U.S. Has High Levels of Illegal Drug Use

In spite of the most stringent drug policies and punitive laws in the world, the United States also has high levels of lifetime illegal drug use. Surveys indicate that the U.S. has illicit drug use rates among the highest in the world, as well as high rates of lifetime tobacco use. European nations, however, report higher rates of alcohol use.

According to the Centers for Disease Control and Prevention (CDC), 11.2% of people in the U.S. over the age of 12 used any illicit drug within the last month.

Drug Use by Country

Data from the World Health Organization (WHO) looking at the global burden of disease suggests that the following countries and regions had the highest share of the population with an alcohol or drug use disorder in 2016:

• Russia: 5.93%
• Eastern Europe: 5.65%
• Estonia: 5.48%
• United States 5.47%
• North America: 5.30%
• Greenland: 5.13%
• Belarus: 5.10%
• Ukraine: 5.10%
• Latvia: 4.79%
• Lithuania: 4.59%

Another study found that European countries had the highest rates of heavy episodic alcohol and tobacco use. Cannabis, opioid, and cocaine dependence were most prevalent among high-income North Americans.

The World Health Organization (WHO) reports that cannabis is the most widely used illicit drug in the world, representing half of all drug seizures worldwide. An estimated 147 million people—2.5% of the world's population—use marijuana each year.

Drug Use in the United States

In the United States, the two most commonly used illicit drugs are marijuana and opioids.

• Marijuana: Marijuana is the most commonly used illegal drug in the U.S., and the second most commonly used psychoactive drug after alcohol. Reports indicate that more than 11.8 million young adults used marijuana in the past year. 
• Opioids: In 2018, misuse of prescription pain relievers is the second most prevalent form of illicit drug use in the U.S. Findings from one survey indicated that 3.6% of the U.S. population misuses prescription pain relievers. The CDC has described opioid misuse in the United States as an epidemic. Of drug-related deaths in the U.S. in 2018, nearly 70% involved the use of opioids. Between 2017 and 2018, however, there was a drop in opioid-related deaths, including declines in deaths attributed to prescription pain killers, heroin, and synthetic opioids.
• Cocaine: In 2014, there were an estimated 1.5 million people over the age of 12 in the U.S. who had used cocaine in the past month. Research also indicates that cocaine use and cocaine-related problems (including overdoses and deaths) increased in the U.S. between the years 2011 and 2015. In particular, cocaine use appears to be increasing among older adults.

Drug Use Patterns

This trend has also been reported in the National Survey on Drug Use and Health (NSDUH) conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA). In 2018, the survey found that 164.8 million people in the U.S. over the age of 12 had used substances including tobacco, alcohol, or illicit drugs in the past month.

Results also indicated that one in five people over age 12—which amounts to 19.4% of the population—had used an illicit drug in the past year. This represents an increase from the years 2015 and 2016, which is mainly due to an increase in the use of marijuana.

While marijuana use increased in young adults between the ages of 18 and 25 as well as in adults over the age of 26, marijuana use did not increase in adolescents between the ages of 12 and 17.

Drug Policies Are Not Enough

Based on the high prevalence of illicit drug use in the United States, it is clear that punitive drug policies are not enough to prevent or reduce drug use. According to one report on global drug use, regions with less punitive, more liberal policies often have lower rates of drug and alcohol use.

"The Netherlands, with a less criminally punitive approach to cannabis use than the United States, has experienced lower levels of use, particularly among younger adults," the report says. "Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in nation-level rates of illegal drug use."

Youth Drug Use Rates

It can also be helpful to look at drug use patterns among kids under the age of 18. The Monitoring the Future Survey collected data from more than 42,500 students from schools across the U.S. According to the results of the survey:

• 11.8% of 8th graders, 28.8% of 10th graders, and 35.7% of 12th graders reported using marijuana in the past year.
• 2.7% of 12th graders reported using heroin in the past year.
• 2.7% of 12th graders reported misusing prescription opioids within the past year. This represents a significant decrease from 2014.
• 6.5% of 8th graders, 11.5% of 10th graders, and 9.1% of 12th graders reported using any illicit drug other than marijuana during the past year. This includes the use of cocaine, methamphetamine, and synthetic cannabinoids.

Shifting Drug Trends

It is important to note that drug use trends are not static. Previous studies indicated that the United States had the highest rates of illicit drug use in the world, but some European countries have seen increases in drug use that have overcome U.S. drug rates.

Drug use also changes in terms of who is using these substances and which substances are most frequently used. Opioid use in the United States saw dramatic increases between the years 2000 and 2014, although prevalence rates from 2018 suggest that these numbers appear to be leveling off or declining.

A Word From Verywell

Understanding drug use patterns in the U.S. and throughout the world can help policymakers develop strategies to respond to illicit drug use. It can also inform the development of community-based programs designed to reduce drug use. The overall goal is to help reduce the heavy individual and societal costs associated with illicit drug use.