In the U.S., about half of the population takes a prescription drug every day, and half of adults have tried illicit drugs at least once. Drug use is a routine part of life for most Americans, whether it's coffee in the morning, alcoholic drinks at night or using anything else to get by. This past year saw some major changes in drug trends, which could give a good indicator of what's to come in 2025 and beyond.
In the 2024 election cycle, Kamala Harris made history by becoming the first presidential candidate to promise to legalize cannabis at the federal level if elected. While that policy change is not something President-elect Donald Trump has said he supports, Harris and President Joe Biden did move to reschedule cannabis from a Schedule I substance (in the same category as heroin) to a Schedule III substance (in the same category as ketamine) this year, pardoning thousands of convictions for possession.
Outside of policy, researchers in the lab continued to learn more about how drugs affect the body. Lenacapavir, a new drug being tested to prevent HIV, successfully prevented infection in 100% of patients tested in clinical trials. With one million people being infected with HIV each year, the journal Science named this drug development as the 2024 breakthrough of the year.
Meanwhile, scientists began to better understand the effects of weight loss drugs like Ozempic and Wegovy (known by the generic name semaglutide) on not just the gut but the brain, and they started to be tested to treat addiction, Alzheimer’s and Parkinson's. Researchers also discovered a new compound in mouse experiments that helps the life-saving opioid reversal medicine naloxone bind to the opioid receptor, which could potentially fight off stronger opioids.
There were plenty of other important news stories about drugs in 2024, but here are four you shouldn’t miss.
01 Deaths declined for the first time since the overdose crisis began
In September, the Centers for Disease Control and Prevention (CDC) released data that show overdose deaths declined nationally by about 10% between April 2023 and April 2024. Although an estimated 94,000 Americans were lost to a fatal overdose this year, it was the first time overdose deaths declined since the crisis began in the 1990s.
While any life saved from an overdose is a win, many were quick to highlight stark racial disparities in these statistics, with deaths still increasing among Black, Hispanic and American Indian and Alaska Native populations.
“In Black communities across this country, the diminishing death rates are not the story,” Tracie Gardner, co-director of the National Black Harm Reduction Network, told Salon earlier this year. “What the numbers don't show are what I would say are the policy realities and the narratives of the communities that have been the hardest hit.”
02 The FDA rejected MDMA for PTSD
This summer, many psychedelic advocates were hopeful that the Food and Drug Administration (FDA) would approve the psychedelic drug MDMA for post-traumatic stress disorder (PTSD). Media coverage reported positive effects in veterans, and Lykos Therapeutics, the organization submitting the new drug application, previously won “breakthrough therapy” designation from the agency after presenting its earlier phase trials.
Yet in August, the FDA did not approve MDMA with psychotherapy as many had hoped. Earlier in the year, a report from the Institute for Clinical and Economic Review, an independent nonprofit, concluded that therapists in the trials encouraged patients to report positive experiences, putting into question the validity of the data. More concerning, one trial participant came forward with allegations that she was sexually abused by her therapists. And ultimately, some of the studies submitted in the new drug application were retracted by the journal that published them.
This wasn’t the only setback for psychedelics in 2024. Massachusetts voters also rejected a ballot measure that would have allowed home-use and growing of psilocybin (the ingredient in "magic" mushrooms), dimethyltryptamine (DMT), mescaline and ibogaine. Psilocybin remains illegal at the federal level, but it has been legalized in Colorado and Oregon, where treatment centers have opened or will soon. Meanwhile, the FDA also granted “breakthrough therapy” status to psilocybin and companies are studying its effects on depression in clinical trials with the hopes of a future approval. In the meantime, many on the political right, including conspiracy theorists like Robert F. Kennedy Jr., have latched onto the psychedelic movement, as this class of drugs is also embraced by Silicon Valley.
03 Public health concerns arise in the Middle East with destruction of Captagon factories
In December, the White House accused President Bashar al-Assad's government in Syria of profiting from sales of an illicit stimulant called Captagon (fenethylline) that many people who work long hours use to stay awake. Searches amid the chaos as Assad's regime falls apart have turned up warehouses and labs poised to ship out large quantities of the drug, which is sold throughout the Middle East and parts of Europe. These were only discovered because a rebel group overthrew Assad, whose brutal regime had ruled over Syria for decades.
In the fallout of this discovery, large quantities of Captagon have been destroyed, which many are concerned could push users to other stimulants and relocate industrial manufacturing to other countries like Iraq. On Dec. 8, Biden said the fall of the regime was a “historic opportunity for the long-suffering people of Syria to build a better future.” However, it is also a vulnerable time in the region with very little stability.
04 "Pink cocaine" entered the mainstream
One of the most popular drugs this year doesn't really exist. "Pink cocaine" is a hot pink mixture of drugs, that often contains all kinds of substances, including MDMA, ketamine, and 2C-B, but doesn’t typically contain actual cocaine. Also known as “tuci,” the drug mix, which is essentially just dye, has been around for years. But it made headlines in 2024 when it was reported to have been used prominently by Sean “Diddy” Combs’ in the fallout of his arrest.
Tuci, typically snorted in powder form, got increasingly popular in 2024 and has been detected in Latin America, Europe and the U.S. Because it is a cocktail of various mystery drugs, users often don’t know what they are getting, and it makes it harder for drug researchers to track the supply as well, said Dr. Joseph Palamar, a drug researcher at New York University.
“It could be somebody up the block had some cocaine, meth, ketamine and some food coloring, and they made their own batch of tuci,” Palomar told Salon in a phone interview. “What I worry about is that fentanyl is going to make its way into the supply and it’s going to turn deadly.”
