Substance Use in California: A Look at Addiction and Treatment

Wendy Holt, DMA Health Strategies


Substance use and substance use disorders (SUDs) are often part of conversations, but not as frequently considered for their place in the health care system. Still clouded by stigma, substance use disorders are slowly beginning to be more broadly understood as chronic illnesses — and the health care system is (also slowly) beginning to identify, treat, and pay for them that way.

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Substance use disorders are common. About 8% of Californians met criteria for substance use disorder, but only 10% of people with a substance use disorder received any type of treatment.

Substance Use in California: A Look at Addiction and Treatment is CHCF’s first Almanac publication to address this topic. It uses the most recent data available to provide an overview of substance use and addiction in California. Topics include prevalence of substance use disorder, use of alcohol and other drugs, mortality, emergency department use, treatment, workforce, and spending.

Key findings include:

  • Alcohol use disorder was more prevalent than other types of substance use disorders. Six percent of Californians reported meeting the criteria for dependence on alcohol, compared to 3% for illicit drugs.
  • Substance use disorders were most prevalent among young adults 18 to 25, occurring at nearly twice the state average rate.
  • Use of alcohol and other drugs often begins in adolescence. By 11th grade, more than half of California students have used alcohol and almost 40% have used marijuana.
  • Alcohol accounted for more nonfatal emergency department visits than all other drug diagnoses combined.
  • The number of heroin-related emergency department visits in California more than tripled between 2006 and 2017.
  • California is undertaking a major effort to expand and improve its SUD services in Medi-Cal through the Drug Medi-Cal Organized Delivery System (DMC-ODS) pilot program.

The full report, all of the charts found in the report, and a quick reference guide are available under Related Materials. 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.