Skip Navigation
Click to open navigation

Spotlight 1: Use, Availability, and Perceived Harmfulness of Opioids Among Youth
(Last Updated: April 2019)

The percentage of 8th-graders who reported using heroin during the past 12 months decreased from 1.4 percent in 1995 to 0.3 percent in 2017. This percentage also decreased from 1.1 to 0.2 percent for 10th-graders and from 1.1 to 0.4 percent for 12th-graders during the same period.

The current opioid epidemic is an increasingly recognized national crisis that affects public health as well as social and economic welfare. In 2016, over 130 people were estimated to die from opioid-related drug overdose every day, and over 2 million suffered from at least one opioid use disorder, such as dependence on pain relievers, during the year (U.S. Department of Health and Human Services 2018). The crisis resulted in a total economic loss of $504 billion in 2015, through the economic cost of fatalities resulting from overdoses and the nonfatal costs of opioid misuse, including healthcare spending, criminal justice costs, and lost productivity (The Council of Economic Advisers 2017).

Young adolescents are particularly susceptible to harm from the misuse of opioids. Not only do opioid use disorders impact all aspects of adolescents’ lives, including family, school, and their transition into adulthood (Martins et al. 2017), but also youth residing in homes with opioid-dependent parents are at higher risk of exhibiting emotional problems, engaging in risky sexual practices, exhibiting impaired social functioning, and becoming involved in substance misuse (Morton and Wells 2018). Ease of access to and favorable attitudes toward illicit drugs are among the risk factors associated with youth opioid use (Nargiso, Ballard, and Skeer 2015; Sung et al. 2005).

Using data from the Monitoring the Future (MTF) survey,2 this spotlight examines the national trends in opioid use among 8th-, 10th-, and 12th-graders from 1995 to 2017, as well as by student and family characteristics in 2017. In addition, it looks at trends in students’ reported ease of access to opioids and their perceived harmfulness of opioid use over time. Two main categories of opioids (heroin and narcotics other than heroin) and three time intervals during which drug use occurred (ever used, used during the past 12 months, and used during the past 30 days) are discussed in this spotlight.3 Only drug use not under a doctor’s orders is included in the use of narcotics other than heroin and the use of OxyContin and Vicodin, two commonly prescribed narcotics.

In 2017, about 0.7 percent of 8th-graders reported ever using heroin, 0.3 percent reported using heroin during the past 12 months, and 0.2 percent reported using heroin during the past 30 days (table S1.1). Among 10th-graders, 0.4 percent reported ever using heroin, 0.2 percent reported using heroin during the past 12 months, and 0.1 percent reported using heroin during the past 30 days. While these overall rates were low, they nevertheless represented, for the year 2017, approximately 28,900 8th-graders and 16,600 10th-graders who had ever used heroin, 12,400 8th-graders and 8,300 10th-graders who had used heroin during the past 12 months, and 8,300 8th-graders and 4,200 10th-graders who had used heroin during the past 30 days.4

Also in 2017, about 0.7 percent of 12th-graders reported ever using heroin, 0.4 percent reported using heroin during the past 12 months, and 0.3 percent reported using heroin during the past 30 days. These rates translated to approximately 27,800 12th-graders in 2017 who had ever used heroin, 15,900 who had used heroin during the past 12 months, and 11,900 who had used heroin during the past 30 days. Data on the use of narcotics other than heroin not under a doctor’s orders were also available for 12th-graders. Compared to 12-graders’ use of heroin, 12th-graders’ use of narcotics other than heroin was more common: 6.8 percent of 12th-graders reported ever using narcotics other than heroin, 4.2 percent reported using narcotics other than heroin during the past 12 months, and 1.6 percent reported using narcotics other than heroin during the past 30 days. These rates translated to approximately 269,600 12th-graders in 2017 who had ever used narcotics other than heroin, 166,500 who had used narcotics other than heroin during the past 12 months, and 63,400 who had used narcotics other than heroin during the past 30 days.


Figure S1.1. Percentages of 8th- and 10th-graders reporting heroin use, by grade and recency of use: Selected years, 1995 through 2017

Figure S1.1. Percentages of 8th- and 10th-graders reporting heroin use, by grade and recency of use: Selected years, 1995 through 2017

SOURCE: University of Michigan, Institute for Social Research, Monitoring the Future, selected years, 1995 through 2017.


Between 1995 and 2017, heroin use among 8th-, 10th-, and 12th-graders decreased across all use intervals. For instance, the percentage of 8th-graders who reported using heroin during the past 12 months decreased from 1.4 percent in 1995 to 0.3 percent in 2017 (figure S1.1 and table S1.1). This percentage also decreased from 1.1 to 0.2 percent for 10th-graders and from 1.1 to 0.4 percent for 12th-graders during the same period (figure S1.2 and table S1.1). Although the percentages of 12th-graders in 2017 who reported ever using narcotics other than heroin, using narcotics other than heroin during the past 12 months, and using narcotics other than heroin during the past 30 days were not measurably different from the corresponding percentages in 1995, they all represented decreases from their corresponding percentages in 2005. The use of OxyContin and Vicodin during the past 12 months also generally decreased for 8th-, 10th-, and 12th-graders between 2005 (the first year of data collection for these survey items) and 2017.


