Top 25 Most Commonly Abused Substance

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. Substance misuse patterns and substance use disorder require a comprehensive psychiatric and physical evaluation by a qualified clinician. So, always refer to a licensed mental health specialist for diagnosis and treatment.

Substance misuse or addiction is a major public health crisis in the U.S. Nearly 1 in 6 Americans aged 12 or older had a substance use disorder in 2024. This means licit, illicit, and prescription medication misuse - which are widely misused in the U.S.

Here, we will explore the top 25 most misused substances in the country.

The National Institute on Drug Abuse (NIDA) lists the following as the top-most abused substances in the U.S.:

1. Alcohol: One of the most widely used and misused substances in the U.S. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that nearly 134.3 million aged 12 and older drink in a given month, while 27.9 million struggle with an alcohol use disorder.

2. Nicotine: Found in tobacco products like cigarettes, cigars, e-cigarettes, and vapes, the NIDA reports that 61.6 million say that they use tobacco or vaping nicotine in a given month.

3. Marijuana: Also known as cannabis, it is one of the most commonly used illicit drugs in the U.S. The Centers for Disease Control and Prevention (CDC) says that 52.5 million used marijuana at least once in a year.

4. Prescription Opioids: Often misused pain relievers, they are a leading contributor to the opioid epidemic and overdose. The NIDA reports that nearly 5 million struggle with a prescription opioid use disorder.

5. Heroin: A powerful illicit opioid with high dependence potential and overdose risk, the NIDA reports that nearly 1 million struggle with heroin misuse in a period of 12 months.

6. Fentanyl and Other Synthetic Opioids: Extremely potent opioids, they are responsible for a large share of overdose deaths nationally.

7. Cocaine: A stimulant with significant potential for misuse, including powder and crack cocaine variants, the National Center for Drug Abuse Statistics (NCDAS) reports that 1 in 5 overdose deaths were related to cocaine.

8. Methamphetamine: A highly addictive stimulant that has seen rising use nationwide. The NCDAS reports that nearly 1.2% men and 0.6% women use methamphetamines in the U.S.

9. Amphetamines (like Adderall): Prescribed for attention-deficit/hyperactivity disorder (ADHD) but often misused for stimulant effects, the NCDAS reports that amphetamines are misused in North America.

10. MDMA (Ecstasy/Molly): A very infamous club drug with stimulant and hallucinogenic properties, the National Library of Medicine (NLM) says that 2.6 million report using ecstasy in a year.

11. Benzodiazepines: Prescription sedatives like Valium or Xanax are often misused for anxiety or sleep. NCDAS reports 1.7% misuse of prescription sedatives such as these.

12. Barbiturates: An older class of sedatives with high misuse risk, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 0.2% report misusing barbiturates in a year.

13. Ketamine: Ketamine is used medically for anesthesia, but it is also misused recreationally. The NLM reports that 1.1% use ketamine in a year.

14. PCP (Phencyclidine): A hallucinogenic drug with dissociative effects, NIDA says that it is among the most commonly misused substances in the U.S.

15. GHB (Gamma-Hydroxybutyrate): A CNS depressant often misused in social settings, peer-reviewed studies in NLM have reported that its misuse is relatively rare in the U.S.

16. Flunitrazepam (Rohypnol): A benzodiazepine sedative-hypnotic, it has been gaining significant media traction in the U.S., given its misuse and connection with date rapes.

17. Dextromethorphan (DXM): Found in cough medicine, peer-reviewed studies in NLM say that it has the potential for misuse. In fact, when consumed in high doses (1500 mg per day), it can give rise to psychosis.

18. LSD (Acid): Classic hallucinogen used recreationally, the U.S. Department of Justice says that 20.2 million in the U.S. have used LSD at least once in their lifetime.

19. Psilocybin (Magic Mushrooms): Peer-reviewed studies in the NLM say that 32 million use psychedelics at least once in their lifetime, including psilocybin.

20. Mescaline: A naturally occurring hallucinogen in cactus species, the NLM says that 8 million use mescaline at least once in their lifetime.

21. Inhalants: Common household products (glue, paint thinner, nitrous oxide) are misused for quick intoxication, especially by adolescents, as they are easily and cheaply available. This is why NIDA says they are among the most commonly misused substances.

22. Anabolic Steroids: They are misused to enhance athletic performance, despite serious health risks. NIDA mentions anabolic steroids among the most commonly misused substances in the U.S.

23. Prescription Sedatives (Non-Benzodiazepine): Commonly known as “z drugs”, they are used to treat insomnia or anxiety, but can be misused as well.

24. Prescription Pain Relievers (Non-Opioid): Prescription pain relievers like analgesics can be misused. They also come with serious side effects.

25. Synthetic Cathinones: Commonly known as “bath salts”, these lab-made stimulants are often marketed as such to evade drug laws. However, NIDA says illicit synthetic cathinone use can jeopardize safety and become life-threatening.

Substance use disorder impacts millions of Americans. The Office of the Assistant Secretary for Health reports that 20 million in the U.S. have a substance use disorder, and most do not receive the care they need and deserve.

Understanding commonly used substances and misuse patterns helps policymakers, clinicians, families, and communities respond more effectively.

While this list outlines the most commonly abused substances, understanding misuse patterns is a crucial step in the journey. Yet, reaching out is equally crucial - if you or your loved one is struggling with substance misuse, please reach out to NuView Treatment Center today. We offer a full continuum of personalized outpatient care that meets you where you are in this journey.

Contact us at (323) 307-7997 to begin healing today!