Drugs in the United States

The United States consumes more illegal street drugs than any other country on earth.[2] In the United States, the Federal Food, Drug, and Cosmetic Act defined the word "drug" as an "article intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals" and those "(other than food) intended to affect the structure or any function of the body of man or other animals."[3] Consistent with that definition, the U.S. separately defines narcotic drugs and controlled substances, which may include non-drugs, and explicitly excludes tobacco, caffeine and alcoholic beverages.[4]

Federal drug policy

Main article: Federal drug policy of the United States

War on drugs

Main article: War on drugs

The war on drugs is a campaign of prohibition and foreign military aid and military intervention undertaken by the United States government, with the assistance of participating countries, and the stated aim to define and reduce the illegal drug trade.[5][6] This initiative includes a set of drug policies of the United States that are intended to discourage the production, distribution, and consumption of illegal psychoactive drugs. The term "War on Drugs" was first used by President Richard Nixon in 1971.

Drug courts

Main article: Drug courts in the United States

The first Drug court in the United States took shape in Miami-Dade County, Florida in 1989 as a response to the growing crack-cocaine usage in the city. Chief Judge Gerald Wetherington, Judge Herbert Klein, then State Attorney Janet Reno and Public Defender Bennett Brummer designed the court for nonviolent offenders to receive treatment. This model of court system quickly became a popular method for dealing with an ever-increasing number of drug offenders. Between 1984 and 1999, the number of defendants charged with a drug offense in the Federal courts increased 3% annually, from 11,854 to 29,306. By 1999 there were 472 Drug Courts in the nation and by 2005 that number had increased to 1262 with another 575 Drug Courts in the planning stages; currently, all 50 states have working Drug Courts. There are currently about 120,000 people treated annually in Drug Courts, though an estimated 1.5 million eligible people are currently before the courts. There are currently more than 2,400 Drug Courts operating throughout the United States.

Smuggling

Drug smuggling across US borders may be done by several means.[7] Packages may be carried by people, or by cars, trucks and Railcar, hidden in Compartment.[7] Boats and submarines penetrate sea borders.[7] Drones pass above and tunnels pass below the usual routes of smuggling.[7]

Pharmacological drugs

Doping in sports

Main article: Doping in the United States

Doping is the taking of performance-enhancing drugs, generally for sporting activities. Doping has been detected in many sporting codes, especially baseball and football.

Substance Athlete population Percentage of athletes using substance[8]
Any substance banned by WADA Elite athletes across sports (positive drug tests) 2% over past year
Anabolic steroids Professional football players (self-report) 9% used at some point in career
Opiates Professional football players (self-report) 52% used at some point in career (71% of those misused at some point in career)
Smokeless tobacco Professional basketball players (self-report) 35%–40% over past year
Professional football players (self-report) 20%–30% over past year

Major League Baseball

See also: List of banned substances in baseball

The Mitchell Report

Main article: Mitchell Report

In December 2007 US Senator George Mitchell released Report to the Commissioner of Baseball of an Independent Investigation into the Illegal Use of Steroids and Other Performance Enhancing Substances by Players in Major League Baseball. Major League Baseball asked Mitchell to conduct an independent investigation to see how bad steroid use was in baseball. In the report, Mitchell covers many topics and he interviewed over 700 witnesses. He covers the effects of steroids on the human body. He also touches on human growth hormone effects. He reports on baseball's drug testing policies before 2002 and the newer policies after 2002. Mitchell also named 86 players in the report that had some kind of connection to steroids. Among those named were: Andy Pettitte, Roger Clemens, Barry Bonds, and Eric Gagne. To finish his report, Mitchell made suggestions to the Commissioner of Baseball about drug testing and violations of the drug testing policies. Mitchell also reported that he would provide evidence to support the allegations made against such players and would give them the opportunity to meet with him and give them a fair chance to defend themselves against the allegations. The report also includes a paper trail of evidence that states, "Former Mets club house attendant, Kirk Randomski sent performing enhancement drugs to the players mentioned in the report." Quinn, T.J. and Thompson, Teri Daily News Sports Writers [New York, N.Y.] CT. (2007):66[9][10]

