Men More Likely to Misuse Prescription Stimulants Than Women


Men are 37% more likely to misuse prescription stimulants and 75% more likely to abuse methamphetamine than women, results of a national annual drug use survey show.


  • Investigators analyzed 5-year data (2015-2019) from the National Survey on Drug Use and Health, which included 282,500 US participants aged 12 and older and asked them about use and misuse of prescription stimulants, cocaine, and methamphetamine in the past year.

  • Participants were considered to have stimulant abuse and stimulant use disorders if they met DSM-IV criteria.

  • Respondents’ age and sexual orientation were used as moderators in the analysis.


  • After controlling for demographic variables, investigators found men had a 37% increased risk of stimulant use than women (P < .001), yet there was no significant difference in prescription stimulant use disorder between the two sexes.

  • Compared with women, men had significantly higher odds of past-year use of powder cocaine (adjusted odds ratio [aOR], 1.92), crack cocaine (aOR, 2.22), and methamphetamine (aOR, 1.78) (all P < .001).

  • Men were also more likely than women to have past-year cocaine use disorder and methamphetamine use disorder (aOR, 2.02 and aOR, 1.76, respectively; P < .001 for both).

  • Gender differences in illicit stimulant use were less pronounced after adjustment for age and sexual orientation, characterized by small to no differences in adolescents and bisexuals.


Although the gender gap was smallest for prescription stimulants, the authors note that “consideration of gender differences in prescription stimulant misuse trends will continue to be important, particularly as the medical prescription of stimulants is increasing among women.”


R. Kathryn McHugh, PhD, of McLean Hospital in Belmont, Massachusetts, led the study, which was published online November 4 in The American Journal on Addictions. The study was funded by the National Institute on Drug Abuse and the Charles Engelhard Foundation.


The findings were limited by sampling methods used in the national survey, which excluded vulnerable groups such as unhoused and incarcerated individuals. Also, investigators combined 5 years of data, which could have obscured year-to-year variations. Finally, the study relied on DSM-IV diagnoses, so replication of the findings with DSM-V data would be needed to update diagnoses.


Co-author Roger D. Weiss, MD, has reported consulting for Alkermes. The other authors have reported no relevant financial relationships.

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