Texas Drug and Alcohol Statistics - World Forum for Mental Health

Statistical Data on Drugs in Texas

Texas confronts a complex drug crisis that, while less severe than national trends, continues to claim thousands of lives and affect hundreds of thousands of residents annually. The state records 3,136 overdose deaths per year, translating to a rate of 10.8 per 100,000 residents—47.83% lower than the national average, yet increasing at 2.28% annually. The crisis has shifted dramatically from prescription opioids to methamphetamine and synthetic opioids, with fentanyl now involved in 82.1% of all opioid overdose deaths and methamphetamine emerging as the DEA’s number one drug threat across all Texas field divisions. This comprehensive analysis examines the current state of drug and substance abuse in Texas based on official data from the Department of State Health Services, DEA field divisions, treatment admission records, forensic laboratories, and national surveys spanning multiple years through 2023.

Overdose Death Statistics

Overall Overdose Deaths

Annual overdose deaths: 3,136
Percentage of all deaths from overdose: 1.55%
Annual rate of increase (3-year trend): 2.28%
Overdose death rate: 10.8 per 100,000 residents
Comparison to national average: 47.83% lower
Texas share of nationwide OD deaths: 4.46%

Texas Overdose Death Statistics

Texas maintains an overdose death rate significantly below the national average, though deaths have been increasing at over 2% annually. The state accounts for a relatively small proportion of nationwide overdose deaths despite its large population.

Opioid-Specific Deaths

Total opioid overdose deaths (2023): 3,181
Opioid death rate: 10.5 per 100,000 residents
Percentage of all overdoses involving opioids: 55.9%
Deaths involving synthetic opioids (e.g., fentanyl): 82.1% of opioid deaths
Deaths involving heroin: 13.5% of opioid deaths
Deaths involving prescription opioids: 18.8% of opioid deaths
Comparison to national rate: 56.3% lower

Synthetic opioids, particularly fentanyl, dominate opioid-related deaths in Texas, representing over four-fifths of opioid fatalities. This reflects a national trend of illicitly manufactured fentanyl replacing pharmaceutical opioids and heroin as the primary driver of overdose deaths.

Historical Overdose Trends

Drug poisoning death rate (2021): 15.8 per 100,000
Drug poisoning death rate (2017): 9.4 per 100,000
Increase over 5 years: More than 75%
2018 data: Drug overdoses nearly tripled from 2000 to 2018
2018 opioid deaths: 1,402

Texas experienced a dramatic acceleration in drug poisoning deaths between 2017 and 2021, nearly doubling the rate. Males have death rates over twice as high as females, with non-Hispanic Whites and non-Hispanic Blacks showing the highest rates.

Deaths by County (2014-2016, per 100,000 residents)

County	Overdose Deaths
Harris	1,384
Dallas	949
Bexar	614
Tarrant	592
Travis	415
El Paso	220
Collin	227
Nueces	193
Denton	178
Montgomery	171
Galveston	151
Fort Bend	120

Urban counties with major metropolitan areas show the highest absolute numbers of overdose deaths, with Harris County (Houston) and Dallas County leading significantly.

Specific Drug Analyses

Methamphetamine

Threat Assessment

DEA ranking: #1 drug threat in Texas (2019)
Forensic lab analysis: 40% of all items examined (2018), up from 21% in 2005
Average purity: 97.5% (Mexican-sourced)
P2P-based production: 98.4% of samples (2018)

Deaths

2017 methamphetamine deaths: Nearly 800
2018 methamphetamine deaths: 957
Deaths also involving heroin: 189
Deaths also involving fentanyl: 66

Treatment Demographics (2018)

Total admissions: 12,385 (17.5% of all treatment admissions)
Gender: 55.6% male, 44.4% female
Race/Ethnicity: 66.9% White, 26.5% Hispanic, 6.9% Black
Average age: 34.4 years
Route of administration: 58.6% smoking, 32.3% injecting, 0.6% inhaling
No secondary substance use: 43.4%
Also using marijuana: 27.5%

Historical Trends

Treatment admissions increased from 3% (1995) to 18% (2018)
Route changed from primarily injecting (68% in 1995) to primarily smoking (59% in 2018)
Racial composition shifted from 91% White (1995) to 72% White (2018)

Methamphetamine has emerged as Texas’s primary drug threat, with exceptionally high purity levels from Mexican sources and increasing treatment admissions. The shift from injection to smoking may reflect changing demographics and drug availability patterns.