Recreational drugs by type

Alcohol

Alcohol access

A survey of over 6000 teenagers revealed:

  • Teenagers and young adults typically get their alcohol from persons 21 or older. The second most common source for high school students is someone else under age 21, and the third most common source for 18- to 20-year-old adults is buying it from a store, bar or restaurant (despite the fact that such sales are against the law).
  • In the 12th grade, boys were more likely than girls to buy alcohol from a store, bar or restaurant.
  • Teenagers with higher weekly incomes are more likely to buy alcohol from a store, bar or restaurant.
  • It is easy to get alcohol at a party and from siblings or others 21 or older.[11]

How easy is it for youth to buy alcohol?

  • When young females attempted to buy beer without an ID at liquor, grocery or convenience stores, 47–52% of the attempts, beer was sold (1, 2) and nearly 80% of all the stores sold beer to the buyers at least once in three attempts; nearly 25% sold beer all three times.(1)
  • When young females attempted to buy beer without an ID at bars or restaurants, 50% of the attempts resulted in a sale to the buyer.(2)
  • When young males and females attempted to buy beer without an ID at community festivals, 50% of the attempts resulted in a sale to the buyer.(3)[11]

Of note:

Cannabis

Main article: Cannabis in the United States

The use, sale, and possession of cannabis containing over 0.3% THC by dry weight in the United States, despite laws in many states permitting it under various circumstances, is illegal under federal law.[17] As a Schedule I drug under the federal Controlled Substances Act (CSA) of 1970, cannabis containing over 0.3% THC by dry weight (legal term marijuana) is considered to have "no accepted medical use" and a high potential for abuse and physical or psychological dependence.[18]

Cocaine

Main article: Cocaine in the United States

Cocaine is the second most popular illegal recreational drug in the United States behind cannabis,[19] and the U.S. is the world's largest consumer of cocaine.[20]

In 2020, the state of Oregon became the first U.S. state to decriminalize cocaine.[21][22] This new law prevents people with small amounts of cocaine from facing jail time. In 2020, the U.S. state of Oregon would also become the first state to decriminalize the use of heroin.[23] This measure will allow people with small amounts to avoid arrest.[24]

Methamphetamine

Main article: Methamphetamine in the United States

Opioids

This section is an excerpt from Opioid epidemic in the United States.[edit]

The number of yearly U.S. opioid overdose deaths from all opioid drugs.
U.S. yearly overdose deaths, and the drugs involved. Among the 108,000 deaths in 2022, the largest share was related to fentanyl and other synthetic opioids (73,838 deaths).[26]
Total drug overdose deaths in the United States.

There is an ongoing opioid epidemic (also known as the opioid crisis) in the United States, originating out of both medical prescriptions and illegal sources. It has been described as "one of the most devastating public health catastrophes of our time".[27] The opioid epidemic unfolded in three waves. The first wave of the epidemic in the United States began in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years.[28] The second wave was from an expansion in the heroin market to supply already addicted people. The third wave, starting in 2013, was marked by a steep tenfold increase in the synthetic opioid-involved death rate as synthetic opioids flooded the US market.[29][30]

In the United States, there were approximately 109,600 drug-overdose-related deaths in the 12-month period ending January 31, 2023, at a rate of 300 deaths per day.[31] From 1999 to 2020, nearly 841,000 people died from drug overdoses,[32] with prescription and illicit opioids responsible for 500,000 of those deaths.[33] Drug overdose deaths totaled 70,237 in 2017, with 47,600 involving an opioid.[34][35] This surpassed deaths from car crashes (37,133) by 28%.[36] A December 2017 report estimated that 130 people die every day in the United States due to opioid-related drug overdose.[37] The great majority of Americans surveyed in 2015 who used prescription opioids did not believe that they were misusing them.[38]

