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Substance Abuse

Substance Abuse Across the Life Stages

Substance abuse remains a serious concern for Americans of all ages.

Children and Adolescents

  • On an average day in 2006, youth used the following substances for the first time: 7,970 drank alcohol; 4,348 used an illicit drug; 4,082 smoked cigarettes; and 2,517 used pain relievers nonmedically.8
  • Daily marijuana use increased among students in 8th, 10th, and 12th grades from 2009 to 2010. Among 12th graders, marijuana use was at its highest point since the early 1980s, with 6.1 percent of all high school seniors reporting marijuana use.8
  • Prescription medications, such as painkillers, and over-the-counter cough and cold medicines are some of the most abused drugs among high school seniors.8
  • 13.8% of students in 8th grade, 28.9% of students in 10th grade, and 41.2% of students in 12th grade consumed at least 1 drink in the past 30 days. Youth who used alcohol in the past month drank an average of 4.7 drinks per day on the days they drank.


  • In 2009, people age 18 to 25 had the highest rates of current drug use of any age group, at 21.2%. This is largely driven by the widespread use of marijuana among this age group (18.1%).5
  • 41.7% of young adults age 18 to 25, 36.3% of adults age 26 to 34, and 19.2% of people age 35 or older reported binge drinking in 2009.5
  • Adults dependent on alcohol report higher rates of illicit drug use and nonmedical use of prescription drugs compared with the general population.9

Determinants of Substance Abuse

Several biological, social, environmental, psychological, and genetic factors are associated with substance abuse. These factors can include gender, race and ethnicity, age, income level, educational attainment, and sexual orientation.10 Substance abuse is also strongly influenced by interpersonal, household, and community dynamics.

Family, social networks, and peer pressure are key influencers of substance abuse among adolescents. For example, research suggests that marijuana exposure through friends and siblings was a primary determinant of adolescents’ current marijuana use.11 Understanding these factors is key to reducing the number of people who abuse drugs and alcohol and improving the health and safety of all Americans.


8Johnston, LD, O’Malley, PM, Bachman, JG, et al. Monitoring the Future: National Results on Adolescent Drug Use: Overview of Key Findings, 2009. Bethesda, MD: National Institute on Drug Abuse, National Institutes of Health; 2010. Available from [PDF - 1.3MB] 

9Hedden SL, Martins SS, Malcolm RJ, et al. Patterns of illegal drug use among an adult alcohol dependent population: results from the national survey on drug use and health. Drug Alcohol Depend. 2010;106(2-3):119–125; and comparison data for the general population aged 18 or older from the 2007 NSDUH (Full Text). Available from [PDF - 1.3MB]

10Centers for Disease Control and Prevention. CDC health disparities and inequalities report: United States, 2011. MMWR. 2011;60(suppl). Available from [PDF - 3MB]

11Galea S, Nandi A, Vlahov D. The social epidemiology of substance use. Epidemiol Rev. 2004;26(1):36–52.

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