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In 2016, an estimated 48.5 million persons in the US, or 18.0% of persons aged 12 years and older, reported use of illicit drugs or misuse of prescription drugs in the past year. This estimate includes use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, and methamphetamines, and the misuse of prescription drugs. Reported prevalence of illicit drug use in the past year by drug type was: 13.9% for marijuana, 0.4% for heroin, 1.9% for cocaine, and 0.5% for methamphetamine. Reported prevalence of prescription drug misuse by drug type was: 4.3% for prescription pain relievers, 2.1% for prescription stimulants, 2.2% for prescription tranquilizers, and 0.6% for prescription sedatives. Reported prevalence of opioid misuse (heroin use or prescription pain reliever misuse) in the past year was 4.4%.

Illegal drug use and misuse of prescription drugs is costly to our nation. The National Institute on Drug Abuse in the National Institutes of Health (NIH) estimates that illicit drug use cost $11 billion in health care alone and $193 billion each year when costs related to crime and lost work productivity are included in 2007. Prescription opioid misuse cost $26 billion in health care and $78.5 billion overall in 2013.

Between 1999 and 2017, more than 700,000 people died from a drug overdose in the United States. The current epidemic of drug overdoses began in the 1990s with overdose deaths involving prescription opioids, driven by dramatic increases in prescribing of opioids for chronic pain. In 2010, rapid increases in overdose deaths involving heroin marked the second wave of opioid overdose deaths. The third wave began in 2013, when overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl, began to increase significantly. In addition to deaths, nonfatal overdoses from both prescription and illicit drugs are responsible for increasing emergency department visits and hospital admissions.

Around 68% of the more than 70,200 drug overdose deaths in 2017 involved an opioid. The number of overdose deaths involving opioids (including prescription opioids, illegal opioids and illicitly manufactured fentanyl) was 6 times higher in 2017 than in 1999. On average, 130 Americans die each day from an opioid overdose.

In 2017 among students in Hawai'i public schools:
  • 9,500 students used marijuana in the past 30 days - 18.1% of high school (HS) and 7.6% of middle school (MS) students
  • 7,000 students have ever taken a prescription drug such as OxyContin, Vicodin, tranquilizers, Valium, Xanax or Ritalin without a doctor's prescription - 12.2% of HS and 6.8% of MS students
  • 2,600 students have ever used methamphetamines (speed, crystal, crank or ice) - 4.8% of HS and 2.1% of MS students
  • 3,500 students have ever used ecstasy - 7.6% of HS and 1.5% of MS students
  • 1,900 HS students have ever used heroin - 4.5% of HS students
  • 1,200 HS students have ever used a needle to inject an illegal drug into their body - 2.8% of HS students

In the United States, 7.7 million adults have co-occurring mental and substance abuse disorders. This doesn't mean that one caused the other and it can be difficult to determine which came first, but:
  • 37.9% of the 20.3 million adults with substance abuse disorders also had mental illness, and
  • 18.2% of the 42.1 million adults with mental illness also had substance abuse disorders.

Patients can reduce the risk of misusing prescription medications by:
  • Following the directions as explained on the medication label, or by the doctor or pharmacist
  • Being aware of potential interactions with other drugs, including alcohol
  • Never stopping or changing a dosing regimen without first discussing it with the doctor
  • Never using another person's prescription and never giving their prescription medications to others
  • Storing prescription stimulants, sedatives and opioids safely
  • Disposing of unused or expired prescription medications properly

CDC uses a variety of data tools and resources to understand the scope of the drug use and overdose epidemic, both for overdose deaths and nonfatal overdoses treated in emergency departments or by emergency medical services.

Hawai'i IBIS Health Indicator Reports

Hawai'i Health Matters Indicator Dashboards

Behavioral Risk Factor Surveillance System (BRFSS)

Pregnancy Risk Assessment Monitoring System (PRAMS)

Youth Risk Behavior Survey (YRBS)

Vital Statistics Death Record Data