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.

Keywords: NHANES; addiction; adolescence; cocaine; epidemiology; frequency; methamphetamine; onset; prevalence; risk factors.

Figure 1

Estimated prevalence of past-month cocaine and methamphetamine use by survey years, NHANES 2005–2018. Prevalence is represented as the percentage of the U.S. population reporting using cocaine or methamphetamine in the past month. Values on the graphs represent percent change compared to the previous survey year, with values in green indicating an increase and values in red indicating a decrease compared to the previous cycle.

Figure 2

Median age (and interquartile range) of onset of cocaine and methamphetamine use by survey years, NHANES 2005–2018.

Figure 3

Demographic characteristics of people reporting lifetime use of cocaine and methamphetamine in the NHANES 2005–2018. A represents Education Level and B represents Annual Household Income. Numbers on each wedge represent percent of the sample with the characteristic of interest, rounded to the nearest whole number. GED = General Educational Development Test.