Drug accessibility and use from high school through after college: Insights from the national surveys on drug use and health.

Objective: To examine changes in perceived drug accessibility and its association with substance use from high school through post-college adulthood. Participants: U.S. individuals aged 16-25 from the 2023 National Survey on Drug Use and Health (n = 6,380). Methods: Participants were categorized into six educational stages from right before college to some time after college. Survey-weighted generalized linear models assessed accessibility/use to cannabis, cocaine, crack, heroin, and LSD, and the likelihood of being approached by drug sellers. Results: Educational stage was associated with accessibility to cannabis, cocaine, heroin, crack, and LSD. Cannabis accessibility increased after the first college year and remained high post-college, and greater accessibility predicted cannabis use. Post-college adults had lower odds of being approached by drug sellers than high school students. Conclusions: Drug accessibility varies across educational stages, with cannabis showing high access and a link to use, highlighting the need for stage-specific prevention strategies.