Nearly one in four Americans used an illicit drug in the past year, a startling figure that opens the door to a complex global reality where substance use patterns and their devastating consequences reveal urgent public health crises.
Key Takeaways
- In 2022, 24.9% of people aged 12 or older in the US (70.4 million) used illicit drugs in the past year, with marijuana being the most common at 18.7%.
- Globally, an estimated 296 million people used cannabis in 2021, representing 5.8% of the adult population aged 15-64.
- In the US, past-month cocaine use among adults aged 26+ rose to 2.0% in 2021 from 1.7% in 2019.
- Males aged 18-25 in US had 35.2% past-year marijuana use in 2022.
- Among US females 12+, past-year illicit drug use was 24.1% vs 25.8% males in 2021.
- US adults 18-25 had highest past-month illicit drug use at 39.5% in 2022.
- Heroin/cocaine injection causes 39% HIV cases among US adults 25+ in 2021.
- Chronic marijuana use linked to 2.4 times higher risk of schizophrenia in predisposed youth.
- Opioid misuse leads to 80% of US cirrhosis deaths among young adults 25-44.
- US drug overdose deaths rose 30% from 2019-2020 to 91,799.
- Fentanyl involved in 68,242 overdose deaths in US 2021, up 23% from 2020.
- Opioid overdose death rate 32.6 per 100,000 among US males 25-44 in 2021.
- US treatment admissions 2.3 million in 2021 for SUD.
- Only 10.3% of US people with opioid use disorder receive medication treatment.
- Methadone reduces overdose death risk by 50% in OUD patients.
Illicit drug use is widespread and its harmful consequences are increasing globally.
Demographics
- Males aged 18-25 in US had 35.2% past-year marijuana use in 2022.
- Among US females 12+, past-year illicit drug use was 24.1% vs 25.8% males in 2021.
- US adults 18-25 had highest past-month illicit drug use at 39.5% in 2022.
- In 2021, 15.4% of US high school seniors reported past-year marijuana use daily.
- Non-Hispanic whites in US had 26.1% past-year illicit drug use vs 22.4% blacks in 2021.
- Urban US residents past-year drug use 27.3% vs 20.1% rural in 2022.
- College non-attendees aged 18-25 had 28.4% past-month marijuana use vs 20.1% attendees in 2021.
- In Europe, males 2.5 times more likely to use cannabis than females in 2021.
- US unemployed adults past-year illicit drug use 42.5% vs 23.8% employed in 2022.
- Hispanic US youth 12-17 past-month illicit drugs 9.2% vs 6.8% non-Hispanic white in 2021.
- In Canada, Indigenous adults cannabis use 32% vs 24% non-Indigenous in 2022.
- US adults with mental illness past-year drug use 45.2% vs 18.9% without in 2021.
- Low-income US households (<$20k) 32.4% past-year drug use vs 18.2% high-income in 2022.
- In UK, 16-24 year olds drug use 19.8% vs 6.5% 40-59 in 2021/22.
- US veterans past-year prescription misuse 12.1% vs 6.2% civilians in 2021.
- LGBTQ+ US youth past-month drug use 25.4% vs 12.3% straight in 2021.
- In Australia, males methamphetamine use 2.1% vs 0.8% females 14+ 2022.
- US rural white non-Hispanics opioid misuse 12.5% vs urban 8.3% in 2021.
- College graduates US adults drug use 19.6% vs non-grads 28.4% past year 2022.
- In France, unemployed past-year cannabis 22.4% vs employed 9.8% 2021.
- US Asian Americans lowest illicit drug use 14.2% past year vs Native Americans 32.1% 2021.
- Females in Europe cocaine use increased 25% more than males 2017-2021.
- US 18-25 full-time students marijuana past month 19.8% vs part-time 24.3% 2022.
- In Brazil, favela residents crack use 15.2% vs 3.4% general urban 2019.
- US adults 65+ past-year drug use 13.4% vs under 18 15.2% but different drugs 2021.
- South Africa coloured population cannabis use 21% vs black 11% 2019.
- In US, bisexual adults drug use 40.7% past year vs heterosexual 22.4% 2021.
Demographics Interpretation
Between unemployment, mental health, and education gaps, the story behind these numbers isn't so much about who is using drugs as it is about who is trying to cope with the weight of modern life, proving that while demographics may change, the need for accessible support is a universal constant.
Health Impacts
- Heroin/cocaine injection causes 39% HIV cases among US adults 25+ in 2021.
- Chronic marijuana use linked to 2.4 times higher risk of schizophrenia in predisposed youth.
- Opioid misuse leads to 80% of US cirrhosis deaths among young adults 25-44.
- Methamphetamine use increases stroke risk by 3-4 fold in users under 45.
- Cocaine use associated with 6-fold increase in heart attack risk within 1 hour of use.
- Fentanyl contamination causes 90% of US opioid overdose deaths involving synthetics in 2022.
- Long-term cannabis smoking raises lung cancer risk by 20% per joint equivalent to tobacco.
