Prevalence of use and percentage of misuse by medication and demographic characteristics among US young adults aged 18–25 years, National Survey of Drug Use and Health, 2015–2018
| Opioid | Stimulant | Tranquilliser | Sedative | |||||
| Any use (medical/misuse) in the past year | Past-year misuse* (among any users) | Any use (medical/misuse) in the past year | Past-year misuse* (among any users) | Any use (medical/misuse) in the past year | Past-year misuse* (among any users) | Any use (medical/misuse) in the past year | Past-year misuse* (among any users) | |
| Prevalence (%) | Proportion (%) | Prevalence (%) | Proportion (%) | Prevalence (%) | Proportion (%) | Prevalence (%) | Proportion (%) | |
| Overall | 30.2 (29.7–30.7) | 23.3 (22.5–24.2) | 14.1 (13.7–14.5) | 51.3 (49.8–52.7) | 11.5 (11.2–11.9) | 45.1 (43.6–46.7) | 3.5 (3.3–3.7) | 19.0 (16.8–21.2) |
| Sex | ||||||||
| Female | 33.9 (33.2–34.6) | 19.2 (18.3–20.2) | 12.8 (12.3–13.3) | 50.4 (48.3–52.5) | 12.9 (12.4–13.4) | 38.6 (36.6–40.6) | 4.0 (3.8–4.3) | 17.5 (14.9–20.2) |
| Male | 26.6 (25.9–27.2) | 28.5 (27.2–29.9) | 15.4 (14.8–16.0) | 52.0 (50.0–54.0) | 10.1 (9.6–10.6) | 53.4 (50.9–55.8) | 3.0 (2.7–3.3) | 21.0 (17.2–24.8) |
| Age, years | ||||||||
| 18–20 | 27.8 (27.0–28.6) | 22.9 (21.5–24.2) | 13.6 (13.0–14.2) | 50.0 (47.6–52.4) | 10.4 (9.8–10.9) | 51.0 (48.3–53.8) | 3.0 (2.7–3.3) | 22.3 (18.1–26.6) |
| 21–25 | 30.2 (29.7–30.7) | 23.3 (22.5–24.2) | 14.1 (13.7–14.5) | 51.3 (49.8–52.7) | 11.5 (11.2–11.9) | 45.1 (43.6–46.7) | 3.5 (3.3–3.7) | 19.0 (16.8–21.2) |
| Race/ethnicity | ||||||||
| White (non-Hispanic) | 32.3 (31.6–33.0) | 24.9 (23.8–26.0) | 19.0 (18.4–19.5) | 51.5 (49.9–53.2) | 14.5 (14.0–15.0) | 44.3 (42.4–46.2) | 4.5 (4.2–4.8) | 19.8 (17.1–22.4) |
| Black (non-Hispanic) | 30.9 (29.7–32.1) | 18.8 (17.0–20.7) | 6.1 (5.4–6.7) | 42.1 (36.6–47.6) | 7.1 (6.4–7.7) | 48.7 (43.7–53.6) | 2.1 (1.7–2.5) | 12.0 (6.1–17.8) |
| Asian (non-Hispanic) | 17.8 (16.0–19.7) | 15.7 (11.6–19.8) | 7.4 (6.2–8.7) | 55.9 (47.5–64.3) | 4.0 (3.0–4.9) | 43.2 (31.2–55.2) | 1.4 (0.9–1.9) | – |
| Hispanic | 27.5 (26.4–28.6) | 22.7 (20.8–24.7) | 9.1 (8.4–9.9) | 52.7 (48.5–56.8) | 9.0 (8.3–9.7) | 45.9 (41.9–49.9) | 2.5 (2.1–2.9) | 17.2 (11.3–23.1) |
| Other (non-Hispanic) | 35.2 (32.9–37.5) | 27.4 (23.7–31.1) | 14.3 (12.6–16.1) | 52.0 (45.4–58.5) | 11.9 (10.3–13.4) | 50.5 (43.7–57.4) | 4.6 (3.6–5.6) | 25.8 (15.6–36.0) |
| Education | ||||||||
| Middle school or less | 27.4 (26.3–28.4) | 19.7 (17.9–21.5) | 17.1 (16.2–17.9) | 55.3 (52.4–58.2) | 11.1 (10.3–11.8) | 37.0 (33.7–40.3) | 3.6 (3.2–4.1) | 20.1 (15.2–24.9) |
| <High school | 31.1 (27.5–34.7) | 30.0 (23.7–36.4) | 9.5 (7.3–11.8) | 33.7 (22.3–45.1) | 13.1 (10.5–15.7) | 51.4 (40.9–62.0) | 4.1 (2.4–5.8) | – |
| High school | 36.0 (32.5–39.5) | 30.7 (25.3–36.2) | 9.3 (7.1–11.5) | 33.6 (22.7–44.5) | 14.2 (11.7–16.8) | 47.1 (37.6–56.7) | 3.5 (2.1–4.9) | – |
| Some college | 30.1 (29.4–30.9) | 24.3 (23.0–25.6) | 10.5 (10.0–11.0) | 44.8 (42.2–47.3) | 10.3 (9.8–10.8) | 47.7 (45.1–50.3) | 3.0 (2.7–3.3) | 19.6 (15.9–23.4) |
| College+ | 31.8 (31.0–32.7) | 23.5 (22.1–24.9) | 17.1 (16.4–17.8) | 54.5 (52.2–56.7) | 13.0 (12.3–13.6) | 46.7 (44.1–49.3) | 4.0 (3.7–4.4) | 18.6 (15.2–22.1) |
| Poverty level† | ||||||||
| Poverty | 30.5 (29.6–31.5) | 23.0 (21.4–24.5) | 13.6 (12.9–14.4) | 53.7 (50.8–56.6) | 10.9 (10.2–11.5) | 46.9 (43.8–50.1) | 3.6 (3.2–3.9) | 15.1 (11.6–18.6) |
| up to 2 x threshold | 30.9 (29.9–31.9) | 23.4 (21.8–25.1) | 11.5 (10.8–12.2) | 46.0 (42.9–49.2) | 10.9 (10.2–11.5) | 44.7 (41.5–47.9) | 3.2 (2.8–3.6) | 15.9 (11.8–20.0) |
| >2 x threshold | 29.9 (29.2–30.6) | 23.7 (22.5–24.9) | 15.5 (14.9–16.1) | 51.4 (49.4–53.4) | 12.2 (11.7–12.7) | 44.5 (42.3–46.7) | 3.7 (3.4–4.0) | 22.2 (18.8–25.7) |
| Health insurance | ||||||||
| No insurance | 28.2 (26.9–29.5) | 27.9 (25.4–30.3) | 9.4 (8.6–10.3) | 48.4 (43.7–53.2) | 10.9 (10–11.8) | 49.9 (45.6–54.2) | 2.9 (2.4–3.4) | 18.5 (12.2–24.8) |
| Private | 29.6 (29.0–30.2) | 22.9 (21.8–23.9) | 17.2 (16.7–17.8) | 53.1 (51.4–54.8) | 12.0 (11.6–12.5) | 45.2 (43.2–47.2) | 3.6 (3.4–3.9) | 21.3 (18.3–24.3) |
| Medicaid | 34.2 (33.0–35.3) | 22.3 (20.6–23.9) | 8.6 (7.9–9.2) | 42.3 (38.3–46.3) | 10.8 (10.0–11.5) | 43.3 (39.7–47.0) | 3.6 (3.2–4.1) | 13.2 (9.3–17.2) |
| Medicare | 38.1 (28.2–47.9) | 23.2 (10.2–36.2) | 14.2 (6.6–21.7) | 48.8 (19.6–78.1) | 13.7 (7.4–20.1) | 44.3 (20.2–68.3) | – | – |
