2025 National Survey Shows Substance Use Continues to Shift: What Employers Need to Know

By Working Partners®

Every year, the National Survey on Drug Use and Health (NSDUH) provides one of the most comprehensive looks at substance use and mental health in the United States. Conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), the survey represents thousands of interviews with Americans age 12 and older and helps identify national trends that impact families, communities, healthcare providers—and employers.

The newly released 2025 NSDUH continues to show that America's relationship with alcohol, marijuana, nicotine, and other substances is changing. For employers responsible for maintaining a safe, productive workplace, these trends matter.

The data reinforces an important reality:

Perhaps the most discussed finding from the report is the continued increase in marijuana use.

While alcohol remains the most commonly used substance overall, marijuana use has continued to climb over the past several years, particularly among adults.

The survey found:

• Nearly 44 million Americans reported using marijuana in the past month.

• Approximately 21.4 million people reported using marijuana on a daily or near-daily basis.

• Daily or near-daily marijuana use now exceeds daily alcohol consumption and regular cigarette smoking.

This reflects changing public attitudes, expanding legalization, and increased availability of cannabis products.

However, legalization should never be confused with workplace safety.

As the National Institute on Drug Abuse notes:

Those effects may significantly impact employees working in safety-sensitive positions.

Although marijuana receives much of today's attention, alcohol continues to be the most commonly used substance in America.

According to the NSDUH:

• More than 129 million Americans reported drinking alcohol in the past month.

• Millions continue to engage in binge drinking.

• Alcohol Use Disorder remains a significant public health concern.

For employers, alcohol impairment remains one of the most overlooked workplace risks because it is legal, socially accepted, and often consumed outside working hours.

Yet alcohol-related impairment can still affect:

• judgment

• reaction time

• attendance

• productivity

• workplace injuries

  
  

Traditional cigarette smoking continues to decline. However, nicotine use has not disappeared—it has evolved. Electronic cigarettes and vaping remain common, particularly among younger adults.

While vaping itself may not violate many workplace drug policies, employers should recognize that vaping devices can also be used to consume THC and other substances. Appearance alone rarely tells the full story.

The NSDUH also continues to demonstrate the strong connection between substance use and mental health. Many individuals experiencing anxiety, depression, trauma & serious psychological distress also report higher rates of substance use.

SAMHSA emphasizes that behavioral health should be viewed as a whole-person issue rather than separating mental health from substance use.

For employers, this reinforces the value of offering supportive resources such as:

• Employee Assistance Programs (EAPs)

• supervisor training

• early intervention

• reasonable suspicion training

• clear pathways to assistance

  
  

A Drug-Free Workplace Program should not focus solely on testing—it should also provide employees with access to help before situations escalate.

Many employers assume substance use is a personal issue. In reality, it can directly affect workplace operations.

Potential impacts include:

• Increased absenteeism

• Reduced productivity

• Higher workers' compensation costs

• More workplace accidents

• Increased turnover

• Greater liability exposure

A well-designed Drug-Free Workplace Program helps organizations reduce these risks while ensuring employees understand expectations before problems arise.

One misconception that continues to grow alongside marijuana legalization is the belief that employers cannot enforce workplace drug policies. That simply is not true.

Many states—including Ohio—continue to protect employers' ability to:

• prohibit workplace impairment

• prohibit possession or use while working

• require drug testing when permitted by law

• maintain drug-free workplace policies

• discipline employees who violate policy

Employers should review their policies regularly to ensure they reflect current federal, state and local laws while preserving workplace safety.

The changing landscape makes employee education increasingly valuable.

Employees should understand:

• why workplace policies exist

• how impairment affects safety

• available resources for confidential assistance

• consequences of policy violations

• how to seek help before problems become disciplinary issues

Likewise, supervisors should receive ongoing training on recognizing and appropriately responding to possible impairment in the workplace.

The 2025 National Survey on Drug Use and Health confirms that substance use patterns in the United States continue to evolve. While marijuana use continues to increase and public attitudes shift, employers' responsibilities remain unchanged:

Protect employees.

Maintain safe workplaces.

Apply policies consistently.

Support employees who need help.

A strong Drug-Free Workplace Program is not simply about compliance—it is about protecting people while helping organizations remain productive, consistent, and prepared for today's workplace challenges.

To view the report in it entirety click here: https://www.samhsa.gov/data/data-we-collect/nsduh-national-survey-drug-use-and-health/national-releases/2025

Don't navigate today's changing workplace alone. Whether you have questions about the 2025 NSDUH findings or your Drug-Free Workplace Program, Working Partners® is here to provide trusted guidance, practical solutions, and expert support every step of the way.

References

• Substance Abuse and Mental Health Services Administration (SAMHSA). 2025 National Survey on Drug Use and Health (NSDUH) Annual National Report.

• Substance Abuse and Mental Health Services Administration (SAMHSA). 2025 NSDUH Companion Infographic Report.

• National Survey on Drug Use and Health (NSDUH) Overview.