Annual surveys on drug and alcohol consumption in the United States are the primary sources of information about the use of recreational drugs. Over the years, this research has demonstrated shifting trends and geographical differences in substance abuse. But the findings have consistently highlighted a significant co-occurrence and complex inter-relationship between substance use disorders with other psychiatric illnesses. To illustrate the drugs that are popular in the United States and show the modern trends in substance abuse, here are the most commonly used recreational drugs in America, both legal and illegal.
How Many Americans Currently Use Recreational Drugs?
Approximately 47.7 million Americans aged 12 and older currently use illicit drugs, according to national survey data from SAMHSA. This represents nearly 17% of the U.S. population in this age group.
Annual surveys consistently reveal shifting trends in substance use across different regions and demographics. The data also shows significant overlap between substance use disorders and other mental health conditions.
What Are the Most Commonly Used Legal Recreational Drugs?
Alcohol: America’s Most Used Intoxicant
An overwhelming 86% of American adults report drinking alcohol at some point in their lifetime. More concerning, 26% of adults admit to binge drinking within the past month.
Binge drinking and heavy alcohol use significantly increase addiction risk. An estimated 14.4 million Americans have alcohol use disorder, yet less than 8% received addiction treatment in the past year.
Why Alcohol Remains Socially Acceptable Despite Risks
American culture normalizes and even encourages drinking in social situations. Because alcohol is legal, people perceive it as less dangerous than illegal substances.
This social acceptance causes many people to forget alcohol is a powerful recreational drug. Alcohol abuse associates with liver disease, cardiovascular problems, neurological damage, and increased cancer risk.
Tobacco: Leading Cause of Preventable Death
Approximately 40 million American adults smoke cigarettes currently. Every day, roughly 1,600 adolescents under age 18 smoke their first cigarette.
Smoking or exposure to secondhand smoke claims half a million American lives annually. The economic burden of smoking-related diseases exceeds $170 billion each year in healthcare costs and lost productivity.
Health Consequences of Tobacco Use
Smoking damages nearly every organ system in the body. Beyond lung cancer, tobacco causes chronic obstructive pulmonary disease (COPD), emphysema, and irreversible lung damage.
Smoking significantly increases stroke risk, heart attack risk, aneurysms, and peripheral vascular disease. Coronary artery disease caused by smoking is the leading cause of death in the United States.
Which Illegal Drugs Are Most Commonly Used in America?
Marijuana: Most Prevalent Illegal Drug
Marijuana remains the most commonly used illegal recreational drug despite state-level legalization efforts. Approximately 45% of American adults report using marijuana at some point in their lifetime.
Cannabis use is particularly widespread among adolescents and young adults. More than 35% of 12th graders reported past-year marijuana use in nationwide surveys.
What Are the Health Effects of Marijuana?
An estimated 37 million Americans use marijuana, many unaware of its wide-ranging health effects. Marijuana is addictive and directly affects brain function.
Regular cannabis use can cause problems with memory, learning, attention, and brain development. These effects are especially pronounced in adolescents whose brains are still developing.
Cocaine: High Emergency Department Impact
Nearly 15% of American adults report cocaine use in their lifetime. Roughly 40% of drug-related emergency department visits involve cocaine.
Cocaine claims approximately 5,000 American lives each year. This highly addictive stimulant increases dopamine levels in the brain, creating intense euphoric effects that drive repeated use.
Dangers of Cocaine Use
Repeated cocaine use causes heart rhythm disturbances, heart attacks, seizures, strokes, and coma. Even first-time cocaine use can cause sudden death from cardiac arrest or seizures.
The drug’s unpredictable effects make every use potentially life-threatening, regardless of prior experience with the substance.
Heroin and the Opioid Crisis
Nearly 950,000 Americans report heroin use in the past year, a number rising steadily over the past 15 years. This trend is driven largely by young adults aged 18-25.
Approximately 170,000 people use heroin for the first time each year. Heroin use affects communities nationwide and is no longer confined to urban areas.
Long-Term Effects of Heroin Abuse
Besides addiction, long-term heroin abuse damages the lungs, heart, brain, and liver. Mixing heroin with other drugs creates unpredictable and dangerous effects.
Overdose deaths involving opioids increased six-fold between 1999 and 2018, claiming 47,000 American lives in 2018 alone. These deaths involve prescription opioids, synthetic opioids like fentanyl, and heroin.
Hallucinogens: LSD and MDMA Usage
Approximately 15% of Americans have used hallucinogenic drugs like LSD (acid) and MDMA (Ecstasy/Molly). These powerful mind-altering substances cause sensations and images that seem real but are not.
Hallucinogens produce potent effects by interfering with brain chemicals that regulate mood, sleep, hunger, muscle control, body temperature, sensation, and sexual behavior. Users may experience “bad trips” involving terrifying thoughts, anxiety, and loss of reality perception.
Methamphetamine: Highly Addictive Stimulant
The lifetime prevalence of methamphetamine use in the United States is just over 5%. Crystal meth is a powerful, highly addictive stimulant with severe effects on the nervous system.
Short-term health effects include increased wakefulness, decreased appetite, rapid breathing, irregular heart rate, elevated blood pressure, and increased body temperature. Long-term use causes dental problems (“meth mouth”), skin sores, cognitive impairment, and psychosis.
Methamphetamine and Infectious Disease Risk
People who use methamphetamine face increased risk of contracting HIV and hepatitis through injection drug use and risky sexual behavior. NIDA research shows meth use impairs judgment and increases engagement in unsafe practices.
What Is the Scope of Prescription Drug Misuse?
Daily Prescription Drug Misuse Statistics
Nearly 5,500 Americans misuse prescription pain relievers for the first time each day. An estimated 2 million Americans misuse prescription pain pills annually.
