OBJECTIVE: To estimate the self-reported prevalence of prescription opioid use and illicit drug use in the U.S. METHODS: Self-reported prescription opioid use and illicit drug use (mostly non-opioid) were obtained for adults and adult workers (NHANES 2005-2016). RESULTS: Prevalence (95% CI) of prescription opioid use was 6.5% (6.0-7.0) (adults) and 4.1% (3.7-4.5) (workers). Prevalence of illicit drug use was 9.5% (8.8-10.1) (adults) and 10.2% (9.4-11.1) (workers). Among occupations, prevalence of prescription opioid use was highest in personal care (6.5%; 4.1-10.4) and healthcare practitioners (5.9%; 3.8-9.0); for illicit drug use, construction/extraction (18.0%; 15.1-21.3) and food preparation (15.8%; 12.5-19.7). CONCLUSION: The prevalence of prescription opioid use was elevated among some occupations. Judicious prescription strategies and targeted interventions are both needed. The prevalence of illicit drug use among certain occupational groups suggests the need to ensure access to therapy.

We aimed to describe coronavirus disease 2019 (COVID-19) deaths among first responders early in the COVID-19 pandemic. We used media reports to gather timely information about COVID-19-related deaths among first responders during March 30-April 30, 2020, and evaluated the sensitivity of media scanning compared with traditional surveillance. We abstracted information about demographic characteristics, occupation, underlying conditions, and exposure source. Twelve of 19 US public health jurisdictions with data on reported deaths provided verification, and 7 jurisdictions reported whether additional deaths had occurred; we calculated the sensitivity of media scanning among these 7 jurisdictions. We identified 97 COVID-19-related first-responder deaths during the study period through media and jurisdiction reports. Participating jurisdictions reported 5 deaths not reported by the media. Sixty-six decedents worked in law enforcement, and 31 decedents worked in fire/emergency medical services. Media reports rarely noted underlying conditions. The media scan sensitivity was 88% (95% CI, 73%-96%) in the subset of 7 jurisdictions. Media reports demonstrated high sensitivity in documenting COVID-19-related deaths among first responders; however, information on risk factors was scarce. Routine collection of data on industry and occupation could improve understanding of COVID-19 morbidity and mortality among all workers.