Since 1975, the annual Monitoring the Future survey has been conducted with researchers at the University of Michigan, Ann Arbor, and funded by the National Institute on Drug Abuse (NIDA), a branch of the National Institutes of Health. For 50 years and counting, this survey has been administered to students in 8th, 10th, and 12th grades who self-report their substance use behaviors over various time periods, such as past 30 days, 12 months, or lifetime. Survey questions dig into students’ perceptions of harm, disapproval of use, and perceived availability of substances, including over-the-counter (OTC) cough and cold medicines that contain the active ingredient dextromethorphan (DXM).

Monitoring the Future has been reporting rates of OTC cough and cold medicine abuse since 2006. In 2024, prevalence changed slightly by one percentage point or less in each of the three grades surveyed and researchers noted that none of the increases were statistically significant. Overall, OTC abuse rates remain low at 3.7% in 2024, but there are certain trends important to watch when looking at each age group.

Breakdown of OTC Cough & Cold Medicine Abuse Across Grade Levels Surveyed:

• Among eighth graders, the percentage of students who self-reported OTC medicine abuse rose year-over-year from 4% to 4.4%. It’s important to keep an eye on rates among this grade level, as we noted previously. The lowest rate of 2% was recorded in 2015, and the highest rate of 4.6% was reported in 2020.
• Among 10th graders, the rate of abuse went up from 3% in 2023 to 4% in 2024. This is a trend to watch, but it’s also worth noting that this is two-thirds of the 6% high reported in 2009.
• Among 12th graders, the abuse rate increased from 2.4% in 2023 to 2.8% in 2024. The 6.9% high of was reported when the survey first started tracking this outcome in 2006.

It’s worth noting that in recent years the grades have tended to reverse the order of their prevalence levels, with the 8th graders tending to have the highest prevalence and the 12th graders having the lowest. The only other class of drugs that currently shows such a pattern is inhalants.

In addition to looking at OTC cough and cold medicine abuse rates, use of legal stimulants, like stay-awake substances, were surveyed; teen usage of such substances reached the lowest levels ever recorded by the survey. While this is promising, the survey also looked at energy drinks and found that consumption of these beverages reached the highest levels ever recorded for 10th and 12th graders. This is a signal for parents to also keep a close eye on the caffeine intake of teens, as mixing OTC medicines with energy drinks may cause additional harmful effects.

A Look at Overall Substance Use Self-Reported by Teens:

Looking more broadly, reported use for almost all substances decreased dramatically between 2020 and 2021 after the COVID-19 pandemic, as related changes like school closures and social distancing changed teens’ relationship with substances. Most reported substance use among adolescents held steady at these lowered levels in 2022 and in 2023. The data from 2024, however, saw a decrease in some substance use areas, such as illicit drugs, while seeing an increase in others.

Breakdown of Illicit Drug Use and Drug Abstention Across Grade Levels Surveyed:

In 2024, levels of any illicit drug use were at record lows for lifetime and past 12-month use and near record lows for past 30-day use.

Abstention from drug use is defined here as no past 30-day use of alcohol, marijuana, or nicotine by vaping or cigarettes. Abstention from drug use, reached levels in 2024 that were at the highest ever 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).

While illicit drug use was at record lows and drug abstention reached record highs in 2024, use rates for over-the-counter substances increased, showing a worrying trend.

Breakdown of Racial Identity Among Survey Participants:

14.5% of participants identified as Black or African American, 0.6% as American Indian or Alaska Native, 3.66% as Asian, 35.36% as Hispanic, 1.4% as Middle Eastern, 0.3% as Native Hawaiian or Pacific Islander, 37.33% as White, and 6.8% as more than one of the preceding categories.

Breakdown of Gender Identity Among Survey Participants:

48.66% of students identified as male, 47.1% identified as female, 1% identified as other, and 3.2% selected the “prefer not to answer” option.

All participating students took the survey via the web – either on tablets or on a computer – with respondents taking the survey in-person at school in 2024. Therefore, students with less engagement in school – a known risk factor for drug use – may have been less likely to participate in the survey.

In Closing:

The Monitoring the Future survey is updated each year to factor in relevant changes in overall substance use trends. We’ll continue to keep a close eye on new trends that emerge, as well specific trends related to OTC cough and cold medicine abuse, and keep you informed accordingly.

For more information on ways to help your teen learn how to make safe choices with OTC medicines, check out the links below.