Additionally, 1.5 million people misuse tranquilizers and approximately 275,000 misuse sedatives for the first time each year. These numbers represent only new users, not the millions already dependent on these substances.
Which Age Group Misuses Prescription Drugs Most?
Young adults aged 18-25 are most affected by prescription drug misuse. This age group shows the highest rates of recreational use for opioid pain relievers, benzodiazepines, and stimulants.
Access to prescription drugs often occurs through family medicine cabinets, friends, or illegal online pharmacies. Many young adults mistakenly believe prescription drugs are safer than street drugs.
Opioids Drive Overdose Deaths
Opioids currently account for nearly 70% of all drug overdose deaths in the United States. This category includes prescription pain relievers like oxycodone and hydrocodone, as well as illegal opioids like heroin and fentanyl.
Recreational use of prescription drugs claims thousands of lives annually. The opioid crisis affects every demographic group and geographic region across America.
Which Age Group Has the Highest Drug Use Rate?
People aged 18-25 show the highest drug use rates across all categories. Roughly 39% of individuals in this age group used an illicit substance in the past year.
This rate exceeds all other age brackets, indicating greater vulnerability during young adulthood. This period involves major life transitions, peer pressure, and developing independence without full brain maturity.
Does the United States Lead in Overdose Deaths Globally?
Yes, the United States has the world’s highest overdose death rate among developed nations. Recent data shows America leads all other countries in fatal overdoses.
The opioid epidemic drives this crisis, with over 100,000 overdose deaths annually in recent years. Synthetic opioids like fentanyl now contaminate other drug supplies, increasing overdose risk even among people using non-opioid substances.
What Is the Economic and Social Cost of Drug Use?
Healthcare and Economic Burden
Substance abuse costs the United States hundreds of billions of dollars annually. Healthcare costs, lost productivity, criminal justice expenses, and accident-related costs all contribute to this burden.
Smoking alone accounts for $170 billion in healthcare costs yearly. Alcohol abuse adds another estimated $249 billion in economic costs when including accidents, crime, and lost work productivity.
Social and Community Impact
Drug use affects families, workplaces, and entire communities. Children of parents with substance use disorders face higher risks of abuse, neglect, and developing their own addictions.
Communities experience increased crime, strained emergency services, and reduced quality of life in areas heavily affected by drug trafficking and use.
Frequently Asked Questions About Recreational Drug Use
What percentage of Americans have tried illegal drugs in their lifetime?
Approximately 50% of Americans aged 12 and older have tried an illegal drug at some point in their lifetime, with marijuana being by far the most common. However, current use rates are much lower, with about 17% (47.7 million people) reporting illicit drug use in the past month. Legal substances like alcohol (86% lifetime use) and tobacco remain more prevalent than any illegal drug.
Why do young adults have the highest drug use rates?
Young adults aged 18-25 face unique risk factors including brain development that continues into the mid-20s, peer pressure, stress from life transitions, curiosity, and easier access to substances. This age group has a 39% past-year illicit drug use rate, higher than any other demographic. The prefrontal cortex, responsible for impulse control and decision-making, doesn’t fully mature until around age 25.
Are prescription drugs safer than street drugs for recreational use?
No, prescription drugs are not safer when used recreationally without medical supervision. Prescription opioids, benzodiazepines, and stimulants carry serious risks including addiction, overdose, and death. These medications are calibrated for specific medical conditions with careful dosing. Opioids account for nearly 70% of overdose deaths, many involving prescription drugs obtained illegally or used inappropriately.
What makes opioids so deadly compared to other drugs?
Opioids suppress respiratory function, causing breathing to slow or stop entirely during overdose. The margin between a dose that produces euphoria and a fatal dose is narrow, especially with potent synthetic opioids like fentanyl. Contamination of drug supplies with fentanyl has made all illicit drug use more dangerous, as users may unknowingly consume lethal doses mixed into other substances.
How does marijuana legalization affect usage rates?
State-level marijuana legalization has increased accessibility but research on long-term usage rate changes shows mixed results. Some studies indicate modest increases in adult use but not dramatic spikes. However, legalization has increased marijuana potency in commercial products and may reduce perceived risk, particularly among adolescents. The full public health impact of widespread legalization is still being studied.
Can someone die from their first time using a drug?
Yes, first-time drug use can be fatal with certain substances. Cocaine can cause cardiac arrest or seizures even on first use. Opioids can cause respiratory depression leading to death, especially with potent synthetic versions or when combined with alcohol. Contaminated drugs pose additional risks, as users don’t know what substances or dosages they’re actually consuming.
Treatment for Substance Use Disorders
If you or someone you care about is struggling with recreational drug use, professional treatment can help. Substance use disorders are chronic medical conditions requiring specialized care, not moral failures requiring willpower alone.
Discover Recovery offers comprehensive addiction treatment programs in Washington. Our evidence-based approaches address both the physical dependence and underlying factors contributing to substance use.
We provide customized treatment plans for alcohol addiction, prescription drug misuse, and illegal drug dependencies. Our medical team specializes in safe detoxification, behavioral therapy, and relapse prevention strategies.
Contact Discover Recovery today to discuss treatment options and verify your insurance coverage. Recovery is possible with proper support and professional care.
Reviewed By: Dr. Kevin Fischer, M.D.
Kevin Fischer, M.D. is an experienced leader in the fields of Internal Medicine and Addiction Medicine. He works with patients suffering from Substance Use Disorder to evaluate their comprehensive health needs and prescribe Medication-Assisted Treatment (MAT). In addition, he mentors aspiring health professionals and leads collaborative care through team-based medical models. He also directs treatment strategies and streamlines clinical protocols for effective substance use recovery.