Reduce the proportion of people who had alcohol use disorder in the past year — SU‑13 Data Methodology and Measurement

On this page: About this objective | Methodology | History

About this objective

Data

Data Source: National Survey on Drug Use and Health (NSDUH), SAMHSA

National baseline: 10.6 percent of persons aged 12 years and over had an alcohol use disorder (defined as meeting DSM-IV criteria) in the past 12 months in 2021

National target: 9.9 percent

Numerator

Number of persons aged 12 years and over with alcohol use disorder (defined as meeting DSM-5 criteria) in the past 12 months.

Denominator

Number of persons aged 12 years and over.

National target-setting method

Minimal statistical significance

National target-setting method details

Minimal statistical significance, assuming the same standard error for the target as for the baseline.

National target-setting method justification

Trend data are not available due to the NSDUH redesign. Data from 2021 cannot be compared or combined with data from previous years. The standard error was used to calculate a target based on minimal statistical significance, assuming the same standard error for the target as for the baseline. This method was used because it was a statistically significant improvement from the baseline. The Workgroup Subject Matter Experts viewed this as an ambitious yet achievable target.

Methodology

Questions used to obtain the national baseline data

(For additional information, please visit the data source page linked above.)

From the 2021 National Survey on Drug Use and Health:

Numerator:

DRALC01 [IF ALC12MON = 1 - 3] During the past 12 months, was there a month or more when you spent a lot of your time getting or drinking alcohol?

DRALC02 [IF DRALC01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of time getting over the effects of the alcohol you drank?

DRALC04 [IF ALC12MON = 1 - 3] During the past 12 months, did you try to set limits on how often or how much alcohol you would drink?

DRALC05 [IF DRALC04 = 1] Were you able to keep to the limits you set, or did you often drink more than you intended to?

Usually kept to the limits set
Often drank more than intended

DRALC06 [IF ALC12MON = 1 - 3] During the past 12 months, did you need to drink more alcohol than you used to in order to get the effect you wanted?

DRALC07 [IF DRALCO6=2 OR DK/REF] During the past 12 months, did you notice that drinking the same amount of alcohol had less effect on you than it used to?

DRALC08 [IF ALC12MON = 1 - 3] During the past 12 months, did you want to or try to cut down or stop drinking alcohol?

DRALC09 [IF DRALC08 = 1] During the past 12 months, were you able to cut down or stop drinking alcohol every time you wanted to or tried to?

DRALC10 During the past 12 months, did you cut down or stop drinking at least one time?

DRALC11 [IF DRALC09 = 1 OR DRALC10 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms after you cut back or stopped drinking alcohol?

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren't really there
Feeling like you couldn't sit still
Feeling anxious
Having seizures or fits

DRALC12 [IF DRALC11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped drinking alcohol?

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren't really there
Feeling like you couldn't sit still
Feeling anxious
Having seizures or fits

DRALC13 [IF ALC12MON = 1 - 3] During the past 12 months, did you have any problems with your emotions, nerves, or mental health that were probably caused or made worse by drinking alcohol?

DRALC14 [IF DRALC13 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to have problems with your emotions, nerves, or mental health?

DRALC15 [IF DRALC13 = 2 OR DK/REF OR DRALC14 = 2 OR DK/REF] During the past 12 months, did you have any physical health problems that were probably caused or made worse by drinking alcohol?

DRALC16 [IF DRALC15 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to have physical problems?

DRALC17 [IF ALC12MON = 1 - 3] This question is about important activities such as working, going to school, taking care of doing fun things such as hobbies and sports, and spending time with friends and family

During the past 12 months, did drinking alcohol cause you to give up or spend less time doing these types of important activities?

DRALC18 [IF ALC12MON = 1 - 3] Sometimes people who drink alcohol have serious problems at home, work or school — such as:

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did drinking alcohol cause you to have serious problems like this either at home, work, or school?

DRALC19 [IF ALC12MON = 1 - 3] During the past 12 months, did you regularly drink alcohol and then do something where being drunk might have put you in physical danger?

DRALC20 [IF ALC12MON = 1 - 3] During the past 12 months, did drinking alcohol cause you to do things that repeatedly got you in trouble with the law?

DRALC21 [IF ALC12MON = 1 - 3] During the past 12 months, did you have any problems with family or friends that were probably caused by your drinking?

DRALC22 [IF DRALC21 = 1] Did you continue to drink alcohol even though you thought your drinking caused problems with family or friends?

Methodology notes

Alcohol use disorder (AUD) was defined as meeting criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Respondents who used alcohol on 6 or more days in the past 12 months were classified as having an AUD if they met two or more of the following criteria: (1) used alcohol in larger amounts or for a longer time period than intended; (2) had a persistent desire or made unsuccessful attempts to cut down on alcohol use; (3) spent a great deal of time in activities to obtain, use, or recover from alcohol use; (4) felt a craving or strong desire to use alcohol; (5) engaged in recurrent alcohol use resulting in failure to fulfill major role obligations at work, school, or home; (6) continued to use alcohol despite social or interpersonal problems caused by the effects of alcohol; (7) gave up or reduced important social, occupational, or recreational activities because of alcohol use; (8) continued to use alcohol in physically hazardous situations; (9) continued to use alcohol despite physical or psychological problems caused by alcohol use; (10) increased the amount of alcohol needed to achieve same effect or noticed that the same amount of alcohol use had less effect than before; and (11) either of the following: (11a) experienced a required number of withdrawal symptoms after cutting back or stopping alcohol use or (11b) used alcohol or a related substance to get over or avoid alcohol withdrawal symptoms.

History

Revision History

Revised.

In 2024, the baseline was revised from 5.4% in 2018 to 10.6% in 2021. The target setting method was revised from Projection to MSS. The target was revised from 3.9% to 9.9% using the new target setting method.

Trend issues

SAMHSA started multimode data collection (in-person and web-based collection) for the National Survey on Drug Use and Health (NSDUH) beginning in Quarter 4 (i.e., October to December) of 2020 due to COVID-19 pandemic. The 2021 NSDUH is based on both in-person and web interviews. Prior to 2020, NSDUH data are based on in-person data collection alone. The 2020 NSDUH included only 2 quarters (Quarters 1 and 4) of data collection unlike the four quarters of data collected in other years. Several analyses were conducted to investigate the impacts of these and related methodological issues on estimates for 2021. Using the outcomes of the comparability analyses, the following decisions were made regarding the 2021 NSDUH data. • Estimates from 2021 cannot be compared with those in 2019 or prior years because estimates from a multimode year are not comparable with estimates from a single-mode year. Estimates of change from 2019 or earlier to 2021 would probably be too greatly influenced by the mode effect. • Because of effects on estimates when some quarters of data are excluded or missing, 2020 estimates (based on two quarters of data) cannot be compared with those of any other year, including 2021. Using only 2 quarters of data may yield a different trend than use of 4 quarters of data. • NSDUH data from 2021 should not be combined or compared with any prior data.In addition, the criteria used to categorize AUD among NSDUH respondents changed in 2020 and onward from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to the fifth edition (DSM-5), resulting in some differences in who is classified as having an AUD. • In addition, the criteria used to categorize substance use disorder (SUD) among NSDUH respondents changed in 2020 and onward from the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to the fifth edition (DSM-5), resulting in some differences in who is classified as having an SUD.