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A recent study ([link removed]) in JAMA Health Forum, based on a national survey with 1,515 respondents, found that 10.96% of Americans aged 18 or older reported nonprescription opioid use and 7.52% reported use of illegally manufactured fentanyl (IMF) in the past 12 months.

The survey, led by researchers at RAND and the University of Southern California, was conducted in June 2024. Within the group that reported use of illegally manufactured fentanyl, more than 65% reported that the use was intentional––the remainder said it was unintentional. A majority of those who used illegally manufactured fentanyl answered that it was “likely” or “very likely” that they might overdose from opioid use.

The researchers explained that “our estimate of IMF use is 25 times as large as the 2022 NSDUH rate for those aged 18 years or older (7.5% vs 0.3%).” They note that the difference may be due to the specific questions that were asked and the way in which they were asked, adding that “it remains unclear why these changes would result in such markedly divergent results.” Even so, they stated that “our results are consistent with reports indicating substantial underreporting of illicit opioid use in ongoing national surveys.”

They concluded, “if we conservatively assume no fentanyl use among the 21.5% of the population that is younger than 18 years, the national illicit fentanyl use rate was 5.9% and implies an annual overdose death rate of 0.32% among the population using illicit fentanyl.”
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Foundation for Drug Policy Solutions (FDPS) ([link removed]) is an organization that envisions a world in which children and families thrive, substance use is prevented, and there is rapid access to quality treatment and meaningful pathways to recovery for individuals with substance use disorders. Our mission is to scale up drug policy solutions by educating decision-makers and the public about ways to harness science to prevent drug use, treat addiction, and forge pathways to recovery.

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