for example, depression? The fact is that events become traumatic and lead to mental illness in people who are genetically predisposed to this and who grow up in a negative family environment.

Psychotrauma is a general theoretical concept that does not fully explain the development of a particular disease or condition.

Psychotrauma is never an independent problem or the only cause of the development of a mental disorder. For example, the causes of borderline personality disorder are the organic component of the human brain, emotional instability, as well as destructive relationships in the family. Together, these factors lead to the development of the disease. A child whose parents constantly fight is more likely to develop depression, provided that he has a genetic predisposition for this disorder. A certain factor becomes a traumatic event for a person and leaves an imprint on his behavior and perception in the future, and in the future may develop a mental illness.

See also

Myths about diagnosing mental illness

The most common causes of childhood psychotrauma are insults and depreciation, neglect of the interests of the child, dysfunctional family environment, overprotection by parents, and physical abuse. Research shows that children who have been abused are more likely to suffer from anxiety, depression, low self-esteem, symptoms of post-traumatic stress disorder, and suicidal tendencies in the future.

How to get rid of psychological trauma?

Psychotrauma is a general theoretical concept that does not fully explain the development of a particular disease or condition. Western psychiatrists do not consider psychological trauma as the main factor or cause of the development of mental disorders, unless it refers to specific traumatic events that led to PTSD. Psychotrauma is perceived in the process of diagnosis and treatment as an accompanying and additional factor. Modern psychiatrists and psychotherapists treat diseases that theoretically could be caused by psychological trauma, but they do not deal with the treatment of psychotrauma itself, since they do not perceive it as an independent problem.

Psychotrauma, by definition, cannot be refuted, since any event in our life, from which we became afraid and which was imprinted in our memory, can be called a psychological trauma. And if you always appeal to the concept of psychotrauma, it will become impossible to explain and decompose a behavioral or mental problem into its components, the mechanism for the formation of this problem and the way to solve it will not be clear.

  • Diseases and disorders

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Psychological trauma is not what you are used to thinking about.

What is it really?

Psychological trauma is a mental state. It can be accessed at any age, not only in childhood. Traumatic situations are situations that directly threaten life and health, such as terrorist attacks, disasters, physical and sexual violence. For example, the loss of a job is a serious and difficult event, but it will not be a trauma, but military action is. But it happens that some people, even in an emergency situation, are not injured, they have enough internal resources to withstand a negative event without serious consequences.

Why are childhood injuries dangerous?

Children are distinguished by the fact that they are very dependent and cannot ensure their own safety, therefore an instinctive program operates in them - emotional behavioral complex . He makes you strive to be close to your adult, to have contact with him and to be sure that if something happens, then the adult is nearby. It's so laid down by nature. This adult does not always have to be a mother, this is the whole close circle of people who are nearby. For example, it could be a nanny.

When does childhood trauma occur?

· If important adults for some reason do not respond to the child's call for help or make it clear that they are not going to take care of him, reject and push him away.

· If the parents suffer from depression, alcoholism or other illness.

· If parents have been lost. That is, the death of at least one parent.

· Severe and prolonged illness of a parent, which resulted in a long separation from him.

· Situations when, instead of caring, cruelty is shown towards the child.

In these cases, the attachment program may not work normally. And then the child experiences a state called "attachment panic" . It can have a traumatic trail, even if there is no direct threat to life and health. For example, when a small child is taken to a hospital for treatment without a mother (which was the norm until recently).

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