The problem is significantly worse in rural areas, where socioeconomic variables, health behaviors, and accessibility to healthcare are responsible for a higher death rate.[39] Teen use of opioids has been noticeably increasing, with prescription drugs used more than any illicit drug except cannabis - more than cocaine, heroin, and methamphetamine combined.[40]

Psilocybin

Main article: Psilocybin decriminalization in the United States

In January 2019, the Oregon Psilocybin Society and research firm DHM Research found that 47 percent of Oregon voters supported the legalization of medical psilocybin, while 46 percent opposed it. The percentage of voters in favor increased to 64 percent after key elements of the ballot were clarified to the poll's participants.[41]

An October 2019 online poll conducted by research firm Green Horizons found that 38 percent of U.S. adults supported legalizing psilocybin "under at least some circumstances."[42]

In November 2020, a ballot measure to legalize medical psilocybin passed with 55.8% of voters in favor.[43]

Tobacco

Main article: Tobacco in the United States

Statistics in 2018 estimated that about 14.9% of adults (18 and over) had ever used e-cigarettes, and around 3.2% of all adults in the United States were current e-cigarette users. These same stats also noted that 34 million U.S. adults were current smokers, with E-cigarette usage being highest among current smokers and former smokers who are attempting or have recently quit cigarettes.[44]

Overall, it is estimated that 5.66 million adults in the US population reported current vaping 2.3%. From those users in the population, more than 2.21 million were current cigarette smokers (39.1%), more than 2.14 million were former smokers (37.9%), and more than 1.30 million were never smokers (23.1%).[45]

A significant concern for public health safety in the United States arises also from Mexico, where illicit opium poppy cultivation is on the rise. The Mexican government reported eradicating 21,425 hectares of opium poppy fields in 2014, up from 14,419 hectares in 2013. From 2010 to 2015, the number of heroin seizures along the U.S.-Mexico border more than doubled. According to the DEA, Mexican drug trafficking organizations are not only major suppliers of heroin but also the largest international sources of cocaine, marijuana, and methamphetamine that enter the United States.[46]

Costs

443,000 Americans die of smoking or exposure to secondhand smoke each year. For every smoking-related death, another 20 people suffer with a smoking-related disease. (2011)[47]

California's adult smoking rate has dropped nearly 50% since the state began the nation's longest-running tobacco control program in 1988. California saved $86 billion in health care costs by spending $1.8 billion on tobacco control, a 50:1 return on investment over its first 15 years of funding its tobacco control program.[47]

According to data from October 2023 to September 2024, approximately 87,000 deaths due to drug overdoses were reported in the United States.[48]

