1. Wilson M. Compton, M.D., M.P.E. Director, Division of Epidemiology, Services and Prevention Research National Institute on Drug Abuse 2 November 2011 Prescription Drug Abuse in the USA

3. Prevalence of Past Year Drug Use Among 12 th graders 2010 Monitoring the Future Study * Nonmedical use Categories not mutually exclusive Drug Prev. Drug Prev. Alcohol 65.2 MDMA (Ecstasy) 4.5 Marijuana/Hashish 34.8 Inhalants 3.6 Vicodin* 8.0 Cocaine (any form) 2.9 Amphetamines* 7.4 Ritalin* 2.7 Cough Medicine* 6.6 Cocaine Powder 2.6 Adderall* 6.5 LSD 2.6 Tranquilizers* 5.6 Ketamine 1.6 Salvia 5.5 Steroids* 1.5 Hallucinogens 5.5 Rohypnol 1.5 OxyContin* 5.1 Crack 1.4 Sedatives* 4.8 GHB 1.4

4. Prevalence of Past Year Drug Use Among 12 th graders 2010 Monitoring the Future Study * Nonmedical use Categories not mutually exclusive Drug Prev. Drug Prev. Alcohol 65.2 MDMA (Ecstasy) 4.5 Marijuana/Hashish 34.8 Inhalants 3.6 Vicodin* 8.0 Cocaine (any form) 2.9 Amphetamines* 7.4 Ritalin* 2.7 Cough Medicine* 6.6 Cocaine Powder 2.6 Adderall* 6.5 LSD 2.6 Tranquilizers* 5.6 Ketamine 1.6 Salvia 5.5 Steroids* 1.5 Hallucinogens 5.5 Rohypnol 1.5 OxyContin* 5.1 Crack 1.4 Sedatives* 4.8 GHB 1.4

5. Large Number of Past Year Initiates of Pharmaceuticals: Persons Aged 12 or Older, 2010 Numbers in Thousands Source: SAMHSA, 2010 National Survey on Drug Use and Health Marijuana Pain Relievers Tranquilizers Ecstasy Inhalants Cocaine Stimulants LSD Sedatives Heroin PCP

6. First Specific Drug Associated with Initiation of Illicit Drug Use among Past Year Illicit Drug Initiates Aged 12 or Older: 2010 Note: The percentages do not add to 100 percent due to rounding or because a small number of respondents initiated multiple drugs on the same day. The first specific drug refers to the one that was used on the occasion of first-time use of any illicit drug. 3.0 Million Initiates of Illicit Drugs Marijuana (61.8%) Pain Relievers (17.3%) Inhalants (9.0%) Hallucinogens (3.0%) Stimulants (2.5%) Tranquilizers (4.6%) Cocaine (0.1%) Sedatives (1.9%) Heroin (0.1%) Source: SAMHSA, 2010 National Survey on Drug Use and Health

7. Dependence on or Abuse of Specific Illicit Drugs in the Past Year among Persons Aged 12 or Older, 2010 Numbers in Thousands Source: SAMHSA, 2010 National Survey on Drug Use and Health

8. Numbers in Thousands + Difference between this estimate and the 2008 estimate is statistically significant at the .05 level. SAMHSA: 2008 National Survey on Drug Use and Health 66% Increase in Treatment Admissions Increasing for Pharmaceutical Opioids: Ages 12+ in USA

9. Increasing Treatment for Pharmaceutical Opioids

10. Source: Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2010 Opioid Analgesics increased from 144,600 to 305,900 (111%), 2004 to 2008 Benzodiazepines increased from 143,500 to 271,700 (89%), 2004 to 2008 No change in illicit drug reports (1.9 million to 1.9 million overall, non-alcohol illicit 1.0 million to 1.0 million, cocaine 475,425 to 482,188, ). Emergency Department Mentions Increasing for Pharmaceuticals, Not for Illicit Drugs in the USA

11. Source: CDC Vital Signs, November 2011 DEATHS: Marked Increase in Unintentional Drug Overdose Drug overdose death rates in the US have more than tripled since 1990. Nearly 15,000 persons died of prescription opioid overdoses in 2008.

12. Deaths from Opioids Vary by State: Unintentional Overdose Deaths in U.S. States 2008 Source: CDC Vital Signs, November 2011

13. Total Number of Prescriptions for Hydrocodone and Oxycodone Products Dispensed by US Retail Pharmacies, Years 1991−2009 Source: SDI’s Vector One® National, VONA 03-16-10 Hydrocodone & Oxycodone 1991-2009 Source: SDI’s Vector One®: National, VONA 03-16-10 Stimulants 1991-2009 Projected Number of Prescriptions for Stimulants* Dispensed by US Retail Pharmacies, Years 1991-2009 * excludes modafinil and atomoxetine products

14. Increases in deaths parallel opioid sales increases as well as prescription opioid treatment admissions Source: CDC Vital Signs, November 2011

15. People Abusing Analgesics Mostly Do Not Obtain Them by Prescription: Most Recent Source for Ages 12+ 1 Other category includes Wrote Fake Prescription," "Stole from Doctor’s Office/Clinic/Hospital/Pharmacy," and "Some Other Way." Free from Friend/ Relative (55.0%) Bought/Took from Friend/Relative (16.2%) Drug Dealer/ Stranger (4.4%) Bought on Internet (0.4%) Other 1 (4.6%) One Doctor (17.3%) More than One Doctor (2.1%) Source Where Respondent Obtained Source: SAMHSA, 2009 and 2010 National Survey on Drug Use and Health Free from Friend/Relative (6.3%) Bought/Took from Friend/Relative (6.5%) Drug Dealer/ Stranger (2.3%) One Doctor (79.4%) More than One Doctor (3.6%) Bought on Internet (0.2%) Other 1 (1.7%) Source Where Friend/Relative Obtained

16. Responses

17. Effects of Preventive Intervention on Lifetime Prescription Drug Use: Data from 2 Studies Adapted from Spoth, Trudeau, Shin, & Redmond (2008).

22. Summary Abuse of pharmaceuticals, especially opioids, is an urgent matter requiring coordinated federal, state and local responses. Yet, when used properly, opioid, sedative and stimulant pharmaceutical agents have many benefits. Balancing these competing issues is necessary.

23. Visit Our Website @ www.drugabuse.gov http://www.nida.nih.gov/nidamed/