Prescription opioid misuse in young adults has fallen to a record low. The University of Michigan’s annual survey found only about 1.7% of young adults misused prescription opioids in 2021. That is down from a peak in 2006. Marijuana and hallucinogen use rose. Alcohol use stayed common.
Summary: A new annual survey report by the University of Michigan shows opioid misuse in young adults fell to a new record low in 2021. The peak was in 2006. Now just about 1.7% of young adults misuse prescription opioids. But the study found that marijuana and hallucinogen use has gone up in young adults. Alcohol use is still quite common. So the study shows a shift in how young people use drugs.
Misuse of prescription opioids has fallen to a record low in young adults in the US. In 2021, fewer young adults misused prescription opioids than in any year since 1975, a survey found. Of course, this does not mean substance use disorder has become less severe. It also does not mean opioid overdose deaths have dropped.
It is key to know that “prescription opioids” is a vague term. It mostly covers opioids like hydrocodone and oxycodone. Also, this report is about prescription opioid misuse. It is not about opioid overdose and the deaths it causes. So misuse of prescription opioids keeps dropping, while opioid overdose deaths keep rising.
So, no, opioid overdose-related deaths are not decreasing.
Update, August 2026. The sentence above was true when this was written. It is not true now. CDC provisional counts show overdose deaths peaked and then fell. That is true nationally. It is also true in both of the states this site follows most closely. New Jersey fell from a peak of 3,009 in the 12 months ending December 2021 to a provisional 1,597 in the 12 months ending December 2025. Missouri fell from 2,212 in 2022 to a provisional 1,238. Prescription opioid misuse has kept falling over the same period. Both curves are down; neither is at zero.
Opioid misuse also shows no sign of dropping. Still, there is good news: prescription opioid misuse is dropping. This matters. It shows that doctors’ opioid prescriptions are not fueling opioid addiction, as many have claimed. These findings on the significant drop in misuse by young adults come from the Institute for Social Research, The University of Michigan. They were published in the Monitoring the Future Panel Study annual report: National data on substance use among adults ages 19 to 60, 1976-2021.
The new study says only about 1.7% of young adults now misuse prescription opioids. The survey calls them “narcotics other than heroin.” That is a huge drop from a peak of about 9% in 2006. It also means most adults who are prescribed opioids use them responsibly. The MTF survey and CDC data confirm that prescription opioid misuse has been dropping. But the opioid overdose epidemic goes on. It is driven mainly by illegal fentanyl and other street opioids.
One reason misuse dropped is that doctors now prescribe far fewer opioids. Market data shows opioid prescriptions have fallen by half since their peak in the early 2000s. But the picture is not as rosy as it sounds. Prescription opioid misuse keeps dropping. But the use of illegal opioids is not. Worse, misuse of many other drugs is rising. More young adults now misuse marijuana and hallucinogens than in the year 2000.
The MTF survey found other reasons for concern too. Alcohol misuse shows no sign of a significant drop. Vaping is gaining ground. People may not smoke cigarettes, but they now vape nicotine more often. These findings show the drug landscape is shifting fast. Doctors now need to focus on the harms of marijuana and hallucinogen misuse. They also need to focus more on other drugs, like stimulants, that still cause many deaths.
Alcohol use disorder is still a major problem. Heavy drinking seemed to be dropping in the last few years. But things changed in 2021. The Covid-19 pandemic seems to have caused a significant rise in drinking.
Frequently asked questions
What counts as a prescription opioid?
Prescription opioids are pain medicines such as hydrocodone and oxycodone. The University of Michigan survey groups them as narcotics other than heroin. The survey tracked this misuse, not overdose deaths. That is why the two numbers can move in different directions.
Why has prescription opioid misuse gone down?
A major reason is that doctors now write far fewer opioid prescriptions. Market data shows prescriptions have fallen by half since their peak in the early 2000s. Misuse among young adults dropped from about 9% in 2006 to about 1.7% in 2021. This also shows most people prescribed opioids use them responsibly.
Are opioid overdose deaths going down?
Yes, as of the August 2026 update. CDC provisional counts show overdose deaths peaked and are now falling. In Missouri they went from 2,212 in 2022 to a provisional 1,238. In New Jersey they went from 3,009 to a provisional 1,597. Deaths are down, but not at zero. Illegal fentanyl still drives most of them.
Which drugs are young adults using more?
The same survey found more young adults using marijuana and hallucinogens than in 2000. Vaping nicotine is gaining ground even as cigarette smoking falls. Alcohol use stays common. Drinking rose in 2021 during the Covid-19 pandemic. Stimulants also still cause many deaths. The drug landscape is shifting fast.
Related reading
Opioid Prescriptions and the Opioid Epidemic: New Studies · Marijuana and Tobacco Worsen Pain · Opioid Prescribing Limits and Overdose Deaths