"Abstention from drug use is defined here as no past 30-day use of alcohol, marijuana, or nicotine by vaping or by cigarettes. Abstention levels in 2024 were at the highest recorded by the survey since it first started tracking this outcome in 2017. The percentage of students who abstained from drug use in 2024 was 67% in 12th grade (compared to 53% in 2017), 80% in 10th grade (compared to 69% in 2017), and 90% in 8th grade (compared to 87% in 2017). The increases from 2023 to 2024 were statistically significant in 12th and 10th grade.

"Alcohol use, marijuana use, and nicotine vaping all decreased in 2024 in 12th grade, in 10th grade, and in 8th grade.

"In 2023, 24.3% of adults experienced chronic pain, and 8.5% of adults experienced high-impact chronic pain (or 34.9% of adults who had chronic pain). Women were more likely than men to experience chronic pain. Chronic pain was also generally higher in American Indian and Alaska Native adults and those age 65 and older. Similarly, high-impact chronic pain was higher in women, American Indian and Alaska Native adults, and those age 65 and older. Percentages of adults who had chronic pain and high-impact chronic pain in the past 3 months increased with decreasing urbanization level.

• "In 2023, 24.3% of adults had chronic pain, and 8.5% of adults had high-impact chronic pain (Figure 1, Table 1).
• "Women were more likely to have chronic pain (25.4%) and high-impact chronic pain (9.6%) than men (23.2% and 7.3%, respectively)."

"Steroids

"In 2023 lifetime prevalence of anabolic steroid use was 1% in all grades. In general, lifetime, past 12-month, and past 30-day use have decreased, sometimes unevenly, since highs in the early 2000s.

"Prevalence of past-12 month ketamine use among 12th grade students has been below 2% for the past decade and in 2023 stood at 1%. This 'club drug' was added to the survey in 2000. It showed little change in its usage levels through 2002. Since then use has declined in all grades. Because of the very low levels of use of this drug by 2011, questions about its use were dropped from the questionnaires administered to 8th and 10th graders."

"SCRA vaping products were almost exclusively on sale as liquid formulations for refilling EVDs. It therefore does not appear that the rise in popularity of disposable nicotine e-cigarettes [17] has so far impacted on the online SCRA vaping product market. The most common bottle size on sale was 5mL. Given the lack of data on the concentration of SCRA in these liquids, it is difficult to quantify how many SCRA doses this may constitute.

"This study provides evidence of a rapidly evolving and active online marketplace from which SCRA vaping products seem to be easily obtainable, but also difficult to identify as controlled substances. Using simple search terms on a widely used search engine, we identified 62 websites selling SCRA vaping products, with 1225 individual listings and 128 unique brands.

"Since the early 1990s, binge drinking (defined as drinking at least 4 drinks in a row for women or at least 5 drinks in a row for men) has been a key indicator of risky drinking. 

"However, the binge threshold may not clearly distinguish drinking risk. A person who consumes five drinks over a few hours may or may not show signs of intoxication, depending on factors including body composition, food and water intake, and tolerance. In contrast, a person who consumes ten drinks over the same time period is at high risk for alcohol poisoning and other negative outcomes. 

"The tusi phenomenon complicates the drug landscape because it has the potential to confuse both people who use and researchers alike. With respect to people who use, given the drug concoction’s name, people may assume the drug is 2C/2C-B. Since many partiers are unfamiliar with 2C series drugs (14), there is also potential for people to simply think this is a new (and perhaps benign) drug – especially given that the powder is pink with a sweet scent.