Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

438 IV. SPECIAL POPULATIONSthe treatment of women (Substance Abuse and Mental Health ServicesAdministration, 2001a; U.S. Department of Health and Human Services, 1993,1994).EPIDEMIOLOGYIn general, men are more likely to report any use of psychoactive substances,including alcohol and nicotine. However, changes in use differ by gender. Forexample, over the last 30 years, the proportion of U.S. men who smoke hasfallen at a much greater rate than the corresponding decrease among women, sothat the difference is progressively smaller (27 vs. 23%). Among adolescentsages 12–17, girls already outnumber boys in rates of tobacco use (14 vs. 13%).Furthermore, while reduction in the rate of smoking has been detected amongboys, the same is not true for girls (Substance Abuse and Mental Health ServicesAdministration, 2001b).Table 20.1 summarizes data on rates of substance use disorders. These rateswere estimated for noninstitutionalized U.S. adults, ages 15–54, from a diagnosticinterview based on criteria according to the revised third edition of Diagnosticand Statistical Manual of Mental Disorders (DSM-III-R; American PsychiatricAssociation, 1987), administered to more than 8,000 subjects in the early1990s as part of the National Comorbidity Survey (Warner, Kessler, Hughes,Anthony, & Nelson, 1995). The overall higher prevalence in men masks subgroupgender differences. Women ages 45–54 reported a higher lifetime prevalenceof drug dependence (other than alcohol or nicotine) than did men (3.8%compared to 2.1% for men), whereas the 12-month prevalence is similarbetween the sexes at this age (0.8% for women, 0.6% for men). This findingTABLE 20.1. Relative Prevalence of Addictive Disordersin the United States, Ages 15–54Disorder Males (%) Females (5) Male:female ratioLifetime abuse/dependenceAny substance 35.4 17.9 2.0:1Alcohol 32.6 14.62 2.2:1Other drug a 14.6 9.4 1.6:112-month abuse/dependenceAny substance 16.1 6.6 2.4:1Alcohol 14.1 5.3 2.7:1Other drug a 5.1 2.2 2.3:1Note. Date from the National Comorbidity Study (Warner et al., 1995).a Excludes nicotine; includes nonmedical use of prescription psychotropics.