Background: The prevalence of stimulant misuse and use disorder varies by substance type, and trends in prevalence are changing rapidly as stimulant use increases nationwide. Despite demonstrated sex differences in the motivation for and effects of using stimulants, sex differences in the prevalence of stimulant misuse and use disorder have not yet been well characterized (NIDA, 2020). The aim of this study was to investigate sex differences in the prevalence of stimulant misuse and use disorder in the United States, across three stimulant classes (cocaine, prescription stimulants, methamphetamine).
Methods: We analyzed data from persons ages 12 and older who participated in the 2015-2018 National Surveys on Drug Use and Health (NSDUH). Descriptive statistics were used to quantify population estimates of the prevalence of past-year powder cocaine, crack cocaine, methamphetamine, and nonmedical prescription stimulant use and use disorder. A logistic regression was used to control for potential confounds of the association between sex and stimulant use; bivariate associations were calculated using chi-square tests for descriptive purposes. Data were weighted to reflect the complex design of the NSDUH sample and were analyzed using SPSS software.
Results: Men were more likely than women to use all stimulant categories, however, the magnitude of this difference was smaller for prescription stimulants. The magnitude of sex differences was substantially smaller in adjusted models and only remained significant for cocaine and methamphetamine misuse. This reduction in effect sizes may be attributable to overlap between sex and other drug use, which was strongly associated with stimulant misuse and stimulant use disorder.
Conclusion: Identifying sex differences in the prevalence of stimulant misuse and use disorder has important implications for understanding and monitoring at-risk, sex-based subgroups.
Further research examining these associations longitudinally is needed to establish temporal or causal relationships and to characterize sex-specific use motivators.