title: Examining gender differences in substance use and age of first use among rural Appalachian drug users in Kentucky.
abstract: BACKGROUND
  Previous research suggests gender differences exist in types of substances used and age of first use. Recent studies exploring contextual differences in substance use between rural Appalachian and urban environments show different patterns of substance use in rural environments.
  
  
  OBJECTIVE
  This study explores whether previously established differences in gender and age of first use exist within a rural Appalachian environment.
  
  
  METHODS
  Data are from a community-based study of drug users in rural Appalachia (N=400). Self-reported substance use was recorded using an interviewer-administered questionnaire with questions from the Addiction Severity Index (ASI).
  
  
  RESULTS
  On average, participants were 32 years old (X=32.33; median=31.00; interquartile range (IQR)=12) and the majority were male (59%). Examining the past 30-day substance use, more males reported alcohol (adjusted odds ratio (AOR): 2.11, 95% CI: 1.36, 3.23; p=.001) and any illegal drug use (AOR: 1.85, 95% CI: 1.16, 2.95; p=.010), which included heroin, cocaine, crack cocaine, methamphetamine, marijuana, and hallucinogens, after controlling for sociodemographic characteristics. ANCOVA analyses showed that males reported the use of alcohol (p=.000), marijuana (p=.007), and hallucinogens (p=.009) at a significantly younger age than females.
  
  
  CONCLUSIONS
  Findings suggest more men report the use of alcohol and "street" drugs, including heroin, crack cocaine, methamphetamine, marijuana, and hallucinogens. Furthermore, males report the use of alcohol, marijuana, and hallucinogens at a significantly younger age.
  
  
  CONCLUSIONS
  Understanding gender differences in substance use as well as other differences among individuals living in rural Appalachia presents important opportunities to incorporate this knowledge into substance abuse early intervention, prevention, and treatment efforts.
authors.affiliation: Department of Sociology, Social Work, and Criminology, Morehead State University, Morehead, KY 40351, USA. l.shannon@moreheadstate.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Shannon
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Havens
authors.forename: Carrie
authors.initials: C
authors.lastname: Oser
authors.forename: Rick
authors.initials: R
authors.lastname: Crosby
authors.forename: Carl
authors.initials: C
authors.lastname: Leukefeld
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology*; D001061:Appalachian Region / Q000453:epidemiology; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D013287:Illicit Drugs