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Drug and Substance Abuse

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Nov 10, 2022.

Drug abuse: a national epidemic

The abuse of drugs or other substances, whether they are illegal drugs or prescription opioid drug, alcohol, or tobacco is one of the nation's most pressing public health issues. According to the National Center for Drug Abuse Statistics (NCDAS), 31.9 million Americans 12 years or older are illegal drug users (used illegal drugs within the last 30 days).

Drug abuse occurs when people willingly consume illegal substances or legal, prescription drugs for the purpose of altering their mood, or getting “high”. Regular drug abuse may lead to drug addiction or other bodily harm. Drug abuse usually involves selling, buying or abusing these substances, which can lead to arrest, criminal charges, and imprisonment.

The term “drug abuse” is often associated with illegal drugs such as cocaine, heroin, or LSD. More recently, dangerous designer drugs such as bath salts (cathinones) or club drugs such as ecstasy (MDMA) have become increasingly popular. And even legal substances such as tobacco and alcohol are linked with dangerous abuse. Marijuana, while illegal according to federal law, is now legal for recreational or medical use in multiple states.

  • Designer drugs are synthetic chemicals altered in often unknown ways to produce substances that may be more potent, and frequently more dangerous. Designer drugs may resemble the effects of other illegal drugs, because the chemical formula of a designer drug is manipulated, they often cannot be classified as illegal until state or federal regulations are changed.
  • Club drugs might be used by youth in all-night “rave” or dance parties, at bars and at concerts for their psychoactive effects.
  • Alcohol and tobacco
  • Prescription opioids
  • Fentanyl, carfentanil and nitazenes (ISO) found in street drugs, often unknown to the user, and may lead to overdose and death.

The latest synthetic opioid group, called nitazenes (specifically, isotonitazene or "ISO"), has been seen in Tennessee and Washington, D.C. areas since 2019. It is reportedly as deadly as fentanyl, but not as widely known. Nitazenes are not approved prescription products and appear to be smuggled into the U.S. from China. Like fentanyl, it is being mixed into other drugs and can lead to overdose and death.

ISO is often mixed in with street heroin, or pressed into counterfeit opioid pills sold on the streets, like counterfeit Dilaudid 'M-8' tablets and oxycodone 'M30' tablets. In powder form, ISO appears yellow, brown, or off-white in color.

Abused substances are not always illegal

Drug abuse can also occur with legal prescription drugs used in illegal ways, as is seen with the ongoing opioid epidemic. The levels of prescription opioid (narcotics) abuse in the U.S. surpasses the abuse of many illegal drugs. The unlawful use of steroids as performance enhancing drugs like anabolic steroids seen in college-level, Olympic and professional sports has resulted in a unique set of international anti-doping standards.

Alcohol and cigarette tobacco (nicotine) use, although declining in teenagers, remains as some of the most abused substances in the U.S.

are the ultimate outcomes of many of the legal substances that are frequently illegally abused in the nation.

Veterinary medicines

Increasingly, veterinary medicines are being abused or included in street drugs For example, there are reports of contamination of illegal drugs with xylazine (known as "tranq"), an FDA-approved, non-opioid animal tranquilizer and pain reliever. It may be diverted from the legal animal supply or illicitly produced. The are no approved uses of xylazine for humans.

Xylazine is not an opioid, but is sometimes added to drugs of abuse, like the opioids fentanyl or heroin, and users may not be aware they are being exposed. Overdose deaths due to xylazine have increased in recent years, and naloxone may not reverse its lethal effects.

Overview of drugs of abuse

The following documents detail common drugs or other substances of abuse. Sections may include: descriptions, extent and methods of abuse, typical user experience, health and pregnancy hazards, addiction treatment options.


Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.