About 58% of Americans aged 12 and older used tobacco, nicotine vapes, alcohol, or an illicit drug in the past month, based on the 2024 National Survey on Drug Use and Health. If you narrow the question to illicit drugs specifically, roughly 1 in 4 young adults used one in the past year, and cannabis alone accounts for the majority of that use.
The numbers shift dramatically depending on which substance you’re asking about, what age group you’re looking at, and whether you mean “ever tried” or “used recently.” Here’s how it breaks down.
Cannabis Is the Most Commonly Used Illicit Drug
About 52.5 million Americans, or roughly 19% of the population, used cannabis at least once in 2021. That makes it by far the most popular federally illegal substance in the country. Among young adults aged 18 to 25, the rate is nearly double the national average: 35% used marijuana in the past year alone.
Cannabis use has been climbing steadily for over a decade, driven partly by legalization in many states and partly by shifting attitudes. For context, past-year cannabis use in the early 2000s hovered around 10 to 11% of the population.
How Other Illicit Drugs Compare
Beyond cannabis, the percentages drop off sharply. Among people aged 12 and older in 2023:
- Cocaine: 1.8% (about 5 million people) used it in the past year
- Methamphetamine: 0.9% (about 2.6 million people)
- Heroin: 0.2% (about 660,000 people)
These numbers represent past-year use, not regular or daily use. The share of people using these substances on any given month is smaller still. Heroin use, in particular, has declined from its peak during the early years of the opioid crisis, though the drug supply has shifted toward synthetic opioids like fentanyl, which don’t always show up in survey responses the same way.
Prescription Drug Misuse
A significant chunk of drug use in the U.S. involves prescription medications taken outside of how they were prescribed, whether that means taking someone else’s pills, using higher doses, or using them to get high. In 2021, among people aged 12 and older:
- Prescription pain relievers: 3.1% (about 8.7 million people) misused them in the past year
- Prescription tranquilizers or sedatives: 1.7% (about 4.9 million people)
- Prescription stimulants: 1.3% (about 3.7 million people)
Pain reliever misuse remains the largest category, though it has decreased from its peak in the mid-2010s. Stimulant misuse, often involving medications prescribed for ADHD, has stayed relatively stable.
Young Adults Use Drugs at the Highest Rates
Age is the single biggest predictor of drug use. In 2024, 38.1% of young adults aged 18 to 25 (about 13.3 million people) used an illicit drug in the past year. That means roughly 6 in 10 young adults in that age range did not use any illicit drug during the same period.
Marijuana accounts for the vast majority of young adult drug use. Of the 13.3 million young adults who used an illicit substance, 12.2 million used marijuana, meaning most young adult “drug use” in the statistics is cannabis and nothing else. The rates for cocaine, hallucinogens, and stimulant misuse are all significantly lower in this group, though still higher than in older age brackets.
Drug use generally declines with age. People over 50 report illicit drug use at much lower rates, though that gap has been narrowing as the generation that grew up with more widespread cannabis exposure moves into middle age.
Use Versus Substance Use Disorder
There’s an important distinction between using a substance and developing a problem with it. In 2024, 16.8% of people aged 12 and older, about 48.4 million Americans, met the clinical criteria for a substance use disorder. That includes disorders involving alcohol, not just illicit drugs.
A substance use disorder means the person’s use is causing significant problems in their life: failed attempts to cut back, withdrawal symptoms, neglecting responsibilities, or continuing to use despite clear harm. Not everyone who uses drugs develops one. The majority of people who try cannabis or drink alcohol, for example, never meet the threshold. But for those who do, the treatment gap is enormous. In 2021, only about 6% of people with a substance use disorder received any form of specialized treatment.
The Overdose Crisis in Numbers
Roughly 105,000 people died from drug overdoses in the U.S. in 2023. Opioids were involved in about 76% of those deaths, averaging 217 opioid-related overdose deaths per day. The opioid overdose death rate in 2023 was nearly 10 times what it was in 1999, though it did decline by 4% compared to 2022, the first meaningful drop in years.
These numbers don’t reflect total drug use so much as the lethality of certain substances in the current supply. Fentanyl contamination in street drugs has made overdose far more likely even for occasional users, which is why overdose deaths climbed so steeply even as some categories of drug use held steady or declined.
Putting the Numbers in Perspective
If you combine all forms of substance use, legal and illegal, the majority of Americans are using something. That 58.3% figure from the 2024 survey includes tobacco, nicotine vapes, and alcohol alongside illicit drugs. Alcohol alone accounts for a huge share of that number.
For illicit drugs specifically, the picture is more nuanced. About 1 in 5 Americans used cannabis in the past year. Somewhere between 1% and 3% misused prescription medications. And fewer than 2% used cocaine, meth, or heroin. The overall percentage of people using “hard” drugs is relatively small, but in a country of over 330 million, even 1% translates to millions of people, which is why the public health impact is so large.