November 11, 2022

Substance-use disorders

These neurobiological disorders involve a complex interplay between genetics and environment and are an active area of study for Kaiser Permanente.

The office of the U.S. surgeon general defines substance use disorders as “medical illness[es] caused by repeated misuse of a substance or substances, characterized by clinically significant impairments in health [and] social function, and impaired control over substance use, and diagnosed through assessing cognitive, behavioral, and psychological symptoms.”1 They are neurobiological disorders that involve a complex interplay between genetics and environment, and they are often effectively treated.

The 2020 National Survey on Drug Use and Health estimated that 10% of Americans over age 11 have alcohol use disorders.2 More than 20% of Americans age 12 and older use marijuana or illicit drugs.2 Approximately 5.8% of Americans misuse prescription drugs, while 3.4% misuse opioid drugs.2 The Centers for Disease Control and Prevention estimates that 12.5% of American adults are current smokers,3 while 2.3% use smokeless tobacco products.4

Misuse of all these substances varies with respect to the prevalence of use and use disorders — each has different risk factors, associated health risks, treatment modalities, and treatment outcomes.

Kaiser Permanente publications related to substance abuse disorders since 2007

Source: Kaiser Permanente Publications Library and Scite metrics, as of January 5, 2022.

KP publications related to substance abuse disorders since 2007: 692 journal articles, 18,756 citations, 66 citations in PubMed guidelines

Substance use disorders are an active area of study for Kaiser Permanente Research. Scientists across the organization have published nearly 700 articles related to substance use disorders since 2007.5 These articles, which have been cited almost 19,000 times, are the product of observational studies, randomized controlled trials, meta-analyses, and other studies led by Kaiser Permanente scientists.

Our unique environment — a fully integrated care and coverage model in which our research scientists, clinicians, medical groups, and health plan leaders collaborate — lets us contribute generalizable knowledge on substance use disorders and many other research topics.


  1. U.S. Department of Health and Human Services. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS; 2016.
  2. Substance Abuse and Mental Health Services Administration Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration;2021
  3. Centers for Disease Control and Prevention. Fast Facts and Fact Sheets: Smoking and Tobacco Use. 2022. Accessed October 6, 2022.
  4. Cornelius ME, Loretan CG, Wang TW, et al. Tobacco Product Use Among Adults - United States, 2020. MMWR Morb Mortal Wkly Rep. 2022;71(11):397-405.
  5. KPPL Search, conducted on January 5, 2022: (dc.title:alcoholism OR dc.title:addiction OR title:”chemical dependency” OR dc.title:smok* OR dc.title:”substance abuse” OR dc.title:drink* OR dc.title:”drug abuse” OR title:”substance use” OR dc.title:”drug misuse” OR dc.title:”opiate addiction” OR dc.title:”opioid ad- diction” OR dc.title:marijuana OR dc.title:cannabis OR dc.title:nicotine OR(title:”opioid overdose”~10) OR (title:”tobacco cessation”~10) OR (title:”alcohol and drug treatment”~10) OR abstract:”problem drinking” OR abstract:”12-step” OR dc.subject.mesh:”Substance-Related Disorders” OR dc.subject.mesh:”Marijuana Abuse” OR dc.subject.mesh:Alcoholism OR dc.subject.mesh:”Amphetamine-Related Disorders” OR dc.subject. mesh:”Opioid-Related Disorders” OR dc.subject.mesh:”street drugs” OR dc.subject.mesh:”tobacco use” OR dc.subject.mesh:”Tobacco Use Cessation” OR dc.subject.mesh:”Smoking Cessation” OR dc.subject.mesh:nicotine OR dc.subject.mesh:”Substance Abuse Treatment Centers” OR citation:Addiction OR citation:”J Addict Med” OR citation:”Drug Alcohol Depend” OR citation:”J Subst Abuse Treat”) AND dc.type:”Journal Article” AND[2007 2022].