Emergence of Sex Differences in U.S. Adolescent Substance Use

Area of Science:

• Adolescent Health
• Substance Use Research
• Sex Differences in Health

Background:

• Adolescence is a critical period for substance experimentation and the development of sex-specific use patterns.
• Historically, male and female substance use patterns diverge by young adulthood, with males exhibiting higher overall use.
• Existing literature needs further examination using nationally representative data to understand emerging sex differences in adolescent substance use.

Purpose of the Study:

• To investigate sex-specific patterns of adolescent substance use.
• To identify the age at which significant sex differences in substance use emerge.
• To analyze a broad range of substances within a nationally representative sample.

Main Methods:

• Utilized data from the 2019 Youth Risk Behavior Survey (n=13,677) of high school students.
• Employed weighted logistic analyses of covariance, adjusting for race/ethnicity.
• Evaluated 14 substance use outcomes stratified by age category for males and females.

Main Results:

• Males reported higher rates of illicit substance use and cigarette smoking compared to females.
• Females reported higher rates of prescription opioid misuse and synthetic cannabis use.
• Significant divergence in substance use between sexes typically occurred at age 18+, with males showing higher odds for most illicit substances.

Conclusions:

• Sex differences in adolescent substance use are evident for most, but not all, substances by age 18+.
• Emerging sex-specific patterns in adolescent substance use can inform targeted prevention strategies.
• Identifying peak ages for intervention is crucial for addressing adolescent substance use disparities.