Drug use in the U.S. statistics & facts

Drug use in America: the big picture

Drug use touches almost every community in the United States. The most important source of data on it is the National Survey on Drug Use and Health, or NSDUH, run by the Substance Abuse and Mental Health Services Administration, which interviews tens of thousands of people aged 12 and over every year. Its latest results, for 2025, were published in July 2026. They show that 69.8 million people, or 24.0 percent of the population aged 12 and over, used an illicit drug in the past year, most of them marijuana, and that 44.6 million people, 15.3 percent, had a substance use disorder involving alcohol, drugs or both.

The picture is changing in important ways. Marijuana use has risen as more states have legalized it, and more Americans now say they smoke marijuana than cigarettes. Misuse of prescription opioids has fallen, teen drug use remains near historic lows, and overdose deaths have dropped sharply since their 2022 peak. Yet only about one in six people who need treatment for a substance use disorder receive it. This report sets out the data on who uses which drugs, how use differs by age, the scale of addiction and treatment, the legal cannabis market, overdoses and the drug supply.

How many Americans use illicit drugs?

In 2025, 24.0 percent of people aged 12 and over used an illicit drug in the past year, down from a peak of 25.5 percent in 2024 but above the 22.2 percent recorded in 2021, the first year of the current survey methods. Marijuana accounts for most of this use: 21.2 percent of people aged 12 and over used it in the past year, or 61.6 million people.

A plateau after years of growth: past-year illicit drug use eased to 24.0 percent in 2025 from 25.5 percent in 2024, while marijuana use slipped to 21.2 percent.

SAMHSA notes that the increases in marijuana and hallucinogen use since 2021 came entirely from adults aged 26 and older; use among adolescents and young adults declined. That is a notable shift from the historic pattern, in which drug use was concentrated among teenagers and people in their early twenties. The growing share of middle-aged and older users reflects the normalisation of legal cannabis, and a population that grew up in the era of the 1960s and 1970s drug culture now reaching retirement age. Our data on the US population by sex and age shows how the age structure of the population itself is shifting.

Which drugs do Americans use?

Marijuana is by far the most widely used illicit drug, with 61.6 million past-year users in 2025. Hallucinogens, including psilocybin mushrooms, LSD and MDMA, came a distant second with 9.1 million users, or 3.1 percent of the population, and have grown since 2021. About 6.9 million people misused prescription opioids, 4.9 million used cocaine and 2.7 million used methamphetamine.

Marijuana dominates: 61.6 million people used marijuana in 2025, almost seven times as many as the next most common drug type, hallucinogens.

The trends for each drug differ. Since 2021, misuse of prescription opioids has fallen from 3.0 to 2.4 percent of the population, reflecting tighter prescribing rules and prescription monitoring programmes. Misuse of prescription tranquilisers and sedatives has also fallen, from 1.7 to 1.5 percent. Cocaine, methamphetamine and prescription stimulant misuse have not changed significantly. Heroin use has become rare, with about 581,000 past-year users in 2025, as heroin has largely been replaced on the illicit market by fentanyl, which is far more potent and usually taken unknowingly or in counterfeit pills.

Among marijuana users, smoking remains the most common method, used by 74.8 percent of past-year users in 2025, but almost half, 49.2 percent, consumed marijuana in food or drinks, 39.2 percent vaped it and 14.5 percent used concentrates by dabbing. The rise of edibles and vapes, with far higher potencies than the cannabis of previous decades, is one reason health researchers are concerned about increases in cannabis use disorder.

Drug use by age group

Young adults remain the group most likely to use drugs. In 2025, 36.3 percent of people aged 18 to 25 used an illicit drug in the past year, and 33.7 percent used marijuana. Among adults aged 26 and over, the figures were 23.5 and 20.6 percent, and among adolescents aged 12 to 17, 11.2 and 8.7 percent.

Peak in the early twenties: more than a third of 18 to 25 year olds used an illicit drug in 2025, three times the share of adolescents.

Because adults aged 26 and over make up most of the population, they account for the large majority of drug users in absolute terms: 53.8 million of the 69.8 million people who used an illicit drug in 2025. Prescription opioid misuse follows a different pattern from other drugs: it was highest among adults aged 26 and over, at 2.5 percent, compared with 2.0 percent of young adults and 1.6 percent of adolescents, reflecting the role of prescribed painkillers in middle age.

Teen drug use remains low

Drug use among American teenagers fell sharply during the COVID-19 pandemic and has stayed below pre-pandemic levels since. The Monitoring the Future survey, funded by the National Institute on Drug Abuse and run by the University of Michigan, surveyed 23,726 students in 270 schools between February and June 2025. It found that reported use of most drugs held steady compared with 2024.

Alcohol still leads among teens: 41 percent of 12th graders drank alcohol in the past year, 26 percent used marijuana and 20 percent vaped nicotine.

