title: Trends in substance abuse preceding stroke among young adults: a population-based study.
abstract: OBJECTIVE
  Approximately 5% of strokes occur in adults aged 18 to 44 years. Substance abuse is a prevalent risk factor for stroke in young adults. We sought to identify trends in substance abuse detection among stroke patients.
  
  
  METHODS
  Using a population-based design, we sought to identify all patients aged 18 to 54 years experiencing a stroke (ischemic or hemorrhagic) in the Greater Cincinnati and Northern Kentucky Study region during 1993 to 1994, 1999, and 2005. Demographic and clinical characteristics and substance use data were obtained retrospectively from chart review and adjudicated by physicians.
  
  
  RESULTS
  The number of young patients identified with a stroke increased from 1993 to 1994 (297) to 2005 (501). Blacks (61% vs 51%; P<0.02) and men (61% vs 47%; P<0.002) reported substance abuse (current smoking, alcohol, or illegal drug use) more frequently than did whites and women. Overall use of substances increased across study periods, 45% in 1993 versus 62% in 2005 (P=0.003). The trend was significant for illegal drug use (3.8% in 1993 vs 19.8% in 2005) and ever smoking (49% in 1993 vs 66% in 2005). Documentation of both cocaine and marijuana use increased over time. In 2005, half of young adults with a stroke were current smokers, and 1 in 5 abused illegal drugs.
  
  
  CONCLUSIONS
  Substance abuse is common in young adults experiencing a stroke. The observed increase in substance abuse is contributing to the increased incidence of stroke in young adults. Patients aged younger than 55 years who experience a stroke should be routinely screened and counseled regarding substance abuse.
authors.affiliation: University of Cincinnati College of Medicine, Department of Neurology, and Cincinnati Children's Hospital, 260 Stetson St, Suite 2300, Cincinnati, OH 45267, USA.
authors.forename: Felipe
authors.initials: F
authors.lastname: de los Ríos
authors.forename: Dawn O
authors.initials: DO
authors.lastname: Kleindorfer
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Broderick
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Moomaw
authors.forename: Opeolu
authors.initials: O
authors.lastname: Adeoye
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Flaherty
authors.forename: Pooja
authors.initials: P
authors.lastname: Khatri
authors.forename: Daniel
authors.initials: D
authors.lastname: Woo
authors.forename: Kathleen
authors.initials: K
authors.lastname: Alwell
authors.forename: Jane
authors.initials: J
authors.lastname: Eilerman
authors.forename: Simona
authors.initials: S
authors.lastname: Ferioli
authors.forename: Brett M
authors.initials: BM
authors.lastname: Kissela
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002545:Brain Ischemia / Q000453:epidemiology*; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult