Substance Use in California Almanac — 2025 Edition

Substance use in California is widespread. Almost half of Californians age 12 and older reported using alcohol in the past month, and about one in four 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. Approximately 5.6 million Californians age 12 and older (17%) reported meeting the criteria for a substance use disorder (SUD) in 2022 to 2023.

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

KEY FINDINGS INCLUDE:

• The average annual rate of substance use disorder for young adults (age 18 to 25) was over three times the rate for adolescents (age 12 to 17).
• Between 2019 and 2023, the number of emergency department visits for non-heroin opioid use tripled.
• In 2023, 7,560 Californians died from an opioid-related overdose. The death rate per 100,000 population from fentanyl increased from 0.2 deaths in 2013 to 18.3 deaths in 2023.
• California’s Drug Medi-Cal Organized Delivery System (DMC-ODS) provides organized SUD treatment to eligible Medi-Cal members. As of August 2024, 39 counties, representing 96% of the state’s Medi-Cal population, had implemented DMC-ODS.
• Almost two in five people with commercial HMO and PPO health plans who had an alcohol or other drug dependence diagnosis had an initial treatment visit within 14 days of diagnosis, meeting the national quality recommendation.

The full 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. To see past editions of this almanac, contact us.