In 2025, 26 percent of 12th graders, 16 percent of 10th graders and 8 percent of 8th graders reported using marijuana in the past year. Nicotine vaping was reported by 20 percent of 12th graders, and alcohol by 41 percent. New products are drawing attention: 9 percent of 12th graders had used hemp-derived delta-8 THC and 7 percent nicotine pouches. The survey also recorded small but statistically significant increases in heroin and cocaine use in some grades, although both remain at very low levels, below 1.5 percent. In the NSDUH, 13.7 percent of people aged 12 to 20 drank alcohol in the past month in 2025, down from 15.6 percent in 2021.

Marijuana: legal, popular and growing

Marijuana has moved from the margins to the mainstream within a generation. In 1969 only 12 percent of Americans told Gallup that marijuana should be legal; support reached a record 70 percent in 2023 and stood at nearly two thirds in 2025, with a fall among Republicans. Actual use has followed. In July 2026, 17 percent of US adults told Gallup they smoke marijuana, tying the record high and exceeding the 11 percent who smoke cigarettes, and 15 percent said they consume marijuana edibles.

More than doubled: the share of adults who smoke marijuana rose from 7 percent in 2013 to 17 percent in 2026, now above the 11 percent who smoke cigarettes.

By April 2026, recreational cannabis was legal for adults in 24 states and Washington DC, and medical marijuana was legal in another 16 states; most of the remaining states allow only limited low-THC or CBD products. At the federal level marijuana remained a Schedule I controlled substance until April 2026, when the Drug Enforcement Administration moved FDA-approved marijuana products and marijuana covered by state medical licenses to Schedule III. Recreational marijuana remains in Schedule I, and further hearings on broader rescheduling began in June 2026.

The legal market is large but under pressure. State-legal cannabis sales were about 29.1 billion dollars in 2025, down slightly from 30.1 billion in 2024, according to an industry analysis, as oversupply pushed down prices. The industry employed about 412,500 full-time workers. Use by age varies widely: 25 percent of adults aged 30 to 49 and 23 percent of those aged 18 to 29 told Gallup they smoke marijuana, against 5 percent of those aged 65 and over.

The rise of hallucinogens

Hallucinogens are the fastest-growing category of illicit drug use after marijuana. In 2025, 9.1 million people aged 12 and over, 3.1 percent of the population, used a hallucinogen in the past year, up from 7.6 million, or 2.7 percent, in 2021. The category includes LSD, psilocybin mushrooms, MDMA, also known as ecstasy or molly, ketamine used without a prescription, PCP and DMT. As with marijuana, SAMHSA found that the growth came from adults aged 26 and over rather than from younger people.

Changing laws and attitudes help explain the trend. Oregon became the first state to create a regulated psilocybin therapy programme, which opened in 2023, and Colorado voters approved a similar natural medicine programme that began licensing services in 2025. Several cities have made enforcement of laws against natural psychedelics their lowest priority. Clinical research into psilocybin and MDMA for depression and post-traumatic stress disorder has attracted widespread media attention, although the Food and Drug Administration declined to approve MDMA-assisted therapy in 2024 and asked for further studies. Health experts warn that unsupervised use carries risks, particularly for people with a history of psychosis.

Vaping and alcohol: the legal substances

Although this report focuses on illicit drugs, the two most widely used addictive substances in the United States are legal. In 2025, 129.1 million people aged 12 and over, 44.4 percent, drank alcohol in the past month, down from 47.4 percent in 2021, and 56.8 million, 19.5 percent, engaged in binge drinking, down from 21.7 percent. The long-term decline in drinking, especially among young people, is one of the clearest trends in the national data, and alcohol use disorder, at 25.7 million people, fell from 10.6 percent of the population in 2021 to 8.9 percent in 2025.

Nicotine vaping is moving in the opposite direction. In 2025, 29.3 million people aged 12 and over, 10.1 percent, vaped nicotine in the past month, up from 8.3 percent in 2022, even as cigarette smoking continued to fall. Vapes have also become a major way to use cannabis: 37.1 percent of people who used marijuana in the past month vaped it. Together, these shifts show how the market for addictive substances is moving from smoked products toward vapes, edibles and other new formats.

Substance use disorders: 44.6 million people

A substance use disorder is a medical condition in which the use of alcohol or drugs causes significant problems, such as failing to meet obligations, being unable to cut down, or continuing to use despite harm. In 2025, 44.6 million people aged 12 and over, 15.3 percent of the population, had a past-year substance use disorder, down from 16.7 percent in 2021. More than half of these cases, 54.1 percent, were mild, while 22.5 percent were severe.

Drugs and alcohol almost equal: 26.0 million people had a drug use disorder and 25.7 million an alcohol use disorder in 2025.

