Age of Onset and Its Related Factors in Cocaine or Methamphetamine Use in Adults from the United States: Results from NHANES 2005–2018

Abstract

Cocaine and methamphetamine are widely used illicit psychostimulants worldwide, with steadily increasing global markets that may impact on the frequency of use. Importantly, their use typically begins in youth. This is a particular concern because there is a link between the early age of first substance use and severity of substance use disorder later in life. The aim of the present study was therefore to investigate trends in prevalence, frequency, and age of onset of cocaine or methamphetamine use between 2005 and 2018 in the United States, using the nationally representative NHANES datasets. Factors associated with the ages of cocaine or methamphetamine use onset were also identified. From 2005 to 2018, prevalence and frequencies of cocaine or methamphetamine use increased, while age of onset remained relatively stable (~20 years of age). Annual household income, use of other substances, and intravenous drug use were identified as factors associated with early onset cocaine or methamphetamine use. These factors have important implications toward developing new prevention programs to reduce psychostimulant use.

The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder

“…161 In the US, the peak age for initiating nonmedical use of prescription stimulants is 16 to 19 years, and the median age of initiation of cocaine and methamphetamine use is approximately 20 years. 162,163 Adolescents and young adults often cite cognitive enhancement as a reason for prescription stimulant misuse. 164 StUD is rare among adolescents, with 0.1% meeting criteria for methamphetamine use disorder, 0.0% for cocaine use disorder, and 0.9% for prescription stimulant use disorder in 2021.…”

“…Stimulant use rates are higher among young adults (ie, ages 18 to 25): 3.7% reported nonmedical use of prescription stimulants, 3.5% reported use of cocaine, and 0.5% reported use of methamphetamine in the past year 161 . In the US, the peak age for initiating nonmedical use of prescription stimulants is 16 to 19 years, and the median age of initiation of cocaine and methamphetamine use is approximately 20 years 162,163 . Adolescents and young adults often cite cognitive enhancement as a reason for prescription stimulant misuse 164 …”

Birth cohort‐specific consideration in an Emergency Department Hepatitis C Testing Programme: A description of age‐related characteristics and outcomes

“…[7][8][9] Stimulant injection drug use, including cocaine and methamphetamine, used in isolation or with opioids, is also on the rise, disproportionately involving younger adults. 10,11 In response to contemporary age specific data, in April 2020, the CDC revised its HCV testing recommendation to be inclusive of all adults ≥18 years of age. 12 In this context, the Emergency Department (ED) has become an increasingly important medical setting for non-focused, largevolume HCV testing.…”

Influence of reconsolidation in maintenance of cocaine-associated contextual memories formed during adolescence or adulthood

“…Patients that suffer from SUDs often report starting drug use during adolescence 1 , 2 , with recent reports showing that the severity of SUD diagnosis during adolescence increases the risk for problematic drug use in adulthood 3 , 4 . Cocaine use disorders affect up to 1.5 million people in the US, with reports of increased cocaine use in adolescents and young adults from 2005 to 2018, highlighting the importance of studying relapse during this developmental period 5 , 6 .…”