Substance use patterns in a community sample of adult women in the United States: Alcohol, Cannabis, and other drug use

Aims: Substance use is a significant public health problem among women in the United States, although limited data exist on patterns of use across different demographic groups. This cross-sectional survey study aimed to examine in adult women (1) patterns of substance use (i.e., alcohol, cannabis, other drugs, and prescription medication misuse) and (2) whether these patterns varied by age cohort. Methods: From July to September 2024, we conducted an online cross-sectional survey of women ages 18–70 in the community who reported substance use in the prior 30 days. Using latent class analysis, we analyzed data from 2296 women. Results: Overall, heavy use was common particularly for alcohol and cannabis (approximately 18% and 22%, respectively). Heavy substance use patterns varied qualitatively with age. The prevalence of heavy alcohol use (≥16 days/month) increased with older age cohort, as did prescription medication misuse. Heavy cannabis use (≥ 16 days/month) decreased with older age cohort. In a latent class analysis of substance use patterns, four discrete classes emerged: (1) alcohol use with some cannabis (approximately 57% of the sample), (2) heavy cannabis with some alcohol (27%), (3) polysubstance use (10%), and (4) prescription medication misuse with some alcohol (6%). Conclusions: Among adult women who reported recent substance use, more than half used more than one substance, and use patterns varied with age cohort. Consideration of polysubstance use, age cohort, and life stage is critical in designing effective substance use prevention, early intervention, and treatment for adult women.