Substance Use and

Mental Illness across the

United States
Lulia Aklilu, Catharine Carfagno, Anna Nguyen

1
Background information - key terms
mental illness
A disorder is characterized
by a clinically significant
disturbance in an
individual’s cognition,
emotional regulation, or
behavior.
serious
mental illness
Having, at any time during the past
year, a diagnosable mental,
behavior, or emotional disorder
that causes serious functional
impairment that substantially
interferes with or limits one or
more major life activities.
substance
misuse
Use of a substance for a
purpose not consistent with
legal or medical guidelines,
specifically: use without a
prescription of the
respondent’s own, or use in
greater amounts, more often,
or longer than told to take a
drug
2
Background information
● 1 in 5 Americans are diagnosed with mental illnesses each year, with 50%
of Americans experiencing a period of mental illness in their lifetime
● 80,411 overdoses from opioid use occurred in 2021
● Research indicates that 43% of people in SUD treatment for nonmedical
use of prescription painkillers have a diagnosis or symptoms of mental
health disorders, particularly depression and anxiety
● 21 states have fully legalized marijuana for recreational use, and 18 states
have legalized marijuana strictly for medicinal purposes

3
Data collection
The Substance Abuse and Mental Health
Services Administration (SAMHSA), a branch
of the United States department of health and
human services, conducts the National Survey
of Drug Use and Health (NSDUH) every year.

● Age ranges starting from 12 years old

● Illicit and legal drug use and misuse
● Reports of mental health disorders and
treatment admissions
● All data included was collected in 2021

4
WE CHOOSE TO EVALUATE DATA COLLECTED ON:

Occurrences of
Marijuana use serious mental illness
in adults 18+ in adults 18+

Opioid use and Occurrences of any

misuse in adults 18+ mental illness
in adults 18+

5
RESEARCH QUESTIONS

How does opioid use impact mental health

1 disorders across the United States?

How does marijuana use impact mental

2 health disorders across the country?

Where are mental health issues and opioid

3 use most prevalent within the United States?

6
results

7
 There is a significant
(0.0104 *) influence of
marijuana use on the
percentage of the
population that has any
mental illness

8
 There is a very significant
(4.29e-06 *** ) influence of
opioid use on the percentage
of the population that has
any mental illness

9
 Results: percentage of population that engages in
opioid use across the united states by region and by
state

Average
across
US:
3.43%

10
Percentage of the population with any mental illness and
percentage of population that engages in opioid use
across the united states

Average
across
US:
23.6%

11
Percentage of the population with Serious mental illness and
percentage of population that engages in opioid misuse
across the united states

Average
opioid
misuse:
2.2%

Average
serious
mental
illness:
5.8%

12
Spatial Autocorrelation for clustering of
opioid misuse across the US

Percentage of Population Engaging in

Opioid Misuse by State

13
Lisa plot of clusters and outlier states with
percentage of opioid misuse

14
 conclusions
● While Marijuana Use has a significant impact on Mental Illness in the United States, Opioid
Use has an even greater influence
● The percentages of Opioid Use and Misuse are higher in the South, while the rates of Mental
Illness and Serious Mental Illness are higher in the West
● Although the highest percentages of usage and mental illness don’t overlap, it is still
observed that the higher percentages of Usage, the higher rates of Mental Illness over the
average.
● Moran’s I test shows that there is spatial autocorrelation of states with higher percentages of
Opioid Misuse and some Southern states show clustering for the high levels
Overall:
● The South seems to be a region that can be at risk for higher levels of Opioid Use and
Misuse, with specific emphasis on Tennessee and Kentucky
● The Midwest seems to have higher levels of Mental Illness, with specific emphasis on
Oklahoma and Nebraska

15
references
1. https://www.who.int/news-room/fact-sheets/detail/mental-disorders#:~:text=A%20m
ental%20disorder%20is%20characterized,different%20types%20of%20mental%20diso
rders.
2. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-
use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
3. https://www.ncbi.nlm.nih.gov/books/NBK53217/
4. https://www.cdc.gov/mentalhealth/learn/index.htm#:~:text=How%20common%20are
%20mental%20illnesses,some%20point%20in%20their%20lifetime.&text=1%20in%205
%20Americans%20will,illness%20in%20a%20given%20year.
5. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=
Opioid%2Dinvolved%20overdose%20deaths%20rose,with%2080%2C411%20reported
%20overdose%20deaths.
6. https://www.axios.com/2023/04/20/weed-pot-april-20-medical-marijuana-legal

16