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The Most Common Addictions in the United States

By 
Hannah Friedman
|
 July 12th, 2023|   Clinically Reviewed by 
Dr. Malasri Chaudhery-Malgeri, Ph.D.

Both drug and behavioral addictions are extremely common in the United States. And drug addiction is steadily on the rise. 

In 2021, the Substance Abuse and Mental Health Services Administration (SAMHSA) found that nearly 50 million Americans have drug or alcohol addictions.1 Behavioral addictions, like gambling and internet use, are also a growing concern. 

If you’re wondering how to overcome addiction, you can start by learning about the most abused drugs in the United States. 

Alcohol Addiction

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 11.3% of adult Americans have alcohol addiction.2 A report from the National Council on Alcoholism and Drug Dependence even calls alcohol “the most commonly used addictive substance3 in the United States.”

Causes:

There are several possible causes of alcohol addiction:4 

Alcohol is widely available, and many people feel social pressure to drink.5 This can also contribute to addiction.

Effects: 

According to the CDC, long-term excessive drinking puts you at risk6 of physical health problems:

  • High blood pressure
  • Liver disease
  • Cancer

Alcohol addiction also affects mental health.7 It can lead to depression, memory problems, and even antisocial behavior.

Treatments:

There are many treatments for alcohol addiction. Experts report that a few specific types of therapy are especially helpful:8

  • Cognitive behavioral therapy (CBT)
  • Motivational enhancement therapy (MET)
  • Contingency management
  • Couples therapy
  • 12-Step programs

Opioid Addiction

There is currently an opioid addiction crisis in the United States.9 These drugs play a role in nearly 75% of all overdose deaths. According to SAMHSA, 1% of all Americans over the age of 12 had opioid addiction in 2020.10 

Causes:

Many factors contribute to opioid addiction,11 like genetics and mental health issues. Childhood trauma also makes you more vulnerable. Chronic pain is a major risk factor,12 especially if you manage it with an opioid prescription. 

Effects:

Opioid abuse has many health risks.13 As your tolerance goes up, you may need higher and higher doses to manage physical pain. This addiction also cuts into the time you spend with loved ones, damaging your relationships.

Opioid use can be life-threatening. Overdose causes respiratory depression, in which you can stop breathing. Without immediate medical attention, this is often fatal.

Treatments:

Opioid addiction treatment normally includes more than one type of care: 

Marijuana Addiction

In 2020, marijuana addiction was one of the 3 most common addictions in the United States.16 As cannabis becomes more socially acceptable, rates of this addiction may continue to rise. 

Causes:

The younger you are when you start using marijuana,17 the higher your risk of addiction. The drug’s potency also plays a role.

As more states legalize cannabis, scientists are developing more potent strains. According to Tom Freeman, Director of the Addiction and Mental Health Group at the University of Bath, high-potency marijuana has 4 times the risk of addiction.18 

Effects:

There’s a relationship between marijuana use and mental health issues,19 but we need more data to determine which one causes the other. Research shows that marijuana addiction shares symptoms with anxiety and depression. Long-term marijuana use also causes memory problems.20 

Treatments:

Most marijuana rehabs focus on counseling. During treatment, you might engage in a few types of talk therapy:21

  • MET
  • CBT
  • Contingency management

Scientists are still researching medications to treat cannabis addiction. 

Cocaine Addiction

SAMHSA estimates that 1.3 million people have cocaine addiction22 in the United States. Nearly 25% of these people are teenagers. Some studies suggest that teens are more vulnerable to cocaine addiction23 than adults. 

Causes:

In addition to age, genetics play a role in cocaine addiction.24 What’s more, ongoing cocaine use can change your brain activity, so your reward system responds only to the drug. Over time, that increases your risk of addiction.

Effects:

Cocaine causes a wide range of physical symptoms. Snorting cocaine harms your nasal passages,25 causing nosebleeds, sinus issues, and respiratory problems. Smoking crack cocaine causes lung damage. Cocaine also impacts your cardiovascular system, reducing blood flow throughout the body. 

Treatments:

Most rehabs treat cocaine addiction with behavioral therapy. Contingency management and various types of CBT are especially beneficial treatments.26 There are currently no FDA-approved medications for this condition. 

Methamphetamine Addiction

Reports show that in 2019, over 2 million American adults used methamphetamine,27 up from 1.6 million in 2015. In the same time period, the number of deaths and arrests related to methamphetamine skyrocketed.

Causes:

Several experiences increase your risk of meth addiction:28

  • Drinking
  • Smoking
  • Attention deficit and hyperactivity disorder (ADHD)
  • Family history of legal issues
  • Family history of drug use

Effects:

Meth addiction causes many physical and mental health symptoms:29 

  • Paranoia and hallucinations
  • Anxiety
  • Organ damage, especially to the lungs, liver, and kidneys
  • Dental problems
  • High blood pressure
  • Permanent neurological changes

Treatments:

In treatment for methamphetamine addiction, you’ll probably engage in behavioral therapy. According to the National Institute on Drug Abuse (NIDA), CBT and contingency management are “the most effective treatments30 for methamphetamine addiction.”