Heroin

Availability and Types

Primary types: Mexican black tar (29% pure), powdered brown, Mexican white (80-85% pure)
Fentanyl involvement: 12% of heroin deaths (2018)
DEA assessment: Moderately available, stable

Treatment Demographics (2018)

Total admissions: 10,307 (14.6% of all admissions)
Gender: 57.6% male, 42.4% female
Race/Ethnicity: 61.6% White, 20.3% Black, 17.1% Hispanic
Average age: 36 years (increased from 27 in 1974)
Route of administration: 82% injection, 14% inhaling

Combinations

54% with diphenhydramine (used to convert tar to powder)
15% with methamphetamine
3% with fentanyl

Historical Changes

White admissions increased from 40% (1974) to 63% (2018)
Average age increased 9 years since 1974

Deaths

2018 heroin deaths: 684
Also consumed fentanyl: 80 deaths
Also used tramadol: 11 deaths

Heroin users in Texas are becoming older and increasingly White. The relatively low fentanyl involvement in heroin deaths (compared to national patterns) may reflect regional differences in drug supply chains.

Cocaine/Crack

Market Characteristics

Average purity: 85.5% (2019)
Global production increase: From 185,000 hectares (2009) to 289,800 (2017)

Treatment Demographics (2018)

Total admissions: 5,496 (7.8% of all admissions)
Gender: 53.1% male, 46.9% female
Race/Ethnicity: 46.2% White, 42.9% Black, 10.6% Hispanic
Average age: 39.8 years
Route of administration: 46.4% smoking, 51.6% inhaling

Texas Cocaine Treatment Demographics Statistics

Historical Trends

Peak admissions: 35% of all treatment (1994)
Current admissions: 8% of all treatment (2018)
Crack smokers decreased from 76% (1995) to 46% (2018)
Hispanic admissions increased from 13% (1995) to 30% (2018)
Black admissions decreased from 57% to 43%

Cocaine/crack admissions have declined dramatically since the 1990s, with a shift away from crack smoking toward powder cocaine use. The demographic composition has become more diverse, with increasing Hispanic representation.

Prescription Opioids

Prescribing Trends

Doctors’ prescriptions: Enough for 32.2% of residents
High-dose prescriptions (≥90 MME): Decreased from 7.3% (2014) to 6.7% (2017)
Mean daily dose: Decreased from 58.1 MME (2015) to 56.2 MME (2017)

Top Dispensed Controlled Substances (FY 2019)

Hydrocodone
Tramadol
(Fentanyl not in top 15)

Treatment Demographics (2018)

Total admissions: 2,372 (3.4% of all admissions)
Gender: 59.6% male, 40.4% female
Race/Ethnicity: 66.4% White, 26.2% Hispanic, 7.0% Black
Average age: 36.9 years

Texas Prescription Opioids Treatment Demographics Statistics

Fentanyl Trends

2016: 66% of poison cases involved medical product
2018: 28% involved medical product (suggesting increased illicit supply)

Prescription opioid treatment admissions declined 31% from 2014-2018, reflecting successful efforts to reduce prescribing. However, illicit fentanyl has increasingly replaced pharmaceutical opioids as a threat.

Benzodiazepines

Deaths and Combinations

2017 deaths: 572
2018 deaths: 484
Also involved fentanyl: 53%
Also involved tramadol: 22%
Days of opioid/benzo overlap: Decreased from 11.4 (2015) to 10.6 (2017)

Treatment Demographics (2018)

Total admissions: 1,116 (1.6% of all admissions)
Gender: 51.0% female, 49.0% male
Race/Ethnicity: 60.9% White, 30.9% Hispanic, 6.9% Black
Average age: 28.8 years

Benzodiazepine deaths decreased from 2017 to 2018, though over half involved dangerous combinations with fentanyl. Women represent a slight majority of treatment admissions, unusual among substance categories.

Marijuana/Cannabis

Youth Patterns

Middle/high school lifetime use: 22%
Middle/high school past-month use: 14%
Treatment admissions reporting no other drug: 51%
Also using alcohol: 20%

Treatment Demographics (2018)

Total admissions: 16,028 (22.7% of all admissions)
Gender: 67.9% male, 32.1% female
Race/Ethnicity: 56.4% Hispanic, 29.7% White, 13.9% Black
Average age: 25.6 years (youngest category)

Deaths

2018 death certificates listing cannabis: 73
Deaths from accidents/trauma: 7
Overdoses with other drugs: 39

Edible/Concentrate Cases (2018)

Edible preparations: 84 cases
Concentrated extracts: 39 cases
Oral capsules/pills: 7 cases

Marijuana represents a large portion of treatment admissions, particularly among younger users and Hispanics. While marijuana-related deaths are relatively rare, edible products present particular risks for youth.

Synthetic Cannabinoids

Deaths and Patterns

2018 death certificates: 46 (synthetic cannabinoids like 5F-ADB)
Price point: As low as $2
User demographics: Often economically disadvantaged
Polydrug use with marijuana: Decreased over time
Cocaine/crack use increased

Treatment Demographics (2018)

Total admissions: 535 (0.8% of all admissions)
Gender: 62.6% male, 37.4% female
Race/Ethnicity: 58.3% White, 21.9% Black, 18.0% Hispanic
Average age: 23.7 years (youngest treatment population)

Texas Synthetic Cannabinoids Treatment Demographics Statistics

Synthetic cannabinoid use is driven partly by low cost and may serve as marijuana substitutes for economically disadvantaged populations. Users are among the youngest seeking treatment.

