Misuse of Rx Opioids by Young Adults Falls to Record Lows

By Pat Anson, PNN Editor

The misuse of prescription opioids by young adults has fallen to the lowest levels ever recorded, according to an annual survey that’s been tracking drug use in the U.S. since 1975. The Monitoring the Future (MTF) survey also found that use of marijuana and hallucinogens by young adults rose to an all-time high last year.

The MTF survey and annual report is a joint project of the National Institute on Drug Abuse (NIDA) and the University of Michigan. Over 28,000 people were surveyed last year, including young adults aged 19 to 30 and adults aged 35 to 60.

Only 1.7% of young adults reported using “narcotics other than heroin,” a poorly named category that refers to the non-medical use of prescription opioids such as hydrocodone and oxycodone. Misuse of prescription opioids has been in a steep decline since reaching a peak of 8.9% in 2006.

NON-MEDICAL USE OF Rx OPIOIDS BY YOUNG ADULTS AGED 19-30

Source: Monitoring the Future

“One of the best ways we can learn more about drug use and its impact on people is to observe which drugs are appearing, in which populations, for how long and under which contexts,” said Megan Patrick, PhD, a research professor and principal investigator of the MTF study. 

“Monitoring the Future and similar large-scale surveys on a consistent sample population allow us to assess the effects of ‘natural experiments’ like the pandemic. We can examine how and why drugs are used and highlight critical areas to guide where the research should go next and to inform public health interventions.”

The MTF survey reflects the declining role that prescription opioids have in the U.S. drug epidemic, which is primarily fueled by illicit fentanyl and other street drugs. According to the IQVIA Institute, a healthcare data tracking firm, prescription opioid use has fallen by 48% over the past five years and now stands at levels last seen in 2000.

Once the most widely prescribed drug in the United States, hydrocodone (Vicodin) prescriptions have plummeted since the opioid was reclassified as a Schedule II Controlled Substance in 2014 and became harder to obtain.

According to the MTF survey, only 1.3% of young adults reported using Vicodin last year, down from a peak of 9.2% in 2009.

VICODIN USE BY YOUNG ADULTS AGED 19-30

Source: Monitoring the Future

Marijuana and Hallucinogens

While fewer younger adults are misusing prescription opioids, they are using marijuana and hallucinogens far more often.

Daily marijuana use (use on 20 or more occasions in the past 30 days) in 2021 reached the highest levels ever recorded since the MTF survey started monitoring it in 1988. Daily marijuana use was reported by 11% of young adults last year, up from 8% in 2016 and 6% in 2011.

In 2021, 8% of young adults reported using a hallucinogen such as LSD, ecstasy or psilocybin, an all-time high since the category was first surveyed in 1988. By comparison, only 3% reported using hallucinogens a decade earlier.

“As the drug landscape shifts over time, this data provides a window into the substances and patterns of use favored by young adults. We need to know more about how young adults are using drugs like marijuana and hallucinogens, and the health effects that result from consuming different potencies and forms of these substances,” NIDA Director Nora Volkow, MD, said in a news release.

“Young adults are in a critical life stage and honing their ability to make informed choices. Understanding how substance use can impact the formative choices in young adulthood is critical to help position the new generations for success.”

Alcohol remains the most-used substance among young adults, by far, with nearly 82% reporting alcohol use last year, unchanged from 2020. However, binge drinking (five or more drinks) rebounded to 32% in 2021 from an historic low in 2020, during the early stages of COVID-19 pandemic. 

Teen Misuse of Rx Opioids at Historic Lows

By Pat Anson, Editor

Misuse of opioid pain medication by American teenagers is at an historic low, according to a nationwide survey that also found prescription painkillers have become increasingly harder for teens to obtain.

Nearly 44,000 students in 8th, 10th or 12th grade were questioned about their drug use in the University of Michigan’s annual Monitoring the Future (MTF) survey. Overall, the number of teens drinking, smoking and abusing drugs is at the lowest level since the 1990’s, although marijuana use spiked upward in 2017.

While the so-called opioid epidemic continues to make national headlines, misuse of prescription painkillers by teenagers has been steadily falling for over a decade.

The survey found that 4.2% of 12th graders used “narcotics other than heroin” in the past year, down from 9.4% in 2002.

Only 35.8% of high school seniors said the drugs were easily available in the 2017 survey, compared to more than 54 percent in 2010.

“We’re observing some of the lowest rates of opioid use that we have been monitoring through the survey. So that’s very good news,” said Norah Volkow, MD, director of the National Institute on Drug Abuse. "The decline in both the misuse and perceived availability of opioid medications may reflect recent public health initiatives to discourage opioid misuse to address this crisis."

The misuse of the painkiller Vicodin continues a decade long decline, falling to 2.9% of high school seniors in 2017. That’s down from 10.5% of seniors in 2003. Similar declines were reported in the misuse of OxyContin.

Marijuana use by teenagers rose by 1.3% to 24 percent in 2017, the first significant increase in seven years.

“This increase has been expected by many,” said Richard Miech, lead investigator of the study. “Historically marijuana use has gone up as adolescents see less risk of harm in using it. We’ve found that the risk adolescents see in marijuana use has been steadily going down for years to the point that it is now at the lowest level we’ve seen in four decades.”

For the first time, the survey asked students about vaping.  Nearly 28 percent of high school seniors said they had used a vaping device in 2017. A little over half said the mist they inhaled was "just flavoring," about a third said they inhaled nicotine, and 11% said they vaped marijuana or hash oil.

After years of steady decline, binge drinking appears to have hit bottom. Nearly 17 percent of 12th graders said they had five or more alcoholic drinks in a row sometime in the last two weeks. That’s a lot, but it's down from 31.5% in 1998.