title: Epidemiology of DSM-5 Drug Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III.
abstract: OBJECTIVE
  Current information on the prevalence and sociodemographic and clinical profiles of individuals in the general population with DSM-5 drug use disorder (DUD) is limited. Given the present societal and economic context in the United States and the new diagnostic system, up-to-date national information is needed from a single uniform data source.
  
  
  OBJECTIVE
  To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses overall and by severity level.
  
  
  METHODS
  In-person interviews were conducted with 36,309 adults in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional representative survey of the United States. The household response rate was 72%; person-level response rate, 84%; and overall response rate, 60.1%. Data were collected April 2012 through June 2013 and analyzed from February through March 2015.
  
  
  METHODS
  Twelve-month and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or solvent/inhalant use disorders.
  
  
  RESULTS
  Prevalences of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use disorder was generally greater among men, white and Native American individuals, younger and previously or never married adults, those with lower education and income, and those residing in the West. Significant associations were found between 12-month and lifetime DUD and other substance use disorders. Significant associations were also found between any 12-month DUD and major depressive disorder (odds ratio [OR], 1.3; 95% CI, 1.09-1.64), dysthymia (OR, 1.5; 95% CI, 1.09-2.02), bipolar I (OR, 1.5; 95% CI, 1.06-2.05), posttraumatic stress disorder (OR, 1.6; 95% CI, 1.27-2.10), and antisocial (OR, 1.4; 95% CI, 1.11-1.75), borderline (OR, 1.8; 95% CI, 1.41-2.24), and schizotypal (OR, 1.5; 95% CI, 1.18-1.87) personality disorders. Similar associations were found for any lifetime DUD with the exception that lifetime DUD was also associated with generalized anxiety disorder (OR, 1.3; 95% CI, 1.06-1.49), panic disorder (OR, 1.3; 95% CI, 1.06-1.59), and social phobia (OR, 1.3; 95% CI, 1.09-1.64). Twelve-month DUD was associated with significant disability, increasing with DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and 24.6% received treatment, respectively.
  
  
  CONCLUSIONS
  DSM-5 DUD is a common, highly comorbid, and disabling disorder that largely goes untreated in the United States. These findings indicate the need for additional studies to understand the broad relationships in more detail; estimate present-day economic costs of DUDs; investigate hypotheses regarding etiology, chronicity, and treatment use; and provide information to policy makers about allocation of resources for service delivery and research. Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policy makers about its treatment to encourage affected individuals to obtain help.
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Bridget F
authors.initials: BF
authors.lastname: Grant
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Tulshi D
authors.initials: TD
authors.lastname: Saha
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: W June
authors.initials: WJ
authors.lastname: Ruan
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Risë B
authors.initials: RB
authors.lastname: Goldstein
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: S Patricia
authors.initials: SP
authors.lastname: Chou
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Jeesun
authors.initials: J
authors.lastname: Jung
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Haitao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Smith
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Roger P
authors.initials: RP
authors.lastname: Pickering
authors.affiliation: Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
authors.forename: Boji
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Psychiatry, College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, New York3New York State Psychiatric Institute, New York.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D000987:Antisocial Personality Disorder / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology*; D001883:Borderline Personality Disorder / Q000453:epidemiology; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019263:Dysthymic Disorder / Q000453:epidemiology*; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D058545:Inhalant Abuse / Q000453:epidemiology; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology; D010554:Personality Disorders / Q000453:epidemiology*; D015995:Prevalence; D012569:Schizotypal Personality Disorder / Q000453:epidemiology; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult