The types of prescriptions people abuse most are classified as psychotherapeutic drugs. These are drugs that may be prescribed to aid mental, emotional, and/or physical health.

• Psychotherapeutic drugs are generally categorized as painkillers, stimulants, sedatives, and tranquilizers.
• 59.5% of prescription drug abusers use pain relievers.
• 25.42% of prescription drug users take drugs from multiple categories.
• The most common reason people give for prescription drug abuse is trouble sleeping.
• 75% of prescription abusers receive the drugs from a friend, relative, or healthcare provider.
• 36.7% of abusers misuse their own prescriptions.
• 16% of abused prescriptions are black market purchases.

Painkiller Abuse Statistics

Pain relievers or painkillers are drugs designed to diminish or eliminate pain. Opioids fall under this umbrella term, as well as oxycodone, morphine, and fentanyl.

• 9.7 million people over 12 misuse painkillers, 16.5% for the first time, making it the most-abused type of prescription drug.
• 70% of prescription drug addicts are addicted to painkillers.
• 59.3% of prescription drug abusers misuse painkillers; that’s 3.5% of people over 12.
• 65.7% of painkiller abusers report using the drug to relieve physical pain.
• Just 11.3% of painkiller users misuse the drug to feel good or get high; this is a 6.6% annual increase.
• Other reported reasons for use are to relieve tension (10.0%), help with feelings or emotions (3.8%), help with sleep (3.7%), and to experiment or “see what it’s like” (2.2%).
• 1.9% of painkiller users say they are addicted.
• Side effects of painkiller abuse include seizures, a weakened immune system, an increased risk of heart disease, apnea (stop breathing), coma, and death.

Opioid Abuse Statistics

Opioids are the most abused drug type, with addiction and overdose rates climbing annually.

• 9.3 million people abuse prescription opioids specifically, or 95.9% of people who abuse any prescription painkiller.
• 8.6 million or 92.1% of prescription opioid abusers misuse prescription opioids only.
• 404,000 or 4.0% of prescription opioid abusers also use heroin.
• 54.2% of heroin users also use prescription opioids.
• Opioid abuse has declined 21.3% since 2015.
• Opioid prescriptions increased 169% from 1992 to 2010.
• Pharmacies filled 165 million more opioid prescriptions than stimulant prescriptions in 2010.
• One of the greatest dangers of opioid use is accidental ingestion of fentanyl.

Signs and Symptoms of Opioid Abuse:

• Confusion
• Drowsiness
• Poor coordination
• Pinprick pupils
• Euphoria
• Slowed breathing
• Nausea and/or constipation
• Increased tolerance; increased doses needed to relieve pain
• Hyperalgesia; and increased sensitivity to pain

Signs and Symptoms of Opioid Overdose

• Cold, sweaty skin
• Tremors or shaking
• Trouble breathing
• Difficulty speaking
• Unconsciousness

Stimulant Abuse Statistics

Some of the most popular prescription stimulants are ADHD medications, such as Adderall and Ritalin.

• 4.9 million people over 12 misuse prescription stimulants within 12 months, 18.4% for the first time.
• 51.0% of stimulant abusers are aged 26 or older, representing 1.2% of this age group.
• 40.8% of stimulant users are 18 to 25 years old, representing 5.8% of that age group.
• 8.8% of users are 12- to 17-year-olds, representing 1.7% of that age group.
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• Stimulant abuse is down 10% since 2015.
• Stimulants include amphetamine, methylphenidate, anorectic (weight-loss) stimulants, and Provigil®, among others.
• 19% of stimulant abusers report using the drug to help with academic studies.
• 50.7% of abusers report using stimulants to stay alert and/or concentrate.
• 9.8% of stimulant abusers report using the drug to get high while 4.1% use with the goal of losing weight.
• Other reported reasons for use include experimentation (5.8%) or to increase/decrease the effects of another drug (1.1%).
• 0.2% of stimulant abusers say they are addicted.
• Long-term effects of stimulant abuse include damage to liver, kidneys, and blood vessels.
• Physical side effects of stimulant abuse also include heart attack, stroke, increased blood pressure, an increased risk of heart disease, arrhythmia (irregular heartbeat), seizures, dehydration, apnea, coma, and death.

Sedative and Tranquilizer Abuse

Sedatives and tranquilizers are similar drug types, promoting sleep and calm respectively. Some drugs are classified as both. Tranquilizers are more likely to be abused for the purpose of getting high.

• 5.9 million people over the age of 12 abuse sedatives and/or tranquilizers, 20.1% for the first time.
• 41.1% of tranquilizer abusers report using the drug to relieve tension.
• 20.9% of users report taking tranquilizers as sleep aids while 15.8% use tranquilizers to cope with emotions.
• 6.7% of tranquilizer users do so experimentally.
• 67.8% of sedative abusers report using the drug as a sleep aid.
• 19.6% of users report taking a sedative to relieve tension.
• Other reported reasons for use are emotional coping (4.2%), intoxication (4.1%), and experimentation (1.8%).
• Just 0.7% of tranquilizer users and 0.3% of sedative users say they are addicted.
• Side effects of sedative and/or tranquilizer abuse include liver failure, depression, amnesia, abnormal blood pressure, seizures, nightmares and night terrors, vision reduction or loss, apnea, coma, and death.

People of all ages, races, and socioeconomic backgrounds misuse prescription painkillers.

• Women are 11% more likely than men to be prescribed medication, but men are 22.9% more likely to misuse prescriptions.
• Both men and women are most likely to use pain relievers, with 32.5% more men than women using.
• Women are more likely to use stimulants as study aids or to increase alertness; men are more likely to use stimulants for the purposes of getting high or experimentation.
• College initiates to stimulants are more likely to abuse them as study aids whereas pre-college initiates are more likely to abuse stimulants for fun or out of curiosity.
• Hispanic and Caucasian Americans are most likely to abuse stimulants.
• African Americans are least likely to abuse stimulants, undercutting Asian usage rates by nearly half (47.0%).
• One study found opioid use before high school to be “independently associated with a 33% increase in the risk of future opioid misuse after high school.”

Prescription Abuse by Age

Prescription drug abuse is most common among 18- to 25-year-olds. Some studies indicate that senior and elderly medicated patients may be at heightened risk of developing addiction due to the number and variety of drugs they take for health reasons.

• 14.4% of adults aged 18 to 25 abuse prescription drugs annually.
• More than 80 percent of older patients (ages 57 to 85 years) use at least one prescription medication on a daily basis.
• Among adults aged 40 to 79 years, 69.0% used a prescription within the past 30 days; 22.4% used 5 or more prescriptions.
• Over 50 percent of these older patients take more than five medications or supplements daily.
• Among 12- to 17-year-olds, 4.9% abuse prescriptions annually.
• Hydrocodone-acetaminophen (Vicodin) is the favorite prescription drug among high school seniors with 8% reporting use.
• The stimulant amphetamine/dextroamphetamine (Adderall) are the second favorite, used by 6.5% of 12th-graders.
• 5 of the top 10 reasons teenagers misuse prescription drugs have to do with accessibility.
• 62% of teenagers say they choose to abuse prescription drugs because they’re easy to get from parents’ medicine cabinets.
• 35% say they use prescriptions because they incorrectly believe prescriptions are “safer than illegal drugs”.

A certain set of characteristics help friends, family, doctors, co-workers, etc. of a potential problem with prescription drug abuse.

• Stealing, forging, or selling prescriptions is an indication someone might be abusing drugs. Some of the stash may be for their personal use while sales income helps fund more prescriptions.
• Taking doses beyond the recommended amount in quantity or frequency is a sign that someone has developed a tolerance to the drug; this is a definitive characteristic of addiction.
• Mood swings, hostility, unusual sleeping habits, and poor decision-making are all signs that someone may be abusing prescription drugs. Sedatives and stimulants both have powerful effects on energy and sleep.
• Doctor shopping or seeing an excessive number of medical professionals may be signs of prescription drug abuse. Addicts usually request early refills or “lose” prescriptions until a doctor grows suspicious and stops writing them.

Prescription Abuse Prevention

It is statistically likely that you or someone you know has abused a prescription drug within the last 12 months.