Youth Substance Use (Ages 12-17)

Drug Use Prevalence

Illicit drug use (past month): 160,000 youth (6.07%)
Comparison to national average: 16.42% less likely than average American teen
Marijuana use (past year): 9.40%
Alcohol use (past month): 6.15%
Comparison to national alcohol use: 10.60% less likely than average American teen

Texas youth demonstrate lower rates of substance use compared to national averages for both drugs and alcohol.

Specific Drug Use Among 12-17 Year Olds

Marijuana among recent drug users: 77.50%
Cocaine use (past year): 0.21%
Methamphetamine use (past year): 0.13%
Pain reliever misuse (past year): 2.16%

Substance Use Disorders

Drug Use Disorder (DUD) criteria met: 6.18%
Alcohol Use Disorder (AUD) criteria met: 2.72%

Among youth who use drugs, marijuana is by far the most common substance. However, a significant proportion of Texas youth meet criteria for substance use disorders, indicating serious addiction issues.

Middle and High School Statistics

Lifetime and Past-Month Use

Marijuana lifetime use: 22%
Marijuana past-month use: 14%
Prescription drug misuse (lifetime): 19%
Prescription drug misuse (past month): 7%

Nearly one in four Texas students has tried marijuana, and about one in five has misused prescription drugs at some point, indicating widespread exposure to substances among school-age youth.

Prescription Drug Misuse by Type

Drug Type	Lifetime Use	Past 30-Day Use
Codeine Cough Syrup	13%	4%
Benzodiazepines (Valium, Xanax)	5%	2%
Stimulants (Adderall, Ritalin)	4%	2%
Painkillers (OxyContin, hydrocodone)	4%	1%

Codeine cough syrup is the most commonly misused prescription drug among Texas youth, with significantly higher use rates than other categories.

Youth Perception of Risk

Substance	Somewhat Dangerous	Very Dangerous	Total
Prescription Drugs	13%	75%	88%
Alcohol	30%	49%	79%
Marijuana	14%	56%	70%
ENDS (e-cigs, vapes)	12%	55%	67%

Texas students show high risk perception for prescription drug misuse (88%) but lower perception for marijuana (70%), which may correlate with higher marijuana use rates.

Young Adult Substance Use (Ages 18-25)

Overall Use Patterns

Drug use (past month): 643,000 individuals
Comparison to national average: 27.40% less likely to use drugs
Marijuana use (past year, 2017-2019): 26.5% (823,000 individuals)
Marijuana use (past year, 2022-2023): 28.69%

Young adults show higher substance use rates than youth but remain below national averages. Marijuana use increased from the 2017-2019 period to 2022-2023.

Substance Use Disorders (2017-2019)

Overall substance use disorder: 12.7% (395,000 individuals)
Illicit drug use disorder: 6.2% (192,000 individuals)
Marijuana use disorder: 5.2% (163,000 individuals)
Opioid use disorder: 0.7% (23,000 individuals) – decreased from 2015-2017

Young adults show the highest rates of substance use disorders across all age groups, with over one in eight meeting criteria for some form of substance use disorder.

Adult Substance Use (All Ages 12+)

Current Use Statistics (2022-2023)

Measure	12+ Years	12-17 Years	18-25 Years	26+ Years
Illicit drug use (past month)	2,908,000 (11.66%)	160,000 (6.07%)	643,000 (19.39%)	2,105,000 (11.09%)
Marijuana use (past year)	4,094,000 (16.41%)	249,000 (9.40%)	952,000 (28.69%)	2,894,000 (15.24%)
Marijuana use (past month)	2,570,000 (10.29%)	124,000 (4.69%)	610,000 (18.40%)	1,836,000 (9.67%)
Cocaine use (past year)	380,000 (1.52%)	6,000 (0.21%)	72,000 (2.18%)	302,000 (1.59%)
Heroin use (past year)	57,000	—	1,000 (0.03%)	56,000 (0.29%)
Methamphetamine use (past year)	219,000 (0.88%)	3,000 (0.13%)	7,000 (0.20%)	209,000 (1.10%)
Prescription pain reliever misuse (past year)	808,000 (3.24%)	57,000 (2.16%)	103,000 (3.11%)	648,000 (3.41%)

Marijuana is by far the most commonly used illicit drug across all age groups. Young adults (18-25) show the highest use rates for most substances. Methamphetamine and heroin use are concentrated among adults 26 and older.