Gambling Addiction

Because research into this condition is so new, it’s hard to accurately assess how many people have a gambling addiction. But some reports estimate that “roughly 1 percent of American adults, or about 2.5 million people, have a severe gambling problem.”31

Causes:

Men are at a higher risk for gambling addiction.32 You might also be more vulnerable if you were raised by a single parent or a parent with an addiction. 

Effects:

Unlike substance use disorders, behavioral addictions rarely have physical symptoms. Even so, the effects of gambling addiction33 can be overwhelming:

  • Anxiety which is only relieved by gambling
  • New or worsening depressive symptoms
  • Financial hardship
  • Strained family relationships

Treatments:

When you’re ready to recover from gambling addiction, your care team will help you choose the right treatments. That means something different for everyone. Most programs recommend at least one type of talk therapy to treat gambling disorder:34

  • CBT
  • Psychodynamic therapy
  • Group therapy
  • Family therapy

In rehab, you might also attend a 12-Step group like Gamblers Anonymous (GA).

Internet and Gaming Addiction

At least 93% of Americans are internet users.35 One study found that within that number, 63% of teenage internet users go online every day, and 36% go online several times each day.36 

While we have clear data about internet use, we need more about internet and gaming addiction. Various studies claim that anywhere from 38-90% of internet users have internet addiction.37 Another survey reports that 3.3% of people who play video games have a gaming addiction.38 

Causes:

Gaming and internet addiction are more common among men.39 Several factors make these conditions more likely: 

  • Depression
  • Anxiety
  • ADHD
  • Social isolation
  • Aggressive behavior
  • Low self-esteem

These issues can lead to internet addiction—and vice versa. Unchecked internet use makes the same symptoms even more severe. 

Effects:

Excessive gaming can have serious health effects:40 

  • Back pain
  • Eye strain
  • Carpal tunnel syndrome
  • Sporadic eating habits
  • Sleep problems

Internet addiction also isolates you from loved ones. In extreme cases, it can interfere with work or school.

Treatments:

A growing number of rehabs treat internet and gaming addiction. However, this is a new area of study. Researchers warn that until we have more data, we should approach all treatments for these addictions as experimental.41 

Despite these concerns, mental health professionals recommend a few types of therapy for internet and gaming addiction:42 

  • CBT
  • Wilderness therapy
  • Family therapy

Food Addiction

Various reports estimate that anywhere from 5.8-56.8% of Americans have a food addiction.43 Experts also note the overlap between food addiction and eating disorders44 like bulimia nervosa. 

Causes:

Food addiction and drug addiction45 often co-occur. Either one might make the other more likely. Severe childhood abuse can also lead to food addiction46 in adulthood. This condition is more likely for people with depression, anxiety, and low self-esteem.

Effects:

While food addiction can make you gain weight,47 that’s not true for everyone. More consistently, it leads to overwhelming feelings of guilt and shame. 

Treatments:

Food addiction recovery can include weight loss, but that’s not always the right approach. To treat the root cause of this condition, experts recommend approaching it like a binge eating disorder. CBT and interpersonal psychotherapy (IPT) are popular treatments for food addiction.48

Shopping Addiction

Between 1.8-16% of adults in the United States have a shopping addiction,49 also called compulsive buying.

Causes:

Several co-occurring conditions are common for people with shopping addiction:50

Effects:

Excessive shopping impacts more than your mental health.51 It can also have serious external consequences:

  • Debt
  • Legal issues
  • Relationship problems

Treatments:

Rehab for shopping addiction usually focuses on talk therapy. Data supports CBT and group therapy52 as helpful treatments for this condition.

Pornography Addiction

Like any other behavioral addiction, excessive pornography use can be very serious. But we don’t yet understand the scope of the issue in the United States. That’s partly because news sources commonly circulate false statistics about online pornography.53 

Causes:

Porn addiction is more likely54 for people with certain characteristics:

  • Male
  • Younger age
  • Religious
  • Novelty-seeking

It’s also more common among people who spend a lot of time online. 

Effects:

One study links excessive porn use with anxiety,55 depression, and sexual dysfunction. Porn addiction might cause these symptoms, or vice versa. Porn use also affects relationships.56 This condition can make it easier to objectify your partner. Over time, that disconnect can drive a wedge between you. 

Treatments:

Most rehabs for porn addiction offer several types of therapy. However, researchers say that CBT “might be the most effective technique57 for such patients addicted to pornography.” Some people also attend 12-Step groups like Porn Addicts Anonymous.

To learn more about treatment options for various addictions, search our collection of rehabs to take virtual tours, read reviews, see pricing, and more, and reach out to centers directly.


Frequently Asked Questions About Common Addictions in the U.S.

What are the most common addictions in the United States?

The most common addictions in the U.S. include alcohol addiction, opioid addiction, marijuana addiction, cocaine addiction, methamphetamine addiction, gambling addiction, internet and gaming addiction, food addiction, shopping addiction, and pornography addiction.

What are the causes of alcohol addiction?

Genetic predisposition, a family history of alcohol abuse, co-occurring mental health issues, easy availability of alcohol, and social pressure to drink can all contribute to problem drinking.

How is opioid addiction treated?

Rehabs typically treat opioid addiction through a combination of medications (such as methadone) and talk therapy. Medications help alleviate cravings, while therapy addresses the underlying psychological factors that led to the addiction in the first place.


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