Figure S1.2. Percentages of 12th-graders reporting heroin use and use of narcotics other than heroin, by recency of use: Selected years, 1995 through 2017

Figure S1.2. Percentages of 12th-graders reporting heroin use and use of narcotics other than heroin, by recency of use: Selected years, 1995 through 2017

NOTE: Use of narcotics other than heroin only includes drug use not under a doctor’s orders.
SOURCE: University of Michigan, Institute for Social Research, Monitoring the Future, selected years, 1995 through 2017.


In 2017, differences in opioid use were found by student characteristics such as whether the student had a 4-year college plan and the education of the student’s parents. Among 8th-, 10th-, and 12th-graders, those who had no plans to complete 4 years of college consistently reported higher rates of heroin use, use of OxyContin and Vicodin, and use of all narcotics other than heroin5 during the past 12 months than students who had plans to complete 4 years of college. For instance, 1.7 percent of 8th-graders with no 4-year college plans reported using heroin during the past 12 months, compared with 0.2 percent of 8th-graders with college plans (figure S1.3 and table S1.2). The rates of heroin use for students without college plans versus students with college plans were 0.7 percent versus 0.1 percent among 10th-graders and 0.7 percent versus 0.2 percent among 12th-graders.


Figure S1.3. Percentages of 8th-, 10th-, and 12th-graders reporting heroin use and use of narcotics other than heroin during the past 12 months, by grade and college plans: 2017

Figure S1.3. Percentages of 8th-, 10th-, and 12th-graders reporting heroin use and use of narcotics other than heroin during the past 12 months, by grade and college plans: 2017

! Interpret data with caution. The coefficient of variation (CV) for this estimate is between 30 and 50 percent.
1 Only includes drug use not under a doctor’s orders.
2 Only includes drug use not under a doctor’s orders. In addition to OxyContin and Vicodin, includes other types of narcotics not shown separately.
3 Students who reported they probably won’t or definitely won’t graduate from a 4-year college program.
4 Students who reported they probably will or definitely will graduate from a 4-year college program.
NOTE: Data on narcotics other than heroin were not available for 8th- and 10th-graders.
SOURCE: University of Michigan, Institute for Social Research, Monitoring the Future, 2017.


Across all grades and types of opioids used, opioid use was generally more prevalent among students whose parents had the lowest educational attainment than among students whose parents had the highest educational attainment.6 However, the percentage of 12th-graders who reported using narcotics other than heroin during the past 12 months was higher among students whose parents had the highest educational attainment than among students whose parents had the lowest educational attainment (4.6 vs. 3.3 percent).

With respect to differences in the prevalence of opioid use by students’ sex and race/ethnicity, different patterns emerged depending upon the type of opioid used. In 2017, a higher percentage of female than of male 8th-graders reported using heroin during the past 12 months (0.4 vs. 0.2 percent). In contrast, higher percentages of male than of female 8th-graders reported using OxyContin (1.0 vs. 0.6 percent) and Vicodin not under a doctor’s orders (0.9 vs. 0.4 percent) during the past 12 months. Among 10th-graders, a higher percentage of Black students than of White students reported using heroin during the past 12 months (0.4 vs. 0.2 percent), while higher percentages of White students than of Black students reported using OxyContin (2.3 vs. 1.6 percent) and Vicodin (1.8 vs. 1.2 percent) during the past 12 months. Similarly, the percentage of 12th-graders reporting heroin use during the past 12 months was higher for Black (0.5 percent) and Hispanic (0.4 percent) students than for White students (0.2 percent), while the percentage reporting using narcotics other than heroin during the past 12 months was higher for White students (5.0 percent) than for Black (3.2 percent) and Hispanic (3.8 percent) students.

Ease of access to opioids is one of the risk factors associated with youth opioid use. To assess the availability of opioids, the MTF survey asked students how difficult it would be for them to get heroin or narcotics other than heroin if they had wanted some. The percentage of students who reported that heroin would be fairly easy or very easy to get decreased between 1995 and 2017 among 8th-graders (from 21.1 to 8.1 percent), 10th-graders (from 24.6 to 10.6 percent), and 12th-graders (from 35.1 to 19.1 percent; figure S1.4 and table S1.1). The percentage of students who reported that narcotics other than heroin would be fairly easy or very easy to get also decreased during this period among 8th-graders (from 20.3 to 8.9 percent) and 10th-graders (from 27.8 to 17.7 percent). While the percentage of 12th-graders who reported that narcotics other than heroin would be fairly easy or very easy to get did not measurably differ between 1995 and 2017, it did decrease from a peak of 54.2 percent in 2010 to 35.8 percent in 2017.


Figure S1.4. Percentages of 8th-, 10th-, and 12th-graders reporting that heroin and narcotics other than heroin would be fairly easy or very easy to get, by grade: Selected years, 1995 through 2017

Figure S1.4. Percentages of 8th-, 10th-, and 12th-graders reporting that heroin and narcotics other than heroin would be fairly easy or very easy to get, by grade: Selected years, 1995 through 2017

SOURCE: University of Michigan, Institute for Social Research, Monitoring the Future, selected years, 1995 through 2017.


