(226) Prevalence and sociodemographic characteristics of people with prescription stimulant use disorder: results from the National Survey on Drug Use and Health, 2015-2019

Background: Prescription drugs containing amphetamine and methylphenidate are associated with the potential development of substance use disorders. Prescription stimulant prescribing has increased by 57.9% in the United States (US) from 2012 to 2022 (Drug Enforcement Agency, 2023). No studies to date have estimated the prevalence of prescription stimulant use disorder (PStUD) in adolescent and adult populations in the United States from 2015 through 2019.

Objectives: 1) To estimate the 5-year prevalence of prescription stimulant use disorder among the US community-dwelling population aged ≥12 years from 2015 to 2019, and 2) to describe the sociodemographic characteristics of those with PStUD.

Methods: This cross-sectional study uses the National Survey on Drug Use and Health (NSDUH). NSDUH is an annual, nationally-representative survey on substance use overseen by the Substance Abuse and Mental Health Services Administration and Center for Behavioral Health Statistics and Quality, and samples approximately 100,000 community-dwelling individuals aged ≥12 years. Self-reported PStUD in the past year was ascertained using participant responses to Diagnostic and Statistical Manual of Mental Disorders questionnaire items in the stimulant module. Prevalence was calculated as the number of individuals who met diagnostic criteria for PStUD divided by the number of community-dwelling individuals aged ≥12 in the US that year. Sociodemographic variables of interest included age, sex, race/ethnicity, education, income, employment status, health insurance coverage, metropolitan status, tobacco use, and other substance use. Sample weights were applied to generate nationally representative estimates for both prevalence and sociodemographic variable distributions.

Results: There were 282,768 participants who completed the survey (response rate ~ 68%). Of these participants, 461 (0.16%) reported PStUD, 13,751 participants (4.86%) had prescription stimulant use without PStUD, and 268,556 (94.97%) never used prescription stimulants. After weighting, the estimated US prevalence of PStUD was 0.11%. Among those with PStUD, the majority were aged 18-49 years old (76.8%), male (57.9%), non-Hispanic White (78.8%), with private healthcare insurance (55.6%), and living in a large metropolitan area (51.8%). Tobacco use (75.5%) and opioid use disorder (53.6%) were also reported in the majority of those with PStUD.

Conclusions: Self-reported PStUD between 2015 and 2019 in the US was relatively uncommon (~ 1.1 per 1,000 individuals). Potential risk factors for PStUD that merit further investigation may include early adult age, male sex, White race/ethnicity, private insurance coverage, and tobacco use and/or opioid use disorder.