Abstract: Several years of survey data indicate that illicit drug use among U.S. youth was at its highest level in 1979. Generally, the use of some illicit drugs declined progressively throughout the 1980s, stabilized, and then decreased slightly. Reducing illicit drug use among U.S. youth continues to be a priority of federal, state, and local law enforcement agencies. The U.S. government tracks youth illicit drug use through three nationally representative surveys: National Household Survey on Drug Abuse, Monitoring the Future Study, and Youth Risk Behavior Survey. Other surveys include the Partnership Attitudes Tracking Study, conducted annually to assess youth and parental attitudes about drugs, and Drug Abuse Awareness Network (DAWN), a national surveillance system that monitors trends in drug‐related emergency department visits and deaths. Although survey methods differ, similar trends in drug use are well documented by these surveys. Among American youth, illicit use of drugs such as tobacco, alcohol, inhalants, marijuana, LSD, cocaine, heroin, and methamphetamine has remained relatively stable. However, a noteworthy exception is the increased use of MDMA (methylenedioxymethamphetamine). The physical consequences of “club and recreational drug use” are evidenced in the increased numbers of emergency department visits, specifically those related to MDMA and gamma‐hydroxy‐butyrate use, which may represent a new and emerging trend in illicit drug use.