Abstract
Drug and alcohol use disorders account for a high and potentially preventable proportion of overall disability and mortality. This article reviews published data on the distribution of alcohol and drug abuse and dependence in the USA. Published data shows that alcohol use disorders are more prevalent than illegal drug use disorders, although the persistence of both disorders was similar over a three-year follow-up period. Significant variability exists within sex, racial/ethnic, and age groups. Men, Native Americans, and young adults, aged 18 to 25, are at a higher risk of substance dependence. Environmental correlates of disorder include early environmental factors, political environment, and social contextual factors. Systematically identifying, and measuring variability across demographic populations, will guide prevention and intervention efforts. Future research will expand understanding of the complex interplay between individual and environmental factors that serve to initiate and sustain alcohol and drug use disorders.