- Heroin users have 19 times higher hepatitis C prevalence than general population.
- MDMA use linked to 2.5 times serotonin syndrome risk in heavy users.
- Prescription opioid chronic use doubles depression risk within 2 years.
- Crack cocaine causes 8.5 times higher rate of preterm birth in users.
- Amphetamine psychosis persists in 30% of heavy users post-abstinence.
- Kratom use associated with 1 in 5 users developing dependence symptoms.
- LSD flashbacks occur in 4.6% of users years after last use.
- Oxycodone misuse leads to erectile dysfunction in 40% of male chronic users.
- Synthetic cannabinoids cause kidney failure in 30% of severe intoxication cases.
- Benzodiazepine with opioids increases respiratory depression risk 10-fold.
- Chronic ecstasy use reduces gray matter by 4-6% in memory-related brain areas.
- Inhalant abuse causes sudden death in 1-2% of first-time users via arrhythmia.
- Fentanyl skin exposure risk leads to 50% accidental exposures in bystanders.
- Meth mouth (severe dental decay) affects 40-60% of chronic meth users.
- Heroin withdrawal symptoms peak at 48-72 hours in 90% of users.
- Cannabis hyperemesis syndrome hospitalized 2,774 cases in US 2017 with rising trend.
- Cocaine cardiomyopathy incidence 25% in long-term users over 40.
Health Impacts Interpretation
These statistics paint a grim portrait where the pursuit of a high methodically trades years of health for hours of escape, proving that the body keeps a far more accurate and brutal score than the mind ever could.
Mortality and Overdose
- US drug overdose deaths rose 30% from 2019-2020 to 91,799.
- Fentanyl involved in 68,242 overdose deaths in US 2021, up 23% from 2020.
- Opioid overdose death rate 32.6 per 100,000 among US males 25-44 in 2021.
- Synthetic opioids caused 90% of opioid deaths in US 2022.
- Heroin overdose deaths declined 35% from 2017 peak but still 5,000+ in 2021.
- Methamphetamine overdose deaths tripled from 2015-2019 to 15,883.
- Cocaine-involved overdoses up 52% to 24,486 deaths US 2021.
- Black non-Hispanic US overdose rate 37.5 per 100k vs white 30.6 in 2021.
- Rural US opioid death rate 17.7 per 100k vs urban 15.2 in 2021.
- Benzodiazepine overdoses 12,049 deaths US 2021, often with opioids.
- Global opioid deaths estimated 600,000 annually per WHO 2022.
- Australia opioid overdose deaths 2,200 in 2022, fentanyl main driver.
- Canada opioid deaths 7,328 in 2022, 80% fentanyl-related.
- UK drug deaths 5,583 in Scotland alone 2022, highest in Europe.
- Europe overdose deaths 8,200 in 2021, up 32% from 2012.
- US youth 14-18 overdose rate doubled to 6.6 per 100k 2019-2021.
- Fentanyl pill press deaths 1,800+ among under-25 US 2022.
- Meth overdose with opioids 30% of meth deaths US 2021.
- Native American overdose rate 56.6 per 100k highest US 2021.
- Global cocaine deaths 22,000 estimated 2021 per UNODC.
- US 18-25 overdose deaths 15% of total despite 10% population 2021.
- Iran annual opioid deaths 4,000+ mostly heroin 2021.
- Mexico fentanyl deaths 1,100+ in 2022 first year surge.
- Polydrug overdoses 75% of all US drug deaths 2021.
- Veteran suicide 20% involve opioids US 2021.
- US states like WV overdose rate 81.4 per 100k 2021 highest.
- Naloxone reverses 80% opioid overdoses if administered timely.
Mortality and Overdose Interpretation
We are witnessing a grim and rapidly evolving syndicate of despair, where fentanyl has become the ruthless CEO of death, its synthetic efficiency outsourcing the roles of older drugs while exploiting every vulnerability—from the hopeful young adult to the struggling veteran—and turning polysubstance use into a nearly inescapable trap, all against a backdrop of a world increasingly poisoned by its own prescriptions and illicit innovations.
Prevalence
- In 2022, 24.9% of people aged 12 or older in the US (70.4 million) used illicit drugs in the past year, with marijuana being the most common at 18.7%.
- Globally, an estimated 296 million people used cannabis in 2021, representing 5.8% of the adult population aged 15-64.
- In the US, past-month cocaine use among adults aged 26+ rose to 2.0% in 2021 from 1.7% in 2019.
- Europe saw 8.4 million past-year cannabis users in 2021, stable from previous years per EMCDDA data.
- In 2021, 6.2 million US adults misused prescription pain relievers in the past year.
- Lifetime hallucinogen use among US young adults (18-25) was 10.5% in 2022.
- Australia reported 11.8% past-year cannabis use among 14+ population in 2022-2023.
- In Canada, 26% of adults reported past-year cannabis use in 2022 post-legalization.
