What is the fastest growing drug problem in the United States is likely the nonmedical use of?

The graph shows the percent of people aged 14 and over who had recently used selected illicit drugs between 2001 and 2019. The chart shows a declining trend from 2001 to 2007, in the recent use of any illicit drug (from 16.7% to 13.4%), the main driver for this is cannabis use (from 12.9% to 9.1%) which shares a similar trend. All other illicit drugs reported show similar trends yet have been always below 5%, hence not significant contributors overall.

The graph shows the rate of drug-induced deaths by drug class from 1997 to 2020, including antidepressants, depressants, antipsychotics, non-opioid analgesics and opioids. The chart shows the rate of drug-induced deaths declined between 1999 and 2002 (9.1 to 4.8 deaths per 100,000 population). This decrease was largely driven by a fall in drug-induced deaths where an opioid was present (6.5 to 2.5 deaths per 100,000 population). Since 2006, the rate of drug-induced deaths has started to increase, this increase is primarily driven by opioids, depressants and antidepressants.

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The graph shows the rate of hospitalisations by drug of concern between 2015­­–16 and 2020–21. This includes amphetamines and other stimulants, antiepileptic, sedative-hypnotic and antiparkinsonism drugs, antipsychotics and neuroleptics, cannabinoids, cocaine, non-opioid analgesics, opioids. The chart shows that the rate of drug-related hospitalisations for amphetamines and other stimulants has decreased since 2015–16. All other rates of hospitalisations have remained fairly stable since 2015–16.

The graph shows the proportion of people aged 20–29 that recently used cocaine, ecstasy and meth/amphetamine between 2001 and 2019. The chart shows a decline in recent ecstasy use by people aged 20–29 between 2007 and 2016 (from 11.2% to 7.0%) and an increase in 2019 (9.8%). Recent cocaine use by people aged 20–29 was highest in 2019, the largest increase was between 2016 and 2019 (from 6.9% to 12.0%). Recent meth/amphetamine use by people aged 20–29 was at its lowest in 2019, declining from a peak of 11.2% in 2001 to 2.4% in 2019.

People with mental health conditions

The presence of a mental health condition may lead to a drug use disorder, or vice versa. In some cases where there is a comorbidity, the person who uses drugs can develop a drug use disorder as a consequence of repeated use to relieve or cope with mental health symptoms (Marel et al. 2016).

In 2019, the NDSHS showed that the proportion of people self-reporting a mental health condition was higher among people aged 18 and over who reported the use of illicit drugs in the previous 12 months (26%) than those who had not used an illicit drug over this period (15.2%) (AIHW 2020). For example, mental health conditions were reported by:

• 31% of people who recently used meth/amphetamines (compared with 16.6% of non-users)
• 27% of people who recently used cannabis (compared with 15.4% of non-users)
• 22% of people who recently used ecstasy (compared with 16.7% of non-users)
• 22% of people who recently used cocaine (compared with 16.6% of non-users) (AIHW 2020).

The EDRS reported an increase in self-reported mental health conditions between 2014 and 2020 (from 28% to 52%) (Peacock et al. 2021a). See Physical health of people with mental illness.

People identifying as gay, lesbian or bisexual

People who identify as lesbian, gay, bisexual, transgender, intersex or queer can be at an increased risk of licit and illicit drug use. These risks can be increased by a number of issues such as stigma and discrimination, familial issues, fear of discrimination and fear of identification (Department of Health 2017). The NDSHS provides substance use estimates by sexual identity for people identifying as gay, lesbian or bisexual, however it does not include estimates for people identifying as transgender or intersex (AIHW 2020).

The NDSHS has consistently shown that the proportion of people reporting illicit drug use has been higher among people who identify as gay, lesbian or bisexual than among heterosexual people – 40% compared with 15.4% had used an illicit drug in the previous 12 months in 2019. After adjusting for differences in age, in comparison to heterosexual people, gay, lesbian or bisexual people were:

• 9.0 times as likely to use inhalants in the previous 12 months
• 3.9 times as likely to have used meth/amphetamines in the previous 12 months
• 2.6 times as likely to have used ecstasy in the previous 12 months (AIHW 2020).

The types of illicit drugs people had used in the last 12 months varied quite considerably by a person’s sexual orientation and it is important to note that there are differences in substance use between people who identified as gay or lesbian and people who identified as bisexual (AIHW 2020). 

The Writing Themselves In National Report describes findings from the national survey of health and wellbeing among lesbian, gay, bisexual, trans, queer, asexual (LBGTQA+) young people in Australia. The survey was conducted from September to October 2019 and participants needed to be aged between 14 and 21 years. The survey shows that in the previous 6 months:

• 27% of participants aged 14 to 17 years and 43% of participants aged 18 to 21 years reported using any drug for non-medical purposes.
• 28% of participants reported using cannabis.
• 7.0% of participants reported using ecstasy/MDMA (Hill et al. 2022a).

The Private Lives survey is Australia’s largest national survey of the health and wellbeing of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people, with the age of participants ranging from 18 to 88 years. The survey showed that 44% of participants reported using one or more drugs for non-medical purposes in the previous 6 months. Of this, cannabis was the highest at 30%, followed by Ecstasy/MDMA at 13.9%.

Within the past 6 months, 14.0% of participants reported experiencing a time when they had struggled to manage their drug use or where it negatively impacted their everyday life (Hill et al. 2022b).

Where do I go for more information?

For more information on illicit drug use, see:

• Alcohol, tobacco & other drugs in Australia
• National Drug Strategy Household Survey 2019
• Alcohol and other drug treatment services in Australia annual report
• Australian Burden of Disease Study 2018: interactive data on risk factor burden
• National Drug and Alcohol Research Centre

Visit Illicit use of drugs for more on this topic.

References

ABS (Australian Bureau of Statistics) (2021) Causes of Death, Australia, 2020. ABS cat. no. 3303.0, ABS, Australian Government, accessed 29 September 2021.

AIHW (Australian Institute of Health and Welfare) (2020) National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. AIHW, Australian Government, accessed 5 April 2022.

AIHW (2022a) Alcohol and other drug treatment services in Australia annual report. AIHW, Australian Government, accessed 17 August 2022.

AIHW (2022b) Australian Burden of Disease Study 2018: Interactive data on risk factor burden, AIHW, Australian Government, accessed 28 September 2021.

AIHW (2022c) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government, accessed 17 August 2022.

Bricknell S, (2021) Homicide in Australia 2018-19 | Australian Institute of Criminology (aic.gov.au). Australian Institute of Criminology, Australian Government, accessed 14 May 2021.

Chrzanowska A, Man N, Sutherland R, Degenhardt L, Peacock A et al. (2022) Trends in drug-related hospitalisations in Australia, 1999-2020.  National Drug and Alcohol Research Centre, University of New South Wales, accessed 22 March 2022.

Degenhardt L, Whiteford HA, Ferrari AJ, Baxter AJ, Charlson FJ et al. (2013) Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010, The Lancet 382(9904):1564–74, accessed 5 April 2022.

Department of Health (2017) National Drug Strategy 2017–2026. Department of Health website, accessed 13 October 2019.

Department of Health (2021) Types of drugs, Department of Health website, accessed 22 March 2022.

Hill AO, Lyons A, Jones J, McGowan I, Carman M, Parsons M, Power J, Bourne A (2022a) Writing Themselves In 4: The health and wellbeing of LGBTQA+ young people in Australia. National report, monograph series number 124. Australian Research Centre in Sex, Health and Society, La Trobe University, accessed 22 March 2022.

Hill AO, Bourne A, McNair R, Carman M & Lyons A (2022b) Private Lives 3: The health and wellbeing of LGBTIQ people in Australia. ARCSHS Monograph Series No. 122. Australian Research Centre in Sex, Health and Society, La Trobe University, accessed 22 March 2022.

Marel C, Mills KL, Kingston R, Gournay K, Deady M, Kay-Lambkin F, Baker A, Teesson M (2016) Guidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings (2nd edition). Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, University of New South Wales, accessed 5 April 2022.

Sutherland R, Karlsson A, Price O, Uporova J, Chandrasena U, Swanton R, et al. (2022a) Australian Drug Trends 2021: Key Findings from the National Ecstasy and Related Drugs Reporting System (EDRS) Interviews. National Drug and Alcohol Research Centre, University of New South Wales, accessed 22 March 2022.

Sutherland R, Uporova J, Chandrasena U, Price O, Karlsson A, Gibbs D, et al. (2022b) Australian Drug Trends 2021: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews. National Drug and Alcohol Research Centre, University of New South Wales, accessed 22 March 2022.

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