Drug use disorders affected 26.0 million people and alcohol use disorders 25.7 million, with many people having both. Marijuana use disorder was the most common drug use disorder, affecting 19.3 million people, reflecting both the large number of users and the high potency of modern cannabis products. Some 4.5 million people had a stimulant use disorder, involving cocaine, methamphetamine or prescription stimulants, and 4.0 million had an opioid use disorder. Substance use disorders often occur alongside mental illness, a link explored in our data on mental health worldwide.

The treatment gap

The most striking finding in the national data is how few people with a substance use problem get help. In 2025, 47.2 million people aged 12 and over needed substance use treatment, but only 7.6 million, about 16 percent, received it. That left 39.6 million people who needed treatment without it. SAMHSA notes that its treatment questions changed in 2024, so this figure cannot be compared directly with earlier years.

Five in six go without: of 47.2 million people who needed substance use treatment in 2025, 39.6 million did not receive it.

The gap is even wider for medication, the most effective treatment for opioid and alcohol use disorders. According to the survey, only about 623,000 of the 4.0 million people with an opioid use disorder, 15.7 percent, received medication such as buprenorphine, methadone or naltrexone, and only 679,000 of the 25.7 million with an alcohol use disorder, 2.6 percent, received medication for it. On a more hopeful note, 22.3 million adults, 73 percent of those who said they had ever had a substance use problem, considered themselves in recovery or recovered. The development of new addiction medicines is part of the wider story of the global pharmaceutical industry.

The reasons people give for not getting treatment include not thinking they need it, cost and lack of insurance coverage, not knowing where to go, and concern about stigma. Barriers are highest in rural areas, where treatment programmes and prescribers of addiction medicines are scarce. Policy changes have tried to close the gap: since 2023, any clinician with a standard prescribing registration can prescribe buprenorphine, after Congress removed a special waiver requirement, and naloxone, the drug that reverses opioid overdoses, has been available over the counter since 2023.

Overdose deaths by drug

Overdose deaths are the most tragic consequence of drug use. After rising for most of two decades, they fell 26.2 percent from 105,007 in 2023 to 79,384 in 2024, according to final CDC data, and provisional data suggest about 69,100 deaths in the 12 months to January 2026. The decline was broad-based across every major drug type.

Fentanyl deaths fell by a third: deaths involving synthetic opioids dropped from 72,776 in 2023 to 47,735 in 2024.

Deaths involving synthetic opioids other than methadone, overwhelmingly illicit fentanyl, fell 35.6 percent between 2023 and 2024 but still accounted for about six in ten overdose deaths. Deaths involving psychostimulants such as methamphetamine fell 19.8 percent to 28,722, and cocaine deaths fell 26.7 percent to 21,945; many of these deaths also involved fentanyl. Deaths involving prescription opioids fell 20.7 percent to 7,989 and heroin deaths 33.3 percent to 2,743. Men accounted for 55,076 of the 79,384 deaths in 2024, and the highest death rates were among adults aged 35 to 44, at 44.2 per 100,000.

The drug supply and the border

Changes in the illicit drug supply help explain the fall in overdose deaths. US Customs and Border Protection seized about 11,486 pounds of fentanyl in fiscal year 2025, down 46 percent from 21,308 pounds in 2024 and 57 percent from 26,629 pounds in 2023, according to US Customs and Border Protection data. Researchers and officials have linked the decline to less fentanyl crossing the border, possibly reflecting lower potency, supply disruptions and Chinese controls on precursor chemicals. Cocaine seizures, by contrast, rose 35 percent in fiscal 2025, and more than 85 percent of drugs other than marijuana were seized at official ports of entry rather than between them. The wider border context is set out in our overview of immigration in the United States.

Marijuana seizures at the border fell 28 percent in fiscal 2025, continuing a long decline as domestic legal production has replaced smuggled cannabis. New threats keep emerging: xylazine, a veterinary sedative, has been found mixed with fentanyl in many regions, and nitazenes, a class of synthetic opioids even stronger than fentanyl, have appeared in parts of the drug supply. Drug checking services and fentanyl test strips, now legal in most states, aim to help people detect these substances before using.

What comes next

The data point to a country in transition. Some of the most dangerous forms of drug use are declining: prescription opioid misuse is falling, heroin is rare, teen drug use is low and overdose deaths have dropped by about a third from their peak. At the same time, marijuana use among adults is at record levels and still rising in older age groups, hallucinogen use is growing, and cannabis use disorder has become the most common drug use disorder. Most people with a substance use disorder still receive no treatment.

Three questions will shape the next few years. The first is whether the fall in overdose deaths can be sustained as funding for prevention and treatment faces pressure and the illicit supply changes. The second is how federal cannabis policy evolves after partial rescheduling, and whether legalization leads to more heavy use. The third is whether the treatment gap can be narrowed, through wider access to medication, telehealth and recovery support. The answers will matter not only for public health but for families, workplaces and communities across the country.

Drug use in the US in numbers

A few figures summarise the state of drug use in America.

Together they show both the scale of drug use in the United States and the size of the gap in care.

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