| Other (non-Hispanic) | 28.7 (26.9–30.6) | 21.9 (18.7–25.1) | 12.1 (10.8–13.5) | 51.3 (45.5–57.1) | 10.1 (8.9–11.2) | 38.9 (33.0–44.8) | 3.5 (2.8–4.2) | 16.3 (8.6–24.1) |
| Metro status‡ | ||||||||
| Metro | 29.7 (29.2–30.2) | 23.1 (22.2–24.0) | 14.3 (13.9–14.7) | 51.9 (50.3–53.4) | 11.5 (11.2–11.9) | 45.3 (43.6–47.0) | 3.5 (3.3–3.8) | 18.7 (16.4–21.1) |
| Non-metro | 33.8 (32.6–35.0) | 24.9 (22.9–26.8) | 12.6 (11.8–13.5) | 46.6 (43.0–50.3) | 11.4 (10.6–12.2) | 44.2 (40.4–48.1) | 3.3 (2.9–3.8) | 21.0 (15.3–26.7) |
| Serious psychological distress§ | ||||||||
| No | 27.5 (27.0–28.1) | 19.8 (18.8–20.7) | 12.1 (11.7–12.5) | 51.1 (49.4–52.9) | 8.5 (8.1–8.8) | 44.4 (42.3–46.5) | 2.3 (2.1–2.5) | 18.5 (15.3–21.7) |
| Yes | 39.5 (38.4–40.6) | 31.9 (30.2–33.5) | 21.0 (20.0–21.9) | 51.6 (49.1–54.0) | 21.9 (21–22.9) | 46.1 (43.8–48.5) | 7.6 (7.0–8.2) | 19.5 (16.5–22.5) |
| Recency of non-prescription substance¶ use | ||||||||
| Never used any substance | 17.0 (16.0–18.1) | 6.6 (5.0–8.2) | 3.5 (3.0–4.0) | 7.0 (3.1–10.9) | 3.1 (2.6–3.6) | 7.8 (3.8–11.7) | 1.4 (1.1–1.7) | – |
| Used within past 30 days | 34.3 (33.7–35.0) | 27.9 (26.9–28.9) | 18.9 (18.4–19.5) | 56.1 (54.5–57.6) | 15.1 (14.6–15.5) | 49.8 (48.1–51.5) | 4.3 (4.0–4.6) | 21.5 (18.9–24.1) |
| Used during past 30 days to 12 months | 26.3 (25.1–27.6) | 12.2 (10.4–14.0) | 6.6 (5.8–7.3) | 25.1 (20.4–29.8) | 6.3 (5.6–6.9) | 23.5 (18.6–28.4) | 2.8 (2.3–3.3) | 9.1 (4.8–13.4) |
| Used more than 12 months ago | 26.5 (24.6–28.4) | 10.5 (8.0–12.9) | 4.9 (4.0–5.8) | 9.1 (4.2–14.1) | 5.4 (4.5–6.4) | 14.9 (8.3–21.4) | 1.9 (1.4–2.5) | – |
| Number of non-prescription substance¶ use (past 30 days) | ||||||||
| 0 | 22.4 (21.7–23.2) | 10.1 (9.0–11.2) | 5.0 (4.6–5.4) | 16.9 (14.0–19.9) | 4.8 (4.4–5.2) | 17.5 (14.3–20.7) | 2.1 (1.8–2.3) | 9.2 (5.5–12.9) |
| 1 | 29.0 (28.2–29.8) | 14.7 (13.5–15.9) | 10.9 (10.3–11.4) | 44.3 (41.6–47.1) | 8.6 (8.1–9.1) | 29.7 (26.9–32.5) | 2.6 (2.3–2.9) | 11.3 (8.0–14.5) |
| 2 | 35.9 (34.7–37.1) | 28.0 (26.2–29.9) | 22.0 (21.0–23.1) | 54.6 (51.9–57.3) | 15.5 (14.6–16.4) | 50.3 (47.1–53.5) | 4.7 (4.2–5.2) | 23.2 (18.2–28.3) |
| 3 | 43.4 (41.6–45.2) | 43.9 (41.2–46.6) | 31.5 (29.8–33.2) | 63.1 (60.0–66.3) | 27.5 (25.9–29.1) | 57.1 (53.6–60.5) | 7.4 (6.5–8.4) | 27.6 (22.0–33.2) |
