New Survey Reveals Increased Illicit Opioid Use Among Americans

A recent survey conducted by researchers from RAND Corporation and the University of Southern California has uncovered troubling data regarding the prevalence of illicit opioid use in the United States. The study indicates that 11% of American adults reported using illicit opioids, such as fentanyl, in the past year. This figure significantly exceeds the rates identified in previous federal studies, which estimated such usage at less than 0.5%.

The survey highlights a critical need for improved methodologies in tracking the opioid crisis, as current federal estimates may substantially underestimate actual usage. According to the findings published in the journal JAMA Health Forum, 7.5% of respondents specifically reported using illicitly manufactured fentanyl, a potent synthetic opioid linked to the majority of overdose deaths in the country.

David Powell, the lead author of the study and a senior economist at RAND, emphasized the limitations of existing federal surveys, which often take years to yield results. By employing a more immediate approach, the researchers were able to gather data in a fraction of the time, thus providing a clearer picture of current trends in illicit opioid usage.

The opioid epidemic in the U.S. has evolved from its initial surge due to prescription painkillers to a broader crisis involving heroin and, more recently, synthetic opioids like fentanyl. While the transition has been alarming, the federal government's method of tracking this issue has not kept pace with the crisis's changing landscape.

The National Survey on Drug Use and Health, the largest ongoing assessment of drug use in the U.S., only began gathering data on fentanyl usage in 2022, reporting a mere 0.3% prevalence rate that year. However, the new study suggests that the actual figure is exponentially higher, prompting researchers to question the effectiveness of the current survey methodologies. Many previous studies have reported elevated rates of illicit opioid use, indicating a persistent gap between perceived and actual drug use.

The RAND study surveyed 1,515 American adults in June 2024, asking questions about their use of nonprescription opioids, including heroin and illicitly manufactured fentanyl. Notably, the study also asked participants whether their use was intentional or unintentional. Results revealed that 7.7% of respondents intentionally used nonprescription opioids, while another 3.2% reported unintentional use. Among those who used nonprescription opioids, a significant portion (4.9%) indicated they intentionally used fentanyl, with an additional 2.6% reporting unintentional use.

In terms of initial exposure to opioids, 39% of respondents indicated their first use involved a prescription medication, while 36% reported their first encounter involved non-prescribed prescription opioids. Only 25% stated that their first experience was with illicitly manufactured opioids.

Mireille Jacobson, a co-author of the study, pointed out the critical need for timely data to effectively address the ongoing opioid crisis. The survey's findings should serve as a valuable data point for policymakers and public health officials aiming to mitigate the epidemic.

Despite its comprehensive approach, the study acknowledges a limitation regarding its reliance on an online platform for data collection. While demographic characteristics of the surveyed population align with national averages, there may be unobserved differences that could affect the results. The researchers plan to further investigate their findings using a more robust survey method in the future.