Prevalence
Opioids are a class of drugs that derive from or mimic the natural substances found in the opium poppy plant, and include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription such as oxycodone (OxyContin), hydrocodone (Vicodin), codeine, morphine, and many others.
Opioids are often used as a form of medication to relax and relieve the body of moderate to severe pain. Due to its relaxing and euphoric effects, many may misuse opioids for non-medical reasons. This can be dangerous because opioids can be highly addictive, and overdoses and death are common.
Opioids Prevalence
In 2024, 21.9% of people aged 12+ in the US had used any opioids (i.e., used heroin or used any prescription pain relievers) in the past year in the United States (US), down from 26.3% in 2023. Adults aged 26+ (24.4%) had the highest prevalence of any opioid use in the past year, followed by young adults aged 18-25 years (13.6%), and youth aged 12-17 years (11.6%) (Figure 1).
In 2024, 2.7% of people aged 12+ had misused opioids (i.e., used heroin, or used prescription pain relievers in any way not directed by a doctor, including use without their own prescription; use in greater amounts, more often, or longer than prescribed; or use in any other way not directed by a doctor) in the past year. Past year opioid misuse fell from 8.7% to 2.6% among young adults aged 18-25, and declined more gradually from 4.2% to 2.8% among adults aged 26+ over the past decade from 2015 to 2024 (Figure 2).
In 2023-2024, 2.5% of people aged 12+ had misused opioids in the past year in California. The prevalence of opioids misuse was highest among young adults aged 18-25 years in 2021-2022 and had decreased to below that of adults aged 26+ years from 2022-2023 (Figure 3).
In Los Angeles County (LAC), 3.2% of individuals aged 12 or older had misused opioids in the past year in 2021-2023. The prevalence of opioids misuse was highest among adults aged 26+ (3.4%) (Figure 4).
Prescription Pain Reliever Misuse
In 2024 in the US, 8.0 million individuals aged 12+ (2.8%) misused prescription pain relievers (i.e., used prescription pain relievers in any way not directed by a doctor, including use without their own prescription; use in greater amounts, more often, or longer than prescribed; or use in any other way not directed by a doctor) in the past year. This represented 11.4% of individuals aged 12+ who used any prescription pain relievers in the past year (NSDUH 2023).
About 1.5 million individuals aged 12+ misused prescription pain relievers for the first time in their life in 2024.
(Notes: Prescription pain relievers include products containing hydrocodone, oxycodone, tramadol, codeine, morphine, prescription fentanyl, buprenorphine, oxymorphone, hydromorphone, Demerol, methadone, or other prescription medication for pain relief. Prescription pain relievers could include some non-opioids because survey respondents could occasionally specify the misuse of other prescription pain relievers that are not opioids.)
In the US, past year misuse of prescription pain relievers was highest among young adults aged 18-25 years, though the prevalence has been steadily decreasing since 2015 while remaining relatively stable for adults aged 26+ years. In 2024, past year misuse of prescription pain relievers among young adults 18-25 years (2.7%) had decreased to below that of adults 26+ years (2.9%) for a second year (Figure 5).
Among past year users of any prescription pain relievers, misuse was most common among users aged 18-25 years, though their prevalence had been steadily decreasing from 24.5% in 2015 to 12.9% in 2023 before jumping in 2024 to 18% while other age groups remained relatively stable over the past decade (Figure 6).
Past year misuse of prescription pain relievers has been consistently decreasing over the past decade across age groups, particularly young adults aged 18-25, which had dipped below that of adults aged 26+ since 2022-2023 (Figure 7).
In Los Angeles County (LAC), 3.0% of people aged 12 or older had misused prescription pain relievers in the past year in 2021-2023. The prevalence of prescription pain reliever misuse among young adults aged 18-25 dropped from 5.8% in 2016-2018 to 2.6% in 2021-2023, which was below that of adults aged 26+ (3.2%) (Figure 8).
In LAC, the SPA 6 (South, 3.3%) had the highest prevalence rates of prescription pain reliever misuse among people aged 12+, while SPA 3 (San Gabriel, 2.7%) had the lowest rates (Figure 9).
Figure 9. Prevalence of opioid misuse in the past year (age 12+), LAC, 2021-2023
Source: NSDUH
Gone to Work/School Under the Influence of Prescription Medications
In 2017, among those who have ever misused prescription medications in LAC, over one-third (36.1%) had misused prescription medications (including pain relievers, sedatives/benzodiazepines and/or stimulants) before or during work/school (Figure 10). (Note: Adults were asked if they had gone to work, and youth were asked if they had gone to school under the influence of prescription medication.)
In 2017, among those who have ever misused prescription medications, 39.7% of males and 31.1% of females misused prescriptions medications before or during work/school (Figure 11).
In 2017, among those who have ever misused prescription medications, the prevalence of ever going to work/school under the influence was highest for youth aged 12-17 years (55.3%) compared to other age groups (Figure 12).
In 2017, among those who ever misused prescription medications, Whites (42.4%) were most likely to have gone work/school under the influence, followed by multi-race/ethnicity (39.2%), Blacks (39.0%), and Hispanic/Latinos (36.5%) (Figure 13).
Heroin Use
In 2024, an estimated 556,000 people aged 12+ (0.2%) in the US had used heroin in the past year. Of those, 30,000 began using heroin for the first time in the past year in 2024 (NSDUH 2024).
In the US, past year heroin use has been declining among young adults aged 18-25 years since 2016, dropping from 0.7% to 0.1% in 2024. Past year heroin use has been fluctuating around 0.3% among adults aged 26+ (Figure 14).
In California in 2023-2024, 0.22% of adults aged 26+, and 0.07% of young adults aged 18-25 had used heroin in the past year (Figure 15).
In 2021-2023, past year use of heroin in LAC was highest among those aged 26+ (0.34%), followed by those aged 18-25 years (0.08%) (Figure 16).
In LAC, heroin use among individuals age 18+ years was highest in the SPA 4 – Metro region (0.34%), while the lowest prevalence was 0.28% in SPA 2 – San Fernando Valley (Figure 17).
Figure 17. Prevalence of heroin use in the past year (age 18+), LAC, 2021-2023.
Source: NSDUH
References
Figures 10-13. Prescription Medication Misuse and Public Perceptions in Los Angeles County: Findings from the 2017 Community Needs Assessment (CNA). Health Outcomes and Data Analytics, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, March 2019.
Figure 1-4, 5-6, 14. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH). National Reports and Tables. NSDUH Detailed Tables. 2016-2020, 2022-2024.
Figure 3, 7, 15. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH). State Reports and Tables. NSDUH All State Specific Tables. 2015-2023.
Figures 4, 8-9, 16-17. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health (NSDUH). NSDUH Substate Region Estimates by Age Group. 2021-2023.