Stimulant use disorder: amphetamine—type stimulants. Estimated 12-month prevalence of amphetamine—type stimulant use disorder in the United States is 0.2% among 12- to 17- year-olds and 0.2% among individuals 18 years and older. Rates are similar among adult males and females (0.2%), but among 12- to 17-year-olds, the rate for females (0.3%) is greater than that for males (0.1%). Intravenous stimulant use has a male-to-female ratio of 3:1 or 4:1, but rates are more balanced among non-injecting users, with males representing 54% of primary treatment admissions. Twelve-month prevalence is greater among 18- to 29-year-olds (0.4%) compared with 45— to 64-year-olds (0.1%). For 12- to 17-year-olds, rates are highest among whites and African Americans (0.3%) compared with Hispanics (0.1%) and Asian Americans and Pacific Islanders (0.01%), with amphetamine-type stimulant use disorder virtually absent among Native Americans. Among adults, rates are highest among
Native Americans and Alaska Natives (0.6%) compared with whites (0.2%) and Hispanics (0.2%), with amphetamine-type stimulant use disorder virtually absent among African
Americans and Asian Americans and Pacific Islanders. Past-year nonprescribed use of prescription stimulants occurred among 5%—9% of children through high school, with 5%—35% of college-age persons reporting past-year use.
Stimulant use disorder: cocaine. Estimated 12-month prevalence of cocaine use disorder in the United States is 0.2% among 12- to 17—year-olds and 0.3% among individuals 18 years and older. Rates are higher among males (0.4%) than among females (0.1%). Rates are highest among 18- to 29-year-olds (0.6%) and lowest among 45- to 64-year-olds (0.1%). Among adults, rates are greater among Native Americans (0.8%) compared with African Ameri- cans (0.4%), Hispanics (0.3%), whites (0.2%), and Asian Americans and Pacific Islanders (0.1%). In contrast, for 12- to 17-year-olds, rates are similar among Hispanics (0.2%), whites (0.2%), and Asian Americans and Pacific Islanders (0.2%); and lower among African Amer- icans (0.02%); with cocaine use disorder virtually absent among Native Americans and
Alaska Natives.
Stimulant use disorders occur throughout all levels of society and are more common among individuals ages 12—25 years compared with individuals 26 years and older. First regular use among individuals in treatment occurs, on average, at approximately age 23 years. For pri- mary methamphetamine—primary treatment admissions, the average age is 31 years.
Some individuals begin stimulant use to control weight or to improve performance in school, work, or athletics. This includes obtaining medications such as methylphenidate or amphetamine salts prescribed to others for the treatment of attention-deficit/hyperac- tivity disorder. Stimulant use disorder can develop rapidly with intravenous or smoked administration; among primary admissions for amphetamine-type stimulant use, 66% re- ported smoking, 18% reported injecting, and 10% reported snorting.
Patterns of stimulant administration include episodic or daily (or almost daily) use.