Drug use and deaths per state

State Population (2010) Drug Users (2010) Drug Deaths (Total 2010) Drug Deaths (per 100,000) Federal Grants (2010) Grant/Drug User
Alabama 4,779,736 06.73%[49] 554 12 $80,040,503 $248.82
Alaska 710,231 11.79%[50] 75 11 $30,760,934 $367.36
Arizona 6,392,017 08.95%[51] 981 15.5 $138,524,069 $242.36
Arkansas 2,915,918 07.96%[52] 326 11.5 $47,138,163 $203.09
California 37,253,956 09.07%[53] 4178 11.4 $832,107,905 $246.26
Colorado 5,029,196 11.72%[54] 747 15.4 $111,188,470 $188.64
Connecticut 3,574,097 08.23%[55] 444 12.7 $103,493,029 $351.84
Delaware 897,934 09.14%[56] 102 11.8 $24,161,839 $294.40
Florida 18,801,310 07.80%[57] 2936 16.1 $338,129,029 $230.57
Georgia (U.S. state) 9,687,653 07.32%[58] 1043 10.6 $321,114,660 $452.83
Hawaii 1,360,301 09.92%[59] 142 11.1 $37,176,146 $275.50
Idaho 1,567,582 08.00%[60] 133 8.9 $21,076,027 $168.06
Illinois 12,830,632 07.17%[61] 1239 9.6 $234,968,808 $255.41
Indiana 6,483,802 08.79%[62] 827 13.0 $91,020,232 $159.71
Iowa 3,046,355 04.08%[63] 211 7.1 $58,962,185 $474.39
Kansas 2,853,118 06.77%[64] 294 10.6 $40,234,098 $208.30
Kentucky 4,339,367 08.41%[65] 722 17 $100,547,625 $275.52
Louisiana 4,533,372 07.16%[66] 862 20.1 $80,230,847 $247.18
Maine 1,328,361 09.09%[67] 161 12.2 $36,320,286 $300.79
Maryland 5,773,552 07.29%[68] 807 12.7 $192,136,722 $456.50
Massachusetts 6,547,629 08.87%[69] 1003 15.6 $245,061,344 $421.96
Michigan 9,883,640 08.95%[70] 1524 15.3 $243,556,706 $275.33
Minnesota 5,303,925 08.24%[71] 359 6.9 $95,867,509 $219.35
Mississippi 2,967,297 06.39%[72] 334 11.4 $50,554,343 $266.62
Missouri 5,988,927 07.38%[73] 730 12.4 $123,020,244 $278.34
Montana 989,415 10.02%[74] 132 13.8 $28,332,837 $285.79
Nebraska 1,826,341 06.43%[75] 92 5.2 $34,675,170 $295.27
Nevada 2,700,551 09.35%[76] 515 20.1 $46,367,799 $183.63
New Hampshire 1,316,470 12.15%[77] 172 13.0 $55,388,743 $346.29
New Jersey 8,791,894 06.42%[78] 797 9.2 $113,795,702 $201.61
New Mexico 2,059,179 10.07%[79] 447 12.8 $150,896,974 $727.71
New York 19,378,102 09.82%[80] 1797 9.2 $1,875,136,099 $985.39
North Carolina 9,535,483 08.88%[81] 1223 13.0 $403,912,656 $477.01
North Dakota 672,591 05.3%[82] 28 4.3 $36,344,108 $1,019.55
Ohio 11,536,504 07.61%[83] 1691 14.7 $207,925,242 $236.84
Oklahoma 3,751,351 08.09%[84] 687 19 $67,359,062 $221.95
Oregon 3,831,074 12.80%[85] 564 15.1 $104,298,167 $212.69
Pennsylvania 12,702,379 06.57%[86] 1812 14.6 $283,229,043 $339.38
Rhode Island 1,052,567 13.34%[87] 142 13.4 $43,604,718 $310.55
South Carolina 4,625,364 06.70%[88] 584 13.2 $77,790,340 $251.02
South Dakota 814,180 06.28%[89] 34 4.3 $31,840,106 $622.72
Tennessee 6,346,105 08.22%[90] 1035 16.8 $107,211,391 $205.52
Texas 25,145,561 06.26%[91] 2343 9.8 $384,444,836 $244.23
Utah 2,763,885 06.24%[92] 546 20.6 $47,059,651 $272.86
Vermont 625,741 13.73%[93] 57 9.2 $58,913,913 $685.73
Virginia 8,001,024 07.33%[94] 713 9.2 $173,221,243 $295.36
Washington 6,724,540 09.59%[95] 1003 15.5 $130,527,165 $202.40
West Virginia 1,852,994 06.79%[96] 405 22.4 $45,059,469 $358.13
Wisconsin 5,686,986 08.67%[97] 639 11.4 $107,259,369 $217.54
Wyoming 563,626 06.82%[98] 68 13 $12,483,581 $324.76
 United States 308,143,815 08.11% 38260 12.4 $8,304,469,106 $332.19

See also

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  97. ^ "Wisconsin Drug Control Update" (PDF).
  98. ^ "Wyoming Drug Control Update" (PDF).
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