"The age-adjusted rate of drug overdose deaths in the United States decreased 4.0% from 2022 (32.6 deaths per 100,000 standard population) to 2023 (31.3) (Table).

"Harms related to methamphetamine use are a growing public health problem. In 2021, 1.6 million Americans met the criteria for stimulant use disorder (methamphetamine type), hereafter called methamphetamine use disorder (MUD; 1). Recent research indicates methamphetamine overdose mortality and patterns of risky use have increased in recent years, particularly for those with socioeconomic risk factors and comorbidities [1].

"In 2023, 12% of high school students had ever misused prescription opioids, defined as taking prescription pain medicine, such as codeine, Vicodin, OxyContin, Hydrocodone, or Percocet, without a doctor’s prescription or differently than how a doctor told them to use it. Female students were more likely than male students to have ever misused prescription opioids. White students were less likely than Black, Hispanic, and Multiracial students to have ever misused prescription opioids.

"In 2023, 10% of high school students had ever used certain illicit drugs (defined as cocaine, inhalants, heroin, methamphetamines, hallucinogens, or ecstasy). Black students were less likely than American Indian or Alaska Native, White, and Multiracial students to have ever used select illicit drugs. LGBTQ+ students were more likely than cisgender and heterosexual students to have ever used select illicit drugs."

"In 2023, 17% of high school students used marijuana during the past 30 days. Female students were more likely than male students to currently use marijuana. Asian students were less likely than students from most other racial and ethnic groups to currently use marijuana. LGBTQ+ students were more likely than cisgender and heterosexual students to currently use marijuana."

"In 2023, 22% of high school students drank alcohol during the past 30 days. Female students were more likely than male students to currently drink alcohol. Asian and Black students were less likely than Hispanic, White, and Multiracial students to currently drink alcohol. LGBTQ+ students were more likely than cisgender and heterosexual students to currently drink alcohol."

"Research has shown a shifting trend from injecting toward smoking opioids since 2020, especially along the West Coast (Kral et al., 2021, Parent et al., 2021, Kingston et al., 2022, Megerian et al., 2024,

"Using data from the 2023 NSSSP, the largest sample of U.S. SSPs collected to date, we found 44 % of SSPs reported distributing pipes for smoking. SSPs that offered pipes to their participants had a 62 % higher rate of participant encounters compared to SSPs that did not offer pipes.

"First, if the goal of the policy shift is to reduce preventable deaths and other harms, it may be key to clearly distinguish which organizations, private and public, benefit from the criminalization of drug use before integrating their inclusion into guiding the model (Michaud et al., 2024a).

"Despite clear evidence demonstrating the effect of alcohol consumption on cancer risk, there is a large gap in public understanding of the risk.