Substance use in California is widespread: Half of Californians over age 12 reported using alcohol in the past month, and 20% reported using marijuana in the past year. While many people use substances safely, the overuse or misuse of alcohol and other drugs, including illicit drugs, can lead to immediate or long-term health problems. Nine percent of Californians met the criteria for a substance use disorder (SUD) in the last year.

The health care system is moving toward acknowledging substance use disorders as chronic illnesses, yet only about 10% of people with an SUD in the last year received treatment. Overdose deaths from both opioids and psychostimulants, such as amphetamines, are soaring.

Substance Use in California: Prevalence and Treatment uses the most recent data available to provide an overview of substance use and addiction in California. Topics include prevalence of substance use, emergency department visits, deaths, and treatment.

Key findings include:

• The death rate from fentanyl increased 10-fold from 2015 to 2019. The rate of prescription opioid deaths fell 30% from 2011 to 2019.
• The number of amphetamine-related emergency department visits increased nearly 50% between 2018 and 2020. The number of non-heroin-related opioid ED visits more than doubled in the same period.
• California’s Drug Medi-Cal Organized Delivery System pilot program has been implemented in 37 counties, which represent 96% of the state’s Medi-Cal population.
• Between 2017 and 2019 the number of facilities offering residential care for substance use treatment grew by 68%, and the number of facilities offering hospital inpatient care more than doubled.
• Approximately 40% of commercial HMO and PPO health plan members with an alcohol or other drug dependence diagnosis received care that met the national quality standard of an initial treatment visit within 14 days of diagnosis.

The full report, a quick reference guide, and all the charts found in the report are available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Behavioral Health in California.