Illicit drug use is a major public health concern in the United States (US), where estimated 53.2 million people in the US had used illicit drugs in 2018. In particular, stimulant use, including the illicit use of methamphetamine, cocaine, and the misuse of prescription (Rx) stimulants, is a growing problem in the US.
Past Year Use
In 2018, an estimated 1.9 million (0.7%) Americans aged 12 or older had used methamphetamine in the past year, of which about 205,000 were new users (approximately 560 each day). Among recurrent users of methamphetamine aged 12 or older, 0.4% developed methamphetamine use disorder for dependence and abuse (NSDUH, 2018).
Overall past year methamphetamine use increased by 17% from 2015-2018 (Figure 1). From 2015-2018, young adults aged 18 to 25 had highest prevalence of past year methamphetamine use, followed by adults aged 26 or older, and youth aged 12 to 17 (Figure 2).
Among high school students, the percent that had ever used methamphetamine has been decreasing from 2003-2017 in the US. Los Angeles County (LAC), which historically had a high prevalence of ever use of methamphetamine among high school students, had consistent large decreases since 2005, nearing that of the overall US estimates in 2017 (Figure 3).
Male high school students had a higher estimated prevalence of ever use of methamphetamine than female students in LAC for most years during the 2003-2017 period. The estimated prevalence among females surpassed that of males in 2005, 2007, and 2017. In 2017, 2.5% of male students and 2.7% of female students had ever used methamphetamine in their lifetime (Figure 4).
In LAC, Hispanic high school students had the highest prevalence of ever use of methamphetamine in 2005 (12.2%), but this has since decreased consistently to 2.2% in 2017 (Figure 5).
The prevalence of ever use of methamphetamine among high school students of other race/ethnic groups fluctuated over the period. In 2017, whites had the highest prevalence of ever use of methamphetamine compared to other race/ethnic groups (Figure 5).
Past Year Use
In 2018, an estimated 5.5 million (2.0%) Americans aged 12 or older had used cocaine in the past year, of which about 874,000 were new users (approximately 2,400 each day). Among recurrent users of cocaine aged 12 or older, 0.4% developed cocaine use disorder for dependence and abuse (NSDUH, 2018).
The prevalence of ever used cocaine in the past year among individuals aged 12 or older in the US had dropped from 2.5% in 2002 to 1.5% in 2011, then increased to 2% in 2018 (Figure 6). In LAC, overall cocaine use has been increasing since 2010-2012, when it also surpassed both national and California state rates (Figure 7).
At the national, state, and local LAC level, the prevalence of past year cocaine use was by far the highest among individuals aged 18-25 compared to adults aged 26 or older and youth aged 12-17. The prevalence of past year cocaine use decreased for youth aged 12-17 years from 2006-2016, but increased for adults, particularly young adults aged 18-25 years over the past decade. The increasing trend for past year cocaine use among young adults started in 2010-2012 in California, followed by LAC in 2012-2014, then the US in 2014 (Figures 8-10).
Ever use of cocaine among high school students has decreased from 2003-2017, reflecting past year cocaine use trends among youth. In 2015, US prevalence rates for ever cocaine use surpassed that for LAC. In 2017, 4.8% of US high school students had ever used cocaine, compared to 4.0% in LAC (Figure 11).
In LAC, male high school students had a higher prevalence of ever using cocaine than female students from 2007 to 2017, except in 2005.
In 2017, 4.0% of male students, and 3.8% of female students had ever used cocaine (Figure 12).
Hispanic high school students historically had the highest (but decreasing) prevalence of ever using cocaine in LAC. In 2017, the prevalence of ever using cocaine among Hispanics continued to decrease, while that for white students increased and surpassed Hispanics to be the race/ethnicity with the highest prevalence (5.7%) (Figure 13).
Past Year Use
There were estimated 5.1 million Americans aged 12 or older that had misused Rx stimulants in the past year corresponding to 1.9% of the population (Figure 14). Among recurrent users of Rx stimulants aged 12 or older, 0.2% developed Rx stimulant use disorder for dependence and abuse (NSDUH, 2018).
The prevalence of Rx stimulant misuse remained constant from 2015-2018 (Figure 14).
Young adults aged 18 to 25 had highest prevalence of past year Rx stimulants misuse, followed by youth aged 12 to 17, and adults aged 26 or older. In 2018, 6.5% of young adults aged 18-25 misused Rx stimulants in the past year (Figure 15).
Centers for Disease Control and prevention (CDC). High School Youth Risk Behavior Survey (YRBS). Retrieved from https://nccd.cdc.gov/youthonline/App/Results.aspx?LID=LO. Retreived 2019.
National Drug Early Warning System (NDEWS). Los Angeles County Sentinel Community Site (SCS) Drug Use Patterns and Trends, 2015-2018
National Survey on Drug Use and Health (NSDUH). 2006-2016. Substate Region Estimates. http://www.samhsa.gov/data/all-reports?sort_bef_combine=field_date_printed_on_report%20DESC&items_per_page=15&keys=Substate Region Estimates
National Survey on Drug Use and Health (NSDUH). 2018. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Tables 1.1A, 1.1B, 4.4B.