Age trends in rates of substance use disorders across ages 18-90: Differences by gender and race/ethnicity

•Substance use disorders (alcohol, tobacco, cannabis, opioid) generally decrease with age.•Men have higher rates of substance use disorders than women at most ages from 18 to 90.•White participants report higher rates of most substance use disorders in young adulthood.•Black participants report higher or equal rates to white participants in midlife.

BackgroundAlthough research has documented age differences in substance use, less is known about how prevalence of substance use disorders (SUDs) vary across age and differ by gender and race/ethnicity.MethodsTime-varying effect models (TVEMs) were estimated on data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC III; N = 36,309), a nationally representative survey of the adult population. The sample was 44% male; 53% White, 21% Black, 19% Hispanic/Latino, 6% other race/ethnicity. Prevalence of four SUDs (alcohol, tobacco, cannabis and opioid use disorders) were flexibly estimated across ages 18-90 by gender and race/ethnicity.ResultsEstimated SUD prevalences were generally higher for men compared to women at most ages until the 70s. However, disparities by race/ethnicity varied with age, such that for most SUDs, estimated prevalences were higher for White participants at younger ages and Black participants at older ages.DiscussionResults suggest relatively constant disparities by gender across age, and a crossover effect for Black and White participants. Findings demonstrate that Black individuals in midlife may be an important target of intervention programs for some substances.