According to the National Survey on Drug Abuse and Health, which substances had the highest levels of dependence or abuse in 2009?

The correct choice highlights marijuana, pain relievers, and cocaine as substances with the highest levels of dependence or abuse reported in 2009, according to the National Survey on Drug Abuse and Health.

In that year, there was significant concern and attention around opioid pain relievers, which were leading to increased reports of misuse and dependence. Additionally, marijuana usage was prevalent and commonly reported among individuals both in casual use and in terms of dependency issues. Cocaine also remained a widely abused substance during that period, contributing to the overall statistics of substance abuse and dependence.

Identifying these specific substances reflects an understanding of the patterns and behaviors associated with substance use in that timeframe, which were critical for developing treatment protocols and preventive measures. This choice illustrates the growing awareness regarding prescription drug dependency, especially concerning opioids and pain relievers, along with other well-known drugs of abuse.