Substance Use Disorders (2022-2023)

Disorder Type	Total (12+)	Youth (12-17)	Young Adults (18-25)	Adults (26+)
Any substance use disorder	3,730,000 (14.95%)	216,000 (8.17%)	745,000 (22.44%)	2,769,000 (14.59%)
Drug use disorder	1,868,000 (7.48%)	163,000 (6.18%)	429,000 (12.93%)	1,275,000 (6.72%)
Opioid use disorder	509,000 (2.04%)	27,000 (1.02%)	40,000 (1.20%)	442,000 (2.33%)
Pain reliever use disorder	459,000 (1.84%)	27,000 (1.01%)	40,000 (1.20%)	392,000 (2.06%)

Nearly 15% of Texans ages 12 and older meet criteria for a substance use disorder. Young adults have the highest rate at over 22%, more than double the youth rate.

Treatment Access

Measure	Total Population	Percentage
Received substance use treatment (past year)	1,016,000	4.07%
Classified as needing treatment	4,166,000	16.70%
Needing but not receiving treatment	3,198,000	75.76%

A significant treatment gap exists in Texas, with approximately three-quarters of individuals who need substance use treatment not receiving it. This represents a major public health challenge.

Regional and National Comparisons

Texas vs. National Averages (2017-2019)

Youth (12-17)

Past-month marijuana use: Texas 5.5% vs. National 6.8%
Past-month illicit drug use: Texas 6.9% vs. National 8.2%

Young Adults (18-25)

Past-year marijuana use: Texas 26.5% vs. National 35.0%
Past-year marijuana use disorder: Texas 5.2% vs. National 5.6%
Past-year illicit drug use disorder: Texas 6.2% vs. National 7.5%
Past-year substance use disorder: Texas 12.7% vs. National 14.7%

All Ages (12+)

Past-year marijuana use: Texas 11.8% vs. National 16.2%
Past-year marijuana use disorder: Texas 1.3% vs. National 1.6%
Past-year heroin use: Texas 0.15% vs. National 0.30%
Past-year opioid use disorder: Texas 0.3% vs. National 0.7%
Past-year illicit drug use disorder: Texas 2.1% vs. National 2.9%
Past-year substance use disorder: Texas 5.9% vs. National 7.4%

Texas consistently maintains substance use and disorder rates below national averages across all age groups and most substance categories. This pattern holds for both use prevalence and diagnosed disorders.

General Drug Use Comparison

Past-month illicit drug use (Texas): 6.26%
Past-month illicit drug use (National): 8.02%
Illicit drugs other than marijuana (Texas): 3.3%
Illicit drugs other than marijuana (National): 3.58%

Texas residents are about 22% less likely to use illicit drugs than the national average, a pattern consistent across multiple survey periods.

Drug Treatment Statistics

Treatment Facility Overview

Active treatment facilities: 550
Total patients served annually: 35,995
Outpatient services enrollment: 31,281 annually
Residential (non-hospital) enrollment: 4,033 annually
Hospital-based drug rehab patients: 681
Facilities offering free treatment: 11

Texas maintains a substantial treatment infrastructure, though the vast majority of patients are served through outpatient rather than residential programs.

Treatment Costs

Service Type	Average Individual Cost	State Ranking
Outpatient rehab	$1,698	18th (cheapest to most expensive)
Residential rehab	$56,623	18th (cheapest to most expensive)

U.S. public spending on Texas outpatient services: $53.13 million (2.30% of national total)
U.S. public spending on Texas residential treatment: $228.4 million (4.4% of national total)

Texas ranks in the middle range nationally for drug rehabilitation costs. Residential treatment is substantially more expensive than outpatient services, though Texas receives a disproportionately large share of federal residential treatment funding relative to its population.

Treatment Enrollment Trends (2014-2018)

Substance	2014	2015	2016	2017	2018	% Change
Total Admissions	77,057	75,110	73,490	76,356	70,543	-8.5%
Alcohol	19,400 (25.2%)	19,176 (25.5%)	17,716 (24.1%)	17,532 (23.0%)	16,165 (22.9%)	-16.7%
Methamphetamine	10,837 (14.1%)	11,153 (14.8%)	12,450 (16.9%)	12,721 (16.7%)	12,322 (17.5%)	+13.7%
Heroin	10,950 (14.2%)	10,734 (14.3%)	10,349 (14.1%)	11,190 (15.6%)	10,307 (14.6%)	-5.9%
Marijuana	17,134 (22.2%)	16,857 (22.4%)	16,818 (22.9%)	17,363 (22.7%)	16,028 (22.7%)	-6.5%
Cocaine/Crack	7,200 (9.3%)	6,496 (8.6%)	6,004 (8.2%)	5,631 (7.4%)	5,496 (7.8%)	-23.7%
Prescription Opioids	3,445 (4.5%)	3,461 (4.6%)	2,554 (3.5%)	2,300 (3.0%)	2,375 (3.4%)	-31.1%
Benzodiazepines	1,191 (1.5%)	1,210 (1.6%)	1,165 (1.6%)	1,320 (1.7%)	1,116 (1.6%)	-6.3%
Synthetic Cannabinoids	454 (0.6%)	642 (0.9%)	698 (0.9%)	643 (0.8%)	535 (0.8%)	+17.8%

Methamphetamine treatment admissions increased significantly over this period, becoming the second-most common reason for treatment after alcohol. Prescription opioid admissions declined sharply (31%), likely reflecting reduced prescribing practices. Overall treatment admissions decreased despite population growth, which may indicate barriers to treatment access.

