This report that provides data on the adults in recovery from their substance use and/or mental health problem and provides policy recommendations identified as supporting recovery. Using data from the 2021 National Survey on Drug Use and Health (NSDUH), this report shows that 70 million adults aged 18 or older perceived that they ever had a substance use and/or mental health problem. For substance use specifically, of the 29.0 million adults who perceived that they ever had a substance use problem, 72.2% (or 20.9 million) considered themselves to be in recovery or to have recovered from their drug or alcohol use problem. For mental health, of the 58.7 million adults who perceived they ever had a mental health problem, 66.5% (or 38.8 million) considered themselves to be in recovery or to have recovered from their mental health problem.

Recovery is characterized by continual growth and improvement in one’s health and wellness while managing setbacks, which are a natural part of life. The current report leverages data to examine the factors – such as spirituality, treatment, insurance coverage and social supports – that support recovery from substance use and mental health problems more clearly. Through this effort, SAMHSA can better achieve its vision that people with, affected by or at risk for mental health and substance use conditions receive care, achieve well-being and thrive. The report also identifies the resilience that people in recovery develop as they reported few impacts on their behavioral health during the COVID-19 pandemic.

Key findings include:

• Adults who participated in at least one government assistance program, had lower levels of education, or had a lower family income relative to the federal poverty level were generally more likely to be in substance use recovery, but less likely to be in mental health recovery.
• Mental health recovery tended to be more common among adults who were insured or heterosexual.
• The percentage of adults in mental health recovery was significantly higher among those who received any mental health treatment in the past year, including inpatient, outpatient, prescription, or virtual care. The percentage of adults in recovery from either substance use or mental health problems was also lower among those who felt that they needed mental health treatment but did not receive it in the past year.

Overall, the findings reveal that recovery is real and that with a range of holistic, individualized supports, people with mental health and/or substance use conditions can and do overcome these challenges and live productive lives in our communities.