- UK past-year drug use prevalence was 10.4% for ages 16-59 in 2021/22.
- Mexico had 5.4% past-year cocaine use among adults in 2021 per national survey.
- In 2021, 4.8% of US adolescents (12-17) used illicit drugs past month.
- Brazil reported 8.4% lifetime crack cocaine use in urban areas in 2019.
- Japan saw 0.3% past-year methamphetamine use in 2022 national survey.
- South Africa had 13% past-year cannabis use among 15-64 in 2019.
- In 2022, 2.5% of US adults used methamphetamine past year.
- India estimated 2.1% opioid use disorder prevalence in 2021.
- Russia reported 1.8% past-year heroin use in 2020 surveys.
- New Zealand 15% past-year cannabis use in 2023 household survey.
- In Europe, 1.3 million past-year opioid users excluding medical use in 2021.
- US past-year inhalant use among youth 12-17 was 1.6% in 2021.
- China reported 2.4 million registered drug users in 2022, mostly meth.
- France 10.6% past-year cannabis use ages 18-64 in 2021.
- In 2021, 17.4% of US college students used marijuana past year.
- Nigeria 10.8% cannabis use prevalence among adults 15-64 in 2018.
- Sweden 4.1% past-year illicit drug use 17-84 in 2021.
- In 2022, 3.8 million US people used hallucinogens past year.
- Iran 2.8% opioid dependence prevalence in 2019.
- Australia 1.4% past-year methamphetamine use 14+ in 2022.
- US past-month binge alcohol with illicit drugs 5.7% adults 2021.
- Global amphetamine use 29 million people past year 2021.
Prevalence Interpretation
While cannabis maintains its global popularity contest, the persistent and varied undercurrent of harder substance use—from a concerning cocaine creep in the US to millions wrestling with opioids and methamphetines worldwide—reveals a complex and serious public health landscape that no amount of legalization can simply smoke over.
Treatment and Recovery
- US treatment admissions 2.3 million in 2021 for SUD.
- Only 10.3% of US people with opioid use disorder receive medication treatment.
- Methadone reduces overdose death risk by 50% in OUD patients.
- Buprenorphine treatment retention 60% at 6 months vs 40% no med.
- US 1.8 million in specialty treatment for SUD 2021.
- Contingency management boosts meth abstinence 50% more than counseling alone.
- 12-step programs like NA 23% abstinence at 1 year vs 9% no program.
- MAT for opioids increases employment 20% post-treatment.
- US cocaine treatment completion 45% vs 30% opioids 2021.
- Relapse rate 40-60% within 30 days post-detox for most drugs.
- Telehealth SUD treatment rose 300% during COVID to 40% of visits 2022.
- Women in gender-specific treatment 25% higher retention rates.
- US youth SUD treatment gap 90% untreated despite need 2021.
- Naltrexone reduces opioid relapse 50% in first 6 months.
- CBT for cannabis use disorder 20% abstinence vs 10% control at 1 year.
- Australia 120,000 in treatment 2022, 50% for meth/amphetamine.
- Europe 800,000 in opioid substitution therapy 2021.
- Recovery housing residents 70% sober at 6 months post-exit.
- US prison SUD treatment reaches only 11% inmates needing it.
- Vivitrol injections monthly reduce drinking days 25% in AUD.
Treatment and Recovery Interpretation
This bleak spreadsheet of proven solutions, tragically under-deployed, screams that our failure is not in knowing what works, but in mustering the will to use it.
Sources & References
- Reference 1SAMHSAsamhsa.govVisit source
- Reference 2UNODCunodc.orgVisit source
- Reference 3NIDAnida.nih.govVisit source
- Reference 4EMCDDAemcdda.europa.euVisit source
- Reference 5CDCcdc.govVisit source
- Reference 6AIHWaihw.gov.auVisit source
- Reference 7CANADAcanada.caVisit source
- Reference 8GOVgov.ukVisit source
- Reference 9GOBgob.mxVisit source
- Reference 10SCIELOscielo.brVisit source
- Reference 11NCDncd.mhlw.go.jpVisit source
- Reference 12WHOwho.intVisit source
- Reference 13HEALTHhealth.govt.nzVisit source
- Reference 14NNCCnncc.cnVisit source
- Reference 15OFDTofdt.frVisit source
- Reference 16FOLKHALSOMYNDIGHETENfolkhalsomyndigheten.seVisit source
- Reference 17NCBIncbi.nlm.nih.govVisit source
- Reference 18VAva.govVisit source
- Reference 19THETREVORPROJECTthetrevorproject.orgVisit source
- Reference 20AHAJOURNALSahajournals.orgVisit source
- Reference 21JAMANETWORKjamanetwork.comVisit source
- Reference 22DEAdea.govVisit source
- Reference 23HEALTH-INFOBASEhealth-infobase.canada.caVisit source
- Reference 24PUBLICHEALTHSCOTLANDpublichealthscotland.scotVisit source
- Reference 25WWWDASISwwwdasis.samhsa.govVisit source