In 2017, as well as in 1995, the percentages of 10th- and 12th-graders who reported that they could get narcotics other than heroin fairly easily or very easily were higher than the percentages who reported that they could get heroin fairly easily or very easily. However, the differences between these percentages were greater in 2017, indicating that it might be relatively easier to get narcotics other than heroin as compared to getting heroin in 2017 than in 1995. Specifically, in 1995, the difference between the percentages of students who reported they could fairly easily or very easily get narcotics other than heroin and students who reported they could fairly easily or very easily get heroin was 3.2 percentage points for 10th-graders and 4.7 percentage points for 12th-graders. In 2017, in comparison, the difference between the percentages of students who reported they could fairly easily or very easily get narcotics other than heroin and students who reported they could fairly easily or very easily get heroin was 7.1 percentage points for 10th-graders and 16.7 percentage points for 12th-graders. These larger differences in 2017 were mostly driven by the decrease between 1995 and 2017 in the percentage of students who reported they could get heroin fairly easily or very easily.

Attitudes toward opioid use are also correlated with actual use (Sung et al. 2005). The MTF survey asked students how much they thought people risked harming themselves (physically or in other ways) if they were to engage in a given activity related to opioid use. Between 1995 and 2017, the percentage of students who thought people risked harming themselves greatly by taking heroin occasionally without using a needle decreased for both 8th-graders (from 76.8 to 74.7 percent) and 10th-graders (from 85.1 to 81.4 percent; figure S1.5 and table S1.3). Additionally, the percentages of 10th-graders who thought that people risked harming themselves greatly by trying OxyContin once or twice, by taking OxyContin occasionally, and by taking Vicodin occasionally all decreased between 2012 (the first year of data collection for these survey items) and 2017. Among 12th-graders, the percentages who thought people risked harming themselves greatly by trying heroin once or twice and by trying heroin once or twice without using a needle both increased between 1995 and 2017 (from 51 to 63 percent and from 56 to 65 percent, respectively), while the percentage who thought people risked harming themselves greatly by regularly taking any narcotic other than heroin decreased between 2010 (the first year of data collection for this survey item) and 2017 (from 75 to 71 percent).


Figure S1.5. Percentages of 8th-, 10th-, and 12th-graders who reported thinking that people risked harming themselves greatly by trying heroin once or twice without using a needle and by taking heroin occasionally without using a needle, by grade: Selected years, 1995 through 2017

Figure S1.5. Percentages of 8th-, 10th-, and 12th-graders who reported thinking that people risked harming themselves greatly by trying heroin once or twice without using a needle and by taking heroin occasionally without using a needle, by grade: Selected years, 1995 through 2017

SOURCE: University of Michigan, Institute for Social Research, Monitoring the Future, selected years, 1995 through 2017.


In 2017, higher percentages of 10th-graders than of 8th- or 12th-graders reported thinking that people risked harming themselves greatly by trying heroin once or twice without using a needle (72 vs. 63 and 65 percent, respectively) and by taking heroin occasionally without using a needle (81 vs. 75 and 73 percent, respectively). Higher percentages of 10th-graders than of 8th-graders also reported thinking that people risked harming themselves greatly by trying OxyContin once or twice (28 vs. 21 percent), trying Vicodin once or twice (22 vs. 17 percent), taking OxyContin occasionally (41 vs. 33 percent), and taking Vicodin occasionally (32 vs. 27 percent).


This spotlight indicator features data on a selected issue of current policy interest. For more information: Tables S1.1, S1.2, and S1.3, and http://monitoringthefuture.org/.


2 The Monitoring the Future (MTF) survey is a nationally representative sample of 8th-, 10th-, and 12th-graders designed to provide estimates of the beliefs, attitudes, and behavior regarding drug use for students at each grade level. By providing students in the same grade level with the same set of questions over a period of years, the survey is particularly suited for the purpose of studying changes in student responses over time.
3 Questions administered to 8th- and 10th-graders sometimes differed slightly from those administered to 12th-graders, and the points in time at which some questions were introduced also sometimes differed. Readers should take note of the grade(s) and year span(s) specified at each stage of the discussion.
4 These counts, as well as counts for 12th-graders in the following paragraph, are all based on projected fall 2017 public school enrollment (see table 203.10 in Snyder, de Brey, and Dillow 2019) and actual fall 2015 private school enrollment (see table 205.15 in Snyder, de Brey, and Dillow 2019). Fall 2015 private school enrollment is used as proxy for fall 2017 enrollment because projected private school enrollment is not available by grade.
5 Data for use of all narcotics other than heroin are only available for 12th-graders.
6 In this indicator, a student’s parents have the lowest educational attainment if (1) both parents (or the single parent) have not completed any high school; (2) both parents (or the single parent) have completed some high school only; or (3) one parent has not completed any high school and one parent has completed some high school only. Parents have the highest educational attainment if (1) both parents (or the single parent) have completed graduate or professional school after college or (2) one parent has completed graduate or professional school after college and one parent has completed college only.