Medication-Assisted Therapy Enrollment

Methadone recipients (March 2019): 13,326 (increase from 9,833 in 2015)
Buprenorphine recipients (March 2019): 1,764 (decrease from 2,189 in 2015)

Methadone use in opioid treatment programs increased substantially, while buprenorphine use declined. This may reflect differences in accessibility, insurance coverage, or provider availability.

Infectious Disease Connections

Hepatitis C

Texas infection rate: 1.8% (approximately 368,000 cases)
Chronic infections: 80% (about 300,000)
Highest age groups: 19-22, then 30-39
Race/ethnicity burden: 8% Black, 32% Hispanic, 50% White
Gender: 62% female
New cases linked to IV drug use (2022): 21.8 per 100,000
Neonatal opioid withdrawal syndrome (2020): 3.9 per 1,000 births

Texas Infectious Disease Connections Statistics

Hepatitis C represents a significant disease burden in Texas with clear links to intravenous drug use. The high proportion of chronic infections indicates long-term public health impacts.

HIV/AIDS

New diagnoses linked to IV drug use (2023): Approximately 323.9
Men who have sex with men (MSM): 70% of 2018 diagnoses
Heterosexual transmission: 21%
IV drug use: 5%
Historical IDU proportion: Decreased from 32% (1988) to 21% (2018) in treatment programs

Race/Ethnicity of 2018 HIV Cases

37% Black
42% Hispanic
21% White

While IV drug use represents a smaller proportion of HIV diagnoses than in the past, injection drug users remain at significant risk. HIV diagnoses are increasingly concentrated among people of color.

Sexually Transmitted Diseases

Chlamydia

2007 rate: 356.3 per 100,000
2018 rate: 507.4 per 100,000
Higher rates: Females, ages 15-24, Black Texans

Gonorrhea

2007 rate: 132.1 per 100,000
2018 rate: 163.3 per 100,000
Higher rates: Males, ages 15-24, Black Texans

Early Syphilis

2007 rate: 11.1 per 100,000
2018 rate: 14.7 per 100,000
Higher rates: Males, ages 20-29, Black Texans
MSM cases: 28% of all early syphilis

Texas Sexually Transmitted Diseases Statistics

All major STD rates increased from 2007 to 2018, with particular concentration among younger age groups and Black Texans, indicating overlap with populations affected by substance use.

Law Enforcement and Forensic Data

Forensic Toxicology Laboratory Findings (2018)

Substance	Number of Items
Heroin	6,153
Hydrocodone	1,215
Oxycodone	489
Tramadol	485
Fentanyl	263
Methadone	154
Buprenorphine	118

Historical Trends

Heroin items increased from 2,338 (2008) to 6,153 (2018)
Hydrocodone items decreased from 3,597 (2008) to 1,215 (2018)
Fentanyl items increased from 47 (2008) to 263 (2018)
Tramadol items increased from 144 (2008) to 485 (2018)

Forensic laboratories show dramatic increases in heroin and fentanyl evidence alongside decreases in prescription opioids like hydrocodone, reflecting shifts in the illicit drug market.

Poison Control Center Calls (2008-2018)

Year	Buprenorphine	Fentanyl	Heroin	Hydrocodone	Methadone	Oxycodone
2008	83	120	208	723	218	81
2018	94	65	272	171	91	63

Poison control calls for prescription opioids declined substantially (hydrocodone calls down 76%), while heroin calls increased. This pattern mirrors changes in drug availability and prescribing practices.

Distribution of Controlled Substances (ARCOS) – Dosage per 100,000 Texas Population

Year	Buprenorphine	Hydrocodone	Oxycodone	Methadone
2008	176	17,861	4,935	2,700
2018	455	9,271	4,738	2,063
Change	+158.5%	-48.1%	-4.0%	-23.6%

Buprenorphine distribution increased significantly as a medication-assisted treatment, while hydrocodone distribution was cut nearly in half, reflecting deliberate prescribing reductions. Oxycodone and methadone also decreased.

Police Reports by Drug Type

Methamphetamine: 32.4%
Marijuana: 19.6%
Cocaine: 18.5%

Methamphetamine represents nearly one-third of drug-related police reports, significantly exceeding other substances and confirming its status as a primary law enforcement concern.

Methamphetamine Lab Seizures

2007 incidents: 93
2009 incidents: 155
Increase: 67%
National trend (2007-2009): 76% increase
Contributing factors: “Smurfing” (bulk PSE purchases), mobile “one-pot” labs

Texas experienced increased methamphetamine lab seizures following a national trend, though starting from relatively low baseline numbers compared to peak levels in 2003.

