Sex differences in drug use among polysubstance users

Abstract

Background: Available evidence indicates women with substance use disorders may experience more rapid progression through usage milestones (telescoping). The few investigations of sex differences in treatment-seeking populations often focus on single substances and typically do not account for significant polysubstance abuse. The current study examined sex differences in a heterogeneous sample of treatment seeking polysubstance users. We examined patterns of drug use, age at drug use milestones (e.g., initial use, regular use), and progression rates between milestones. Nicotine and alcohol use were also evaluated.

Methods: Participants (n = 543; 288 women) completed personal histories of substance use, including chronicity, frequency, and regularity, as well as inventories assessing affect, and intellectual ability.

Results: Rates of drug use and milestone ages varied by sex and specific drug. Analyses suggested pronounced telescoping effects for pain medication and marijuana, with women progressing more rapidly through usage milestones.

Conclusions: Our data were generally supportive of telescoping effects, although considerable variance in progression measures was noted. The contrast between the marked telescoping observed in pain medication use and the absence of telescoping in other opioids was of particular interest. The discrepancy in telescoping effects, despite shared pharmacologies, suggests the need for further work examining underlying psychosocial factors. These results highlight that the specific sample population, substance, and outcome measure should be carefully considered when interpreting sex differences in substance use.

Keywords: Drug use; Polysubstance use; Sex differences; Telescoping.