Nearly 37 million Americans used one or more illicit drugs during the last year. Overall drug use remains high despite the results of the most recent National Institute on Drug Abuse household survey which showed the use of almost all illicit drugs except cocaine as holding steady or declining. The survey, conducted from June to December 1985, found a 38 percent increase in cocaine use in three years. The national household survey relies on self-reporting and some believe that the accuracy of self-reports have progressively decreased. Also, the survey does not reach the rootless, school dropouts, and other population subgroups that use drugs most frequently. Efforts to cut drug supplies by strengthening law enforcement and reduce drug demand through education and drug testing have little realistic hope for substantial further success. Recommendations include increased federal support for research into addictive disorders, a drug testing program aimed at controlling the spread of drug use, and a presidential commission to stimulate and evaluate new proposals for coping with this serious public health problem. 4 footnotes.