Texas maintains substance use and overdose rates significantly below national averages across most categories, yet faces critical challenges with methamphetamine as the state’s primary drug threat and synthetic opioids driving the majority of overdose deaths. While prescription opioid misuse has declined substantially due to reduced prescribing practices, the state experienced a 75% increase in drug poisoning deaths between 2017 and 2021, indicating an evolving crisis dominated by illicit drugs rather than pharmaceuticals. The most concerning finding is the severe treatment gap, with approximately 76% of Texans who need substance use treatment not receiving it, coupled with declining overall treatment admissions despite population growth, suggesting significant barriers to accessing care that must be addressed to reduce preventable deaths and improve public health outcomes.

Statistical Data on Alcohol in Texas

Texas faces significant challenges related to alcohol consumption across all age groups. The state records over 10,000 annual deaths attributable to excessive alcohol use, with alcohol being the most commonly used substance among youth. The data reveals concerning patterns in underage drinking, binge drinking behaviors, and alcohol use disorders, while also highlighting gaps in treatment access. This comprehensive analysis examines alcohol consumption patterns, health impacts, economic costs, and market trends across Texas populations.

Adult Alcohol Consumption and Deaths

Overall Death Statistics

Total annual deaths from excessive alcohol use: 10,647
Deaths under age 21: 4.0% of total deaths (approximately 426 deaths)
Death rate: 1 death per 2,737 adults aged 18+ (4.90 deaths per 10,000 adults)
Increase in death rate: 44.2% increase in the 5-year average annual rate from 2015 to 2019

The substantial increase in alcohol-related deaths over this period indicates a worsening public health crisis, with Texas experiencing more than 10,000 preventable deaths annually.

Demographics of Alcohol-Related Deaths

Male deaths: 71.1%
Chronic causes (e.g., Alcohol Use Disorder): 56.9%
Adults aged 35 and older: 81.9%
Under age 21: 3.97%

Men are disproportionately affected by alcohol-related deaths, and the majority of deaths stem from chronic conditions rather than acute incidents, suggesting long-term patterns of harmful use.

Binge Drinking Among Adults

Adults who binge drink monthly: 17.6%
Median drinks per binge: 5.6 drinks
Median drinks per binge (top 25% of drinkers): 9.0 drinks
Median binge frequency: 1.8 times per month
Median binge frequency (top 25% of drinkers): 4.1 times per month

Nearly one in five Texas adults engages in binge drinking, with the most active drinkers consuming dangerous quantities at high frequencies, significantly increasing their health risks.

Youth Alcohol Use (Ages 12-17)

Lifetime and Recent Use

Lifetime alcohol use (middle and high school students): 52%
Past month use (middle and high school students): 29%
Past month use (youth aged 12-17, 2017-2019): 9.3% (231,000 youth)
Past month use (youth aged 12-17, 2022-2023): 6.15%

While recent data shows declining use among younger teens, more than half of middle and high school students have experimented with alcohol, with alcohol being the most commonly used drug among Texas youth.

Gender Differences in Youth

Female students drinking in past 30 days: 31%
Male students drinking in past 30 days: 27%
Lifetime use among females: 53%
Lifetime use among males: 50%

Since 2002, teen girls have consistently reported higher alcohol use rates than boys in Texas, a pattern that mirrors national trends where 32% of high school girls report past-month drinking compared to 28% of boys.

Youth Binge Drinking

Middle and high school students binge drinking (past 30 days): 12%
High school seniors binge drinking (past 30 days): 24%
Youth aged 12-17 binge drinking (2022-2023): 3.35%

Nearly one in four high school seniors engages in binge drinking, defined as 5 or more drinks in a two-hour period, exposing themselves to significant risks including accidents, injuries, and long-term health consequences.

High School Seniors

Past month alcohol use (Texas): 47%
Past month alcohol use (National average): 30%

Texas high school seniors drink at significantly higher rates than their national peers, with nearly half reporting recent alcohol use compared to less than one-third nationally.

High School Student Behaviors

Students who drive after drinking: 7%
Students who rode with a drinking driver: 21%

These dangerous behaviors put young lives at risk, with more than one in five students willingly getting into vehicles with impaired drivers.

Young Adults (Ages 18-25)

Alcohol Use Patterns (2022-2023)

Past month alcohol use: 45.20% (1.5 million young adults)
Past month binge drinking: 26.55% (881,000 young adults)
Past month binge drinking (2017-2019): 31.5% (978,000 young adults)

Young adults show the highest rates of current drinking and binge drinking among age groups, though binge drinking rates have remained relatively stable between 2015-2019.

Alcohol Use Disorder

Past year alcohol use disorder: 13.77% (457,000 young adults)
Past year alcohol use disorder (2017-2019): 8.5% (265,000 young adults)

The prevalence of alcohol use disorder among young adults decreased between 2002-2004 and 2017-2019, with Texas rates lower than the national average of 9.8% during 2017-2019.

