News Release - 2022 Iowa Drug Control Strategy Released

For Immediate Release
Tuesday, November 9, 2021

Contact: Susie Sher 515-725-0308

Report: Iowa Substance Use Trends and Response Efforts Impacted by Pandemic

The 2022 Iowa Drug Control Strategy builds on challenges and achievements for addressing substance use issues over the next year.  The Strategy calls for a comprehensive range of substance abuse prevention, substance use disorder treatment and drug enforcement responses.

According to recent federal studies, Iowa ranks 6th lowest in the nation in the rate of total illicit drug use, and 5th lowest in the rate of drug overdose deaths.  However, amid the pandemic and more potent substances and substance combinations, the new annual report says alcohol-related and drug overdose deaths have risen to record levels.

“Iowans face a growing threat from psychoactive substances that are increasing in variety and strength, and doing so with quickening speed,” said Dale Woolery, Director of the Governor’s Office of Drug Control Policy. “The types of substances available to Iowans is expanding, polysubstance use involving mixtures of lethal drugs is becoming more common, potencies are rising in many products, and for many these risks are being exacerbated by pandemic stressors.”

The 2022 Iowa Drug Control Strategy contains an array of the most recent data indicators available for monitoring current and emerging developments.  Some of the key findings include:


  • Sales of alcoholic beverages remained strong in 2020, as alcohol-related deaths rose 26% to a record 836.  


  • In 2020, Iowa joined the federal government in raising the legal smoking/vaping age to 21.  
  • Though recent state data are unavailable due to pandemic-related delays, national data show that after displacing much of youth smoking in recent years, teen vaping of nicotine declined sharply over the last two years, from 27.5% of U.S. high school students in 2019 to 11.3% in 2021.  


  • Iowans’ past month use of marijuana ranks 3rd lowest in the U.S. among those 12+ (6.7%), and 9th lowest among youth 12-17 (5.71%).  
  • Nationally, the average level of THC—marijuana’s main psychoactive ingredient—in concentrates (e.g., oils, waxes and edibles) was 53.63%, more than four times the level of a decade ago.  
  • A recent U.S.-Canada study showed teen lifetime vaping of THC doubled in the last seven years, and there was a seven-fold increase in past 30-day THC vaping.  


  • Iowa meth labs numbered eight in 2020, the lowest level in over 20 years.  
  • Meanwhile, the volume and purity of meth smuggled from Mexico into Iowa remains at or near all-time highs, with law enforcement seizure amounts submitted to Iowa’s crime lab on pace to exceed 231,000 grams (513 pounds) in 2021.  
  • Stimulant-related overdose deaths (159 in 2020) and the proportion of Iowans entering substance use disorder treatment primarily due to meth (23.7% in 2021) remain at or near record levels.  


  • The proportion of Iowans entering substance use disorder treatment primarily due to cocaine remains relatively low (1.2% in 2021).  
  • Though much less prevalent than meth, law enforcement cocaine seizure amounts submitted to the Iowa crime lab are on track to reach their highest level in six years (over 14,000 grams projected for 2021).  


  • Even as the number of prescription opioids dispensed to Iowans decreased for the fourth straight year, opioid-related overdose deaths increased 35% to 210 in 2020 vs. 2019.  
  • And, just as the Iowa crime lab reports more fentanyl and fentanyl-combination submissions, fentanyl was implicated in 87% of Iowa’s opioid overdose deaths in the first half of 2021. 
  • Life-saving naloxone administrations by Iowa EMS personnel rose 808%, from 304 in 2016 to 2,760 in 2020. 

Polysubstance Use

  • Reports from behavioral health and law enforcement professionals indicate more Iowans are using multiple substances together or in succession (e.g., fentanyl and heroin).  These accounts are substantiated by a new report on Methamphetamine Use in Iowa, indicating a 13% increase in meth-related polysubstance use over a recent eight-year period.  Intentional or accidental, polysubstance use raises concerns about elevated health risks.  


  • New synthetic opioids continue to emerge, as do additional synthetic cannabinoids and cathinones.  In 2020, the DEA reported identifying one new substance about every three weeks.
  • The organic substance Kratom (Mitragyna speciose), sold as an uncontrolled substance in Iowa, is on the DEA “Drugs of Concern” list.  Amid conflicting claims about therapeutic benefits versus misuse or addiction, kratom can have opioid or stimulant effects, depending on its usage.  Though relatively few, the number of Iowa hospital human exposure calls about patients using kratom is projected to exceed 20, the highest level in six years of record-keeping.  Additionally, two Iowa overdose deaths in the last five years reportedly involved the use of kratom.  

Iowa’s comprehensive Drug Control Strategy identifies trends and prioritizes responses, including promising approaches for reducing substance misuse in Iowa.  The report sets several broad goals for future progress:

  • Reduce deaths related to the use of alcohol, tobacco and other drugs;
  • Reduce injuries associated with the use of drugs, including from drug-impaired driving;
  • Reduce youth use alcohol, nicotine and marijuana (THC);
  • Increase access to substance use disorder (SUD) services;
  • Increase employment among those in or completing substance use disorder (SUD) treatment; and
  • Reduce incarcerations for drug-related offenses, and the disproportionate number of minorities referred to the justice system.

“New ways of connecting those needing help with substance use disorder treatment services has been a focus during the pandemic,” said Woolery.  “Iowans now have additional telehealth and diversion-to-treatment options, with even more being considered in a growing number of communities.”

A recent survey of the Impact of COVID-19 in Iowa’s Small Towns by Iowa State University found nearly 40% of rural residents reported their mental health and relationships with close friends and family became much worse off during the pandemic.  About 20% said signs of depression were evident, and 15% reported signs of anxiety.  A new 2020 National Survey on Drug Use and Health reports a continued pandemic-effect on substance use and mental health across the U.S., finding 25.9 million past users of alcohol and 10.9 million past year users of other drugs reported they used those substances “a little more or much more” than they did before the beginning of the pandemic.

Substance use disorder treatment works, as demonstrated in the annual Iowa Outcomes Monitoring System Study by the University of Iowa’s Consortium for Substance Abuse Research and Evaluation.  Six months after Iowans completed substance use disorder treatment, the study shows: a decrease in substance use relapse for all substances, including a 26-point decline for those with a meth use disorder; 46-point drop in re-arrests; and a 13-point improvement in employment.

The Iowa Department of Public Health’s Your Life Iowa program provides information, resources, crisis support, and referrals for problem gambling, substance use, and mental health. Your Life Iowa is free and confidential and can be accessed 24/7 at or 855-581-8111.

In satisfaction of Iowa Code 80E, requiring an Annual Report by the Drug Policy Coordinator, the 2022 Iowa Drug Control Strategy has been submitted to Governor Kim Reynolds and members of the Iowa Legislature.  The full report is available at: