The United States has struggled with substance use problems for decades, and the most recent drug use issue involves opioids like heroin. The opioid crisis has caused a surge in overdose deaths and substance use disorders over the past decade. However, opioids aren’t the only problem substance in the country. Alcohol is one of the most commonly misused substances, and other drugs plague certain areas with addiction and overdose issues. 

Learn more about the scope of drug use in the United States and the prevalence of substance use disorders all over the country. 

Overview of Key Drug Use Statistics

  • 31.9 million people reported using illicit drugs in a 2018 survey.
  • There were 67,367 overdose deaths in 2018.
  • More than 20 million people had a substance use disorder in 2018.
  • Prescription drugs cost the U.S. $26 billion in healthcare in 2013.

How Many People Use Drugs?

Substance use is common in the United States. Legal drug and alcohol use is prevalent all over the country. Alcohol is one of the most common substances in the United States next to caffeine and nicotine. Marijuana is the next most popular recreational drug, and it’s legal to use in a growing number of states. In states where marijuana is illegal, it’s the most used illicit drug. 

According to the 2018 National Survey on Drug Use and Health, 164.8 million people in the U.S. over the age of 12 reported using some substance in the past month. That’s about 60.2 percent of the population. Only two out of five people did not use drugs, cigarettes, or alcohol in the past month. The vast majority of reported substance use involved alcohol, accounting for 139.8 million people. However, 31.9 million reported using illicit drugs. 

When it comes to illicit drugs, the 2018 survey found that one in five people used marijuana illicitly, and the use of the drug increased from the previous survey. The second most common illicit drug used illegally were prescription opioids. In 2018, 3.6 percent of people misused prescription opioids like oxycodone. Prescribers often give out more opioids than needed to avoid a relapse of pain symptoms. But an excess of prescription opioids may mean the drugs make their way to people with no prescription. 

The survey found that more than half of people that abused prescription opioids obtained them from friends. The overprescribing of opioids may have contributed to the overall opioid crisis. However, according to the Centers for Disease Control and Prevention, opioid prescribing in the U.S. peaked in 2012, and the numbers are slowly decreasing. 

The prevalence of drug use in the United States increases the country’s overall substance use problem, leading to public health issues like addiction and overdose.

The Prevalence of Substance Use Disorders

Doctor and patient discussing drug and alcohol treatment in MarylandAccording to the survey in 2018, there were more than 20 million people over the age of 12 that met the qualifications for a substance use disorder. More than 14 million of those cases involved an alcohol use disorder, and two million had an opioid use disorder. Many of these substance used disorders co-occur with other issues like mental illness. Around 358,000 adolescents had both a substance use disorder and a mental health issue in 2018. 

Adults also struggled with co-occurring issues. Around 9.2 million adults had a substance use disorder with some sort of mental illness. Around 3.2 million adults had a serious mental illness alongside substance issues. Mental health issues and substance use problems can feed off of each other, worsening each condition. In many cases, both problems need to be addressed at the same time for treatment to be successful. 

Drug Overdose Death Rates

The opioid crisis has caused an increase in drug overdose deaths in the United States. Other drugs, like alcohol and cocaine, also contribute to overdoses alongside opioids. In 2010, there were 38,329 deaths, and the numbers started to rise more dramatically. In 2017, the numbers spiked with 70,237 overdose deaths. The year after saw the first decrease in a decade, but the numbers were still high, with 67,367 deaths

Opioids have been the leading cause of the spike in overdose deaths. They were involved in 46,802 overdose deaths in 2018. Prescription drugs were involved in 14,975 overdose deaths that same year, which marked a significant decrease from 2017. Heroin is one of the most common illicit opioids in the U.S., and it was involved in 14,996 deaths in 2018. The powerful synthetic opioid fentanyl and its analogs were involved in 31,335 overdose deaths. These synthetic opioids may often be mixed into other drugs, dramatically increasing the potency of the mixture without the user knowing. 

Other drugs are also involved in the overdose spike, but they are often mixed with opioids. For instance, cocaine was involved in 14,666 overdose deaths in 2018. However, close to 15,000 of those cases involved opioids.

The Cost of Drug Use

Substance use disorders can represent a significant financial burden for individuals and communities. Drug dependence can cause powerful compulsions to buy and use drugs each day, regardless of your finances. Not only does frequent compulsive drug use cause you to buy drugs consistently, but it can also affect your ability to maintain employment. As a drug dependence gets worse, you may need more and more of a drug each day to feel normal. You may need to use it at odd hours, like in the morning or the middle of the workday. It can also cause impairments that make it difficult to focus or perform tasks at work. 

Long-term substance use disorders often lead to financial instability, but it can also lead to problems like legal issues and homelessness. 

Widespread substance use problems, as seen in the opioid crisis, can have a significant impact on communities. Healthcare costs that are associated with responding to substance use problems in the U.S. can be extensive. Plus, there are other factors like costs associated with the criminal justice systems, homelessness response, and lost work productivity. According to NIDA, prescription opioid misuse alone costs the U.S. $26 billion in healthcare and more than $78 billion in overall costs. Illicit drugs cost $11 billion in healthcare and $249 billion overall, according to data from 2010. 

Where Do Drugs Come From?

Drugs come from a variety of sources in and outside of the United States. Domestic substances like alcohol and prescription drugs are commonly abused. Alcohol’s prevalence in culture and distribution makes it easy to obtain and misuse. Prescription drugs are commonly misused, but that may be harder to obtain for long periods of time. Prescription drugs come from legal prescriptions that are later used by someone else without a prescription or used in high amounts. Excess pills are often given out to friends and family, or they can be bought illegally. However, prescription drugs may be expensive or difficult to obtain over time. 

In many cases, prescription opioid use may lead to the use of illicit heroin, which may be cheaper and easier to buy. According to the National Institute on Drug Abuse, prescription opioid misuse is a significant risk factor for later heroin use. 

Illicit drugs like heroin are mostly produced outside of the U.S. and trafficked in over the border and by sea. According to the U.S. Drug Enforcement Administration, transnational criminal organizations are responsible for the influx of illicit drugs like heroin, fentanyl, and cocaine. Mexican cartels are a major source of heroin in the country. Both Mexico and China are the largest sources of fentanyl. The DEA also reports that drug traffickers also manufacture counterfeit prescription drugs and sell them as the genuine product. 

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