Risk Perception

Young adults perceiving great risk from 5+ drinks once/twice weekly: 40.40% (1.34 million)

Less than half of young adults perceive frequent heavy drinking as highly risky, suggesting a need for enhanced education about alcohol’s dangers.

College Students in Texas

Alcohol Use (2017 Survey)

Lifetime alcohol use: 78%+
Past year alcohol use: 72%+
Past month alcohol use: 57%+

Alcohol use is nearly universal among Texas college students, with more than three-quarters having tried alcohol at some point.

Binge Drinking Among College Students

Males with 5+ drinks in one sitting (past 30 days): 37%
Females with 4+ drinks in one sitting (past 30 days): 34%
Males binge drinking 6+ times (past 30 days): 7%
Females binge drinking 6+ times (past 30 days): 4%

More than one-third of college students engage in binge drinking, with a concerning subset drinking heavily multiple times per month, increasing their risk of academic problems, injuries, and developing alcohol use disorders.

Driving Behaviors Among College Students

Drive after drinking at least monthly: 20% (1 in 5)
Rode with an impaired driver: 22%

Dangerous drinking and driving behaviors are alarmingly common among college students, putting themselves and others at serious risk.

Ages 12-20 (Underage Drinking)

Use Patterns (2022-2023)

Measure	Number (thousands)	Percentage
Past month alcohol use	500	13.00%
Past month binge drinking	282	7.33%
Alcohol use disorder (past year)	192	5.00%
Perceive great risk from 5+ drinks 1-2x/week	1,605	41.73%

Despite being below the legal drinking age, 13% of individuals aged 12-20 report recent alcohol use, with more than half of those engaging in binge drinking patterns.

All Adults (Ages 26+)

Alcohol Use (2022-2023)

Past month alcohol use: 47.57% (9.0 million)
Past month binge drinking: 22.40% (4.3 million)
Past year alcohol use disorder: 10.02% (1.9 million)

Nearly half of adults over 26 drink alcohol, with more than one in five engaging in binge drinking, demonstrating that problematic drinking extends well beyond young adulthood.

Overall Population Statistics (Ages 12+)

Current Use (2022-2023)

Measure	Number (thousands)	Percentage
Past month alcohol use	10,692	42.86%
Past month binge drinking	5,221	20.93%
Perceive great risk from 5+ drinks 1-2x/week	11,651	46.70%

Historical Trends (2016-2017)

Past month alcohol use (ages 12+): 10.6 million+
Past month binge drinking (ages 12+): 5.3 million+
Past month alcohol use (ages 12-20): 600,000+
Past month binge drinking (ages 12-20): 300,000+

Texas Population Historical Trends Statistics

More than two in five Texans aged 12 and older drink alcohol, with approximately half of drinkers engaging in binge drinking patterns.

Alcohol Use Disorders

Prevalence by Age Group (2022-2023)

Age Group	Number with AUD (thousands)	Percentage
Ages 12-17	72	2.72%
Ages 18-25	457	13.77%
Ages 26+	1,903	10.02%
Ages 12+ (Total)	2,431	9.75%
Ages 18+	2,359	10.58%

Nearly 2.5 million Texans suffer from alcohol use disorder, with young adults aged 18-25 showing the highest prevalence rates at nearly 14%.

Historical Context

National AUD prevalence (2018): 14.8 million+ individuals aged 12+
Texas AUD prevalence (2016-2017): 1 million+ individuals aged 12+
Texas AUD prevalence (2017-2019): 4.5% (1.0 million individuals aged 12+)

Texas AUD rates during 2017-2019 were lower than both the regional average (4.9%) and national average (5.3%), though the disorder still affects approximately one million Texans.

National Context (2016-2017)

Ages 12-20 (Nationally)

Past month alcohol use: 7.1 million+
Past month binge drinking: 4.3 million+
Past month heavy alcohol use: 800,000+

All Ages (12+)

Past month alcohol use: 139.8 million+
Past month binge drinking: 67.0 million+
Past month heavy alcohol use: 16.5 million+

Texas represents a significant portion of national alcohol consumption and problems, with patterns largely consistent with national trends but with some areas of concern, particularly among high school students.

Excessive Drinking Statistics

State-Level Data

Excessive drinking rate in Texas: 18.2%
Texas ranking among states: 37th
Highest county rate: Loving County at 25%
Second highest county: Travis County at 23%

Texas ranks in the middle nationally for excessive drinking, though significant variation exists between counties, with some urban and rural areas showing notably higher rates.

Risk Factors for Alcoholism in Texas

Key Risk Indicators

Texas national ranking for alcoholism risk: Highest in the U.S.
Uninsured citizens: 13,878 per 100,000
National context: Texas has the most uninsured Americans
Citizens without formal schooling: 1,849 per 100,000 (third-highest nationally)

Texas Risk Factors For Alcoholism Statistics

The combination of high uninsurance rates and lower educational attainment contributes to Texas having the highest risk for alcoholism in the nation, as these factors limit access to prevention, intervention, and treatment resources.

