Evidence continues to build that most cocaine abuse centers around a cohort of long-term addicts, with few new users. Heroin abuse has reached major levels in several cities. The most notable cities are on the East Coast where purity is very high, prices are low, snorting is becoming the predominant route of administration, and new younger users are being reported. Cities west of the Mississippi basically still report an older injecting population but also report increased heroin abuse. Marijuana use continues to escalate in almost all cities and is fueled in large part by young people, LSD continues to be abused by high school students, PCP use appears to mainly revolve around marijuana and cigarette use, methamphetamine is a major problem on the West Coast, and prescription drugs are abused to a significant extent. AIDS cases continue to increase, and intravenous drug use is a significant risk factor in these cases. Brief descriptions of drug problems in 20 major U.S. cities and in Australia, Canada, Germany, and South Africa are included.