• Always follow usage instructions. Never use a prescription in a way other than as directed by your doctor.
• Don’t order prescriptions online unless it is with a known reputable pharmacist. Many cases of accidental overdose can be traced to websites advertising as pharmacies that fill prescriptions at a very discounted rate. Many of these drugs are counterfeit and contain deadly doses of a substance unknown to the user.
• Never sell or give away prescription drugs. Sharing prescriptions is dangerous for many reasons, among them enabling drug abuse.
• Always properly dispose of leftover prescriptions. Many pharmacies offer safe destruction and disposal services for prescription drugs.
• Encourage treatment without judgement or shame. By the time they realize they need treatment, most drug addicts have already experienced judgement and shame. Their final hurdle is fear of failure, so focusing on progress and success is crucial. Everyone needs some help to overcome addiction.

Historical Context

Humans have abused substances for thousands of years. Psychotherapeutic drugs were unknown until the 1950s.

• Valium® (diazepam) was one of the earliest psychotherapeutic brands available; it has remained one of the most prescribed medications worldwide since its market launch in 1963.
• Prescription drug abuse generally was not part of national drug abuse and addiction studies until the 21^st century, when prescription opioid abuse became an evolving problem.
• From 2002 to 2012, between 2.3 and 2.8 million Americans aged 12 and older abused prescriptions for the first time each year.
• In 2013, 2.0 million tried prescription drugs for the first time.
• In 2015, the International Narcotics Control Board reported that Americans were responsible for 99.7% of the world’s hydrocodone consumption.
• While prescription rates and prescription abuse increased over decades, many psychotherapeutic drug classes, such as stimulants, are diminishing in both use and abuse.
• Initiation levels are higher, however, exceeding 2013’s initiates by 85%.
• In 2017, the U.S. Department of Health and Human Services declared opioid abuse and addiction a national public health emergency.

Most American adults consume alcohol at least once in their lifetime. Among them, 6.7% will develop Alcohol Use Disorder (AUD).

• 10.2% of Americans aged 12 years and older had Alcohol Use Disorder in 2020.
• 24.0% of people aged 18 years and older reported binge drinking in the last 30 days; this is a 7.0% decline between 2019 and 2020.
• Every day, 385 Americans die as a result of excessive alcohol use.
• 83.9% of these deaths involve adults aged 35 or older.
• Alcohol causes 10% of deaths among 15- to 49-year-olds.
• Worldwide, up to 3 million people die every year as a result of alcohol abuse.
• Alcohol-related deaths account for at least 5.3% (some estimate as high as 6.0%) of the world’s deaths.
• Alcohol causes 13.5% of deaths among 20- to 39-year-olds.
• Men are 3 times as likely as women to die as a consequence of alcohol abuse.
• The World Health Organization (WHO) has determined excessive alcohol use is responsible for 7.1% of disease among males and 2.2% among females.
• Collectively, Americans lose over 3.59 million years of potential life due to excessive drinking.

Alcohol Abuse & COVID-19

Economists as well as healthcare and addiction specialists agree the pandemic and quarantines of 2020 had a significant impact on nationwide alcohol consumption. As a result, statistics from this period may be misleading.

• Online liquor sales rose 262% year-over-year (YoY) in the first 3 weeks of March 2020, coinciding with most state-wide lockdowns.
• Liquor store sales increased 54% YoY during that same time period.
• In April 2020, YoY alcohol sales were up 234%.
• In a Johns Hopkins-University of Maryland-Baltimore survey, 60.1% of participants report drinking more alcohol after March 1, 2020.
• 34.1% report binge drinking at least once; 7.0% report extreme binge drinking.
• 45.7% report increased stress as a reason for their increased drinking.
• Other reasons for increased drinking include increased alcohol availability (34.4%) and boredom (30.1%).
• Also in March, 180 people died in Iran after consuming homemade alcohol due to the rumor that it would protect them from COVID.
• Similar deaths occurred in nations where alcohol is illegal and often includes toxins.[1]

Alcohol Abuse & Children

Children aged 17 years and younger are much more likely to live with an alcoholic parent than they are to be diagnosed with a learning disability or ADHD.

• 1.7% of 12- to 17-year-olds have AUD.
• Females aged 12 to 17 years are 61.5% more likely to have AUD than their male peers.
• 12.1% of children 17 years and under live with at least one parent with alcohol use disorder.
• Among them, 18.7% live in single-parent households.
• Children living in single-parent households are 47.6% more likely to live with an alcoholic father than they are an alcoholic mother.
• 9.3% of single fathers are alcoholic while 6.3% of single mothers are alcoholic.
• Intoxicated adults are responsible for 150 child deaths every year.
• Among kids living with substance abusing parents, 86.2% live with a parent who abuses alcohol.

Analysis: Emerging Trends in Alcohol Abuse

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has identified an emerging trend that it has labeled “High-Intensity Drinking.” The definition of High-Intensity Drinking (HID) includes the consumption of “alcohol at levels that are two or more times the gender-specific binge drinking thresholds”.[2]

Due to its status as an emerging trend, there are few peer-reviewed studies. Available data indicate HID is common among binge drinkers and that it is typically associated with special occasions “including holidays, sporting events, and, notably, 21st birthdays.”[3]

• HID behavior peaks at age 21.
• Between 80% and 90% of 21^st birthday celebrants consume alcohol.
• Males are consistently twice as likely to report excessive alcohol use than females.
• HID is associated with negative consequences, such as injury and aggression.
• 12.4% of young adults aged 25 and 26 report at least one instance of HID in within the previous 14 days.
• Each year, 97,000 sexual assaults among American college students involve alcohol.

Alcohol-Related Illness and Death

Nearly 100,000 annual deaths are attributable to alcohol abuse. More than half of them are due to long-term use.

• Alcoholic liver disease is the leading killer, causing 19.1% of all alcohol-related deaths.
• 53.7% of alcohol-related deaths are due to chronic misuse.
• 52.4% of chronic misuse deaths are attributable to alcohol alone; 47.6% include additional factors, such as other chronic health issues or drug abuse.
• Alcohol poisoning another leading killer, causing 32% of acute alcohol-related deaths.
• 22.5% of acute-alcohol related deaths are due to suicide.
• Suicides involving alcohol kill more people than car accidents involving alcohol, which account for 16.1% of acute-alcohol related deaths.

Alcohol Deaths & Demographics

Alcohol Use Disorder and alcoholism have damaged some groups or demographics more than others. Alcohol abuse statistics indicate some inequalities may be due to social conditioning.

• 69.1% of alcohol-related deaths are men, a 3.2% decline from the previous year’s 5-year average.
• Excessive drinking kills 3,983 Americans under the age of 21 each year; 75.1% of them are male.
• 31.8% of people who die from excessive alcohol use are between the ages of 50 and 64 years old.
• 16.1% of people who die from alcohol are under the age of 35.
• 37.2% of people killed in alcohol-related car crashes are between the ages of 20 and 34 years old.
• 85.9% of people aged 65 and older who die from excessive alcohol use die from chronic conditions as opposed to acute causes.
• 50- to 64-year-olds are almost twice as likely to die from chronic alcohol abuse than from acute alcohol-related causes.
• 96.5% of teenagers who die from excessive alcohol use die from acute causes, such as suicide or car accidents, as opposed to chronic conditions, such as liver disease.

Alcohol Abuse & Death by State

State-level data from the Centers for Disease Control and Prevention (CDC) reflects annual averages from 2015-2019. More recent data is available from some individual state agencies; collection methodology is not uniform, however.

State totals exclude territories and unspecified residency and will not necessarily equal the national total.

Most binge drinkers live in Midwestern states.

New Mexico has the largest alcohol-related death rate per capita.

Southern states see the highest rate of alcohol-related deaths due to acute causes (i.e. accidents, homicide, etc.).

Southern states also see the highest rate of under-21 alcohol-related deaths.

California, Texas, and Florida see the highest number of deaths.

The second-most recent state-level dataset regarding excessive alcohol consumption released by the CDC included data collected from 2011 to 2015.

State averages will not necessarily equal the national average due to population variations.