Drug Use Rates in America

The National Survey on Drug Use and Health (NSDUH), a yearly interview sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides the most accurate estimates of tobacco, alcohol, and drug use in America.

According to the 2020 NSDUH findings, illicit drug use rates have increased, particularly due to trends in marijuana use and the abuse of prescription-type psychotherapeutic drugs.

SAMHSA suggests using caution when comparing the results to past years, however, due partly to methodological changes. The coronavirus pandemic and other events of the past few years are also believed to have played a part in shifts in drug use behavior.

In 2020, NSDUH respondents reported which drugs, if any, they had used in the 30 days before the survey. Based on those findings, the government estimates that:

• 37.3 million people aged 12 or older in the United States (13.6%) are "current users" of some kind of illicit drug.
• 59.3 million (21.4%) people over age 12 used illicit drugs in the past year.

According to the NSDUH survey results for 2020, 14.5% of the U.S. population (or 40.3 million people) over 12 have a substance use disorder. 

Pandemic Effects on Drug Use

In the wake of the COVID-19 pandemic, many wondered if drug use may have increased in 2020 and 2021. While statistics covering this time period are still emerging, a June 2020 report from the Centers for Disease Control and Prevention (CDC) found that 13% of Americans reported turning to substances to deal with emotions and stress caused by the pandemic. 

However, the "Monitoring the Future" survey by the National Institute on Drug Abuse (NIDA) found that substance use decreased significantly among adolescents in 2021.

Teens reported experiencing greater anxiety, boredom, depression, and loneliness. However, drug use rates decreased, including for substances that are most commonly used by teens, including alcohol, marijuana, and vaping.

Increase in Pain Reliever Misuse

According to the NSDUH, the use of illicit drugs in general has decreased slightly since 2015. However, the use of prescription-type pain relievers has increased in recent years.

Survey results suggest that 9.3 million people over 12 reported non-medical use of prescription painkillers. However, these numbers are still considerably higher than they were in the past. In 2002, only 4.1% of the population aged 18 to 25 reported misusing pain relievers, but that percentage jumped to 4.9% in 2006.

Marijuana Use Driving the Increase

Overall, the use of illicit drugs in the U.S. increased from 20.4 million people in 2007 to 24.6 million in 2013 to 37.3 million in 2020. However, not all illicit drugs saw an increase.

• Cocaine: The past year cocaine use decreased between 2019 and 2020.
• Marijuana: The overall increase is mainly attributed to the increase in marijuana use from 14.5 million users in 2007 to 49.6 million in 2020.
• Meth: Methamphetamine use has increased significantly in use after an earlier decline. In 2007, an estimated 731,000 people used meth, but by 2007 that number had dropped to 353,000. By 2020, the survey estimated the number of meth users at 2.5 million.

First-Time Drug Users

SAMHSA estimates that 2.8 million first started using marijuana in the past year. Approximately 1.2 million people reported beginning the misuse of prescription pain relievers in the past year. 

According to a study published in JAMA Pediatrics, the average age when drug use first begins has risen somewhat, to 17.

Where Do People Get Drugs?

According to the NSDUH survey, those who used pain relievers non-medically in the past 12 months got them from the following sources:

• 47.2% got them from a friend or family member in some way
• 34.4% were given them for free by a relative or friend
• 9.2% bought them from a friend or family member
• 3.7% took them from a friend or family member without asking
• 42% procured them from a doctor
• 6.2% got them from a dealer or other stranger

Of the people who said they got pain relievers from a relative or friend for free, 80.7% said the drugs had originally been obtained from just one doctor.

Illegal Drug Use and Employment

SAMHSA suggests that around 70% of pepople who use illicit substances are employed. However, only 8.8% of full-time employees are drug users.

Other NSDUH findings indicated that:

• 9.4% of part-time employees are drug users.
• Of unemployed adults, 18.5% are illicit drug users.

Underage Drinking and Drunk Driving

According to the National Highway Traffic Safety Administration, there was a 14% increase in drunk driving deaths between 2019 and 2020. 

The 2020 NSDUH survey found that 2.1 million (8.2%) adolescents between the ages of 12 and 17 reported drinking alcohol within the past month.

The Centers for Disease Control and Prevention found that among high school students:

• 29% reported drinking alcohol
• 17% reported riding with a driver who had been drinking
• 14% reported binge drinking
• 5% reported driving after drinking alcohol

The CDC notes that rates of both current and binge drinking among high school students have declined over the past few decades.