| 4 | 51.6 (48.5–54.8) | 58.7 (54.4–62.9) | 45.2 (42.0–48.3) | 70.5 (66.3–74.7) | 38.8 (35.8–41.9) | 70.4 (65.8–75.0) | 8.8 (6.9–10.6) | 27.7 (17.8–37.6) |
| 5+ | 66.4 (60.8–72.1) | 72.1 (65.1–79.1) | 62.0 (56.1–67.8) | 77.6 (70.8–84.3) | 58.1 (52.1–64.1) | 86.2 (81.2–91.3) | 14.8 (9.8–19.7) | 39.9 (22.9–56.9) |
| Number of non-prescription substances¶ used (past years) | ||||||||
| 0 | 19.9 (18.9–20.8) | 8.2 (6.8–9.5) | 3.9 (3.5–4.4) | 7.8 (4.7–10.9) | 3.8 (3.3–4.2) | 10.8 (7.2–14.5) | 1.6 (1.3–1.9) | 9.4 (3.2–15.6) |
| 1 | 26.5 (25.6–27.3) | 9.9 (8.8–11.0) | 6.6 (6.1–7.0) | 27.4 (24.1–30.6) | 6.0 (5.6–6.4) | 18.2 (15.3–21.1) | 2.2 (2.0–2.5) | 9.1 (5.8–12.4) |
| 2 | 31.8 (30.7–32.9) | 17.5 (16.0–19.1) | 13.8 (13.0–14.6) | 44.9 (41.9–48.0) | 10.3 (9.6–11.0) | 31.9 (28.5–35.3) | 3.3 (2.9–3.7) | 12.0 (8.0–16.0) |
| 3 | 36.4 (35.0–37.8) | 31.4 (29.2–33.5) | 21.3 (20.1–22.5) | 53.7 (50.6–56.9) | 17.0 (15.9–18.1) | 47.9 (44.4–51.4) | 4.9 (4.3–5.5) | 20.0 (14.9–25.1) |
| 4 | 43.1 (41.2–45.1) | 41.8 (38.9–44.7) | 33.4 (31.5–35.3) | 65.0 (61.8–68.2) | 26.3 (24.6–28.1) | 58.6 (54.9–62.4) | 7.3 (6.2–8.4) | 23.4 (17.6–29.1) |
| 5+ | 54.7 (52.2–57.2) | 66.1 (62.9–69.3) | 57.9 (55.4–60.4) | 73.4 (70.5–76.3) | 47.1 (44.5–49.6) | 77.7 (74.7–80.7) | 11.1 (9.4–12.7) | 41.6 (33.8–49.3) |
Estimates in bold type indicate statistically significant differences within the demographic subgroup. Estimates with relative standard errors ≥40% were suppressed (–). Results are unadjusted (ie, crude).
*Misuse was defined as a report by the respondent that they had used the psychoactive prescription medication in the past year in any way not directed or prescribed, including use without a prescription of individual’s own, or deviations in the dose (greater amounts), frequency (more often) or duration (longer).
†Poverty status was defined using the Federal Poverty Threshold of each survey year.
‡Metro status assessed whether the respondent lived in a metropolitan statistical area or not delineated by the Office of Management and Budget.
§Presence of serious psychological distress was defined as Kessler-6 Psychological Distress Scale Score ≥13.
¶Non-prescription substances include alcohol, cigarettes, cigars, marijuana, cocaine, heroin, inhalants and hallucinogens.