Prescription Drug Misuse and Abuse

SAMHSA addresses prescription drug misuse and abuse using a public health approach that includes early intervention, prevention, treatment, and recovery support services.


Prescription drug misuse and abuse is the intentional or unintentional use of medication without a prescription, in a way other than prescribed, or for the experience or feeling it causes. Results from the 2014 National Survey on Drug Use and Health (NSDUH) (PDF | 3.4 MB) indicate that about 15 million people aged 12 or older used prescription drugs non-medically in the past year, and 6.5 million did so in the past month. This issue is a growing national problem in the United States. Prescription drugs are misused and abused more often than any other drug, except marijuana and alcohol. This growth is fueled by misperceptions about prescription drug safety, and increasing availability. A 2011 analysis by the Centers for Disease Control and Prevention found that opioid analgesic (pain reliever) sales increased nearly four-fold between 1999 and 2010; this was paralleled by an almost four-fold increase in opioid (narcotic pain medication) overdose deaths and substance abuse treatment admissions almost six times the rate during the same time period.

Prescription drug abuse-related emergency department visits and treatment admissions have risen significantly in recent years. Other negative outcomes that may result from prescription drug misuse and abuse include overdose and death, falls and fractures in older adults, and, for some, initiating injection drug use with resulting risk for infections such as hepatitis C and HIV. According to results from the 2014 NSDUH report, 12.7% of new illicit drug users began with prescription pain relievers.

A 2008 report by the Coalition Against Insurance Fraud (PDF | 2.3 MB)(link is external) estimates that the abuse of opioid analgesics results in more than $72 billion in medical costs alone each year. This is comparable to costs related to other chronic diseases such as asthma(link is external) and HIV.

The problem of prescription drug abuse and overdose is complex, involving insufficient oversight to curb inappropriate prescribing, insurance and pharmacy benefit policies, and a belief by many people that prescription drugs are not dangerous. The 2014 National Drug Control Strategy (PDF | 1.5 MB) serves as the blueprint for reducing drug use and its consequences in the United States. The new strategy reviews the progress made over the past four years and looks ahead to continuing efforts to reform, rebalance, and renew the national drug control policy to address the public health and safety challenges of the 21st century.

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Last Updated: 10/30/2017

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