Gender Effects on Drug Use, Abuse, and Dependence: A Special Analysis of Results From the National Survey on Drug Use and Health

Background: Gender is increasingly being studied for risk and protective factors underlying substance abuse and addiction. Objective: The aim of this study was to assess gender differences in rates of substance abuse and dependence among drug users. Methods: A national population sample was examined, focusing on 2 age groups (youths, aged 12-17 years, and young adults, aged 18-25 years) and several commonly abused substances (alcohol, marijuana, and nonmedical prescription medication use). Combined annual data from the National Survey on Drug Use and Health (NSDUH), aggregated from 200272005, were used for gender comparisons of rates of substance use, as well as abuse and dependence, among users. Results: Overall rates of substance use were significantly higher for males than for females (P < 0.01 for all substances except sedatives and tranquilizers); however, patterns of use, abuse, or dependence among users differed by age group and drug. Interestingly, patterns for youths differed from the overall population and from young adults. Girls exceeded boys in their use of alcohol (P < 0.01) and their nonmedical use of psychotherapeutics (ie, prescription-type pain relievers, stimulants, tranquilizers, sedatives) (P < 0.01); among users, girls were significantly more likely to be dependent on the latter (P < 0.01). Boys reported significantly greater use and abuse of and dependence on marijuana (P < 0.01). In the young adults, the proportion of female users reporting dependence on cocaine or psychotherapeutics was significantly higher than for male users (P < 0.01), who nonetheless reported significantly greater use of these drugs (P < 0.01). Among users, males generally exceeded females in meeting abuse criteria (P < 0.01 for marijuana among 12- to 17-year-olds and for alcohol, marijuana, and psychotherapeutics among 18- to 25-year-olds), with some exceptions mainly in the youngest cohort. Conclusions: In this national population sample of youths and young adults, these findings suggest that gender, age, and substance of abuse may all play a role in the observed patterns of drug use, abuse, and dependence. Understanding the reasons for these differences and continuing to evaluate these patterns over time could help in the development of targeted and more effective prevention and treatment interventions. (Gend Med. 2010;7:402-413) (C) 2010 Excerpta Medica Inc.