Substance Use Treatment

Treatment Statistics (2022-2023, Ages 12+)

Measure	Percentage
Received substance use treatment (past year)	4.07%
Classified as needing treatment	16.70%
Not receiving treatment among those needing it	75.76%

A critical treatment gap exists, with three-quarters of Texans who need substance use treatment not receiving it, representing over 1 million people based on 2016-2017 estimates.

Treatment by Age Group (2022-2023)

Ages 12-17: 4.44% received treatment; 60.01% needing treatment didn’t receive it
Ages 18-25: 4.17% received treatment; 82.67% needing treatment didn’t receive it
Ages 26+: 4.00% received treatment; 75.51% needing treatment didn’t receive it
Ages 18+: 4.03% received treatment; 76.95% needing treatment didn’t receive it

Young adults face the largest treatment gap, with more than 82% of those needing help not receiving it, likely contributing to higher rates of alcohol use disorders in this age group.

Treatment Admissions (2018)

Total admissions where alcohol was primary substance: 16,165
Male admissions: Nearly two-thirds (approximately 66%)
Ages 26-44: Over 50%
Non-Hispanic white individuals: Over 50%
Hispanic/Latino individuals: Over 29%

Treatment admissions reflect the demographics most affected by severe alcohol problems, with middle-aged males making up the majority of those seeking help.

Economic Impact

Costs to Texas Taxpayers

2010 costs: $18.821 billion
2022 equivalent (adjusted for inflation): $25.408 billion
Cost per drink: $2.69 (in 2022 US dollars)
Years of potential life lost annually: 274,633 years

Texas Alcohol Economic Impact Statistics

Excessive alcohol use imposes a massive economic burden on Texas, costing taxpayers over $25 billion when accounting for inflation, in addition to the tragic loss of hundreds of thousands of years of potential life.

Texas Alcoholic Beverage Market (2022)

Spirits Volume Sales

Category	Volume Sales (9-liter cases, thousands)	Dollar Sales (millions)
Vodka	4,141	$1,930
Tequila	3,617	N/A
Cocktails	3,413	$1,532
Straight Whiskey	2,245	$823
Canadian Whisky	1,306	$830
Cordials/Liqueurs	1,258	$547
Rum	1,093	$685
Scotch Whisky	517	$453
Gin	470	$209
Irish Whiskey	219	N/A

Vodka dominates the Texas spirits market by volume, followed by tequila and ready-to-drink cocktails, reflecting consumer preferences for versatile spirits and convenience products.

Wine Volume Sales

Category	Volume Sales (thousands, 9-liter cases)
Table Wine	13,494
Champagne & Sparkling	1,614
Dessert & Fortified	391.8
Vermouth & Aperitif	63.6
Wine Coolers	Unknown

Table wine accounts for the vast majority of wine sales, with champagne and sparkling wines representing a small but significant premium segment.

Beer Volume Sales

Category	Volume Sales (thousands, 2.25 gallon cases)	Volume Sales (barrels, thousands)
Light Beer	139.1	10,096
FMBs & Hard Seltzer	31.8	2,311
Imported Beer	30.1	2,181
Craft Beer	26.0	1,889
Super & Super Premium	23.4	1,699
Popular Beer	14.4	1,042

Light beer dominates the Texas beer market by a significant margin, accounting for more than all other categories combined. The growing popularity of flavored malt beverages (FMBs) and hard seltzers reflects changing consumer preferences, particularly among younger drinkers.

Texas faces a critical public health crisis with alcohol use, recording over 10,600 annual deaths and costing taxpayers more than $25 billion. The state demonstrates the highest risk for alcoholism in the nation, driven by widespread lack of health insurance and educational disparities. Most concerning is that three-quarters of Texans needing substance use treatment don’t receive it, while youth drinking rates—particularly among high school seniors—significantly exceed national averages. Addressing this crisis requires urgent investment in prevention, education, and accessible treatment services across all communities.

Conclusion

In general, Texas faces a dual crisis of drug and alcohol abuse that, while showing lower rates than national averages, continues to claim over 13,000 lives annually and costs taxpayers more than $25 billion. The state’s drug landscape has shifted dramatically from prescription opioids to methamphetamine as the primary threat and fentanyl-involved deaths comprising over 82% of opioid fatalities, while alcohol remains the most commonly used substance among youth with high school seniors drinking at rates 57% above the national average. Most critically, approximately 76% of Texans who need substance use treatment are not receiving it, representing a severe gap in healthcare access that is compounded by Texas having the highest risk for alcoholism in the nation due to widespread lack of insurance and educational disparities. Addressing these interconnected crises requires urgent, coordinated investment in prevention, education, harm reduction, and accessible treatment infrastructure across all Texas communities.